The "Wholesome Contact" non-pharmacological, volunteer-delivered multidisciplinary programme to prevent hospital delirium in elderly patients : study protocol for a randomised controlled trial

Background: In hospital settings, delirium affects as many as 50% of older patients, aggravating their symptoms and worsening their condition, and therefore increasing the risk of in-hospital complications and death. The aim of this study is to assess the efficacy of structured, non-pharmacological care, delivered to older hospitalised patients by trained volunteers (students of medical fields), on the reduction of incidence of adverse health-related outcomes. Methods/design: This trial will be a randomised, investigator-blind, controlled trial conducted in an internal medicine and geriatric ward in Poland. We aim to include 416 patients who are 70 years of age and have been hospitalised for medical reasons. Eligible patients will be randomised 1:1 to receive structured, non-pharmacological care delivered by students of medicine, psychology and nursing, together with standard medical treatment or standard medical care alone. The protocol of interventions has been designed to cover nine main risk factors for delirium, with the scope of multidisciplinary interventions being individualised and tailored. The protocol will be aimed at immobilisation, vision and hearing impairment, cognitive impairment and disorientation, stress and anxiety, sleep–wake cycle disturbances, dehydration and malnutrition, and pain. A structured evaluation of patients’ cognition, mood, anxiety and functional performance is planned to be carried out twice, on the day of group allocation and at discharge; structured screening assessment for delirium will be conducted daily using the Confusion Assessment Method. The primary outcome will be the incidence of delirium in hospital; secondary outcomes will be in-hospital changes in cognition, mood and anxiety, and functional status, occurrence of falls and death. Discussion: Delirium prevention programmes are being introduced worldwide. A particular novelty of our project, however, is that invitations for voluntary work with older patients at risk for delirium will be addressed to medical students. With the use of the service learning method, the students will shape their attitudes, increase their knowledge and understanding of hospital care, and master competencies to work within interdisciplinary teams, which establishes the originality and practicality of the project

Is there the gap in public health literature in Europe?

Introduction and objective: The growing expectations for the effectiveness of public health increase the demand for scientific literature, concerning research, reviews and other forms of information. The bibliographic databases are of crucial importance for researchers and policy makers. The objective of this study is to estimate the supply of scientific literature related to public health in selected European countries, which are available to a wide range of users. Material and Methods: Analysis of the number of bibliographic records on topics related to public health was based on searches in Ovid MEDLINE ( R) in May and June 2011. According to MeSH terms, 11 keywords and names of 13 European countries were used in the search. Publications from the years 2001–2010 were analyzed. A number of publications indexed under ‘public health’, and related to selected countries were compared with the size of the population of those countries, GDP, total expenditure on health and burden of disease (DALYS’s). Results: The most popular topic was ‘health policy’, whereas the topics ‘occupational health’ and ‘environmental health’ were less prevalent. There were no significant changes in the number of publications in 2001–2010. The number of articles indexed under ‘public health’ had significant positive correlation with national GDP, expenditure on health and population size, and negative with DALY’s. Conclusions: According to the criteria accepted in this study, the Nordic countries – Finland, Sweden and Norway – were very productive in this respect. Poland and other Central European Countries were less productive

Telemedicine solutions in cardiology : a joint expert opinion by the Information Technology and Telemedicine Committee of the Polish Cardiac Society, the Section of Noninvasive Electrocardiology and Telemedicine of the Polish Cardiac Society, and the Clinical Research Committee of the Polish Academy of Sciences (short version, 2021)

ABSTRACT Telemedicine involves diagnostic, therapeutic and educational services being offered remotely by healthcare professionals to exchange crucial clinical information. It is a rapidly developing form of medical activity and part of medical industry, with advanced technologies already available in Poland. Cardiology is one of the fields in which telemedicine methods were pioneered and introduced into everyday practice. Some of these methods have already become standard procedures for diagnosis and treatment in some Polish centers, with other soon to follow. Clinical study results not only demonstrate reliability and usefulness of telemedicine technologies but also show that their use in clinical practice improves the patients’ prognoses and quality of life. Moreover, study results in highly developed countries show a potential cost-effectiveness of telemedicine from the perspective of healthcare systems. There is an unquestionable need to establish clear rules for telemedicine use in Poland, which would ensure their high quality and adequate clinical application. This paper is a summary of the current status of telemedicine solutions used in cardiology, with a particular focus on the Polish healthcare system, and presents both the commonly available solutions and those that are expected to develop rapidly in the near future

Redox-Active Glycol Nucleic Acid (GNA) Components: Synthesis and Properties of the Ferrocenyl-GNA Nucleoside, Phosphoramidite, and Semicanonical Dinucleoside Phosphate

Ferrocenylated glycol nucleic acid (Fc-GNA) components are rarely studied in the field of xeno nucleic acid (XNA) chemistry. As an attempt to contribute to XNA chemistry, in the present article we report a seven-step synthesis of the first semicanonical dinucleoside containing the Fc-GNA nucleoside linked to the adenosine nucleoside with a phosphodiester bond. First, the nucleoside-bearing ethynylferrocenyl moiety in the C5 position of the uracil nucleobase was obtained. In the following steps, the nucleoside was transformed into the phosphoramidite intermediate that in turn was reacted with N6-benzoyl-2′,3′-O-isopropylideneadenosine to afford the target dinucleoside phosphate with 47% yield. The newly obtained Fc-GNA nucleoside is redox-active, and on the basis of this property (function), it belongs to a new class of functional GNA (fun-GNA) nucleosides. The electrochemistry of the Fc-GNA nucleoside, dinucleoside phosphate, and ferrocenyl furanopyrimidone nucleoside that was obtained as an undesired byproduct of Fc-GNA nucleoside synthesis was investigated by cyclic voltammetry (CV). The CV result showed the presence of a one-electron ferrocenyl-centered redox wave in each case. The half-wave potentials of the Fc-GNA nucleoside and dinucleoside phosphate were 89 and 99 mV, respectively, against the FcH/FcH+ couple. Finally, the activity of the newly obtained Fc-GNA components was studied against the nontumorigenic mouse L929 and human cervix adenocarcinoma HeLa cells. The synthesized compounds showed no cytotoxic activity against the tested cell lines.K.K. thanks the National Science Center in Cracow, Poland (grant OPUS UMO-2018/29/B/ST5/00055), for financial support. Crystallographic measurements were carried out at the Biological and Chemical Research Centre, University of Warsaw, established within the project cofinanced by European Union from the European Regional Development Fund under the Operational Programme Innovative Economy, 2007–2013. The X-ray diffraction data were collected at the Core Facility for Crystallographic and Biophysical Research to support the development of medicinal products sponsored by the Foundation for Polish Science (FNP)

Cardiology telemedicine solutions : opinion of the experts of the Committee of Informatics and Telemedicine of Polish Society of Cardiology, Section of Non-invasive Electrocardiology and Telemedicine of Polish Society of Cardiology and Clinical Sciences Committee of the Polish Academy of Sciences

 For several years, we have observed the dynamic development of technologies that allow patients to access medical care from the comfort of their homes, without direct contact with the doctor. Innovative solutions based on telemedicine improve care coordination and communication among clinicians, patients, and their families, as well as increases patients’ security and gives them greater independence, thus eliminating health care inequalities. The rapidly growth of telemedicine and the adoption of new technologies in clinical practice is also observed in Poland. Crucial moment for the telemedicine facilitation process in our country was Baltic Declaration approved by Minister of Health in 2015, as well as the Medical Profession Amendment Act and remote medical care admission. Since then, as part of the work of the Information Technology and Telemedicine Committee of the Polish Cardiac Society and the Telemedical Working Group, important steps have been taken to implement a telemedicine solutions in the Polish healthcare system, resulting in improved quality and efficiency of this system. The presented document reflects the above actions and encompasses following issues: available telemedicine solutions in the world, analysis of their effectiveness based on clinical trials, funding opportunities, legal status and development prospects telecardiology in Poland.For several years, we have observed the dynamic development of technologies that allow patients to access medical care from the comfort of their homes, without direct contact with the doctor. Innovative solutions based on telemedicine improve care coordination and communication among clinicians, patients, and their families, as well as increases patients’ security and gives them greater independence, thus eliminating health care inequalities. The rapidly growth of telemedicine and the adoption of new technologies in clinical practice is also observed in Poland. Crucial moment for the telemedicine facilitation process in our country was Baltic Declaration approved by Minister of Health in 2015, as well as the Medical Profession Amendment Act and remote medical care admission. Since then, as part of the work of the Information Technology and Telemedicine Committee of the Polish Cardiac Society and the Telemedical Working Group, important steps have been taken to implement a telemedicine solutions in the Polish healthcare system, resulting in improved quality and efficiency of this system. The presented document reflects the above actions and encompasses following issues: available telemedicine solutions in the world, analysis of their effectiveness based on clinical trials, funding opportunities, legal status and development prospects telecardiology in Poland

Comprehensive cardiac rehabilitation as the keystone in the secondary prevention of cardiovascular disease

Comprehensive cardiac rehabilitation (CR) is a mainstay of the secondary prevention of cardiovascular disease. In the European Society of Cardiology guidelines, comprehensive cardiovascular rehabilitation has the highest class of recommendation and level of evidence as an effective method for the treatment of patients with ST-segment elevation myocardial infarction, after myocardial revascularization, with chronic coronary syndrome, for CVD prevention in clinical practice, and in patients with heart failure (HF). This document presents an expert opinion of the Cardiac Rehabilitation and Exercise Physiology Section of the Polish Cardiac Society concerning the definition, goals, target population, organization of rehabilitation services, standard clinical indications and methods of implementation. Moreover, it describes psychosocial risk factors influencing the course of CR and secondary prevention of cardiovascular disease in patients undergoing CR. Comprehensive CR is as a process that should be implemented as soon as possible, continued without interruption, and consist of multiple stages. Moreover, it should be tailored to the individual clinical situation and should be accepted by the patient and their family, friends, and caregivers

Aerobic Dehydrogenative Heck Reaction of Ferrocene with a Pd(OAc)₂/4,5-Diazafluoren-9-one Catalyst

The aerobic dehydrogenative Heck alkenylation of ferrocene with alkenes, catalyzed by a Pd­(OAc)₂/4,5-diazafluoren-9-one system, is disclosed. Monoalkenylated ferrocenes were obtained in moderate yields and selectivities using various electron-poor alkenes. Oxygen at an atmospheric pressure was the sole oxidant. The reaction can be carried out at room temperature (several days) or at 70 °C (∼3 h)

Aerobic Dehydrogenative Heck Reaction of Ferrocene with a Pd(OAc)₂/4,5-Diazafluoren-9-one Catalyst

The aerobic dehydrogenative Heck alkenylation of ferrocene with alkenes, catalyzed by a Pd­(OAc)₂/4,5-diazafluoren-9-one system, is disclosed. Monoalkenylated ferrocenes were obtained in moderate yields and selectivities using various electron-poor alkenes. Oxygen at an atmospheric pressure was the sole oxidant. The reaction can be carried out at room temperature (several days) or at 70 °C (∼3 h)