Impact of the COVID-19 pandemic crisis on the health care system in less developed regions of Poland

PURPOSE: The aim of the study was to develop a model for assessing the satisfaction of patients of GP practice with access to health services in the Lubelskie Voivodeship, in terms of eliminating inequalities in the quality of these services and developing a scenario for the revitalization of the health care system in relation to the inhabitants of the underdeveloped region in the period after the cessation of pandemic.DESIGN/METHODOLOGY/APPROACH: The research method included developing a research tool in the form of a survey questionnaire, validating the tool, conducting Phase I and II of the survey, and evaluating the performance of the outpatient specialty care subsystem. The analysis of the research results was directed at developing the assumptions of a model for restoring functionality and increasing resilience of the healthcare system.FINDINGS: It was found that the level of patient satisfaction with the functioning of the health care system during a pandemic, both in the form of medical tele-consultation and in the form of direct contact with personnel in a health care facility, depends on the age and the level of education. There were no differences in terms of sex and place of residence (town, village). It was also found that the very limited availability of advanced diagnostic methods, showing an unfavorable trend in the period preceding the outbreak of the pandemic, deteriorated further and poses a critical threat to the functioning of the health care system for patients with chronic diseases (oncological, neurodegenerative etc.)PRACTICAL IMPLICATIONS: The results of the research will be used to construct a model for the reconstruction and revitalization of the health care system in the Lubelskie Voivodeship after the pandemic.ORIGINALITY/VALUE: The study presents results of the current research. The development of the research results will be continued in order to construct a comprehensive model.This article in part on basic healthcare presents the results of research funded under the Faculty of Management of the Lublin University of Technology (Discipline Council for Management and Quality Sciences) 2020/2021.peer-reviewe

Evaluation of symptoms of anxiety and depression in women with breast cancer after breast amputation or conservation treated with adjuvant chemotherapy

Introduction Evaluation of the presence of symptoms of anxiety and depression in women treated for breast cancer who underwent surgical procedure using one of two alternative methods, either radical mastectomy or breast conserving treatment (BCT). Material and Methods A questionnaire survey involved 85 patients treated in a conservative way and 94 patients after breast amputation. Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and depression degree evaluation questionnaire were used in the study. The patients’ responses were statistically analyzed. Results Based on the HADS questionnaire, the total anxiety level in the group of women treated with BCT was 6.96 points, while in the group of patients who had undergone mastectomy the value was 7.8 points. The observed results were statistically significant. In the case of depression, the following values were found: patients after amputation had 8.04 scale value points, and those after BCT had 6.8 scale value points. The observed differences were statistically significant. Negative correlation was found between the level of anxiety and depression. The total level of depression evaluated using the Beck scale was 16.3 points in the BCT group, which means that they suffered from mild depression, while in the mastectomy group the level was 19.6 points, which corresponds to moderate depression. Conclusions The level of anxiety and depression among women with breast cancer was influenced by the type of the applied surgical procedure and adjuvant chemotherapy. Demographic variables did not influence the level of anxiety and depression

Validation of the Polish version of Satisfaction with Asthma Treatment Questionnaire (SATQ)

Introduction: Among the chronically ill there is a tendency for non-compliance with medical recommendations, which is often due to low satisfaction with the offered treatment. Satisfaction with Asthma Treatment Questionnaire (SATQ) is a questionnaire for measuring satisfaction with the inhalation treatment of asthma in patients of more than 18 years of age. SATQ is a standardized tool that has not been previously used in Poland. SATQ consists of 4 domains: efficiency, ease of use, the burdening with asthma treatment and side effects and concerns. Aim: To validate the Polish language version of SATQ questionnaire and an overall verification of the usefulness of the tool relative to trials from clinical practice. Material and methods : The degree of difficulty and comprehension of the questions and the reliability and validity of the Polish version of the questionnaire was determined in 67 patients with asthma (mean age: 45.8 ±14.3 years (range maximum – at least 18–65 years). The vast majority of patients in the study group have used the inhalers for more than 1 year and were educated in the field of aerosols management. The resulting scores are calculated by adding up the scores for each question and dividing by the number of questions. The reliability of the questionnaire design was verified using the Spearman rank correlation coefficients between elements and ranges between band assessments and evaluations and overall assessment of quality and patient satisfaction with treatment. Internal consistency and reliability of the tool was assessed using Cronbach’s . The values of Cronbach’s α were evaluated with respect to the threshold value of 0.70. Results : SATQ questionnaire was understandable and easy to fill out for all subjects. The filling time of SATQ was designed as to be within 5–10 min. Cronbach’s α was reached on all scales, demonstrating the reliability of the analyzed scale and lack of redundancy. Conclusions : The Polish version of SATQ questionnaire meets the basic psychometric criteria and can be used to assess satisfaction with the inhalation treatment of asthma

Effective immobilisation of a metathesis catalyst bearing an ammonium-tagged NHC ligand on various solid supports

An ammonium-tagged ruthenium complex, 8, was deposited on several widely available commercial solid materials such as silica gel, alumina, cotton, filter paper, iron powder or palladium on carbon. The resulting catalysts were tested in toluene or ethyl acetate, and found to afford metathesis products in high yield and with extremely low ruthenium contamination. Depending on the support used, immobilised catalyst 8 shows also additional traits, such as the possibility of being magnetically separated or the use for metathesis and subsequent reduction of the obtained double bond in one pot

Effect of infliximab on the levels of TNF-alpha and TGF-beta in the whole blood cultures of irradiated patients.

TGF-beta is supposed to be the major cytokine responsible for post-radiation fibrosis of healthy tissues and actively modifies post-radiation changes. The growth of TGF-beta level induces the expression of collagen synthesis gene which triggers off the production of fibrosis of hyaline membranes. The main purpose of this study was to discover the way and methods of reducing post-radiation damage of normal tissues and provide an adequate scientific justification for using Infliximab as an effective radio protector in the neoplasm radiotherapy. A group of 97 patients were subjected to the experiment. Randomly selected patients were assigned to 3 groups according to the radiation exposure. The samples of whole blood were suspended in RPMI 1640 growth medium standardized according to the number of leukocytes. Two milliliters of whole blood was taken from each patient immediately before irradiation and 100 microl sample of the blood was placed in wells with 0.8 mg/ml of Infliximab or without the preparation. TGF-beta levels in blood culture without cA2 before irradiation showed continuous rise from 3978 to 8950 pg/ml at the 96th h. In the post irradiated group without cA2, a continuous growth was recorded till the 48th h (from 4758 to 13324 pg/ml at the 24th h) and then a slight decline to 11950 pg/ml at 96th h, respectively. In the cultures with cA2, TGF-beta levels before irradiation showed also the peak value at the 48th h (from 4050 to 7340 pg/ml at the 48th h) and then started to go down (6500 pg/ml at the 72nd h and 5720 pg/ml at the 96th h). In the post-irradiated group, during the first 6 hours, there was a growth from 4717 pg/ml to 7462 pg/ml, and then a paradoxical increase to 16885 pg/ml at the 12th h. From the 12th h the values started to decrease to 6895 pg/ml at the 96th h. The obtained results confirmed the hypothesis of decreasing the TGF-beta expression by inactivating TNF-alpha with a monoclonal antibody (Infliximab) in the patients' whole blood culture in vitro. These observations are a good starting point for further experiments in vitro and in vivo, whose main objective is to reduce post radiation fibrosis

Effect of infliximab on the levels of TNF-alpha and TGF-beta in the whole blood cultures of irradiated patients.

TGF-beta is supposed to be the major cytokine responsible for post-radiation fibrosis of healthy tissues and actively modifies post-radiation changes. The growth of TGF-beta level induces the expression of collagen synthesis gene which triggers off the production of fibrosis of hyaline membranes. The main purpose of this study was to discover the way and methods of reducing post-radiation damage of normal tissues and provide an adequate scientific justification for using Infliximab as an effective radio protector in the neoplasm radiotherapy. A group of 97 patients were subjected to the experiment. Randomly selected patients were assigned to 3 groups according to the radiation exposure. The samples of whole blood were suspended in RPMI 1640 growth medium standardized according to the number of leukocytes. Two milliliters of whole blood was taken from each patient immediately before irradiation and 100 microl sample of the blood was placed in wells with 0.8 mg/ml of Infliximab or without the preparation. TGF-beta levels in blood culture without cA2 before irradiation showed continuous rise from 3978 to 8950 pg/ml at the 96th h. In the post irradiated group without cA2, a continuous growth was recorded till the 48th h (from 4758 to 13324 pg/ml at the 24th h) and then a slight decline to 11950 pg/ml at 96th h, respectively. In the cultures with cA2, TGF-beta levels before irradiation showed also the peak value at the 48th h (from 4050 to 7340 pg/ml at the 48th h) and then started to go down (6500 pg/ml at the 72nd h and 5720 pg/ml at the 96th h). In the post-irradiated group, during the first 6 hours, there was a growth from 4717 pg/ml to 7462 pg/ml, and then a paradoxical increase to 16885 pg/ml at the 12th h. From the 12th h the values started to decrease to 6895 pg/ml at the 96th h. The obtained results confirmed the hypothesis of decreasing the TGF-beta expression by inactivating TNF-alpha with a monoclonal antibody (Infliximab) in the patients' whole blood culture in vitro. These observations are a good starting point for further experiments in vitro and in vivo, whose main objective is to reduce post radiation fibrosis

Rational and Then Serendipitous Formation of Aza Analogues of Hoveyda-Type Catalysts Containing a Chelating Ester Group Leading to a Polymerization Catalyst Family

Analogues of the well-known Hoveyda–Grubbs catalyst bearing both a chelating ester function and a chelating nitrogen atom were obtained. These complexes behave differently depending on the character of the chelating amine. Complexes containing a secondary amine underwent unexpected spontaneous oxidation of the amine group, leading to the Schiff base analogues. In contrast, complexes containing a tertiary amine were prone to intramolecular cyclization in the presence of a base (Et₃N). Probing the activity of such (pre)­catalysts in ring-closing metathesis reactions (RCMs) revealed their dormant character and excellent thermo-switchability. In particular, complexes bearing an iminium nitrogen fragment were found to be very useful in a delayed ring-opening metathesis polymerization (ROMP) and were therefore commercialized

Ru-Based Complexes with Quaternary Ammonium Tags Immobilized on Mesoporous Silica as Olefin Metathesis Catalysts

Ruthenium olefin metathesis catalysts bearing a polar quaternary ammonium group in N-heterocyclic ligand were immobilized on silica and siliceous mesoporous molecular sieves with different pore sizes (SBA-15 and MCM-41). The activity of the heterogeneous catalysts was found to increase with an increase in pore size of the support used, with the best results observed for SBA-15-supported catalyst. The influence of reaction conditions (temperature, solvent, catalyst, and substrate concentration) on the efficiency of new heterogeneous catalysts was established. A significant influence of the counterion present in the ruthenium complex on the activity of immobilized catalysts was also found: those derived from chloride containing ion exhibited the highest activity. High activity in ring-closing metathesis of substrates as citronellene, 1,7-octadiene, and diallyl compounds as well as in cross-metathesis of unsaturated aliphatic compounds with methyl acrylate was observed under optimized conditions. In some cases, heterogenization led to catalysts with efficiency higher than those observed for corresponding homogeneous complexes