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People with intellectual disabilities experience stigma and discrimination. In caring for people with intellectual disabilities, special attention should be paid to respecting their dignity and subjectivity. The aim of this study is to emphasize the importance of respecting the dignity and subjectivity of adults with intellectual disabilities and the importance of communicating with them. The paper is based on a literature analysis of intellectual disability issues. The literature analysis indicates that the subject of intellectual disability concerns the subjectivity and the dignity of the people as well as the barriers to communication with the environment and medical personnel. It is fundamental to conduct research into care of people with intellectual disabilities. In addition, there is a need to organize training for all members of the therapeutic team, especially in the area of communication issues with people with intellectual disabilities.

Spirituality as an integral part of human life has a significant impact on the understanding of disease, reactions associated with it, and decisions made in the treatment process. Therefore, it is important for effective therapeutic and care management. Spiritual care consti-tutes an important element of holistic nursing care focused on the needs of patients with dementia in cooperation with the therapeutic team, and it prevents depersonalisation of the patients, taking into account their psychosocial needs. Progressive dementia affects human functioning in terms of basic everyday activities and the possibility of self-care. If the care is focused solely on satisfying the patient’s biological needs, it often becomes task-oriented care and depersonalises the patient’s individuality, whose psychosocial needs are not taken into account. The knowledge of spiritual aspects of the patient’s functioning allows these issues to be included in the care and treatment plan, thus enhancing the effectiveness of the therapeutic process. Spiritual care is a valuable and integral element of holistic care, emphasising the broader aspect of humanity, and the recognition of spiritual needs alongside physical, social, and emotional needs involves the commitment and cooperation of all care providers. The aim of this paper was to present selected issues of spiritual care provided to patients suffering from dementia disorders. Selected issues were presented on the basis of available literature analysis. The approach to the individual needs of patients emphasises the holistic dimension of care. Spiritual care should be provided by the therapeu-tic team at every stage of contact with the patient.

W leczeniu ran, a zwłaszcza ran przewlekłych, wykorzystuje się środki, które warunkują proces ich gojenia poprzez oczyszczanie, zapobieganie rozwojowi infekcji, a także wspomaganie ziarninowania i naskórkowania. Wielolekowa oporność wynikająca ze stosowania antybiotyków w leczeniu ran kierunkuje dalsze badania w obszarze skutecznych i dobrze tolerowanych preparatów ponadtlenkowych. Brak rozwoju oporności na środki antyseptyczne, uszkadzające nieodwracalnie patogeny, stanowi obiecującą perspektywę potencjału antyseptycznego leczenia ran. Antyseptyki, z uwagi na skuteczność, dobrą tolerancję oraz bezpieczeństwo znajdują coraz szersze zastosowanie w badaniach – od in vitro do klinicznych. W niniejszej pracy dokonano przeglądu badań w zakresie skuteczności zastosowania podchlorynów w procesie gojenia ran.

AIMS Iron deficiency (ID) is frequent in heart failure (HF), linked with exercise intolerance and poor prognosis. Intravenous iron repletion improves clinical status in HF patients with left ventricular ejection fraction (LVEF) ≤45%. However, uncertainty exists about the accuracy of serum biomarkers in diagnosing ID. The aims of this study were (i) to identify the iron biomarker with the greatest accuracy for the diagnosis of ID in bone marrow in patients with ischaemic HF, and (ii) to establish the prevalence of ID using this biomarker and its prognostic value in HF patients. METHODS AND RESULTS Bone marrow was stained for iron in 30 patients with ischaemic HF with LVEF ≤45% and 10 healthy controls, and ID was diagnosed for 0-1 grades (Gale scale). A total of 791 patients with HF with LVEF ≤45% were prospectively followed up for 3 years. Serum ferritin, transferrin saturation, soluble transferrin receptor (sTfR) were assessed as iron biomarkers. Most patients with HF (n = 25, 83%) had ID in bone marrow, but none of the controls (P

Analiza piśmiennictwa potwierdza skuteczność specjalistycznych opatrunków zawierających srebro i utrzymujących wilgotne środowisko w leczeniu ran. Opatrunki te zmniejszają obciążenie mikrobiologiczne rany, zapobiegają rozwojowi infekcji, wspomagają proces ziarninowania i naskórkowania. Brak rozwiniętej oporności drobnoustrojów na srebro stanowi obiecującą perspektywę miejscowego, antybakteryjnego leczenia ran i owrzodzeń. Skuteczność, dobra tolerancja oraz bezpieczeństwo związane z użyciem produktów z tej grupy znajdują potwierdzenie w badaniach in vitro i badaniach klinicznych. Opatrunek piankowy Mepilex® Ag, dzięki zawartości siarczanu srebra oraz miękkiej, silikonowej warstwy kontaktowej w technologii Safetac®, działa przeciwbakteryjnie, pozwala zmniejszyć ból podczas zmiany opatrunku oraz przyspiesza gojenie tkanek. Obecny w opatrunku węgiel aktywny zmniejsza nieprzyjemny zapach rany z cechami infekcji. Celem pracy była analiza badań w zakresie zastosowania opatrunku Mepilex® Ag w leczeniu ran.

Circular Economy (CE) package accepted by the European Union (EU) in December 2015 promotes close-loop flows of materials. The main targets provided in the documents refer to the prevention of waste landfilling, efficient use of resources and energy, as well as re-use waste and by-products. Sewage sludge—residue from Waste Water Treatment Plant (WWTP)—has a great fertilizer potential and should be recycled in line with the CE strategy. Sewage sludge usage for agricultural purposes seems to be the best sustainable option of its disposal. New EU regulations related to fertilizers derived from bio-waste and by-products assume the uniformity of legislation in Member States and simplification of procedures for introducing innovative fertilizers into the internal market. The characteristic of organo-mineral fertilizers obtained from dried sewage sludge is presented in the paper. In order to obtain balanced NPK fertilizers straight mineral fertilizers, poultry litter ash and phosphoric/nitric acids or a mixture of these were added. As a result organo-mineral fertilizers with N + P2O5 + K2O > 20% were produced. It was found that the largest contribution of contaminants in products comes from Wet Process Phosphoric Acid.

Background: The hormonal metabolism of adipose tissue differs across regions of fat. This issue has never been verified in male patients with coronary artery disease (CAD) with and without systolic...

Multiple sclerosis as a disease of various dynamic and unpredictable consequences at different periods of the disease can lead to quality of life reduction. One of the guarantors for maintaining a good quality of life is accepting the disease. The aim of the study was to evaluate the quality of life, taking into account the sexual sphere and acceptance of the disease among young adults with multiple sclerosis.The study included 120 people of both sexes, aged from 18 to 35 years of age suffering from multiple sclerosis during remission, independent in everyday activities or requiring a minimum of help. The study used a questionnaire MSQOL-54 instrument and the AIS scale. The statistical analysis used the following: Kruskal-Wallis test, Mann-Whitney test, Chi2, Spearman coefficient. Program Statistica 7.1 was also used. The level of significance was p0.05.The overall quality of life increases with the acceptance of the disease (Spearman r-0.364; p=0.000). It has been demonstrated the existence of significant statistical positive correlation between satisfaction with the sexual sphere and acceptance of the disease (Spearman’s r 0.271; p=0.005) and satisfaction with the sexual sphere and quality of life (Spearman’s r 0.467; p=0.000).The factor determining the quality of life of patients with MS is the acceptance of the disease. Satisfaction with sexual life is a significant factor in assessing the quality of life by patients and the acceptance of their illness.

Iron deficiency (ID) may be an important, treatable co-morbidity complicating cardiovascular diseases, but considerable uncertainty exists about the diagnostic accuracy of blood tests. Accordingly, we investigated the relationship between blood tests for ID and iron stores in bone marrow aspirates, the diagnostic gold-standard for ID, in patients with stable coronary artery disease (CAD).Bone marrow aspirates were obtained from 65 patients with stable CAD undergoing cardiac surgery and 10 healthy controls. ID was defined as depleted extracellular iron stores (0-1 grade according to Gale scale) accompanied by ≤10% of erythroblasts containing iron.Bone marrow ID was found in 31 (48%) patients with CAD but in none of the controls (p0.01). Amongst patients with CAD, ID was present in 10 of 16 (63%) with and 21 of 49 (43%) without anaemia (p=0.17). The clinical profiles of patients with and without ID were similar. Of circulating biomarkers of ID, serum soluble transferrin receptor had the strongest association with bone marrow ID (area under curve: 0.876±0.048, 95% confidence interval: 0.762-0.948, for cut-off of ≥1.32mg/L-sensitivity: 67%, specificity: 97%).Almost half of patients with stable CAD have profound bone marrow iron depletion that can be accurately assessed non-invasively using serum soluble transferrin receptor.

Deficiencies of anabolic hormones are common in men with heart failure (HF). It remains unclear whether the deranged metabolism of these hormones is the pathophysiological element of HF itself or is the consequence of co-morbidities or/and treatment in HF.We examined 382 men with systolic HF. Serum hormones (i.e. total testosterone [TT], DHEAS, IGF-1) were assessed using immunoassays, serum free testosterone (eFT) - using the Vermeulen equation.Prevalence of TT and eFT deficiencies was similar in men with HF agedversus ≥60 years (23% and 32% for TT and eFT deficiencies). Deficiencies in DHEAS and IGF-1 were more common in younger (63% and 92%) than older patients (48% and 73%). In men60 years, TT deficiency was accompanied by the therapy with digoxin, eFT deficiency - the therapy with digoxin and the presence of diabetes, DHEAS deficiency - the therapy with loop diuretic (all p0.05). In men ≥60 years, TT deficiency - the therapy with loop diuretic, DHEAS deficiency - the therapy with spironolactone and digoxin, and hsCRP, IGF-1 deficiency - the high hsCRP (all p0.05).Deficiencies in anabolic hormones are common in younger and older men with HF. Some therapies (but not major co-morbidities) may contribute to anabolic deficiencies.

Poziom akceptacji choroby nowotworowej oraz wybór strategii radzenia sobie są uwarunkowane sposobem jej postrzegania przez pacjenta i następstwami wynikającymi z jej przebiegu. Celem badania była ocena stopnia akceptacji choroby i strategii radzenia sobie przez młodych dorosłych z chorobą onkologiczną. Przebadano 53 osoby w wieku 18–35 lat z chorobą onkologiczną. Zastosowano skale AIS i Mini-MAC oraz autorski kwestionariusz ankiety. W analizie statystycznej wykorzystano testy: t-Studenta, Shapiro-Wilka, U Manna-Whitneya, Kruskala-Wallisa, Levene'a oraz współczynnik korelacji r-Spearmana. Za poziom istotności przyjęto p < 0,05. Średni wskaźnik akceptacji choroby u badanych wynosił 29,0, a wśród strategii radzenia sobie dominowały duch walki i pozytywne przewartościowanie. Badani prezentowali średni poziom akceptacji choroby i dominowały u nich strategie będące reprezentantą konstruktywnego stylu radzenia sobie z chorobą. Wykazano związek między akceptacją choroby w grupie młodych dorosłych a strategiami: zaabsorbowanie lękowe i bezradność/beznadziejność. The acceptance level of a cancer disease and the choice of coping strategies are conditioned by the patient's perception of the disease and its consequences. The aim of the study was to assess the degree of disease acceptance and coping strategies for young adults with oncological disease. 53 patients aged 18-35 years with oncological disease were examined. AIS and Mini-MAC scales were used as well as the author's questionnaire survey. Statistical analyzes used the t-Student, Shapiro-Wilk, Mann-Whitney U, Kruskal-Wallis, Levene and r-Spearman’s correlation factor. Significance level was assumed to be p < 0.05. The average acceptability score for the subjects was 29.0, and among the coping strategies the fighting spirit and positive re-evaluation dominated. The subjects presented the average level of disease acceptance and strategies that dominated representing the constructive style of coping with the disease. The link has been demonstrated between disease acceptance in young adults and strategies: anxiety absorption, helplessness and hopelessness.

Child epilepsy can be source of negative emotions and stress in pa- rents. Social support is an external personal resource coupled with the process of coping with difficult situations.The aim of the study evaluation the severity of negative emotions and ways of dealing with the stress of parents of children with epilepsy in relation to the received social support.The study was conducted in one of the children's hospitals in Małopolska, on 213 parents (148 women and 65 men) aged 21 to 66 years. The study used: HADS-M (Hospital Anxiety and Depression Scale Modified HADS-M, BSSS (Berlin Social Suport Scale), Inventory for Measurement Coping Mini-COPE and the author's questionnaire. Statistical analysis used Pearson and Spearman's correlation and Mann-Whitney test and t-test. Calculations were performed using IBM SPSS Statistics 20 Statistical significance was p ≤0.05.The dominant emotion that accompanied the parents was anxiety. Parents have used more strategies based on active coping, and seeking emotional support or instrumental. It has been shown there is a correlation between the level of intensity of negative emotions and social support, and also correlation between social support and ways of coping with stress.Parents expressed negative emotions but not of high severity which may be related to the choice of active coping strategies. Steps should be taken not only to assess the prevalence of negative emotions in a group of parents, but also to reduce the level of their intensity by exposing the importance of social support.

For many people diagnosed cancer and the treatment process is connected with emergen- ce and long-term existence of many negative emotions such as: depression, anxiety and stress. The aim of this study was to evaluate the intensity of negative emotional states of people diagnosed with cancer and the need for social support, as well as, exploration of the interdependence between these variables. Statistical analysis showed a significant correlation between the occurrence of disorders and border states, of both anxiety and depressive character and high level of stress in the test.

Cancerous disorders are the second most common cause of death among children. Blood cancer is a stressful and traumatic situation for the child, as well as the parents. To overcome the stress of child's illness parents adopt different coping styles. In overcoming these difficulties, the invaluable role is played by social support they receive from medical staff, family or institution.To assess the feeling of stress for parents of children diagnosed with blood cancer, to determine how they choose to deal with stress in a difficult situation.The study group consisted of 63 parents of children diagnosed with blood cancer. The study used the PSS-10 scale to assess the stress experienced by parents, 40 GP ISEL scale to assess social support, Inventory Ways to Measure Coping and the author's questionnaire.High perception of stress was observed among parents. It was found that the strategy based on active coping (taking action to improve the situation) got the highest scores among the strategies for coping with stress. The study showed that parents can most often count on material support.The feeling of stress severity among parents is high, particularly among women and people with higher education. The actions of medical team should take into account the needs of parents in raising and maintaining the resources to adapt to the difficult situation of child's disease.

We report a case of a 59 year-old man with hypertrophic cardiomyopathy who developed a pathological structure attached to the lead of cardioverter-defibrillator that has been detected by echocardiography. The authors describe a difficult differential diagnostic process aiming at the differentiation between cardiac device-related infective endocarditis and lead-associated thrombus. Imaging of the heart with a pathological structure using PET scan seems to be useful in these clinical circumstances.