Prevalence, awareness, treatment and control of hypertension in the adult Polish population : multi-center National Population Health Examination Surveys : WOBASZ studies

Introduction: Hypertension is one of the main risk factors of cardiovascular diseases. The first aim of the study was to evaluate the prevalence, awareness and treatment of hypertension as well as treatment effectiveness (blood pressure < 140/90 mm Hg) in a representative sample of the Polish population over the age of 19, examined in the WOBASZ II program. The second aim was to assess the changes in these parameters between 2003-2005 (WOBASZ study) and 2013-2014 in adults aged 20-74. Material and methods: Sampling was performed in three stages, stratified according to voivodeship (province), type of commune, and gender. Finally, the study included 6163 persons (3406 women and 2757 men) examined in the years 2013-2014 (aged ≥ 19 years). For comparison the data from 14 755 persons (7783 women and 6452 men aged 20-74 years) examined in the years 2003-2005 were used. Results: In the years 2013-2014, the age-standardized prevalence of hypertension, awareness, treatment and control was 42.7%, 59.3%, 46.1%, and 23% respectively. In the last decade an increase in the prevalence of hypertension (relative ratio (RR) 1.12; 95% confidence interval (CI): 1.07- 1.18), treatment (RR = 1.26; 95% CI: 1.17-1.36) and control (RR = 2.16; 95% CI: 1.91-2.45) was found. In contrast, the awareness decreased nonsignificantly (RR = 0.98; 95% CI: 0.92-1.05). Conclusions: The prevalence of hypertension in Poland is high, and increased by about 12% in 10 years. Although the number of treated patients and blood pressure control improved nearly twofold over the last decade, this is still below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Poland should still be intensifie

Agency in urgency and uncertainty. Vaccines and vaccination in European media discourses

Although Covid-19 was not the first pandemic, it was unique in the scale and intensity with which societies responded. Countries reacted differently to the threat posed by the new virus. The public health crisis affected European societies in many ways. It also influenced the way the media portrayed vaccines and discussed factors related to vaccine hesitancy. Europeans differed in their risk perceptions, attitudes towards vaccines and vaccine uptake. In European countries, Covid-19-related discourses were at the centre of media attention for many months. This paper reports on a media analysis which revealed significant differences as well as some similarities in the media debates in different countries. The study focused on seven European countries and considered two dimensions of comparison: between the pre-Covid period and the beginning of the Covid pandemic period, and between countries. The rich methodological approach, including linguistics, semantic field analysis and discourse analysis of mainstream news media, allowed the authors to explore the set of meanings related to vaccination that might influence actors' agency. This approach led the authors to redefine vaccine hesitancy in terms of characteristics of the “society in the situation” rather than the psychological profile of individuals. We argue that vaccine hesitancy can be understood in terms of agency and temporality. This dilemma of choice that transforms the present into an irreversible past and must be taken in relation to an uncertain future, is particularly acute under the pressure of urgency and when someone's health is at stake. As such, it is linked to how vaccine meaning is co-produced within public discourses

Trust matters: The Addressing Vaccine Hesitancy in Europe Study

The article presents the design of a 7-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study is comprised of 1) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination), 2) participant observation and in-depth interviews of healthcare professionals (HCPs) and vaccine hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among HCPs involved in discussing childhood vaccines with parents. In this article, we present the selection of countries and regions, the conceptual basis of the study, the details of the data collection and the process of designing and evaluating the interventions as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and method

Our good is the public good-reframing the communication of professional groups : anatomy of the resident doctors’ protests in Poland

This article analyses the protests of resident doctors in Poland, with a particular focus on their hunger protest in October 2017. We use a theoretical framework of three types of groups - epistemic communities, communities of practice and interest groups - to show their strategies used for gaining influence upon healthcare. We show the dynamics of the protest, with a shift from self-centred to public-oriented demands. We present how a professional group managed to shape the public discourse on healthcare, introducing their key demands, which became not only media catchphrases, but also the axis of the media discourse on any future healthcare reforms. We also reconstruct how the resident doctors defined and identified themselves as an epistemic community, with an elaborate and well-planned strategy employed to gain public visibility, media attention and public support

From community of practice to epistemic community : law, discipline and security in the battle for the legalisation of medical cannabis in Poland

Although public debates on cannabis are ongoing in many countries, there are currently no EU‐wide rules for either medical or recreational use of cannabis. Numerous studies have illustrated that creating such rules is a complex challenge. The battle over the legalisation of medical use of cannabis in Poland is a good example for analysing the mutual impact of the social practices that various actors perform through and by the discourses in the field of health care: how they discursively create their own roles and take positions and how they shape the coalitions and opposition in trying to achieve their strategic goals. This article aims to reconstruct and explain how different types of knowledge are discursively used to sustain or question power relations in the healthcare field. The dispersed knowledge‐power influences social actors, who try to define or redefine social practices and aspire to guide them in the healthcare field. The presented approach allows authors to go beyond the social actors’ perception vs institutional regulations and to analyse discursive actions as elements of the complex networks of meanings activating various type of resources. Those dynamic networks, involving the different (and sometimes the same) actors in the different actions, open the new fields of rationality. Starting by identifying the crucial actors and their discursive actions visible in the mainstream press discourse, we will reconstruct three types of groups related to medical cannabis. We will then investigate three types of dispositives - law, discipline and security - to investigate the relations between discursive and non‐discursive elements. The proposed analysis belongs to the Critical Discourse Analysis (CDA) paradigm and includes investigation of the media discourses and in‐depth interviews with the identified actors

The anti-vaccination Robinsons : isolated actors of the mainstream vaccination discourse in Poland

Vaccinations are treated as a tool that can eliminate disease or at least reduce morbidity and mortality. The programmes implemented by the World Health Organization aim to completely eradicate certain infectious diseases. At the same time, the number of people who choose not to vaccinate, or question the effectiveness and necessity of vaccination, is increasing. Called as anti-vaccinationists, they are treated by the dominant discourse as irrational, selfish and irresponsible. In this article, we analyse the media discourse around vaccination, pointing out that the institutionalised message supports the vaccination policy, while displacing and ridiculing actors who are opposed to the current vaccination procedure. Labelled as one type of group and pushed out of the dominant discourse, they organise themselves in their spaces and practise their coping strategies. We call them ‘the Robinsons’ (inspired by Robinson Crusoe) because, locked in their islands, they close themselves off from the current discourse, forming their own knowledge and their own practices. Our aim is to show the discursive mechanisms of pushing out them of the mainland

Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes

Insulin resistance and hyperandrogenemia observed in polycystic ovary syndrome (PCOS) are associated with metabolic disturbances and could be connected with body composition pattern. To date, several studies defining the parameters of body composition using dual energy X-ray absorptiometry (DXA) method in the group of PCOS patients have been published, however, without the analysis in different phenotypes. The aim of the present study was to investigate the relationships between serum androgens concentration, insulin resistance and distribution of fat mass using DXA method in various PCOS phenotypes according to the Rotterdam criteria. We examined 146 women: 34 (38%) had PCOS phenotype A, 20 (23%) phenotype B, 20 (23%) phenotype C and 15 (16%) phenotype D (with mean age of each phenotype 25 years), and 57 control subjects (mean age of 25.5 years). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum concentrations of testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S) were assessed and free androgen index (FAI) was calculated. In phenotypes A, B and C, we observed higher FAI in comparison to the control group (all p &lt; 0.01). Serum concentrations of androstenedione and DHEA-S were higher in phenotypes A and C in comparison to the control group (all p &lt; 0.01). However, only in phenotype A we found higher visceral adipose tissue (VAT) mass and android/gynoid ratio (A/G ratio) in comparison to the control group (all p &lt; 0.01). In phenotype A, we observed connection of VAT with FAI (r = 0.58, p &lt; 0.01). Accordingly, A/G ratio was related with FAI in all phenotypes (all p &lt; 0.05). Additionally, in phenotype C, A/G ratio was related to serum concentrations of DHEA-S and androstenedione (r = 0.46, p = 0.03; r = 0.53, p = 0.01, respectively). We also found connections of HOMA-IR with VAT and A/G ratio in all phenotypes (all p &lt; 0.05). Women with phenotype A had higher amount of VAT and A/G ratio in comparison to the control group. Serum concentration of androgens and insulin resistance are connected with VAT and A/G ratio in normoandrogenic and hyperandrogenic PCOS phenotypes

P1 promoter IGF-1 polymorphism and IGF-1, IGF-R, LSF, and TSG 101 expression profile in endometriosis

Objectives: The presence of the endometrium outside the uterine cavity affects about 10% of women of childbearing age. Studies of the progression of endometriosis to cancer have been supported by numerous evidences of gene expression or gene defect caused by oxidative stress and inflammation. We decided to check the expression of selected factors responsible for the proliferation, as in the stages of neoplasia. Material and methods: A group of 80 women with ovary localization of endometriosis was qualified for research. The control group was 90 patients with ovarian simplex or follicular cysts. The DNA isolation, immunohistochemical analysis of IGF 1, IGF–R, TSG 101, and LSF expressions with a quantitative scoring of slides and electron microscopy was performed. Results: The IGF-1-immunopositive cells in the reference group were in statistically significantly higher number compared to the cells forming the foci of endometriosis (p = 0.0282). However, the number of IGF-R-immunopositive cells was comparable to the endometriosis (p = 0.1264). In the control group, the number of LSF-immunopositive cells was statistically significantly higher in comparison to endometriosis foci (p = 0.000001), but the number of TSG 101-immunositive cells was comparable to endometriosis foci (p = 0.3834). A weak negative correlation between the number of cells expressing the TSG 101 factor and the IGF-1 receptor was found in the endometriosis group (r = –0.26, p = 0.0196). The analysis of CA single nucleotide polymorphism in the DNA isolated from both groups showed a comparable incidence of MSS and MSI-L genotypes (chi2 p = 0,9160). Conclusions: How these factors affect the development of endometriosis and whether they could be helpful in the diagnosis requires further research

How Gene Survival Depends on Their Length

Abstract. Gene survival depends on the mutational pressure acting on the gene sequences and selection pressure for the function of the gene products. While the probability of the occurrence of mutations inside genes depends roughly linearly on their length, the probability of elimination of their function does not grow linearly with the length because of the intragenic suppression effect. Furthermore, the probability of redefinition of the stop and start codons is independent of the gene length while shortening of gene sequences by generating stop codons inside gene sequences depends on gene length