The individual face to face with public health: a conflict of interests or a conflict of conditions?

Sytnik-Czetwertyński Janusz, Cianciara Dorota. The individual face to face with public health: a conflict of interests or a conflict of conditions? Journal of Education, Health and Sport. 2016;6(2):223-237. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.46590http://ojs.ukw.edu.pl/index.php/johs/article/view/3394https://pbn.nauka.gov.pl/works/716770  The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015).755 Journal of Education, Health and Sport eISSN 2391-8306 7© The Author (s) 2016;This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, PolandOpen 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 commercialuse, 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: 05.01.2016. Revised 12.02.2016. Accepted: 21.02.2016.  The individual face to face with public health: a conflict of interests or a conflict of conditions? Janusz Sytnik-Czetwertyński Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Poland Dorota Cianciara Institute of Epidemiology and Health Promotion, School of Public HealthMedical Centre for Postgraduate Education, Warsaw, Poland  AbstractThe freedom of man and the freedom of the citizen are two entirely different domains. By nature, man is created for freedom, yet he does not possess the ability to effectively provide himself with a feeling of security. Man is therefore forced to negotiate, and in exchange for the abandonment of certain rights to freedom, receives a guarantee of relative peace. In order to enforce its obligations, the state is sometimes forced, in the name of the public good, to pacify the intentions of the individual and enforce pro-social actions. The issue discussed here is therefore reduced to the following: is the domain of public health one of those which should remain under the complete, or merely partial, control of the state (such as defence for instance), or should it remain open to the rights and demands of citizens? The conclusion seems to be the following: the public health perspective is a social one and there is therefore little room for a wide-ranging dialogue with the individual. On the other hand, the system cannot close itself entirely to the reactions of society, since it is supposed to serve people and not its own ideals. It must possess the capacity to not lose sight of people and their problems, so often defying any prognoses and expectations, within the process of enacting public health policy.  Key words: face to face, public health

Recovery from COVID-19 crisis in public health perspective

Introduction. Assessments of the response to the COVID-19 pandemic so far are negative. They can be summarized as: the world was not prepared, action was insufficient, public and private institutions failed people to protect their health and everyday life. The pandemic highlighted public health weakness. Purpose. The aim is: (1) to polemic with the comparison of the pandemic to the black swan, (2) to list the negative and positive effects of the pandemic mentioned in the literature, (3) to discuss public health attributes related to counteracting epidemics, and (4) to present ways of recovery after pandemic crisis from a public health perspective. The state of knowledge. Comparing the COVID-19 pandemic to the black swan is incorrect. The literature describes the negative effects of a pandemic better than its positive effects, but there is a trend to explore unexpected positive effects or the balance of losses and gains. The public health tasks in counteracting epidemics include the development and implementation of preparedness and response plans, pursuit of health equity and fairness and care on the most vulnerable through interdisciplinary and cross-sectoral activities. The literature recommends many solutions to improve the health systems, including public health, and to strengthen the role of public health. They can be assigned to three groups: macro factors related to the political-economic context, meso factors related to the internal principles of the health system functioning and micro factors related to the functioning of the system in relations with users. Conclusions. Public health is essential to national security. It is up to decision makers, the establishment, citizens and the community to implement the postulates to improve the health and public health system.

There’s nothing better (yet?) for improving evidence-based practice than knowledge translation

WHO Framework Convention on Tobacco Control entered into force 55 years after the first publication on relationship between smoking and lung cancer. The need to increase use of evidence into practice is widely emphasized. Purpose. Presentation of the knowledge translation process and discussion of the basis on which this concept was created. The state of knowledge. The concept of knowledge translation was created at the beginning of the 21st century in response to problems related to the production and dissemination of scientific evidence, including the so-called the know-do gap. These problems constitute a significant barrier to adherence to the principles of evidence-based medicine and practice. The translation of knowledge is seen as an operationalization of the above principles and a shortening of the path from evidence to effect. There are many approaches to knowledge translation, and there are problems and limitations in evaluating this process. This can cause confusion amongst stakeholders in the health system. Conclusions. Knowledge translation is a developmental and increasingly popular concept. There is no (yet?) better tool to improve evidence-based practice, both in medicine and public health than knowledge translation. The issue of knowledge translation should be disseminated in literature, tested in research, raised in discourse and implemented in health professionals education in Poland

Negative opinion on work as variable of career shift among doctors in Poland. Are we running out of doctors in post-COVID times?

Introduction and objective. Work conditions and evaluation, stress, professional burnout among doctors are the subject of analyzes and research in Poland. Less attention is focused on the problem of leaving the profession. The aim of the study was to determine the relationship between the socio-demographic and professional characteristics of doctors and the subjective assessment of their current work and the willingness to undertake an alternative career. Material and methods. A survey was conducted among 315 doctors attending courses at the Medical Center of Postgraduate Education in 2018/19. The questionnaire consisted of 14 questions. The dependent variable was the declaration of willingness to change the medical profession to another, if it was possible to maintain income. The explanatory variables were socio-demographic and professional characteristics: gender, age and the performance of surgical and non-surgical specialties as well as subjective assessment of current professional work in terms of 10 attributes of a doctor's work. The analysis used the Pearson χ2 test, Spearman's rank correlation coefficient and clustering. Results. The vast majority of doctors admitted that their work was interesting (95.9%), but nervous (90.5%) and threatening (77.8%). Nervousness was significantly more often indicated by young doctors. 18.1% of physicians declared their willingness to change their profession. The desire to change profession was most strongly associated with the opinion that work was unpleasant and disgusting. Conclusions. More doctors reported the disadvantages of their work than its advantages. Every fifth declared a willingness to change their profession. The willingness to change profession was strongly related to the overall negative assessment of one's own work. Presumably, as a result of the COVID-19 pandemic, more and more doctors will evaluate their work negatively, which may prompt them to change their profession. This situation requires monitoring the impact of COVID-19 on the workforce and taking remedial measures.Wprowadzenie i cel pracy. Warunki i ocena pracy, stres, wypalenie zawodowe wśród lekarzy są przedmiotem analiz i badań w Polsce. Mniej uwagi skupia problem odejścia od zawodu. Celem badania było określenie związku między cechami społeczno-demograficzno-zawodowymi lekarzy i subiektywną oceną ich aktualnej pracy a chęcią podjęcia kariery alternatywnej. Materiał i metody. Przeprowadzono badanie ankietowe wśród 315 lekarzy odbywających kursy w Centrum Medycznym Kształcenia Podyplomowego w roku 2018/19. Kwestionariusz składał się z 14 pytań. Zmienną objaśnianą była deklaracja chęci zmiany zawodu lekarza na inny, jeśli utrzymanie dochodów byłoby możliwe. Zmiennymi objaśniającymi były cechy społeczno-demograficzno-zawodowe: płeć, wiek i wykonywanie zabiegowej i niezabiegowej specjalności lekarskiej oraz subiektywna ocena aktualnej pracy zawodowej w aspekcie 10 atrybutów pracy lekarza. W analizie wykorzystano test χ2 Pearsona, współczynnik korelacji rang Spearmana oraz klasteryzację. Wyniki. Zdecydowana większość lekarzy przyznała, że ich praca jest interesująca (95,9%), ale nerwowa (90,5%) i zagrażająca (77,8%). Nerwowość była istotnie częściej wskazywana przez młodych lekarzy. Chęć zmiany zawodu zadeklarowało 18,1% lekarzy. Chęć zmiany zawodu była najsilniej związana z opinią, że praca jest nieprzyjemna i odrażająca. Wnioski. Więcej lekarzy zgłaszało wady swojej pracy niż jej zalety. Co piąty zadeklarował chęć zmiany zawodu. Chęć zmiany zawodu była silnie związana z całościowo negatywną oceną własnej pracy. Przypuszczalnie w wyniku pandemii COVID-19 coraz więcej lekarzy będzie negatywnie oceniać swoją pracę, co może skłaniać do zmiany zawodu. Sytuacja ta wymaga monitorowania wpływu COVID-19 na kadrę oraz podejmowania środków zaradczych. &nbsp

Staff shortages and inappropriate work conditions as a challenge geriatrics and contemporary healthcare service at large faces

Deficit of human resources in health care is  a widespread problem occurring not only in Polish system. Demanding work, emotional stresses and insufficient support are often associated with the doctor's shift mode of work and an excess of duties combined with a shortage of time allocated to their performance. It can be assumed that most of the doctors intend to continue their work so far, but its negative features may in the future affect their decisions about choosing a different career path, especially if the shortage of medical personnel increases. This may further overburden doctors (especially young doctors) with excess working hours, reduce the quality of their activities, increase the chances of committing an unintended medical error related to exhaustion, and lead to functional burnout. This situation may lead to a renewed intensification of economic emigration to other countries, both in the EU and outside the EU, which create more favourable working conditions for working life. The scale of the problem is  exacerbated by the increasing health needs of the aging population, causing an increasing burden on the health care sector, both in the near and distant future. This can create a vicious cycle where increasing burdens will drain physicians out of public health system, and increase the burden put on remaining physicians. The resulting restriction of access to medical services will lead to the deterioration of the health condition of the Polish population. In order to prevent such a situation, it would be necessary to increase the motivation to remain both in the medical profession and at work in Poland through actions aimed at improving working conditions and strengthening the sense of occupational safety of doctors. These activities should be especially aimed at group of medics starting their professional lives