Implications for limiting visits to patients residing in hospital wards during the COVID-19 pandemic

The impact of COVID-19 on the healthcare system has been devastating, as the system has had to undergo major changes, including the postponement of scheduled surgeries, the admission of patients in a state of emergency, and the use of teleportation. At the same time, the COVID-19 pandemic caused restrictions on visits to hospitalized patients by relatives, despite recommendations for family visits to patients in hospitals, as an important component of quality care provided. Material and methods: The study included 198 relatives of hospitalized patients in the period from March 2020 to March 2022 in the Silesian province. To achieve the research objective, a questionnaire developed entirely by the Authors, consisting of 9 questions, was used. The questionnaire concerned the assessment of restrictions on visits to hospitalized patients by relatives during the pandemic. The survey was conducted between November 2021 and March 2022. Results: The majority of relatives (91%) indicated that they were able to contact (including by phone) the patient every day during their hospital stay. At the same time, the largest number of respondents marked the answer that visiting patients during their stay in the hospital ward was prohibited (97%). In addition, 39% of respondents answered that it was "rather bad" to restrict visits to a loved one staying in the hospital during the pandemic. Conclusions: Undoubtedly, when considering the implementation of rules restricting patient visitation during the COVID-19 pandemic, relevant authorities should carefully look at and compare the potential harm of the issued decision to restrict visitation by relatives along with the risk of virus transmission. Currently, there are insufficient studies formally assessing the effects of restrictions on patient visits by relatives. However, it is clear from the authors' survey that the majority of relatives are rather negative about the implemented restrictions on patient visits

Consideration on the health risk reduction related to attainment of the new particulate matter standards in Poland:a top-down policy risk assessment

Policies can influence health of a population in various ways. Numerous epidemiological studies supported by toxicological investigations demonstrate a positive association between ambient concentrations of airborne particulate matter and increased adverse cardio-respiratory events, including morbidity and mortality. The aim of this paper was to present the concept of the top-down health policy risk assessment approach model developed to estimate the expected health risk reduction associated with policy aiming at attaining the new particulate matter ≤ 10 μm in diameter (PM10) standards in Poland. The top-down approach guides the analysis of causal chains from the policy to health outcomes. In this case study we tried to estimate the predicted health effects of the policy change over the past 20 years. Since Polish annual standard for PM10 changed from 50 μg/m3 in 1990 to 40 μg/m3 in 2010, we calculated the relative risk associated with decreasing PM10 in diameter to 10 μg/m3 in the annual level of PM10 for 6 adverse health effects. The relative risk slightly decreased for almost all adverse health effects, which means that the relative decrease in the incidence of health effects from the baseline incidence should range from about 0.5–0.6% for heart disease admissions to > 1% for respiratory admissions. The obtained results indicate that implementation of the new ambient air standards could influence improvement of the health status of Polish population. A top-down policy health risk assessment model can be one of the main tools in this process, providing harmonized guidance how to seek evidence-based information, which could serve policy-makers

TIME BASED MANAGEMENT IN HEALTH CARE SYSTEM: THE CHOSEN ASPECTS

Time-based management (TBM) is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms). Over the past two decades a systematic review of Polish literature (since 1990) and peer reviewed articles published in international journals based on PubMed/Medline (2001–2011) have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary. Med Pr 2014;65(4):555–56

Exposure to PM2.5 and PM10 pollution and the risk of respiratory diseases in upper Silesia inhabitants

Background: Multiple studies confirm that PM2.5 and PM10 can affect lung growth and development in children and adolescents, the number of medical visits, and hospital emergency admissions due to asthma, respiratory symptoms, and upper and lower respiratory tract disorders. Objective: The objective of this study was the measurement-based assessment for determining whether the concentrations of PM10 and PM2.5 are within admissible limits or exceeded in the Upper Silesia urban area (Silesia province) and to examine the relationship between PM concentrations and the number of admissions in Primary Health Care due to respiratory diseases like asthma and chronic bronchitis for children, adolescents and adults. Material and methods: The data provided by the Voivodship Inspectorate for Environmental Protection in Katowice, National Health Fund - Silesian Department, and the District Sanitary-Epidemiological Station in Katowice for the period 2012-2017 was used in the statistical analysis. Results: The increase in the number of excessive levels of average daily PM10 concentration was observed in almost all measurement stations, both for the acceptable level, information, and alarm level. The increase in average annual PM2.5 concentrations was also observed. The results showed an increased prevalence of respiratory diseases (ICD-Diagnosis Code 10-CM: J017, J030, J034, J038, J040) during the study period in 14 of 20 cities of Silesia province, consistently higher for children than adults. Conclusions: In Silesia province, the air quality is poor and has deteriorated over the last few years. Exposure to ambient PM2.5 and PM10 was significantly associated with the development of respiratory tract diseases in children and adults

Changing health behaviors under lockdown: the impact of the COVID-19 pandemic on adult physical activity and well-being

Introduction. Obesity is recognized as one of the increasingly common diseases of civilization. It poses a great threat to the health and life of every person. Overweight and obesity have also been called a worldwide epidemic. Obesity is most often caused by prolonged positive energy balance: bad eating habits, low physical activity and other problems such as emotional. The current pandemic situation also promotes the incidence of overweight and obesity. Aim of the study. The main aim of the study was to investigate the impact of lockdown on the occurrence of overweight and obesity in adult population, while the specific aim was to investigate the impact of COVID-19 pandemic on the level of physical activity among adults. Material and Methods. A total of 244 adults participated in the study on the impact of lockdown on overweight and obesity. The criterion for inclusion in the study was a correctly completed questionnaire. The questionnaire was properly completed by 237 respondents, who were then qualified for further analysis. The study was conducted during the fall and winter seasons using a proprietary survey questionnaire. Data analysis was carried out using Microsoft Excel 2010, and the results and conclusions of the scientific study were obtained from it. Results and Conclusions. The results of the study indicate that the respondents do not have enough knowledge about proper nutrition. In addition, it was found that their physical activity is decreasing and they are working more and more often remotely, which limits their movement during the day

Use of Policy Risk Assessment Results in Political Decision Making

The RAPID project established, during the first period, a thematic network of risk assessment experts, including relevant partners in the ten countries involved, the "Risk assessor database". The project devoted a specific activity, a single work package, to the dissemination and discussion of the methodology developed during" first two years of the project. National workshops were planned in each country to facilitate integrated knowledge translation activity, using a participatory approach to increase potential knowledge-users awareness on the RAPID project, and to engage them in using the RAPID guidance. Workshops were conceived to present case studies and the RAPID guidance to a targeted audience, to discuss and collect further insights, and integrate different perspectives in the final version of the policy evaluation methodology. However, national workshops also actively contributed to develop evidence based methodological guidance and increase its quality and relevance for potential users by bridging know-do gap between researchers and stakeholders; by involving decision makers and potential users in the knowledge creation process; by facilitating diverse stakeholder participation from governmental, academic and private sectors, carefully identified by national RAPID surveys as having direct expertise in the field of risk assessment. The cultural and administrative differences existing in the countries involved in RAPID guarantee the inclusion of a wide range of perspectives. Results of the national workshops helped to identify barriers and solutions for using the guidance, for adapting necessary changes to it and for communicating results to other potential users.

Public Health, Policy Analysis, Risk Assessment,and Impact Assessment

Public health has been defined as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals"(Winslow 1920) or as "the art of applying science in the context of politics so as to reduce inequalities in health while ensuring the best health for the greatest number"(WHO1998). As the challenges of public health have evolved, from sanitary surveillance and infectious diseases in the past, to chronic diseases, lifestyle factors,socioeconomic conditions, occupational and environmental health determinants,health reforms and others, so have the methods of assessment advanced by research technologies development. The new health threats and epidemics, such as AIDS, SARS (Severe Acute Respiratory Syndrome), influenza H5N1, or emergencies like natural disasters or bioterrorism, effects of globalization and migration present new tasks to public health governance requiring new working methods.

Assessment of health risks of policies

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessmentwith special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals.