Who Receives Home-Based Perinatal Palliative Care: Experience from Poland

The current literature suggests that perinatal palliative care (PPC) programs should be comprehensive, initiated early, and integrative. So far there have been very few publications on the subject of home-based PC of newborns and neonates. Most publications focus on hospital-based care, mainly in the neonatal intensive care units. Objective. To describe the neonates and infants who received home-based palliative care in Lodz Region between 2005 and 2011. Methods. A retrospective review ofmedical records. Results. 53 neonates and infants were admitted to a home hospice in Lodz Region between 2005 and 2011. In general, they are a growing group of patients referred to palliative care. Congenital diseases (41%) were the primary diagnoses; out of 53 patients 16 died, 20 were discharged home, and 17 stayed under hospice care until 2011. The most common cause of death (56%) was cardiac insufficiency. Neurological symptoms (72%) and dysphagia (58%) were the most common clinical problems.The majority of children (45%) had a feeding tube inserted and were oxygen dependent (45%); 39 families received psychological care and 31 social supports. Conclusions. For terminally ill neonates and infants, perinatal palliative care is an option which improves the quality of their lives and provides the family with an opportunity to say goodby

Ričard I. Koen, Mirjam Rajner, "Samuel Hiršenberg, 1865-1908: poljski jevrejski umetnik u nemirima", Litman biblioteka jevrejske civilizacije, London 2022, 360 str.

Biografistyka naukowa to niedoceniany gatunek wśród rozpraw akademickich, choć jest jednym z najtrudniejszych. Wymaga bowiem kunsztownej, interdyscyplinarnej metodologii łączącej osobiste, niekiedy intymne, przekazy źródłowe i informacje z historią działalności danej osoby wpisaną w szerszy kontekst dziejowy, społeczny i kulturowy, często także zróżnicowany geograficznie. Mimo to biografie naukowe traktowane są z reguły jako opracowania pomocnicze do tzw. poważnych monografii opisujących złożone idee, zjawiska i problemy badawcze.Naučna biografija je potcenjen žanr među akademskim disertacijama, iako je jedan od najtežih. To zahteva razrađenu, interdisciplinarnu metodologiju koja kombinuje lične, ponekad intimne, izvore i informacije sa istorijom aktivnosti date osobe u širem istorijskom, društvenom i kulturnom kontekstu, često i geografski raznolikom. Uprkos tome, naučne biografije se obično tretiraju kao pomoćne studije tzv ozbiljne monografije koje opisuju složene ideje, pojave i probleme istraživanja

Development and implantation of a pilot education program for pediatric palliative care in Poland

In many countries over the last forty years palliative medicine have been recognised as a separate speciality and associated with adult cancer patients. Pediatric palliative medicine is a specific discipline which is very distinct from palliative care of adults. In Poland pediatric palliative care has been provided as a home based model of care. Dynamic development of palliative care of children in Poland in the last sixteen years proves high demand for that service. Despite of the dynamic development of the pediatric palliative care in Poland there are two main challenges in that field: difficulties in staff recruitment and significant deficits in the knowledge of the pediatric palliative care. Those difficulties arise as a result of a lack of training among students In majority of Polish medical universities (both for doctors and nurses) palliative care is a part of the teaching program. However most of programs include only adult palliative care. Pediatric curriculum does not cover palliative care. That paper describes development and implantation of a pilot education program for pediatric palliative care in Poland.In many countries over the last forty years palliative medicine have b� � � � � � een recognised as a separate speciality and associated with adult cancer patients. Pediatric palliative medicine is a specific discipline which is very distinct from palliative care of adults. In Poland pediatric palliative care has been provided as a home based model of care. Dynamic development of palliative care of children in Poland in the last sixteen years proves high demand for that service. Despite of the dynamic development of the pediatric palliative care in Poland there are two main challenges in that field: difficulties in staff recruitment and significant deficits in the knowledge of the pediatric palliative care. Those difficulties arise as a result of a lack of training among students In majority of Polish medical universities (both for doctors and nurses) palliative care is a part of the teaching program. However most of programs include only adult palliative care. Pediatric curriculum does not cover palliative care. That paper describes development and implantation of a pilot education program for pediatric palliative care in Poland

Influence of the cognitive-behaviorak therapy on P300 potential in children with psychogenic nonepileptic events and tension headache : preliminary results

Podstawy: W leczeniu napadów rzekomopadaczkowych i napięciowych bólów głowy u dzieci stosowana jest psychoterapia. Umysłowe funkcjonowanie dzieci wiąże się z endogennymi parametrami neurofizjologicznymi. Cel: Celem tej pracy było ustalenie, czy endogenny potencjał poznawczy P300 u dzieci z napadami rzekomopadaczkowymi i napięciowymi bólami głowy jest różny i czy zmienia się on pod wpływem terapii poznawczo-behawioralnej. Materiał i metody: Badaniami objęto dotychczas grupę 12 dzieci z napadami rzeko­ mopadaczkowymi i 8 z napięciowymi bólami głowy. U wszystkich zastosowano 8-1 O sesji psychoterapeutycznych. Potencjał P300 zarejestrowano przed przeprowadzeniem terapii i po niej oraz dodatkowo w obu cyklach po 3-minutowej hiperwentylacji. Oce­niono czas reakcji, liczbę błędów i odsetkowe skupienie uwagi u dzieci. Wyniki: Średnie wartości wszystkich wyników potencjału P300 były lepsze w gru­ pie dzieci z napięciowymi bólami głowy niż u dzieci z napadami rzekomopadaczko­ wymi. Im krótszy był czas reakcji w pierwszym badaniu, tym wyższy był wskaźnik uwagi i krótszy czas reakcji w kolejnym badaniu w grupie z napadami w odróżnieniu od dzieci z napięciowymi bólami głowy. W obu badanych grupach zastosowanie hiper­ wentylacji wiązało się z wyraźnym wydłużeniem czasu reakcji w badaniu P300, przy niezmieniających się pozostałych parametrach (liczby błędów i procent uwagi). Wnioski: Wstępne wyniki badań zdają się wskazywać na różnicę parametrów potencjału P300, chociaż nieznamienną statystycznie, u dzieci z napadami rzekomo­ padaczkowymi i napięciowymi bólami głowyBackground: Psychotherapy is being used in the treatment o f nonepileptic psychogenic seizures and tension headaches in children. Intelectual functioning of children is related to certain endogenous neurophysiological parameters. Aim: The goal of this study was to establish whether the endogenous potential P300 is different in children with nonepileptic psychogenic events and with tension headache, and whether it changes under the influence o f the cognitive-behavioral psychotherapy. Matherial and methods: The study included so far a group o f 12 children with nonepileptic psychogenic seizures and 8 children with tension headache. The P300 potential was registered before and after the therapy and additionally in both cycles after a 3 minutes hyperventilation. The reaction time, the amount o f mistakes and the\ud percentage o f attention focus was measuerd in all children. Results: Medium scores o f all P300 measures were better in the group with tension headaches than in children w ith psychogenic nonepileptic events. The shorter was the reaction time in the first examination, the higher the attention score and the shorter the reaction time in the second examination in the nonpeileptic seizure group, but not in the tension headache group. In both tested groups hyperventilation related to a substantial prolongation o f the P300 reaction time, with other m easures remaining the same (mistake count and % attention). Conclusions: The preliminary results seem to show a difference in the P300 paramteres, although not one that is statistically significant, in children with nonepileptic seizures and tension headaches. It also applies to the influence o f cognitive-beahioral psychotherapy and hyperventilation

Spatiotemporal variation in the pollination systems of a supergeneralist plant: is Angelica sylvestris (Apiaceae) locally adapted to its most effective pollinators?

Background and Aims: In terms of pollination systems, umbellifers (plants of the carrot family, Apiaceae) are regarded as generalists, since their (usually dichogamous) flowers are visited by a wide range of insects representing several taxonomic orders. However, recent analyses of insect effectiveness revealed that these plants may be pollinated effectively by a narrow assemblage of insect visitors. Of particular interest was whether populations of an umbellifer species varied in pollinator assemblages and whether this could lead to local specialization of the pollination system. We also explored whether variation in pollinator assemblages was associated with variation in floral traits, and whether this variation influences reproductive output. Methods: The focus was on Angelica sylvestris, a common European species visited by a taxonomically diverse insect assemblage. In three populations, located along an ~700-km transect, over three growth seasons insect visitors were identified, their effectiveness was assessed by surveying pollen loads present on the insect body, insect activity on umbels, nectar and scent composition was studied, and transplantation experiments were performed. Key Results: The populations investigated in this study differed in their nectar and scent profiles and, despite the similar taxonomic composition of insect visitor assemblages, were effectively pollinated by disparate pollinator morphogroups, i.e. flies and beetles. Although this suggested local adaptations to the most effective pollinators, analyses of body pollen loads and behaviour on umbels demonstrated functional equivalency of the visitor morphogroups, which is probably related to the fact that A. sylvestris bears few ovules per flower. The transplantation experiments confirmed that reproductive success was not related to the source of experimental plants and that the insects do not exhibit preferences towards local genotypes. Conclusions: Angelica sylvestris is morphologically well adapted to ecological generalization, and there is little evidence that the surveyed populations represent distinct pollination ecotypes. Most likely, the observed variation in floral characters can be interpreted as 'adaptive wandering'. Specialization in this family seems possible only under very special circumstances, for example when the pollinator community comprises insect visitor groups that clearly differ in their pollination capacity (e.g. due to differences in their functional morphology) and/or have different perceptional biases (e.g. for colour or scent). However, the barrier to the evolution of morphological adaptations resulting in the fine-tuning of the flower towards particular pollinator types may arise from the architectural constraints on the floral bauplan that make umbellifers so uniform in their floral displays and so successful in attracting large numbers of pollinators

Job satisfaction among health professionals of Home Hospice for Children of Lodz Region

Background: Job satisfaction in palliative care proffesionals seems to be one of the most important factor for effectiveness and quality of care. The aim of this study was to evaluate job satisfaction in our team. Material and methods: The anonymous questionnaire designed specifically for the study was divided into six domains: evaluation of self-abilities, evaluation of job responsibility, relationships within the team, relationships with patients and their families, work organisation and social conditions and general work evaluation. All variables have been standardized to a range of 0 to 100 points. Results: Mean level of job satisfaction was evaluated as good. Mean results in all six domains were above 50 points. Highest level of satisfaction (above 75 points) was shown in the domain regarding relationship with patients and their families. Lowest level of satisfaction was shown in domains showing relationship within the team and general work evaluation. Conclusion: Highest job satisfaction could contribute to improve the quality of home palliative care Adv. Pall. Med. 2010; 9, 3: 67–72Background: Job satisfaction in palliative care proffesionals seems to be one of the most important factor for effectiveness and quality of care. The aim of this study was to evaluate job satisfaction in our team. Material and methods: The anonymous questionnaire designed specifically for the study was divided into six domains: evaluation of self-abilities, evaluation of job responsibility, relationships within the team, relationships with patients and their families, work organisation and social conditions and general work evaluation. All variables have been standardized to a range of 0 to 100 points. Results: Mean level of job satisfaction was evaluated as good. Mean results in all six domains were above 50 points. Highest level of satisfaction (above 75 points) was shown in the domain regarding relationship with patients and their families. Lowest level of satisfaction was shown in domains showing relationship within the team and general work evaluation. Conclusion: Highest job satisfaction could contribute to improve the quality of home palliative care Adv. Pall. Med. 2010; 9, 3: 67–7

The Impact of Pediatric Palliative Care Education on Medical Students’ Knowledge and Attitudes

Purpose. Most undergraduate palliative care curricula omit pediatric palliative care (PPC) issues. Aim of the study was to evaluate the pilot education programme. Methods. All 391 students of Faculty of Medicine (FM) and 59 students of Division of Nursing (DN) were included in anonymous questionnaire study. Respondents were tested on their knowledge and attitude towards PPC issues before and at the end of the programme and were expected to evaluate the programme at the end. Results. For final analysis, authors qualified 375 double forms filled in correctly (320 FM and 55 DN). Before the programme, students’ knowledge assessed on 0–100-point scale was low (FM: median: 43.35 points; 25%–75%: (40p–53.3p); DN: 26.7p; 13.3p–46.7p), and, in addition, there were differences (P<0.001) between both faculties. Upon completion of the programme, significant increase of the level of knowledge in both faculties was noted (FM: 80p; 73.3–100; DN: 80p; 66.7p–80p). Participation in the programme changed declared attitudes towards some aspects of withholding of special procedures, euthanasia, and abortion. Both groups of students positively evaluated the programme. Conclusions. This study identifies medical students’ limited knowledge of PPC. Educational intervention changes students’ attitudes to the specific end-of-life issues. There is a need for palliative care curricula evaluation.The programme has been awarded and 90% financed by the Foundation for the Development of the Education System, Measure V Edition, Development of the Polish Higher Education Institution. Since August 2009, the project has been completed with the support granted by Iceland, Liechtenstein, and Norway by means of cofinancing from the European Economic Area Financial Mechanism and the Norwegian Financial Mechanism, as a part of the Scholarship and Training Fund. Sponsor was not involved in the conduct of the study or development of the submission

Opracowanie i wdrożenie pilotażowego programu edukacyjnego z zakresu opieki paliatywnej nad dziećmi w Polsce

W wielu krajach, w ciągu ostatnich 40 lat medycyna paliatywna została uznana za odrębną specjalizację lekarską, związaną głównie z opieką nad dorosłymi pacjentami chorującymi na nowotwory złośliwe. Pediatryczna opieka paliatywna jest dyscypliną szczególną, różniącą się znacznie od opieki paliatywnej nad osobami dorosłymi. W Polsce opieka paliatywna nad dziećmi świadczona jest głównie w modelu opieki domowej. Dynamiczny rozwój opieki paliatywnej nad dziećmi w Polsce w ciągu ostatnich 16 lat świadczy o dużym zapotrzebowaniu na tego typu świadczenia. Mimo dynamicznego rozwoju pediatrycznej opieki paliatywnej w Polsce, wyzwaniem pozostają dwa główne zagadnienia: trudności z naborem personelu oraz istotne braki w wiedzy z tej dziedziny. Trudności te są wynikiem braku odpowiedniego kształcenia studentów w tym zakresie. W większości polskich uniwersytetów medycznych (zarówno na wydziałach lekarskich, jak i pielęgniarskich) opieka paliatywna wchodzi w skład programu nauczania, jednak przeważająca część tych programów dotyczy wyłącznie opieki paliatywnej nad dorosłymi. Program nauczania pediatrii nie obejmuje opieki paliatywnej. Niniejszy artykuł przedstawia opracowanie i wprowadzanie w życie pilotażowego programu edukacyjnego dotyczącego pediatrycznej opieki paliatywnej w Polsce

Neuropsychological biological assessment and psychotherapy effectiveness with psychogenic nonepileptic events and tension headache : preliminary results

Podstawy: Psychogenne napady rzekomopadaczkowe i napięciowe bóle głowy są schorzeniami, które najczęściej nie wymagają leczenia farmakologicznego. Cel: Poznanie, jaka jest u dzieci efektywność psychoterapii poznawczo- -behawioralnej w leczeniu napadów rzekomopadaczkowych i napięciowych bólów głowy. Materiał i metody: W ramach realizowanego przez Katedrę Neurologii Dzieci i Młodzieży oraz Pracownię Neuropsychologii Uniwersyteckiego Szpitala Dziecięcego w Krakowie projektu badawczego do leczenia włączono dotychczas 20 pacjentów, w tym 12 dzieci z psychogennymi napadami rzekomopadaczkowymi (11 dziewcząt) oraz 8 z napięciowymi bólami głowy (7 dziewcząt). U wszystkich dzieci przeprowadzono 10 sesji psychoterapii w nurcie poznawczo-behawioralnym przez 2 tygodnie, trwających 45-105 minut. Wyniki'. Uzyskane wyniki ilościowe nie różnicują na poziomie istotności statystycznej dzieci z obu grup. W dotychczasowej obserwacji bezpośrednia efektywność psychoterapii okazuje się większa w grupie dzieci z napadami rzekomopadaczkowymi niż w grupie z napięciowymi bólami głowy. Jest to wynik wymagający dalszych badań, a w szczególności długofalowej obserwacji skutków leczenia.Background: Both disorders, psychogenic nonepileptic events and tension headache, are usually treated without drugs. Aim: Assessment of the effectiveness of cognitive-behavioral therapy in children with pseudoepileptic events and tension headache. Material and methods: In the course of the project being conducted by the Chair of Pediatric and Adolescent Neurology and the Neuropsychological Laboratory there were 20 patients admitted so far, including 12 children with psychogenic nonepileptic seizures (11 girls), and 8 children with tension headaches (7 girls). There were 10 cognitive-behavioral psychotherapy sessions conducted in each case, 45-105 minutes each, once a day in the course of two weeks. Results: The quantitative results do not differentiate children from both groups on a statistically significant level. In our early, preliminary observation, the short term immediate effectiveness of psychotherapy appears to be better in children with psychogenic seizures than in the tension headache group. This is a result demanding further investigation, particularly a long-term observation of the stability of this effect