Postawy kobiet wobec zapłodnienia in vitro

Praca recenzowana / peer-reviewed paperInfertility, as defined by the World Health Organization, is the inability to become pregnant despite of regular sexual intercourse for more than a year without pregnancy prevention. The causes of infertility can result from both – the female and male side. The aim of this study was to understand the attitudes of women aged 20–25years towards in vitro fertilization in vitro. How they perceive the in vitro method and where they get the information about in vitro fertilization. Does the IVF (in vitro fertilization), awakening so much controversy, is consistent with the views of the respondents? The study involved 50 women from the district Dabrowski (voivodeship małopolska, Poland), aged between 20 and 25 years old. The method used in research was a diagnostic survey involving a questionnaire created by the author of the thesis. Respondents were informed about the aim of the survey and its anonymity. Conducted survey obtained information about the level of knowledge and attitudes of women towards in vitro fertilization. The study found that the respondents are aware that the cause of infertility can lie on both, the women and men side. Respondents despite of declaring a Roman Catholic religion, accept the in vitro method as a chance to have their own children, that can’t be conceived in a natural way. Surveyed women showed a signifi cant defi cit of knowledge about extracorporeal in vitro fertilization. This knowledge should be given by the public health nurses

Działania opiekuńcze w profilaktyce i terapii

Praca recenzowana / Peer-reviewed paperOpieka jest potrzebna wszystkim, zarówno dzieciom, jak i dorosłym, a w sposób szczególny osobom starszym, w tym terminalnie chorym. Prezentowane w niniejszej monografi i teksty uwzględniają właśnie tę wieloczynnikową aktywność opiekuńczą. Autorami poszczególnych rozdziałów są pracownicy naukowi zaangażowani w proces edukacyjny w zakresie nauk o zdrowiu, pracujący w Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego, ale także studenci PWSZ w Tarnowie. W różnorodnym zakresie przedstawili i omówili oni główne tezy monografii

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Height loss and the incidence of vertebral fractures in DXA (VFA) study.

Osteoporoza jest coraz częstszym zaburzeniem wytrzymałości kości, które u osób w starszym wieku prowadzi do zwiększonego ryzyka złamań. Ze względu na duże rozpowszechnienie na całym świecie osteoporoza stanowi poważny problem ekonomiczny i społeczny. Obniżenie gęstości mineralnej kości (BMD) może prowadzić do złamań kręgosłupa. Praca ma charakter badawczy. Składa się z czterech głównych rozdziałów oraz podsumowania i wniosków. We wstępie zawarto najważniejsze informacje wprowadzające w tematykę pracy. Poruszono takie zagadnienia jak: budowa, patologie i złamania osteoporotyczne kręgosłupa. Przedstawiono metody diagnostyki złamań kręgosłupa a także problem jakości życia po tych złamaniach. Praca opiera się na najnowszych doniesieniach naukowych z ostatnich lat, skąd próbowano odszukać danych literaturowych na temat zależności obniżenia wzrostu a złamań kręgosłupa. Głównym celem pracy było zbadanie zależności między obniżeniem wzrostu a występowaniem złamań osteoporotycznych kręgosłupa w badaniu Vertebral Fracture Assessment (VFA). Grupę badawczą stanowiło 30 pacjentów Krakowskiego Centrum Medycznego. Praca zawiera charakterystykę grupy badawczej, materiał i metody, tabelaryczne zestawienie otrzymanych wyników, a także wnikliwą analizę złamań kręgosłupa oraz obniżeń wzrostu. W badanej grupie 18 pacjentów miało złamanie kręgosłupa. Obniżenie wzrostu o minimum 4 cm wystąpiło także u 18 pacjentówNa podstawie przeprowadzonych badań stwierdzono, że wraz z wiekiem zwiększa się liczba złamań osteoporotycznych kręgosłupa oraz postępuje obniżenie wzrostu. W grupie 30 pacjentów KCM poddanych badaniu nie zaobserwowano ścisłej zależności między wielkością obniżenia wzrostu a ilością i wielkością złamań kręgosłupa.Osteoporosis is a disease which affects bone strength and thus increases the risk of a broken bone among elderly people. Because of its prevalence all over the world, osteoporosis poses a serious economic and social problem. A lowering of bone mineral density (BMD) can contribute to vertebral fractures. This licentiate project is a research work. It consists of 4 chapters, summary and conclusions. The most important information concerning the topic of my research are included in the introduction. The structure of the humans spine, pathology and osteoporosis-related vertebral fractures are discussed. Both the methods of the diagnosis of vertebral fractures and the quality of life after an osteoporotic vertebral body fractures are presented. The work is based upon the latest scientific works from the last 10 years concerning the relationship between height loss and spine fracture. The main aim of this licentiate project is to investigate the relationship between height loss and osteoporotic spine fracture in DXA (VFA) test. Research group was constituted 30 patients from Krakowskie Centrum Medyczne (Cracow Medical Centre). This work consist: characteristics of research group as well as used materials and methods, tabulation of the achieved results and in-depth analysis of spine fractures and height loss. Establishing relationship between spine fractures and height loss in research group was challenging.In this study, 18 patents had broken spine. Minimum four centimeter heigh loss occurred also in 18 patients. On the basis of the conducted research it was concluded that as people age, the amount of osteoporotic spine fractures and height loss increases. In the group of 30 patients from Krakowskie Centrum Medyczne no strict correlation between the height loss and spine fractures has been observed

Development of speaking skills in foreign language teaching

Celem niniejszej pracy dyplomowej była gruntowna analiza sprawności mówienia oraz stworzenie odpowiedniego zestawu ćwiczeń, który przyczyniłyby się do poprawy efektywności tej sprawności. W części teoretycznej zostały wyjaśnione najważniejsze kwestie dotyczące mowy i zdolności mówienia, jak również zmieniająca się rola tej sprawności w poszczególnych metodach dydaktycznych. Kolejnym ważnym elementem pracy było wyjaśnienie umiejętności mówienia z punktu metodycznego, i odpowiedź na pytania: czym jest komunikacja na lekcji języka obcego, jak ocenia się sprawność mówienia, jakie problemy, trudności związane z mówieniem spotykają uczniów na lekcji, co może ich zachęcać i motywować do mówienia oraz jakie ćwiczenia wpływają korzystnie na rozwój tej umiejętności. W części praktycznej zostają przedstawione ćwiczenia, które ze względu na swoją formę i treść w najwyższym stopniu rozwijają sprawność mówienia. Zestaw ćwiczeń powstał na podstawie analizy podręczników dla młodzieży, jak również z inwencji własnej. Przeanalizowane i zaproponowane w zestawie ćwiczenia mają na celu przygotowywanie, tworzenie i symulowanie komunikacji na lekcji języka obcego. W pracy została wykorzystana metoda analityczno-syntetyczna. Dostępne źródła zostały poddane wnikliwej analizie, dzięki której możliwe było przedstawienie wniosków.The aim of this master thesis was to show thorough analysis of efficiency of speaking and to create an appropriate set of exercises which would improve the effectiveness of this ability. The theoretical part concludes the main important information about speech and the speaking ability. It has been also explained the changing role of efficiency in the various teaching methods. Another important part of the study was to clarify the speaking ability from the methodological point and to answer the questions: How is the communication in in the language classroom. How to evaluate the speaking efficiency. What problems, difficulties with speaking of students can observe in lessons. What can encourage and motivate them to speak. Which exercises contribute positively to development of this skill. The practical part has concluded exercises, which by the virtue of its form and content, show the development of speaking skills to the highest degree. A set of exercises was based on the analysis of the young student’s workbooks, as well as my own invention. Analyzed and suggested exercises are aimed to preparing, creating and simulating communication in the language classroom. The master thesis has been used the analytic and synthetic method. The available sources have been checked very carefully. Therefore, the conclusions were possible to be presented.

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

International audienceSummaryBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.MethodsWe used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson’s correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).FindingsThe correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.InterpretationBMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified