Validation of the Polish version of P-QoL questionnaire

Objective: Pelvic organ prolapse (POP) is a common morbidity that affects many women and significantly decreases quality of life. The severity and the impact of the prolapse on the quality of life are important parameters in the management and follow-up of affected patients. The aim of this validation study was to validate the Polish version of the Prolapse Quality of Life questionnaire (P-QoL). Material and methods: The P-QOL questionnaire was translated into Polish and administered to women recruited from two gynecological outpatient clinics (n = 231). Both symptomatic and asymptomatic women were included in the study and examined in supine position using the Pelvic Organ Prolapse Quantification System (POP-Q). The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women. Results: A total number of 154 symptomatic and 77 asymptomatic women were included. There was a strong correlation between severity of the disease based on physical findings (POP-Q scale) and the P-QoL scores in main prolapse quality-of-life domains. The overall scores for each life domain were significantly different between symptomatic and asymptomatic women (p < 0.001). All the questions regarding symptoms showed significant differences (p < 0.001) between both groups. Conclusions: The Polish version of P-QoL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in Polish-speaking women suffering from urogenital prolapse

Towards improving the quality of internships in medicine and allied health professions

Introduction: One of the important elements influencing the well-being of society is a highly educated, professional staff of the entire therapeutic team. Physiotherapists play a significant role in this team, which is why the higher education system is expected to make efforts to develop optimal education programs, including the development of practical skills. The purpose of this article is to present the Healint4All project, whose mission is to facilitate international internships for students of physiotherapy and other medical professions, which will allow high-class professionals in the healthcare sector to enter the job market. Material and methods: A step-by-step process of creating a protocol for auditing places of clinical practice was prepared. Virtual, interactive teaching resources were developed to prepare auditors. A literature analysis, focus interviews in groups of academic teachers, practitioners, and students. A pilot study of the protocol in live environments was conducted. Results: Both potential auditees (medical institutions) and auditors (universities) positively assessed the newly created tool. The recommendations included paying attention to transparency, simplicity, and linguistic correctness in all language versions of the protocol. It was suggested that the protocol, containing everything useful, should not be too long and would not burden the user with time. Conclusions: In the opinion of students and experts who evaluated the Healint4All protocol, it will contribute to increasing the supply and quality of international placements offered by healthcare organizations throughout Europe, as well as simplifying the processes involved in organizing these for students, educational institutions, and healthcare organizations

The Fe-Mg interplay and the effect of deposition mode in (Ga,Fe)N doped with Mg

The effect of Mg codoping and its deposition mode on the Fe distribution in (Ga,Fe)N layers grown by metalorganic vapor phase epitaxy is investigated. Both homogeneously- and digitally-Mg codoped samples are considered and contrasted to the case of (Ga,Fe)N layers obtained without any codoping by shallow impurities. The structural analysis of the layers by high-resolution transmission electron microscopy and by high-resolution- and synchrotron x-ray diffraction gives evidence of the fact that in the case of homogenous-Mg doping, Mg and Fe competitively occupy the Ga-substitutional cation sites, reducing the efficiency of Fe incorporation. Accordingly, the character of the magnetization is modified from ferromagnetic-like in the non-codoped films to paramagnetic in the case of homogeneous Mg codoping. The findings are discussed vis-`a-vis theoretical results obtained by ab initio computations, showing only a weak effect of codoping on the pairing energy of two Fe cations in bulk GaN. However, according to these computations, codoping reverses the sign of the paring energy of Fe cations at the Ga-rich surface, substantiating the view that the Fe aggregation occurs at the growth surface. In contrast to the homogenous deposition mode, the digital one is found to remarkably promote the aggregation of the magnetic ions. The Fe-rich nanocrystals formed in this way are distributed non-uniformly, giving reason for the observed deviation from a standard superparamagnetic behavior.Comment: 13 pages, 14 figure

Co-creation of a virtual interactive teaching package for auditors of healthcare placements - towards assurance of quality of health care traineeships

To provide medical and allied health professionals students with the best clinical learning environments, quality processes must be in place, and these require innovation to assure audit material resources that are fit for purpose, can work well within the situation and provide the correct teaching and learning to train auditors. HEALINT4ALL ERASMUS+ Strategic partnership provides medical education and allied health professionals with an audit system to facilitate quality assurance of EU clinical learning environments by mapping and innovatively adapting a newly established audit protocol and support tools to suit the Higher Education needs for wider application to medicine and professionals allied to medicine. The project conducted a literature scoping review followed by interviews and focus groups across all 6 European partners of clinicians, students and educators of service needs and best practice, resulting to map standards and requirements for clinical learning environments and develop a protocol to assess the quality of placements. Next, it developed a digital interactive platform for European and national placements appraisal following user-centred design to allow the collaboration between Higher Education Institutions (HEIs), and HEIs and placements. In order the application of the HEALINT4ALL protocol within the digital interactive tool to be beneficial, the auditors of the healthcare placements should have the necessary competences to perform the audits utilising the HEALINT4ALL a digital interactive platform. An online or blended learning approach is preferred to fit with the clinical academics' needs that will undertake the role of auditor. Thus, HEALINT4ALL co-created a Virtual Interactive Teaching Package for Training the Auditors of Healthcare Placements. It followed a modified ASPIRE framework to develop the package. The ASPIRE framework stands for Aims, Storyboarding, Population, Implementation, Release and Evaluation. This work describes the co-creation journey that engaged stakeholders in 6 different countries in order to co-design the resources, experts in the field that reviewed the content to ensure its high quality, the development that followed and the first pilot's evaluation from experts. While some efforts have been made towards the standardisation of auditing clinical placements, to the best of our knowledge this is the first attempt to develop a short curriculum to training the auditors of healthcare placements and implemented as a virtual interactive teaching package

Efficacy and safety of larotrectinib in TRK fusion-positive primary central nervous system tumors

BACKGROUND Larotrectinib is a first-in-class, highly selective tropomyosin receptor kinase (TRK) inhibitor approved to treat adult and pediatric patients with TRK fusion-positive cancer. The aim of this study was to evaluate the efficacy and safety of larotrectinib in patients with TRK fusion-positive primary central nervous system (CNS) tumors. METHODS Patients with TRK fusion-positive primary CNS tumors from two clinical trials (NCT02637687, NCT02576431) were identified. The primary endpoint was investigator-assessed objective response rate (ORR). RESULTS As of July 2020, 33 patients with TRK fusion-positive CNS tumors were identified (median age: 8.9 years; range: 1.3-79.0). The most common histologies were high-grade glioma (HGG; n = 19) and low-grade glioma (LGG; n = 8). ORR was 30% (95% confidence interval [CI]: 16-49) for all patients. In all patients, the 24-week disease control rate was 73% (95% CI: 54-87). Twenty-three of 28 patients (82%) with measurable disease had tumor shrinkage. The 12-month rates for duration of response, progression-free survival, and overall survival were 75% (95% CI: 45-100), 56% (95% CI: 38-74), and 85% (95% CI: 71-99), respectively. Median time to response was 1.9 months (range 1.0-3.8 months). Duration of treatment ranged from 1.2-31.3+ months. Treatment-related adverse events were reported for 20 patients, with Grade 3-4 in 3 patients. No new safety signals were identified. CONCLUSIONS In patients with TRK fusion-positive CNS tumors, larotrectinib demonstrated rapid and durable responses, high disease control rate, and a favorable safety profile

Childhood rhabdomyosarcoma metastatic to bone marrow presenting with disseminated intravascular coagulation and acute tumour lysis syndrome: review of the literature apropos of two cases

The paper presents diagnostic and therapeutic difficulties in two adolescents with widespread rhabdomyosarcoma (RMS) presenting with severe haemorrhages resulting from disseminated intravascular coagulation (DIC) and with laboratory features of acute tumour lysis syndrome (ATLS). Other published cases of childhood RMS with DIC at admission have been listed and reviewed. It has been concluded that the clinical picture of a widespread RMS in children may resemble acute hematologic malignancy and pose a big diagnostic problem. That is why the presence of small blue round cells morphologically similar to lymphoblasts and/or myeloblasts in bone marrow (BM), lacking hematopoietic makers, should prompt the pathologist to consider possible diagnosis of RMS. Inclusion of desmin, MyoD1 and myogenin Myf4 to the immunohistochemical panel is obligatory in such cases. When the representative histopathological tumour specimens are difficult to obtain, the flow cytometric immunophenotyping of BM metastases could help the standard morphological/immunohistological diagnostic procedures and advance the diagnosis. Recently, the flow cytometric CD45− CD56+ immunophenotype together with Myf4 transcript has been assigned to RMS cells infiltrating BM. In children with disseminated RMS complicated with DIC rapid polychemotherapy aimed at diminishing the malignancy-triggered procoagulant activity should be initiated. However, in cases with concomitant ATLS the initial doses of chemotherapy should be reduced and the metabolic disorders and renal function monitored. The prognosis in children with RMS metastatic to BM with signs of DIC or ATLS at admission depends on the response to chemotherapy, however generally it is highly disappointing

Biodiversity and structure of spider communities along a metal pollution gradient

The objective of the study was to determine whether long-term metal pollution affects communities of epigeal spiders (Aranea), studied at three taxonomic levels: species, genera, and families. Biodiversity was defined by three indices: the Hierarchical Richness Index (HRI), Margalef index (DM) and Pielou evenness index (J). In different ways the indices describe taxa richness and the distribution of individuals among taxa. The dominance pattern of the communities was described with four measures: number of dominant species at a site, percentage of dominant species at a site, average dominant species abundance at a site, and the share of the most numerous species (Alopecosa cuneata) at a site. Spiders were collected along a metal pollution gradient in southern Poland, extending ca. 33 km from zinc and lead smelter to an uncontaminated area. The zinc concentration in soil was used as the pollution index.The study revealed a significant effect of metal pollution on spider biodiversity as described by HRI for species (p = 0.039), genera (p = 0.0041) and families (p = 0.0147), and by DM for genera (p = 0.0259) and families (p = 0.0028). HRI correlated negatively with pollution level, while DM correlated positively. This means that although broadly described HRI diversity decreased with increasing pollution level, species richness increased with increasing contamination. Mesophilic meadows were generally richer. Pielou (J) did not show any significant correlations. There were a few evidences for the intermediate disturbance hypothesis: certain indices reached their highest values at moderate pollution levels rather than at the cleanest or most polluted sites