The need of prenatal public health initiatives in Poland

The author emphasizes the achievements of the Polish Gynecological Society in the field of improving the health indicators concerning perinatal mortality among infants during the last two decades in Poland. Attention is paid to the contribution of the members of the Society to organizational change in Polish health care after 1990, which resulted in the improvement of the care of mother and child. It is also underlined that the members of the Society contributed to the creation of early detection system of breast and cervical cancer in Poland. However, it is noteworthy that in ‘Polish Gynecology’ – the publication of the Polish Gynecological Society – the number of reports devoted to risky health behaviors of women during periconceptional period and pregnancy is scarce. The author draws attention to the percentage of women who smoke cigarettes and consume alcohol before and during pregnancy. Emphasis is also placed on the problem of nutritional disorders (mainly pathological methods of dieting) among Polish women during the reproductive period and in the first weeks of pregnancy (before the pregnancy is confirmed). These aspects may result in epigenetic changes shaping the phenotype of the offspring. The author refers to the Barker’s theory of Developmental Origins of Adult Diseases and warns that the abovementioned health behaviors of women may bring about negative effects for the offspring and future generations, namely susceptibility to chronic diseases: arterial hypertension, obesity, type 2 diabetes and metabolic syndrome. Negative effects for the health of offspring may also result from low level of physical activity of women before and during pregnancy. The author concludes that it is necessary to intensify the efforts of the Polish Gynecological Society in the areaof prenatal public health

Wpływ czynników społeczno-demograficznych i klinicznych na jakość życia chorych na padaczkę

Background. Epilepsy is one of the most common neurological disorders. Its diagnosis affects the level and quality of life, as well as the daily functioning of people suffering from this disease. Their quality of life assessment is equally dependent on biological, psychological and social factors.Aim. The aim of this study was to determine the relationship between the quality of life of epileptic patients and socio-demographic and clinical factors.Material and methods. The study involved 154 people suffering from epilepsy. Most of them lived in a city with over 60.000 inhabitants and had secondary education. More than a half were retired. The method used in the study was a diagnostic survey. The study adopted surveying as a research technique. A statistical analysis of the results was carried out using the Statistica for Windows 9.0 statistical package. The p values p<0.05 were considered statistically significant.Results. A statistically significant correlation between the quality of life of epileptic patients and socio-demographic factors like: a place of residence (χ2=35.31; p=0.008), education (χ2=56.47; p=0.0007), professional status (χ2=71.86; p=0.0003), and age (χ2=31.16; p=0.02). There was no correlation between the quality of life of people with epilepsy and their sex (χ2=15.61; p=0.07) and marital status (χ2=30.35; p=0.2). The results displayed no relationship between the quality of life and seizure frequency (χ2=43.88; p=0.1) and the number of hospitalizations (χ2=34.15; p=0.5).Conclusions. The higher the level of education and professional activity, the higher the subjective assessment of the quality of life of patients. Respondents living in urban agglomerations asses their quality of life higher compared to those living in rural areas. The older the respondents and the longer disease, the worse the subjective assessment of the quality of life and health. (PNN 2013;2(4):155-164)Wprowadzenie. Padaczka jest jednym z najczęstszych neurologicznych zespołów chorobowych. Jej rozpoznanie rzutuje na poziom i jakość życia chorego na padaczkę, jego codzienne funkcjonowanie, a ocena jakości życia zależy w jednakowej mierze od czynników biologicznych, psychicznych i społecznych.Cel. Celem badań było określenie zależności, między jakością życia a czynnikami społeczno-demograficznymi i klinicznymi osób chorych na padaczkę.Materiał i metody. W badaniach uczestniczyły 154 osoby chore na padaczkę. Większość mieszkała w mieście powyżej 60 tys. mieszkańców i posiadała wykształcenie średnie. Ponad połowa była na rencie. W pracy zastosowano metodę sondażu diagnostycznego. W obrębie sondażu uwzględniono ankietowanie jako technikę badawczą. Analizę statystyczną wyników przeprowadzono za pomocą pakietu statystycznego Statistica for Windows 9.0. Za istotne przyjęto prawdopodobieństwo testowe na poziomie p<0,05.Wyniki. Wykazano istotną statystycznie zależność pomiędzy jakością życia osób chorych na padaczkę a takimi czynnikami społeczno–demograficznymi, jak: miejsce zamieszkania (χ2=35,31; p=0,008), wykształcenie (χ2=56,47; p=0,0007), status zawodowy (χ2=71,86; p=0,0003), wiek (χ2=31,16; p=0,02). Nie stwierdzono zależności między jakością życia osób na padaczkę a płcią (χ2=15,61; p=0,07) i stanem cywilnym (χ2=30,35; p=0,2). Wykazano brak zależności między jakością życia a częstością napadów padaczkowych (χ2=43,88; p=0,1) i liczbą hospitalizacji (χ2=34,15; p=0,5).Wnioski. Im wyższy jest poziom wykształcenia i aktywności zawodowej, tym wyższa jest subiektywna ocena jakości życia badanych. Ankietowani zamieszkujący aglomeracje miejskie wyżej oceniają jakość życia niżeli mieszkańcy wsi. Im starsi badani i dłuższy czas trwania choroby, tym gorsza subiektywna ocena jakości życia i stanu zdrowia. (PNN 2013;2(4):155-164

Diabetes and depression : a combination of civilization and life-style diseases is more than simple problem adding : literature review

The article presents a review of current medical and psychological literature published between 2000 - 2010, with the use of the PubMed database, concerning the occurrence of anxiety and depression in diabetic patients, with particular consideration of those aff ected by complications. Anxiety and fear are the most frequent emotional disorders among diabetic patients. Depression occurs in approximately 30% of patients with diabetes. Both diabetes and depression belong to so called ‘life style’ or ‘civilization diseases’. Numerous studies have confi rmed that the course of depression in patients with diabetes is more severe, and the relapses of depression episodes are more frequent. The studies show that diabetic patients experience various types of psychosocial and emotional problems due to which the monitoring of own state of health is not the priority in life. In the process of treatment of both sole diabetes and concomitant anxiety and depression it is important to adjust and motivate patients to apply widely understood therapeutic recommendations. The treatment of depression syndrome in the course of diabetes does not have to lead to improvement in glycaemic control. The following factors infl uencing the therapeutic eff ect should be mentioned: duration of diabetes, presence of complications, and the eff ect of the drugs applied on body weight, or possibly initial diabetes management. It seems, therefore, that the patient education model based on the provision of knowledge concerning diabetes and its complications, methods of treatment, principles of nutrition and health-promoting life style, may be insuffi cient, at least for patients with depression. The results of a review of reports shows that an optimum treatment of diabetes, in accordance with the current state of knowledge, requires from physicians a special consideration of psychological and psychiatric knowledge for the 2 following reasons: 1) eff ectiveness of therapy to a high degree depends on the proper behaviour of a patient; 2) considerably more frequent, compared to the total population, occurrence of the symptoms of emotional disorders negatively aff ect the course of diabetes

Comparison of maternal and fetal blood levels of caffeine and its metabolite. A pilot study

Objective: The aim of the study was to compare caffeine and paraxanthine concentrations in venous blood of pregnant women and in the umbilical cord blood of their newborns. Materials and Methods: Pregnant women who gave birth at the Clinic of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw were included in the study. Caffeine and paraxanthine concentrations were analyzed in 30 samples of venous blood serum drawn from the women before delivery and 30 samples of umbilical cord blood serum of their newborns. Caffeine intake in the last 24 hours before delivery was estimated using a questionnaire. Statistical analysis employed a linear logistic regression model, Wilcoxon rank sum test and a non-parametric Spearman’s rank correlation coefficient. Results: No difference was found between caffeine concentration in maternal venous blood and neonatal umbilical cord blood. However, paraxanthine level in venous blood was higher than in umbilical cord blood (p = 0.04). Conclusions: Caffeine consumed by a pregnant woman passes through the placenta to the fetus freely

Włoszczak-Szubzda A, Jarosz MJ. Professional communication competences of nurses

Abstract Introduction: Dissonance between the high 'technical' professionalism of nurses and the relatively low level of patient satisfaction with care received is a phenomenon observed in many countries. Many studies show that it occurs in the case of an inadequate interpersonal communication between nurses and patients. Methods: Three basic scopes of communication competences were involved in the research process: a) motivation, b) knowledge, c) skills, and the following three methods were used: 1) documentation analysis (standards, plans and educational programmes); 2) diagnostic survey concerning professional communication competences of nurses in nursing care -a questionnaire form designed by the authors; 3) self-reported communication skills in nursing care -adjective check list. The study group covered a total number of 108 respondents in the following subgroups: 1) professional nurses who, as a rule, were not trained in interpersonal communication (42 respondents); students of nursing covered by a standard educational programme (46 respondents); 3) students of nursing who, in addition to a standard educational programme, attended extra courses in professional interpersonal communications nursing (20 respondents). The data obtained were subjected to statistical analysis with the use of descriptive statistics and hypothesis testing

Nutrition and lifestyle in patients pharmacologically treated due to hypertension

Background: Proper nutrition and physical activity are together an important way of non-pharmacological treatment of arterial hypertension. The aim of the study was to answer the question whether patients with hypertension use non-pharmacological methods of hypertension treatment. Methods: The study included a group of 280 patients aged 18–85, suffering from hypertension. In the study, 10 nutritional and non-nutritional factors affecting the treatment of hypertension were analyzed. Data regarding the diet were collected by a method of 24-h recall. Basic anthropometric measurements (body weight, body height, waist and hip circumference) were taken, as well as threefold measurement of blood pressure. The data were statistically analyzed. Results: The average value of blood pressure was 131.2 ± 15.5/82.9 ± 10.5 mm Hg. Approximately 90% of the respondents had abnormal body weight, i.e. excessive weight or obesity. Abdominal obesity according to waist hip ratio assessment was diagnosed in 87% of women and 66% of men; according to the measurement of waist circumference, it was diagnosed in 140 (81%) women and 88 (81%) men. Among the ingredients with antihypertensive effect, the sodium intake was 4,417.8 ± 2,052.7 mg/d, which when converted to salt is on average 11 g/d, potassium: 3,808.5 ± 1,265.7 mg/d, calcium: 724.6 ± 413.7 mg/d, and magnesium: 383.9 ± 139.3 mg/d. One in 5 (18%) people declared smoking. Only 5% of subjects reported high level of physical activity. Conclusions: In persons with diagnosed hypertension, vast majority of patients did not implement non-pharmacological hypertension treatment