Quality of primary health care in Poland from the perspective of the physicians providing it

Background: Primary care (PC) allows patients to address most of their health needs and is essential for high quality healthcare systems. The aim of the study was to analyze the insight of nine core dimensions of Polish PC system: “Economic conditions”, “Workforce”, “Accessibility”, “Comprehensiveness”, “Continuity”, “Coordination”, “Quality of care”, “Efficiency” and “Equity” and to identify the characteristics of the providing physicians that influence their perception of the quality of care.Methods: A cross-sectional study was conducted as part of an international QUALICOPC project. In Poland a nationally representative sample of 220 PC physicians was selected from the database of Polish National Health Fund by a stratified random sampling procedure. The research tool was a standardized 64-item questionnaire. Each of the respondents’ answers were assigned a numerical value ranging from−1 (extremely negative) to +1 (extremely positive). The quality indicators were calculated as an arithmetic mean of variables representing particular PC dimensions.Results: The mean scores for the majority of the dimensions had negative values. Accessibility of care was perceived as the best dimension, while the economic conditions were evaluated most negatively. Only a small part of variation in quality evaluation could be explained by physicians’ characteristics.Conclusions: The negative evaluation of primary care reflects the growing crisis in the health care system in Poland. There is an urgent need to apply complex recovery measures to improve the quality of primary care

Family medicine in post-communist Europe needs a boost. Exploring the position of family medicine in healthcare systems of Central and Eastern Europe and Russia

<p>Abstract</p> <p>Background</p> <p>The countries of Central and Eastern Europe have experienced a lot of changes at the end of the 20th century, including changes in the health care systems and especially in primary care. The aim of this paper is to systematically assess the position of family medicine in these countries, using the same methodology within all the countries.</p> <p>Methods</p> <p>A key informants survey in 11 Central and Eastern European countries and Russia using a questionnaire developed on the basis of systematic literature review.</p> <p>Results</p> <p>Formally, family medicine is accepted as a specialty in all the countries, although the levels of its implementation vary across the countries and the differences are important. In most countries, solo practice is the most predominant organisational form of family medicine. Family medicine is just one of many medical specialties (e.g. paediatrics and gynaecology) in primary health care. Full introduction of family medicine was successful only in Estonia.</p> <p>Conclusions</p> <p>Some of the unification of the systems may have been the result of the EU request for adequate training that has pushed the policies towards higher standards of training for family medicine. The initial enthusiasm of implementing family medicine has decreased because there was no initiative that would support this movement. Internal and external stimuli might be needed to continue transition process.</p

Data Descriptor : A European Multi Lake Survey dataset of environmental variables, phytoplankton pigments and cyanotoxins

Under ongoing climate change and increasing anthropogenic activity, which continuously challenge ecosystem resilience, an in-depth understanding of ecological processes is urgently needed. Lakes, as providers of numerous ecosystem services, face multiple stressors that threaten their functioning. Harmful cyanobacterial blooms are a persistent problem resulting from nutrient pollution and climate-change induced stressors, like poor transparency, increased water temperature and enhanced stratification. Consistency in data collection and analysis methods is necessary to achieve fully comparable datasets and for statistical validity, avoiding issues linked to disparate data sources. The European Multi Lake Survey (EMLS) in summer 2015 was an initiative among scientists from 27 countries to collect and analyse lake physical, chemical and biological variables in a fully standardized manner. This database includes in-situ lake variables along with nutrient, pigment and cyanotoxin data of 369 lakes in Europe, which were centrally analysed in dedicated laboratories. Publishing the EMLS methods and dataset might inspire similar initiatives to study across large geographic areas that will contribute to better understanding lake responses in a changing environment.Peer reviewe

Stratification strength and light climate explain variation in chlorophyll a at the continental scale in a European multilake survey in a heatwave summer

To determine the drivers of phytoplankton biomass, we collected standardized morphometric, physical, and biological data in 230 lakes across the Mediterranean, Continental, and Boreal climatic zones of the European continent. Multilinear regression models tested on this snapshot of mostly eutrophic lakes (median total phosphorus [TP] = 0.06 and total nitrogen [TN] = 0.7 mg L−1), and its subsets (2 depth types and 3 climatic zones), show that light climate and stratification strength were the most significant explanatory variables for chlorophyll a (Chl a) variance. TN was a significant predictor for phytoplankton biomass for shallow and continental lakes, while TP never appeared as an explanatory variable, suggesting that under high TP, light, which partially controls stratification strength, becomes limiting for phytoplankton development. Mediterranean lakes were the warmest yet most weakly stratified and had significantly less Chl a than Boreal lakes, where the temperature anomaly from the long-term average, during a summer heatwave was the highest (+4°C) and showed a significant, exponential relationship with stratification strength. This European survey represents a summer snapshot of phytoplankton biomass and its drivers, and lends support that light and stratification metrics, which are both affected by climate change, are better predictors for phytoplankton biomass in nutrient-rich lakes than nutrient concentrations and surface temperature

Carbon Nanomaterials from Carbon Monoxide Using Nickel and Cobalt Catalysts

Two catalysts, nickel and cobalt, supported on MgO were used for carbon nanomaterials deposition by CO disproportionation. The syntheses were performed at 795 and 900 K in the hydrogen atmosphere. The resulting products were investigated using atomic force microscopy, scanning electron microscopy, and high-resolution transmission electron microscopy. Although in the literature carbon nanofibres are expected to form in the hydrogen presence, we obtained carbon nanotubes, which were multiwall and twisted with the outer diameter of 10-120 nm and the tube length up to 10 μm

Ciecze elektroreologiczne zawierające polielektrolity

Electrorheological (ER) fluids belong to the broadly studied class of so called "intelligent materials" whose properties are sensitive to external stimuli. The ER fluids increase their viscosity upon application of an electric field. This paper reports the results of electrorheological experiments and describes a synthetic procedure leading to an ER suspension exhibiting predetermined characteristics. The fluid was designed for application in a prototype ER clutch.Ciecze elektroreologiczne (ER) należą do intensywnie badanej grupy tak zwanych inteligentnych materiałów, których właściwości można modyfikować za pomocą czynników zewnętrznych. Cechą charakterystyczną cieczy ER jest gwałtowny i odwracalny wzrost lepkości pod wpływem przyłożonego pola elektrycznego. Niniejsza praca zawiera wyniki eksperymentów elektroreologicznych i opis syntezy prowadzącej do otrzymania zawiesiny elektroreologicznej spełniającej określone parametry użytkowe. Ciecz została sporządzona w celu zastosowania w prototypowym sprzęgle elektroreologicznym

FT-IR and EPR studies of changes of chemical structure of ampicyline during thermal sterilization

Zbadano zmiany struktury chemicznej oraz generowanie wolnych rodników w ampicylinie podczas sterylizacji w temperaturach 160 stopni C, 170 stopni C i 180 stopni C. Jako metody badawcze zastosowano spektroskopię FT-IR i EPR.. Wykazano, że sterylizacja w temperaturach od 160 stopni C do 180 stopni C powadzi do zmian struktury chemicznej ampicyliny oraz powoduje powstawanie dużej ilości wolnych rodników w próbce. Widma FT-IR uwidaczniają częściową degradację grupy karboksylowej w trakcie ogrzewania leku. Zależność kształtu widm EPR od mocy mikrofalowej wskazuje na złożony charakter układu centrów paramagnetycznych sterylizowanej ampicyliny.Changes of chemical structure and formation of free radicals in ampicyline during sterilization at temperatures 160 degrees of C, 170 degrees of C, and 180 degrees of C were studied. FT-IR and EPR were applied as experimental methods. It was proved that sterilization at temperatures from 160 degrees of C to 180 degrees of C lead to changes of chemical structure of the ampicyline and causes formation of high amount of free radicals. FT-IR spectra show that carboxyl groups are partly evolved during heating of this drug. Dependence of lineshape of EPR spectra on microwave power indicates complex character of paramagnetic centers system of ampicyline