Rationing of health care services to the elderly in the opinion of staff hospital emergency departments

Abstract Introduction. Rationing of medical services is based on several rules, among which stand out the ethical rules. This means equal access to health care for everyone regardless of age, religion, gender or social status. Possible discrimination because of age is called ageism, which consists of resentment, making unjust and unfair judgment or abusive choices in relation to the elderly. Purpose of the work. The aim of this study was to investigate the views of staff of hospital emergency departments on the ethical aspects of the rationing of health care services to the elderly. Material and methods. The study was conducted in 2017 in a group of 60 nurses and 60 paramedics working in emergency departments Lublin province. Diagnostic survey method was used. The collected material was subjected to statistical analysis using the software SPSS IBM Statistic. Results. The age of the patient, in determining order of medical care, was important to 18.4% (n = 22) tested. For nurses, the criterion of age was statistically more significant than for paramedics (

Training Using a Commercial Immersive Virtual Reality System on Hand-Eye Coordination and Reaction Time in Young Musicians: A Pilot Study

The implementation of virtual reality (VR) opens up a wide range of possibilities for the development of dexterity, speed and precision of movements. The aim of this study was to investigate whether immersive VR training affected the hand-eye coordination and reaction time in students of the state music school. This study implemented a single-group pre-post study design. This study enrolled 14 individuals, submitted to a 15 min training session of the immersive music game "Beat Saber", once a day for 5 consecutive days. The plate-tapping test (PTT) and the ruler-drop test (Ditrich's test) were used to assess the reaction time. Trial-making test (TMT) A and TMT B were used to assess coordination and visual attention. Analysis of the results showed a statistically significant improvement in hand-eye coordination and reaction time of music school students using the TMT-A (p < 0.002), TMT-B (p < 0.001), Ditrich's test for the non-dominant hand (0.025) and PTT (0.0001) after applying a week-long training period in immersive VR. The results obtained in the present study show that the VR system, along with the immersive music game, has the potential to improve hand-eye coordination and reaction time in young musicians, which may lead to the faster mastering of a musical instrument

Children’s mental resilience : what do parents and teachers know about it?

Rozwój dziecka i postępy przez nie czynione są przedmiotem żywego zainteresowania bliskich mu dorosłych - rodziców i nauczycieli. ­Celem prezentowanego badania było poszukiwanie odpowiedzi na pytanie o wiedzę rodziców i nauczycieli dziecka w wieku przedszkolnym na temat jego odporności psychicznej. Była ona zdefiniowana jako czynniki ochronne - inicjatywa, samokontrola i przywiązanie oraz czynniki ryzyka w postaci zachowań niepokojących. Uczestnikami badania byli rodzice i nauczyciele 335 dzieci w wieku 2-6 lat. W badaniu wykorzystano skalę obserwacyjną DECA (The Devereux Early Childhood Assessment) przeznaczoną dla dzieci w wieku od 2,0 lat do 5 lat i 11 miesięcy. Narzędzie składa się z 37 pozycji, wypełniane jest przez rodziców dziecka oraz jego nauczyciela przedszkolnego. Uzyskane wyniki wykazały różnice w zakresie oceny przez dorosłych zarówno czynników ochronnych, jak i czynników ryzyka: matki oceniły najwyżej inicjatywę dzieci, wyższe wymagania w zakresie samokontroli dzieci zaobserwowano u ojców w porównaniu z matkami i nauczycielami. Przywiązanie jako trzeci czynnik ochronny zostało ocenione wyżej przez rodziców niż przez nauczyciela. Nauczyciele zauważyli istotnie mniej zachowań trudnych u dzieci niż matki. W zakresie zachowań niepokojących stwierdzono tendencję nauczycieli do spostrzegania chłopców w sposób stereotypowy jako mniej grzecznych niż dziewczynki. Okazało się, że wiedza matek, ojców i nauczycieli na temat zasobów odporności psychicznej dziecka różni się w istotny sposób. Może to także wynikać z odmiennego zachowania dziecka w środowisku przedszkolnym i domowym oraz z wpływu czynników społecznych.Children's development and achievements are of great interest to their adult significant others, notably parents and teachers. The aim of the presented research was to investigate what parents and teachers of preschool children know (and fail to know) about the children's psychological resiliency - defined via the protective factors of initiative, self-control and attachment, as well as risk factors in the form of behavioral concerns. The research was conducted among the parents and teachers of 335 preschool children aged 2-6 years. The study used the observational Devereux Early Assessment Scale, suitable for children aged 2 years 0 months - 5 years 11 months. The scale consists of 37 items and is filled in by the children's parents and preschool teachers. Significant differences were obtained in how parents and teachers assess children's protective factors and behavioral concerns. Mothers provided the highest scores of children's initiative, as compared to fathers and teachers. Fathers had higher expectations of a child's self-control than mothers and teachers. Attachment was scored higher by parents than teachers, who, on the other hand, reported more behavioral concerns in children than their parents. Moreover, teachers had a tendency to stereotypically perceive boys as demonstrating more behavioral concerns than girls - which was not observed in parents. The results indicate that the knowledge and perception of children's resiliency demonstrated by their teachers, mothers and fathers significantly varies, suggesting that these observers apply different judgment standards, and/or that children demonstrate different levels of protective factors and behavioral concerns at home vs. at preschool, due to the social-psychological factors

Odporni rodzice – odporne dzieci. Jak zasoby psychiczne rodziny wpływają na odporność psychiczną dziecka

The child’s mental resilience is a resource based on biological (temperament, health) and social factors (parental influence and family atmosphere). Research on dealing with stress shows that a resilient family forms a resilient child. The aim of the study was to seek relationships between the mental resilience of parents and their children. The subjects of the study were parents of preschool children (N = 129) aged 5-6 years (M = 5.77, SE = 0.44), including 121 mothers and 115 fathers, from eight kindergartens in Krakow. Two psychometric tests, filled in by the parents, were used: DECA (Devereux Early Childhood Assessment) observational scale, which measures child’s mental resilience and its components (initiative, self-control and attachment), and the intensity of child’s problematic behaviours; as well as the SPP-25 (Resiliency Assessment Scale) to assess the level of resil- iency in parents. The study showed strong positive relationships between the mental resilience of parents and the mental resilience of their children, both as a whole and in terms of its components. No significant differences in resistance profiles were observed between children with higher and lower levels of problematic behaviour. The experience of difficult life events was associated with a lower level of all aspects of mental resilience in both children and their parents. The popularization of knowledge about the importance of having and developing the mental resilience of parents for the mental health of their children is an important social task. This goal can be achieved&nbsp;e.g. by educating parents in kindergartens.Odporność psychiczna dziecka jest zasobem opartym na czynnikach biologicznych (temperament, stan zdrowia) i społecznych (wpływ wychowawczy i atmosfera w rodzinie). Badania nad radzeniem sobie ze stresem pokazują, że odporna rodzina kształtuje odporne dziecko. Celem badania było poszukiwanie związków pomiędzy odpornością psychiczną rodziców i ich dzieci. Osobami badanymi byli rodzice dzieci w wieku przedszkolnym (N = 129) w wieku 5-6 lat (M = 5,77, SE = 0,44), w tym 121 matek oraz 115 ojców, z ośmiu przedszkoli na terenie Krakowa. Zastosowano dwie metody psychometryczne wypełniane przez rodziców: skalę obserwacyjną DECA (The Devereux Early Childhood Assessment), mierzącą odporność psychiczną dziecka i jej składowe (inicjatywę, samokontrolę i przywiązanie) oraz natężenie dziecięcych zachowań problemowych, a także Skalę Prężności Psychicznej SPP-25 do oceny poziomu odporności psychicznej rodziców.&nbsp;Badanie wykazało silne, pozytywne związki odporności psychicznej rodziców z odpornością psychiczną ich dzieci, tak w ujęciu całościowym, jak i w zakresie jej czynników składowych. Nie zaobserwowano istotnych różnic w profilach odporności pomiędzy dziećmi z wyższym i niższym poziomem zachowań problemowych. Doświadczenie trudnych wydarzeń życiowych wiązało się z niższym poziomem wszystkich aspektów odporności psychicznej zarówno u dzieci, jak i u ich rodziców.&nbsp; Upowszechnianie wiedzy o znaczeniu posiadania i rozwijania zasobów odporności psychicznej rodziców dla zdrowia psychicznego ich dzieci jest ważnym zadaniem społecznym na drodze popularyzacji wiedzy, jak i pedagogizacji rodziców w przedszkolu

Evaluation of the coexistence of cognitive disorders, leukoaraiosis and other risk factors in patients with stroke

Background. Stroke is a common cause of mortality and disability. There are many risk factors for stroke amongwhich leukoaraiosis (LA) is mentioned. Historically, LA was a radiological term, however, today it is classified asCerebral Small Vessel Disease (CSVD) which clinical presentation depends on the affected brain area. Higher prevalenceof LA is found not only in stroke patients, but also in patients with hypertension and other cerebrovascular riskfactors. Therefore, the aim of the study was to evaluate the relationship between the present LA, selected laboratorytests, the carotid ultrasound markers and cognitive tests results in patients with stroke. Material and methods. The study included 102 patients (W: 56, M: 46) at the age of 70.9 ± 11.5 hospitalized dueto stroke in the Stroke Unit of the Department of Neurology. The clinical assessment included NIHSS score, MMSEtesting, laboratory blood tests, carotid duplex USG and CT scan of the brain. Patients were dichotomized based onthe presence of LA in the CT scan. Results. LA was present in 25 (24.5%) patients. It was more frequently found in older patients (&gt; 72 years old;p &lt; 0.001). In the LA group, higher levels of LDL cholesterol (p = 0.002), lower hemoglobin concentration(p = 0.03) and higher platelets count (p = 0.04) were observed. The carotid ultrasound showed higher intimamediacomplexes in the LA group (p = 0.02). The functional test showed lower scores on the clock test in patientswith LA (p = 0.04). The presence of LA was three times less likely to be present in patients administered withbeta1-adrenolytics (p = 0.03). Conclusions. The occurrence of leukoaraiosis in patients with acute stroke is associated with clustering of othervascular risk factors cognitive impairment, and may be related to ongoing cardiovascular therapy

Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients : an Observational Study

: Introduction: Defunctioning ileostomy has been widely used in patients undergoing low anterior rectal resection to reduce the rate of postoperative leakage. It is still not clear whether interval between primary procedure and ileostomy reversal has an impact on treatment outcomes. Methods: In our prospective observational study we reviewed 164 consecutive cases of patients who underwent total mesorectal excision with primary anastomosis. Univariate and multivariate regression models were used to search for risk factors for prolonged length of stay and complications after defunctioning ileostomy reversal. Receiver operating characteristic curves were utilized to set cut-off points for prolonged length of stay and perioperative morbidity. Results: In total, 132 patients were included in the statistical analysis. The median interval between primary procedure and defunctioning ileostomy reversal was 134 (range: 17–754) days, while median length of stay was 5 days (4–6 interquartile range (IQR)). Prolonged length of stay cut-off was established at 6 days. Regression models revealed that interval between primary surgery and stoma closure as well as complications after primary procedure are risk factors for complications after defunctioning ileostomy reversal. Prolonged length of stay has been found to be related primarily to interval between primary surgery and stoma closure. Conclusions: In our study interval between primary surgery and stoma closure along with complication occurrence after primary procedure are risk factors for perioperative morbidity and prolonged length of stay (LOS) after ileostomy reversal. The effort should be made to minimize the interval to ileostomy reversal. However, randomized studies are necessary to avoid the bias which appears in this observational study and confirm our findings

Dielectric and electric properties of Ba0.996La0.004Ti0.999O3 ceramics doped with europium and hafnium ions

Lanthanum-modified BaTiO3 electroceramic materials have superior dielectric and piezoelectric properties. Ba0.996La0.004Ti0.999O3 (BLT4) seems to be a serious candidate for ultracondensator applications. This manuscript describes the results of hafnium and europium modification of BLT 4 ceramics. The pure and doped ceramic materials were synthesized by the conventional mixed oxide method. The microstructure of obtained samples was examined by scanning electron microscope. The investigations reveal strong correlations between the presence of admixture and the grain size, which was especially visible in the case of the hafnium dopant. The frequency and temperature dielectric characteristics measurements revealed a decrease in electric permittivity. Moreover, the impedance spectroscopy investigations showed severe changes in grains and grain-boundary resistivity, which was connected with changes in electric conductivity