Proste interwencje poprawiające przestrzeganie zaleceń terapeutycznych przez dzieci z przewlekłymi chorobami wątroby — doświadczenia jednego ośrodka i przegląd piśmiennictwa

Leczenie przewlekłych chorób wątroby u dzieci często jest nieskuteczne ze względu na nieprzestrzeganie zaleceń terapeutycznych. Celem pracy było wypracowanie prostych, łatwych do wprowadzenia interwencji poprawiających akceptację przewlekłego leczenia przez dzieci. W bazie PubMed przy użyciu słów kluczowych: adherence, compliance, therapy, chronic diseases, children wyszukano anglojęzyczne publikacje z ostatnich 10 lat, poświęcone przestrzeganiu zaleceń terapeutycznych przez dzieci, skupiając się na chorobach wątroby. Następnie przeprowadzono dyskusję okrągłego stołu, mającą na celu wypracowanie interwencji poprawiających akceptację długotrwałego leczenia. W dyskusji wzięli udział pracownicy Kliniki Pediatrii i Chorób Infekcyjnych we Wrocławiu (9 lekarzy, średni staż pracy 15 lat) — ośrodek ten zajmuje się dziećmi z przewlekłymi chorobami wątroby w wieku 0–18 lat. W ostatnich 5 latach odnotowano: 556 przypadków zachorowań na zapalenie wątroby typu B, 409 na zapalenie wątroby typu C, 37 na chorobę Wilsona, 50 na autoimmunologiczne zapalenie wątroby, 39 na niealkoholowe stłuszczeniowe zapalenie wątroby oraz 138 nieprawidłowych prób wątrobowych. Wyszukiwanie PubMed przyniosło 321 wyników. Na podstawie streszczeń do dyskusji wybrano 7 publikacji. Za czynniki sprzyjające nieprzestrzeganiu zaleceń uznano: przyjmowanie licznych tabletek, zwłaszcza kilka razy dziennie, terapię lekami o częstych działaniach ubocznych, brak wiedzy o możliwych działaniach ubocznych, wieloletnie leczenie, chorobę Wilsona, wiek dojrzewania, częstą zmianę lekarza prowadzącego i niski status społeczno-ekonomiczny. Za interwencje poprawiające adherencję uznano: budowanie bardziej osobistych relacji z pacjentem, zaangażowanie emocjonalne, zainteresowanie problemami zdrowotnymi oraz osobistymi nastolatków (np. stały lekarz prowadzący), zmniejszenie liczby przyjmowanych tabletek przez stosowanie wyższych dawek, uprzedzenie o możliwych działaniach niepożądanych, zwiększenie częstości konsultacji, regularną kontrolę prób wątrobowych w celu wczesnego wykrycia przerwania leczenia, edukację dzieci na temat ich choroby i telefoniczne nadzorowanie leczenia. Wyniki leczenia dzieci z przewlekłymi chorobami wątroby można poprawić przez wprowadzenie prostych interwencji zwiększających akceptację dla terapii, na przykład częstsze kontrole, bardziej osobiste relacje z lekarzem prowadzącym, zmniejszenie liczby tabletek oraz edukację pacjentów i ich rodziców na temat choroby. Forum Medycyny Rodzinnej 2011, tom 5, nr 4, 345–35

Development of internal audit systems in Polish university hospitals

Objectives: The purpose of this article is to discuss the regulations on and the functioning principles for internal audits in the Polish health care system. Additionally, this study presents selected results of empirical research with regard to the effectiveness of internal audits in university hospitals. Research Design & Methods: To determine the research problems related to the functioning of the internal audit systems in selected university hospitals the authors analysed specialist literature and reviewed earlier studies addressing this question. On the basis of the analysis of such literature and applicable legislation the authors prepared an anonymous questionnaire and distributed it among internal auditors from a number of university hospitals in the voivodship (region) of Western Pomerania, including the city of Szczecin, and in the city of Poznań. Findings: This paper discusses the legal basis and functioning principles for internal audits in the Polish health care sector. On the basis of a pilot survey study carried out in selected university hospitals in Poland the authors evaluated internal audit efficiency. This study has shown that the perception of the auditor’s role and auditing efficiency varies significantly in comparable institutions. These conclusions should be considered as an inspiration for more advanced studies. Implications / Recommendations: The constantly growing scope of health care institutions bound by the internal audit obligations shows that such audits are indeed necessary and demonstrates the efficiency of internal audits in the public sector. Contribution / Value Added: The authors point to potential further research on internal audit efficiency in the Polish health care system

Comply or explain principle in the context of corporate governance in companies listed at the Warsaw stock exchange

PURPOSE: The objective of this article is to evaluate to what extent Corporate Governance Statements (CGS) prepared by companies listed on the Warsaw Stock Exchange (GPW) are consistent with Best Practice for GPW Listed Companies.DESIGN/METHODOLOGY/APPROACH: In the first part we applied critical review of subject literature and the monographic method. In the second part, the content analysis method was used, and the basic source material were the CGS for 2018 and 2019. The study group consisted of all WIG20, MWIG40 and sWIG80 companies listed on Warsaw Stock Exchange that submitted their 2018and 2019 reports (280 reports). The CGS were studied using methods including content analysis, comparative and descriptive analysis, and induction.FINDINGS: The analysed CGS helped to answer the question to what extent GPW listed companies pursue the “comply or explain” principle regarding compliance with corporate governance principles and recommendations specified in Best Practice for GPW. The authors investigated whether and to what extent Best Practice is applied and whether the disclosures are useful for the stakeholders. The results indicate that the examined companies follow different approaches to the corporate governance reporting obligations.PRACTICAL IMPLICATIONS: Indicating the gap between the expected and the actual scope of disclosures regarding the corporate governance in CGS, which are the primary source of nonfinancial information for a listed company.ORIGINALITY/VALUE: The study leads to a general conclusion that the imperfect scope of the reported corporate governance information, as well as the quality and usefulness of the disclosures, consists both in the alignment between Best Practice for GPW Listed Companies and currently applicable regulations in Poland, and in the way, companies choose to follow the said document. The study fills a research gap in non-financial disclosures in annual reports. The paper also indicates directions for further study.peer-reviewe

Assessment of the level of implementation of internal audits in Polish public hospitals

Purpose: The aim of the article is to evaluate the work of internal audit units in Polish public hospitals. An additional objective was the assessment of the indicators used by the Ministry of Finance (MF) to verify the work of auditors in government administration units. Design/Methodology/Approach: The authors have analysed specialized literature concerning audit issues in hospitals analyzing data included in the MF reports for 2012-2019, presenting indicator values related to internal audits, their quality and efficiency. Findings: Studying the literature of the subject revealed that there is a research gap concerning evaluation of the efficiency of internal audits at hospitals. Practical Implications: The authors’ analysis of MF reports of internal audit units in hospitals and the interpretation of the indicators contained in them enabled evaluation of the functioning of internal audits at analysed hospitals and determining their position compared to other entities from the research sample. Indicator values for hospitals vary from those obtained from other public sector units, as particular public finance sector units’ function in various legal and organizational environments and vary in operational aims and specificity. Originality/Value: The results from the conducted analysis should be regarded as a starting point for more advanced evaluation studies of the functioning of internal audits in hospitals.peer-reviewe

Silver-doped TiO2 prepared by microemulsion method: Surface properties, bio- and photoactivity

A series of Ag-TiO2 photocatalysts were obtained in microemulsion system (water/AOT/cyclohexane), using several Ag precursor amounts ranging from 1.5 to 8.5 mol.%. The photocatalysts’ characteristics by X-ray diffraction, STEM microscopy, UV–vis spectroscopy, X-ray photoelectron spectroscopy, BET methods showed that a sample with the highest photo- and bioactivity had anatase structure, about 90m2/g specific surface area, absorbed light over 400nm and contained 1.64 at.% of silver (0.30 at.% of Ag0 and 1.34 at.% of Ag2O) and about 13 at.% of carbon in the surface layer. The photocatalytic activity of the catalysts was estimated by measuring the decomposition rate of phenol in 0.21mM aqueous solution under visible and ultraviolet light irradiation. The bioactivity of silver-doped titanium dioxide nanocomposites was estimated using bacteria Escherichia coli and Staphylococcus aureus, yeast Saccharomyces cerevisiae and pathogenic fungi belonging to Candida family. All modified powders showed localized surface plasmonresonance (LSPR) in visible region with almost the same position of LSPR peaks indicating that similar sizes of silver, regardless of used amount of Ag, is deposited on titania particles during microemulsion method. STEM microscopy revealed that almost 50% of observed silver nanoparticles deposited at the TiO2 surface are in the range from 5 to 10 nm