Nauczyciel w dobie pandemii

In times of the pandemic, the teacher at every educational level is faced with many new challenges. The following article presents the duties and problems faced by the teaching staff nowadays. The studies that highlight the most common problems in distance learning are briefly discussed. There are presented the competences that are needed in the work of a teacher and those that are needed during online learning. We present the students' needs at this specific time and the problems of the educational environment related to stress.W czasach pandemii nauczyciel na każdym poziomie edukacyjnym postawiony jest przed wieloma nowymi wyzwaniami. W poniższym artykule zaprezentowano obowiązki oraz problemy z jakimi w obecnych czasach musi mierzyć się grono pedagogiczne. Omówiono pokrótce badania, które przedstawiały najczęściej występujące problemy podczas zdalnego nauczania. Przedstawiono kompetencje, które potrzebne są w pracy nauczyciela oraz te, które potrzebne są podczas nauki online. Zaprezentowano potrzeby uczniów w tym specyficznym czasie oraz problemy środowiska edukacyjnego związanego ze stresem

Management of patients with valvular and non-valvular atrial fibrillation in Poland: Results from Reference Cardiology University Center

Background: Information on epidemiology of atrial fibrillation (AF) in Middle European Countries such as Poland is limited. Methods: We studied 1,556 patients with AF. We focused on different types of AF in terms of clinical features and management. Results: CHA2DS2-VASc score was 3.5 ± 1.7 and HAS-BLED score — 2.4 ± 1.1. In-hospital mortality was 2%. The CHA2DS2-VASc score was the highest in permanent AF (p < 0.001) and the HAS-BLED score was the highest in paroxysmal and permanent AF (p < 0.001). The CHA2DS2-VASc score ≥ 2 was found in the majority of non-valvular AF patients. Permanent AF was associated with the highest thromboembolic risk (p < 0.001). Valvular AF was more commonly observed in patients with permanent AF (p = 0.004). Seventy-one percent of pa­tients who had CHA2DS2-VASc > 2 received antithrombotic therapy. Acetylsalicylic acid alone was most common in paroxysmal AF (p < 0.001). Patients with valvular AF had more often permanent AF (p < 0.004). Valvular AF patients were more often prescribed antithrombotic therapy (p = 0.001). The in-hospital mortality did not differ between patients with valvular and non-valvular AF (p = 0.3). In multivariate logistic regression, odds of in-hospital death were higher for patients > 75 years old (OR = 6.26, p = 0.001, 95% CI 2.06–19.02) and with ejection fraction < 35% (OR = 5.25, p < 0.001, 95% CI 2.24–12.32). Conclusions: Our population with AF have similar risk of stroke and bleeding as in Euro­pean registries. The need for anticoagulation in AF patients is well established in daily medical care in Poland similarly to Western Europe. Patients with valvular AF are more frequently prescribed antithrombotic therapy than patients with non-valvular AF. In-hospital mortality is relatively low in both valvular and non-valvular AF patients and is connected with old age and diminished ejection fraction

Znaczenie rokownicze EKG u chorych dializowanych

Wstęp: W związku z dużą chorobowością i śmiertelnością u osób dializowanych ważne jest zidentyfikowanie pacjentów z wysokim ryzykiem powikłań sercowo-naczyniowych. Jednak określenie czułych i specyficznych wskaźników prognostycznych jest niezwykle trudne, co wynika z wieloczynnikowego podłoża obrazu klinicznego przewlekłej choroby nerek. Celem pracy była analiza spoczynkowego zapisu elektrokardiograficznego (EKG) chorych dializowanych oraz ocena wartości prognostycznej zmian patologicznych w 3-letniej obserwacji. Wyniki: W badanej 100-osobowej grupie dializowanych pacjentów śmiertelność całkowita po 3 latach wynosiła 52%, a niekorzystne zdarzenia sercowe (zgon z jakiejkolwiek przyczyny, nagłe zatrzymanie krążenia, zawał serca, udar, potrzeba rewaskularyzacji) zarejestrowano u 57%. Nagłe zatrzymanie krążenia wystąpiło u 12% osób, zawał serca u 12%, udar u 3%, rewaskularyzacja wieńcowa u 5%. Ryzyko zgonu z każdej przyczyny rosło w sposób istotny statystycznie wraz z wystąpieniem rytmu pozazatokowego (p = 0,045), obecnością obniżenia odcinka ST (p = 0,04) oraz przerostu prawej komory (p = 0,03), zwłaszcza definiowanego według kryterium R/S V5/6 < 1 (p = 0,02). Nagłe zatrzymanie krążenia korelowało jedynie z obecnością bloku prawej odnogi pęczka Hisa (p = 0,002). Zawał serca istotnie częściej występował u pacjentów z obecnością R/S V5/6 < 1 (p = 0,01), a także u chorych z wydłużonym odstępem QTc (p = 0,04). Średnia wartość QTc wynosiła 510 ms. Stwierdzono istotną statystycznie korelację między potrzebą rewaskularyzacji a obecnością przerostu lewej komory definiowanego kryterium RI + SIII > 2,5 mV (p = 0,03) oraz przerostu lewego przedsionka (p = 0,01). W analizie nie wykazano istotnej statystycznie zależności między patologicznymi zmianami w zapisie EKG a udarem mózgu. Wystąpienie rytmu pozazatokowego, obniżenia odcinka ST oraz przerostu prawej komory według kryterium R/S V5/6 < 1 korelowało ze złożonym punktem końcowym (p = 0,03, p = 0,01 oraz p = 0,03, odpowiednio). Obecność w EKG bloku lewej odnogi pęczka Hisa nie miała istotnego wpływu na ryzyko zgonu oraz wystąpienia pozostałych analizowanych punktów końcowych. Wnioski: Wybrane nieprawidłowe zmiany w spoczynkowym zapisie elektrokardiograficznym u dializowanych chorych w istotny sposób korelują ze śmiertelnością ogólną oraz z wystąpieniem niekorzystnych zdarzeń sercowych. Badanie elektrokardiograficzne będące metodą nieinwazyjną, powszechnie dostępną i tanią może służyć jako wskaźnik ryzyka powikłań sercowo- -naczyniowych w tej szczególnie zagrożonej populacji

Patients with Atrial Fibrillation and Chronic Kidney Disease More Often Undergo Angioplasty of Left Main Coronary Artery – a 867 Patient Study

Background/Aims: Several studies have implicated atrial fibrillation (AF) as a contributing factor in chronic kidney disease (CKD) and cardiovascular events. The prevalence of coronary artery disease (CAD) in patients with AF varies substantially from 17% to 46.5%. There are only few studies concerning renal function in population with AF undergoing coronary angiography. The aim of the present study was to assess which type of AF is dominant in CKD population scheduled for coronary angiography and if it can influence patients’ outcome, the association between renal impairment and the type of coronary procedures in AF patients and the influence of renal function on in-hospital mortality. Methods: We retrospectively studied 867 patients with AF hospitalized due to coronary angiography in two year time. The cut off value of CKD was eGFR ≤ 60 ml/min./1.73m2 evaluated by CKD-EPI formula. Results: A total of 867 patients with AF (44% women; mean age 72±10 years) were included in the analysis. The mean eGFR was 44±11ml/min./1.73m2 in patients with CKD and 89±18 ml/min./1.73m2 in patients with preserved renal function. Patients with CKD and AF were older (p&#x3c; 0.001), had more often diabetes (p=0.009), heart failure (p&#x3c; 0.001) and anaemia (p&#x3c; 0.001). Patients with CKD and AF had more often permanent type of AF (p&#x3c; 0.001). In CKD patients CHA2DS2VASc score was 4.3±1.5 and HAS-BLED score was 2.0±1.2 and it was significantly higher as compared to population with preserved renal function (p&#x3c; 0.001, p=0.02, respectively). The use of oral anticoagulation was less frequent in CKD group (p&#x3c; 0.001) although these patients had higher CHA2DS2VASc score. Patients with AF and CKD were more often admitted due to myocardial infarction (STEMI or NSTEMI) (p=0.02, p&#x3c; 0.001, respectively) and more often underwent percutaneous coronary intervention (PCI) (p=0.01). Among coronary arteries the percutaneous coronary intervention (PCI) of left main artery was done more frequently in CKD patients (p=0.01). Among CKD population in-hospital mortality was significantly higher in patients with eGFR &#x3c; 30 ml/min (p&#x3c; 0.001). Conclusion: Patients with CKD had more often permanent type of AF. Percutaneous interventions of the left main coronary artery, the only elective procedures influencing patients’ prognosis, were done more frequently in CKD patients with AF. In-hospital mortality was significantly higher in patients with severe renal impairment. Despite the higher risk of ischaemic stroke in CKD group the use of oral anticoagulation therapy was significantly less frequent and the patients were deprived of the confirmed benefits of such treatment

Teacher in the age of pandemic

W czasach pandemii nauczyciel na każdym poziomie edukacyjnym postawiony jest przed wieloma nowymi wyzwaniami. W poniższym artykule zaprezentowano obowiązki oraz problemy z jakimi w obecnych czasach musi mierzyć się grono pedagogiczne. Omówiono pokrótce badania, które przedstawiały najczęściej występujące problemy podczas zdalnego nauczania. Przedstawiono kompetencje, które potrzebne są w pracy nauczyciela oraz te, które potrzebne są podczas nauki online. Zaprezentowano potrzeby uczniów w tym specyficznym czasie oraz problemy środowiska edukacyjnego związanego ze stresem.In times of the pandemic, the teacher at every educational level is faced with many new challenges. The following article presents the duties and problems faced by the teaching staff nowadays. The studies that highlight the most common problems in distance learning are briefly discussed. There are presented the competences that are needed in the work of a teacher and those that are needed during online learning. We present the students' needs at this specific time and the problems of the educational environment related to stress

Effectiveness of Personalized Low Salicylate Diet in the Management of Salicylates Hypersensitive Patients: Interventional Study

Salicylic acid and its derivatives (including acetylsalicylic acid/aspirin) are popular in medicine. They also occur naturally in many food products. The aim of the study was to investigate the effect of the personalized low salicylate diet (PLSD) on the reduction of asthma, rhinosinusitis and urticaria symptoms in patients with hypersensitivity to aspirin (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs). To achieve the research goal, a prospective, nonrandomized, baseline-controlled intervention study was conducted. Thirty patients diagnosed with NSAIDs hypersensitivity, who despite pharmacotherapy had symptoms of hypersensitivity, were included in the study. The PLSD was recommended for all participants for a period of two to four weeks. The intensity of subjectively declared symptoms of asthma, rhinosinusitis and urticaria were measured before and after dietary intervention, using, respectively, the asthma control test (ACT), the sino-nasal outcome test (SNOT-22) and the four-item itch questionnaire (FIIQ). Diet adherence and salicylate intake were measured by a 3-day food record. The severity of symptoms improved significantly after the intervention. The median of the ACT score was 24 scores before and 25 after the dietary intervention (p &lt; 0.002), the median of the SNOT-22 score was 25 before and 13 after a dietary intervention (p &lt; 0.0002) and the median of the FIIQ score was 5 before and 0 after a dietary intervention (p &lt; 0.0002). The intake of salicylates decreased from 0.79 mg/day (before intervention) to 0.15 mg/day (p &lt; 0.001) (during intervention). Although the usefulness of a low salicylate diet in the treatment of salicylate hypersensitivity is controversial, the results of our study indicate that the PLSD may have a positive effect in reducing symptoms of salicylate hypersensitivity and could be an additional tool supporting the therapy of these patients

Dietary Intervention Effectiveness, Clinical Outcomes and Nutrient and Salicylate Intakes in Older Adults Living in Long-Term Care Homes: The Results from the Senior&rsquo;s Plate Project

Optimal nutrition is an important part of the therapeutic process offered to patients in long-term care, as it can significantly influence their nutritional and health status. The aim of this study was to assess the impacts of a dietary intervention on the nutritional status, clinical outcomes and selected nutrient and salicylate intakes among older adults living in a long-term care nursing home. To achieve the research goal, a prospective, non-randomized, baseline-controlled intervention study was conducted. The study was conducted within the framework of the &ldquo;Senior&rsquo;s Plate Project&rdquo;, a project established in 2018 by the Polish Society of Dietetics. Methods: A 3 month dietary intervention, which included one serving of supplementary food, served as a second breakfast (Nestle Sinlac). Energy, nutrients and salicylates intakes were estimated on the basis of the menus. Food and beverage intakes among residents were verified by health care personnel. Anthropometric measurements and clinical examinations were conducted according to standard procedures at baseline and after intervention. Results: Of the 38 residents qualified for the study, 29 completed the program. Residents&rsquo; body mass index (BMI) values ranged from 13.3 kg/m2 to 34 kg/m2. A BMI &lt; 22 kg/m2, indicating underweight, was found in 19 subjects. The dietary intervention resulted in increased body weight (57.8 &plusmn; 12.3 vs. 59.4 &plusmn; 12.6 kg), BMI (22.4 &plusmn; 4.0 vs. 23.0 &plusmn; 4.1 kg/m2) and body fat (19.2 &plusmn; 8.7 vs. 20.6 &plusmn; 8.9 kg). Significant changes in the levels of biochemical parameters, including serum calcium (8.7 vs. 9.5 mg/dL), potassium (4.1 &plusmn; 0.6 vs. 4.5 &plusmn; 0.5 mmol/L) and zinc (74.1 &plusmn; 10.9 vs. 109.0 &plusmn; 20.4 &micro;g/dL), were observed. Energy, protein, fat and carbohydrate intakes were significantly higher in the third month of the intervention as compared to the baseline. The estimated medial daily intake of salicylates was low and ranged from 0.34 mg to 0.39 mg. Conclusions: The dietary intervention resulted in beneficial and significant changes in the nutritional status, biochemical parameters and nutrition of residents of the long-term care home. These results suggest that practical and individualized approaches are required to improve the nutritional status and clinical outcomes of nursing homes residents

The effectiveness of human resource management on the example of the food industry

eISSN 2345-0916; eISBN 9786094491283Everything formed in the company including products, services and all ideas are created by human. Therefore, human capital is one of the most important resources of an organization and source of achieving company’s success. The relation between employee fulfilment, satisfaction of their work and their effectiveness, commitment, performance and identification with the organization seems to be obvious. The goal of the paper is to present the review of the literature in the field of human capital management and the cognitive purpose is the analysis of the implementation of selected elements of human resource management and most of all methods and tools that improve the performance of employees. The research method was a survey carried out among the selected employees in Natures Way Food – organization based in Southern England, West Sussex. The study involved 100 randomly selected employees of Natures Way Foods. As a method of data collection was used the auditorium questionnaire consisting of 30 questions carried out in the workplace of surveyed people. The survey was anonymous and its results served for conclusions and proposals for changes in the implementation of HR processes, affecting the efficiency of employeesVytauto Didžiojo universitetasŽemės ūkio akademij

Quality assessment of living of sick persons with the multiple sclerosis

Wstęp. Stwardnienie rozsiane (SM) jest chorobą ośrodkowego układu nerwowego, charakteryzującą się obecnością rozsianych ognisk demielinizacji w mózgu i rdzeniu kręgowym z początkowo przemijającymi, a potem z utrwalonymi licznymi zaburzeniami neurologicznymi. Cel pracy. Celem pracy było dokonanie oceny jakości życia chorych na stwardnienie rozsiane oraz poznanie czynników determinujących tę ocenę. Materiał i metody. Badanie zostało przeprowadzone w siedzibie Stowarzyszenia Rozsianego w Bydgoszczy, na grupie 31 osób. Chorzy byli kwalifikowani na podstawie rozpoznania klinicznego SM. W badaniu posłużono się kwestionariuszem Funkcjonalnej Oceny Stwardnienie Rozsianego (FAMS), Rozszerzoną Skalą Niewydolności Ruchowej Kurtzkego (EDSS) oraz własnym kwestionariuszem. Wyniki. Średnia wieku badanych wyniosła 55 lat; 93,5% osób pochodziło z miasta. Były to osoby w większości z wykształceniem średnim, nieaktywne zawodowo. U około 50% ankietowanych występowała postać pierwotnie postępująca. Średni wiek zachorowania wyniósł 34 lata. Głównym rodzajem leczenia była rehabilitacja (67,7%). Analizie poddano korelacje między ogólną jakością życia a jej poszczególnymi wymiarami. Wnioski. Większość badanych wysoko oceniła swoją jakość życia. Istnieje związek pomiędzy ogólną oceną jakości życia, a jej poszczególnymi wymiarami. Płeć istotnie koreluje z ogólną jakością życia. Analizowane czynniki kliniczne nie wpływają na ogólną jakość życia badanych. Problemy Pielęgniarstwa 2012; 20 (4): 442&#8211;453Introduction. Multiple sclerosis is a disease of central nervous system characterized by presence of disseminated demyelinisation in brain and spinal cord with initally transient and then with many continous neurological disorders. Aim of the study. Assessment of ill of multiple sclerosis patient&#8217;s life quality and recognition determinants of this evaluation. Material and methods. Analysis was conducted in habitat of Multiple Sclerosis Association in Bydgoszcz on group of 31 people. Patients were qualified on the basis of medical diagnosis of multiple sclerosis. Analysis used a questionnaire of FAMS, EDSS and personal questionnaire. Results. Average age was 55 years old. 93,5% of studied came from city. Mainly people with secondary education, economically inactive. About 50% of respondents had primarily progressive disease faze. The average age of illnes was 34 years old. The main type of treatment was rehabilitation (67,7%). I analyzed the correlations between generall life quality and this various dimensions. Conclusions. Most respondents highly appreciated their quality of life. There is relationship between the overall assessment of quality of life and it&#8217;s various dimensions. Gender correlated with the overall quality of life. Analyzed clinical factors did not affect the overall quality of life for patients. Nursing Topics 2012; 20 (4): 442&#8211;45