Weight stigma and fat phobia in Poland – attitudes towards people living with obesity and the level of knowledge about obesity among the social media internet respondents and medical professionals

IntroductionObesity often subjects individuals to stigmatization, impacting self-esteem, contributing to depression, social isolation, and even exacerbating weight gain. Our research aimed to evaluate weight stigma, fat phobia, their expressions, and obesity-related knowledge among social media internet respondents and medical practitioners in Poland.MethodsConducted through Computer-Assisted Web Interview (CAWI), our study employed the Fat Phobia Scale (FPS) and tailored questions, analyzing 1705 questionnaires.ResultsThe respondents averaged a score of 3.60  ±  0.62 on the FPS. Interestingly, men exhibited higher stigma levels than women. Variables like BMI, residency, and interactions with people having obesity did not significantly impact stigma levels. Approximately 74.0% of respondents found individuals with obesity less attractive than those with normal weight, while 32.2% identified obesity as a cause of shame. Only 69.1% were aware of the BMI-based obesity diagnosis criterion.ConclusionGiven limited knowledge of Poland’s weight stigma landscape, our research yields crucial insights for shaping social campaigns and enhancing educational initiatives in obesity management for healthcare professionals. Further studies will be instrumental in addressing patient and practitioner needs effectively

The comparison of use of antibiotics due to acute respiratory infections in the rural population of primary care in 2010 and 2017

Respiratory tract infections are the most common reason because of which patients report to a family doctor. The role of the family doctor is to assess both the symptoms suggesting the aetiology of infection, as well as performing additional tests, in order to make a definitive diagnosis. An increasing clinical problem is antibiotic resistance. Therefore, the objectives of this study were to assess and compare antibiotic use due to acute respiratory infections in the rural primary care population for over a 7-year period. A retrospective examination of electronic medical records covered 4355 declared patients in 2010 and 3959 patients declared in 2017. The analysis included advice - medical consultations due to acute respiratory infections, related or not related to the antibiotic prescription. In 2010, 2531 such consultations were given, and in 2017 - 1687. The results of our analysis indicate that in the surveyed rural population there was a decrease in both the frequency of consultations for respiratory infections (58.12% vs 42.61%) and the frequency of prescribing antibiotics / chemotherapeutics for this reason (50.8% vs 34, 6%). The type of antibiotic, which was most often used in the diagnosis of J06 (dominating both in 2010 and in 2017), has changed as well - from azithromycin to amoxicillin. The structure of diagnoses of respiratory tract infections systemized by ICD-10 has also been slightly changed. The reducing frequency of prescribing antibiotics as well as the change of the "first choice" antibiotic in the treatment of acute respiratory infections is a favorable trend and may result from the doctors' greater awareness of antibiotic resistance. Likewise, the change in the structure of diagnoses made by doctors from unspecified to specific ones may indicate greater awareness, resulting in treating specific diseases with targeted antibiotics. Further studies are needed to assess the choice of antibiotic therapy by the general practitioner

The role of interleukin-18 in the pathogenesis of bronchial asthma and other allergic diseases and in activation of basophils and mastocytes

Interleukina 18 (IL-18) jest prozapalną cytokiną produkowaną przez szereg komórek, biorącą udział w patogenezie chorób o podłożu zapalnym jak na przykład astma atopowa. Wykazano, że IL-18 wpływa na limfocyty T, wywołując nadwrażliwość drzewa oskrzelowego oraz rozwój stanu zapalnego. Ponadto stymuluje limfocyty Th1 do wydzielania cytokin i chemokin stymulujących nacieki w drogach oddechowych i odczyn zapalny. Pobudza także mastocyty i bazofile biorące udział w odczynie atopowym. Astma atopowa jest chorobą charakteryzującą się eozynofilowymi naciekami w drogach oddechowych wraz z remodelingiem, nadmiernym wydzielaniem śluzu oraz wysokimi stężeniami IgE w surowicy. Wyniki ostatnich badań wykazały, że w patogenezie astmy rolę odgrywa także odpowiedź immunologiczna typu Th2 związana z atopią oraz rozwojem stanu zapalnego przy udziale IgE oraz prozapalnych cytokin, jak na przykład Il-18. W niniejszym opracowaniu omówiono rolę IL-18 w aktywacji mastocytów i bazofili oraz patogenezie chorób atopowych.Interleukin-18 is a proinflammatory cytokine produced by a wide range of cells and is involved in the pathogenesis of several inflammatory diseases such as atopic asthma. It was recently demonstrated that IL-18 acts on T cells to induce airway inflammation and airway hyperresponsiveness. These observations strongly indicate that IL-18 stimulates Th1 cells to produce cytokines and chemokines responsible for the airway infiltration and inflammatory responsiveness. Moreover IL-18 activates mast cells and basophils playing the important role in atopy. Atopic asthma is characterized by eosinophilic airway inflammation, remodeling, mucus hypersecretion and high serum levels of IgE. Most current data suggest that asthma drives development of a Th2 lymphocyte-predominant immune response, which is associated with atopy and IgE mediated inflammation via pathways involving the production of proinflammatory cytokines such as IL-18. Here we discuss the functional role of IL-18 in activation of mast cells and basophils and pathogenesis of allergic diseases

Attitudes and delivering brief interventions for heavy drinking in primary health care: analyses from the ODHIN five country cluster randomized factorial trial

Contains fulltext : 170028.pdf (publisher's version ) (Open Access)In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers' screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity

Impact of practice, provider and patient characteristics on delivering screening and brief advice for heavy drinking in primary health care secondary analyses of data from the ODHIN five country cluster randomized factorial trial

BACKGROUND: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. OBJECTIVES: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline. METHODS: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised. RESULTS: Nurses tended to screen more patients than doctors (OR = 3.1; 95%CI: 1.9, 4.9). Screen-positive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95%CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95%CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status. CONCLUSIONS: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552

Impact of primary health care providers’ initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

Background: Brief interventions in primary healthcare to detect and intervene in risky alcohol consumption are cost-effective in reducing drinking problems, but poorly implemented in routine care. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.Methods: In a cluster randomised factorial trial 120 Primary Healthcare Units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. Results: Data from 746 providers of 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore there were no significant interactions between these characteristics and allocated groups. Conclusions: The extent to which providers’ managed to change their brief intervention proportions when submitted to different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research more attention is needed for the causal relation between these parameters, as it can inform us whether to focus on these or not in implementation trajectories

Oral Health Related Behaviors in Relation to DMFT Indexes of Teenagers in an Urban Area of North-West Poland—Dental Caries Is Still a Common Problem

Caries has a negative influence on health and is still a public health problem among children and adolescents in Poland. The aim of this study was to analyze the association of dietary habits, oral hygiene behaviors and the frequency of usage of dental services with the dental caries index in teenagers in North-West Poland. The study enrolled 264 children (147M/117F) aged 15. Participants filled out a questionnaire regarding age, sex, frequency of visits to the dentist, dietary habits and oral hygiene behaviors, and the Decayed Missing Filled Teeth Index (DMFT) was calculated. Caries was found in 88.6% of subjects. The lower or no caries experience group (DMFT ≤ 5) comprised of 180 subjects, while higher caries experience (DMFT > 5) was found in 84 teenagers and was significantly inversely associated with tooth brushing after the last meal (OR = 0.45; 95% CI:0.21–0.97; p = 0.04) and the daily use of dental floss (OR = 0.12; 95% CI:0.01–0.92; p = 0.04). There is an emerging need for the implementation of effective caries prevention and recovery programs in Poland. Health promotion focusing on oral hygiene behaviors should be disseminated more widely because lower caries experience was demonstrated in teenagers declaring healthy oral habits. Another important need is the development of multi-sectorial actions aiming at the improvement of dietary habits

Wpływ suplementacji kwasem foliowym na parametry krzepnięcia, zapalne, lipidowe i funkcję nerek u osób z niską i średnią zawartością kwasu foliowego w diecie

Background: The human body requires folic acid (FA) to produce blood cells, secure cell division, and growth. Moreover, this vitamin is important in the prevention of cardiovascular disease (CVD). Because the results of studies on the use of FA in the prevention of CVD are ambiguous, it seems necessary to conduct further research, which will explain in which cases supplementation is effective. Aim: To assess the impact of FA supplementation on the coagulation, inflammatory, lipid parameters, and kidney function in subjects with atherosclerosis risk factors, depending on the content of FA in their diet. Methods: The study enrolled 97 young adult Caucasian individuals (34 males and 63 females) with atherosclerosis risk factors. This population was divided into two groups: A — with low content of FA in the diet (< 40% of reference daily intake) and B — with moderate content of FA in the diet (40–90% of reference daily intake). The participants were asked to take FA in the low-dose of 0.4 mg/24 h for 3 months. Results: Low-dose FA supplementation resulted in elevation of FA concentrations (79% vs. 75.1%) in the studied groups and, concomitantly, a decrease in homocysteine concentrations (21% vs. 20.3%). Mean level of creatinine decreased after FA supplementation in both groups (0.93 ± 1.1 vs. 0.72 ± 0.15 mg/dL and 0.83 ± 0.16 vs. 0.77 ± 0.15 mg/dL). These differences were statistically significant (p < 0.0001). The difference in mean estimated glomerular filtration rate values before and after FA supplementation was statistically significant in group A (p = 0.002) and on the border of statistical significance in group B (p = 0.06). Conclusions: FA supplementation has no influence on the coagulation, inflammatory and lipid parameters in subjects with atherosclerosis risk factors depending on the content of FA in their diet. However FA supplementation may have a beneficial effect on kidney function in subjects with low content of FA in the diet.  Wstęp: Ludzki organizm wymaga kwasu foliowego (FA) do produkcji krwinek oraz zabezpieczenia podziału komórek i ich wzrostu. Ponadto ta witamina jest ważna w prewencji chorób sercowo-naczyniowych (CVD). Przeprowadzono wiele szeroko zakrojonych badań klinicznych obejmujących duże populacje, w których oceniano użycie FA w prewencji przede wszystkim udaru mózgu i zawału serca. Większość tych badań dotyczyła jednak profilaktyki drugorzędowej. Ponieważ wyniki stosowania FA w profilaktyce CVD są niejednoznaczne, konieczne wydaje się prowadzenie dalszych badań, które wyjaśnią, w jakich przypadkach suplementacja jest korzystna. Cel: Celem badania była ocena wpływu suplementacji FA na parametry krzepnięcia, zapalne, lipidowe i funkcję nerek u osób z czynnikami ryzyka miażdżycy, w zależności od wyjściowego stężenia FA w ich diecie. Metody: Do badania włączono 97 młodych osób dorosłych (34 mężczyzn i 63 kobiety) z czynnikami ryzyka miażdżycy, takimi jak dodatni wywiad rodzinny w kierunku przedwczesnego udaru niedokrwiennego mózgu, nadciśnienie tętnicze, dyslipidemia, nadwaga i otyłość, palenie tytoniu, niska aktywność fizyczna. Populacja została podzielona na dwie grupy: A — z niską zawartością FA w diecie (< 40% zalecanego spożycia) i B — ze średnią zawartością FA w diecie (40–90% zalecanego spożycia). Uczestników badania poproszono o przyjmowanie FA w niskiej dawce 0,4 mg/24 h przez 3 miesiące. Zaproponowana dawka została ustalona na podstawie doniesień z piśmiennictwa i wcześniejszych badań autorów. We krwi badanych oznaczono stężenia: FA, homocysteiny, profilu lipidowego — cholesterolu całkowitego, frakcji HDL, frakcji LDL i triglicerydów, apolipoproteiny AI, apoliporoteiny B, lipoproteiny (a), czynnika von Willebranda, fibrynogenu, białka C-reaktywnego i kreatyniny. Wyniki: Suplementacja niskimi dawkami FA spowodowała wzrost jego stężeń (79% vs. 75,1%) w obu grupach ze współtowarzyszącym obniżeniem stężeń homocysteiny (21% vs. 20,3%). Jednak różnice te nie były istotne statystycznie. Różnice w średnich stężeniach parametrów krzepnięcia, zapalnych i lipidowych nie były znamienne statystycznie po suplementacji FA. Średnie stężenie kreatyniny obniżyło się po suplementacji FA w obu grupach badanych (odpowiednio 0,93 ± 1.1 vs. 0,72 ± 0,15 mg/dl i 0,83 ± 0,16 vs. 0,77 ± 0,15 mg/dl). Różnice te były istotne statystycznie (p < 0,0001). Średnie wartości estymowanego wskaźnika filtracji kłębuszkowej przed suplementacją i po suplementacji FA różniły się znamiennie w grupie A (p = 0,002) i były na granicy istotności statystycznej w grupie B (p = 0,06). Wnioski: Suplementacja FA nie wpływa na parametry krzepnięcia, zapalne i lipidowe u osób z czynnikami ryzyka miażdżycy w zależności od wyjściowego stężenia FA w ich diecie. Jednak podaż FA może mieć korzystny wpływ na funkcję nerek wśród osób z niską zawartością FA w diecie. Poprawa w zakresie funkcji nerek może się wiązać z korzystnym wpływem FA na śródbłonek naczyń.