Search

Since the Russian invasion of Ukraine on Feb 24, 2022, more than 6 million Ukrainians, including hundreds of thousands of older people, have sought safety abroad. Older people generally have a higher burden of disease than younger people and the aim of our study was to estimate this burden in older Ukrainian refugees, given the potential financial and logistical impacts on the health-care systems of receiving countries.On May 20, 2022, we searched the official websites of the Polish Ministry of Digitisation for data on Ukrainian refugees who had applied between Feb 24, 2022, and May 19, 2022 for a Polish personal identification number (PESEL). We extracted the number of older people (ie, of pension age, which in Ukraine is 60 years or older for men, and 55 years or older for women). We calculated the percentage of older people among these PESEL applicants then extrapolated this percentage to two groups, for which population data had been extracted from UN, WHO, and Polish Border Guards websites: refugees who had crossed into Poland but had not applied for a PESEL and refugees who had fled to neighbouring countries other than Poland. Between April 4 and May 19, 2022, we searched the Ukrainian Ministry of Health official website for data on the prevalence and incidence of various diseases in the Ukrainian population of older people. We asked the Ukrainian Ministry of Health to confirm and expand on the website data, and thereby obtained annual data for 2010-17. The ministry did not supply tuberculosis statistics, so on May 21, 2022, we searched the Ukrainian Ministry of Health website and extracted the most recent tuberculosis data, which were for 2020. We then calculated the absolute prevalence and incidence of diseases in older refugees.As of May 19, 2022, 6·3 million Ukrainians had fled their country, including 3·5 million (56%) who had entered Poland. 1 114 418 people applied for a PESEL, including 109 985 older people (91 349 Ukrainian women aged 55 years or older and 18 636 Ukrainian men aged 60 or older). We estimated that the overall number of older Ukrainian refugees was 624 690. We estimated that these older refugees have a mean of 2·5 diseases each, the most frequent of which are cardiovascular diseases, followed by gastrointestinal, respiratory, musculoskeletal, and genitourinary diseases. We estimated that the expected absolute incidence is greatest for pulmonary disorders (71 689 diagnoses), followed by cardiovascular (49 327), ocular (24 100), musculoskeletal (20 367), and genitourinary (16 836) disorders. The estimated number of new diagnoses per year was 4578 for tuberculosis and 7827 for cancer.Our data indicate that the disease burden of older Ukrainian refugees is considerable. Although our estimates are only approximations, they provide a basis for predicting which areas of health care will most need to be reinforced to meet the challenge of the potential financial and logistical impacts on receiving countries.There was no funding source for this study.

Znaczący odsetek osób z populacji powyżej 75 roku życia doświadcza epizodu dużej depresji. Objawy depresji, demonstrowane przez pacjentów w wieku podeszłym, są często traktowane jako naturalny element procesu starzenia się, przez co wielu pacjentów w wieku podeszłym pozostaje niezdiagnozowanych, bądź jest zdiagnozowana nietrafnie. Postuluje się, że stosowanie diety śródziemnomorskiej może przeciwdziałać rozwojowi depresji oraz łagodzić objawy depresyjne między innymi ze względu na przeciwzapalne właściwości takiego sposobu odżywiania się. Celem niniejszego przeglądu systematycznego było oszacowanie czy stopień adherencji do diety śródziemnomorskiej ma związek z występowaniem i nasileniem objawów depresyjnych u osób powyżej 65 roku życia. Ze względu na niejednorodną metodologię włączonych badań, przedstawiony przegląd jest przeglądem narracyjnym. Do przeglądu włączono 9 badań spośród 317 wyekstrachowanych artykułów. We wszystkich badaniach z wyjątkiem jednego stwierdzono, że stosowanie diety śródziemnomorskiej jest związane z niższą częstością występowania objawów depresyjnych. Dieta śródziemnomorska ze względu na wysoką zawartość antyoksydantów i składników działających przeciwzapalnie jest uznawana za najzdrowszy sposób odżywiania się i stanowi jeden z najczęściej badanych modeli żywieniowych

P u r p o s e: Oral health and diseases are significant components of general health. However, oral health-care remains at the lowest of older patients' priorities. The inability to obtain dental care can result in progression of dental disease, leading to a diminished quality of life and overall health. Teledentistry (TD) provides an opportunity to improve the quality of oral health services. The aim of our narrative review was to analyze the usefulness of teledentistry as a part of telemedicine to improve oral health in the elderly. Materials/Methods: The PubMed database search was done for: teledentistry, oral health, oral- health related diseases, elderly, older adults. R e s u l t s: The applicability of TD has been demonstrated from children to older adults. Older adults have many obstacles in getting oral health care, including low income, lack health insurance, frailty, anxiety, depression, mobility problems or other handicaps. Available data suggests that the usefulness of TD in the provision of oral care in elderly people living in residential aged care facilities. Moreover, TD procedures were found to be as accurate as traditional face-to-face dental examinations, they was cost-effective and well accepted among patients and caregivers. C o n c l u s i o n s: TD might be a very useful tool for professional education, improving access and patient satisfaction of dental care. However, such TD modes would be difficult to widely implementation in community-dwelling older people who cannot access dental care. The ongoing "Patient centric solution for smart and sustainable healthcare (ACESO)" project will add to the intelligent oral health solutions.

Alloplasty is one of the most frequently performed procedures, as it hugely improves the quality of life.The purpose of this study was to determine the incidence, risk factors, and clinical implications of postdischarge pneumonia after hip endoprosthesis in Polish adults.This retrospective study was conducted using the database of the National Health Fund (Narodowy Fundusz Zdrowia) containing data from 55 842 hip arthroplasties performed in 2017.Postdischarge pneumonia was identified in 371 patients and accounted for 26.6% of all postdischarge infections, with incidence rate of 0.7%. Multivariable analysis showed a significantly higher risk of pneumonia in patients aged 65 and older (odds ratio [OR], 3.5; 95% CI, 2.40-5.03), urgently admitted (OR, 4.0; 95% CI, 3.16-4.98), operated in winter (OR, 1.7; 95% CI, 1.37-2.11), and hospitalized in the intensive care unit (OR, 5.9; 95% CI, 3.65-9.46). Preventative factors were pre‑surgery treatment for diseases of the musculoskeletal system (OR, 0.7; 95% CI, 0.59-0.91) and postoperative rehabilitation (both outpatient and inpatient; OR, 0.3; 95% CI, 0.10-0.99 and OR, 0.7; 95% CI, 0.42-0.99, respectively). Seventy patients (18.9% of pneumonia cases) required inpatient pneumonia treatment. The in‑hospital case fatality rate observed in postdischarge pneumonia was 21.4%.Pneumonia is one of the most common postoperative infections after hip endoprosthesis, especially in winter, requiring rehospitalization. Efforts should be made to prepare patients in the perioperative period.

The SARS-CoV-2 pandemic contributed to the implementation of changes in the methodology of conducting many courses at medical universities. Achieving learning outcomes was associated with self-discipline and an increased portion of students' independent work. The aim of the study is to analyze the adaptation of teaching methods to the requirements of the COVID-19 pandemic at the Department of Medical Education of Jagiellonian University Medical College. The university authorities, instructors and students made every effort not to neglect their education. The Microsoft Teams platform allowed for the efficient organization of remote classes. Lectures, activities based on dialogue, brainstorming and role-playing were conducted via the Internet. Presentations and short films were made available to students. The safety of individuals participating in classes was guaranteed by password access and an invitation sent prior to an online meeting. Remote learning allowed for the synthesis and deepening of students' knowledge, improvement of communication skills and development of clinical thinking as future doctors. The disadvantages of online education was the inability to improve practical skills, especially on phantoms, under the direct supervision of a trained instructor.

The aim of the study was to determine the predominant learning style and type of intelligence based on the VARK questionnaire and Multiple Intelligences Questionnaire respectively in second year medical students. Determining the relationship between individual preferences of students, based on their learning style and predominant type of intelligence and the perception of the modified Peyton's four-step approach used to teach cardiac auscultation.The opinion of participants 236 of the modified four-step approach was attained through the use of anonymous questionnaires. Using the VARK questionnaire, the participants' learning style was defined. The predominant type of intelligence was determined by the Multiple Intelligences Questionnaire.The kinesthetic style was the predominant unimodal learning style in second year medical students (in Polish and international students). The most predominant type of intelligence in Polish students was visual-spatial and mathematical and logical, while in international students the predominant types were visual-spatial and mixed type of intelligence. Quantitative analysis indicated that the modified Peyton's approach is a valuable learning and teaching method for most students, independent of their predominant learning style or intelligence type. The exception was a small group of students with linguistic intelligence predominance according to the Multiple Intelligence Questionnaire, for which the Peyton method was more difficult.This study proves that the modified Peyton's approach is useful and effective didactic tool and can be successfully applied to most students. This is a new learning strategy for teaching cardiac auscultation in laboratory conditions in classes for a significant majority. Due to the fact that a group of students with a predominance of linguistic intelligence more often perceived the Peyton method to be difficult, it is worth combining traditional methods with new ones in class so that all students, regardless of unimodal learning style or prevailing type of intelligence, are taught satisfactorily.

OSCE (Objective Structured Clinical Examination) is a common method of assessing clinical skills used at many universities. An important and at the same time difficult aspect of good examination preparation is obtaining a properly trained and well-motivated group of assessors. To effectively recruit and maintain cooperation with assessors, it is worth to know their opinion. The aim of this study was to investigate the opinions of teacher-examiners about OSCE and to identify the factors that could shape this opinion and influence on motivation.A cross-sectional study was conducted using a questionnaire on teachers who participated as OSCE examiners. This questionnaire consisted of 21 questions about their perceptions. Answers were rated in a five-point Likert-type scale. Chi-square or Fisher's exact test was used to analyze the data.A total of 49 (out of 52) teachers participated in this study. Nearly 90% of examiners believed that it is fair, more than 90% that it is transparent. Despite the fact that 67% of examiners believe the examination is difficult to organize and 71% believe it is stressful for students, according to 72% of respondents the OSCE has a positive effect on learning. More than 91% of examiners believed that the OSCE is an appropriate test to assess students' skills. Opinions about examination were independent of specialty, seniority, gender or taking the OSCE as students.Teacher-examiners viewed the OSCE as a fair and transparent examination, adequate for assessment of skills and, despite it being difficult to organize, worth doing as it is appropriate to assess practical skills and positively influences students' motivation to learn tested skills.

The aim of the study was to evaluate the usefulness of the modified Peyton's four-step approach in the teaching of cardiac auscultation and to determine students' perception of Peyton's four-step approach.The opinion of the participants on the usefulness of the modified four-step approach was attained through the use of anonymous questionnaires, voluntarily completed by students, and on the basis of semi-structured interviews conducted with a subset of students. 187 second-year students of our 6-year long curriculum were enrolled. They attended an obligatory Laboratory Training of Clinical Skills course. The average group size was 16 students.The survey findings identified that 88.1% of participants found it helpful in developing their understanding of cardiac auscultation. 89.8% of all participants claimed that the new modified four-step approach facilitated memorization. The modified Peyton's four-step method allows for better organization of classes in the opinion of 87.6% students. The advantages of the method were noticed by the majority of students.The modified Peyton's four-step approach in the teaching of cardiac auscultation under laboratory conditions was perceived by students to be a comprehensible method that facilitates understanding and memorization. This approach allows for improved organization of classes. From the student's perspective this method allows one to master the technique of cardiac auscultation in the classroom, through the increased demand of the participants' attention, activity and involvement.

Patient-centered care (PCC) is associated with better relationships, resulting in a decrease in symptoms, hospitalizations and health costs. However, studies analyzing factors influencing patient-centered attitudes show ambiguous results. The purpose was to assess the impact of the Clinical Communication Course (CCC) in Jagiellonian University, Cracow and other factors on Patient-Centered Attitudes (PCA) and Attitude toward Clinical Skills Learning (CSLA).We retrospectively compared Polish-speakers (CCC+, n = 160), English-speakers (CCCen+, n = 55) after the CCC and upperclassmen Polish-speakers without it (CCC-, n = 122). Validated questionnaires to measure PCA (Leeds Attitude Toward Concordance II and Patient-Practitioner Orientation Scale (PPOS)) and for CSLA (Communication Skills Attitude Scale with negative subscale (CSAS-N)) were used. The higher the scores, the more PCA, and negative CSLA respectively. Students completed questionnaires and answered questions regarding age, sex, motivation to study (coded as humanitarian - MotHUM, financial - MotFIN, combination - MotMIX) and considered specialization - coded as with more human contact (family medicine, psychiatry, pediatrics - SpecHUM) and others (SpecNHUM). Statistics were prepared in R.CCC+ scored higher in PPOS (2.91 vs. 2.74; p = 0.003) than CCC- and higher in CSAS-N than CCCen+ (31.22 vs. 28.32; p = 0.004). In CCC+ SpecHUM scored lower than SpecNHUM in PPOS (2.65 vs. 2.94, p = 0.012). MotFIN scored higher then MotMIX in PPOS (3.01 vs. 2.7, p = 0.036). Correlations were statistically significant.CCC improved PCA in CCC+. They showed more negative CSLA than CCCen+. Among CCC+, surprisingly, SpecNHUM presented more PCA than SpecHUM as well as MotFIN compared to MotMIX.

This paper describes a new approach to detection and tracking of potential cyberattacks from analyzing large quantities of cyber-related webpage text, using ontological knowledge about such attacks combined with composable causal models represented in Probabilistic Soft Logic. The stages of a cyberattack kill chain are viewed as a sequence of both observed and unobserved events (e.g., reconnaissance, weaponize, exploit, install) and explicit mentions of, or related to, such events are examined as potential signals for a future attack. Using a suite of natural language processing techniques, sentences from input news texts are automatically classified according to the described cyberattack event, then enriched with named entity recognition for the rapid detection of key elements that might be associated with potential cyberattacks. We present our work as a framework for rapid and flexible predictive analysis of the ever-increasing amount of cyber-related text data, with initial experiments indicating that event detection using parsing and named entity recognition combined with statistical relational learning show promise in time-series prediction from news text.

We demonstrate a system for understanding natural language utterances for structure description and placement in a situated blocks world context. By relying on a rich, domain-specific adaptation of a generic ontology and a logical form structure produced by a semantic parser, we obviate the need for an intermediate, domain-specific representation and can produce a reasoner that grounds and reasons over concepts and constraints with real-valued data. This linguistic base enables more flexibility in interpreting natural language expressions invoking intrinsic concepts and features of structures and space. We demonstrate some of the capabilities of a system grounded in deep language understanding and present initial results in a structure learning task.

We introduce the CUBISM system for the analysis and deep understanding of multi-participant dialogues. CUBISM brings together two typically separate forms of discourse analysis: semantic analysis and sociolinguistic analysis. In the paper proper, we describe and illustrate major components of the CUBISM system, and discuss the challenge posed by the system’s ultimate purpose, which is to automatically detect anomalous changes in participants’ expressed or implied beliefs about the world and each other, including shifts toward or away from cultural and community norms.

Background: Proton pump inhibitor (PPI) use was reportedly associated with an excess of adverse cardiovascular (CV) events, thus making their systemic effects relevant to public health. PPIs reduce gastric acid secretion, causing increased gastrin release. Gastrin stimulates β-cell neogenesis and enhances insulin release, exerting an incretin-like effect. Our aim was to assess, if PPI usage is associated with altered glycaemia in patients with CV disease. Methods: We retrospectively analyzed medical records of 102 subjects (80 with ischemic heart disease) who underwent a routine oral glucose tolerance test while hospitalized in a cardiology department. Fasting and 2-h postload glucose levels were compared according to PPI use for ≥1 month prior to admission. Results: Compared to 51 subjects without PPIs, those on a PPI were older, more frequently male, had a lower body-mass index and a tendency to a worse renal function. PPI users and non-users exhibited similar glucose levels at baseline (5.6 ± 0.9 vs. 5.5 ± 1.1 mmol/l, P = 0.5) and 2-hrs post glucose intake (9.8 ± 3.0 vs. 9.9 ± 3.4 mmol/l, P = 0.9). This was consistent across subgroups stratified by gender or diabetes status. The results were substantially unchanged after adjustment for different characteristics of subjects with and without PPIs. Conclusions: PPI use does not appear associated with altered glycaemia in subjects with CV disease. Unchanged glucose tolerance despite PPI usage may result from simultaneous activation of pathways that counteract the putative PPI-induced incretin-like effect.

While highly constrained language can be used for robot control, robots that can operate as fully autonomous subordinate agents communicating via rich language remain an open challenge. Toward this end, the central goal of the SUBTLE MURI project was to develop an autonomous system that supports natural, continuous interaction with the operator through language before, during, and after mission execution. The operator communicates instructions to the system through natural language and is given feedback on how each instruction was understood as the system constructs a logical representation of its orders using linear temporal logic. While the plan is executed, the operator is updated on relevant progress via language and images and can change the robots orders. Unlike many other integrated systems of this type, the language interface is built using robust, general purpose parsing and semantics systems that do not rely on domain-specific grammars. The natural language system uses domain-general components that can easily be adapted to cover the vocabulary of new applications. We demonstrate the robustness of the natural language understanding system through a user study where participants interacted with a simulated robot in a search and rescue scenario.

We present an approach for automatic annotation of commercial videos from an arts-and-crafts domain with the aid of textual descriptions. The main focus is on recognizing both manipulation actions (e.g. cut, draw, glue) and the tools that are used to perform these actions (e.g. markers, brushes, glue bottle). We demonstrate how multiple visual cues such as motion descriptors, object presence, and hand poses can be combined with the help of contextual priors that are automatically extracted from associated transcripts or online instructions. Using these diverse features and linguistic information we propose several increasingly complex computational models for recognizing elementary manipulation actions and composite activities, as well as their temporal order. The approach is evaluated on a novel dataset of comprised of 27 episodes of PBS Sprout TV, each containing on average 8 manipulation actions.

In this paper we investigate the utility of an interactive, desktop-based virtual reality (VR) system for training personnel in hazardous working environments. Employing a novel software model, CRAM (Course Resource with Active Materials), we asked participants to learn a specific aircraft maintenance task. The evaluation sought to identify the type of familiarization training that would be most useful prior to hands on training, as well as after, as skill maintenance. We found that participants develop an increased awareness of hazards when training with stimulating technology — in particular (1) interactive, virtual simulations and (2) videos of an instructor demonstrating a task — versus simply studying (3) a set of written instructions. The results also indicate participants desire to train with these technologies over the standard written instructions. Finally, demographic data collected during the evaluation elucidates future directions for VR systems to develop a more robust and stimulating hazard training environment.