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Oats are susceptible to contamination by Fusarium mycotoxins, including deoxynivalenol (DON), zearalenone (ZEN), and T-2/HT-2 toxins, posing food safety risks. This study analyses the variation in levels of 14 mycotoxins in 200 individual oat kernels from two DON-contaminated batch samples (mean = 3498 µg/kg) using LC-MS/MS. The samples also contained deoxynivalenol-3-glucoside (DON-3G), 3-acetyldeoxynivalenol (3-ADON), 15-acetyldeoxynivalenol (15-ADON), and ZEN. Contamination levels varied notably among individual kernels, with DON detected in 70% of them, followed by DON-3G (24.5%) and 3-ADON (20.5%). Importantly, 8% of kernels exceeded the EU legal limit for DON (1750 µg/kg), and some occasionally surpassed limits for ZEN and T-2/HT-2. Correlation analyses revealed strong associations between DON and its derivatives but weaker correlations with other toxins. Mycotoxin ratios varied widely, indicating that although they often co-occur, their concentrations differ between kernels. Contamination did not significantly impact kernel weight, though a slight trend toward lower weights in contaminated kernels was noted. Additionally, sampling statistics showed that as the percentage of selected kernels increased, the probability of batch sample rejection for DON contamination rose significantly. The study highlights the heterogeneity of mycotoxin contamination in oat batches, emphasising the importance of accurate detection and regulatory compliance to ensure safer oat-based products.

Introduction: Schools are important settings for the promotion of healthy diet and sufficient physical activity to prevent civilisation diseases related to lifestyle., Objective: To describe school physical activity and nutrition environment in elementary schools in Poland, and to asses differences in school physical activity and nutrition environments, depending on school location and size., Material and Methods: Data was used from the World Health Organisation European Childhood Obesity Surveillance Initiative (COSI) conducted in 2016 in 135 Polish schools. Logistic regression was used to asses association between the location and individual school environment indicator. On the basis of answers to 20 questions about school physical activity and nutrition environment, a positive school environmental assessment index was compiled., Results: Large, urban schools were characterised by a significantly greater availability of sweet snacks, whereas flavoured milk with added sugar was more often available in small and rural schools. The univariate logistics analysis parameters showed that an urban-rural location had a significant association for the availability of an indoor gym and existence of a canteen and a shop. Analysing the positive schools environmental assessment index, there were no statistically significant differences in mean values due to location, but statistically significant differences were found depending on the school size, with the highest level in large schools and the lowest in small schools., Conclusions: The factor which adversely differentiates the school environment in terms of healthy nutrition and physical activity is primarily the school size, and then the school location. Systemic and social solutions should aim at reducing the small school "exclusion syndrome", both in rural and in urban areas, also with regard to infrastructure and availability of conditions conducive to healthy nutrition and physical activity.

Objective: Introduction: Self-rated health (SRH), an indicator which is extensively used in population studies, constitutes a measure of health closely linked to morbidity, mortality and overall health status and enjoys popularity in surveys monitoring adolescents. Most studies show that at puberty girls assess their health as worse than boys do, and the difference widens with age. Moreover, puberty is a crucial period for health, since it is the time when health risk behaviours are often initiated or become established. Aim: To analyse the associations between high scores on self-rated health among 15-year-old girls, participants of the Healthy Me programme, and their selected health behaviours., Patients and Methods: Material and methods: The study covered a group of 1173 second-grade female students from 48 lower secondary schools located in rural and urban areas of 16 voivodeships all over Poland. The participants answered questions about chronic diseases or disability, self-rated health, diet, leisure activities, physical activity and health risk behaviours. In the statistical analysis, the association between self-rated health and individual indicators of health behaviour was examined using logistic regression., Results: Results: Two thirds of the girls assessed their health as excellent or good. Only approximately 5% of the respondents made the "extreme negative" assessment. In the final multivariate analysis, five factors remained important predictors of high self-rated health scores: regular participation in physical education classes, vigorous physical activity, daily breakfast consumption, consumption of fruit at least once a day and sleep for at least 8 hours a day., Conclusion: Conclusions: Regular participation in physical education classes, vigorous physical activity, consumption of breakfast and fruit every day, as well as sleep for at least 8 hours a day are powerful predictors of high scores on self-rated health of 15-year-old adolescent girls. Public health activities aimed at adolescents should focus on the positive aspects of health and a lifestyle paying special attention on pro health behaviours.

The Aim: to identify the barriers to engaging in physical activity that are perceived by adolescents with overweight and obesity, and to establish whether a correlation exists among the barriers they perceive and the health-oriented motivation for undertaking physical activity., Material and Methods: The study was conducted on a representative sample of 2,300 students aged 13-16 years. The data was collected through an anonymous survey. Young people were asked about their body weight and height, the barriers to physical activity and the health-related motives to engaging in it. The IOTF (International Obesity Task Force) standard by T. J. Cole was used to categorise overweight and obesity, while the PCA - Principal Component Analysis - to assess the motivation for physical activity. Logistic regression was used in the analyses of the correlations among the body weight, the level of health-oriented motivation and the occurrence of accumulated barriers to physical activity., Results: Overweight and obesity was found in 12.4% of the respondents; more often in boys (17.8%) than in girls (7.8%). The most frequently perceived barriers to undertaking physical activity among overweight adolescents include deficiencies in energy, time and support. Three barriers (lack of energy, skills and willpower), as well as the perception of several barriers occurring simultaneously, were reported more frequently by overweight students in comparison with their peers with a normal weight. Among the health-oriented motivation for physical activity in the group of adolescents with overweight and obesity, the most important one was the need to improve health, while the least important the need to look good. The excess of body weight turn out to be an important predictor of the perception of cumulative barriers to physical activity only among adolescents with a weak motivation to undertake physical activity [OR 2.51; CI (1.43-4.42), <0.001]., Conclusions: Young people with overweight and obesity, but with a strong health-oriented motivation, perceive barriers to physical activity similarly to their peers with a normal weight. Thus, motivation is a key element shaping the physical activity of overweight and obese young people by changing their perception of the barriers. In overcoming the barriers to physical activity in obese adolescents, one should aim to comprehensively reduce body weight and to support health-oriented motivation.

Objective: To identify barriers to physical activity (PA) for adolescents according to the gender and age and examine the association between these barriers and youths' physical activity., Subjectand Methods: 3346 students aged 10-16 years (1759 girls) took part in the cross-sectional, nationally representative study. For this paper the dataset was created from adolescents who reported perceived barriers to PA, N = 2300, (1259 girls), range 13-16 years. Barriers and physical activity (MVPA) were analysed for all participants, as well as by gender, age group and place of residence. Multiple regression analysis was used to examine the relationships between perceived barriers and physical inactivity for all and than separately for boys and girls., Results: Lack of energy, lack of time and lack of support were three of the five barriers reported by more than 40% of adolescents, statistically more likely by girls than boys and older youth than younger. For boys - lack of time (OR = 2.56; CI = 1.66-3.96), lack of skills (OR = 2.35; CI = 1.94-3.95), lack of willpower (OR = 1.71, CI = 1.05-2.80) and lack of support (OR = 1.64, CI = 1.11-2.41) were the predictors contributing to low level of PA. For girls lack of skills (OR = 3.16, CI = 1.62-6.18), lack of energy (OR = 1.84, CI = 1.14-2.96), lack of support (OR = 1.64, CI = 1.07-2.54) and lack of time (OR = 1.61,CI = 1.00-2.60) were positively and statistically significant associated with physical inactivity., Conclusions: 1. Perceived barriers to physical activity among adolescents have strong negative impact on recommended PA level. For girls lack of skills is the strongest predictor of low PA, for boys - lack of time. 2. Identification more precisely barriers to physical activity among adolescents will enable to developed more effective interventions in high-risk populations.

Objective: To estimate the prevalence of meeting health behaviour guidelines regarding eating breakfast, fruit and vegetable consumption and physical activity and to identify adolescents who accumulate the unhealthy behaviours., Subject and Methods: Cross-sectional study was conducted in 2008 in adolescents aged 13-year-old (N = 574). They self-reported their physical activity (MVPA--Moderate-to-Vigorous Physical Activity), regularity of breakfast eating and fruit and vegetable consumption. The adherence to physical activity and nutritional guidelines were described. Relationships between dependant variables and sex and place of residence were examined. Cluster analysis was used to identify subgroups of youths whose accumulate the unhealthy behaviours., Results: The proportion of adolescents who met each health recommendation varied: 69% ate breakfast on 5 school days, 46.9% consumed at least once a day fruit and vegetable and 27.5% performed recommended daily physical activity. Boys were significantly more active (p < 0.001) and ate breakfast more frequently than girls (p < 0.04). A gender difference in fruit and vegetable intake was not statistically significant. Only 11.5% of adolescents fulfilled all three recommendations, more often boys than girls (p = 0.020). Almost 54% of adolescents had multiple unfavorable health behaviours, and 14,1% all three of them - significantly more often girls than boys (p = 0.011). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations., Conclusions: The unhealthy behaviours tend to accumulate among teenagers - more often in girls than in boys, becoming the risk factors for different chronic diseases. Widespread dissemination of healthy lifestyle guidelines among adolescents, their parents and teachers, and undertake interventions aimed to reduce unhealthy behaviours could bring health benefits in the future.

Aim: To examine the level of optimism in 13-year-olds and the relationship between optimism and self-reported health and family psychosocial and economic factors., Material and Methods: Adolescents at the age of 13 years (n=605) and their parents, identified in the third stage of a prospective cohort study in 2008, was analysed. To examine the level of optimism the short Polish version of the Wagnilda and Young scale (Resilience Scale) were used. The level of optimism and the relationship between family socio-economic factors and family functioning in the family (parenting practices, satisfaction with family contacts) were examined. For the evaluation of probability of a high level of optimism among 13-year-old girls and boys the multivariate model of logistic was used., Results: Girls had a significantly higher level of optimism. Girls and boys with positive attitude to life rated their health significantly better than their peers with negative attitude. Univariate analyses showed that with the level of optimism father's education level among girls and the professional status of the parents among boys, was significantly associated. Family affluence reported by children, positive parenting and satisfaction with family contacts, were significantly associated with the attitude to life, both in girls and boys. The level of optimism among boys was also related with the level of discipline by the mother and the level of control exercised by both parents. Finally, for girls multiple regression analyses showed that father's positive parenting was a predictor of high level of optimism [OR=0,45; CI(OR):0,23-0,85; p=0,014]. In boys, mother's positive parenting [OR=0,39; CI(OR):0,19-0,82; p=0,013] and appropriate father's control were found to be significant predictors of optimism [OR=0,33; CI(OR): 0,13-0,84; p=0,020]., Conclusions: Very high self-reported health by the majority of young people with positive attitude to life shows that optimism is a strong predictor of subjective health. Positive parenting practices and good level of parental control, have a significant impact on optimism in teenagers.

Objective: 1. To estimate the time spent in sedentary behaviour (watching TV, using the computer, doing homework). 2. To assess the link between the total time spent on watching TV, using the computer, doing homework and dietary habits, physical activity, parental practices and body mass., Material and Methods: Cross-sectional study was conducted in Poland in 2008 among 13-year olds (n=600). They self-reported their time of TV viewing, computer use and homework. Their dietary behaviours, physical activity (MVPA) and parenting practices were also self-reported. Height and weight were measured by school nurses. Descriptive statistics and correlation were used in this analysis., Results: The mean time spent watching television in school days was 2.3 hours for girls and 2.2 for boys. Boys spent significantly more time using the computer than girls - respectively 1.8 and 1.5 hours, while girls took longer doing homework - respectively 1.7 and 1.3 hours. Mean screen time was about 4 hours in school days and about 6 hours during weekend, statistically longer for boys in weekdays. Screen time was positively associated with intake of sweets, chips, soft drinks, "fast food" and meals consumption during TV, and negatively with regularity of meals and parental supervision. There was no correlation between screen time with physical activity and body mass., Conclusion: Sedentary behaviours and physical activity are not competing behaviours in Polish teenagers, but their relationship with unhealthy dietary patterns may lead to development of obesity. Good parental practices, both mother's and father's supervision seems to be crucial for screen time limitation in their children. Parents should become aware that relevant lifestyle monitoring of their children is a crucial element of health education in prevention of civilization diseases. This is a task for both healthcare workers and educational staff.

Aim: To analyse the relationship between the frequency of family meals and the body weight of 13-year-olds and its selected determinants., Material and Methods: The study was conducted in 2008 as the last stage in a prospective cohort study of 605 children. Questionnaires containing questions about the frequency of family meals, the general regularity of meals, fruit and vegetable consumption, physical activity and the number of hours spent watching television or at the computer were sent to 13-year-olds by mail. School nurses performed anthropometric measurements of the pupils' weight and height. Statistical analyses were performed, i.e. Pearson's correlations, the two-step cluster analysis and the logistic regression analysis., Results: Most of the young people (80-90%) eat each of the main meals in the company of their parents at least once a week, 21% have breakfast with their parents every day, 41% - dinner, and 45% - supper. The frequency of family meals correlated negatively with the girls' BMI and the number of hours they spent watching television or at the computer, while positively with physical activity, regular meals and vegetable consumption in adolescents of both genders. The lowest mean values of BMI were found in a group of adolescents often eating family meals, the highest - in the group of young people who rarely ate family meals (over 20% of young people in this group were overweight), but the differences were statistically significant only for girls (p=0.025). The probability of less than 2 hours of sedentary behaviour daily, physical activity of at least 60 minutes per day and everyday vegetable and fruit consumption is twice as high in adolescents often consuming meals with their parents, and with the daily consumption of all the meals in this way - more than fourfold higher than in other groups., Conclusions: Family meals treated as a predictor of a healthy lifestyle can indirectly protect adolescents from overweight and obesity. Promoting family meals should be an important method of preventing obesity, particularly among teenage girls.

Objectives: 1. To examine the prevalence of selected risk factors for atherosclerosis: overweight, tobacco smoking, low physical activity, psychological distress and type A personality (characterized by tenseness, impatience, competitiveness, and aggressiveness) in adolescents and to assess the frequency the coexistence of risk factors (≥3) in relation to gender, age and school type., Methods: A cross-sectional study was carried out in a representative sample of youth aged 16 and 18 years (N=2983) in 8 voivodeships in Poland. The frequency of five atherosclerosis risk factors and their coexistence (≥3) was examined using self-reported questionnaires, in relation to gender, age and school type. Logistic regression analyses were used to assess the influence of the variables (gender, age and school type) on odds ratios of risk factor coexistence., Results: Low physical activity was the most common risk factor, statistically more frequent in students from Basic Vocational Schools than in other school types (p<0.05). In Basic Vocational Schools there was also the highest percentage of cigarette smokers (p<0.001). Psychological distress and type A behaviour were observed most frequently in students from General Upper Secondary Schools. The highest risk factor accumulation (≥3) was observed among students from Basic Vocational Schools (40%), significantly more frequent in girls than boys (47.5% and 37.5% respectively). Multivariable analyses show that students from Basic Vocational Schools had twice the odds (OR=2.25, p<0.001) to have the coexistence of risk factors for atherosclerosis as compared with students from General Upper Secondary Schools, girls had almost twice as many occurrences (OR=1.83, p<0.001) as boys and 18-year-olds 1.5 more than 16-year-olds (OR=1.46, p<0.001)., Conclusion: 1. A significant difference in the prevalence of risk factors for atherosclerosis in youth from different school types requires precise definition of priority health promotion activities depending on school type. 2. Students from Basic Vocational Schools should be the target group for intervention aimed at reducing atherosclerosis risk factors.

Introduction: Previous studies on relationships between the current family structure, socioeconomic status and family members' body mass don't give unequivocal results. A life course perspective evaluates the contribution of early life factors jointly with later life factors to identify risk and protective processes., Objectives: The relationship between economic status, family structure in first and thirteenth year of life, their changes in this period and overweight among 13-year olds in Poland., Participants and Methods: A study sample was the prospective cohort of 11 937 children enrolled in the observation in neonatal period, examined in the third year of life (questionnaire survey of 1250 mothers) and at the age of thirteen (561 children and their parents fulfilled questionnaires, children's height and weight were measured). Overweight criteria was BMI >85 percentile using WHO 2007 growth reference., Results: Higher prevalence of overweight was found in adolescents living in single-parent families than in 2-parent families (30.2% vs. 19.5%; p=0.049). The highest prevalence of adolescents' overweight was observed in families, whose structure changed during 13 years (in ""broken"" families - 32.7%, in reconstructed - 36.4%, p=0.033); the risk of overweight in these children increased twice compared to intact families. Adolescents from families whose reported economic status worsened during 13 years, were twice more likely to be overweight than their peers from middle and high economic status families (p=0.057)., Conclusions: The prevalence of overweight among adolescents in 2-parent families is significantly lower than in other family types. Unfavorable changes in family economic status and structure are the strongest redictors of overweight in 13-year-olds.

The Aim of the Study: To investigate the differences in the dietary patterns of Polish overweight and normal weight adolescents., Materials and Methods: The study was carried out on a group of 1906 pupils from gymnasium (lower secondary school) aged 13-15 years, of whom 953 were overweight and 953 had normal body mass. The sample was taken from a representative group of 8386 pupils. Their height and body weight were measured, and their BMI was calculated. Overweight was defined as BMI ł85 percentile for gender and age. Using the method of "selection in pairs", each overweight pupil was paired with a pupil with normal body weight. The research tool was a self-reported questionnaire, containing questions regarding how often selected food products were usually consumed during the week, how regularly basic meals (breakfast, lunch, supper) were eaten, and data on snacking., Results: Overweight adolescents consumed unhealthy products such as sweets and crisps significantly less often than their peers with appropriate body mass. Overweight girls ate dark bread significantly more often, and consumed soft drinks less often than their peers with normal weight. Overweight adolescents had more irregular meals than those with normal weight: only 44% overweight adolescents had breakfast every day, significantly less than adolescents with normal weight. Nevertheless, overweight teenagers snacked significantly less often than young people with normal body mass. The overweight teenagers also less often chose snacks with high fat content, sugar and salt, and more often vegetables, fruits, as well as yoghurt and kefir., Conclusions: 1. Our study shows that compliance of low energy diet alone does not ensure the maintenance of normal body weight. Irregularity of meals and breakfast skipping play an important role in developing overweight and obesity in adolescents. 2. In future studies on dietary patterns in a larger sample of adolescents, emphasis should be placed on adding questions about portion size, food preparation and meal time. Eating behaviours of parents should be also examined in relation to their body weight.

Objective of the Study: To examine the prevalence of overweight and obesity among parents and their 13-year-old children in Poland, and relationships between parental and child obesity., Participants and Methods: The study was conducted in 2008 as a part of prospective cohort follow-up study from 1995. The sample included 579 children (289 girls, 290 boys), their parents (549 mothers, 487 fathers). Parental height and weight were self-reported. Height and weight of children were performed by school nurses. IOTF criteria was used to determine overweight and obesity in children. For adults overweight was defined as BMI > or = 25.0 and obesity BMI > or = 30.0. The relation of parental-child overweight was tested by the odds ratio (OR)., Results: The prevalence of overweight was 43.4% for mothers and 71% for fathers (p < 0.001), including obesity respectively 12.3% and 20.3%, more often among rural mothers (48.1%) than urban (38.5%) (p = 0.69). Prevalence of childhood overweight was 16.7% for boys and 13.5% for girls, obesity respectively 2.4% and 1.0%. Overweight was observed more often in urban than rural areas, respectively 17.1% and 13.3%. OR for child hood overweight was the highest when both parents were overweight OR = 3.90 (1.57-9.72), when the mother alone was overweight OR = 2.55 (1.56-4.16), when father alone--OR = 2.10 (1.09-4.05)., Conclusion: Overweight and obesity is a family problem. In the obesity prevention, interventions should be directed towards the entire family.

Objective: To examine the prevalence of overweight and obesity in Polish adolescents in 2005 using both the International Obesity Task Force (IOTF) cut-offs and a national reference; to compare this to data collected in 1995; and to assess whether there were differences in overweight or obesity by gender and place of residence in 1995-2005., Design: BMI was calculated from measured height and weight, collected in a cross-sectional study in five regions of Poland in 2005. Adolescents were categorised as normal, overweight or obese based on IOTF cut-off values, and by national weight for stature tables, where the 90th and 97th percentiles were used as cut-off values for overweight and obesity., Setting: Population-based study set in Poland., Subjects: A two-stage sampling method was used to recruit 8065 pupils (3980 boys and 4085 girls) aged 13-15 years., Results: The prevalence of overweight and obesity was 12·5 % and 1·9 %, respectively. No significant gender differences were found, either in overweight or obesity. The prevalence of overweight and obesity in 2005 had increased 2 % compared to 1995. Overweight and obesity among adolescents were not related to urban-rural residence, but there were significant regional differences., Conclusions: Monitoring trends in overweight and obesity among adolescents in all regions of Poland using the same reference criteria is important. Since regional differences in overweight and obesity rates among adolescents were observed both in 1995 and 2005, future research should investigate the potential causes of these differences.

The Aim of the Study: 1. Current physical status and selected pubertal features were assessed in Polish 13-year old adolescents, in urban and rural areas. 2. Dynamics and secular trends of body height, mass and body mass index in 1980-2008 were analyzed., Material and Methods: The study was conducted in 2008 in prospective cohort of 605 children (305 girls and 300 boys), who had been observed in the neonatal period, later at age of 3 years and now at age of 13 years. 49% adolescents were from urban and 51% from rural area. For secular trend analyses comparisons of the age and sex-specific means of body height, mass and BMI from 2008 with previous data from 1980, 1999 and 2005 in 13-year old were carried out. Similar comparison was made concerning average age at menarche by using previous probit analysis to determine average age at menarche during the last 3 decades., Results: Mean values of anthropometric features in adolescents were a little higher in 13-yrs old living in urban than rural area, but were statistically insignificant. Two thirds of examined 13-year-old girls already had their first period (menarche), statistically more often urban living girls (p = 0,017). The median age at menarche for entire group of 13-year-old girls estimated by means of Kaplan-Meier analysis was 12.77 years. The girls from urban areas had their first menses earlier than their rural living peers (12.65 and 12.88 years, p = 0.01). There were no statistically significant differences in urban and rural boys concerning age of appearance of facial hair. There are increases of mean height and weight values during the period of 30 years in 13-year-olds (2.51 cm and 2.2 kg for girls and 5.51 cm and 5.08 kg for boys) and BMI 0.21 kg/m3 and 0.75 kg/m2 for girls and boys. The average age of menarche was almost the same as in Warsaw girls in 1986 and 1996., Conclusions: 1. The study confirmed a reduction of differences in somatic development between 13-years olds in rural and urban areas. 2. Difference in mean age at menarche is still observed, they show earlier maturation in urban girls (about 2 months earlier than in rural girls). 3. Positive secular trend in height in Polish 13-year-olds is observed during the last 3 decades. 4. The mean age at menarche in Polish girls stabilized at 12.77 years in the last decade.

Aim: To analyse the influence of selected family socioeconomic factors on the regularity of meals consumption among 13-years aged adolescents., Material and Method: Group of 605 13-years olds identified in the prospective cohort study in 2008 was analysed. Data was gathered with use of posted questionnaires. On the basis of information given by children the regularity (4-5 times a week) of meals consumption on school days and eating meals with parents were correlated with parents' educational level, occupational status and perceived family wealth. The study also recognised the distinction between urban and rural residents., Results: Most questionnaires were filled out by mothers (95%), only 5% by fathers. In urban area, the mother's occupation and the perceived family wealth, correlate with children meals consumption and eating meals with parents. Children whose mothers have a job eat breakfast 1.5 times and supper 3 times less regularly, than children whose mothers don't work. Children from poor families eat breakfast 14 times less regularly than children from rich families as well as eat supper 3 times less regularly than children from average wealthy families. In the rural area, the regularity of meals consumption significantly influence the mother's education. Children whose mothers have a secondary education, compared with children of mothers with basic education, are 4 times more likely to eat dinner and supper regularly., Conclusion: The family socioeconomic factors significantly correlate with regularity of 13-years olds meals consumption and regularity of family meals. The place of residence involve the different factors influencing meals consumption habits. It was shown that children and fathers were too little engaged in family life, including family meals preparation and consumption.

Aim: To investigate the relationship between parenting practices and mental health of adolescents with different body mass index., Methods: The investigation was conducted in 2008 as part of prospective cohort study of 605 children (305 girls and 300 boys).They were observed in the neonatal period, at the age of 3 years and at the age of 13 years. By mail the adolescents received the Short Form of the Alabama Parenting Questionnaire (APQ-9) and the General Health Questionnaire (GHQ-12). School nurses performed anthropometric measurements: weight and height of pupils. In statistical analysis, hierarchical linear regression models were assessed for mother and father parenting practices, both for the whole group of adolescents and for adolescents in groups stratified by the Body Mass Index (BMI)., Results: Stepwise linear regression revealed that in the total sample, positive parenting (praising and rewarding) by the mother explains 5% of variance of adolescents mental health (father's positive parenting explains 4%), consequent discipline of mother or father--1%, supervision by the mother--0.4%, by the father--2.5%. In the group of overweight adolescents positive parenting by the mother explains 13% (in normal weight group--3%) of adolescents mental health variance, positive parenting by the father--15% (in normal weight group--2%). Supervision by the father explains 7% of overweight adolescents mental health (in normal weight group--1.5%). For overweight girls the most important predictors of mental health are positive parenting by the both parents and father's supervision., Conclusions: Parenting practices are important predictors of adolescents' mental health, especially for overweight youths. Positive parenting (praising and rewarding) may play a significant role in improving overweight adolescents' mental health.

Introduction: School-based physical education (PE) is often proposed as a strategy for obesity prevention and treatment. Thus the role of PE teachers is crucial on this field., Objectives: The purpose of this study was to investigate the perception of PE teachers towards overweight and obese pupils aged 13-15 years, especially psychosomatic problems and support for obese adolescents in realisation of physical activity programme., Material and Method: A random sample of 185 PE teachers from 112 lower secondary schools in Poland were surveyed regarding their perception of pupils obesity and their support for obese adolescents., Results: PE teachers observed many negative features among obese pupils: Two thirds of teachers (67% male and 74% teachers with work experience 6-10 years) observed decreased physical fitness and exercise capacity in this group of pupils. Body-related barriers in obese pupils and anxiety caused by weight related peer teasing were observed by respectively 30% and 20% teachers more often women teachers and teachers with shorter work experience. PE teachers were engaged in activities to support obese pupils: 90% of them assessed obese pupils by personal development, 70% conducted counseling and 20% cooperated with obese pupils' parents. Two third of teachers reported successes in their work with obese pupils. Their difficulties were connected with body-related barriers in pupils (24%), and aversion to exercise and physical efforts and location of PE lessons at school (9-16%)., Conclusions: 1. The PE teachers can play an important role in preventing and combating obesity in pupils. 2. PE teachers should be motivated to organize interesting PE lessons, school sport and competitions for both normal and overweight pupils.

Unlabelled: Access to health care, including preventive health care for pupils affects the health of society. Equal access to pupils'preventive health care means the same level of preventive services for all children and adolescents regardless of school type, place and region of domicile., Aim: To analyse the quality of preventive health care for pupils in school year 2007/2008 in all school types in Poland, giving special attention to inequalities and access of this healthcare., Material and Methods: Reports from national public statistics filled by school nurses regarding preventive healthcare for pupils were analysed. Special attention was given to inequalites in access to, Result: Disparities in access to preventive health care were observed. They affected more often pupils from rural schools, basic vocational schools and special schools. As a result, 60% rural elementary schools did not have a school health office. School nurses working in these schools were overburdened, each of them had to look after excessive number of pupils. Nearly one-quarter of basic vocational school pupils didn't have periodic check-up. Pupils from these schools less frequently participated in health education conducted by school nurses compared with pupils from other school types. In special schools school nurses were overburdened. One school nurse from these schools had to look after above limit of pupils' number (above 25% in urban and above 75% in rural schools)., Conclusions: 1. Inequalities in access to preventive health care affected pupils from rural, basic vocational schools and special schools. They reflected existing social disparities in Poland. 2. Inequalities exist mainly in the social groups, who are at risk of social exclusion. 3. Equal opportunity for pupils'preventive health care requires systemic solutions in health and educational cooperation at government level.

Unlabelled: Social exclusion constraints the development of individuals and groups. Especially endangered are inhabitants of villages and small towns. To prevent social exclusion of children and adolescents from poor families or with social dysfunctions, community clubs are being organized. THE PURPOSE of the study was a preliminary assessment of preparing community clubs tutors for health education and evaluation of parents' activities in preventive health care for children., Material and Methods: the questionnaire survey was carried out in a sample of 19 community centre tutors and 144 parents (in 84% these were mothers) of children attending these centres. Children of surveyed parents were aged 4-16 years (M = 10.5; SD = 2.5), 70% of them 7-12 years old. Community centre tutors were asked about their knowledge of preventive health care, the current health education activities, cooperation with parents, and local social care institutions. Parents were asked about the use of preventive health care facilities by their children., Results: The largest group of community club tutors assessed their own knowledge about the children's preventive health care as sufficient or good. Their knowledge about active methods in health education was self-assessed as average. In practice, active methods in health education were used only by half of surveyed tutors. Periodic preventive health examinations were performed in 57-86% of the children and 56-75% were vaccinated., Conclusions: 1. There is a need to implement health education in community clubs, but this requires improving the knowledge of tutors, especially about using active methods. 2. Only a complex approach to prophylaxis can bring real advantages for child health and help in giving equal opportunities and eliminating health inequalities among children.

Aims: 1. Comparison of cut-off points for selected anthropometric parameters in children and adolescents between reference values for Polish Institute of Mother and Child (IMD) and WHO growth, Methods: The accepted reference system were IMD reference values and the differences for mean (50th) and 3rd and 97th percentile for height and weight were calculated for boys and girls. The differences between BMI units for overweight (85th) and obesity (95th) percentile were compared. Warsaw 1980 reference values were used to estimate secular trend influence on differences between IMD and WHO cut-off points in stunting adolescents., Results: Comparison of height-for-age showed the largest differences with positive values relative to 3rd percentile in the Polish population. Boys aged 16 years attain 4% (6.2 cm) of 3rd percentile height value and girls aged 14 years 2.3% (2.8 cm). Secular trend of the Polish population did not influence the differences between IMD and WHO values in stunting adolescents. The differences for 85th and 95th percentile of BMI were most pronounced in prepubescence and the largest values were for boys and girls aged 10 years., Conclusions: 1. National height-for-age references should be used for growth assessment in Polish school-aged children and adolescents especially in stunting adolescents identified in puberty. 2. WHO norms for BMI, can be used as a tool for identifying overweight and obesity in epidemiological studies in Poland and for international comparisons. 3. The usefulness of WHO norms for clinical evaluation of overweight and obesity should be discussed among experts.

Introduction: Growth and development assessment of infants and young children is a very important component of early prophylaxis in paediatric health care. In 2006 the World Health Organization published the new Child Growth Standards for children up to 5 years of age. They describe the optimal pattern of young children development., Aim of the Study: 1. To compare the cut-off points for selected anthropometric parameters in children up to 5 years between reference values for Polish children and WHO Child Growth Standards. 2. To attempt to answer the question whether the WHO Child Growth Standards can be implemented to assess health and development in children up to 5 years in Poland., Methods: The differences for mean (50th percentile) and extreme values (3rd and 97th percentile) for length/height for age and weight for age were calculated for boys and girls. The differences in BMI units for overweight (mean + 1 SD) and obesity (mean + 2 SD) were compared using the z-score method., Results: Comparisons of the WHO and Polish length/height and weight for age showed no differences in children aged 1-60 months. Small differences were seen in the 3rd percentile (less than 2%) in children aged 3 and 6 years. BMI values for overweight and obesity were slightly lower for Polish children in the first 6 months of life than in WHO standards. These differences have positive values for boys and girls starting at 9th month and increasing in toddlers., Conclusions: WHO standards reflect the optimal growth pattern for children from birth up to 5 years. Therefore these instruments should be adopted for Polish children to assessing their growth.

Early identification of children with developmental delay is an important task for the primary care physicians. Different screening tests are used to detect developmental disorders in infants and young children. The authors describe screening tools currently available in Poland in the primary care setting. The review of the standardized developmental screening tests available in other countries is given: parent report instruments, such as Ages and Stages Questionnaires (ASQ), Parent's Evaluation of Developmental Status (PEDS) and instruments that require direct examination as the Denver-ll Developmental Screening Test (DDST) and Bayley Infant Neurodevelopmental Screener (BINS). The authors describe a proposed standardized developmental screening instrument of infants and young children for primary care pediatricians and family doctors in Poland.

Aim of the Study: to examine the prevalence of nutritional status and growth disorders in 13-year-olds in Poland by sex and place of residence and changes during the period 2005 to 2008., Participants and Methods: The study was conducted in 2008 as a part of prospective cohort follow-up study of 605 children (305 girls and 300 boys), from birth to 13 years. Analyses of anthropometric measurements: height and weight were performed. Institute of Mother and Child growth references for height-for-age and BMI-for-age (1999) were used to assess physical disorders., Results: The prevalence of overweight (BMI > or = 85th percentile) was 14% and underweight (BMI < 5 percentile) was 4,1%. Short stature (< 10th percentile of height) was found in 6%, and 6,2% were above 97th percentile of height. We found no statistically significant difference in nutritional and growth status disorders by sex and place of residence. The overall prevalence of overweight (including obesity) did not change from 2005 to 2008. Prevalence of underweight decreased especially among boys (9% to 3,1%, p=0,010) and among adolescents from rural area (8,2% to 4%, p=0,058). We found some evidence for equalization of the percentages of short stature in boys and girls, rural and urban adolescents. The tall stature rate rose only among girls (3,8% to 8,3%, p=0,050)., Conclusions: Disappearance of the prevalence of physical disorders by sex and place of residence has been observed in the last few years in Poland. Overweight among 13-year-olds is not growing and acceleration of height is still observed.

Unlabelled: THE PURPOSE of the study was to analyse the relationships between social environment (school, family, peers) factors and distress of adolescents aged 18 years., Material and Methods: the questionnaire survey was carried out in the sample of 1379 pupils in the third grade of upper secondary schools; mean age of pupils 18.7 years. The questionnaire contained scale GHQ-12 (General Health Questionnaire) and questions from HBSC (Health Behaviour in School-aged Children. A WHO Collaborative Cross-national Study) survey, concerning school attitude, family structure, parental bonding, communication with parents and peers' relationships. Comparative analyses were done by chi2 test. Odds ratio and multivariate logistic regression models were estimated for risk assessment., Results: over 40% of 18 year olds had a higher level of psychological distress, significantly more frequent among girls than boys (p < 0.001), and urban than rural adolescents (p < 0.01). Pupils from general upper secondary schools more often felt distress than pupils from basic vocational schools (50% vs. 27%, p < 0.001). Girls who reported not liking school and felt pressured by schoolwork had a higher level of distress (Exp(B) = 1.8 and 2.1). Significant relationships were found between worse parental bonding, difficulties in communication with parents and higher level of distress both in boys and girls (Exp(B) from 1.8 to 2.8). Lack of same-sex close friends and no time spent with them after school were predictors of higher distress mostly in boys (Exp(B) od2,2 do 11.5)., Conclusion: school problems (prospect of school-leaving e xams), difficult family relationships and especially lack of same-sex friends and spending time with them outside school are risk factors for psychological distress of youth aged 18 years.

Unlabelled: The aim of the study was to analyse the relationships between objective body mass index and subjective body image, life satisfaction and self-esteem of adolescents., Material and Methods: the study was carried in 5 regions in Poland, on the sample of over 8,000 pupils aged 13-15 yrs, from randomly chosen 112 lower secondary schools. School nurses measured the height and weight of pupils, calculated the BMI and qualified overweight pupils (BMI> or =85 percentile) to the obese group (n = 953). Matching gender and age, from the rest of pupils, they found the non-obese group with BMI between 15 and 75 percentile (n = 953). Pupils from both groups participated in a questionnaire study containing the Rosenberg Self-Esteem Scale, Cantril ladder and Stunkard Body Figure Perception Questionnaire. Hierarchic regression analyses and structural equation models were calculated., Results: in the obese group the percentage of pupils satisfied with their life was lower (76% vs 82%, p<0.001), and low self-esteem higher than in the non-obese (37% vs 23%, p<0.05). The predictor of life satisfaction and self-esteem was subjective body image, and not the objective body mass index. Objective body mass (BMI) determined the body image and relationship between BMI and life satisfaction or self-esteem of adolescents was only indirect., Conclusions: change of subjective body image in obese adolescents is a chance for improving their quality of life and in consequence undertaking effective struggle with obesity.

Unlabelled: Overweight and obesity has become an increasing problem in school aged children and adolescents also in Poland. Early detection and treatment of this disorder is crucial. On the basis of height and body mass measurements, the body mass index (BMI) is calculated and is used to assess overweight for maximal correlation with body fat. BMI has been widely used to measure obesity in adults worldwide and it is also used in childhood obesity. The cut-off points of BMI value are the main problem in children and adolescents obesity because BMI varies substantially by age and gender during childhood and adolescence. The aim of the study was a comparison of two methods which were used to assess overweight and obesity in adolescents. A modification of the current screening test for physical development disorders is also proposed., Material and Methods: in comparative analysis of overweight and obesity prevalence we used data from our survey in a representative group of over 8000 adolescents aged 13-15 years, in 2005. Different standards have been used to define overweight and obesity: using 85th BMI percentile or 90th BMI percentile for overweight and 95th BMI percentile or 97th BMI percentile for obesity., Results: the two standards produced consistent estimates of the prevalence of obesity in our sample, but prevalence of overweight produced statistical significant differences. We found underestimation of overweight especially in boys using the standard with 90th BMI percentile references. In case of individual screening test, underestimation of overweight may give a falsely negative result., Conclusions: 1. Using the Polish standards with 85th percentile references as cut-off point of BMI value instead 90th percentile for overweight increases screening sensitivity. 2. National standards with cut-off points BMI> or =85th percentile for overweight and BMI> or =95th percentile (obesity) are also useful tools for estimation of overweight and obesity prevalence in epidemiological studies and in international comparisons.

The aim of this study was to determine the prevalence of overweight and obesity in Polish adolescents aged 13-15 years using three research tools: 1. BMI > or = 85th (overweight) and BMI > or = 95th percentiles (obesity) using Polish national reference data, 2. WHO standard, 3. International Obesity Task Force (IOTF) standard. Height and weight were measured in randomly selected group of over 8000 adolescents in 5 regions in Poland. The prevalence of overweight and obesity using these tools was similar--about 13%. The prevalence of obesity ranged from 2.2 to 4.5%, depending on the methods used. We found underestimation for obesity especially in girls using international standards. WHO and IOTF standards are useful to estimate overweight and obesity to international comparisons. For national use: clinical and epidemiological Polish references data and definition BMI > or = 85th (overweight) and BMI > or = 95th percentiles (obesity) are better tools.

The aim of the study was to examine the prevalence of underweight in Polish teenagers in demographic and regional context. The examination was conducted in 5 regions in Poland, in a representative cohort of 8067 13-15 years pupils in 112 lower secondary schools. The measurements of body height and mass were taken and body mass index (BMI) was calculated in all participants. Pupils with BMI value below 5 percentile of sex-specific growth charts were categorized as underweight. In statistical analysis was used multivariate logistic regression and chi-square test with SPSS v.14 application. The prevalence of underweight in pupils was 4,2%, more prevalent in boys than girls, younger pupils (13 years) than older (15 years). The prevalence of underweight pupils was almost the same in urban and rural area. We found regional differences in prevalence of underweight in examined pupils. The highest prevalence was found in Kujawy region, and the lowest in Podlasie. In the last decade the prevalence of underweight in this population increased approximately 2--4% between 1995 and 2005, with retaining the same regional differences. Results of our study show that regional factors (ethnic, cultural) play more important role than urbanization in prediction prevalence of underweight in adolescents in Poland.

This study was designed to evaluate the current smoking status among adolescents of upper-secondary schools in Poland and to examine potential relationships between environmental factors (place of living and school type) and current cigarette smoking, smoking experimentation and age of first cigarette. Questionnaire survey was conducted in February - March 2005 as a project: "Health perception, life satisfaction and health behavior of upper-secondary school pupils in Poland in psychosocial and economical determinants' context". The data was collected from representative sample of pupils in Poland (N=3123), Ist and IIIrd grade students at upper-secondary schools of different school types. Almost 3/4 adolescents had reported the attempts of smoking, 1/4 declared current smoking. The smoking prevalence among boys was higher than among girls, among older pupils (18 y.) than younger (16y.) and among students living in towns. Especially there was a significant difference of rate of smoking among young women from towns than from rural areas. Special risk group of cigarette smoking were pupils of basic vocational schools. Risk of current smoking was more than 4 times higher among them, than among pupils from general secondary schools. Strategies aimed at influencing smoking behavior need to be directed especially to basic vocational schools students and girls in towns.

Aim: To analyse the relationships between selected subjective health complaints and psychological distress of 15-19 yrs old adolescents in Poland., Material and Methods: The health survey of the population was conducted by the Central Statistical Office in 1996 in 19203 households inhabited by 62749 people. Dates were received from 5407 adolescents of 15-19 yrs, using AZD-2 questionnaire. Questions concerning subjective health complaints and psychological distress, tested by modified scale GHQ-12 (General Health Questionnaire), was answered by 3708 adolescents., Results: Subjective health complaints reported 1.9-27.5% of adolescents in the age of 15-19. They experienced feeling nervous and irritability the most often (more than 20% under survey), the most rarely -- insomnia and apathy. Every tenth questioned adolescent at the age 15-19 experienced psychological distress. Psychological distress occurred more often in girls, people living in town and raised with age. Risk of subjective health complaints was higher for people with distress. The highest risk (8 times) was for apathy and insomnia. Psychological distress increased the risk of subjective health complaints for boys more than for girls.

Aim: To analyse relationships between selected elements of family, school and peer environments and susceptibility to medically treated repeated injuries in pupils aged 11, 13 and 15 yrs in Poland., Material and Methods: The survey was carried out in 2002 on the representative sample of pupils (N=6383), within the Health Behaviour in School-aged Children: A WHO Collaborative Cross-national Study (HBSC)., Results: Outcomes of the study indicate that frequency of repeated injuries amounts to 8.6% and rises for pupils from incomplete families (for children living with stepmother OR=3.6, 95% CI 1.40-8.99), being in touch with many friends (OR=2.35, 95% CI 1.82-3.03), whose parents are not ready to help them with school problems (OR=4.28, 95% CI 2.24-8.18) and teachers are not friendly (OR=2.79, 95% CI 1.78-4.38)., Conclusions: Improving relations in families and schools can help in decreasing the frequency of repeated injuries among adolescents.

The aim of the study was to analyse: annual occurrence of injuries in pupils aged 11, 13 and 15 years in Poland, common location of injury occurrence and type of activity, as well as the type of body harm. The results of the survey were compared with similar studies in 1994 and 1998 and series of trends were drawn. The survey was carried out in Poland within the Health Behaviour in School-aged Children. A WHO Collaborative Cross-national Study (HBSC). The representative sample (N = 6383) was selected by two-stage, cluster drawing with stratification by place of residence. As the survey instrument the international questionnaire was used, translated and adapted for national purposes. Selected determinants of injuries were examined by crude odds (OR) with 95 per cent confidence interval (CI) calculated from contingency tables with the use of EPI INFO 6.04d software. Results of the study indicated the linear increase of non-fatal injuries among 11, 13, 15 years old pupils in 1994-2002 (from 17.6% to 28.4%) and even more evident increase of repeated injuries in the same time (from 2.1% to 8.6%, respectively). School and home were the most common location of injuries occurrence, while training for sport was the most common type of activity. Boys, living in urban areas were at highest risk of injuries in total, and by selected injuries outcomes. An increase of awareness that injuries are preventable and implementation of well know in the world prevention strategies are needed to stop disadvantageous trends in non-fatal medically treated injuries among school-aged children.

The aim of this article is the presentation of principles in reforming preventive health care system for pupils. In this context the goals and tasks of school health care policy programme "Implementation of standards in health care for school-age population" are shown and discussed. Results of programme realisation in 2002 are also discussed.

The goal of this work is the presentation of the first version of standards in preventive health care over pupils in Poland, carried out by school nurses or school hygienists and primary health care physicians. Targets, main principles of standards and the course of all activities during their preparation are discussed. Main elements of this document: standards of requirements concerning qualifications, employment of personnel performing preventive health care over pupils, prophylactic room in school, equipment and procedures in preventive health care of pupils are presented. Standards of procedures and indicators of their implementation are also discussed.

The aim of the investigations carried out by the National Institute of Mother and Child in school-aged children and adolescents including a group of obese pupils, was to assess the health behaviour concerning eating habits and food consumption. A part of these investigations was carried out in framework of international collaborative studies. In a representative group of pupils in Poland, we found that vegetable, dark bread and milk consumption remained on low level, while the use of soft drinks increased. The number of children who ate breakfast at home and lunch at school decreased especially in girls. We found a statistically evident difference in eating habits between obese adolescents and these with normal body mass, especially concerning regularity of meal consumption. We find, that it is very difficult to change incorrect eating habits in obese adolescents. We observe in our outpatient clinic, that obese adolescents have changed the quantity of food, but they haven't changed their habits. The recommended by dietitions increase of fruits, vegetables and low fat milk consumption in their diet was not generally accepted.

School children and adolescents needs particularly good medical health care because of the specific character of this developmental period and the danger due to risky behaviours among pupils. The aim of this study was to assess the quality prophylactic health care for pupils in the early stage of initiating health care reforms. The initiation of the health reform on January 1st 1999 caused a deterioration of prophylactic medical health care in pupils. It may also produce more health problems among school children and adolescents in the future.

We present clinical problems and the therapy of a 52 year old patient with Wolf-Parkinson-White syndrome and numerous episodes of Morgagni-Adams-Stokes syndrome. In that patient atrio-ventricular tachycardia caused atrial fibrillation. Short refractory period of the accessory pathway and the ventricular muscle allowed for extremely fast ventricular rate with haemodynamic collapse and syncope. Long-term treatment with propafenone or amiodarone did not prevent the arrhythmias. Electrophysiological study pre- and intraoperation including the epicardial mapping were performed several weeks after discontinuation of therapy with amiodarone. The studies revealed left free wall accessory pathway. Dr. A. Biederman and al. performed dissection of the accessory pathway. There were no evidence of conduction through the accessory pathway during the post operation electrophysiologic study. The patient has neither reentrant tachycardias nor atrial fibrillation episodes.