An Investigation into the Neurobiology of Treatment Response in patients with Major Depression: The Placebo Effect.

Recent trends in clinical neuroscience have moved toward identifying neurobiological predictors of antidepressant treatment effects in order to improve overall treatment efficacy in Major Depression, a pervasive and debilitating disorder in which complete remission occurs for only one-third of treatment-seeking patients. However, predictors of placebo effects have largely been overlooked. This is not a small concern: substantial placebo response rates have been documented within antidepressant clinical trials. Hence, neuroimaging predictors of placebo responses may elucidate the neural pathways responsible for depression recovery. Moreover, these predictors may identify patients with a greater susceptibility to placebo effects; in turn, informing patient stratification in antidepressant clinical trials to better distinguish between drug-specific and placebo effects or augment prescribed treatments for patients in clinical settings. This dissertation takes a network-based resting-state functional connectivity (rsFC) approach to investigate predictors of placebo and antidepressant responses with particular focus on the default-mode, salience, and executive networks. This approach allows for consistency with the inherent network organization of the brain and the network-based characterization of depression. Through this investigation, enhanced rsFC of the rostral anterior cingulate (rACC) within the salience network has emerged as a strong predictor of responses to placebo with antidepressant expectations. Furthermore, heightened rACC rsFC within the salience network manifests as a neurobiological pattern differentiating healthy subjects from depressed patients. Finally, in light of evidence that genetic variability within placebo-related pathways modulate placebo treatment outcomes in depression as well as analgesia, where neural and molecular bases of placebo have been extensively mapped, the final chapter of this dissertation observed an effect of genetic polymorphisms within the prepronociceptin gene, an endogenous opioid precursor neuropeptide associated with nociception and depression, on analgesic placebo-induced µ-opioid activation within the rACC and other well-established, placebo-related regions. This effect further corresponded with placebo-associated stress responses and anxiety. These findings enlighten our understanding of the neurobiology behind depression recovery through placebo effects and illustrate the importance of the rACC within antidepressant responses and healthy functioning. Finally, they contribute to a growing database of potential clinical neuroimaging and genetic markers of placebo responses which may substantially benefit therapeutic care in depression.PhDNeuroscienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/116639/1/masikora_1.pd

Management of a medical entity based on models of competitiveness of enterprises on the example of Corten Medic Medical Center

Competitiveness of a company is one the most crucial determinates in the managing process which is independent of the sector of the economy. This issue is distinctively complex in the health care sector, for the specificity of the service it provides – saving lives and good health of patients. Therefore, the healthcare sector of the economy, the mechanisms, and processes that it undergoes are specific and different from other free market sector. This specificity also refers to competitiveness aspect in the health care sector. The aim of the research was primary analysis of competitiveness factors and determinants in the health care sector. A proper overview of potential enterprise competitiveness models has also been carried out, which could be implemented in managing of health care unites. With accordance to the presented analysis of the available models, cause and effect model competitiveness model has been chosen to analyse and asses CM Corten Medic health care unit’s competitiveness potential

Kluczowe czynniki konkurencyjności podmiotów leczniczych

Introduction: The healthcare sector, like other sectors of the economy, is based on competition. Due to the uniqueness of the services provided (involving saving human health and life), the competitiveness of healthcare entities differs from the typical free market. Purpose: The aim of the study was to identify the factors of competitiveness of healthcare entities in four distinguished areas of competitiveness of enterprises - external factors (macro- and micro-environment) and internal factors (resources and assets). Results: Macro-environment factors were grouped into: political-legal, economic, social, technological, and demographic. Micro-environment was divided into: consumers, competitors (considering their intensity and entry barriers), and suppliers. Resources were divided into: financial assets, room infrastructure, and equipment facilities. Assets, on the other hand, were characterized based on the elements of the organization's system, determining their efficiency – strategy, styles, competencies, employees, structure, and organization's culture.  Conclusions:  The review and systematization of factors influencing the competitiveness of healthcare entities enables to assess their competitive potential in the context of individual areas and key success factors.Wstęp: Rynek ochrony zdrowia, podobnie jak inne sektory gospodarki oparty jest o konkurencyjność. Z uwagi na unikalność świadczonych usług (polegających na ratowaniu ludzkiego zdrowia i życia), konkurencyjność podmiotów leczniczych różni się od typowego wolnego rynku. Cel: Celem pracy była identyfikacja czynników konkurencyjności podmiotów leczniczych w czterech wyróżnionych obszarach konkurencyjności przedsiębiorstw – czynników zewnętrznych (makro- i mikrootoczenie) oraz czynników wewnętrznych (zasoby i aktywa). Wyniki: Czynniki makrootoczenia zostały pogrupowane na: polityczno-prawne, ekonomiczne, społeczne, technologiczne i demograficzne. Mikrootoczenie zostało podzielone na: konsumentów i konkurentów, uwzględniając ich intensywność oraz bariery wejścia na rynek oraz dostawców. Zasoby podzielono na: aktywa finansowe, infrastrukturę pomieszczeń oraz wyposażenie w sprzęt. Natomiast aktywa zostały scharakteryzowane w oparciu o elementy systemu organizacji, warunkujące ich sprawczość – strategię, style, kompetencje, pracowników, strukturę oraz kulturę organizacji.  Podsumowanie: Dokonany przegląd i systematyzacja czynników wpływających na konkurencyjność podmiotów leczniczych umożliwia ocenę ich potencjału konkurencyjności w kontekście poszczególnych obszarów i scharakteryzowanych w nich kluczowych czynników sukcesu

Olejki eteryczne – co trzeba o nich wiedzieć

Artykuł zamieszczony jest w : Życie Uczelni : biuletyn informacyjny Politechniki Łódzkiej, nr 155, Luty 2021W produktach do pielęgnacji skóry, nie tylko samych dłoni, można wykorzystać także olejki eteryczne. Należy jednak pamiętać, że pod tą nazwą kryje się ściśle określona grupa surowców

Skóra dłoni – pielęgnacja w okresie pandemii

Artykuł zamieszczony jest w : Życie Uczelni : biuletyn informacyjny Politechniki Łódzkiej, nr 155, Luty 2021Skóra dłoni ulega niekorzystnym zmianom znacznie szybciej niż skóra innych części ciała. Jest ona wyposażona praktycznie wyłącznie w gruczoły potowe, nie posiada gruczołów łojowych. To powoduje, że jest słabo zabezpieczona naturalną warstwą ochroną i jest szczególnie podatna na działanie wielu szkodliwych czynników zewnętrznych

Microbiological quality of drinking water in public and municipal drinking water supply systems in Osijek-Baranja County, Croatia

Microbiological and chemical quality of drinking water primarily results from water origin and type of applied water treatment. Since the drinking water is one of the mean way through which many infectious agents can be transmitted to humans causing waterborne diseases, constant monitoring of drinking water quality in water supply systems is needed. This study investigates the microbiological quality of drinking water in twenty five public and municipal water supply systems in the area of Osijek-Baranja County in eastern Croatia. The microbiological analyses were conducted for following parameters: total coliforms, Escherichia coli, colony count at 22 °C and 37 °C, enterococci and Clostridium perfringens. In most of investigated water supply systems processed groundwater are used, and since increased concentrations of some chemical compounds in water can influence on appearance and growth of microbiological populations, in this study relevant physicochemical parameters were also measured and correlated with obtained values of analyzed microbiological parameters. Five physicochemical indicators were determined: temperature, turbidity, pH value, free residual chlorine and ammonium concentration. Results indicated that 149 of 1503 analyzed drinking water samples were non-compliance with microbiological criteria set by Croatian regulations (88.7 % and 89.2 % of 149 had values of colony count at 22 °C and 37 °C higher than the required). Total coliforms, enterococci and Escherichia coli were founded in 3.9 %, 1.1 % and 1 % of non-compliance drinking water samples, respectively. Clostridium perfringens was not detected in any of the drinking water samples. Calculating Pearson’s coefficients of correlation among analyzed microbiological and physicochemical indicators, very weak correlations were obtained. The highest but negative correlation was observed between appearance of microbiological population and concentrations of free residual chlorine (lower free residual chlorine – higher appearance of microbiological population) and positive correlation between turbidity and appearance of microbiological population (higher turbidity – higher appearance of microbiological population)

The essence and scope of competitiveness of healthcare organisations in Poland

Purpose – The paper presents an analysis of the broadly defined essence of competitiveness in the healthcare sector and the closely related issue of the competitiveness of healthcare organisations accounting for the specifics of key types of competition in healthcare. The objective of the paper is to demonstrate that the essence of competition between healthcare organisations is represented by a better use of resources by some enterprises and enhanced cost efficiency in the conditions of the increased demand for top quality services. Research method – The research methodology applied in the study was literature research, the analysis of available empirical research results and of the laws and regulations applicable to the healthcare market. The analysis focused on the specifics of the Polish healthcare market and the ensuing conse-quences for the competitiveness of healthcare organisations. Results – The results of the analysis show how complex the issue of competitiveness of healthcare organisations is and how relevant it is for the increase of quality, availability, and innovativeness of healthcare for patients.Tomasz Sikora: [email protected] Kanecki: [email protected] Sikora: [email protected] Bogdan: [email protected] Sikora - Medical Center Corten MedicKrzysztof Kanecki - Department of Social Medicine and Public Health, Medical University of WarsawAgnieszka Sikora - Medical Center Corten MedicMagdalena Bogdan - Department of Social Medicine and Public Health, Medical University of WarsawAct, 2011, Ustawa z dnia 15 kwietnia 2011 r. o działalności leczniczej (Dz.U. z 2011 r. nr 84 poz. 455).Arrow K.J., 1979, Lecznictwo z punku widzenia niepewności i ekonomii dobrobytu, Eseje z teorii ryzyka, WN PWN, Warszawa.Bloom N., Propper C., Seiler S., Reenen J.V., 2010, The impact of competition on management quality: evidence from public hospitals, “CEP Discussion Paper”, No. 0983, pp. 1-47.Cooper Z., 2011, In brief: competition in the public sector: good for the goose, good for the gander?, “The Magazine for Economic Performance”, Paper Number CEPCP341, pp. 14-15.Corrigan P., Mitchell C., 2011, The hospital is dead, long live the hospital, Reform, London.Dobija M., 2000, Human resource costing and accounting as a determinant of minimum wage theory, „Zeszyty Naukowe. Akademia Ekonomiczna w Krakowie”, nr 553, s. 39-61.Donabedian A., 1998, The quality of care: how can it be assessed?, “JAMA”, vol. 260(12), pp.1743-1748, DOI: 10.1001/jama.260.12.1743.Greenshields G., 2000, Cele i strategie prywatyzacji opieki szpitalnej w Polsce, Bywater Consulting, Warrington.Hauke E., 1995, Poradnik dla zapewnienia jakości w szpitalu. Wskazówki do praktycznego użytku, Instytut Organizacji Szpitalnictwa im. L. Boltzmanna w Wiedniu, Warszawa.Kowalska K., 2005, Racjonowanie usług medycznych – spojrzenie ekonomisty, „Diametros”, nr 5, s. 223-233.Lisiecka-Biełanowicz M., 2001, Zarządzanie jakością usług zdrowotnych, Zarządzanie w ochronie zdrowia. Narzędzia pracy menedżera, Kolegium Zarządzania Akademii Ekonomicznej, Katowice.Łukasiewicz G., 2009, Kapitał ludzki organizacji. Pomiar i sprawozdawczość, WN PWN, Warszawa.Misiński W., 2007, Modelowanie systemu powszechnych ubezpieczeń zdrowotnych w Polsce, Wydawnictwo Akademii Ekonomicznej im. Oskara Langego, Wrocław.Perechuda K., Chomiak-Orsa I., 2013, Znaczenie kapitału relacyjnego we współczesnych koncepcjach zarządzania „Zarządzaniei Finanse”, nr 4(1), s. 293-307.Pędziński B., 2016, Innowacyjne Centrum Diagnostyczno-Lecznicze – od teorii do praktyki, Łomżyńskie Centrum Medyczne, Łomża.Rabiej E., 2013, Formy organizacyjne podmiotów leczniczych – uwarunkowania prawne i ekonomiczne, „Przedsiębiorstwo i Region”, nr 5, s. 100-108.Rudawska I., 2007, Opieka zdrowotna, aspekty rynkowe i marketingowe, WN PWN, Warszawa.Stępiński J., Karniej P., Kęsy M., 2011, Innowacje organizacyjne w szpitalach, Wolters Kluwer business, Warszawa.Suchecka J., 2010, Ekonomia zdrowia i opieki zdrowotnej, Wolters Kluwer Polska, Warszawa.Tyszko P., Wierzba W., Kanecki K., Jagielska A., 2007, Transformationof the ownership structure in Polish Healthcare and its effects, “Central and European Journal of Medicine”, vol. 2(4), pp. 528-538, DOI: 10.2478/s11536-007-0045-z.Walsche K., Smith J., 2011, Zarządzanie w opiece zdrowotnej, Wolters Kluwer business, Warszawa.Wielicka K., 2014, Zarys funkcjonowania systemów opieki zdrowotnej w wybranych krajach Unii Europejskiej, „Zeszyty Naukowe Politechniki Śląskiej”, nr 70, s. 491-504.Wiercińska A., 2012, Specyfika rynku usług zdrowotnych, „Zarządzanie i Finanse”, nr 2(2), s. 165-176.www 1, An assessment of possible improvements to the functioning of the Polish healthcare system 2011, http://www.ey.com/Publication/vwLUAssets/Organizacja_procesu_bud-zetowego_pl.pdf/$FILE/Ocena_mozliwosci_poprawy_EN.pdf [date of entry: 12.03.2018].www 2, Healthcare Leadership Model, NHS, https://www.leadershipacademy.nhs.uk/ wp-content/uploads/2014/10/NHSLeadership-LeadershipModel-colour.pdf [date of entry: 20.09.2021].www 3, Planowane wydatki na zdrowie w latach 2018-2020, 2021, https://stat.gov.pl/ obszary-tematyczne/zdrowie/zdrowie/wydatki-na-ochrone-zdrowia-w-latach-2018-2020,27,1.html [date of entry: 20.09.2021].www 4, Zarządzenie nr 47/2016/DSOZ Prezesa NFZ, http://www.nfz.gov.pl/zarza-dzenia-prezesa/zarzadzenia-prezesa-nfz/zarzadzenie-nr-472016dsoz,6486.html [date of entry: 12.03.2018].www 5, Zarządzenie Nr 3/2014/DSOZ Prezesa NFZ, http://www.nfz.gov.pl/zarza-dzenia-prezesa/zarzadzenia-prezesa-nfz/zarzadzenie-nr-32014dsoz,5902.html [date of entry: 12.03.2018].4(106)182

RNA-based vaccines – types, strategies of delivery and overview of RNA vaccines

  The discovery of mRNA by Sydney Brenner dates back to 1961, but the in vivo expression of mRNA was successful only in 1990, which initiated the development of vaccines based on this molecule. During Sars-CoV-2 pandemy the interest in the use of nucleic acids in the production of drugs and vaccines has increased significantly. The success of mRNA vaccines against Sars-CoV-2 has particularly empowered the pharmaceutical industry to create newer and newer generation products based on RNA modification that could help not only in Covid-2019, but also in the prevention and treatment of other infectious diseases. RNA has a very high potential - it can be used in highly personalized therapies, furthermore the production of mRNA is cheaper, faster than the current therapeutics and the process of mRNA making is more flexible due to the great ease of producing mRNA in the process of transcription. Modifying of the structure of ribonucleic acid and the methods of its delivery leads to the creation of newer and newer vaccines. In this review, we present the potential of RNA molecule in producing vaccines, types of RNA vaccines, strategies of RNA delivery and review of existing RNA-based vaccines