Work in rehabilitation of persons with disabilities in Poland: formal and legal conditions and reality pragmatics

In the article the materials of the Act on vocational and social rehabilitation and employment of persons with disabilities are presented by the author. An attention is paid to the definition of persons with disabilities and three degrees of disability (minor, moderate or severe). The author describes the situation of persons with disabilities in Poland, the centers for the disabled that were isolated from institutional and social life. New approach to the “work” in the context of rehabilitation to the persons with disabilities is presented in the article. Work is an important form of social rehabilitation as it introduces the disabled to the environment of healthy persons, integrates and socializes them with the society. A model of the social-vocational rehabilitation is analyzed in the given article. У статті представлені матеріали Акту з професійної та соціальної реабілітації та працевлаштування осіб з обмеженими можливостями. Представлено визначення осіб з обмеженими можливостями та три степені осіб з обмеженими можливостями. Автор описує ситуацію (положення) та центри для осіб з обмеженими можливостями у Польщі, які ізольовані від інституційного та соціального життя. У статті представлено новий підхід до працевлаштування осіб з обмеженими можливостями. Праця є важливою формою реабілітації осіб з обмеженими можливостями, оскільки вона вводить неповносправних в оточення здорових людей, інтегрує й соціалізує їх з суспільством. Модель соціально-професійної реабілітації описано у статті

Assessment of students’ benefits resulting from their participation in an innovative project : a case study

PURPOSE: The objective of this paper is to determine the benefits for students of practical training in a multi-sectoral environment, involving practitioners, outside the university.DESIGN/METHODOLOGY/APPROACH: The research was conducted in the scope of an international project based on the following research methods, questionnaires, in-depth interviews and focus group interviews with students from four different countries.FINDINGS: Participation in the experimental practical training outside the university allowed the students to gain additional knowledge and contacts in various milieus. Their soft competences were developed better than their hard competences. The students have become more aware of the determinants of their choice of career path and their educational needs.PRACTICAL IMPLICATIONS: The implementation of selected elements of practical training outside the university can bring beneficial results for both students and academic staff.ORIGINALITY/VALUE: Incorporation of innovative training students by practitioners, outside the university, and in a multi-sector environment – into the academic education system.The project is funded under the program of the Minister of Science and Higher Education titled “Regional Initiative of Excellence” in 2019–2022, project number 018/RID/2018/19, the amount of funding PLN 10 788 423,16.peer-reviewe

Post-merger returns in frontier markets, or how we learned to stop worrying and love the acquirers

This study presents the results from a comprehensive out-of-sample test of long-run returns following mergers and acquisitions (M&As). Using a unique sample from 23 frontier markets of almost 800 transactions conducted during the years 1992 to 2016, we implement both cross-sectional tests and time-series examinations based on a calendar-time portfolio approach. Contrary to evidence from developed markets, the M&As in these frontier markets do not lead to abnormal underperformance of acquirers, regardless of whether they paid for the acquisition with cash or stock. The results are robust to many considerations, including subsample and subperiod analysis, alternative formation periods, different portfolio construction approaches

Vitamin D in children with primary hypertension

Introduction: Recent evidence suggests that vitamin D plays a role in pathogenesis of arterial hypertension. The aim was to assess vitamin D in children and adolescents with arterial hypertension. Material and methods: In 49 children (14.29 ± 3.17 years) with arterial hypertension we evaluated vitamin D status (according to Polish 2018 Guidelines), serum calcium, phosphorus, parathormone, alkaline phosphatase, office blood pressure, ABPM (including ambulatory arterial stiffness index [AASI]), BMI, GFR, uric acid, lipids and albuminuria. None of the children were supplemented with vitamin D. Results: Mean vitamin D concentration was 19.74 ± 9.68 ng/mL. Vitamin D severe deficiency (0–10 ng/mL) was found in 5 (10.2%), deficiency (> 10–20 ng/mL) in 29 (49.0%), suboptimal concentration (> 20–30 ng/mL) in 17 (34.7%), optimal concentration (> 30 to 50 ng/mL) in 1 (2.0%), and high concentration (> 50 to 100 ng/mL) in 2 (4.1%) children. Vitamin D was higher in spring-summer vs. autumn-winter (21.79 ± 10.19 vs. 15.53 ± 7.08 ng/mL, p = 0.03). Vitamin D correlated with height Z-score (r = 0.39, p < 0.01), BMI Z-score (r = -0.34, p = 0.02), uric acid (r = -0.31, p = 0.04), triglycerides (r = -0.37, p = 0.01), but not with office blood pressure and ABPM parameters except for heart rate (r = -0.38, p < 0.01). In 24 children treated with antihypertensive medications vitamin D correlated with AASI (r = 0.50, p = 0.04). Conclusions: Inadequate vitamin D supply is ubiquitous in children with arterial hypertension. Vitamin D deficiency should be suspected especially in autumn-winter period and among obese and short children. The relation between vitamin D status and ambulatory arterial stiffness index suggests negative influence of vitamin D on arterial wall but requires further investigations

Ambulatory blood pressure monitoring and subclinical inflammation in children with chronic kidney disease

Background. Children with chronic kidney disease (CKD) are characterized by increased risk of hypertension andchronic low-grade inflammation. The aim of the study was the analysis of relation between parameters of ambulatoryblood pressure monitoring (ABPM) and subclinical inflammation in children with CKD. Material and methods. Study group included 27 paediatric patients (age 14.23 ± 3.57 years) with CKD stage 2–5;18 children with previously recognized hypertension. In all patients we evaluated ABPM, office blood pressure,complete blood count and selected clinical and biochemical parameters. Results. In the study group, GFR was from 7.05 to 86.73, mean 40.88 ± 25.82 mL/min/1.73 m2. All 9 childrenwithout hypertension had normal blood pressure in ABPM, but ABPM detected poor blood pressure control in 7among 18 (38.9%) children with previously recognized and treated hypertension. Abnormal circadian blood pressureprofile was found in 12 (44.4%) children: 9/18 (50.0%) with hypertension and 3/9 (33.3%) with normal BP. Systolic,diastolic, mean blood pressure and diastolic blood pressure load correlated with neutrophil count, neutrophilto-lymphocyte ratio and platelet-to-lymphocyte ratio (r = 0.39–0.49, p = 0.010–0.044); diastolic and mean bloodpressure and diastolic blood pressure load with parathormone (r = 0.48–0.57, p = 0.005–0.023); diastolic bloodpressure load with phosphate and calcium-phosphorus product (r = 0.44–0.47, p = 0.021-0.030); diastolic bloodpressure dipping with phosphate (r = –0.43, p = 0.034). Conclusions. 1. Ambulatory blood pressure monitoring should be used in children with chronic kidney disease on aregular basis, especially in those with arterial hypertension. 2. Blood pressure in children with chronic kidney diseasemay be related to degree of subclinical inflammation

Ujemna echokardiograficzna próba dobutaminowa u kobiet jako wyznacznik niskiego ryzyka choroby wieńcowej

Wstęp: Echokardiograficzną próbę dobutaminową (EDST, echocardiographic dobutamine stress test) uznaje się za cenną metodę diagnostyczną u pacjentów z chorobą wieńcową. Wobec dowodów odrębności przebiegu choroby niedokrwiennej serca u kobiet i mężczyzn, zwraca się uwagę na konieczność oceny prowadzonych badań w zależności od płci. Cel pracy: Porównanie wartości wyniku EDST u kobiet i mężczyzn ze spontanicznymi bólami w klatce piersiowej, z dodatnim (+) wynikiem próby wysiłkowej (ETT, electrocardiographic treadmill test), bez zmian w dużych naczyniach w wykonanej koronarografii naczyń wieńcowych. Materiał i metody: Echokardiograficzną próbę dobutaminową przeprowadzono według powszechnie przyjętego protokołu obciążenia dobutaminą w zakresie 5-40 mg/kg/min, przy zmianie stężeń o 5 mg co 3 min. Przy dużych stężeniach - od 25 mg - dopuszczono podawanie Atropiny i.v. (0,25&#8211;1,0 mg). Oceniano pojawienie się zaburzeń kurczliwości, wskaźnik zaburzeń kurczliwości (WMSI) przy małej oraz dużej dawce dobutaminy, rejestrowano tętno podczas próby, osiągnięty odsetek tętna maksymalnego i pojawienie się bólu w klatce piersiowej. Według znanych kryteriów kwalifikowano wynik próby jako: zdecydowanie dodatni (++), dodatni (+), ujemny (&#8211;) i niediagnostyczny. U wszystkich pacjentów wykonano koronarografię. Wyniki: Przebadano 50 kobiet i 39 mężczyzn w wieku 50,9 &plusmn; 8,2 oraz 48,8 &plusmn; 10,9 lat. Już u 10% kobiet i 12,8% mężczyzn stwierdzono zaburzenia kurczliwości odcinkowej lewej komory serca w spoczynku. U kobiet przy małych dawkach dobutaminy zaburzenia ustępowały i ponownie występowały przy dużych dawkach leku, zaś u mężczyzn zaburzenia stopniowo narastały od początku stosowanych obciążeń. W wyniku próby ustalono: wynik zdecydowanie dodatni u 7 kobiet (14,0%) i 6 mężczyzn (15,8%), dodatni u 7 kobiet (14,0%) i 6 mężczyzn (15,8%), ujemny u 33 kobiet (66,0%) i 16 mężczyzn (42,1%), p < 0,05; niediagnostyczny u 3 kobiet (6,0%) i 10 mężczyzn (26,3%), p < 0,05. W próbach fałszywie dodatnich u mężczyzn dominują rozległe, bezbólowe lub o małym natężeniu bólu, zaburzenia kurczliwości, w próbach fałszywie dodatnich u kobiet - ból dławicowy bez zaburzeń kurczliwości. Wniosek: Wartość EDST dla kobiet i mężczyzn bez zmian w naczyniach epikardialnych serca różni się; dla kobiet ujemny wynik testu wyklucza ryzyko choroby wieńcowe