The effectiveness of ‘practice while watching’ technique for the first aid training of the chemical industry employees

INTRODUCTION: Industrial accidents constitute about 20% of all causes of accidents. They are often sudden, unexpected and may lead to tragic consequences, which however can be partially reduced if first aid and emergency treatment are given as soon as possible. The most important part of a chain of survival is the bystanders’ response. In practice, it is highly dependent on the ability of co-workers to perform basic first-aid tasks. The aim of this paper was to present the effectiveness of ‘practice while watching’ training method for the first aid training of the chemical industry employees. The authors focused on the most important elements of the training, which have an impact on the acquisition of knowledge and skills of first aid.  MATERIAL AND METHODS: The training involved 69 employees of the chemical industry. The test sheets were used for the assessment, where each of the action steps was assigned points 0 for incorrect and 1 for a properly performed activity.  RESULTS: Each step was completed by at least 76% of workers. When providing both adult and infant CPR, the main difficulty was calling for help. Younger employees obtained better results than older colleagues.  CONCLUSIONS: The study demonstrated the high effectiveness of the ‘practice while watching’ method. In addition, workers’ age turned out to be a significant variable which affected their performance.

Good practices in asynchronous e-learning — a short guideline document for Polish medical teachers — a pilot study

INTRODUCTION: E-learning is gaining popularity also in medical education. It offers students unlimited access to educational materials, helps meet their individual preferences by adapting various learning styles, and is considered to be at least as effective as traditional lectures. However, this can only be true provided that e-learning is of good quality. Short guidelines may be used to familiarise medical teachers with good practices in e-learning, but they should meet the needs of their users, and some areas may require more attention. They should be identified, and medical teachers should be provided with additional resources covering them. This study aimed to develop a short guideline for Polish medical teachers and determine potentially troublesome areas. METHODS: A detailed review of the literature was performed to create a guideline on preparing and conducting e-learning classes. The most important items from it were listed as an evaluation template and pre-tested on a sample of 10 e-learning courses in a search for areas requiring more attention. RESULTS: Half of the courses did not provide students with a syllabus, and none of them clearly defined intended learning outcomes. Also, adult learning concepts were not introduced satisfactorily. Only seven out of 10 courses used activities at all, and they often tested simple knowledge reproduction, were limited to poorly-written test questions, and placed at the end of lessons. CONCLUSIONS: In this pilot study three potentially troublesome areas were identified: defining learning outcomes, application of adult learning theory, and choice of activities. KEY WORDS: e-learning quality, e-learning guidelines, medical teacher

Pre-hospital management of penetrating pelvic injuries — a case study

INTRODUCTION: Penetrating pelvic injuries and the complications caused by them are a global problem in the provision of services by emergency medical teams. They often pose a significant challenge for medical personnel, particularly in patient evacuation and stabilization during transport. CASE REPORT: The emergency medical service (EMS) was dispatched to a traffic accident — the report contained information about one conscious victim with a foreign body within the patient's body. At the accident scene, a delivery truck crashed into the tow bar of a trailer standing on the road, and one person was seriously injured due to the impact. The preliminary assessment confirmed a foreign body penetrating the right thigh, deformation and enlargement of the thigh contour, pain in the thigh, pelvis, and tenderness in the thoracic-lumbar spine with the end part of the tow bar hook palpable under the skin. The victim was suspected of having a femur fracture, pelvic injuries, and damage to internal organs. On neurological examination, sensation and motor functions were preserved in all limbs. The evacuation procedure was established after the Fire Department (FD) rescuers arrived. The injured person was removed from the vehicle on an orthopedic board with the help of eight rescuers. The victim was placed on his left side with the right side elevated, with continuous manual stabilization supported by a blanket, pillows, and orthopedic boar straps. CONCLUSIONS: Each traumatic injury event requires selecting and using the appropriate equipment. A good compromise between speed and precision of actions should not significantly contribute to the worsening of the injury. An increase in a rescuer's substantive knowledge on how to proceed in the case of this type of trauma and injuries, as well as close cooperation with the fire department, will undoubtedly result in more appropriate actions

Transferase S-glutathione class p gene (GSTP1) polymorphism in thyroid cancer patients

Wstęp: Jednym z potencjalnych genów zwiększających ryzyko zachorowania na niektóre nowotwory jest gen GSTP1 kodujący enzym szlaku detoksykacyjnego transferazę S-glutationu klasy &#960;. Polimorfizmy w obrębie tego genu mogą prowadzić do substytucji aminokwasów, co wpływa na strukturę centrum aktywnego enzymu i zmienia aktywność katalityczną wobec części substancji kancerogennych. Niewłaściwe działanie szlaku utylizacji substancji szkodliwych przekłada się bezpośrednio na zwiększenie liczby czynników oddziałujących z DNA i prowadzących do mutacji, co może zapoczątkowywać onkogenezę. Cel: Celem pracy była analiza dwóch polimorfizmów genu transferazy S-glutationu (GSTP1) pod względem ich asocjacji z występowaniem raka zróżnicowanego tarczycy (DTC, differentiated thyroid cancer). Dodatkowo przeprowadzono analizę wpływu badanych polimorfizmów na wiek rozpoznania choroby. Materiał i metody: Badania przeprowadzono u 156 osób. Grupę kontrolną stanowiły 53 zdrowe osoby, a grupę badaną - 103 osoby ze zdiagnozowanym DTC. Genotypowanie przeprowadzono za pomocą metody PCR&#8211;RFLP (polymerase chain reaction&#8211;restriction fragment length polymorphism). Wyniki: W przypadku obu polimorfizmów nie wykazano znamiennej statystycznie asocjacji z występowaniem raka tarczycy. Porównano częstości alleli oraz wyznaczono potencjalne allele ryzyka. Dla polimorfizmu c.313A>G był to allel Ile, OR = 1,257; 95% CI [0,792&#8211;1,997] (p = 0,332); dla polimorfizmu c.341C>T allel Val, OR = 1,283; 95% CI [0,6260&#8211;2,631] (p = 0,495). Przy korelacji wieku rozpoznania choroby z określonymi genotypami w grupie chorych wykazano znamienną statystycznie asocjację genotypu Val/Val (polimorfizm c.313A>G) z wcześniejszym wiekiem rozpoznania choroby (41,1 &plusmn; 15,2 w porównaniu z genotypami Ile/Val + Val/Val 48,9 &plusmn; 13,2 [p < 0,05]). Nie stwierdzono takiej asocjacji dla polimorfizmu c.341C>T. Wnioski: Nie można stwierdzić znamiennej statystycznie asocjacji polimorfizmów GSTP1 z występowaniem raka tarczycy w badanej grupie, natomiast obecność genotypu Val/Val (polimorfizm c.313A>G) wiąże się z wcześniejszym wystąpieniem choroby.Introduction: One of the potential genes which can increase the risk of cancer is GSTP1 gene. It encodes enzyme called glutathione S-transferase &#960; class, which is involved in the detoxification of a variety of potential carcinogenic compounds. Polymorphism in this gene can cause the amino acid substitution. This substitution, close to the substrate binding site, changes the enzymatic activity for particular substrates and subsequently increases the risk of carcinogenesis. The aim of this study was to evaluate the function of GSTP1 polymorphism in thyroid cancer and possible association between GSTP1 polymorphism and age at diagnosis. Material and methods: 103 patients with differentiated thyroid cancer (DTC) and 53 individuals from control group were examined using PCR&#8211;RFLP. Results: Statistically insignificant association of studied polymorphisms with thyroid cancer was observed. Comparison of allele frequency between cases and control groups revealed the presence of risk alleles. For the first polymorphism Ile OR = 1.257; 95% CI [0.792&#8211;1.997] (p = 0.332), and for the second one Val OR = 1.283; 95% CI [0.6260&#8211;2.631] (p = 0.495). The presence of Val/Val (c.313A>G) led to a significant earlier age of onset as compared with other genotypes (p < 0.05). Mean age at diagnosis for Val/Val genotype was 41.1 &plusmn; 15.2, and for Ile/Val + Ile/Ile reached 48.9 &plusmn; 13.2. There was no association between age and genotype for c.341C>T polymorphism. Conclusions: Statistically insignificant association of GSTP1 gene polymorphism with thyroid cancer was observed in studied group of patients. The Val/Val genotype for c.313A>G polymorphism led to earlier age of tumour diagnosis as compared with other genotypes

The COVID-19 drive-through point — screening and testing — first in Poland complex centre experience

Introduction: Rapid widespread of the SARS-CoV-2 virus in early 2020 caused global chaos. In the initial period, a lack of knowledge of epidemiology and viral contamination, as well as no availability of either causal treatment or preventive vaccination, resulted in mass testing of symptomatic individuals as the priority for protection. This study aimed to evaluate the effectiveness and safety of the first COVID-19 (coronavirus disease) drive-through testing model in the Greater Poland Region. Material and methods: The authors demonstrate step-by-step the creation and development of the Centre of Medical Simulation Poznan University of Medical Sciences (PUMS) COVID-19 drive-through testing point for 3.5 million inhabitants in the Greater Poland Region during the 1st through 4th coronavirus pandemic waves. For staff education, low and high-fidelity simulation techniques were used. Additionally, the number of tests performed at the swab point and the efficiency of the developed testing model were evaluated and assessed in all pandemic waves. Results: PUMS POST (point of screening and testing) activity lasted 24 months. Improvement of staff skills developed through simulation training increased the median number of 91 patients tested each day (with a median of 25 tests per hour) during the 1st wave to a maximum of 260 patients tested each day (135 tests per hour) during the 4th wave when the new drive-through POST system was employed (p &lt; 0.001). Conclusion: The present study supported the previous preliminary reports that drive-through systems developed during the COVID-19 pandemic proved to be efficient and safe for mass population testing. Moreover, the Medical Simulation Centre confirmed the effectiveness of staff skills improvement

Analysis of the Possibility of Elimination of Threats Resulting from the Modification of Bullet Trajectory after Hitting the Target in Garrison Shooting Ranges

. During shooting operations in garrison shooting ranges, a phenomenon of random deflection of the bullet flight path was noticed which may cause secondary reflections from accidentally hit technical and ballistic shooting range elements and the ground of the actual plane of the shooting range (ricochets posing a threat to people and property within the shooting range and safety zones). Minimisation of this phenomenon must be considered during the design and operation of the shooting ranges. In 20202022 the Military Institute of Armament Technology (Zielonka, Poland) carried out tests with the aim of determining the impact of the shooting target or military target material or design (hereinafter referred to as the targets) on the risk of occurrence of modifications of bullet trajectory that cause the bullets to leave the shooting zone. The paper presents example results of these tests that show, but are not limited to, that the reasons to modify the direction of the bullet path after target penetration and any ricochets include: target material (flat or corrugated sheet metal, cardboard, plywood, etc.), target wooden legs, and even metal elements fixing the legs to the target. On the basis of the test it was shown that the metal targets prohibited on intermediate lines may cause significant deflections of the bullet flight path after penetration and dangerous ricochets. Due to the reason presented above, the metal targets are placed on the last line of targets before the main bullet trap only where the technical and ballistic parameters of the bullet trap ensure that any ricochets are captured. It was stated that the contact targets used on intermediate target lines and provided with wooden legs may cause bullet trajectory changes comparable to or even greater than in the case of the prohibited metal targets. To this end it is advisable to establish legal framework covering the ballistic inspection of the target materials to be used in garrison shooting ranges

Effect of BMI on the Quality of Life in Patients After Appendectomy Depending on Surgical Modality

Acute appendicitis is one of the most common diseases requiring rapid surgical intervention. The disease occurs most often in people between 10 and 30 years of age, the risk of acute appendicitis during the whole life is 6-20%. The aim of the study was to assess the impact of BMI on the quality of life of patients operated for acute appendicitis according to the method of operation (LA- Laparoscopical Appendectomy OA - Open Appendectomy) and follow-up time after surgery. Material and methods. The study was conducted on a group of 86 randomly selected patients- 40 operated conventionally (18 women and 22 men) and from 46 patients undergoing laparoscopy (33 women and 13 men), which were operated during the period between 15 July 2007 and 27 February 2009. Each patient was assessed by BMI, recognizing the value of > 25 kg/m2 as overweight. In this study the basis of quality of life was a form Medical Outcomes Study36 -the Short Form or SF-36v.2. Results. Patients operated on in LA for 6 months observation to better assessed general health (GH) independently of BMI, while those with BMI ≤ 25 better assessed social functioning (SF) (p =0.027), an overall assessment of Physical Component Summary (PCS) (p = 0.048),Mental Component Summary (MCS) (p = 0.022) as well as an overall indicator of quality of life (p =0.025). The relationships that was not found in observations of more than 6 months after surgery (ns). Conclusions. Questionnaire SF-36v.2 facilitated an objective assessment of quality of life of patients operated on for acute appendicitis. Patients operated on by laparoscopic in observation for 6 months above assessed the quality of life regardless of BMI. The relationships that was not found in observations of more than 6 months after surgery (ns)