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Aim: Evidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration. Materials and methods: We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (n = 93), G2 – head and neck surgery (n = 200), G3 – gastroenterological diseases (n = 94) and G4 – other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered. Results: There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X). Conclusions: Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery. WHAT THIS PAPER ADDS: What is already known on the subject: Clinical signs of penetration or aspiration include coughing, throat clearing and voice changes, while silent penetration or aspiration patients aspirate without demonstrating any clinical symptoms. The most common consequences of silent aspiration include aspiration pneumonia, recurrent lower respiratory tract infections and respiratory failure. Additionally, malnutrition and dehydration can be indicators of silent aspiration. Patients may unknowingly reduce their oral intake and lose weight. Retrospective studies have shown that 20%–30% of patients aspirate silently (e.g. patients after stroke, acquired brain injury, head and neck cancer treatment, prolonged intubation). Clinical examination of swallowing can miss up to 50% of cases of silent aspiration. What this paper adds to existing knowledge: Currently, silent aspiration is often discussed in neurological literature, but its applications to head and neck surgery are limited. In this study, we identify head and neck surgery patients who should be prioritised or considered to be in higher need of instrumental swallowing evaluation due to a higher risk of silent aspiration. What are the potential or actual clinical implications of this work?: Post‐treatment structural changes can result in lower cranial nerve paresis (IX, X, XII) and face injury, in which vagus and glossopharyngeal nerves are injured. After tracheostomy and radiotherapy, patients with problems swallowing saliva need careful clinical examination, particularly cranial nerve examination. [ABSTRACT FROM AUTHOR]

The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to investigate how nursing students utilised the "DiagNurse" mobile app to assess patient health conditions during their clinical apprenticeships. Material and methods. This prospective, quasi-experimental post-test study included a convenience sample of 62 undergraduate nursing students. In the course of the work, they utilized paper-based measurement scales (first measurement) and the mobile app (second measurement) to assess patient health conditions during clinical practice. In total, 432 clinical condition assessments were performed on patients in the first measurement and 432 in the second measurement. Following the clinical assessment, two types of post-tests were employed to ascertain the usability of the mobile app: quantitative testing using the System Usability Scale and qualitative testing. Results. The mean SUS score was 80.2 (SD 15.67). The majority of the students agreed that the utilisation of the mobile app to assess a patient's health condition is faster (M=3.21) and more convenient (M=3.16) than the use of paper-based scales and questionnaires. On a 0–10 scale, the study participants rated it as "highly recommended" (M=8.03) for fellow nursing students or practicing nurses. Conclusions. Although the "DiagNurse" mobile app was considered a suitable tool for learning clinical patient assessment, the students also proposed some improvements to the app's design. [ABSTRACT FROM AUTHOR]

Simple Summary: Adaptive proton therapy (APT) is an evolving approach to proton beam scanning treatment planning. We performed dosimetric study on two groups of head and neck (H&N) patients to evaluate the influence of plan adaptation on planning target volume (PTV) and organs at risk (OARs) doses, resulting from the changes in patient anatomy observed in control computed tomography (CT). The adapted treatment plans, which incorporated the changes observed in the control CT images, statistically improved mostly PTV coverage compared to initial plan. Study shows that applying adaptive procedures in clinical workflow may increased efficiency by controlling the proper irradiation of the treated area for H&N cancer patients. Applying a proton beam in radiotherapy enables precise irradiation of the tumor volume, but only for continuous assessment of changes in patient anatomy. Proton beam range uncertainties in the treatment process may originate not only from physical beam properties but also from patient-specific factors such as tumor shrinkage, edema formation and sinus filling, which are not incorporated in tumor volume safety margins. In this paper, we evaluated variations in dose distribution in proton therapy resulting from the differences observed in the control tomographic images and the dosimetric influence of applied adaptive treatment. The data from weekly computed tomography (CT) control scans of 21 patients, which serve as the basis for adaptive radiotherapy, were used for this study. Dosimetric analysis of adaptive proton therapy (APT) was performed on patients with head and neck (H&N) area tumors who were divided into two groups: patients with tumors in the sinus/nasal area and patients with tumors in the brain area. For this analysis, the reference treatment plans were forward-calculated using weekly control CT scans. A comparative evaluation of organ at risk (OAR) dose-volume histogram (DVH) parameters, as well as conformity and homogeneity indices, was conducted between the initial and recalculated dose distributions to assess the necessity of the adaptation process in terms of dosimetric parameters. Changes in PTV volume after replanning were observed in seventeen patient cases, showing a discrepancy of over 1 cm 3 in ten cases. In these cases, tumor progression occurred in 30% of patients, while regression was observed in 70%. The statistical analysis indicates that the use of the adaptive planning procedure results in a statistically significant improvement in dose distribution, particularly in the PTV area. The findings led to the conclusion that the adaptive procedure provides significant advantages in terms of dose distribution within the treated volume. However, when considering the entire patient group, APT did not result in a statistically significant dose reduction in OARs (α = 0.05). [ABSTRACT FROM AUTHOR]

Background: Aphasia is often accompanied by impairment of non‐language cognitive functions. Assessment of cognitive capacity in people with aphasia (PWA) with standard neuropsychological methods may be problematic due to their language difficulties. Numerous experimental studies indicate that P300 may be considered as an index of cognitive capacity in both healthy and clinical samples. Accordingly, the measurement of event‐related potentials enables the investigation of behaviourally non‐observable mental processes underlying the cognitive functions that are assessed with neuropsychological tests. Aims: To investigate in PWA the relationship between P300 parameters and cognitive function efficiency measured with neuropsychological methods. Methods & Procedures: A total of 25 PWA after left‐hemispheric stroke participated in the study. Electrophysiological (EEG) signals were recorded during the performance of a visual Go‐No Go task. P300 was identified on nine electrodes, which were then pooled in three lines: left (F3, C3, P3), central (Fz, Cz, Pz) and right (F4, C4, P4). The neuropsychological assessment of cognitive functions included mental speed, short‐term memory, divided attention, executive functions, auditory language comprehension and expression. Outcomes & Results: P300 latency correlated with indices of several cognitive functions: temporal resolution, psychomotor speed, spatial short‐term memory, planning, word and sentence comprehension, as well as verbal fluency. Shorter P300 latencies were accompanied by greater efficiency of the abovementioned functions. In contrast, significant correlations between P300 amplitudes and cognitive measures were fragmentary. Conclusions & Implications: In PWA, P300 latency might be related to cognitive functioning, especially to measures that rely heavily on the speed of information processing. However, P300 seems to be unrelated to more complex cognitive functions. P300 latency may be used as a neurophysiological correlate of cognitive efficiency in PWA and might have potential applications in monitoring the effects of therapeutic interventions in this patient group. What this paper adds: What is already known on the subject: P300 parameters have been reported to be associated with cognitive performance in both healthy individuals and clinical groups (e.g., patients with Alzheimer's disease). Previous studies show that the presence of P300 at the early post‐stroke stage may be a predictor of better recovery of comprehension in PWA. What this paper adds to existing knowledge: Our results show for the first time that P300 may be used as a neurophysiological correlate of cognitive efficiency in PWA. In our study, P300 latency was associated with several languages and non‐language cognitive functions, especially with those whose effectiveness depends mainly on processing speed. In PWA, shorter latency corresponded to more efficient cognitive functioning. What are the potential or actual clinical implications of this work?: P300 measurement may be potentially useful in assessing the efficiency of certain cognitive functions in PWA. It may be also used to monitor the recovery process of PWA and to verify the effects of therapeutic interventions. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

At present, female life expectancy exceeds male life expectancy almost worldwide. However, numerous studies indicate that this disparity is gradually decreasing. In Poland, the gender gap in life expectancy peaked in 1991 when it amounted to 9.2 years. Since then, a narrowing of the gap has been observed, reaching 8 years in 2021. Decreasing differences in life expectancy between men and women in Poland were mainly the result of a reduction in mortality due to ischaemic heart disease, cerebrovascular disease, and a number of malignancies.Less attention has been paid to chronic obstructive pulmonary disease (COPD) although it is the third leading cause of death worldwide. This paper includes an analysis of mortality due to chronic obstructive pulmonary disease COPD. The male excess mortality was calculated as the ratio of mortality rates in the male population scaled up to the corresponding rates in the female population using both crude and standardised detailed mortality rates. The Joinpoint model was used to determine time trends. It was shown that from 2008 to 2021, the excess mortality of men due to COPD in Poland decreased by 3.3% per year from 2.4 to 1.7 when using crude coefficients, while when standardised coefficients were applied, it decreased significantly by 3.9% per year from 3.8 to 2.4. The decrease in the excess mortality of men in Poland was due to a simultaneous decrease in mortality in the population in general; however, a greater decrease was observed in the male population. The mortality of men and women, and, at the same time, the excess mortality of men caused by COPD in Poland decreased faster in the period studied than in other European countries. [ABSTRACT FROM AUTHOR]

Introduction: Vitiligo is a chronic skin condition caused by progressive cutaneous hypomelanosis. Aim: The aim of the study was to determine its epidemiology and clinical aspects. As considerable progress has been made in understanding of the pathogenesis of vitiligo and its classification as an autoimmune disease, the paper pays particular attention to coexisting autoimmune or atopic diseases. Material and methods: The study included 55 patients attending the Diagnostic and Treatment Center of Skin Diseases in Lodz. Data were collected during outpatient dermatological consultation. Results: The most common type of vitiligo was nonsegmental (85.5%) followed by segmental (12.7%) and unclassified (2.1%). The first skin lesions were mostly located on the hands (45.5%) and face (38.2%). Older patients with higher body mass index tended to demonstrate a higher body surface area. Of the patients, 63.6% demonstrated an autoimmune or atopic comorbidity, the most common of which were type 1 diabetes mellitus (18.2%), psoriasis (16.4%) or Hashimoto's thyroiditis (14.5%). Location on the face was associated with a significantly greater incidence of autoimmune or atopic co-morbidities. Conclusions: A facial location may serve as a predictive factor for other autoimmune or atopic diseases in vitiligo patients. Determining clinical factors in vitiligo patients which could be associated with a higher risk of autoimmune comorbidities may allow for their early diagnosis and suitable treatment. [ABSTRACT FROM AUTHOR]

Copyright of Long-Term Care Nursing / Pielegniarstwo w Opiece Dlugoterminowej is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The ability to understand figurative language, including metaphors and proverbs, decreases with age, although the phenomenon is not universal. Cognitive capacities and education play an important role in the competence connected with figurative language use and comprehension in people during the second half of life. Aims: To identify possible similarities and differences in task performance by subjects representing middle adulthood (40–49 and 50–59 years old) and late adulthood (60–69 and 70–92 years old). Additionally, the analyses took into account factors significantly affecting the results, that is, tasks type (metaphors versus proverbs), the way the answer is given (open‐ended versus multiple choice) and types of answers (abstract and concrete). This study also aimed to identify some cognitive correlates of task completion. Methods & Procedures: A total of 86 Caucasian subjects, aged 40–92 years, participated in this study (Mwhole group = 62.37, SD = 15.53); the group included 20 subjects aged 40–49 years (Mage = 45.4; SD = 3.05), 20 aged 50–59 years (Mage = 55.50; SD = 2.64), 20 aged 60–69 years (Mage = 64.40; SD = 2.78), and 26 aged 70–92 years (Mage = 79.15; SD = 6.27). A total of 20 well‐known Polish metaphors and 20 popular Polish proverbs were used to assess the level of proverb and metaphor comprehension. The Montreal Cognitive Assessment Scale and Vocabulary subtest of the Polish version of WAIS‐R were applied to assess the cognitive functions. Outcomes & Results: The results of the analyses suggest that there are differences as well as certain similarities between the groups. At 70+ years of age, the ability to explain and comprehend metaphors and proverbs decreases when compared with younger adults. In the 70+ group, the ability to grasp the meaning of both metaphors and proverbs is similar, unlike in the younger groups which present a better ability to explain and comprehend metaphors than proverbs. The conditions related to the types of tasks, that is, spontaneous interpretation and choice of responses, do not affect scores of the oldest subjects. Conclusions: The analysis of response types, that is, abstract versus concrete, shows that, compared with younger groups, people aged 70+ years tend to less frequently provide abstract explanations and more often give concrete (but correct) responses, referring to situational data or examples from everyday life. Moreover, attention, short‐term/delayed memory and lexical reserve influence the ability to use and comprehend figurative language to a varied degree. What this paper adds: What is already known on the subject: Studies focusing on metaphor and proverb interpretation by people in middle and late adulthood are rather scarce, and what is more, they provide inconclusive results. Research has shown that the capacities related to attention and memory, as well as language resources and executive functions, all deteriorate in older people, which negatively affects their ability to understand metaphors and proverbs. However, varied methods are applied to assess these skills, which may explain why the related findings are inconsistent. What this paper adds to existing knowledge: The novelty of this study lies in the fact that the analyses took into account the type of task (metaphors versus proverbs), the method of responding (open‐ended versus multiple‐choice) and the nature of the answer (abstract versus concrete). This allowed us to highlight intergroup differences and to show specific characteristics of proverb and metaphor spontaneous interpretation and choice of correct answers. The results were compared among the participants representing relatively narrow age ranges classified as middle and late adulthood. What are the potential or actual clinical implications of this work?: Analysis of how people in middle and late adulthood interpret metaphors and proverbs might constitute an element of preliminary screening assessment showing whether a decrease in this capacity is in the normal range or if it reflects a serious cognitive decline. It would be worthwhile if the diagnostic process included varied task designs, that is, both metaphors and proverbs, as well as spontaneous interpretation and multiple‐choice, as well as varied types of responses. [ABSTRACT FROM AUTHOR]

Introduction: Despite progress in the field of water safety, Poland has been experiencing much higher mortality due to drowning than in other countries of the EU region. The main aim of the paper is to examine the changes in drowning frequency and their causes. Material and methods: All available sources of data on drowning in Poland were analysed. Crude and age-standardized mortality rates due to drowning were calculated. A jointpoint regression model was employed in the analysis of long-term trends in annual mortality rates. Results: In total, 7350 persons died due to various types of drowning (ICD-10 codes: W65-W74, V90, V92, X37-X39, X71, Y21) in Poland in the years 2013-2021. The most frequent type of registered drowning was a drowning in natural waters - 3990 (54.3% of registered cases). The second cause of death due to drowning were falls into the water - 914 (12.4% of cases). Age-standardized death rates of males due to drowning in the years 2013-2021 dropped from 4.3 to 2.7 per 100,000. Among females the age-standardized rate decreased from 0.8 to 0.6 per 100,000. The annual percentage change of mortality (APC) in Poland was -4.0%. The downward trend of mortality was only significant among males (APC = -4.4% vs. APC = -2.6% among females). Mortality reduction was especially high among the youngest age groups: 0-14 years old (APC = -7.9%) and 15-29 years old (APC = -6.5%). Conclusions: There is a need to properly address drowning prevention tailored to groups with risk factors in Poland such as males, elderly people, and people with low socio-economic status. [ABSTRACT FROM AUTHOR]

INTRODUCTION AND OBJECTIVE: Occupational stress-related factors among working municipal police officers in Poland have not been examined in the literature. The purpose of the paper was to evaluate the impact of selected work-related factors on occupational stress in active municipal police officers in Warsaw by using configural frequency analysis (CFA). MATERIALS AND METHODS: A cross-sectional study was conducted among 578 participants, which accounted for 55.1% of all municipal police officers in Warsaw. The majority of study participants were men (72%) (mean age 43 years old). Two groups of workplace-related stress factors were analysed in the study: physical conditions and organisational working conditions causing stress. The study was carried out using the PAPI method (Paper-and-Pencil Interviewing), based on a proprietary questionnaire developed for the study. CFA searches for templates and patterns in contingency tables. RESULTS: Municipal police officers who claimed that stress did not affect health, took advantage of psychological/psychiatric advice less often than those who thought so (1.7% vs 10.1%; χ2 = 20.152, df = 2, P = 0.000). Those who declared that they often experienced stress at work were also more prone to claiming that one or two factors affected their level of stress: physical abuse, contact with infectious materials, working at uncomfortable temperatures or working in a noisy environment. In the opinion of the study population, there were some factors which contributed to the occurrence of stress at work, and these factors included: working in a hurry, lack of necessary resources, devices and materials at work, the need to be available at all times and the unpredictability of the work. The municipal police officers from the study population combined two or three methods to cope with stress, such as watching TV, surfing the Internet and talking with their families. CONCLUSION: Due to the specificity of a municipal police officer's occupation, special attention should be paid to the occupational stress risk factors characteristic for this group of professionals, and measures should be taken to reduce the number of stressors. It is important to organise training events devoted to effective methods of coping with stress. There is need to carry out more in-depth studies of occupational stress among municipal police officers. [ABSTRACT FROM AUTHOR]

There is some indication that discrimination as well as low levels of life satisfaction render young people at risk of cyberhate victimization. Adopting a socio-ecological perspective, this paper examines whether supportive family, peer and school environments may buffer against the effects of perceived discrimination and low life satisfaction on cyberhate victimization. Data from four countries (N = 3396) of the EU Kids Online IV survey on children aged 11–17 (51% girls) revealed a positive association between perceived discrimination and cyberhate victimization, but this impact was moderated by supportive family and peer environments. A negative association between life satisfaction and cyberhate victimization was mitigated by peer support. However, no associations with the school context were found. The current study provides new insights on how social support on different levels of the social environment may buffer against potential risk factors for cyberhate victimization and can inform decision-makers towards intervention and prevention strategies. [ABSTRACT FROM AUTHOR]

Human Papillomavirus (HPV) is the main cause of cervical cancer and genital warts and constitutes one of the most common sexually transmitted infections. Cervical cancer is the only reproductive cancer that has a primary prevention programme through the introduction of HPV vaccinations. Even though the majority of European countries have nationally funded HPV vaccination programmes, in Poland these are exclusively local and scarcely funded. Moreover, the majority of local programmes are directed to females only. Meanwhile, Poland has one of the highest cervical cancer incidence rates among high income countries. The aim of this study was to measure HPV vaccination levels among final-year students in Poland and to establish the association between vaccination status and gender, region and level of sexual education received. This study is a part of the POLKA 18 Study, which used original self-reported paper-based questionnaires distributed in schools in six Polish regions. The study was conducted between April and December 2019. The obtained data were analysed in STATA 17. In total, 2701 fully completed questionnaires were collected. Over half of the respondents (58.2%) did not know their HPV vaccination status. Only 16.0% of the respondents replied that they have been vaccinated against HPV (18.2% of females and 14.5% of males). There was no direct association between vaccination status and access to 'family life education' classes. The vaccination level significantly differed among the different regions of Poland (p < 0.0001), with the Śląskie and Wielkopolskie regions achieving the highest rates. At least a quarter of adolescents after their sexual debut have not been vaccinated against HPV. Regions with immunization programmes introduced to their provincial capitals had higher vaccination rates. Our findings indicate the need for the introduction of state-funded vaccination programmes at the national level for the vaccination rate to increase, which will have the potential to decrease cervical cancer incidence in the country. [ABSTRACT FROM AUTHOR]

Nowadays, one of the most important economic and social phenomena is population ageing. Due to the low activity rate of older people, one of the most important challenges is to take various actions involving active ageing, which is supposed to extending working life, and along with it—improve the competencies of older people. The aim of this paper is to evaluate the relevance of different competencies for extending working life, with limiting the analysis for Poland. The paper also assesses the competencies of mature Polish people (aged 50+, but still in working age). In the statistical analysis, I used logistic regression, as well as descriptive statistics and appropriate statistical tests. The results show that among the actions aimed at extending working life, the most important are those related to lifelong learning, targeted at improving the competencies of the older generation. The competencies (both soft and hard) of people aged 50+ are more important than their formal education. [ABSTRACT FROM AUTHOR]

Introduction: Following the introduction of COVID-19 lockdown, studies have shown an increase in domestic violence in many countries. The aim of the study was to assess the frequency of seeking domestic violence information and support during the initial COVID-19 lockdown (March - April 2020) in Poland. Material and methods: We analysed searches for information on domestic violence on Google and the use of the domestic violence crisis helpline in the lockdown period compared to previous years. Google search terms were selected by the authors of the paper and then the frequency of searches performed in March and April 2020 and in the corresponding months of 2015-2019 were determined using the Google Trends tool. Additionally, we compared the data obtained from the national helpline Blue Line in March - April 2020 vs. the corresponding months in 2019. Results: An increase in the number of reports of domestic violence was observed in comparison to the previous year (+6.9%), with the largest increase in the number of reports by email (+77.7%). At the same time, the number of reports from persons under 18 years old was lower (-48.5%). An increase in reports of both physical and psychological violence was observed. Google Trends data showed an increase in searches for 'psychological help' and a decrease in searches for domestic violence and addiction (p < 0.05). Conclusions: The presented results highlight a potential short-term increase of domestic violence during COVID-19 lockdown periods, with growing importance of Internet-based tools for seeking help (e-mails, and web search engines to a lesser extent). [ABSTRACT FROM AUTHOR]

Background: Accurate symptom monitoring is vital when managing pediatric asthma, providing an opportunity to improve control and relieve associated burden. The CHILDHOOD ASTHMA CONTROL TEST (C-ACT) has been validated for asthma control assessment in children; however, there are concerns that response option images used in the C-ACT are not culturally universal and could be misinterpreted. This cross-sectional, qualitative study developed and evaluated alternative response option images using interviews with children with asthma aged 4–11 years (and their parents/caregivers) in the United States, Spain, Poland, and Argentina. Interviews were conducted in two stages (with expert input) to evaluate the appropriateness, understanding and qualitative equivalence of the alternative images (both on paper and electronically). This included comparing the new images with the original C-ACT response scale, to provide context for equivalence results. Results: Alternative response option images included scale A (simple faces), scale B (circles of decreasing size), and scale C (squares of decreasing quantity). In Stage 1, most children logically ranked images using scales A, B and C (66.7%, 79.0% and 70.6%, respectively). However, some children ranked the images in scales B (26.7%) and C (58.3%) in reverse order. Slightly more children could interpret the images within the context of their asthma in scale B (68.4%) than A (55.6%) and C (47.5%). Based on Stage 1 results, experts recommended scales A (with slight modifications) and B be investigated further. In Stage 2, similar proportions of children logically ranked the images used in modified scales A (69.7%) and B (75.7%). However, a majority of children ranked the images in scale B in the reverse order (60.0%). Slightly more children were able to interpret the images in the context of their asthma using scale B (57.6%) than modified scale A (48.5%). Children and parents/caregivers preferred modified scale A over scale B (78.8% and 90.9%, respectively). Compared with the original C-ACT, most children selected the same response option on items using both scales, supporting equivalency. Following review of Stage 2 results, all five experts agreed modified scale A was the optimal response scale. Conclusions: This study developed alternative response option images for use in the C-ACT and provides qualitative evidence of the equivalency of these response options to the originals. Plain English summary: Accurate monitoring of the symptoms associated with pediatric asthma is important when managing the condition. The CHILDHOOD ASTHMA CONTROL TEST (C-ACT) is a questionnaire widely used to measure asthma severity in young children (aged 4–11 years). Each question answered by the child in the C-ACT has four possible answer choices. To help children answer, each choice is presented alongside an image of a male child's face ranging from sad to happy. However, there are concerns that the images used are not culturally universal and could be misinterpreted—due to difficulties translating to electronic formats and a lack of differentiation between the images used. Through interviewing children with asthma, we aimed to address these concerns by developing and testing new images. Alternative image options developed included simpler faces, circles of decreasing size and squares of decreasing quantity. Children aged 4–11 years old were interviewed to test whether they understood the response scale using the new images and if they answered in the same way as with the original images. Interviews were conducted in two stages, with expert guidance at key stages. Results showed that children can interpret and understand the newly developed images and that they answer the questions the same as they would using the original images. These new images have the advantages of being culturally neutral and easier to implement on an electronic device. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject? (Scientific Rationale): Mental health care in Poland lags behind that of many other countries, and coercive measures are used on a regular basis.Scant research has been conducted in Poland regarding the treatment of psychiatric patients.The perspectives of Polish psychiatric nurses towards aggression remain unknown. What does this paper add to the existing knowledge?: The translated and validated Attitude Towards Aggression Scale (ATAS) in Polish will serve as an instrument that gauges Polish nurses' attitudes towards aggression. The Polish nurses have unenlightened and negative attitude towards aggression. What are the implications for practice?: There is now an instrument in Polish by which we can gauge the attitudes of mental health nurses, which must precede any educational efforts. Polish nurses showed more restrictive and antiquated attitudes about patient violence than nurses in some other parts of the world. With a shift to more positive attitudes, the use of coercion could be reduced, resulting in improved patient care. Introduction: In Poland, the mode and site of patient treatment have changed little in the past 75 years, despite therapeutic advances worldwide. There is limited information regarding attitudes of nurses towards aggression in psychiatric settings in Poland, nor has there been an instrument in Polish to measure it. Aim: To translate and validate the Attitudes Towards Aggression Scale (ATAS) for use in Poland, and to assess the attitudes of three groups of nursing personnel towards aggression. Method: We surveyed 980 psychiatric and general nurses as well as nursing students. We translated the ATAS into Polish, and validated it using exploratory factor analysis. Results: The Polish version of the ATAS showed good psychometric properties. We found that Polish nurses perceived patient aggression extremely negatively. Discussion: Polish nurses perceive aggression as destructive, negative and not to be tolerated, leading to use of restraints. Among the three groups, psychiatric nurses showed the most negative attitude towards aggression. Thus, education is needed for preservice and inservice nurses alike to address this issue. What this study adds to existing evidence: We now have a validated instrument to assess nurses' attitudes about aggression. We also know that Polish nurses have exceedingly negative attitudes towards aggression. Implications for Practice: The Polish version of ATAS was found valid and reliable. Therefore, we can now measure the attitudes of Polish nurses towards aggression, which was not possible previously. The baseline data provide a starting point from which to determine effects of educational efforts. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nursing / Pielegniarstwo Polskie is the property of Poznan University of Medical Sciences Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper discusses participatory research with young people who are leaving public care in Finland to begin independent lives. The aim of the research, organised by SOS Children's Villages International, was to bring about change in alternative care arrangements, particularly those involving young people's transition to independence. The project used a participatory research design based on employing care-leaving peers as co-researchers. This paper adheres to the methodological principles of empowerment in analysing the personal experiences of young people leaving alternative care with the goal of informing good practice. The findings suggest that the peer research method can be an effective means of empowering young people to develop research skills and to be involved in knowledge production, as well as serving as a means of promoting improved services for “care-leavers”, those young people who are leaving either foster care or institutional care. The participatory and peer research method challenges the traditional understandings of expertise and knowledge production. Although the hierarchy between adult researchers and young people as co-researchers is still evident, the method provides possibilities for better understanding the social- and health-service systems and their challenges and pitfalls from a user's perspective. [ABSTRACT FROM PUBLISHER]

Languages vary in the type of contexts that affect prosodic prominence. This paper reports on a production study investigating how different types of foci influence prosody in Polish and Czech noun phrases. The results show that in both languages, focus and givenness are marked prosodically, with pitch and intensity as the main acoustic correlates. Like Germanic languages, Polish and Czech patterns show prosodic focus marking in a broad range of contexts and differ in this regard from other fixed-word-stress languages such as French. This suggests that (a) Polish and Czech are similar to Germanic languages and are unlike Romance languages in marking a variety of types of focus prosodically; (b) there is no close correlation between fixed word stress and lack of prosodic focus marking because Polish, which has fixed stress on the penult, shows prosodic focus marking for all types of focus; and (c) there is no straightforward relationship between flexible word order and whether focus and givenness are prosodically marked, contrary to earlier claims, because both Czech and Polish, with their relatively flexible word order, are more similar to English than Romance languages. [ABSTRACT FROM AUTHOR]

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Aim: The aim of this paper was to examine if among alcohol dependent subjects hope is positively related to mental health. Additional aim was to verify if length of abstinence and involvement in Alcoholics Anonymous are important factors for mental health and hope. Method: The sample consisted of 115 dependent subjects participating in Alcoholics Anonymous from Wielkopolska. The following tools were used: Herth Hope Scale (HHS), tree scales being indicators of mental health: level of stress, evaluation of life up to now and subjective mental health as well as two one item scales regarding length of abstinence and length of being in Alcoholics Anonymous. Results: Noticed positive correlation between hope and evaluation of life up to now as well as negative correlation between hope and level of stress. Length of abstinence and length of being in Alcoholics Anonymous negatively related to level of stress. Length of abstinence correlated positively with subjective evaluation of mental health. Conclusion: Hope is an relevant factor for mental health of Alcoholics Anonymous. Higher level of hope is positively related to evaluation of live. Additionally hope the same as length of abstinence and length of being in Alcoholics Anonymous were buffer the stress level. Participating in Alcoholics Anonymous is related to better evaluation of mental health. [ABSTRACT FROM PUBLISHER]

Background. The issue of physical activity of pregnant women, including determining proper recommendations, has been a broadly discussed topic in international circles. Objectives. The aim of this paper is to present the suitability of the Pregnancy Physical Activity Questionnaire (PPAQ) for measuring the physical activity of pregnant women in Poland. Material and methods. The study included 162 questionnaires, which were filled in correctly by pregnant women (third trimester) who took part in childbirth classes organized by a childbirth school. As a research method, the PPAQ was chosen. The PPAQ allows pregnant women to self-assess their physical activity in the current trimester. The questions investigated time devoted to various types of activity related to household/caregiving, transportation, sports/exercise in their free time, occupational activity and inactivity. Based on the average weekly energy expenditure, each of these activities is classified by intensity: sedentary activity, light-intensity activity, moderate-intensity activity, vigorous-intensity activity. Results. While using the PPAQ in Poland, it is recommended to reduce the number of questions from 36 to 35, by removing question 18 (time of mowing lawn while on a riding mower). It is also advisable to convert American units of measurement into metric units, which are used in Poland. Conclusions. The Pregnancy Physical Activity Questionnaire in Poland may fill the gap in studies devoted to the physical activity of pregnant Polish women. With this questionnaire, it is possible to determine energy expenditure in terms of intensity and type of physical activity. It also serves as a reliable tool that can be used for international comparisons. [ABSTRACT FROM AUTHOR]

Over the past 30 years, the incidence of cancer in Poland has more than doubled. Advances in technology, early diagnosis and improved treatment make more and more malignancies curable. An increase in the survival of cancer patients has also been observed. An increased rate of survival leads to the development of subsequent malignancies. Their cause is yet unclear however, chemotherapy as well as genetic and environmental factors may be involved in the process. The key prognostic factors for patients who were once diagnosed with cancer are: type of cancer, its stage and available treatment options. The aim of this work is to introduce the issue of multiple primary malignancies, with particular emphasis on their epidemiology. From the perspective of the whole population, the occurrence of multiple malignancies is quite rare. Triple or quadruple malignancies are even less common. Multiple malignancies may develop at any age, although, as it is shown in this paper, the type of cancer, its stage and location vary depending on the age at which the first and later subsequent cancers have presented. The most frequently found subsequent cancers are: colon cancer, lung cancer, cancers of the genital system and breast cancer. Based on statistical analysis and current literature, we discuss the risk of developing a second malignancy depending on the type of cancer that was diagnosed first. [ABSTRACT FROM AUTHOR]

Aim The purpose of the paper was to compare the prevalence of barriers to optimum postoperative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. Background It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. Methods A questionnaire-based study of 1602 nurses working at clinical, provincial and municipal hospitals. Results In the clinical hospitals barriers more often related to a poorly organised systems of care and obstacles in discussing pain management within the team. In provincial and municipal hospitals lack of uninform pain measurement was more evident. Conclusions Despite the availability of effective pain treatments in hospitals difficulties continue with communication, poorly organised care and limited access to clinical guidelines. Implications for nursing management Although there are possibilities of pain relief after surgery, they are still used insufficiently. Postoperative pain management in Poland needs considerable improvement. This study can contribute to the improvement of pain management quality by supporting and developing practical guidelines or management algorithms for nurses, facilitating the effective implementation of new pain management practices. [ABSTRACT FROM AUTHOR]

Maintenance of proper oral hygiene by dental plaque elimination is one of the most important factors affecting the healing process in postoperative oral wounds. Propolis is a substance produced by bees. Ethanolic extract of propolis has bactericidal, fungicidal, anti-inflammatory, and antioxidative properties. Moreover, it can scavenge free radicals. The purpose of this paper is to demonstrate the efficacy of a gel containing 3% of ethanolic extract of Brazilian green propolis (EEP-B) when used for maintaining oral hygiene in patients with postoperative oral mucosal wounds. The hygiene was assessed using API, OHI, and SBI followed by microbiological examinations. The patients were divided into two groups. Group 1 consisted of those who used a gel containing EEP-B for oral hygiene, and group 2 consisted of those who used a gel without EEP-B. Although improved oral hygiene was noted in both groups, the improvement was markedly greater in the group using gel containing EEP-B. Summing up the results of microbiological examinations, EEP-B has beneficial effect on mouth microflora in postoperative period. Propolis preparations used for oral hygiene allow eliminating microorganisms of pathogenic character and physiological flora microorganisms considered as being opportunistic, with no harmful influence on physiological microflora in oral ecosystem. [ABSTRACT FROM AUTHOR]

Background. lung cancer is the most common cause of morbidity and mortality among all cancers. The dominant type of lung cancer is non-small cell lung cancer. early diagnosis, rapid and least possible invasive treatment gives the best chance to extend life expectancy. Considering increasing level of NSCLC morbidity it is extremely important to develop cancer diagnostics, which will allow to implement necessary treatment in early stages. Objectives. The main focus of this paper is to establish level of usability for dimeric form of the pyruvate kinase in NSCLC patient plasma using spectrophotometric method. Material and methods. Participants of the study were chosen from patients of the lower silesian lung disease Centre in Wroclaw. Patients were allocated in to two study groups: first containing patients who were diagnosed with adenocarcinoma, second containing patients who were diagnosed with carcinoma planoepitheliale. The control group was chosen from patients who were not diagnosed with cancer. material in question was plasma, tested on pyruvate kinase activity. Results. Analysis showed a difference in pyruvate kinase activity between patients in study groups and test group. The highest increase in enzyme activity was found in group of patients diagnosed with carcinoma planoepitheliale (134.5%). in the group of patients diagnosed with adenocarcinoma enzyme activity increase reached 132.1% and in test group, 116%. Conclusions. Testing enzyme activity of pyruvate kinase can be an additional helpful method in NSCLC diagnoses, besides diagnostic imaging. This method is characterised by high sensitivity and low invasiveness. [ABSTRACT FROM AUTHOR]

This qualitative study explores psychodynamic therapists' experiences associatedwith unexpected encounters with their patients outside the clinical setting. Information was collected using a semi-structured interview protocol from 10 experienced practitioners in Poland and examined according to the interpretative phenomenological analysis principles. Four overarching themes are discussed in the paper. Results show that accidental encounters often challenged practitioners' privacy, led to involuntary self-disclosure (causing discomfort and distress) and required re-negotiating roles and boundaries in the new context. Various coping strategies were also identified and analysed, including withdrawal, anticipation and avoidance, as well as using community support. Findings are discussed in terms of their implications for mental health professionals and psychotherapy training. [ABSTRACT FROM AUTHOR]

This paper is based on the Polish country-level final report of the European Union Amphora study: contextual determinants and alcohol polices. The authors present the results of a time series analysis model designed to explore and explain the influence of selected alcoholic beverage control policy measures and unplanned sociodemographical determinants on changes in alcoholic beverage consumption from 1960 to the 2000s in Poland. Complex historical and social changes are described, which occurred during the 50 years covered by the study. The study findings confirmed that sociodemographical determinants have an important influence on alcoholic beverage consumption. Study limitations are noted and future research is suggested. [ABSTRACT FROM AUTHOR]

The built environment (BE) impacts on people's disability and health, in terms of overweight, depression, alcohol abuse, poor self-rated health and presence of psychological symptoms; it is reasonable to assume that BE also impacts on participation levels. This paper presents the validation of the COURAGE Built Environment Self-Reported Questionnaire (CBE-SR), an instrument designed to evaluate BE in the context of health and disability. Subjects participating to COURAGE, a cross-sectional study conducted on 10 800 citizens of Poland, Finland and Spain, completed a protocol inclusive of the CBE-SR. Psychometric properties and factor structure were analysed, and factor scores created. Gender differences, differences between persons from different age groups and persons reporting the environment as facilitating, hindering or neutral were calculated. Eight items were deleted so that the final version of CBE-SR comprises 19 items. Cronbach's alpha ranged from 0.743 to 0.906, and test-retest stability was demonstrated for the majority of items. Four subscales were identified: Usability of the neighbourhood environment; Hindrance of walkable environment; Easiness of use of public buildings, places and facilities; and Risk of accidents and usability of the living place. Younger respondents reported their neighbourhood as more usable but perceived walkways as more hindering and public buildings as less easy to use; gender differences were almost inexistent. The CBE-SR is a four-scale instrument with good psychometric properties that measures the person-environment interaction. It is sensitive across age groups and is consistent with the subject's overall judgement of the degree to which the environment is facilitating or hindering. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Poor built environments have a negative impact on the level of a person's participation. However, instruments measuring the person-environment interaction are lacking., The CBE-SR is a valid and reliable instrument that researchers can use to assess the relationships between the intrinsic health state and the objective features of the environment., Understanding this relationship would provide further insight into the need of addressing the individual's functioning either by means of interventions directed to the individual or by making changes to the individual's environment. [ABSTRACT FROM AUTHOR]

This paper examines differences in work restrictions of midlife family carers of older people in terms of prevalence, gender and explanatory variables, in six European countries: Germany, Greece, Italy, Poland, Sweden and the United Kingdom. A sample of 2,897 carers aged 45–64 was extracted from the EUROFAMCARE (Services for Supporting Family Carers of Older People in Europe: Characteristics, Coverage and Usage) European project database, in order to analyse four possible work restrictions experienced in connection with the activity of care-giving: the reduction of working hours; giving up working; difficulties in career developments and forced occasional work. The results show that work restrictions are experienced differently between countries especially by women: they are reported to a higher degree in the United Kingdom, Germany and Greece, less so in Italy, and seldom in Poland and Sweden. Gender differences within countries are not so marked. Country differences are explained in the light of the different welfare regimes characterising the countries under investigation, in order to elucidate how policy makers may act to improve working carers' conditions through appropriate policies. [ABSTRACT FROM PUBLISHER]

Occupational dysphonia is mainly of hyperfunctional origin, expressed by complaints experienced in the vocal tract. The aim of the paper was to evaluate the applicability of the Polish Vocal Tract Discomfort (VTD) scale in the diagnostics of occupational dysphonia. Patients with occupational dysphonia ( n = 218) and controls ( n = 140) were subjected to the VTD scale, VHI evaluation, and maximum phonation time (MPT) measurement. The patients also underwent videostroboscopy. The comparison of the frequency and severity of VTD symptoms showed that the results of the study group were significantly higher ( P = 0.000). The VTD scale is characterized by high values of Cronbach's alpha. This study results indicatethat the VTD scale can be a valuable tool, useful in the diagnostics of occupational dysphonia. [ABSTRACT FROM AUTHOR]

Introduction and aim: This paper aims to outline the relationships between kinesiotherapy methods used in rehabilitation and the recovery of the patient's ability to perform activities of daily living (ADLs), improvement of functional condition, regression of pareses and improvement of conscious state following surgical treatment of traumatic subdural haematomas. Materials and methods: The study was conducted on 84 patients treated surgically for traumatic subdural haematomas, divided into two groups. The key differentiating factor was the kinesiotherapy method used in rehabilitation. Patients were assessed using the International Scale of Muscle Weakness (ISMW), Barthel Index and modified Rankin Scale, while their conscious state was assessed using the Glasgow Coma Scale. Results: A significant improvement of the assessed features was observed in all patients. However, patients treated with proprioceptive neuromuscular facilitation (PNF) and elements of the Bobath concept regained lost function significantly faster than patients treated with traditional kinesiotherapy. No significant differences were observed in the course of improvement of conscious state between the two groups. Conclusions: Treatment using functional elements may significantly accelerate the return of the ability to perform ADLs, improvement in functional condition and regression of pareses in comparison with traditional kinesiotherapy. [ABSTRACT FROM AUTHOR]

Abstract: The proportion of elderly people in the global population is rapidly increasing. Their nutritional status indicates many deficiencies that are risky to health. The aim of this paper was to assess the nutrition and nutritional status in elderly individuals above 60 years old living in their family houses in rural areas. Dietary intake and nutritional status were measured in 174 elderly women and 64 men living in the rural areas of Oleśnica (near Wrocław, SW Poland). Energy intake, consumption of nutrients, selected anthropometric and biochemical indicators, were measured in two groups: one at risk of malnutrition and one with adequate nutrition. Using the mini nutritional assessment (MNA) questionnaire, 238 persons over 60 years of age were qualified according to their nutritional status. Anthropometric and biochemical parameters were measured. The group of women at risk of malnutrition (n =30) showed a statistically significantly lower energy intake in their diet (1127kcal) compared to women with adequate nutrition (1351kcal). The entire group of examined individuals showed a too low consumption of fiber, calcium, vitamins C and D, and folates. Most of the examined women had a too high body mass index (BMI) (on average 28.8), waist circumference was 96.3cm, and the triceps skinfold (TSF) was 25.2mm thick. Women at a risk of malnutrition had statistically significantly lower lipid parameters than those with adequate nutrition (respectively: TC 191.1 vs. 219.1m/dl, p <0.001, LDL-cholesterol 107.1 vs. 125.1m/dl, p <0.008, TG 129 vs. 143mg/dl). Men with a risk of malnutrition had a statistically significantly lower BMI (26.0 vs. 28.7, p <0.04), and also lower waist and arm perimeters compared to men with correct nutrition. According to the Charlson comorbidity index (CCI), 8.2% of person with adequate nutrition had poor prognostic indicator for overall survival. All the examined individuals showed many significant nutritional deficiencies. The group with nutritional risk had more pronounced nutritional deficiencies. Despite a too low energy value of foods among individuals with correct nutrition, their anthropometric parameters paradoxically showed the presence of excessive fatty tissue. The most frequent diseases existed in examined group were coronary artery disease and congestive heart failure. [Copyright &y& Elsevier]

Abstract: Aims: Most papers dealing with radiosurgery for cerebral arteriovenous malformations (AVMs) present the results of gamma-knife treatment, whereas linac radiosurgery is becoming increasingly popular. Moreover, there is still much uncertainty about the rationale of combined endovascular and radiosurgical treatment. The aims of this study were to evaluate obliteration and rebleeding rates, and to determine factors influencing obliteration and adverse effects after linac-based stereotactic radiosurgery for cerebral AVMs. Materials and methods: Records of 62 consecutive patients were analysed. Thirty-one had partial embolisation, five surgery, 29 had no prior treatment. The mean follow-up was 28.4 months. The mean volume treated was 11.7cm3 and included embolised portions of AVMs. Actuarial obliteration rates and annual bleeding hazard rates after radiosurgery were calculated using Kaplan–Meier survival and life table analyses. Results: Actuarial obliteration rates after 1, 2 and 3 years of follow-up were 17, 36 and 40%, respectively. Prior embolisation did not influence the obliteration rate. In 77.3% of patients, obliteration occurred during the first 2 years of follow-up. Annual bleeding hazard rates after stereotactic radiosurgery were 3.4 and 1.1% during the first and second year of follow-up, respectively. Non-symptomatic imaging abnormalities were detected in 33.9% of patients after a median time of 8.8 months. The Spetzler–Martin grade, AVM score, radiation dose, volume and AVM nidus < 3cm significantly influenced the probability of obliteration. A dose less than 15Gy significantly reduced the probability of obliteration. Conclusion: At least a 3 year follow-up is required to accurately assess the outcome. The best effects of the treatment are achieved for small (<3cm), low-grade lesions with a low AVM score. The bleeding risk after stereotactic radiosurgery gradually decreases. [Copyright &y& Elsevier]

Pharmaceutical care requires interprofessional collaboration between pharmacists and physicians. The aim of this paper is to determine the nature of inter-faculty relationships between medical and pharmacy students and its possible influence on the attitudes of medical students towards pharmacists and pharmaceutical care. The study was conducted using anonymous questionnaire administered to all medical students at the Medical University of Warsaw, Poland. The study involved 404 medical students (265 women and 139 men). Fifty-four percent of students reported that they maintained relationships with pharmacy students. Students had mixed views about the nature of the interprofessional relationship between physicians and pharmacists. Only 22% ( n = 87) of the students had heard about pharmaceutical care. However, a number expressed interest in this form of collaboration in their future professional career. Students also claimed that they did not consider themselves prepared for the future collaboration with pharmacists in providing pharmaceutical care services, but they would like to participate in relevant interprofessional workshops with pharmacy students. The results from this study suggest that social relationships between medical and pharmacy students may have some effect on how pharmacists and their role is perceived and also on medical students' attitudes towards pharmaceutical care. [ABSTRACT FROM AUTHOR]