Is the guaranteed health care coverage for long-term nursing home care considered limited by the payer of the National Health Fund?

Stasiak Elżbieta, Stasiak Karolina, Stasiak Łucja, Deluga Alina, Wasil Anna. Is the guaranteed health care coverage for long-term nursing home care considered limited by the payer of the National Health Fund? Journal of Education, Health and Sport. 2017;7(5):24-41. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.569331 http://ojs.ukw.edu.pl/index.php/johs/article/view/4430 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.04.2017. Revised: 18.03.2017. Accepted: 25.04.2017. Czy świadczenia zdrowotne gwarantowane w zakresie pielęgniarskiej opieki domowej długoterminowej powinny być świadczeniami limitowanymi przez płatnika NFZ? Is the guaranteed health care coverage for long-term nursing home care considered limited by the payer of the National Health Fund? Elżbieta Stasiak1, Karolina Stasiak2, Łucja Stasiak2, Alina Deluga3, Anna Wasil1 Katedra Onkologii i Środowiskowej Opieki Zdrowotnej, Zakład Onkologii1 STASIAK medical team2 Katedra Onkologii i Środowiskowej Opieki Zdrowotnej, Pracownia Pielęgniarstwa Środowiskowego3 Słowa kluczowe: kolejki oczekujących, niepełnosprawność, pielęgniarska opieka domowa długoterminowa, starość, świadczenia zdrowotne gwarantowane. Keywords: waiting lists, disability, long-term home-based nursing care, old age, guaranteed health benefits. Streszczenie Osoba w wieku starszym, geriatrycznym a tym samym bardzo często z niepełnosprawnością jest zbyt skąpo i niedostatecznie holistycznie zaopatrywana w realizację świadczeń zdrowotnych w środowisku domowym. Jedną z form jaka funkcjonuje na rynku świadczeń zdrowotnych i dedykowanych osobom starszym i niepełnosprawnym jest pielęgniarska opieka domowa długoterminowa. Ten rynek świadczeń zdrowotnych od ponad 17 lat zorganizowały i prowadzą pielęgniarki jako samodzielna grupa zawodowa w oparciu o zawierane kontrakty z Narodowym Funduszem Zdrowia. Pomimo stale zwiększającego się zapotrzebowania na tego typu opiekę płatnik czyli Narodowy Fundusz Zdrowia traktuje te świadczenia jako limitowane. Świadczenia te są najtańszą formą opieki na rynku świadczeń zdrowotnych skierowaną do osób starszych i niepełnosprawnych. Wobec faktu, że społeczeństwo polskie starzeje się w bardzo szybkim tempie a tym samym zmaga się z wielochorobowością należałoby te świadczenia zdrowotne umieścić w świadczeniach gwarantowanych nielimitowanych. Zmiana ta wprowadziłaby ogromne oszczędności w ochronie zdrowia. Osoba, która ze względu na stan zdrowia kwalifikuje się do realizacji świadczeń zdrowotnych typu pielęgniarska opieka domowa długoterminowa, a z powodu braku miejsc jest wpisywana na listę osób oczekujących. Summary The elderly person in the geriatric age, and thus very often with a disability, is too sparingly provided with holistic health care services in the home environment. One of the forms, which operates in the market of health care services and which is dedicated to the elderly and disabled is a long-term home-based nursing care. For over 17 years the market for health care services has been organized and led by nurses who are an independent professional group and whose actions have been based on the contracts with the National Health Fund. Despite the ever increasing demand for this type of care, the payer or the National Health Fund treats these benefits as limited. These benefits are for the payer the cheapest form of care addressed to the elderly and disabled. In view of the fact that Polish society is aging at a rapid rate and is thus faced with multiple morbidities, these health benefits should be guaranteed and unlimited. This change would bring huge savings in health care. Due to the insufficient number of places, the person who is eligible for long-term home-based nursing care is put on a waiting list

Percentage of LFA-1+ and ICAM-1+ peripheral blood mononuclear cells in children and adolescents with type 1 diabetes does not distinguish patients with vascular complications.

There are only few studies evaluating lymphocytes activation in the diabetic vascular complications. ICAM-1/LFA-1 adhesion molecules not only participate in the lymphocyte T proliferation but also mediate leukocyte migration to the site of inflammation. We assess a relationship between the percentage of ICAM-1 and LFA-1 expressing PBMCs and the evolution of vascular complications in T1D in children and adolescents. The study was carried out on 60 children and adolescents with T1D (aged 9-20): (a) T1D lasting 5 years (n=20), without complications c) T1D lasting >5 years complicated with microalbuminuria, arterial hypertension, diabetic retinopathy (20 n). 20 healthy volunteers, age and sex matched constituted the control group. The expression of adhesion molecules was evaluated by using three-color flow cytometry. In children and adolescents with T1

Necessary and Sufficient Conditions for Robust Minimal Solutions in Uncertain Vector Optimization

Mathematics Subject Classification: 49J52, 49J53, 49N30, 90C31.We introduce a new notion of a vector-based robust minimal solution for a vector-valued uncertain optimization problem, which is defined by means of some open cone. We present necessary and sufficient conditions for this kind of solution, which are stated in terms of some directional derivatives of vector-valued functions. To prove these results, we apply the methods of set-valued analysis. We also study relations between our definition and three other known optimality concepts. Finally, for the case of scalar optimization, we present two general algorithm models for computing vector-based robust minimal solutions.The authors are grateful to the University of Łódź for providing necessary funds and conditions needed to complete this research

A case-control study of the lipid profile of women with breast cancer

Purpose: Neoplastic diseases remain the second most common cause of death, behind cardiovascular diseases, and breast cancer is the leading cause of death among women worldwide. Increased incidence of neoplastic diseases is also known to be accompanied by lipid metabolism disorders.Method: Blood samples for lipid profile testing were taken from the two studied groups, which comprised 110 women with breast cancer and 70 healthy women. Lipid profile testing was conducted on venous blood samples collected among both groups of women on an empty stomach. Statistical analyses were performed using the IBM SPSS Statistics 20 software package.Results: A statistically significant (p<0.05) majority of women with breast cancer had abnormal TC results (67.3%). A statistically significant (p<0.05) majority of control group women (90.0%) had normal HDL-C results. More women with breast cancer (87.3%) had abnormal LDL-C results than healthy women (62.9%), which represented a statistically significant difference (p<0.05). Conclussions: Abnormal lipid profile significantly impacts breast cancer incidence. At the same time it is under influence of abnormal eating habits and low physical activity. Community and oncology nurses, having considerable knowledge about health and lifestyle of their patients, should be more involved in basic education to decrease cancer risk, especially by women with alarming LDL-C level

Increased percentage of L-selectin+ and ICAM-1+ peripheral blood CD4+/CD8+ T cells in active Graves' ophthalmopathy.

The purpose of the study was to evaluate the percentage of CD4+/CD8+ peripheral T cells expressing CD62L+ and CD54+ in patients with Graves' disease and to assess if these estimations could be helpful as markers of active ophthalmopathy. The study was carried out in 25 patients with Graves' disease (GD) divided into 3 groups: 1/ 8 patients with active Graves' ophthalmopathy (GO) (CAS 3-6, GO complaints pound 1 year), 2/ 9 patients with hyperthyroid GD without symptoms of ophthalmopathy (GDtox) and 3/ 8 patients with euthyroid GD with no GO symptoms (GDeu). The control group consisted of 15 healthy volunteers age and sex matched to groups 1-3. The expression of lymphocyte adhesion molecules was evaluated by using three-color flow cytometry. In GO group the percentage of CD8+CD54+, CD8+CD62L+, CD4+CD54+ and CD4+CD62L+ T cells was significantly higher as compared to controls (

Intragenomic diversity of Rhizobium leguminosarum bv. trifolii clover nodule isolates

BACKGROUND: Soil bacteria from the genus Rhizobium are characterized by a complex genomic architecture comprising chromosome and large plasmids. Genes responsible for symbiotic interactions with legumes are usually located on one of the plasmids, named the symbiotic plasmid (pSym). The plasmids have a great impact not only on the metabolic potential of rhizobia but also underlie genome rearrangements and plasticity. RESULTS: Here, we analyzed the distribution and sequence variability of markers located on chromosomes and extrachromosomal replicons of Rhizobium leguminosarum bv. trifolii strains originating from nodules of clover grown in the same site in cultivated soil. First, on the basis of sequence similarity of repA and repC replication genes to the respective counterparts of chromids reported in R. leguminosarum bv. viciae 3841 and R. etli CFN42, chromid-like replicons were distinguished from the pool of plasmids of the nodule isolates studied. Next, variability of the gene content was analyzed in the different genome compartments, i.e., the chromosome, chromid-like and 'other plasmids'. The stable and unstable chromosomal and plasmid genes were detected on the basis of hybridization data. Displacement of a few unstable genes between the chromosome, chromid-like and 'other plasmids', as well as loss of some markers was observed in the sampled strains. Analyses of chosen gene sequences allowed estimation of the degree of their adaptation to the three genome compartments as well as to the host. CONCLUSIONS: Our results showed that differences in distribution and sequence divergence of plasmid and chromosomal genes can be detected even within a small group of clover nodule isolates recovered from clovers grown at the same site. Substantial divergence of genome organization could be detected especially taking into account the content of extrachromosomal DNA. Despite the high variability concerning the number and size of plasmids among the studied strains, conservation of the location as well as dynamic distribution of the individual genes (especially replication genes) of a particular genome compartment were demonstrated. The sequence divergence of particular genes may be affected by their location in the given genome compartment. The 'other plasmid' genes are less adapted to the host genome than the chromosome and chromid-like genes

Development of e-commerce in Poland and the Baltic states

PURPOSE: The article analyses the development of the e-commerce market in Poland and the Baltic States. It presents the dimensions of its functioning - indicating the directions of development, and assesses the potential for further development of e-commerce.DESIGN/METHODOLOGY/APPROACH: The study was based on a literature list and an analysis of industry reports on the latest research in the development of the e-commerce sector to show trends and new solutions that are applicable in the countries studied. When making a decision to purchase a product, customers have to consider many criteria that are relevant to the transaction. In order to achieve the aim of the study, an international study was carried out between November 2021 and December 2021 in Poland and the Baltic States using an online questionnaire. This is an international comparative study conducted on a large group of respondents on a very important and timely topic.FINDINGS: An analysis of the e-commerce market in Poland and the Baltic States reveals that the highest percentage of its participants is in Estonia, followed by Poland and at a similar level in Lithuania and Latvia. E-commerce is subject to strong development, with the strongest growth forecast for the e-commerce market in Poland, which is confirmed by our own research. The effectiveness of e-commerce development in individual countries will be determined by individual approaches tailored to the shopping preferences of e-consumers in each country.PRACTICAL IMPLICATIONS: The analysis scheme developed in the research can be a useful tool to assist entrepreneurs in designing their e-commerce business. Quick response to changes in consumer decisions helps to build competitive advantages.ORIGINALITY/VALUE: The research presented here is part of a larger in-house study, the main aim of which is to explore the applicability of existing and the development of new methods for managing and implementing individual customer choices of the e-commerce marketplace into business.peer-reviewe