Pandemia dezinformacji – prawno-psychologiczny punkt widzenia wobec internetowych ruchów antyszczepionkowych i altmedowych

Nowości, zwłaszcza gdy chodzi o dziedzinę ochrony zdrowia, od początku wzbudzały kontrowersje, objawiające się m.in. powstawaniem ruchów z przedrostkiem „anty” w nazwie. Nie może więc dziwić, że również w obecnej sytuacji pandemii i dużej dynamiczności zmian przepisów prawnych pojawiła się liczna grupa osób, które kwestionują słuszność lub prawdziwość szczepień bądź samej pandemii COVID­‑19 – jednakże, biorąc pod uwagę potęgę narzędzi, jakimi są Internet oraz social media, grupa ta uzyskała szeroką płaszczyznę wypowiedzi oraz dużą grupę odbiorców jej komunikatów. Polaryzacja poglądów na tzw. kontrowersyjne tematy nie jest zjawiskiem, którego nie można uzasadnić, jednakże jeśli w grę wchodzi tematyka zdrowia publicznego, denializm naukowy jest szczególnie niepokojący. Brak reakcji na negowanie osiągnięć oraz faktów nauki może mieć negatywny wpływ na kształtowanie społecznych postaw, zwłaszcza wobec tematów takich jak szczepienia. Jednocześnie stosowanie samych prawnych środków przymusu aparatu państwowego bez próby dogłębnej analizy źródła tego problemu, często wynikającego ze schematu działania ludzkiego mózgu oraz natury tego, jak działamy jako członkowie społeczeństwa, wydaje się być niewłaściwym podejściem. W swojej pracy analizuję prawne środki, jakie są możliwe do podjęcia w odniesieniu do ruchów antyszczepionkowych i altmedowych, oraz staram się wyjaśnić na płaszczyźnie socjopsychologicznej, dlaczego społeczeństwo jest i staje się coraz bardziej podatne na denializm naukowy.Innovations, especially in the field of health care, have aleays been controversial, which has been made particularly apparent, among other things, in the emergence of movements with the prefix “anti” in their names. It comes as no surprise, therefore, that even in the current situation of a pandemic and dynamic changes in legislation, a large group of people has emerged who question the validity or veracity of vaccinations or the COVID­‑19 pandemic itself. Using the power of tools such as the Internet and social media, this group has gained a wide platform for expressing their views and a large audience for their messages. Polarization of views on so­‑called controversial topics is not an unjustifiable phenomenon, but when it comes to public health issues, scientific denialism is particularly troubling. Failure to respond to the denial of the achievements and facts of science can have a negative impact on the formation of social attitudes, especially toward topics such as vaccination. At the same time, using legal coercive measures of the state apparatus alone, without attempting an in­‑depth analysis of the source of this problem, often stemming from the pattern of human brain activity and the nature of how we act as members of society, seems to be the wrong approach. In my paper, I examine the possible legal measures that apply to the anti­‑vaccine and alt­‑med movements and try to explain on a sociopsychological level why society is and is becoming increasingly susceptible to scientific denialism.Uniwersytet w BiałymstokuAdamczyk S., Surdykowska B., Świat pracy na bezdrożach. Refleksje wokół możliwych skutków pandemii COVID­‑19, „Praca i Zabezpieczenie Społeczne” 2020, t. 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on Public Health, „New York Times”, Feb. 1, 2015, https://www.nytimes.com/2015/02/02/us/a discredited­‑vaccine-studys­‑continuing-impact­‑on-public‑health.html [dostęp: 10.01.2020].Harrison E. A., Wu J. W., Vaccine confidence in the time of COVID­‑19, „European Journal of Epidemiology” 2020, Vol. 35, s. 325–330.Komisja Europejska, https://ec.europa.eu/info/strategy/priorities‑2019-2024/europe‑fit-digital‑age/digital‑services-act‑ensuring-safe‑and-accountable‑online-environment_pl [dostęp: 27.04.2021].Kunda Z., The Case for Motivated Reasoning, „Psychological Bulletin” 1990, Vol. 108, s. 480–498.Laskowski M., Nudging towards vaccination: behavioral law and economics approach to childhood immunization policy, „Texas Law Review” 2016, Vol. 94, No. 3, s. 601–628.Lazarus J., Ratzan S. C., Palayew A., Gostin L. O., Larson H. J., Rabin K., Kimball S., El-Mohandes A., A global survey of potential acceptance of a COVID­‑19 vaccine, „Nature Medicine” 2020, No. 27, s. 225–228.Lipowski P., Realizacja szczepień ochronnych – implikacje prawne, „Studia Prawnicze KUL” 2017, nr 3, s. 17–29Megget K., Even COVID‑19 can’t kill the anti­‑vaccination movement, „BMJ” 2020, Vol. 369, s. 1–2.Mercier H., The Argumentive Theory: Predictions and Empirical Evidence, „Trends Cognitive Science” 2016, Vol. 20(9), s. 689–700.Narodowy Instytut Zdrowia Publicznego – Państwowy Zakład Higieny, Na czym polega odporność zbiorowiskowa, https://szczepienia.pzh.gov.pl/faq/na­‑czym-polega‑odpornosc-zbiorowiskowa [dostęp: 10.01.2021].Nguyen A., Catalan-Matamoros D., Digital Mis/Disinformation and Public Engagement with Health and Science Controversies: Fresh Perspectives from COVID­‑19, „Media and Communication” 2020, Vol. 8(2), s. 323–228.Omer S. B., Salmin D. A., Orenstein W. A., DeHart M. P., Halsey N., Vaccine refusal, mandatory immunization, and the risks of vaccine – preventable diseases, „The New England Journal of Medicine” 2009, No. 360, s. 1981–1988, 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Protection of Medical Privilege in eHealth

This article exposes legal and moral concerns regarding medical privilege and safety of patients’ medical data in association with the area of eHealth. Digital technology in modern society provides unbelievable opportunities for patients, but also challenges for their privacy. The availability and incorporation of digital technology in almost every aspect of life provides not only opportunities, but also challenges. The security of medical information in the context of medical privilege seems to be at risk, especially in the mHealth area. This article focuses on the emerging privacy issues regarding medical privilege in eHealth. The article analyzes the framework for eHealth in the Polish legal system, with consideration of current legal acts, in relation to medical privilege and security of patients’ data, especially in m Health and the Internet of Things. Due to the delicate nature of information about patients in medicine, it is strongly needed to balance the safeguarding of data and privacy with the development of [email protected] Konopka – doktorantka w Pracowni Prawa Prywatnego Międzynarodowego, Katedry Prawa Cywilnego i Handlowego na Wydziale Prawa Uniwersytetu w Białymstoku, aplikantka radcowska.Uniwersytet w Białymstoku, PolskaAndrews L., A New Privacy Paradigm in the Age of Apps, “Wake Forest L.Rev” 2018, t. 3.Andrews L., Future Perfect: Confronting Decisions About Genetics, Columbia 2002.Banaszczyk Z., Formy prowadzenia działalności leczniczej, „Studia Prawa Prywatnego” 2016, nr 3.Drozd A., Ustawa o ochronie danych, Warszawa 2008.Gavison R., Privacy and the limits of law, “The Yale Law Journal” 1980, vol. 89, nr 3.Glanowski G., Telemedycyna w świetle ustawy o zawodach lekarza i lekarza dentysty, „Monitor Prawniczy” 2015, nr 18.Jackowski M. (red.), Ochrona danych medycznych. RODO w ochronie zdrowia, Warszawa 2018.Kubiak R., Tajemnica medyczna, Warszawa 2015.Lipowicz I., Szpor G., Świerczyński M. (red.), Telemedycyna i e-Zdrowie. Prawo i informatyka, Warszawa 2019.Sobczak J., Reshef M. (red.), Nowe procedury medyczne a prawo, Toruń 2016.Świtała K., Pacjent jako beneficjent ograniczeń jawności elektronicznej dokumentacji medycznej, Warszawa 2018.25224525

Significance of congestive heart failure as a cause of pleural effusion: Pilot data from a large multidisciplinary teaching hospital

Background: Epidemiological data on the causes of pleural effusion (PE) are scarce. Data on the local prevalence of various causes of PE may play a crucial role in the management strategy of patients with PE. The aim of the study was to investigate the causes of PE and to assess 30-day mortality rate in unselected adult patients treated in a large, multidisciplinary hospital. Methods: Retrospective analysis of medical records, including chest radiographs, of 2835 consecutive patients admitted to the hospital was performed. Radiograhic signs of PE were found in 195 of 1936 patients in whom chest radigraphs were available. These patients formed the study group. Results: The leading causes of PE were as follows: congestive heart failure (CHF; 37.4%), pneumonia (19.5%), malignancy (15.4%), liver cirrhosis (4.2%) and pulmonary embolism. The cause of PE in 6.7% patients was not established. There was a significant predominance of small volume PE as compared to a moderate or large volume PEs (153, 28 and 14 patients, respectively). Almost 80% of patients with CHF presented with small volume PE, while almost 50% of patients with malignant PE demonstrated moderate or large volume PE. Thirty-day mortality rate ranged from 0% for tuberculous pleurisy to 40% for malignant PE (MPE). Conclusions: Pleural effusion was found in 10.1% of patients treated in a large multidisciplinary hospital. CHF was the leading cause of PE. Although 30-day mortality in patients with CHF was rela­tively high, it was lower than that in parapneumonic PE and MPE

Dilatrometric sintering study and characterization of alumina-nickel composites

Alumina-nickel composite samples (with 0, 10 and 20 vol.% of Ni) are prepared via slip casting method. Nickel and aluminium oxide powders were used as precursors and diammonium hydrocitrate and citric acid were used as dispersants. The obtained materials were analysed by dilatometry, X-ray diffraction and SEM. The densities were measured by Archimedes method and the hardness and fracture toughness were determined by using Vickers hardness tester. Special attention was paid to the linear shrinkage and the effective coefficient of thermal expansion measurements. The shrinkage curves were obtained by dilatometry test in a heating mode. It was shown that the increased amount of Ni particles in Al2O3-Ni composite structure causes reduction of starting densification temperature, increasing temperature of maximum densification and decreasing total shrinkage of the sample during sintering

TEZY KONSERWATORSKIE 2015 – PROPOZYCJA REFORMY SŁUŻB OCHRONY ZABYTKÓW

The article explores directions of possible changes to be made to the model of monument protection. It not only recommends specific provisions but also focuses on a model understood as a structure of definitions and relations existing among them. This allows for rough description of a selected aspect of reality. The analysis comes down to deliberations on monument protection system, including necessary duties and competences of government and local government administration bodies. Effects of the principle of subsidiarity and decentralisation of Polish historic preservation administration were brought into special focus. Additionally, narrow scope of duties was determined for state and local government administration bodies.The article explores directions of possible changes to be made to the model of monument protection. It not only recommends specific provisions but also focuses on a model understood as a structure of definitions and relations existing among them. This allows for rough description of a selected aspect of reality. The analysis comes down to deliberations on monument protection system, including necessary duties and competences of government and local government administration bodies. Effects of the principle of subsidiarity and decentralisation of Polish historic preservation administration were brought into special focus. Additionally, narrow scope of duties was determined for state and local government administration bodies

An assessment of the usefulness of a coconut as a model of the human skull for forensic identification of a homicide weapon

The authors made an attempt to verify if a coconut can be used as a model of human skull to determine the homicide weapon. During our experiment 27 strike attempts were performed with the use of 9 different tools. Among them there were authentic murder weapons and instruments which had been used in similar experiments conducted on human skulls in 1955. Depending on the size of an area in contact with a coconut, weapons caused dents corresponding to the shape of a weapon, irregular fractures or long linear cracks. Our results have shown that coconut can be used as an inexpensive screening model of human skull, but only to determine fractures made by tools with small striking surface

Comparison of efficacy and safety of first-line palliative chemotherapy with EOX and mDCF regimens in patients with locally advanced inoperable or metastatic HER2-negative gastric or gastroesophageal junction adenocarcinoma : a randomized phase 3 trial

The aim of the study was to compare efficacy and safety of first-line palliative chemotherapy with (EOX) epirubicin/oxaliplatin/capecitabine and (mDCF) docetaxel/cisplatin/5FU/leucovorin regimens for untreated advanced HER2-negative gastric or gastroesophageal junction adenocarcinoma. Fifty-six patients were randomly assigned to mDCF (docetaxel 40 mg/m(2) day 1, leucovorin 400 mg/m(2) day 1, 5FU 400 mg/m(2) bolus day 1, 5FU 1000 mg/m(2)/d days 1 and 2, cisplatin 40 mg/m(2) day 3) or EOX (epirubicin 50 mg/m(2) day 1, oxaliplatin 130 mg/m(2) day 1, capecitabine 1250 mg/m(2)/d days 1–21). The primary endpoint was overall survival. The median overall survival was 9.5 months with EOX and 11.9 months with mDCF (p = 0.135), while median progression-free survival was 6.4 and 6.8 months, respectively (p = 0.440). Two-year survival rate was 22.2 % with mDCF compared to 5.2 % with EOX. Patients in the EOX arm had more frequent reductions in chemotherapy doses (34.5 vs. 3.7 %; p = 0.010) and delays in subsequent chemotherapy cycles (82.8 vs. 63.0 %; p = 0.171). There was no statistically significant difference in the rates of grade 3–4 adverse events (EOX 79.3 vs. mDCF 61.5 %; p = 0.234). As compared with the mDCF, the EOX regimen was associated with more frequent nausea (34.5 vs. 15.4 %), thromboembolic events (13.8 vs. 7.7 %), abdominal pain (13.8 vs. 7.7 %) and grades 3–4 neutropenia (72.4 vs. 50.0 %), but lower incidences of anemia (44.8 vs. 61.5 %), mucositis (6.9 vs. 15.4 %) and peripheral neuropathy (6.9 vs. 15.4 %). In conclusion, the mDCF regimen was associated with a statistically nonsignificant 2.4-month longer median overall survival without an increase in toxicity. This trial is registered at ClinicalTrials.gov, number NCT02445209