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Introduction: Marijuana is one of the most widely used psychoactive substance. There is evidence of genetic predisposition for addiction., Objective: The aim of the study is to evaluate personality traits measured by the NEO Five-Factor Inventory and State-Trait Anxiety Inventory, combined with analysis of Tag1B rs1079597 and Tag1D rs1800498 located in the DRD2 gene., Material and Methods: The study group consisted of 214 rural cannabinoid users and 301 controls. The same psychometric test and real-time PCR genotyping were performed in both studied groups., Results: The values of Anxiety state, Anxiety trait, NEO FFI: Neuroticism and Openness in the rural cannabis using group were significantly higher than in the control group. On the other hand, lower values were observed among rural people using cannabis compared to the control group for NEO FFI: Extraversion, Agreeability and Conscientiousness. In the Anxiety trait subscale, a 2% association with the polymorphism DRD2 Tag1B rs1079597 was detected in subjects using cannabis. However, for the DRD2 Tag1D rs1800498, there was no effect on the differences in personality traits between rural cannabis users and the control group., Conclusions: The study shows differences in personality traits between the cannabis using group and controls. Interaction between genetic factors and personality traits was also detected. The association showing the combination of psychological characteristics and genetic variants can bring us closer to the overall picture of the issue of marijuana addiction.

Introduction: Substance abuse significantly influences human health and may induce problems with social functioning worldwide. Numerous genetic and environmental risk factors, as well as their interactions, accelerate the development of drug addiction. Etiologically, the dopaminergic mesocorticolimbic reward pathways are related to psychoactive substance addiction, and the reward properties of heroin are connected with changes in the mesolimbic dopaminergic system., Objective: The aim of this study is a haplotypic analysis of subjects addicted to polysubstance. However, with the knowledge that this is not a homogenous subgroup, it was decided to separate and analyze homogenous subgroups of subjects in order to find specific haplotypic variants among them. The subjects in the subgroups were addicted to heroin, and subjects with more than two relapses in the past two years., Material and Methods: The study group comprised of 301 polysubstance addicted rural male subjects. From this group, 2 homogenous subgroups of subjects were isolated and additionally analyzed: (1) a group of heroin addicted subjects (n=61), and (2) a group of heroin-addicted subjects with at least two relapses in the last two years (n=21). The group consisting of all polysubstance addicted rural subjects and both homogenous subgroups were analyzed against a control group of non-addicted subjects (n=300), matching gender and age. Five polymorphisms in the DRD2/ANKK1 region were analyzed: rs1076560, rs1800498, rs1079597, rs6276 in the DRD2 gene, and rs1800497 in the ANKK1 gene., Results: A statistically significant haplotype association was found in analysis of the heroin addicted subjects, compared to controls, and two possible trends - when comparing the whole group of addicted subjects to controls, and in relapse subgroups, compared to the controls., Conclusions: The results obtained showed that haplotypes indicate a part of the biological component of addiction.

Introduction and Objective: Back pain affects specific occupational groups, among which healthcare workers are the most predisposed. Therefore, the aim of this study was to determine the interdependences between subjective disability and their correlation with pain intensity and quality of life assessment among professionally active medical workers, taking into account working, socio-demographic and health conditions., Material and Methods: The cross-sectional study enrolled 110 professionally active medical workers (nurses, midwives, paramedics and physiotherapists). The study was conducted by a diagnostic survey method using 4 questionnaires: Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), World Health Organization Quality of Life BREF (WHOQoL-BREF), and the authors' questionnaire., Results: Back pain was reported by 103 respondents (94%) with the lumbar area indicated the most frequently (72.81%). Severe pain every day was reported by 49.51% of respondents and was associated with longer working time. ODI questionnaire confirmed III and IV degrees of disability in paramedics and nurses, who additionally obtained the lowest results in the quality of life assessment. Correlations between age and VAS were demonstrated (p=0.002), and between VAS and ODI pain (p<0.0001) and ODI disability (p<0.0001)., Conclusions: Back pain associated with professional activities is the consequence of overload. Health care workers should be included in a preventive programme and attend systematic ergonomics courses. Health care facilities should be retrofitted with equipment enabling work in accordance with the principles of ergonomics. The ODI questionnaire, together with the VAS method and scales for testing the quality of life, are useful tools in the clinical assessment of individuals with back pain.

The Taq1A polymorphism located in the ANKK1 gene is one of the most widely studied polymorphisms in regards to the genetics of behavior and addiction. The aim of our study was to analyze this polymorphism with regard to personality characteristics and anxiety measured by means of the Personality Inventory-(NEO Five-Factor Inventory-NEO-FFI) and the State-Trait Anxiety Inventory (STAI) in polysubstance addicted subjects. The study group consisted of 600 male volunteers, including 299 addicted subjects and 301 controls. Psychiatrists recruited members for both groups. Addiction was diagnosed in the case group. In the control group mental illness was excluded. The same psychometric test and genotyping using the real-time PCR (polymerase chain reaction) method was performed for both groups. The results were investigated by means of multivariate analysis of the main effects Multi-factor ANOVA. Significantly higher scores on the scale of STAI state and Neuroticism and Openness traits, as well as lower scores on the scales of Extraversion, Agreeability, and Conscientiousness, were found in the case group subjects, compared to the controls. Differences in frequency of genotypes and alleles of Taq1A polymorphism between the studied groups were not found. Multi-factor ANOVA of addicted subjects and control subjects and the ANKK1 Taq1A variant interaction approximated the statistical significance for the STAI state. The main effects ANOVA of both subjects' groups were found for the STAI state and trait, the Neuroticism scale, the Extraversion scale, and the Agreeability scale. The ANKK1 Taq1A main effects approximated the statistical significance of the STAI trait. Our study shows not only differences in personality traits between addicted and non-addicted subjects, but also the possible impact of ANKK1 on given traits and on addiction itself.

Introduction: Risky alcohol consumption is one of the main threats to the health of both individuals and society as a whole. These threats affect, among others, health, safety and financial situation. Their scale and intensity cause the issue of alcohol consumption to become a significant challenge for public health., Objective: The aim of the study was assessment of the occurrence of the problem of alcohol consumption among residents of rural areas in Western Pomerania and the Lubuskie Province of Western Poland., Material and Methods: The study was conducted on 350 residents of rural areas - 236 females (66.4%) and 114 males (32.6%), median age - 42 y. (range - 20-76 years). The tools used included MAST and AUDIT questionnaires, Health Behaviour Inventory (HBI), Social Activity Questionnaire (SA), and original questions., Results: In the studied group the problem with proper alcohol consumption occurred. High convergence was observed between results obtained by individual respondents with both tools (r=0.868 with p<0.001). Median on the AUDIT scale indicated the possibility of alcoholism occurrence in the studied group, whereas the MAST test indicated the necessity to conduct an in-depth alcohol diagnosis. Factors that differentiated the points scored by respondents in AUDIT test included gender - more women drank alcohol in a risky way (Z=-2.54, p=0.011), education, health behaviours, professional passivity, and using various forms of support. In the AUDIT test, the alcoholism threat was over 7 times higher in people without permanent employment (vs. employed people), OR=7.41 (95% CI-4.56-12.04), and in MAST test it was over 4 times higher in these individuals: OR =4.45 (95% CI-2.64-7.49)., Conclusions: Results indicate the need to intensify the work of regional facilities for solving alcohol problems, as well as educational campaigns in schools and health care facilities.

Many factors are involved in addiction. The dopaminergic system is thought to be the key element in this process. The mesolimbic dopamine system is a crucial element in the reward system. Changes in this system are thought to be leading to substance use disorders and dependence. Therefore, for our study we chose an analysis of two polymorphisms in genes (Variable Number of Tandem Repeats in DRD4 and DAT1 ) responsible for dopaminergic transmission, which might be implicated in the scores of personality traits measured by the NEO-FFI test. The study group consisted of 600 male volunteers-299 addicted subjects and 301 controls. Both groups were recruited by psychiatrists; in the case group addiction was diagnosed; in the controls a mental illness was excluded. In both groups the same psychometric test and genotyping by the PCR VNTR method were performed. The results were investigated by a multivariate analysis of the main effects ANOVA. In the presented study no DRD4 main effects were found for any of the analyzed traits but the DRD4 main effects approximated to the statistical significance for the extraversion scale. However, no DAT1 main effects were found for any of the analyzed traits but the DAT1 main effects approximated to the statistical significance for the agreeability scale.These associations open new possibilities for addiction research.

Coordination of healthcare effectively prevents exacerbations and reduces the number of hospitalizations, emergency visits, and the mortality rate in patients with chronic respiratory diseases. The purpose of this study was to determine clinical effectiveness of ambulatory healthcare coordination in chronic respiratory patients and its effect on the level of healthcare services as an indicator of direct medical costs. We conducted a retrospective health record survey, using an online database of 550 patients with chronic respiratory diseases. There were decreases in breathing rate, heart rate, and the number of cigarettes smoked per day, and forced vital capacity (FVC) and forced expired volume in 1 s (FEV1) increased after the implementation of the coordinated healthcare structure. These benefits were accompanied by increases in the number of visits to the pulmonary outpatient clinic (p < 0.001), diagnostic costs (p < 0.001), and referrals to other outpatient clinics (p < 0.003) and hospitals (p < 0.001). The advantageous effects of healthcare coordination on clinical status of respiratory patients above outlined persisted over a 3-year period being reviewed.

Chronic respiratory diseases are determined by genetic predisposition, and environmental and socioeconomic variables. One genetic factor underlying susceptibility to such diseases can be the ABO blood group system. The purpose of this study was to investigate the hypothesis that there would be a relationship between the blood group and risk of developing asthma and chronic obstructive pulmonary disease (COPD). We reviewed medical history files of patients with the diagnosis of COPD or asthma, including those suffering from a cancerous disease accompanied by asthma or COPD, hospitalized from January 2016 to July 2017. The study involved 248 adult patients (85 women and 163 men; median age 65, range 20-95 years) with COPD (177; 71.4%) and asthma (71; 28.6%) with a known blood type. We found that the most frequent was blood type A (97; 39.1%) and the least blood type AB (26; 8.0%). The distribution of individual blood types in asthma was not different from that in COPD patients. Significant differences were found between the distribution of O and pooled non-O blood types (A, B, and AB); the pooled category was more frequent in both asthma and COPD patients. We conclude that the blood type is not a prognostic differentiating between the occurrence of asthma or COPD, although both are less common in people with blood type O. Further investigation is required to set the predisposing role of the ABO antigens for chronic respiratory diseases.

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Asthma patients should be considered not only in terms of the medical aspects, but also the nonmedical issues associated with the psychological domain, since these are factors that can significantly improve patients' health state, quality of life, and illness acceptance, and can contribute to the reduction of healthcare utilization. The purpose of this study was to assess the acceptance of illness among asthma patients and their quality of life in the psychological domain, as well as to identify factors that influence illness acceptance and quality of life in the psychological domain. We examined 172 patients with asthma (median age: 58; range: 18-89 years) recruited from two pulmonology wards. We demonstrate that the patients with low levels of illness acceptance and a high healthcare service index had low quality of life in the mental domain. Older age; being separated, divorced, or widowed; and having BMI > 25, all significantly affect the levels of quality of life and illness acceptance. In conclusion, measurements of health-related quality of life and illness acceptance are useful for estimating the impact and progression of asthma. These results confirm that psychological functioning should be taken into account alongside the somatic state.

This study evaluated the effect of menopausal hormone therapy (MHT) on serum concentration of copper in postmenopausal women depending on passive or active exposure to tobacco smoke or lack thereof. The study included healthy postmenopausal women aged 42-69 years, who used ( n = 76) or did not use ( n = 76) MHT. Salivary cotinine and serum copper concentrations were determined in all the study subjects. Salivary cotinine exceeded 14 ng/ml in 14 women from the MHT group (18.5%) and in 16 controls (21.1%). Up to 41 (27%) study subjects had serum copper above the upper normal limit (1.17 mg/l). No correlation was found between salivary cotinine and serum copper in women with cotinine concentrations <14 ng/ml, and these two parameters correlated weakly in subjects with cotinine >14 ng/ml. Salivary concentration of cotinine increased with serum copper level in the MHT group, but not in the controls; smokers using MHT presented with significantly higher serum copper than nonsmokers. These findings imply that MHT does not affect serum concentration of copper in women who are not exposed to tobacco smoke. However, MHT seems to contribute to unfavorable increase in serum copper in passive and active smokers.

Governments struggle to fund health services and there is a growing interest in the cost, clinical characteristics, and interventions for high utilizers of care, such as persistent frequent attenders to primary care. The purpose of this study was to determine the components shaping the phenomenon of frequent attendance in patients with chronic respiratory diseases in primary care settings. We examined 200 adult patients with chronic diseases (median age 65, range 18-90) recruited from 126 general practitioners. We conclude that, in patients with chronic respiratory diseases, frequent attendance can be expected among those with a low level of satisfaction with their quality of health, a low level of QoL in the physical domain as much as QoL in the social relationships domain, making multiple visits to a doctor (more than 4 visits), taking more than five drugs, being treated for more than three chronic diseases, waiting at the doctor's office for no more than 30 min, receiving a greater number of primary care services, and requiring the assistance of a district nurse. Such patients may need social support interventions and monitoring of their clinical status.

The literature lacks reports on the role played by the Environmental domain of quality of life (QoL) in care for patients with chronic respiratory diseases. Such information has a high potential for implementation in modern medicine based on a 'tailor-made' holistic healthcare model. The purpose of this study was to determine the components that shape the Environmental domain of QoL in patients with chronic respiratory diseases. The study group consisted of 305 adult patients (median age 65 years) with at least one chronic respiratory disease. The greatest contribution to a high value of QoL in the Environmental domain among patients with chronic respiratory diseases was made by the coexistence of high QoL levels in other domains and in satisfaction with QoL. Programs for preventing a decline in QoL in the Environmental domain should include patients with low scores for the above variables as well as those with a low level of education, those who have not shown an improvement in their psychological well-being in the past 12 months, those with a low level of positive mental attitudes or healthy eating habits, a low Camberwell index, and low levels of overall pro-health behavior.

There are scarce reports in the literature on factors affecting the assessment of the quality of care for patients with chronic respiratory diseases. Such information is relevant in the accreditation process on implementing the healthcare. The study group consisted of 133 adult patients with chronic respiratory diseases and 125 adult patients with chronic non-respiratory diseases. In the present study, the level of satisfaction from healthcare provided by the primary healthcare unit, disease acceptance, quality of life, health behaviors, and met needs were examined, as well as associations between variables with the use of correspondence analysis. The results are that in patients with chronic respiratory diseases an increase in satisfaction depends on the improvement of well-being in the mental sphere. The lack of problems with obtaining a referral to a specialist and a higher level of fulfilled needs also have a positive effect. Additionally, low levels of satisfaction should be expected in those patients with chronic respiratory diseases who wait for an appointment in front of the office for a long time, report problems with obtaining a referral to additional tests, present a low level of health behaviors, and have a low index of benefits.

The literature lacks reports on the role of the social relationships domain (SRD) of quality of life (QoL) in shaping care for patients with chronic respiratory diseases in primary care. In this study we examined a group of 582 patients with chronic respiratory diseases and chronic non-respiratory diseases recruited from 199 primary care centers. In the patients with chronic respiratory diseases, higher SRD correlated with more frequent patient visits due to medical issue, fewer district nurse interventions over the past 12 months, less frequent hospitalizations over the past 3 years, and fewer chronic diseases. In these patients, a high SRD was most effectively created by high QoL in the Psychological, Environmental, and Physical domains, and the satisfaction with QoL. Programs for preventing a decline in SRD should include patients with low scores in the Psychological, Environmental, and Physical domains, those who show no improvement in mental or somatic well-being in the past 12 months, those with a low level of positive mental attitudes, unhealthy eating habits, and with low levels of met needs. Such programs should include older widows and widowers without permanent relationships, with only primary education, living far from a primary care center, and those whose visits were not due to a medical issue.

Purpose: The case study was to determine the effectiveness of tensegrity massage in a patient after mastectomy., Design: Tensegrity massage was performed in a 50-year-old woman after mastectomy. The purpose of the massage was to normalize the tension of musculo-ligamento-fascial system in the chest, shoulder girdle, and back., Methods: The patient was subjected to a series of six massage sessions, 45 minutes each, twice a week., Findings: The applied massage therapy contributed to the reduction of the postoperative scar tenderness and painfulness, to the relaxation of the muscular tone within the shoulder girdle, and to the improvement of the patient's general feeling., Conclusions: Tensegrity massage is an effective therapy in the elimination of pain and abnormal tissue tension induced by extensive scarring after mastectomy., Clinical Relevance: The presented massage procedure had a positive effect immediately after the therapy and after 1-month follow-up., (© 2014 Association of Rehabilitation Nurses.)

Objectives: Health-related quality of life (HRQoL) can serve as a multidimensional means of evaluating the relationship between the presence of wind turbines in residential areas and their consequence for health. The purpose of this study was to determine whether a relationship exists between the presence of wind farms at different stages of development and the HRQoL of people living in their vicinity in Poland., Method: The instruments employed in this study were the SF-36v2, a questionnaire measuring self-reported health problems, and a sociodemographic questionnaire. The study involved 1277 people who lived within 2 km from a wind turbine., Results: The highest overall QoL scores were obtained by respondents living the closest to wind turbines. The mental health, role emotional, and social functioning scores were significantly higher among respondents living near wind farms and wind-farm construction sites than among those living close to locations where wind farms were planned but where construction had not yet begun. Positive correlations were found between physical and mental component scores and reactions to the news of plans to construct a wind farm. Significant differences in physical and mental component scores were observed between residents who reacted calmly and those who responded with apprehension. Residents who expected the improvement of their financial standing as a result of the wind farm assessed their general health higher than those who did not expect to receive any economic benefits. The lowest QoL scores corresponded to frequent headaches, stomach aches, and back pain over the previous three months, as well as recurrent problems with falling asleep, anxiety, and a lack of acceptance of the project., Conclusion: The lowest overall QoL and general health scores were noted among residents of places where wind-farm developments were either at the stage of planning or under construction. In order to find ways of reducing environmental stress and its adverse effects on health, it is necessary to conduct research on residents of places where a wind farm is either planned or under construction, or has just been completed.

Quality of life (QoL) combined with the acceptance of illness reflects the efficiency of therapy and the level of patients' satisfaction with medical care. Education, marital status, and place of residence were used as the socio-economic status indicators. The purpose of this study was to determine the relationship between the levels of QoL and acceptance of illness (AI) and the socio-demographic data in patients with chronic obstructive pulmonary disease (COPD). The study involved 264 adult COPD patients. The average duration of COPD was 9 years (Q1-Q3: 3.0-12.0). The duration of the disease was significantly shorter in patients from rural areas. QoL correlated positively with AI (r = 0.69, p < 0.0001). The general QoL and AI were most strongly influenced by education, gender, and age. Education is a strong predictor of QoL and AI, and the latter correlate with the socioeconomic status of COPD patients. It is recommended that COPD patients with a low level of education have regular medical check-ups and are included in the preventive programs by general practitioners to improve their somatic status and QoL level.

Introduction: Demographic facts and forecasts about lengthening life expectancy motivate to systematize the knowledge of health problems experienced by women at the age of 50 and older. It refers to the whole health policy including health economics. Longer female life spans cause that an increasing number of women suffer from health problems associated with the perimenopausal period, and become health care recipients. Also a shift of retirement age is the reason to take interdisciplinary actions for women's health and quality of life. This study describes a decline in the levels of many bioelements in hair, urine and blood serum, which progresses with age. It not only correlates with a decrease in the synthesis and secretion of estrogen, but also environmental pollution, unhealthy lifestyle and the use of substances., Aim of the Study: The aim of this study was to determine the correlation between serum zinc levels in postmenopausal women and such variables as the use of substances (cigarettes, alcohol) and menopausal hormone therapy (MHT). Material and method: The study was conducted among 152 healthy women being 1-16 years after menopause. The women were divided into study group (MHT users) and control group (MHT non-users). A sub-division criterion was the use of substances (cigarettes, alcohol). Serum zinc levels were determined in all women. Results: The use of substances significantly contributed to the lowering of serum zinc levels in postmenopausal women. MHT users had statistically higher average zinc levels in blood serum, which referred both to smokers and consumers of alcohol and those who did not use these substances., Conclusions: (1) The use-of substances (cigarettes, alcohol) contributes to the lowering of zinc levels in blood serum. (2) MHT positively affects serum zinc levels in postmenopausal women regardless of whether they use substances (cigarettes, alcohol) or not.

Introduction: Health status and health-related quality of life of postmenopausal women are issues, which nowadays pose a serious challenge to many domains of science. Climacteric symptoms which occur at this stage of life, lower its quality and make a negative contribution to self-reported health status, are mostly observed in a particular group of women. Evaluation of health behaviors performed using a standardized questionnaire, the Health Behavior Inventory (HBI), may help establish a comprehensive diagnosis of women's health, and thus select effective interventions. A systemic approach to menopause assumes that full fitness of women and good quality of their lives can be maintained not only by means of pharmacotherapy but also other forms of action, especially health education oriented towards changes in the lifestyle and promotion of healthy behaviors., The Aim of This Study: Aim of the study is to perform a HBI-based assessment of women's health behaviors in such categories as healthy eating habits (HEH), preventive behaviors (PB), positive mental attitudes (PMA), and health practices (HP)., Material and Methods: The study involved 151 healthy postmenopausal women. A research tool was a standardized questionnaire, the Health Behavior Inventory (HBI)., Results: The surveyed women obtained 70% of the maximum score on average, which suggests a medium level of health behaviors in this group. The levels of health behaviors in the categories of positive mental attitudes and health practices significantly differed between older women and their younger counterparts (higher levels were observed among older respondents). There were also significant differences in the levels of healthy behaviors between women with secondary and higher education (those better educated declared healthy behaviors more often). There was no correlation between the level of health behaviors and the BMI of the surveyed women., Conclusions: Older women attached greater importance to positive mental attitudes, and so they avoided tension, stress and depressing situations. They also attached more weight to health practices (HP), i.e. the number of hours devoted to sleeping, resting and physical activity. The main determinant of a healthy lifestyle was higher education.

The purpose of this study was to analyse the associations of emotional control with sociodemographic and clinical variables in a sample of patients with a range of chronic somatic diseases. The relationships between emotional control, coping styles and adjustment to the disease were investigated. The sample consisted of 300 patients with the mean age of 54.60 ± 17.57 years. Courtauld Emotional Control Scale was used to measure the patients' tendency to suppress negative emotions, Coping Inventory for Stressful Situations was used to measure coping styles and Acceptance of Illness Scale was applied to determine adjustment to the disease. Patients with neurological conditions showed significantly lower suppression of anger. Levels of emotional control were found to be related to gender, age and educational level but not to the place of residence. Task-oriented style of coping with stress correlated positively with suppression of depression and anxiety, whereas acceptance of illness correlated negatively with suppression of anger. Levels of emotional control are only weakly related to the type of diagnosis; however, some clinical samples may show lower suppression of anger. Suppression of negative emotions is weakly related to adjustment indicators such as certain coping styles and acceptance of illness., (Copyright © 2013 John Wiley & Sons, Ltd.)

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.

Background: The objective of this study was to assess the possibility of implementation of the WHO Green Page as a tool to supplement basic medical interviews with environmental health risk factors for children., Methods: The WHO Green Page questionnaire was tested on parents of children who visited family practice doctors., Results: A total of 159 parents took part in the study. It was noted that 24.3% of caregivers expressed concern about their children's environment without naming the risk factors. It was also found that 23.7% of the parents demonstrated knowledge and awareness of existing real environmental risks, and 7.0% of them stated that their children had sustained injuries in connection with road traffic prior to the questionnaire study., Conclusions: The WHO Green Page will provide additional information to the basic medical interview and, if regularly updated, will allow for monitoring of changing environmental conditions of children.

Survey-based study what purpose was to analyse respondents' opinions about contacts with HIV/AIDS-affected people. It was performed using a paper-pencil method during visits of respondents at primary care centres and on-line through a link to the questionnaire distributed among patients of primary care physicians. The study involved 302 respondents, 80% of whom were women; the average age was 34.48 years. The majority of respondents did not know anyone with HIV/AIDS (89.6%). About 83.3% claimed that they would not decrease contacts with HIV/AIDS-affected people. According to 64.1% of respondents, children with HIV/AIDS should go to kindergarten/public or non-public school. We selected a group of respondents, who previously were not but now are inclined to limit such contacts. These respondents can be a potential target group for HIV/AIDS educational programmes. Most respondents think that there is insufficient information about the HIV/AIDS in the mass media.

Aim: The aim of this work is to assess the impact of replacement therapy on social and professional re-adaptation of people addicted to opioids., Material and Methods: This study covered 82 patients (52 male, 30 female; mean age of 39.9 years) addicted to opioids and treated with methadone. An analysis of medical records served as a research method., Results: Participation in the methadone programme influenced taking up a job by 47.5% of addicted; improving the legal situation, i. e., reduction of the number of criminal cases for 42.7% of addicted; and the feeling of positive impact on social re-adaptation by 96.3% of addicted., Conclusions: Replacement therapy with methadone fosters professional activation, reduces criminality and gives a feeling of social re-adaptation for people addicted to opioids., (© Georg Thieme Verlag KG Stuttgart · New York.)

The purpose of this study was to analyze psychosexual needs of nursing care home residents in Poland. The authors attempted to answer the question 'how do residents satisfy their psychosexual needs?' This survey-based study was performed with respect to the residents' right to privacy and intimacy. The residents were also informed that they could withdraw from the study at any stage. The history was taken from 85 subjects (60% women, 40% men). The mean age was 74.2±11.2. The most important psychosexual needs included: conversation, tenderness, emotional closeness (empathy, understanding), sexual contacts and physical closeness. As the most important elements of the relationship, respondents mentioned mutual respect and conviction that they can rely on their partners. Most respondents felt sexual tension occasionally, others once a week or less frequently. They relieved sexual tension through intimate contacts with their long-term partners, watching erotic films, masturbation, walking and diverting attention to other activities. Every fourth respondent was satisfied with his/her sexual life. The majority of seniors repeated stereotypes about sexuality of the elderly. Almost 71% claimed that sex in elderly people was taboo, 64% said that sex was for young people only, and 51% thought that sex was not important in life. Old age makes little difference to psychosexual needs. Most seniors need closeness manifesting as tenderness and conversations. Many old people are sexually active. Thus, it is worth considering whether people living in cohabitation should not have the possibility of staying together in nursing care home., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: Patients with at least one chronic disease requiring regular contact with their GP, additional tests and systematic use of medicines constitute one of the challenges for the future of primary medical care. To date, no studies have been published describing the most important factors in increasing the quality of care for the chronically ill., Objectives: To evaluate correlations between patients' characteristics and their assessments of the quality of health care and to identify the primary factors influencing the quality of care for chronically ill patients., Material and Methods: The sample for the current analysis included 232 chronically ill adult patients of primary care clinics in Poland. The patients' opinions regarding subjective and objective examinations, their participation in clinical decision-making processes, psychosocial factors, contact with the doctor in emergency situations and confidence in the doctor were investigated., Results: The strongest correlations defining the quality of care for the chronically ill were identified as the occurrence of hypertension (0.248, p < 0.001), the patient's gender (0.271, p < 0.001), the patient's level of education (0.169, p < 0.01) and the patient's age (0.155, p = 0.018). The results of the ANOVA test were statistically significant (p < 0.05) for the occurrence of myocardial infarction, hypertension, type 2 diabetes, psoriasis, multiple sclerosis, the doctor's gender, the patient's gender, age and education., Conclusions: The areas that the participants gave the highest ratings to are subjective and objective examinations, kindness and willingness to help. The strongest correlations between high assessments of the quality of care provided for chronically ill patients at primary care clinics were observed in the following variables: gender, age, level of education, frequency of visits, therapy conducted by a doctor at a specialist clinic, arterial hypertension, COPD and/or myocardial infarction.

The purpose of this study was to determine quality of life (QoL) and acceptance of illness in patients with chronic respiratory diseases. The study involved 315 adult patients of the mean age of 63.9±15.7 years. The World Health Organization Quality of Life Instrument Short Form and the Acceptance of Illness Scale were used. The mean score for QoL was 2.0±1.3. The highest scores were obtained in the Social Relationship Domain (13.9±2.7) and the lowest in the Environmental Domain (10.5±2.2). The strongest correlations within QoL domains were noted between Physical and Psychological Domains: r=0.611 (p<0.001), Psychological and Social Domains: r=0.605 (p<0.001). The overall degree of illness acceptance was low (26.0±7.8). The strongest correlations were observed between illness acceptance and Physical: r=0.591 (p<0.001) and Psychological Domains: r=0.450 (p<0.001). We conclude that illness acceptance can be augmented by improving the patient's clinical state and by the provision of psychological support and QoL by improving the Psychological and Environmental Domains., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Purpose: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC), and to assess the relationships between these constructs among patients suffering from chronic somatic diseases., Material and Methods: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57)., Results: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men), age (older subjects showing more frequent health-promoting behavior), education (higher education was associated with less frequent health-promoting behavior) and marital status (widowed subjects reporting more frequent health-promoting behavior)., Conclusions: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

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.

Aim: The study was to assess psychosexual functioning of women after breast cancer treatment, since this problem is very rarely discussed in Polish professional literature., Methods: Our study involved 103 women after breast cancer treatment. The questionnaire was based on the Likert scale, the Beck Depression Inventory, and the authors' own questions., Results: Some 52% of respondents were operated in 2002-2008; 93% had a radical mastectomy or a breast-sparing operation without reconstruction. About 71% accepted themselves before falling ill, and 65% regarded themselves as pretty. After surgery 57% felt attractive as sexual partners, 48.5% found it difficult to look at themselves naked, and 37.9% were embarrassed in their partners' presence. Some 26.21% of the women had a very good and 42.71% had a satisfactory sexual life before the disease. Following surgery, 54% did not notice any changes in their partners' behaviour, 14% avoided intimate situations, and 11% have not had sexual intercourse since the operation., Conclusions: In the relationships where sex was important, the quality of sexual intercourse improved. A factor which contributes to successful sexual life of a woman is her acceptance of her body and her feeling of attractiveness.

Purpose of the Study: To determine the level of alcohol intake (including risky drinking) and tobacco smoking among students of higher medical schools, as well as the level of students' knowledge about epidemiology and consequences of alcohol abuse., Material and Methods: The study was conducted in 2010-2012 and involved 1054 students of medical school. The majority of the participants were female (82.3%). Average age of respondents was 25.13 years (SD = 6.64, median = 24). The questionnaire was to determine the students' knowledge of alcohol abuse, short version of AUDIT and questions about tobacco smoking., Results: The average 100% alcohol intake in Poland was correctly identified by 32.0% (318) of students. The alcohol level in blood which indicates the state after alcohol intake was correctly determined by 57.2% (571) of respondents. Tobacco was the choice of 13.8% (138) of students as the main health risk factor and cause of premature deaths in Europe, alcohol was chosen by 17.8% (177). Cirrhosis was recognized correctly by 52% of students (521) as the most frequent disease caused by alcohol in European men. Regarding the question about the biochemical indicators helpful in diagnostics of alcohol abuse only 27.6% (275) indicated correctly: MCV and GGT. In short version of AUDIT 32.2% (238) of women gained 4 points and above, 56.2% (91) of men gained 5 points and above. Among women: 3.5% (28) have 14 and above standardized portions of an alcoholic drinks during week. Among men: 6.5% (11) have 28 and above standardized portions of an alcoholic drinks during week. Non-smokers represent 20.6% (205) of respondents. A majority (39.4%, 82) indicate they smoke not more than 5 cigarettes per day. The students first began smoking in secondary (21.7%, 45) and high school (45.9%, 95). Smokers statistically significantly more often (p<0.001) drink alcohol. More than four times higher percentage of smokers (10.0% vs 2.3% non-smokers) drink in a day when they drink 10 or more standardized portions of an alcoholic drink (p<0.001). Those who drink at least once a month drink 6 standardized portions of an alcoholic drink statistically significantly more often (p<0.001)were smokers (21.8% vs 10.8% non-smokers). Smokers were more than four times more likely (13.4%) than non-smokers (3.2%) to drink 6 standardized portions of an alcoholic drink once a week. During the majority of weekdays, 6 standardized portions of an alcoholic drink were taken by 2.48% (5) of smokers (vs 0% non-smokers)., Conclusions: A high percentage of students in medical schools drink riskily. Especially the risky drinking was observed among smoking students. The level of knowledge gained by respondents about alcohol abuse is still insufficient. Programs that promote avoiding tobacco smoking and alcohol abuse are necessary among children during the first years of education (in primary school and earlier).

Introduction: Multiple sclerosis is the most common cause of disability among young people, affecting the emotional and intellectual condition of the patient. Assessment of the quality of life enables long-term planning of the strategy of support and thus should constitute a permanent part of care for multiple sclerosis patients. The aim of this study was to assess the impact of gender, age, duration of the disease, and economic status of multiple sclerosis patients on the quality of life in separate domains., Material and Methods: A diagnostic survey was conducted in 64 patients with multiple sclerosis. We administered a questionnaire developed by us with questions referring to sociodemographic data of the patients. We also used the standard SF-36 questionnaire with eight scales., Results: No significant differences between male and female SM patients were noted as regards the quality of life in each scale. Wealthy patients experienced a higher quality of life as regards the general health and physical functioning in comparison to patients with a middle economic status. There was no effect of the place of residence on the quality of life. Elderly patients and patients with long-term multiple sclerosis had a poorer quality of life in the physical functioning, general health, vitality, and role-emotional domains., Conclusions: 1. Gender and place of residence of multiple sclerosis patients has no effect on any of the scales of the quality of life. 2. High economic status favors a higher quality of life in the physical functioning and general health scales. 3. Age and long duration of multiple sclerosis are important factors decreasing the quality of life in most scales.

Nowadays can observe not only changes of views on human sexuality but also of its nomenclature. These changes also apply to the issues related to human sexuality which plays an role in psychological purposes. The article discusses psychological and pedagogical aspects of human sexuality on the threshold of adult life. 83 students of post-GCSE faculties of the medical school were interviewed. The aim of the study was to determine the attitude towards sexual life expressed by young people entering their adult life. The study tool was a questionnaire technique. Results were statistically analyzed. The results showed that: the level of knowledge of sexual life is low among adults: lack of correlation between emotional and cognitive elements of attitudes towards human sexuality; sexual behaviours depend on human sex.

Children's rights are nowadays an important social, pedagogic, legal and moral problem. Practical respecting of resolutions included in the Convention on the Rights of the Child is far from perfect and requires changing social way of thinking. To attain this, the contents and essence of children's rights have to be disseminated and consequently enforced. The aim of my research was to answer the question: "What are the conditions for upholding children's right to respect at children wards?". The subject of my analysis was nurses' value hierarchy and individual conditions influencing respecting children rights. Research procedures were directed towards finding the answer to the following question: "What is the range of upholding children's right to respect?". I defined children's right to respect on the basis of analysis of Janusz Korczak's scientific output and the provisions of the Convention on the Rights of the Child. The rights being the subject of my research are classified either as "soft" or "hard" rights. "Soft" rights are defined in articles no. 12-16 and 31. Rights defined in articles no. 6, 7, 9 and 24 are referred to as "hard" rights. The synthesis of research results leads to the following solution of the research problem: The assumption of a strong influence of the most important values on mental life-thinking, perception, emotional-motivation processes, attitude and behavior of questioned nurses did not have proper empirical confirmation. Nurses' value hierarchy does not ensure upholding of children's right to respect in hospitals. Nurses' awareness of children rights reaches average level, while their knowledge and activity are at low level, and understanding of essence of children's rights and valuation of the rights--at average level. Average level of awareness of respecting children's rights makes children's existence in hospital imperiled by intuitive, often routine activities of nurses. The level of nurses' awareness is differentiated by age, place of employment and seniority. The dependence of awareness level upon questioned nurses' education has not been proved. The scale of upholding of children's right to respect has been defined on the basis of assumed indices conditioning the respect at an average level. It does not prove that children rights are respected in hospitals, as some of the rights are respected only to a small extent, causing menace to children existence. To change the existing situation, regular assessment of respecting children rights by all medical personnel shall be conducted regularly. Legal issues shall be included in the list of obligatory subjects of nursing studies and of all external forms of additional nurse training. These and other activities shall ensure existential safety for children in the hospital and increase the prestige of a nurse as a job.

The aim of a study was to evaluate health, psychological and social problems related to rehabilitation of cerebral palsy children (c.p. children). The study was based on 30 children c.p. who after diagnosis underwent systematic complex rehabilitation. Half of the children was under observation in outpatient clinics and their parents played the role of physiotherapeutists another half of the children apart from ambulatory kind of rehabilitation was hospitalized periodically in rehabilitation centres. Each half year all the children underwent control examinations of physical and motor development (including evaluation of postural and righting reflexes) as well as of psycho-motor development. Environmental conditions, parental attitudes towards examined children taking into consideration their evolution were also evaluated. The therapeutic team consisting of a paediatrician, neurologist, psychologist, physiotheraupeutist and psychiatrist took advantage of these examinations in psychotherapy of parents. Observation period of children was from 1:6 to 3 years. Age when rehabilitation was initiated was below 20 months of life. It was observed that result are influenced mainly by the degree of neurological disorders not by the conditions of rehabilitation. There are differences with regard to motor efficiency between rehabilitation at home and in rehabilitation center. Treatment at home has a better effect upon psychomotor development of children with more serious developmental disorders. Infections of upper respiratory tract are more rare in this group of children. There are two reasons why children in preschool age should be recommended for sanatorium treatment: medical indication e.g. operation and social indications.