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Introduction and Objective: The aim of the study is to discuss the legal framework for telemedicine services in Poland, and to present telemedicine solutions used in selected European countries., Material and Methods: The analysis of legal cts was chosen as a research method in order to determine legal possibilities for medical professionals to use telemedicine services. A literature review was undertaken to demonstrate the possibilities of telemedicine as used in the United Kingdom, Germany, Norway, The Netherlands and Sweden., Results: The Act on the professions of a doctor and a dentist states that the doctor and the dentist can perform their profession via ICT systems or communication systems. The doctor is obliged to practice in accordance with current medical knowledge and available methods. 'Available methods' include considering information and communication measures that may allow prevention, recognition or treatment. The Act on the profession of a nurse and a midwife states that the nurse and midwife perform the professions using current medical knowledge and the mediation of ICT systems or communication systems. Thus, the legislator has clearly authorized persons performing these professions to provide services in the field of telemedicine. However, despite the existence of a legal basis for using telemedicine, its development in Poland is not as high as in the United Kingdom, Germany, Norway, The Netherlands or Sweden., Conclusions: The legislator gradually introduces legal solutions necessary for the development of telemedicine services, although the pace of these changes, as well as building the technical infrastructure that is the basis for the proper provision of telemedicine services, are too slow.

Objective: The aim of this study was to create a Polish adaptation of the Multidimensional Attitudes Scale toward Persons with Disabilities (MAS) by performing a statistical psychometric analysis in a sample of Polish students., Material and Methods: The study included 540 person (82.0% of students and 18.0% of workers), whose attitudes towards the disabled were measured with the Polish version of the MAS (MAS-PL). Mean age of respondents was 24.72 years (SD = 5.7), with a significant majority of women (n = 455, 84.3%). Data was collected during university classes and via an online survey., Results: Factor analysis yielded a three-factor structure of the MAS-PL, including affective, cognitive, and behavioural domains, which explained almost 45% of the total variance. Further factor-based solutions increased this percentage only slightly (0.8)., Conclusions: The Polish version of the MAS scale (MAS-PL) has been developed and presented as a reliable instrument for studying the attitudes of Poles towards people with disabilities. The scale can be used as a preliminary assessment tool when creating educational programmes, including those for training and social Policy, as well as assessing the effectiveness of programmes. Studies with the use of the MAS-PL will allow comparisons of research findings conducted with the use of MAS scales in other English-speaking (original/English MAS) or Spanish-speaking (Spanish MAS) populations and German (G-MAS), Korean (MAS-K), Serbian (Serbian MAS), Turkish (Turkish MAS) and French populations (French MAS autism).

Introduction and Objective: For many years, Europe has been struggling with the problem of an aging society. It is obvious that everyone would like to live longer while retaining good psycho-physical health and social activity. This, however, is influenced by many factors, such as health, which may be a form of limitation in everyday life or in performing social roles in accordance with the norms., Objective: The aim of the study was to analyze the use of scales for functional assessment of basic and complex daily living activities in individuals aged 80+ in various EU countries., Materials and Method: Potentially essential articles were obtained through review and analysis of the PUBMED (MEDLINE) database by entering the following keywords: functional activities of daily living, ADL, IADL, complex activities of daily living, basic activities of daily living. Article selection was based on the following inclusion criteria set by the authors and the appointed Advisory Board., Results: Assessment of independence and fitness of elderly persons in the area of basic and complex activities of daily living provides information on the quality of life of senior individuals. Analysis of research data used for comparing functional independence of senior persons on the basis of ADL and IADL scales is difficult due to the discrepancies, which may be confusing for researchers studying this area., Conclusions: The use of different methodologies for assessing functional fitness of elderly individuals makes it difficult to interpret, compare and practically apply the outcomes. Standardization of research methods used for assessment of basic and complex daily living activities in 80+ persons would enable comparing the obtained data in an interdisciplinary perspective.

Introduction: To-date, the influence of heavy metals such as Pb or Cd on mental functioning, and especially on the occurrence of depressive and anxiety-related disorders, has not been well understood., Objectives: 1) Assessment of Pb and Cd levels in whole blood of postmenopausal women. 2) Assessment of the severity of anxiety and depressive symptoms depending on Pb and Cd levels in whole blood of postmenopausal women., Material and Methods: The survey-based study involved 198 healthy postmenopausal women from West Pomeranian province in Poland. It was performed using the Primary Care Evaluation of Mental Disorders (PRIME-MD), Beck's Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The second part of the study was based on biochemical analysis of the levels of heavy metals (Pb, Cd)., Results: The mean level of Pb was 19.85 ± 8.99 µg/l and Cd 0.87±0.98 µg/l; these levels were within normal ranges. Analysis of the mean levels of Pb and Cd in whole blood of postmenopausal women in relation to the severity of depressive symptoms did not reveal statistically significant differences. Correlation analysis demonstrated a statistically significant (p<0.05) negative correlation (-0.22) between the level of Pb and the severity of anxiety as a state. Correlations between the levels of Pb and Cd and the severity of anxiety as a trait were not statistically significant., Conclusions: The mean Pb and Cd levels in whole blood of healthy postmenopausal women did not exceed acceptable limits. The study did not confirm a relationship between the levels of selected heavy metals and the severity of anxiety and depressive symptoms in healthy women. However, there was a relationship between the level of Pb and the severity of anxiety as a state.

Introduction and Objective: Psychiatric disorders (and their high rates of prevalence) in primary care have been widely analyzed, but the problem of underdiagnosis remains unresolved. This becomes increasingly more important in rural health centres in the face of lack of epidemiological data from these centres. The aim of this study is focused on the relationship between general health, psychiatric symptomatology and personality characteristics in the context of an adequate diagnosis., Materials and Methods: 518 primary care patients in 6 Polish urban clinical centres were studied using (in order of administration): a sociodemographic questionnaire, the General Health Questionnaire (GHQ-28) and Eysenck Personality Questionnaire (EPQ-R)., Results: The investigated sample was representative for urban primary care patients. The findings confirmed a significant association between neuroticism and general health. The strongest relation with current functioning and mental distress of the patients (GHQ general score) was observed in case of symptoms of anxiety and insomnia. The symptoms of depression may be the most difficult to identify (psychiatric symptoms assessed using GHQ sub-scales)., Conclusions: According to the GHQ assumptions and confirmed by the presented study, sub-threshold psychiatric symptomatology affects the functioning of primary care patients and their general health. This correlates with personality factors. Improving adequacy of diagnosis becomes extremely important, as it may often be the only chance for appropriate therapy of mental problems for people living in rural areas due to lower availability of specialistic mental services. Further epidemiological studies concerning rural primary care and prevalence of the spectrum of mental disorders need to be conducted.

Introduction and Objective: Wind power is employed worldwide as an alternative source of energy. At the same time, however, the health effects of wind turbines have become a matter of discussion. The purpose of this study is a critical review of available reports providing arguments both for and against the construction of wind farms. The authors also attempt to propose recommendations in accordance with the Evidence-Based Medicine (EBM) guidelines. In the case of exposure to wind farms, a randomized controlled trial (RCT) is impossible. To obtain the highest-level recommendations, analysis of case-control studies or cohort studies with control groups should be performed. Preferably, it should include geostatistical analysis conducted with the use of variograms and the kriging technique. Combinations of key words were entered into the Thomson Reuters Web of Knowledge (SM) and the Internet search engine Google. SHORT DESCRIPTION OF STATE OF THE ART: The nuisance caused by wind turbines is stereotypically linked with the noise that they produce. Nevertheless, the visual aspect of wind farms, opinions about them, and sensitivity to sound seem to be of the greater importance. To date, the direct correlations between the vicinity of modern wind farms, the noise that wind turbines make, and possible consequences to health have not been described in peer reviewed articles. Health effects are more probably associated with some environmental factors leading to annoyance or frustration. All types of studies share the same conclusion: wind turbines can provoke annoyance. As with any project involving changes in the local environment, a certain level of irritation among the population can be expected. There are elected officials and government representatives who should decide what level of social annoyance is acceptable, and whether wind power advantages outweigh its potential drawbacks. The influence of wind turbines on human emotional and physical health is a relatively new field of research. Further analyses of these issues are justified, especially because none of the studies published in peer-reviewed journals so far meet the criteria for cohort or case-control studies., Summary: Due to methodology, currently available research results do not allow for higher than C-level recommendations. In the case of wind farms, the ideal types of research would be: a retrospective observation of a particular group of residents before and after the wind farm construction, case-control studies or cohort studies with control groups matched in respect of socioeconomic factors, predisposition for chronic diseases, exposure to environmental risk factors, and only one variable which would differentiate cases from controls--the distance between place of residence and a wind farm.

Introduction and Objective: The level of trace elements is extremely important for the maintenance of normal functioning of the human body. The risk of disturbance of their balance increases especially dynamically during the period of menopause. The objective of the study was the effect of MHT on the levels of bioelements (Mg and Zn) in blood plasma, and toxic metals (Pb and Cd) in the whole blood in postmenopausal women., Materials and Methods: The study covered 323 women at postmenopausal age from the population of the West Pomeranian Region, in whom the levels of Mg, Zn, Pb and Cd were determined. The women were divided into two groups: study and control. The study group were 152 women who used menopausal hormone therapy (MHT). The control group were 171 women who did not use MHT, and had had their final menstrual period at least one year prior to inclusion in the study. The mean age of the women examined was 56±5., Results: Significantly higher levels of the bioelements Mg, Zn were observed in women who used MHT, compared to the control group (p<0.05). The concentration of Pb in whole blood was significantly lower in the study than the control group: 16.09±7.33 µg/l and 20.18±9.01 µg/l, respectively. An elevated level of Cd in whole blood was found in both groups of women: 0.9±1.03 µg/l and 0.8±1.1 µg/l, respectively. It was noted that women who used MHT more frequently declared the presence of climacteric symptoms (p<0.05)., Conclusions: 1) Higher levels of Mg and Zn were found in blood plasma of women who used MHT. 2) The mean concentration of Cd in the blood of women in both groups was similar. 3) In women who use MHT the level of Pb in whole blood was lower, compared to the rest of the women.

Introduction: Schizophrenic patients present cognitive dysfunctions which are regarded to be one of endophenotypical markers predisposing to schizophrenia. Currently, schizophrenia can be treated as a neurodegenerative and neurodeveloping disease with genetic background., Objective: Assessment of the possible positive effect of neuropsychological rehabilitation in schizophrenia, in patients presenting cognitive dysfunctions. An additional aim was to verify the hypothesis that some genetic polymorphisms can be a prognostic factor for success in neuropsychological rehabilitation., Material and Methods: 41 participants and 40 control subjects were randomly selected. Both groups had the diagnosis of paranoid schizophrenia. Cognitive functions were checked with the Wisconsin Card Sorting Test, Trail Making Test, and Stroop Test at the beginning and end of the experiment. In the research group, each patient trained with the rehabilitation programme RehaCom, whereas the control group did not receive such training. Genes COMT rs4680 and BDNF rs6265 were analysed in the genetic part of study., Results: RehaCom procedures appear to be useful in the neuropsychological rehabilitation of cognitive dysfunctions in patients diagnosed with schizophrenia. The research group showed a moderate improvement in the training programmes. Analysis of parameters obtained in the neuropsychological tests showed a slight improvement in both groups. At the present time, analysis of the polymorphisms of genes cannot be treated as a prognostic factor for the success of neuropsychological rehabilitation because statistical analyses showed few dependences with little statistical significance., Conclusions: Cognitive rehabilitation produces moderate improvement in cognitive functioning.

Background: The quality of life has three main characteristics: it always refers to the living conditions of an individual; it is measured both with subjective and objective indicators; and it is a multidimensional concept., Aim of the Study: To assess how the quality of life is affected by the close proximity of wind farms., Material and Methods: The study group consisted of 1,277 Polish adults (703 women and 574 men), living in places located near wind farms. The mean age was 45.5 ± 16.10. Some 33.2% of participants lived more than 1,500 m from wind farms; 17% - below 700 m. The research tool consisted of the Norwegian version of the SF-36 General Health Questionnaire, the Visual Analogue Scale (VAS) for health assessment, and original questions., Results: Regardless of the distance between a place of residence and a wind farm, the highest quality of life was noted within the physical functioning subscale (mean 76±27.97), and the lowest within the general health (mean 55.3±24.06). Within all scales, the quality of life was assessed highest by residents of areas located closest to wind farms, and the lowest by those living more than 1,500 m from wind farms., Conclusions: Close proximity of wind farms does not result in the worsening of the quality of life. Similar research should be conducted before any intended investment, and at least 6 months after construction of a wind farm.

Introduction and Objective: The developing brain of a child is extremely prone to damage resulting from exposure to harmful environmental factors, e.g. heavy metals. Intoxication of children's organisms with lead and cadmium affects their intellectual development. Even a relatively small amount of this metal in children's blood can lead to developmental dysfunctions. The aim of this study was to analyse the correlation between blood lead and cadmium levels in children with behaviour disorders and their functioning in the home., Material and Methods: This survey-based study was conducted among 78 families with children diagnosed as having behaviour disorders. It was performed using the ADHD-Rating Scale-IV. To determine lead and cadmium levels the laboratory procedure was based on Stoppler and Brandt's method., Results: The mean blood lead level was 19.71 µg/l and the mean blood cadmium level was 0.215 µg/l. Higher blood lead levels in children correlates positively with incidences of hyperactive and impulsive behaviour in the home, as assessed by parents (p=0.048). Statistically significant effects of cadmium on children's behaviour were not noticed., Conclusions: The effect of lead on the developing organism of a child has such behavioural consequences as attention disorders, hyperactivity and impulsive behaviour which, in turn, may interfere with children's functioning in the home. A negative effect of cadmium on the functioning of children with behaviour disorders in the home was not proved.