The role of the key educational paths for ESA new member states as a risk reduction index for the newcomers

The new ESA member states are an important factor in the development of European sustainability and independence in space. Cooperation between European countries in the field of space, gives a strong conviction that we operate without borders in space. It is therefore necessary to create not so much international links, but rather supranational ones. This also applies to space education. One of the primary missions of ESA is to create a community of highly specialized engineers, managers, as well as scientists who will focus on developing the space economy and allowing societies to understand our role and interactions with space. Based on the experience gained in the period after Poland's accession to ESA, the authors would like to emphasize the role of key educational pathways that can guide ESA officers in new member countries and in any country that has already entered ESA structures or plans to enter in the near future. The authors would like to emphasize that there are several ways to share and improve knowledge and would like to present the main insights of the study conducted in this respect. Drawing on the Polish space industry and using it as a reference basis, but also applying some observations from the Czech Republic and now Latvia, the authors identified the following main learning paths: • The activity of students within student associations, who implement space projects through dedicated programs; • The role of YGTs who, after a period of training at ESA, return with a set of knowledge to their countries; • The importance of the know-how of the international space market, in particular global companies setting up subsidiaries in new ESA member countries and bringing their experience and knowledge there; • Dedicated educational programs for people who do not have a formal space education (engineering) but want to develop in various areas of the space industry; The sequence of the presented educational pathways is not accidental. The authors want to present the role of each pathway and show how it can be applied in practice. The authors recognize some deficiencies in the presented pathways, as well as note a trend towards strengthening interest in dedicated educational programs at the undergraduate and postgraduate levels. Based on their own educational experience and taking into account the status quo of space education (at least) in central Europe, the authors would like to present ideas for structuring professional education in the space industry, taking into account its recent changes, where the demanding factor of business competition should be added to the technological factor. So, where an interdisciplinary approach should be adopted. Each educational pathway has been analysed from the point of view of risks and opportunities. This analysis can be applied by new participants in the commercial space market (understood as new companies or scientific groups), but also by new ESA member states at the institutional level

Comparison of results of sequential home oxygen therapy in patients using stationary or portable oxygen sources

Introduction: In long term oxygen therapy (LTOT) two oxygen sources are used, i.e. the stationary oxygen concentrator (OC) and portable liquid oxygen (LO). Polish NHS reimburses stationary oxygen sources only. The aim of this study was to compare the effect of change from OC into LO in patients treated using LTOT. Material and methods: The study involved 30 patients qualified to LTOT. The degree of dyspnoea intensity, (MRC, Borg scale), exercise tolerance (6MWT), fitness, daily use of oxygen therapy, red blood count, lung function, number of exacerbations as well as health related quality of life (SGRQ) were assessed before introduction of LTOT, after 6 months of oxygen therapy using OC and after 6 months from change into LO. Results: During first 6 months RBC decreased from 5.4 to 5.1 (p < 0.0001), HTC from 50.1% to 47.8% (p < 0.0001), 6MWD increased from 337.7 to 378.7 m (p < 0.0001), SGRQ score improved from 72.1 points to 64.4 points (p < 0.0001). Treatment with LO resulted in further improvement in studied parameters: RBC decreased from 5.1 to 4.8 (p < 0.0001), HTC from 47.8% to 44.3% (p < 0.0001), 6MWD increased from 378.7 m to 413 m (p < 0.0001), SGRQ score improved from 64.4 points to 54.9 points (p < 0.0001). Significant increase in daily oxygen breathing hours from 13.7 to 18.9 (p < 0.0001) was also observed. Conclusions: Use of liquid oxygen enables oxygen therapy at home and during ambulation and increases oxygen breathing hours, thus improving red blood count, exercise capacity and health related quality of life.Wstęp: W domowym leczeniu tlenem (DLT) korzysta się z dwóch źródeł tlenu: stacjonarnego koncentratora tlenu (KT) i przenośnego tlenu ciekłego (TC). W Polsce Narodowy Fundusz Zdrowia finansuje DLT za pomocą KT. Celem pracy było porównanie wpływu zmiany źródła tlenu z KT na TC na stan chorych objętych DLT. Materiał i metody: Badaniem objęto 30 chorych zakwalifikowanych do DLT. Ocenie poddano stopień nasilenia duszności (MRC, Skala Borga), tolerancję wysiłku (6MWT), sprawność fizyczną, czas stosowania tlenoterapii, parametry morfologii krwi, wyniki badań czynności płuc, liczbę zaostrzeń oraz zależną od zdrowia jakość życia (SGRQ). Badania przeprowadzono przed rozpoczęciem DLT, po 6 miesiącach tlenoterapii z użyciem KT i po 6 miesiącach tlenoterapii za pomocą TC. Wyniki: W ciągu pierwszych 6 miesięcy leczenia stwierdzono obniżenie liczby krwinek czerwonych (RBC) z 5,4 do 5,1 (p < 0,0001), hematokrytu (Ht) z 50,1% do 47,8% (p < 0,0001), wydłużenie dystansu 6MWT z 337,7 m do 378,7 m (p < 0,0001) oraz poprawy wyniku SGRQ z 72,1 do 64,4 punktu (p < 0,0001). (p < 0,0001), Ht z 47,8% do 44,3% (p < 0,0001), wydłużenie dystansu 6MWT z 378,7 m do 413 m (p < 0,0001) oraz poprawę wyniku SGRQ z 64,4 do 54,9 punktu (p < 0,0001). Zaobserwowano też znaczne zwiększenie liczby godzin oddychania tlenem w ciągu doby z 13,7 do 18,9 (p < 0,0001). Wnioski: Ciekły tlen, umożliwiający korzystanie z tlenu w domu i poza nim, zwiększa liczbę godzin oddychania tlenem na dobę, co skutkuje większym wpływem na zmienne hematologiczne, sprawność fizyczną i jakość życia

Fazy gotowości do zmiany zachowań i ich uwarunkowania a zachowania w sferze aktywności fizycznej i żywienia wśród starszych pacjentów objętych w Krakowie opieką pielęgniarek środowiskowo-rodzinnych. Implikacje dla promocji zdrowia

The associations between stages of behavioral change, their conditons and health behaviors concerning physical activity and nutrition of older patients covered with community nurses care in Kraków. Implications for health promotionIn frame of the European Project CHANGE (Care of Health Advertising New Goals for Elderly people) the study of health behaviours regarding healthy nutrition and physical activity was conducted on patients in age of 60 and more covered with care of community nurses. Objectives: To assess association between physical activity and nutritional habits, stages of change of these behaviors among older patients and other psychosocial conditions regarding planning of health education intervention to change their health behaviours. Methods: 108 persons at age avg. 69.6 (SD 60–87) were interviewed by questionnaire (assessing the frequency of intake of particular food products, physical activity, motivation and stage of change these behaviors, satisfaction with physical condition and general wellbeing) by the trained community nurses. Results: Results showed sedentary style of life in most studied patients. Among physical activity the frequency of daily walking was the highest (69%), while 70% of older people did not exercise. In study group 42% were not aware of importance of physical activity for their health. But the awareness of importance of healthy nutrition was high, and about half of study group (48%) reported that they eat meals with reduced fat, and 80% eat high fiber food. The rules of healthy nutrition were not fully respected. Positive correlations were shown between intention to change, stage of change of health behavior and performance of physical activity and healthy eating. Those behaviors were positively related to well-being and satisfaction with physical condition. Conclusions: Health promotion programs for older patients should be planned in different way depending on their stage of change of health behaviors. There is a need to raise awareness of importance of physical activity, and to educate older patients about recommended types of exercises and recreation. In case of recommendations of healthy nutrition, the awareness is high and performance definitely more frequent, therefore health promotion programs should stimulate development of permanent social support to maintain change of these behaviors

Usefulness of transesophageal echocardiography before cardioversion in atrial arrhythmias

Background: Although many thromboembolism risk factors are well defined, formation of thrombus ordense spontaneous contrast (sludge) in the left atrium remains enigmatic and confounding. Exclusionof the thrombus is extremely important with respect to planned reversal of sinus rhythm. Data regardingthe routine transesophagal echocardiography (TEE) before cardioversion are inconclusive. The authorsfocused on analyzing the usefulness of TEE before cardioversion by assessment of factors influencing therisk of thrombus and/or dense spontaneous echo contrast with the intention of extending indications forTEE in the group with a high risk of thrombus or to forgo TEE in the low risk group. Methods: Two hundred sixty-nine consecutive patients with persistent (&gt; 48 h) atrial fibrillationor atrial flutter, in whom a direct current cardioversion was planned, were undergoing TEE for thedetection of the left atrial thrombus or dense spontaneous echo contrast. Additional clinical and echocardiographic data were collected. The relationship between both thrombus and dense spontaneous echo contrast and covariates was analyzed with the use of binary logistic regression. Results: Left atrium (LA) appendage (LAA) thrombus and/or sludge were detected in 79 (29%)patients. Signs of dementia in mini-mental state examination (hazard ratio [HR]: 1.16; p = 0.005),low velocities in LAA (HR: 3.38; p = 0.032); presence of spontaneous echo contrast in LA (HR: 3.38;p = 0,003) consecutive episode of AF (HR: 2.27; p = 0,046); longer duration of atrial fibrillation (HR:1.009; p = 0.022); were significant predictors of thrombus and/or dense spontaneous echo contrast.None of the patients with a CHA2DS2VASc score ≤ 1 had thrombus or sludge in the LAA. Among patientswith a CHA2DS2VASc score &gt; 1, the prevalence of thrombus or sludge in LAA was independentof the CHA2DS2VASc score value.Conclusions: Amongst many factors, including an established as risk for thromboembolism onlya few of them increased the risk for the presence of thrombus in LAA: low velocities in LAA, presenceof spontaneous echo contrast, longer duration of arrhythmia, consecutive (not first) arrhythmia episodeand signs of dementia from a mini-mental state examination questionnaire. It was believed that therecould be a need for an extension of indications of TEE in vast majority of the patients with atrial arrhythmias, due most often to an unpredictable occurrence of thrombus and potentially disastrousthromboembolism. The only exception could have been the group of the patients with a CHA2DS2VAScscore ≤ 1

Morphology and position of the right atrioventricular valve in relation to right atrial atructures

The right atrioventricular valve (RAV) is an important anatomical structure that prevents blood backflow from the right ventricle to the right atrium. The complex anatomy of the RAV has lowered the success rate of surgical and transcatheter procedures performed within the area. The aim of this study was to describe the morphology of the RAV and determine its spatial position in relation to selected structures of the right atrium. We examined 200 randomly selected human adult hearts. All leaflets and commissures were identified and measured. The position of the RAV was defined. Notably, 3-leaflet configurations were present in 67.0% of cases, whereas 4-leaflet configurations were present in 33.0%. Septal and mural leaflets were both significantly shorter and higher in 4-leaflet than in 3-leaflet RAVs. Significant domination of the muro-septal commissure in 3-leflet valves was noted. The supero-septal commissure was the most stable point within RAV circumference. In 3-leaflet valves, the muro-septal commissure was placed within the cavo-tricuspid isthmus area in 52.2% of cases, followed by the right atrial appendage vestibule region (20.9%). In 4-leaflet RAVs, the infero-septal commissure was located predominantly in the cavo-tricuspid isthmus area and infero-mural commissure was always located within the right atrial appendage vestibule region. The RAV is a highly variable structure. The supero-septal part of the RAV is the least variable component, whereas the infero-mural is the most variable. The number of detected RAV leaflets significantly influences the relative position of individual valve components in relation to right atrial structures

Effects of the whole-body cryotherapy on a total antioxidative status and activities of some antioxidative enzymes in blood of patients with multiple sclerosis-preliminary study

Objective. There is evidence that multiple sclerosis (MS) is not only characterized by immune mediated inflammatory reactions but also by neurodegenerative processes. Neutralization of oxidative stress and excitotoxicity, might represent a therapeutic approach to provide neuroprotection in MS. The purpose of this study was to compare changes in total antioxidative status and activities of chosen antioxidative enzymes, such as : SOD, CAT in erythrocytes of patients with MS before and after using WBCT with control group. Materials and methods. 32 patients with multiple sclerosis (ICD10-G35) and 20 healthy subjects were recruited for the study. The examined MS group (n=16) was treated with a series of 10 daily exposures in a cryogenic chamber (2-3 min, from -120- to -110-) and program of exercises. The control MS group (n=16) had only exercises. Plasma TAS as well as SOD and CAT activities in erythrocytes were measured. Results. The level of TAS in MS patients was distinctly reduced compared to healthy subjects. After two weeks of WBCT treatment an increase of TAS in the whole examined group (p 0,01) were observed in relation to control MS group. There was not increase of CuZnSOD and CAT activities. Conclusion. Our results suggest positive antioxidant effects of WBCT as a short-term adjuvant treatment for patients suffered due to MS

Analysis of hospital management of chronic respiratory diseases in light of the “Maps of Health Needs” project in Poland

Introduction: The “Maps of Health Needs” project has been carried out in Poland since 2016 and its purpose is to implement quality-promoting and organisational solutions in the Polish healthcare system. This paper is the analysis of hospitalisations for chronic respiratory diseases recorded in Polish National Health Fund databases in 2014. Material and methods: The study included 122,000 hospitalisations of adults and 22,000 hospitalisations of children. Epidemio-logical parameters (incidence and prevalence) and major hospitalisation parameters were determined through statistical analysis. Results: The highest registered incidence was observed in asthma patients (548 per 100,000 inhabitants) followed by COPD patients (233 per 100,000 inhabitants). Asthma patients were also characterised by the highest prevalence, with lower values being observed in COPD patients. In the group of adults, patients aged 65 years or older and 80 years or older accounted for 44% and 14% of hospitalised adults respectively. The analysis also revealed that 66% of hospitalisations of adults included patients with asthma, COPD and respiratory failure. The development of respiratory failure prolongs hospitalisation and increases both in-hospital and post-discharge mortality. In children, 90% of the identified hospitalisations were for asthma, chronic inflammatory lung diseases and cystic fibrosis. Conclusions: The results of the study demonstrate that pulmonary obstructive diseases are associated with a considerable burden. Therefore, corrective actions within the Polish healthcare system are required to decrease the number of hospitalisations for these diseases

Endometrial mRNA expression of prostaglandin synthase enzymes PTGS 2, PTGFS and mPTGES 1 in repeat-breeding cows with cytologically determined endometritis

Little is known about the inflammatory response of the endometrium in repeat-breeding cows with subclinical endometritis (SE). The objective of this study was to evaluate the mRNA expression of prostaglandin-endoperoxide synthase 2 (PTGS 2), prostaglandin F2α synthase (PTGFS) and prostaglandin E2 microsomal synthase 1 (mPTGES 1) in the endometrium of repeat-breeding cows with and without SE. SE was diagnosed cytologically using the cytobrush method, with the threshold being set at 5% polymorphonuclear neutrophils. Biopsy samples were obtained from the endometrium of repeat-breeding cows with SE (n = 10) and without SE (n = 10). The mRNA expression of the synthases was evaluated using qRT-PCR. Significantly higher (P 0.05). Our study confirms that increased endometrial expression of the PTGS 2 gene is involved in the inflammatory response in repeat breeders