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Respiratory syncytial virus (RSV) causes acute lower and upper respiratory tract infections in all age groups. The clinical course of RSV infection differs depending on age and comorbidities. RSV infections are severe in the adult population; the highest risk of complications is seen in the elderly (age over 60 years) and in individuals with certain chronic disorders. Vaccination is the only currently available method of active prevention of RSV infections in adults. RSV vaccines stimulate both the humoral and the cell-mediated immunity and ensure a high level of protection against severe and complicated infection. Vaccination is recommended in all patients over the age of 60 years, particularly those with chronic disease (asthma, chronic obstructive pulmonary disease and other chronic respiratory tract disorders, ischaemic heart disease, heart failure, cardiac arrhythmias, diabetes, chronic kidney disease), immunodeficient individuals and nursing home residents.

Vaccinations are the most effective and economically beneficial form of preventing dangerous infectious diseases. Healthcare professionals should strive for the highest possible immunisation rate in the population, especially among patients from risk groups, which include pregnant women. The vaccination coverage among pregnant Polish women is still unsatisfactory. A consensus on vaccination of pregnant women has recently been achieved by the greatest scientific authorities: global organisations and scientific societies recommend all pregnant women to be vaccinated against pertussis, influenza and COVID-19. Vaccination during pregnancy leads to the production of post-vaccination antibodies that migrate transplacentally to the foetus, providing protection to infants in their first months of life. The inactivated influenza vaccine is safe and effective when given at any stage of pregnancy. Vaccination against pertussis should take place between week 27 and 36 of pregnancy. The COVID-19 vaccine can be administered simultaneously with other vaccines or with a 14-day interval. The American Congress of Obstetricians and Gynecologists (ACOG) recommends vaccination of pregnant women with mRNA COVID-19 vaccines at any stage of pregnancy. As a general rule, pregnant women should not be vaccinated with live, attenuated viruses or bacterial vaccines. Vaccines contra-indicated for pregnant individuals, such as the vaccine against measles, mumps, rubella and varicella, as well as HPV, can be administered after delivery and during the breastfeeding period. Vaccination of pregnant women against rabies or tetanus is necessary for post-exposure prophylaxis.

Annual vaccination is the most effective protection against influenza and its serious complications. It is especially important for people at high risk of severe course of the disease and serious complications: individuals with specific chronic medical conditions, pregnant women, children aged 6–59 months, older people, and healthcare workers. Despite a progressive increase in seasonal vaccine coverage, influenza-related morbidity, mortality, and hospitalization rates remain high and have continued to increase in people aged 65 years and over. Standard vaccines against influenza are less efficient in this group due to immunosenescence. Consequently, more effective vaccines are needed to prevent influenza and its complications in older adults.

Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland This year marks the 20th anniversary of the publication by the Institute of Mother and Child in Warsaw of a document establishing the Polish standards for preventive health care of school-age children and adolescents by general practitioners, which are still in force today. Since then, their health status and the health risk factors have changed. Polish society and its expectations of health care are also different. The Polish economy has grown, and the proportion of the public budget spent on health care has increased. The current system of preventive health care for young people seems to be facing a problem. Over the past decade, the percentage of children and adolescents attending preventive medical visits in Poland has decreased by approximately 30%. During well-care visits, doctors commonly avoid selected physical examinations and sensitive topics, such as sexuality or mental health. It appears that most young people visit doctors only because they falsely believe that check-up visits are mandatory and usually rate the experience negatively. The co-authors of this paper conclude that there is a need for a broad debate on the Polish standards of preventive health care for adolescents and their possible reform, which would lead to their adaptation to the challenges of modern times and the opportunities offered by the progress of medical science and technology. The selection of topics is subjective and certainly does not cover all aspects requiring attention. The authors’ intention is to contribute to further discussion rather than to provide a basis for conclusions or postulates.

Abstract Background Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland. Methods The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022. Results In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) – 26.1%, pregnancy, childbirth and the puerperium (O00-O99) – 18.4%, and factors influencing health status and contact with health services (Z00-Z99) – 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common – 14.9%, followed by abnormal clinical and lab findings (R00-R99) – 11.9%, and infectious and parasitic diseases (A00-B99) – 11.0%. Conclusions Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.

Abstract Congenital toxoplasmosis (CT) is a rare entity and it may pose a life-threatening risk for the newborns. The aim of the study was to evaluate the incidence and other selected factors of CT in Poland. Our study is a population-based study on CT patients in 2007–2021. The study was based on 1504 hospitalization records of first-time diagnosis of CT in newborns. In the study group, we observed 763 males (50.7%) and 741 females (49.3%). The mean and median age was 31 days and 10 days, respectively. Based on the hospital registry, the mean annual CT incidence was estimated to be 2.6 per 10,000 live births (95% CI 2.0–3.2 per 10,000 live births). The incidence of CT cases fluctuated over the years 2007–2021, with the highest incidence in 2010 and the lowest one in 2014. There were no statistically significant differences between the incidence of CT in relation to sex or place of residence. The periodic fluctuations in the number of cases of congenital toxoplasmosis indicates the need to develop effective prevention programs to effectively counteract the disease and its consequences.

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system of unclear aetiology which involves genetic and envi-ronmental factors, including infections. Infections in MS patients increase the risk of exacerbation of the disease. It has been shown that preventing infections reduces the risk of MS relapse and quality of life outcome. Over the past 20 years, the number of drugs available for disease modifying therapy (DMT) in MS patients has grown significantly. Some of the DMT may entail an increased risk of infections, including life-threatening ones such as measles... etc. These infections include measles, infections caused by human papilloma virus (HPV), varicella zoster virus (VZV), hepatitis B virus (HBV), pneumococci and, recently, serious acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Therefore, at the time of MS diagnosis, the patient should be interviewed and screened for prior vaccination and/or serological status prior to starting DMT so that any missing vaccinations can be performed. Most infections can be effectively and safely prevented. Vaccinations should be integral part of the treatment process. They not only prevent life-threatening diseases but also increase the safety of drugs used to change the course of the underlying disease. Some specific recommenadation regarding the use of vaccinations in MS patients treated with DMT are included in summary of product characteristic for particular drugs. Additionally, scientific boards publish guidelines on recommended vaccinations due to changing epidemiological situations with special emphasis on immunocompromised patients.

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era.Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017–2021.Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3–51.9 per 1,000 in 2017–2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations.Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns.

Pneumococcal infections (Streptococcus pneumoniae) remain a significant epidemiological problem globally. Although an invasive pneumo-coccal disease (IPD), which includes meningitis, sepsis and pneumonia with bacteremia, is the most severe form of pneumococcal infection, the main bur-den in terms of morbidity and mortality is associated with community-acquired pneumonia in the elderly. The epidemiology of infections caused by S. pneumoniae serotypes can change naturally in time and by universal vaccination implementation. The proportion of infections caused by serotypes not contained in any available vaccines is constantly increasing. These changes stimulate the development of new vaccines and ensure the broadest possible protection against S. pneumoniae infections. There is a need to raise awareness of the burden of pneumococcal disease in adults and the vaccines used for prophylaxis for pneumococcal infection. The article discusses the pneumococcal infection burden in the adult population and the factors that raise the risk of infections. We characterised available vaccines for adults, highlighting the significant differences between the conjugated and unconjugated polysaccharide vaccines. Current epidemiological data on pneumococcal infections in Europe and Poland is presented. The latest 20-valent pneumococcal conjugate vaccine (PCV20) is described, and the most recent Advisory Committee on Immunization Practices (ACIP) recommendations on primary prevention and the current implementation of vaccination against pneumococcal infections in the adult population in Poland are discussed.

Anthocyanins are phenolic compounds occurring in fruits and vegetables. Evidence from pre-clinical studies indicates their role in glucose level regulation, gut microbiota improvement, and inflammation reduction under diabetic conditions. Therefore, incorporating these research advancements into clinical practice would significantly improve the prevention and management of type 2 diabetes. This narrative review provides a concise overview of 18 findings from recent clinical research published over the last 5 years that investigate the therapeutic effects of dietary anthocyanins on diabetes. Anthocyanin supplementation has been shown to have a regulatory effect on fasting blood glucose levels, glycated hemoglobin, and other diabetes-related indicators. Furthermore, increased anthocyanin dosages had more favorable implications for diabetes treatment. This review provides evidence that an anthocyanin-rich diet can improve diabetes outcomes, especially in at-risk groups. Future research should focus on optimal intervention duration, consider multiple clinical biomarkers, and analyze anthocyanin effects among well-controlled versus poorly controlled groups of patients with diabetes.

This study examines the vaccine market access pathway in Poland to evaluate its efficiency and propose recommendations for its improvement. The research spans a comprehensive analysis of the vaccine assessment process, ranging from pre-registration to sustainability, encompassing critical components such as national immunization technical advisory groups (NITAGs), health technology assessments, resource evaluations, and decision making. This investigation utilizes a multi-phase approach. Initial desk research aimed to collect accumulated evidence about each step of the vaccine access pathway. This constituted the background for an expert panel discussion (n = 13) and a final online questionnaire (n = 12), evaluating the timeframes, inclusiveness, transparency, and consistency of the elements of the process. Poland is a late adopter of new vaccines. The country faces budget constraints and lacks a formalized framework for the inclusion of vaccines into the national immunization program. Notably, NITAGs play a crucial role, yet their limited resources and dependence on public health stakeholders diminish their impact. A formal and well-supported advisory body may become a foundation for decision-making processes. The health technology assessment conducted by the national agency is recognized for its timeliness and transparency, though the absence of fiscal analyses in vaccine assessments is identified as a gap that limits the understanding of the value of vaccinations. Resources are key drivers of decision making, and recent changes in legislation offer increased flexibility in financing vaccines. Challenges in the procurement process include a limited consideration of non-acquisition costs and an increased absence of a documented general strategy for immunization program development in Poland, pointing to a need for strategic planning. In conclusion, this study recommends the establishment of a robust NITAG with enhanced resources, incorporating fiscal analyses, transparent resource allocation, and strategic planning for immunization program development. Addressing these recommendations is crucial for optimizing Poland’s vaccine market access pathway, ensuring timely and efficient population-wide vaccine access.

Invasive meningococcal disease is a dangerous bacterial infection that often leads to death or permanent disability. Immunization is the best strategy to protect individuals against invasive infections caused by Neisseria meningitidis. The effectiveness of vaccines has been demonstrated in many countries where they have been introduced into national vaccination programs. Meningococcal vaccinations in Poland are recommended in the framework of the National Immunization Program. However, they are not reimbursed, meaning the patient or parent covers vaccination costs. In addition, insufficient public awareness of the disease course and risks associated with meningococcal infection, the need for immunization in the first year of a child’s life, the number of doses administered, and the price of the vaccines are barriers to the acceptance and implementation of meningococcal immunization, especially in the youngest children. Recommendations for physicians implementing meningococcal vaccination in children and adults are the result of the work of an expert group.

Several hundred million people are infected with genital genotypes of the human papillomavirus (HPV) annually in the world. The infections transmitted mainly through sexual routes are usually asymptomatic, but can lead to the development of cervical, vulvar, vaginal, anal, and penile cancers, some head and neck cancers, and genital warts (condylomas). The fraction HPV-related cancers ranges from nearly 100% in the case of cervical cancer to several/over a dozen percent in the case of other cancers and diseases. There are no effective drugs against HPV, but prophylactic HPV vaccines are available free of charge in immunization programmes in many countries around the world. In Poland, HPV vaccinations have so far been executed out of pocket or in free- of-charge, local-governmental prevention programmes, but the vaccination coverage of the target population does not exceed 10%. In November 2021, one of the vaccines became available with a 50% reimbursement, work is underway to reimburse the next ones, and the National Oncology Strategy assumes the implementation of the HPV immunization programmes and vaccination of 60% of the teenage population by 2028. Three prophylactic HPV vaccines are registered. All of them are safe and their effectiveness in the prevention of diseases caused by vaccine genotypes is almost 100%, provided that full post-vaccination immunity is obtained before contact with the virus. Girls aged 11–13 years are the priority target cohort for HPV vaccination in Poland. The implementation of routine, free-of-charge HPV immunization in the Preventive Immunization Programme (PIP) for all adolescents should be pursued. Persons over the age of 13 years may also benefit from HPV vaccination and should be vaccinated according to product specifications. In addition to free access under the PIP, the key element for the success of the implementation of HPV vaccinations in Poland will be the education of medical personnel and parents of adolescents to be vaccinated.

Diseases caused by Streptococcus pneumoniae (S. pneumoniae) can be either invasive or non-invasive. In adults, pneumococcal infections most often occur as pneumonia, one of the leading causes of hospitalisation in these patients in Poland. Multiple factors predispose patients to the severe course of pneumococcal disease, including age, comorbidities, immune disorders and unhealthy behaviours, whereas the accumulation of coexisting conditions leads to risk stacking. Therefore, prophylactic vaccinations should be the preferred form of protection against pneumococcal infections in adults, based on high vaccination effectiveness and a relatively low risk of adverse events. Importantly, the current recommendations need to be updated in the context of epidemiological changes and the registration of new conjugate vaccines. This publication aims to present the current knowledge on the prevention of pneumococcal disease among adults and establish practical recommendations on the appropriate immunisation schedules used in Poland.

Background The aim of the study was to assess the state of knowledge of Medical University of Warsaw (MUW) students on COVID-19, modes of transmission and preventive measures. Material and Methods The study was conducted in October 2020. The participants were all the students attending classes at MUW – 8922 persons. All had completed the online training “Work safety and hygiene during COVID-19.” To assess their state of knowledge an online questionnaire was made available on the MUW e-learning platform. The questionnaire comprised 4 parts: (1) awareness of rules of hand hygiene, (2) medical aspects of COVID-19, (3) preventing SARS-CoV-2 infection transmission in health care facilities, and (4) preventing infection transmissions in the society. Results The majority of students (93.9%) demonstrated a sufficient level of knowledge. The highest passing threshold was found on the medical programme (96.7% of students with satisfactory level of knowledge), dentistry (96.2%) and pharmacy (95.5%). The statistically significant factors that differentiated student results proved to be faculty (p < 0.001), study programme (p < 0.001), year of studies (p = 0.001), form of studies (p < 0.001). The participants most often showed full knowledge (100% correct answers in sub-area) of preventing infection transmissions in the society (93.3%) and medical aspects of COVID-19 (91.8%), less complete in terms of ways of preventing infection transmission in health care facilities (85.4%), and in particular hand hygiene rules (78.3%). All the variables characterizing academic status (study programme, faculty, year and form of studies) were statistically significant differentiating factors for students’ full knowledge in all of the 4 analyzed sub-areas, while students’ sex only in the sub-area of COVID-19 medical aspects. Conclusions There is a clear need for conducting systematic educational activities among students of all medical study programmes and assessing their level of knowledge in those areas that were identified as least frequently controlled, namely, hand hygiene and infection transmission in health care facilities. Med Pr. 2022;73(5):369–81

Metabolic syndrome (MetS) is defined as the co-occurrence of at least three of the following metabolic disorders: abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), high blood glucose, and hypertension. The treatment of MetS involves lifestyle changes, including following an appropriate diet. In addition to weight reduction, it is crucial to search for optimal nutritional patterns that are highly effective in optimizing other MetS markers, such as glucose and lipid metabolism, and reducing blood pressure. To date, the effects of a Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet on MetS have been extensively evaluated. Recent epidemiological studies suggest that plant-based diets (PBDs) may be effective in treating MetS; however, there is still a lack of experimental data. This review aims to analyze the potential benefits of different PBDs on MetS determinants based on the available studies. The findings may help personalize dietary interventions and improve patient care for those with MetS.

Several hundred million people are infected with genital genotypes of the human papillomavirus (HPV) annually in the world. The infections transmitted mainly through sexual routes are usually asymptomatic, but can lead to the development of cervical, vulvar, vaginal, anal, penile cancers, some head and neck cancers and genital warts (condylomas). The fraction of HPV-related cancers ranges from nearly 100% in the case of cervical cancer to several/over a dozen percent in the case of other cancers and diseases. There are no effective drugs against HPV, but prophylactic HPV vaccines are available free of charge in immunisation programmes in many countries around the world. In Poland, HPV vaccinations have so far been executed out of pocket or in free-of-charge, local-governmental prevention programs, but the vaccination coverage of the target population does not exceed 10%. Starting in November 2021, one of the vaccines has been available with a 50% reimbursement, and work is underway to reimburse the next ones. The National Oncology Strategy assumes the implementation of the HPV immunisation programmes and vaccination of 60% of the teen population by 2028. Three prophylactic HPV vaccines are registered. All of them are safe and their effectiveness in the prevention of diseases caused by vaccine genotypes is almost 100% provided that full post-vaccination immunity is obtained before contact with the virus. Girls aged 11–13 are the priority target cohort for HPV vaccination in Poland. The implementation of routine, free-of-charge HPV immunisation in the Preventive Immunisation Program (PIP) for all adolescents should be pursued. Persons over the age of 13 may also benefit from HPV vaccination and should be vaccinated according to product specifications. In addition to free access under the PIP, the key element for the success of the implementation of HPV vaccinations in Poland will be the education of medical personnel and parents of adolescents to be vaccinated.

Introduction and objective Shift work has a number of negative effects on human health. It often leads to sleep deprivation, changes of circadian rhythm, level of physical activity and eating habits, and also increases the risk of development of metabolic disorders and gastrointestinal diseases. The aim of the study was to indicate and discuss the most common metabolic disorders and other gastrointestinal pathologies in the context of data from literature concerning shift workers. Review methods The effect of shift work on metabolic disorders in shift workers was assessed by searching reports from the last 10 years in the Medline database (http://www. ncbi.nlm.nih.gov/pubmed) Brief description of the state of knowledge Numerous observations of shift workers unequivocally showed an increased risk of overweight, obesity and metabolic syndrome among this group. Increased waist circumference was characteristic of people working in this employment system in relation to units working only during the day. Many authors emphasized that there is a correlation between shift work and the risk of type 2 diabetes. Moreover, the risk of developing this disease was 9% higher in shift workers. It was found that sleep deprivation, which is typical of shift workers, may increase the level of glycated haemoglobin, HbA1c, and increase the risk of prediabetes. In addition, it is emphasized that sleep disorders occurring in shift workers also contribute to the development or aggravation of reflux disease. Summary The authors highlighted the need for introduction of multidirectional preventive measures among shift workers in order to reduce the negative effect of shift work on humanhealth. In terms of public health, taking into account the type of work performed is an important element of patient care in the field of professional practice of either occupational medicine physicians or general practitioners.

Screening significantly decreases the severity and incidence of conditions, as well as mortality, and therefore can improve the health of the population. Screening in Poland falls below the acceptable level of 45% of organised screening uptake and the recommended level of 65%. Multidimensional factors have been implicated as barriers and facilitators of screening uptake in the primary care setting. This paper summarises the existing evidence on factors influencing screening uptake in a Pap smear for cervical cancer (CC), mammography screening for breast cancer and faecal occult blood test (FOBT) for colorectal cancer (CRC). We performed a literature search in the MEDLINE (PubMed) and EMBASE databases and included articles of any study design published between 2010 and 2020. We also demonstrate the original concept of ‘Ugly Value’, which describes factors that may reduce screening uptake. Primary care practitioners play a vital role in increasing screening rates in the populations and can improve these rates through a variety of systematically implemented strategies and interventions. We determine four areas to improve cancer screening uptake in primary healthcare institutions: data gathering and data use (IT systems, meaningful use of Electronic Health Records to generate reminders, prompting healthcare professionals to refer patients for screening), cost effectiveness (avoiding overuse of screening in low-risk populations), innovative efficient management (use of effective interventions and thoughtful allocation of resources, e.g. engaging nurses into patient navigation instead of assigning them to answer patient concerns about screening by telephone), organisational system (team based, integrated care and patient navigation are ways to improve screening rates).

The competitiveness of contemporary organisations is the foundation of their growth and market operation. Organisational culture, integrating the activities of an organisation with the environment in its own manner, determines the way it adapts to the conditions, and considerably impacts the competitive standing of a business. This is particularly important but, at the same time, increasingly difficult for entities operating on the health care market where goods of the highest order, namely saving life and improving health, are provided. The purpose of this article is to present a theoretical and practical discussion of the essence of the impact of organisational culture on building the competitive advantage of health care providers. The article features both a theoretical discussion based on a literature review and a practical discussion analysing the impact of organisational culture on the competitiveness of the health care provider Corten Medic. Both dimensions of the discussion reveal that organisational culture plays an essential role in building the competitive edge of a company and achieving success. In literature on the subject regarding enterprises operating in the health care sector, little attention is given to the links between organisational culture and the competitiveness of health care providers, although, as demonstrated by the results of this article, they may be highly significant, both for management as well as for patients. The article presents an attempt to define the essence and impact of organisational culture on establishing a competitive advantage.

Respiratory syncytial virus (RSV) is the most common pathogen causing respiratory tract infections in infants, affecting over 90% of children within the first two years of life. It may cause lower respiratory tract infections, which constitute a significant healthcare burden both in the primary and secondary care settings. Meanwhile, the data regarding RSV disease in Poland is scarce, and published data significantly differs from the numbers reported for other countries with longstanding surveillance and reporting systems. A literature review and an expert panel were conducted to (1) understand the healthcare burden of RSV infections in Poland; (2) collect data on infection seasonality, patient pathway, and management patterns; and (3) evaluate RSV infection surveillance in Poland. According to the literature, RSV is the major agent responsible for non-influenza respiratory diseases in Poland. The reported rates of hospitalization for RSV infections are 267.5/100,000 for children under 5 years of age and 1132.1/100,000 for those under 1 year of age. Comparisons with data from other countries suggest that these values may be underestimated, possibly due to insufficient access to microbiological testing and a low awareness of RSV. Infections occur mainly between December and April, however, this pattern has changed following the implementation of preventive measures for coronavirus disease 2019 in the past few years. According to available reports, bronchodilators, antibiotics, corticosteroids, and X-ray imaging have been frequently used. The surveillance system in Poland has limitations, but these may be overcome due to recent changes in healthcare law as well as the availability and reimbursement of diagnostic tests.

The COVID-19 pandemic has been met with an unprecedented response from the scientific community, leading to the development, investigation, and authorization of vaccines and antivirals, ultimately reducing the impact of SARS-CoV-2 on global public health. However, SARS-CoV-2 is far from being eradicated, continues to evolve, and causes substantial health and economic burdens. In this narrative review, we posit essential points on SARS-CoV-2 and its responsible management during the transition from the acute phase of the COVID-19 pandemic. As discussed, despite Omicron (sub)variant(s) causing clinically milder infections, SARS-CoV-2 is far from being a negligible pathogen. It requires continued genomic surveillance, particularly if one considers that its future (sub)lineages do not necessarily have to be milder. Antivirals and vaccines remain the essential elements in COVID-19 management. However, the former could benefit from further development and improvements in dosing, while the seasonal administration of the latter requires simplification to increase interest and tackle vaccine hesitancy. It is also essential to ensure the accessibility of COVID-19 pharmaceuticals and vaccines in low-income countries and improve the understanding of their use in the context of the long-term goals of SARS-CoV-2 management. Regardless of location, the primary role of COVID-19 awareness and education must be played by healthcare workers, who directly communicate with patients and serve as role models for healthy behaviors.

Introduction Creating an impact on health is a long-term process that involves activities of public policy. In Poland, particular policies are formulated in documents at the central, regional and local levels. The presence of health issues in these documents can be a measure of the involvement of various sectors in health protection, and thus a measure of the implementation of health principle.in all policies. Objectives The aim of the study is to compare the health issues and health inequalities in policy documents. Material and methods Study methodology included an analysis and review of documentation. The review covered official documents of government bodies in which central, regional and local policies, accepted for the implementation in 2007–2013 and 2014–2020, were formulated. Results An analysis of 121 documents formulating development policies provided information about health issues and health inequalities in central, regional and local policies. Health inequality issues was identified in 12 health policy programmes implemented by the Ministry of Health. Conclusions Although health issues and health inequalities are present in all documents formulating public policies, they were given the biggest attention in the documents at the central level. It was observed that the level of health inequality representation in the strategies of provinces was very low, in the strategies of counties, it was marginal. Certain activities aiming at the increase in the awareness of health inequality should be undertaken.

Background Influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications. The aim of the study was to assess the impact of selected educational and information interventions on the influenza vaccination coverage (IVC) in nursing personnel and their attitude towards this procedure. Material and Methods The study participants (N = 320) were randomly divided into 4 groups. Group 1 participated in stationary training, whereas group 2 participated in distance learning. Additionally, 2 subgroups were established in each of the groups above: 1 subgroup received a reminder about the vaccination in the form of a short text message, and the other group did not receive any such reminder. The IVC rate in each group was determined; the attitude towards influenza vaccination was measured using the health belief model. Results The highest IVC was obtained after stationary training followed by a reminder in the form of a short test message (36%). The reminder significantly affected IVC in the group attending stationary training (p 0.05, OR = 1.2, 95% CI: 0.51–2.83). Both stationary training and distance learning positively influenced the attitude towards influenza vaccinations. A major change in attitudes towards influenza vaccinations was observed only in the case of stationary training followed by a reminder in the form of a short text message (positive changes in perceived susceptibility and severity took place, perceived vaccination benefits increased, and perceived barriers were reduced). Conclusions Stationary training followed by a reminder in the form of a short text message is more effective in increasing the IVC rate compared to distance learning. It also promotes positive changes in attitudes to this prophylactic procedure, which is why it should be recommended for wider implementation. Med Pr. 2020;71(6):665–85

Introduction and objective Congenital cytomegalovirus (cCMV) infections are common worldwide. CCMV infected newborns are mostly asymptomatic at birth. However, cCMV remains the major infectious cause of congenital abnormalities in the developing foetus and newborns. The aim of the study was to provide recent data on cCMV in Poland. Material and methods Aretrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized from 2009–2018. CCMV incidence rates were estimated on the basis of data taken from a Polish hospital morbidity study, carried out by the National Institute of Public Health. Results The study group consisted of 1,916 hospitalized patients with the first-time diagnosis of cCMV. Among them, 52% were patients up to 30 days of age. The median age was 28 days. The average annual incidence of cCMV was 48 per 100,000 live births (95% CI 23.5–73.4). A significantly higher cCMV incidence rate was observed in patients from more urban than rural regions of Poland (55 per 100,000 vs 39 per 100,000; P

Introduction Airway infections represent one of the most common causes of mortality worldwide. The authors sought to describe patients hospitalized for lung and mediastinum abscesses in Poland from 2009 to 2016. To the authors’ knowledge, this is the first evaluation of the disease in Poland. Material and methods The authors conducted a retrospective, population- based study, using data from 14,932 hospital discharge records. Lung and mediastinum abscesses incidence rates were estimated on the basis of data from a Polish hospital morbidity study, carried out by the National Institute of Public Health. Results The study group consisted of 12,049 patients (74.3% male and 25.7% female patients) hospitalized for the first time with the diagnosis of lung or mediastinum abscesses. The mean and median age was 57.2 and 59 years, respectively. The mean age was significantly higher in females than males (57.9 years vs. 57 years, p < 0.05). Patients were hospitalized with the following diagnosis: abscess of lung with pneumonia (60.9%), abscess of lung without pneumonia (24.9%), abscess of lung and mediastinum (2.6%), gangrene and necrosis of lung (2.8%), abscess of mediastinum (9.7%). The average annual incidence of lung abscesses, including gangrene or necrosis of lung, was 35.7 per million (95% CI: 34.1–37.4) and the average annual incidence of mediastinum abscess was 4.8 per million (95% CI: 4.3–5.3). The incidence rates for all cases of lung or mediastinum abscesses did not vary significantly between urban and rural regions. Conclusions Presented recent data on lung and mediastinum abscesses in Poland may be helpful in comparative analyses among European countries.

Introduction and objective Occupational asbestos exposure is one of the major public health issues. Although asbestos use in Poland has decreased, asbestosis continues to remain an important health concern in the area of occupational medicine. The aim of the study is to perform a descriptive analysis of hospitalization cases in patients suffering from asbestosis in Poland. Material and methods The authors used hospital discharge records to conduct a retrospective, population-based study. To estimate the asbestosis hospitalization rate, data from the Nationwide General Hospital Morbidity Study conducted by the National Institute of Public Health were used. Events were defined as in-patient hospital discharges during 2006–2016. 1,101 hospitalization records of 764 patients were included in the study. Results In the study group of first-time hospitalized patients, the mean and median ages were 68.1 and 69 years, respectively; CI: 67.3–68.9; SD: 11.1, min-max:16–99 years. In this group, significant gender differences were observed (560 males vs. 204 female; P

Purpose. The objective of this study was to evaluate the effectiveness of hospital-based antiepidemic measures aimed at limiting the spread of symptomatic infections and colonization with carbapenem-resistant Enterobacteriaceae (CPE), mainly NDM-producing Klebsiella pneumoniae, with particular emphasis on microbiological screening tests. Methods. This retrospective study was based on data from 168 hospitals under the supervision of the Provincial Sanitary and Epidemiological Station in Warsaw, Poland, in 2016–2017. Analysis of the effectiveness of antiepidemic procedures focused on the type of implemented antiepidemic procedures, the number of microbiological screening tests per year, the geographic location of the hospitals (inside or outside Warsaw), the timing of the screening tests (on admission to hospital or 48 hours later), and the results of the screening tests. Results. Rates of proper isolation of patients infected or colonized with an alarm pathogen including NDM-producing K. pneumoniae increased from 38.0% in 2016 to 49.5% in 2017 (p>0.05). The number of screening tests performed increased by 88% from 68319 in 2016 to 128373 in 2017. The number of epidemic outbreaks of symptomatic infections caused by NDM-producing K. pneumoniae decreased from 11 in 2016 to 7 in 2017 in hospitals in Warsaw, where microbiological screening tests were performed. The number of outbreaks in hospitals outside Warsaw, where the screening tests were not performed or were limited, increased from 8 in 2016 to 24 in 2017. Conclusion. Screening tests increase the chance of detecting colonization by CPE. The implementation of microbiological screening decreased the risk of epidemic outbreaks of symptomatic infections caused by CPE.

In 2022, the National Program for Influenza Prevention coalition will have its 10th anniversary; it is one of Poland’s oldest educational initiatives. The National Program for Influenza Prevention was initiated to prevent a further decline and promote influenza prevention in the A(H1N1) post-pandemic years. In this review, we summarize the structure and operational model of the coalition and identify core functional elements that make it a key non-governmental organization involved in the prophylactics of communicable diseases. The coalition-based organization can operate in a complex environment, such as vaccinations requiring scientific, economic, social, and psychological involvement, and communications with different groups. Anchored to the history of the National Program for Influenza Prevention, we review Poland’s vaccination landscape changes from the last ten years.

The number of people who are afraid of vaccinations and who refuse to submit their children to them is constantly growing in Poland. Certain attempts are being made to change legal provisions regarding the obligation of preventative vaccinations. An important element of this discussion is an analysis of the current legal solutions included in judicial decisions. The aim of this paper is to present court judgements in cases regarding legal responsibility related to the obligation of preventative vaccinations issued by the Supreme Court, district courts, the Supreme Administrative Court and voivodship administrative courts. The subject of the judgments under discussion were, in particular, matters relating to the obligation to undergo mandatory vaccinations; legal sources of the obligation to undergo preventative vaccinations, included in the Announcement of the Chief Sanitary Inspector on the protective vaccine program; mandatory preventative vaccinations and the constitutional rights of citizens; administrative enforcement of the obligation to subject a child to mandatory preventative vaccinations, as interpreted by the state, and contraindications to vaccination; enforced fulfillment of the obligation to subject a child to preventative vaccination, and the legal effect of the refusal to subject a child to a pre-vaccination screening; the use of fines to enforce mandatory preventative vaccinations; administrative fines and criminal liability for failure to undergo vaccinations against infectious diseases; parental refusal to subject a child to mandatory vaccinations; civil liability for compensation; and nature and the enforcement of a parents’ obligation to subject children to protective vaccination. The administrative and criminal law measures provided for in the Act on enforcement procedure in administration, including fines, to enforce the statutory obligation of vaccination may be used to achieve this goal. This has been concluded in judgements which are valid.

Abstract Background The effectiveness of alcohol-based hand rubs (ABHRs) depends substantially on their acceptability and tolerability. In this study, we assessed the acceptability and tolerability of a new ABHR (product EU 100.2018.02). Methods Among physicians, nurses, and cosmetologists who used the ABHR for 30 days, we assessed the product’s acceptability and tolerability according to a WHO protocol. Additionally, we used instrumental skin tests. Participants assessed the product’s color, smell, texture, irritation, drying effect, ease of use, speed of drying, and application, and they gave an overall evaluation. Moreover, they rated the tolerability, i.e. their skin condition, on the following dimensions: intactness, moisture content, sensation, and integrity of the skin. The tolerability was also assessed by an observer as follows: redness, scaliness, fissures, and overall score for the skin condition. Instrumental skin tests included transepidermal water loss, skin hydration, sebum secretion, and percentage of skin affected by discolorations. All assessments were made at baseline (visit 1), and 3–5 days (visit 2) and 30 days (visit 3) later. Results We enrolled 126 participants (110 [87%] women) with a mean age of 34.3 ± 11.65 years. Sixty-five participants (52%) were healthcare professionals (physicians, nurses), and 61 (48%) were cosmetologists. During visit 2 and visit 3, about 90% of participants gave responses complying with the WHO’s benchmark for acceptability and tolerability. Similarly, the ABHR met the WHO criteria for observer-assessed tolerability: on all visits, in more than 95% of participants, the observer gave scores complying with the WHO benchmark. Transepidermal water loss decreased from baseline to visit 3 (p

Background: Influenza constitutes a significant health care burden that can be related to an increased morbidity and mortality. The aim of the study is to show up-to-date information on influenza hospitalization cases in Poland in children aged p < 0.001). The age of patients living in urban regions was significantly lower than the age of patients living in rural regions (2.2 vs. 2.3 years; p < 0.001). A statistically significant increase in hospitalization was observed. Conclusions: The reported increasing trend in hospitalizations indicates the need to take focused measures. Presented data may be useful in comparative analyses in a European context.

Seasonal influenza can have serious morbid consequences and can even result in death, particularly in at-risk populations, including healthcare professionals (HCPs), elderly and those living with a medical risk condition. Although in Europe recommendations exist for annual influenza vaccination in these populations in most countries, the vaccination coverage rate (VCR) is often well below the World Health Organization target of 75% coverage. In our previous survey in 2009 we showed that some elements of national vaccination policies, e.g. reminder systems, strong official recommendation, and easy access, seemed to contribute to achieving higher influenza VCRs among elderly. We repeated the survey in 2016, using the same methodology to assess changes in influenza VCRs among the elderly and in the impact of policy elements on these VCRs. In addition, we collected information about VCRs among HCPs, and those living with a medical risk condition. The median VCR in the 21 countries that had recommendations for influenza vaccination in the elderly was 35.3%, ranging from 1.1% in Estonia to 74.5% in Scotland. The average VCRs for HCPs and those living with medical risk conditions, available in 17 and 10 countries, respectively, were 28.3% (range 7% in Czech Republic to 59.1% in Portugal) and 32.2% (range from 20.0% in the Czech Republic and Hungary to 59.6% in Portugal), respectively. Fewer countries were able to provide data from HCP and those living with medical risk conditions. Since the initial survey during the 2007–2008 influenza season, VCRs have decreased in the elderly in the majority of countries, thus, achieving high VCRs in the elderly and the other target groups is still a major public health challenge in Europe. This could be addressed by the identification, assessment and sharing of best practice for influenza vaccination policies.

Introduction Takayasu’s arteritis (TA) is a rare and potentially life-threatening granulomatous large-vessel vasculitis that involves mostly in the aorta and its proximal branches, and occurs most commonly in young females. This study measures the incidence and prevalence of TA, and assesses the gender distribution and territorial differences in the occurrences of this disease in Poland over a five-year period. To the best of our knowledge, this is the first evaluation of this rare disease in Poland based on a hospital morbidity database. Material and methods Analyses were performed with population-based administrative data obtained from a national hospital morbidity study carried out between January 2011 – December 2015 by the Polish National Institute of Public Health. Yearly incidence rates and prevalence of TA were calculated using the number of TA patients and corresponding census data for the overall Polish population. Results Data included 660 hospitalization records. The final study sample comprised 177 patients: 154 female (87%) and 23 male (13%) with first-time hospitalization for TA. The mean age was 45.4years (95% CI: 42.9–47.8; SD 16.8; range 4–81 years), median 47. The incidence rate of TA was estimated at 0.92 per million per year (95% CI: 0.68–1.16). Five-year TA prevalence was estimated to be 4,6 per million. Incidence rates of TA did not vary significantly between more urban and more rural regions. Conclusions The incidence of TA in Poland was similar or lower to data reported by other European countries. The study provides epidemiological data on TA in Poland that may be useful while comparing it with other geographical regions.

Introduction Paget’s disease (PDB) is a focal disorder of bone remodeling that occurs commonly in older people with decreasing prevalence reported in European countries. This disease is most often asymptomatic, but it can cause a variety of medical complications resulting in considerable morbidity and reduced quality of life. There is little information regarding the epidemiology of PDB in Poland. To the best of the authors’ knowledge, this is the first large epidemiological analysis of this disease in Poland. Objective The aim of this study was to analyze factors that may be related to the PDB epidemiology among hospitalized patients in Poland. Material and methods The analysis was conducted on the basis of population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 – December 2014. Results Analyzed data covered 662 hospitalization records. The final study sample comprised 94 (41.8%) male and 131 (58.2%) female patients with first-time hospitalizations for PDB, with a significant predominance of females (P

In addition to different injuries, infections are the most common reason for giving up training altogether or reducing its volume and intensity, as well as a lack of opportunities to participate in sports competitions. Nowadays, a slow but constant re‑emergence of pertussis, especially among teenagers and young adults, including athletes, can be observed. This paper describes an outbreak of pertussis among professional Polish shooters, focusing on the transmission of Bordetella pertussis infection between members of the national team, its influence on performance capacity and adverse event analysis. From 9 June, 2015 to 31 July, 2015, a total of 4 confirmed and suspected cases of pertussis were reported among members of the Polish Sport Shooting National Team, their relatives and acquaintances. Pertussis significantly decreased exercise performance of the first athlete, a 35-year-old woman, interrupted her training, and finally resulted in failure to win a medal or quota place. Pertussis also significantly decreased performance of the second athlete, a 25-year-old shooter. The other cases emerged in their families. Whooping cough is a real threat to athletes and should be prevented. Preventive measures include appropriate immunization, constant medical supervision, as well as early isolation, diagnostic tests and treatment of all infected sport team members. Regular administration of booster doses of the acellular pertussis vaccine (Tdpa) every 5 years seems reasonable.

The disinfection of surfaces in medical facilities is an important element of infection control, including the control of viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Preparations used for surface disinfection are typically characterized via their activity against test organisms (i.e., viruses, bacteria and fungi) in the laboratory. Typically, these methods use a suspension of the test organism to assess the bactericidal, fungicidal or virucidal activity of a given preparation. However, such suspension methods do not fully imitate real-life conditions. To address this issue, carrier methods have been developed, in which microorganisms are applied to the surface of a carrier (e.g., stainless steel, glass and polyvinyl chloride (PVC)) and then dried. Such methods more accurately reflect the applications in real-life clinical practice. This article summarizes the available methods for assessing the virucidal activity of chemical disinfectants for use in medical facilities based on the current European standards, including the activity against coronaviruses.

Public health and primary health care are complementary strategies for sustaining the health of a society. There are many analyses in the literature on the subject that deal with the possibility of mutual support between public health and primary health care. There reports from many countries include studies of scientific institutions, presentations of specific solutions used by health protection administrations and self-government bodies, programs of study, and courses. However, this issue is rarely raised in Poland. The aim of this article is to present an up-to-date list of public health operations and to where there is room for primary health care activities. A binding list of public health operations was defined by the World Health Organisation (WHO) in 2012 under the name of Essential Public Health Operations (EPHOs). In order to define public health operations more precisely in this article, a questionnaire self-assessment tool for the evaluation of essential public health operations in the WHO European Region was used. Primary health care plays a significant role in the performance of public health operations (EPHOs), whereas the public health operations connected with health protection (EPHO 3), health promotion (EPHO 4) and disease prevention (EPHO 5), are mostly attributed to primary health care. Primary health care provides the information necessary for the performance of public health operations in the field of monitoring population health and well-being – in particular infectious and chronic diseases (EPHO 1), and for health care management and improvement of health care quality (EPHO 6).

Maximizing Health-Related Quality of Life (HRQoL) is one of the most important goals in the work of the family doctor. Providing a high quality of medical services (QMS) should be among the most important challenges in primary health care organizations (PHCOs). In practice, these two areas of activity require continuous improvement, and can complement each other and enhance their mutual impact on the health of patients. The objective of this article is to present selected areas of HRQoL and QMS improvement in the practice of a family doctor, which might contribute to patients’ health, to cost reduction, and to a beneficial reposition of a health center within the medical service market. The paper presents proposals for improving HRQoL and QMS through the use of data from questionnaires filled out by patients, through the cooperation of all the people involved in the delivery of medical services, through adaptation of the IT infrastructure to meet the needs of PHCOs, and through improvements in quality as the result of a process model. QMS is of great importance, especially for both consumers and providers of medical services, including PHCOs. Improvement in quality should be considered as operating on both HRQoL and QMS. This paper presents strategies for selected areas that may contribute to improving QMS, both with respect to the opinions of patients and the functioning of PHCOs.

Currently there is no influenza vaccination guidance for European general practitioners. Furthermore, although the European Council recommends a target seasonal influenza vaccination rate of 75% in the elderly (65 years and above) and in anyone aged >6 months with a chronic medical condition, there remain wide discrepancies throughout Europe. A harmonised guideline regarding not only vaccination strategy but also for the consistent diagnosis of influenza across Europe is essential to support a common approach for the implementation of seasonal influenza vaccination across Europe. This document is based on pre-existing guidelines available in the UK and Netherlands and has been approved by a group of European experts for use throughout Europe. As well as providing a standardised influenza diagnosis, it also reviews the current recommendations for influenza vaccination, the types of vaccine available, the contraindications, vaccine use in special populations (in pregnancy, children, and in those with egg allergy), and concomitant administration with other vaccines. The effectiveness, safety, and timing of the seasonal influenza vaccine are also reviewed. A second section provides practical guidance for general practitioners for the implementation of a seasonal influenza vaccination program, including the selection and notification of those eligible for vaccination, as well as suggestions for the organisation of a vaccination programme. Finally, suggested responses to common patient misconceptions and frequently asked questions are included. The aim of this article is to harmonise the diagnosis of seasonal influenza and the approach of European general practitioners to seasonal influenza vaccination in order to better identify influenza outbreaks and to move towards reaching the target vaccination rate of 75% throughout Europe.

Unexpected isolation, which has not yet been seen on a global scale, has created the conditions for evaluating nutrition in a situation of reduced spatial activity. The study aimed to assess the influence of lockdown on selected eating habits of Polish adults. An anonymous questionnaire was conducted, including questions about eating habits and self-reported anthropometric measurements, referring to “before” and “during” lockdown. We reported the findings of 312 adults (aged 41.12 ± 13.05 years). Overall, 64.1% of the participants were women, 77.7% urban inhabitants and 78.6% employed. The average length of social isolation was 50.79 ± 10.53 days. The majority (51.6%) of the respondents did not eat outside the house during lockdown (p < 0.0001). The number of meals eaten during the day during lockdown increased significantly, 11.2% of the respondents ate 5 and more meals (p < 0.0001). The percentage of people snacking between meals increased by 5.1% during lockdown (p = 0.0001). Eggs, potatoes, sweets, canned meat and alcohol were consumed considerably more commonly during lockdown, while fast-food products, instant soups and energy drinks were eaten or drunk significantly less frequently. A marked decrease in the number of daily servings of the following products was observed: bakery products, red meat, fast food, instant soups, sweet beverages and energy drinks. Conversely, the number of daily servings of sweets and canned meat significantly increased. Two thirds of the respondents reported body weight changes, with 45.86% of the participants being overweight during lockdown. Significant changes in the diet of Polish adults were found during lockdown due to COVID-19.