Legal Status of People with Disabilities Under EU Law

The scope of this paper touches the changes which occurred in the European Union law relating to legal status of disabled persons since the creation of European Community in 1958. The analysis is based on relevant legal sources, ie. treaties, EU regulations, directives and decisions, as well as the ECJ jurisprudence and OECD reports. The article underlines the meaning of the new individual-oriented approach, indicating equality of rights of disabled and healthy. However it also gives attention to practical aspect of said changes, especially the adverse labour market position of disabled people. For these reasons, despite common EU legislature it is important to support and recommend not only social protection, but also social inclusion and acceptance of the disabled persons

Polish School Nurses’ Attitudes and Knowledge towards Topical Fluoride Treatment

Cilj: Željelo se procijeniti mišljenje školskih medicinskih sestara u Poljskoj o topikalnoj primjeni fluorida te njihovo znanje o sigurnosti toga kemijskog spoja. Metoda: U presječnom istraživanju s pomoću anketnog upitnika sudjelovale su 164 školske medicinske sestre. Anketa je obuhvaćala raniju izobrazbu o prevenciji karijesa, mjere poduzete u školama kako bi se prevenirao karijes, suradnju s doktorima dentalne medicine, mišljenje o topikalnoj primjeni fluorida te znanja sestara o njihovoj sigurnosti. Rezultati: Oralno zdravlje bilo je uvršteno u dužnost 93,9 % sestara, a 81,7 % provodilo je lokalnu primjenu fluorida. U izobrazbi o oralnoj problematici nikada nije sudjelovalo njih 52,1 %. Sestre iz gradova češće su sudjelovale i održavale predavanja o prevenciji karijesa i o fluoridima od svojih kolegica u manjim gradovima (p = 0,033 i 0,021 – hi-kvadrat test). Sestre su imale pozitivno stajalište o učinkovitosti i sigurnosti topikalne primjene fluorida. Samo je polovina ispitanica znala za moguću toksičnu dozu, a jedna petina nije znala kolika je koncentracija fluora u gelu. Ta su znanja bila statistički važna, ovisno o razini izobrazbe pojedine sestre (p = 0,019 – Kruskal-Wallisov test). One s niskom razinom znanja nisu bile svjesne moguće štetnosti fluorida te su imale negativno stajalište o učinkovitosti programa fluoridacije u školama. Zaključak: Školske medicinske sestre u Poljskoj imale su pozitivno mišljenje o topikalnoj primjeni fluorida. No, ima manjkavosti u njihovu znanju pa im je potrebna institucionalizirana izobrazba.Aim: The aim of this study was to evaluate the Polish school nurses’ opinion on the topical fluoride treatment and their knowledge about fluoride safety. Material and methods: A cross-sectional study with the use of a self-administered questionnaire was conducted on 164 school nurses. The questionnaire concerned previous training in caries prevention, action taken at schools with regard to caries prevention, cooperation with dentists, opinion on the topical fluoride application program and nurses’ knowledge about fluoride safety. Results: 93.9% of nurses included oral health in their duties and 81.7% accomplished the topical fluoride treatment. 52.1% never attended any training concerning dental issues. Nurses from cities and villages more often than those from towns provided lectures on caries prevention and fluoride topical applications (respectively p= 0.033 and p=0.021, chi2 test). The nurses had a positive opinion on the effectiveness and safety of topical fluoride application. Only a half of respondents knew the fluoride probable toxic dose and one fifth of them did not know the concentration of fluoride in gel. The knowledge was statistically dependent on the level of nurses’ education (p=0.019, Kruskal-Wallis test). Nurses with a low level of knowledge were not aware of a potential harm effect of fluoride and they had negative opinion about the effectiveness of fluoride program at school. Conclusion: Polish school nurses had a positive opinion on topical fluoride treatment. However, there are gaps in their knowledge and the institutional training is needed

Analysis of causes of hospitalizations and type of hypotensive therapy in patients with essential hypertension

Wstęp Główną przyczyną zgonów na całym świecie są choroby układu krążenia. Jednym z najpoważniejszych czynników ryzyka ich wystąpienia jest nadciśnienie tętnicze. Mimo znacznego postępu w dziedzinie rozpoznawania i leczenia nadciśnienia tętniczego, efekty terapii są wciąż niezadowalające, a choroby serca i naczyń są przyczyną przedwczesnej umieralności i inwalidztwa w Polsce. Celem pracy była ocena przyczyn hospitalizacji pacjentów z nadciśnieniem tętniczym oraz analiza ich leczenia w warunkach szpitalnych na podstawie dokumentacji medycznej pacjentów hospitalizowanych z powodu nadciśnienia tętniczego (ICD10) na oddziale kardiologii i chorób wewnętrznych Szpitala Wojewódzkiego w Suwałkach w 2007 roku. Materiał i metody W 2007 roku leczono 1395 pacjentów, w tym 61% z nadciśnieniem tętniczym. Z powodu nadciśnienia tętniczego hospitalizowano 90 osób (7%) (wiek 18–79 lat, 70% kobiet). Przy przyjęciu u 58% stwierdzano ciśnienie tętnicze powyżej 180/110 mm Hg. Żaden z chorych nie miał docelowych wartości ciśnienia. Spośród chorób współistniejących najczęściej występowały: choroba wieńcowa serca (42,2%), miażdżyca kończyn dolnych (20%), dyslipidemia (50%), nieprawidłowe wartości glikemii (33%), otyłość (49%), przebyty incydent ostrego zawału serca (udar, TIA) (13%), przewlekła choroba nerek (28%). W trybie pilnym hospitalizowano 80% osób. Połowa chorych była skierowana przez lekarza rodzinnego, 22% przez lekarza kardiologa, natomiast 15% przez lekarza pogotowia ratunkowego. Wyniki Ponad połowa pacjentów w czasie pobytu w szpitalu była leczona więcej niż trzema lekami hipotensyjnymi, w tym: inhibitorami ACE (87,7%), diuretykami (85,5%), b-adrenolitykami (82,2%) oraz antagonistami wapnia (75,5%). Ponadto u 83,3% osób stosowano kwas acetylosalicylowy, u 57,7% chorych statyny, a 47,7% otrzymywało preparaty potasu. Przy wypisie 89% miało wartości poniżej 140/90 mm Hg, w tym 32% poniżej 120/80 mm Hg. Wnioski Pomimo ogromnego rozpowszechnienia kontroli ciśnienia tętniczego, nadal pozostaje ona niezadowalająca. Zwraca uwagę częste współistnienie chorób towarzyszących, które nie są właściwie leczone. Istnieje pilna potrzeba utworzenia specjalistycznej poradni nadciśnieniowej.Background Cardiovascular diseases are the main cause of morbidity and mortality. Hypertension is the major risk factor for cardiovascular complications. The aim of the study was to assess the causes of hospitalization and type of hypotensive therapy in patients with essential hypertension (ICD10) admitted to the Cardiology Unit of Voivodeship Hospital in Suwalki in 2007. Material and methods There were 1395 patients hospitalized in the cardiology unit in 2007, including 61% of patients with hypertension. Only 90 patients (7%, 70% of females, age range 18–79 years) were admitted to the hospital with the diagnosis of hypertension. At admission in 58% blood pressure values exceeded 180/110 mm Hg. In none of the patients target blood pressure values were found. The most common comorbid conditions were: coronary artery disease in 42,2%, peripheral artery disease in 20%, dyslipidemia in 50%, abnormal glucose metabolism in 33%, cerebrovascular events in 13%, chronic kidney disease in 28%, obesity in 50%. Up to 80% of cases were admitted to the hospital as urgent. Results Half of the patients were sent to the hospital by family physicians, 22% by cardiologists, 15% by an ambulance service. During hospitalization over the half of the patients were treated with more than 3 hypotensive drugs, including angiotensin converting enzyme inhibitors (87.7%), diuretics (85.5%), b-blockers (82.2%) and calcium channel blockers (75.5%). Moreover, 83.3% were given acetylsalicylic acic, 57.7% were given statins, and 47.7% were administered potassium supplements. At discharge, 89% had blood pressure values below 140/90, including 32% with blood pressure values below 120/80 mm Hg. Conclusions Concluding, despite high prevalence of hypertension, blood pressure control is still insufficient. Comorbidities are common in hypertensive patients and they are not adequately treated. Taking all these facts into consideration there is a strong rationale for establishment of hypertension outpatient unit at the hospital with dedicated medical staff

Linkage to primary care after home-based blood pressure screening in rural KwaZulu-Natal, South Africa: a population-based cohort study

Objectives: The expanding burden of non-communicable diseases (NCDs) globally will require novel public health strategies. Community-based screening has been promoted to augment efficiency of diagnostic services, but few data are available on the downstream impact of such programmes. We sought to assess the impact of a home-based blood pressure screening programme on linkage to hypertension care in rural South Africa.  Setting: We conducted home-based blood pressure screening withinin a population cohort in rural KwaZulu-Natal, using the WHO Stepwise Approach to Surveillance (STEPS) protocol.  Participants: Individuals meeting criteria for raised blood pressure (≥140 systolic or ≥90 diastolic averaged over two readings) were referred to local health clinics and included in this analysis. We defined linkage to care based on self-report of presentation to clinic for hypertension during the next 2 years of cohort observation. We estimated the population proportion of successful linkage to care with inverse probability sampling weights, and fit multivariable logistic regression models to identify predictors of linkage following a positive hypertension screen.  Results: Of 11 694 individuals screened, 14.6% (n=1706) were newly diagnosed with elevated pressure. 26.9% (95% CI 24.5% to 29.4%) of those sought hypertension care in the following 2 years, and 38.1% (95% CI 35.6% to 40.7%) did so within 5 years. Women (adjusted OR (aOR) 2.41, 95% CI 1.68 to 3.45), those of older age (aOR 11.49, 95% CI 5.87 to 22.46, for 45–59 years vs <30) and those unemployed (aOR 1.71, 95% CI 1.10 to 2.65) were more likely to have linked to care.  Conclusions: Linkage to care after home-based identification of elevated blood pressure was rare in rural South Africa, particularly among younger individuals, men and the employed. Improved understanding of barriers and facilitators to NCD care is needed to enhance the effectiveness of blood pressure screening in the region

Temporal trends of population viral suppression in the context of Universal Test and Treat: the ANRS 12249 TasP trial in rural South Africa

Introduction: The universal test-and-treat (UTT) strategy aims to maximize population viral suppression (PVS), that is, the proportion of all people living with HIV (PLHIV) on antiretroviral treatment (ART) and virally suppressed, with the goal of reducing HIV transmission at the population level. This article explores the extent to which temporal changes in PVS explain the observed lack of association between universal treatment and cumulative HIV incidence seen in the ANRS 12249 TasP trial conducted in rural South Africa. Methods: The TasP cluster-randomized trial (2012 to 2016) implemented six-monthly repeat home-based HIV counselling and testing (RHBCT) and referral of PLHIV to local HIV clinics in 2 9 11 clusters opened sequentially. ART was initiated according to national guidelines in control clusters and regardless of CD4 count in intervention clusters. We measured residency status, HIV status, and HIV care status for each participant on a daily basis. PVS was computed per cluster among all resident PLHIV (≥16, including those not in care) at cluster opening and daily thereafter. We used a mixed linear model to explore time patterns in PVS, adjusting for sociodemographic changes at the cluster level. Results: 8563 PLHIV were followed. During the course of the trial, PVS increased significantly in both arms (23.5% to 46.2% in intervention, +22.8, p < 0.001; 26.0% to 44.6% in control, +18.6, p < 0.001). That increase was similar in both arms (p = 0.514). In the final adjusted model, PVS increase was most associated with increased RHBCT and the implementation of local trial clinics (measured by time since cluster opening). Contextual changes (measured by calendar time) also contributed slightly. The effect of universal ART (trial arm) was positive but limited. Conclusions: PVS was improved significantly but similarly in both trial arms, explaining partly the null effect observed in terms of cumulative HIV incidence between arms. The PVS gains due to changes in ART-initiation guidelines alone are relatively small compared to gains obtained by strategies to maximize testing and linkage to care. The achievement of the 90-90-90 targets will not be met if the operational and implementational challenges limiting access to care and treatment, often context-specific, are not properly addressed. Clinical trial number: NCT01509508 (clinicalTrials.gov)/DOH-27-0512-3974 (South African National Clinical Trials Register)

Assessment of the possibility of using barley grass (Hordeum vulgare L.) of spring and winter varieties as an ingredient of functional cereal products

W trakcie przeprowadzonych badań oceniono możliwości wykorzystania trawy jęczmienia (Hordeum vulgare L.) jako wzbogacającego składnika przekąskowych produktów funkcjonalnych. Zmieloną trawę z 4 odmian rośliny wykorzystano jako składnik recepturowy funkcjonalnych kulek zbożowych i oceniono pod kątem zawartości polifenoli i chlorofili oraz potencjału antyoksydacyjnego. Wykazano, że odmiana młodego jęczmienia charakteryzuje się różną zawartością związków polifenolowych ogółem oraz chlorofilu. Młody jęczmień wpływa na aktywność przeciwutleniającą funkcjonalnych produktów zbożowych. Odmiana jęczmienia decyduje o składzie i o właściwościach funkcjonalnych przekąskowych kulek zbożowych. Najkorzystniejsze efekty, stwierdzono w próbach z udziałem trawy jęczmiennej odmian Zenek i Iron.The paper assesses the possibilities of using barley grass (Hordeum vulgare L.) as an enriching component of functional snack products - cereal balls with barley grass. Ground grass from 4 cultivars of the plant was used as a recipe component of cereal balls and assessed in terms of antioxidant potential and the content of polyphenols and chlorophylls. It was shown that young barley influences the antioxidant activity as well as the content of polyphenols in functional products. It was found that the barley variety from which the barley grass was produced influenced the functional properties of ce-real balls. In terms of the functional properties of cereal balls, the best results were obtained for barley grass of the Zenek and Iron varieties

The potential of national conifferent forest trees species in agro forest cultivations

Agroleśnictwo to rodzaj upraw integrujący uprawy rolne z drzewami i jest sposobem gospodarowania ziemią, w którym produkcja roślinna i zwierzęca współistnieje na tym samym obszarze z roślinnością drzewiastą i/lub krzewami. Agroleśnictwo sprzyja efektywnemu wykorzystaniu zasobów glebowych i środowiskowych w porównaniu z uprawą monokulturową. Integracja drzew w uprawie rolniczej poprawa żyzność i właściwości fizyczne, biologiczne i chemiczne gleby, a w konsekwencji żywności, drewna i paszy. Taka uprawa sprzyja odpowiedniemu mikroklimatowi wpływając na właściwości i wilgotność gleby. Integracja drzew na gruntach rolnych zapewnia dodatkowe korzyści dla klimatu i środowiska, dlatego może stanowić opłacalną i przyjazną praktykę. W artykule wskazano rodzime gatunki iglastych drzew leśnych, które potencjalnie mogłyby stanowić element upraw agroleśnych z uwzględnieniem ich wykorzystania w żywności funkcjonalnej.Agroforestry is a type of farming that integrates agricultural crops with trees, and is a way of managing the land in which crop and livestock production coexist in the same area with woody plants and/or shrubs. Agroforestry promotes efficient use of soil and environmental resources compared to monoculture farming. The integration of trees in agroforestry improves the fertility and physical, biological and chemical properties of the soil, and consequently food, timber and fodder. Such cultivation promotes an appropriate microclimate by influencing soil properties and moisture content. Integration of trees on agricultural land provides additional climate and environmental benefits and can be a cost-effective and climate-friendly practice. The article identifies native coniferous forest tree species that could potentially be part of agroforestry crops with a view to their use in functional foods

Process influencing the vitamin D content in mushrooms

Powszechnie spożywane gatunki grzybów pod wpływem działania promieni UV (światło słoneczne lub lampa UV) mogą generować istotne z punktu widzenia żywieniowego zawartości witaminy D. Główną formą witaminy D, która występuje w grzybach jest D2 (ergokalcyferol C28H44O) oraz mniejsze ilości D3 (cholekalcyferolC27H44O) i D4 (22-dihydroergokacyferol C28H46O). Witamina D3 w największych ilościach znajduje się w produktach pochodzenia zwierzęcego. Źródłem witaminy D2 są grzyby. Pomimo tego, że procesy technologiczne lub przechowywanie powodują spadek jej zawartości, zawartość D2 w grzybach może stanowić dobre jej źródło w diecie. Celem pracy była analiza aktualnych danych literaturowych w zakresie wpływu promieniowania UV na syntezę witaminy D2 w grzybach, a także wpływu ich przechowywania i obróbki termicznej na jej zawartość i biodostępność.Commonly consumed mushroom species exposed to UV radiation (sunlight or UV lamp) can generate nutritionally important amounts of vitamin D. The most common form of vitamin D in mushrooms is D2, with lesser amounts of vitamin D3 and D4, while vitamin D3 is the most common form of vitamin in animal products. Although the level of vitamin D2 in mushrooms exposed to UV radiation may decrease with storage and cooking, if they are consumed before the expiry date, the level of vitamin D2 is likely to remain above 10 μg / 100 fresh masstherefor mushrooms have the potential to be the only non-animal and unenriched food source that can provide a significant amount of vitamin D2. This review analyses current information on the role of UV radiation in enhancing concentration of vitamin D2 in mushromms, the effects of storage and cooking on D2 content, and bioavailability of vitamin D2 from mushrooms

Opportunities and challenges of the digitalization in sustainable smart agriculture on the example of plant production

Inteligentne rolnictwo (ang. smart farming, smart agriculture) to sposób rozwoju rolnictwa, który kładzie nacisk na technologie informacyjne i komunikacyjne w maszynach, urządzeniach i czujnikach, co pozwala nie tylko na zaawansowany technologicznie nadzór nad gospodarstwem, ale daje też możliwość zdalnego sterowania procesami i pracami. Celem stosowania tzw. cyfryzacji jest optymalizacja i zwiększenie jakości produkcji, redukcja pracy ludzkiej, redukcja przemysłowych środków produkcji oraz zmniejszenie presji środowiskowej. Przewiduje się, że innowacyjne technologie tj. Internet Rzeczy (IoT), technologie satelitarne, przetwarzanie w chmurze czy sztuczna inteligencja przyczynią się do rozwoju rolnictwa, a także będą sprzyjać bezpieczeństwu żywności i ograniczą zmiany klimatyczne. Zastosowanie nowych technologii budzi również pewne obawy oraz stawia nowe wyzwania rolnikom. W niniejszym artykule opisano narzędzia i urządzenia wykorzystywane w inteligentnym rolnictwie, możliwości ich zastosowania, a także przewidywane wyzwania, które pojawiają się przy łączeniu innowacyjnych technologii z konwencjonalną działalnością rolniczą.Smart farming, or smart agriculture, is a way of agricultural development that emphasizes information and communication technologies in networked machinery, equipment and sensors, allowing not only high-tech farm supervision, but also remote control of processes. The goal is to optimize and increase production quality and reduce human labor. Innovative technologies, i.e. the Internet of Things (IoT), cloud computing and artificial intelligence, are expected to inspire growth, as well as confront current difficulties, i.e. food security and climate change. The use of new technologies also raises some concerns and poses new challenges for farms. This article describes the tools and equipment used in intelligent agriculture, the possibilities for their application, as well as the anticipated challenges that arise when combining innovative technologies with conventional farming operations

The role of Polish school nurses in the oral health promotion for 7-19 year-old children and adolescents

Purpose The assessment of the role of school nurses in the oral health education and counselling of children and adolescents aged 7–19 years. Methods A self-administered questionnaire was used to evaluate nurses’ practice in oral health education, previous training in caries prevention, collaboration with a dentist and self-assessment of knowledge. Data were analysed with the Chi square test. Results The study group consisted of 140 Polish school nurses. Respondents declared the following activities: dietary counselling (99.2%), oral hygiene education (92.8%), NHS-funded supervised fluoride prophylaxis (82.8%), and caries screenings (4.3%). 47.1% participated in training on caries prevention, 25.7% had a collaboration with a dentist. Nurses from schools located in towns less frequently provided oral hygiene education (p < 0.005) and dietary counselling, but more often had a collaboration with a dentist (p < 0.05). The youngest nurses were more confident about their knowledge (p < 0.05). There was an association between participation in training on caries prevention and positive opinion on a school-based fluoride prophylaxis (p < 0.01). Nurses who did not include dental topics in their practice worked mainly with pupils older than 15 years, had shorter experience (p < 0.05), secondary education, worked in urban areas and had no training on dental problems (p < 0.01). Conclusion Polish school nurses have potentially crucial roles in improving the oral health status in pupils through oral hygiene education, dietary counselling and fluoride prophylaxis included in their duties