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The development and widespread use of ICT in society are reflected by the way research is designed and conducted. The Computer Assisted Web Interview method is becoming more attractive and is a frequently used method in health sciences. The National Study of ICT Use in Primary Healthcare in Poland was conducted using this method. The aim of this paper is to present the major advantages and disadvantages of web surveys. Technical aspects of methodology and important stages of the aforementioned study, as well as key elements for its procedure, are mentioned. The authors also provide reflections based on their analysis of this national study, conducted between January and April 2014.

Physical activity, along with proper nutrition, is a very important element in child development. Lack of everyday, regular physical activity among young people is a public health problem. The aim of the study was to use cluster analysis to assess the relationship between nutrition and physical activity levels of primary school children. The study included 682 students from randomly selected elementary schools and was performed using a proprietary questionnaire during the 2013/2014 school year. The questionnaire contained questions about eating habits and physical activity, as well as the socio-economic conditions of families. Clusters of students of similar dietary habits were identified using cluster analysis and subsequently compared in terms of physical activity level. We identified four clusters, characterized by relative internal homogeneity and at the same time variability between one another in terms of number of meals throughout the day and time of their consumption. The most important characteristic of Cluster 1 was eating four meals a day including breakfast, which is the most important meal of the day. The diets of children in Cluster 2 abounded with raw vegetables and fruits. Students in Cluster 3 were characterized by a regular and varied diet. The least appropriate behaviour in the field of nutrition was observed among students belonging to Cluster 4. Cluster analysis in the studied population allowed relationships between dietary habits and physical activity to be described. By using the UIAF indicator (Moderate to Intense Physical Activity), a statistically significant association between the eating habits of the children and their physical activity levels was observed. A sufficient level of physical activity was observed in most students belonging to Cluster 3, and high levels of physical activity were observed in a small percentage of children belonging Cluster 4. An average level of physical activity was observed in a high percentage of children belonging to Cluster 4. Low levels of physical activity were most frequently observed in Clusters 4 and 1 and least frequently observed in Cluster 3. All of the identified active forms of free-time activity were most commonly acknowledged in Cluster 3. The study supports a beneficial relationship between students’ eating behaviours and physical activity.

Maintenance of proper health and prevention of diseases of civilization are now significant public health problems. Nutrition is an important factor in the development of youth, as well as the current and future state of health. The aim of the study was to show the benefits of the application of cluster analysis to assess the dietary habits of high school students. The survey was carried out on 1,631 eighteen-year-old students in seven randomly selected secondary schools in Bialystok using a self-prepared anonymous questionnaire. An evaluation of the time of day meals were eaten and the number of meals consumed was made for the surveyed students. The cluster analysis allowed distinguishing characteristic structures of dietary habits in the observed population. Four clusters were identified, which were characterized by relative internal homogeneity and substantial variation in terms of the number of meals during the day and the time of their consumption. The most important characteristics of cluster 1 were cumulated food ration in 2 or 3 meals and long intervals between meals. Cluster 2 was characterized by eating the recommended number of 4 or 5 meals a day. In the 3rd cluster, students ate 3 meals a day with large intervals between them, and in the 4th they had four meals a day while maintaining proper intervals between them. In all clusters dietary mistakes occurred, but most of them were related to clusters 1 and 3. Cluster analysis allowed for the identification of major flaws in nutrition, which may include irregular eating and skipping meals, and indicated possible connections between eating patterns and disturbances of body weight in the examined population.

The youngest population in society is recognized as that at the healthiest stage of life but is burdened by the occurrence of premature death that should be avoidable. There is a need to use adequate statistical methods in assessing the health status of the population of developmental age. The aim of the study was to analyze trends of mortality in children and adolescents by age and gender in the Podlaskie Voivodeship in the years 2003-2012 by joinpoint regression and to identify the causes of mortality. The mortality rate was analysed according to gender and the age groups: 0, 1-4, 5-9, 10-14 and 15-19 years in the Podlaskie Voivodeship. The data were obtained from the Central Statistical Office for the period 2003-2012. Differences in mortality levels between age and gender subgroups were obtained by the Wilcoxon signed-rank test. Join- point regression was used to analyze the trends in mortality. The nomenclature of ICD-10 was used to assess the causes of mortality of children and adolescents. In the Podlaskie Voivodeship in the years 2003-2012 in the 0-19-year-old age group, the highest proportion of deaths (42.4%) occurred during the first year of life. There were differences in mortality rates between boys (8.0/104) and girls (3.1/104) in the 15-19-year-old age group (p < 0.01), and also between the 1-14-year-old and 15-19-year-old age groups (p < 0.01), both among boys (2.1/104 vs. 8.0/104) and girls (1.5/104 vs. 3.1/104). Monotonous trends were shown regarding total mortality rates in infants. There was a drop in the mortality rate of infant girls (AAPC = 5.3%, p < 0.05) and boys (AAPC = 4.7%, p < 0.05). Changes in the direction of the total mortality rate trend were visible in the population of boys aged 1-14 years, in which, between 2003 and 2010, a significant reduction in mortality (AAPC = 9.5%) was observed, while in the years 2010-2012 the trend was not significant. No statistical evidence was found that mortality changed among girls in the 1-14-year-old and 15-19-year-old age groups. Deaths in infancy were due to perinatal conditions and congenital mal- formations. The main causes of mortality in the 1-19-year-old age group were external causes, mainly traffic accidents and intentional self-harm. Joinpoint regression indicated a uniform decrease of mortality in the years 2003-2012 except for boys from 1-14 years old, for whom the decreasing trend was for the years 2003-2010 with subsequent stabilization. The main problems are still infant deaths due to perinatal conditions, traffic accidents and intentional self-harm in boys in the 15-19-year-old age group.

Despite the great expansion and many benefits of information and communication technologies (ICT) in healthcare, the attitudes of Polish general practitioners (GPs) to e-health have not been explored. The aim of this study was to determine the GPs’ perception of ICT use in healthcare and to identify barriers to the adoption of EMR (Electronic Medical Records) in the Podlaskie Voivodeship. Online and telephone surveys were conducted between April and May 2013. Responses from 103 GP practices, 43% of all practices in the region, were analysed. The results showed that 67% of the respondents agreed that IT systems improve quality of healthcare services. In the GP group who declared at least partial EMR implementation, 71.4% see the positive impact of IT on practice staff processes and 66.1% on personal working processes. In this group, more than three-quarters of GPs did not see any positive impact of ICT on the average number of patients treated per day, number of patients within the practice or scope of services. The four most common barriers to EMR implementation were: lack of funds, risk of a malfunction in the system, resistance to change, and lack of training and proper information. Although the use of ICT by Polish GPs is limited, their attitude to e-health is generally positive or neutral and resembles the overall pattern in Europe. Barriers identified by GPs need to be taken into account to ensure the effective implementation of e-health across the country.

The purpose of the study was to analyse the level and the trends of Potential Years of Life Lost due to the main causes of death in Poland in the years 2002-2011. The material for the study was the information from the Central Statistical Office on the number of deaths due to the main causes of death in Poland in the years 2002-2011. The premature mortality analysis was conducted with the use of the PYLL (Potential Years of Life Lost) indicator. PYLL rate was calculated following the method proposed by J. Romeder, according to which premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the average annual percent change (APC - Annual Percent Change) were assessed using jointpoint models and the Joinpoint Regression Program. In the years 2002-2011, PYLL rate for all-cause deaths decreased by 7.0% among men and 8.1% among women. In 2011, the main reasons for PYLL among men were: external causes (27.6%), cardiovascular diseases (24.2%) and cancers (20.3%). Among women the leading causes were: cancers (41.1%), cardiovascular diseases (19.7%) and external causes (12.5%). PYLL rate increased among men for colorectal cancer, and among women for colorectal and lung cancer. The presented epidemiological situation for premature mortality in Poland shows that in the majority of cases it is caused by preventable deaths, which highlights a need to intensify measures in primary and secondary prevention.

Abstract Background Migration and ethical recruitment of health care workers is receiving increased attention worldwide. Europe’s aging population is creating new opportunities for medical doctors for finding employment in other countries, particularly those of a better standard of living. Methods We conducted a survey among 1214 medical students in five out of eleven universities in Poland with medical schools in October 2008. A series of statistical tests was applied to analyse the characteristics of potential migrants. Projections were obtained using statistical analyses: descriptive, multifactorial logistic regression and other statistical methods . Results We can forecast that 26–36% of Polish medical students will emigrate over the next few years; 62% of respondents estimated the likelihood of emigration at 50%. Students in their penultimate year of study declared a stronger desire to migrate than those in the final year. At the same time, many students were optimistic about career opportunities in Poland. Also noted among students were: the decline in interest in leaving among final year students, their moderate elaboration of departure plans, and their generally optimistic views about the opportunities for professional development in Poland. Conclusions The majority of Polish students see the emigration as a serious alternative to the continuation of their professional training. This trend can pose a serious threat to the Polish health care system, however the observed decline of the interest in leaving among final year students, the moderate involvement in concrete departure plans and the optimistic views about the opportunities for professional development in Poland suggest that the actual scale of brain drain of young Polish doctors due to emigration will be more limited than previously feared.

It is known that the perception of bitterness is mediated by type 2 bitter taste receptors (TAS2Rs). However, recent reports have suggested that the carbonic anhydrase 6 (CA6) gene may also influence bitterness sensing. Genetic variants in these genes could influence dietary intake of brassica vegetables, whose increased consumption has been observed in the literature, though inconsistently, to decrease breast cancer (BC) risk. We hypothesized that the estimated odds ratios (ORs) for the association between BC and taster diplotype (PAV/PAV) and/or genotype A/A, will be in the direction of increased BC risk, potentially due to reduced consumption of brassica vegetables. Using a case-control study of BC in Polish women in Poland (210 cases and 262 controls) and Polish immigrant women to USA (78 cases and 170 controls) we evaluated the association of the taster diplotypes in TAS2R38 gene and genotypes in the CA6 gene and BC risk in these two populations individually and jointly. No significant increase in risk was observed for the TAS2R38 PAV/PAV diplotype (tasters) in each population individually or in the joint population. For the CA6 gene, in the joint population, we observed an increased BC risk for the combined G/A and G/G genotypes (non-tasters) vs A/A (tasters), OR = 1.41 (95% CI 1.04–1.90, p = 0.026) which after adjustment for False Discovery Rate (FDR), was not significant at p≤0.05 level. However, for the joint population and for the combined genotype of the two genes AVI/AVI+G* (non-tasters) vs. PAV/*+A/A (tasters), we observed a significant increase in BC risk, OR = 1.77 (95%CI 1.47–2.74, p = 0.01), for the non-tasters, which remained significant after FDR adjustment. In conclusion for the joint population and the joint effect for the two bitter sensing genes, we observed an increase in BC risk for the bitterness non-tasters, association which is in the opposite direction to our original hypothesis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to estimate indirect costs associated with losses in productivity due to sickness absence among registered workers in Poland.Material and Methods: Data on sick leave durations in 2013 was obtained from the Social Insurance Institution (SII) (Zakład Ubezpieczeń Społecznych - ZUS). Based on the number of assumptions, this data was used for calculating absence durations. The costs of lost productivity were estimated on the basis of the measure of gross value added.Results: Estimated losses in productivity due to absenteeism in 2013 together accounted for 4.33% of gross domestic product (GDP) (17.09 billion euro). In the female population, the total value of losses amounted to 9.66 billion euro, but excluding the costs of pregnancy, childbirth, and puerperium (2.96 billion euro), it was 6.7 billion euro. In the male population, the loss amounted to 7.43 billion euro. The highest overall costs of sickness absence based on age were found in the age group of 30-39 years (5.14 billion euro, including pregnancy, childbirth, and puerperium - 1.474 billion euro; respiratory diseases - 0.632 billion euro, injuries and poisonings - 0.62 billion euro). In the group of people aged > 40 years, the highest cost was generated by bone-muscular diseases (1.553 billion euro) and injuries and poisoning (1.251 billion euro). Higher losses in the productivity of women in addition to pregnancy, childbirth, and puerperium were due to mental and behavioral disorders (0.71 billion euro), diseases of the genitourinary system (0.38 billion euro), and neoplasms (0.35 billion euro). At the same time, in men, compared to women, we observed higher losses due to injuries and poisoning (1.65 billion euro), and diseases of musculoskeletal (1.26 billion euro), nervous (0.79 billion euro), circulatory (0.65 billion euro), and digestive (0.41 billion euro) systems.Conclusions: Improvement and further development of effective strategies for prevention of complications of pregnancy and chronic diseases in the workplace are necessary. Policies aimed at reduction of sickness absence could potentially increase prosperity and the socioeconomic situation in Poland. Int J Occup Med Environ Health 2017;30(6):917-932. [ABSTRACT FROM AUTHOR]

Introduction. Transplantation surgery, involving transplantation of cells, tissues and organs, constitutes a common medical practice that saves the lives of a great number of patients. Aim. The purpose of the present paper is to provide a comparative analysis of the legal regulations regarding transplantation that are in practice inside three European countries: Poland and Germany - EU Member States - and Switzerland - a non-EU state. The considerations made herein are meant to find an answer to the question whether the provisions of law regarding transplantation in the specified European countries regulate the legal situation of the donor and the recipient in a similar manner. Material and methods. The paper is based on the following source documents: The Cell, Tissue and Organ Recovery, Storage and Transplantation Act of July 1, 2005; The Act on Donation, Recovery and Transplantation of Organs and Tissues of November 5, 1997 (Transplantation Act - TPG); Federal Act on Transplantation of Organs, Tissues and Cells of October 8, 2004. In our work, we applied two methods, the first being comparative, and the second being dogmatic-legal. The latter consists of analyzing the provisions regarding transplantation as found within the three selected European countries. Results and Discussion. Under Polish, German and Swiss law alike, the recovery of cells, tissues and organs is allowed from an adult, who, under the Polish and German Acts, has full capacity to enter into legal transactions, and who, under the Swiss Act - is an adult who is mentally competent. Of note is that a minor might only be a donor in ex vivo transplantation provided that precisely specified requirements are met. Of additional note is that, under the German and Swiss Acts, recovery of tissues and organs from a human cadaver donor is allowed only if this person gave consent for such recovery prior to their death; under the Polish Act, this is allowed unless the deceased person expressed their objection when alive. Conclusion. As far as ex vivo transplantation is concerned, the legal solutions regarding transplantation in Poland, Germany and Switzerland regulate the legal situation of the donor and the recipient of a transplant in a similar way, although there are a few significant differences. As for ex mortuo transplantations - the legal solutions applied in each country greatly differ. [ABSTRACT FROM AUTHOR]

Copyright of Current Problems of Psychiatry is the property of Medical University of Lublin and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Polish Journal of Public Health is the property of Medical University of Lublin and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of the study was to evaluate differences in breast cancer 5-year relative survival rates between the urban and rural female population in Podlaskie Voivodship in 2001-2002, before the introduction of the Population Screening Programme in 2006. The analysis was based on 659 breast cancer cases diagnosed in 200 1-2002 and registered in CR in Białystok (Voivodship Cancer Registry). Relative survival and relative excess of risk of death after 5 years of diagnosis as function of age and stage among urban and rural women population were calculated. The results showed that survival rates in Podlaskie Voivodship were low (69.4%) in comparison to the European average (79.4%), and they differed between urban and rural areas. Patients living in rural areas had a much lower survival rate than those living in urban areas at local and regional stage of disease, whereas survivals were higher at the metastatic stage. In all age groups considered in the study, the survivals in rural areas were lower than in urban areas. The multivariate analysis confirmed that both the cancer stage and place of residence are independent prognostic factors. Relationship with age was not confirmed. The research results indicate low curability of breast cancer in Podlaskie Voivodship, and significant differences between urban and rural areas. These results need to be considered in the planning and monitoring of further intervention in order to increase the effectiveness of prevention and treatment standards for more disadvantaged rural areas, It is particularly significant when implementing the National Cancer Control Programme. [ABSTRACT FROM AUTHOR]

Extended spectrum β-lactamases production is one of the most common mechanism of resistance to extended spectrum β-lactam antibiotics is increasing worldwide. Twenty five strains of Klebsiella pneumoniae isolated from clinical specimens were tested. Based on the phenotypic confirmatory test all these strains were defined as ESBL producers named ESBL(+). The plasmid DNA from each strains was used to investigate the presence of blaSHV genes responsible for extended spectrum β-lactamases production. Moreover, susceptibility of these strains to antibiotic other than β-lactams in was tested. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate differences in breast cancer incidence and stage of disease between the urban and rural female population in Podlaskie Voivodship in 2001-2002, before the introduction of the Population Screening Programme in 2006. Analysis was based on 696 breast cancer eases diagnosed in years 200l-2002 and registered in the CR in Białystok (Voivodship Cancer Registry). An average annual number of incidence, as well as crude and standardised incidence rates, were calculated. Age-specific incidence rates for 5-year age groups were also calculated and grouped as follows: <50, 50-69, ≤70 years old. Incidence differences related to place of residence: urban or rural, were presented with the use of u/r (urban/rural) ratio. In order to evaluate the stage of disease, a simplified classification recommended by ENCR (European Network of Cancer Registries) for population registries (localised, regional, metastatic) was applied. The breast cancer incidence rate in the urban population was higher than in rural areas with u/r ratio amounting to 1.4. The highest incidence and largely marked differences between urban and rural areas were among women aged 50-69 years with the u/r ratio amounting to 1.8. Overall, the proportion of stage localised in Podlaskie Voivodship was 33.1% and differed between urban and rural areas. The proportion of localised cancer was higher in urban areas, but patients were younger when compared to those living in rural areas. Knowledge of differences in incidence and breast cancer stage in urban and rural women investigated in this research, together with other epidemiological indicators, should be used for monitoring the Population Screening Programmes in these populations. [ABSTRACT FROM AUTHOR]

The measurements of radioactive caesium contents in bottom sediments were carried out in four lakes. First samples (47) were taken in 1992-95. The repeat sampling (109) was performed from the same places in 2005. We examined eight chosen areas in these lakes. In six of them, we observed statistically significant differences in the level of radioactive caesium. It indicates the permanent decrease in the level of 137Cs. The mean annual decrease in the level of radioactive caesium, taking into consideration the radioactive decay, was from 4.2 to 7.8%. In two areas of the profundal zone, we did not observe statistically significant differences in the level of radioactive caesium (lakes Garbas and Rogale Wielkie). Taking into consideration the radioactive decay of caesium, it means about the appearance of the process of accumulation of 137Cs in these areas. [ABSTRACT FROM AUTHOR]

Idiopathic anaphylaxis is a severe, life-threatening systemic or generalized immediate hypersensitivity reaction with symptoms similar to resembling other forms of anaphylaxis. It concers approximately 30-60% of cases in adults and 20% of cases in children. In the pathogenesis of idiopathic anaphylaxis, alpha-gal syndrome, mastocytosis, diseases associated with mast cell activation, and hidden allergens and cofactors - physical exertion, alcohol, drugs can play a significant role. The clinical manifestations of idiopathic anaphylaxis and therapeutic management are identical to those of anaphylaxis with a known causative agent. The paper discusses epidemiology of anaphylaxis, pathomechanism, diagnostics and therapeutic management according to international guidelines. [ABSTRACT FROM AUTHOR]

Introduction. Among individuals allergic to Hymenoptera venom, the severity of post sting anaphylactic response may be associated with a number of risk factors. A relationship between serum basal tryptase level and anaphylactic reaction was shown recently in adults with venom allergy. Aim. The aim of this study was to answer the question whether elevated serum tryptase concentration is the risk factor of severe post sting anaphylactic reaction. Materials and methods. The study involved the medical records of patients with a history of severe post sting systemic reaction (IV degree of H.L. Mueller scale), which were compared with the records for a group of individuals with mild post sting reaction (II degree of H.L. Mueller scale). The basal serum tryptase levels were determined and compared. All laboratory testing was carried out at least 8-18 weeks since the last stinging. Results. Elevated level of basal serum tryptase was observed among patients who suffered severe systemic reactions of IV degree (according to H.L. Mueller scale) in comparison to those recorded in the group of patients with mild (II degree) systemic reaction (11.274 ng/ml vs. 3.569 ng/ml, p<0.05). Conclusion. Elevated level of basal serum tryptase is a significant risk factor for the development of severe post sting reaction. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyze the level and trends of perinatal mortality by mother's place of residence (urban vs rural area) in Poland in 2002-2012., Material and Method: This study was based on the data of the Central Statistical Office on the number of live births, infant deaths (0-6 days) and stillbirths by mother's place of residence (urban vs rural area), reported in 2002-2012 in 16 provinces and Poland in general. Joinpoint model was used to analyze perinatal mortality rate trends over time and average annual percent change (APC). Urban/rural ratio was employed to demonstrate the differences in perinatal mortality between urban and rural areas., Results: In the period analyzed, perinatal mortality in Poland decreased by 3.4% (p<0.05) and 2.7% (p<0.05) per year in urban and rural areas, respectively. Having considered urban areas, perinatal mortality rate was decreasing at the fastest pace in the following provinces: Pomorskie (APC) = -6.6%, p<0.05), Warmińsko-Mazurskie (APC) = -5.4%, p<0.05), Lubuskie i Świętokrzyskie (APC = -4.5%, p<0.05) while for rural areas - Dolnośląskie (APC = -4.3%, p<0.05), Wielkopolskie, Zachodniopomorskie (APC = -3.7%, p<0.05) and Śląskie (APC = -3.2%, p<0.05)., Conclusions: In the study period, a decrease in perinatal mortality was reported in Poland, both in urban and rural areas. The level of perinatal mortality rate as well as the pace of these changes differed between provinces.

Introduction: Treatment delay is a major problem of contemporary oncology. Knowing the time interval between diagnosis and initiation of treatment, together with monitoring this adverse prognostic factor, is an important element of the treatment planning process in the population and can contribute to the improvement of patients' curability., Objective: To assess the waiting time for first treatment of women diagnosed with breast cancer in 2001-2002 in Podlaskie Voivodeship., Materials and Methods: During 2001-2002, there were 709 cases of women with breast cancer who reported to the Voivodeship Cancer Registry in Bialystok. 659 women were diagnosed with a primary invasive breast tumour. A cohort of 499 women who were treated with a curative intent was selected from this group. The waiting time in the created cohort was calculated as the number of days between the date of the breast cancer diagnosis and date of the first treatment., Results: The average time between the date of diagnosis and date of the first treatment was 38 days. The median was 14 days. 28.6% of patients from the selected cohort waited longer than 28 days. The treatment of rural women was initiated faster than the treatment of urban patients.

Introduction: School health education programmes are among the instruments for the prevention of tobacco smoking among children and adolescents. Knowledge obtained in evaluation studies of these programmes indicates the degree of their effectiveness and serves to improve their quality., Objective: Recognition and evaluation of the effect of two-year anti-tobacco programme of health education on the changes in the level of knowledge, attitudes and behaviours of adolescents., Materials and Method: An intervention study was originated in May 2007, and covered 859 first-year schoolchildren from eight public junior high schools in Białystok in Poland, from among 3,318 schoolchildren attending 33 schools. The sample was selected by means of two-stage stratified sampling with consideration of two groups: an intervention group covered with educational actions (417 schoolchildren), and a control group (442 schoolchildren), where anti-tobacco education was not carried out. Before the educational programme and after its completion an evaluation of knowledge, attitudes and behaviours of junior high school adolescents was performed with respect to nicotinism, based on a survey. The educational part consisted in conducting within 2 years, 4 educational classes and 2 competitions concerning tobacco-related problems., Results: After two years, in the group of adolescents covered by the educational programme a significant increase was observed - by 11.6% - in the percentage of schoolchildren who were familiar with the negative effects of tobacco smoking, and an increase by 4.4% of those who were convinced that smoking is harmful. With respect to adolescents' attitudes, the effect of the programme was noted in only one of six components analyzed. After completion of the two-year educational programme, both in the group covered by this programme and the control group, the percentage of smokers significantly increased (by 12.8% and 12.7%, respectively)., Conclusions: It is necessary to evaluate the health education programme from the aspect of both the actual hard effects of the anti-nicotine programme (changes in behaviour), and indirect effects - soft (knowledge, skills) which are a basis for the potential verification of the programme in order to increase its effectiveness.

Introduction: Health education used for increasing the effectiveness of intervention actions should cover a number of factors which exert an effect on learning., Objective: Recognition of the extent to which gender may determine the effects of an anti-tobacco health education programme., Material and Methods: The intervention study was undertaken in May 2007, and covered 859 first-year schoolchildren in Białystok. The sample was selected by means of two-stage stratified sampling with consideration of two groups: an intervention group and a control group., Results: In the group of girls, the 2-year educational programme resulted in an increase in knowledge concerning the negative effects of cigarette smoking by 21%, and being familiar with anti-tobacco actions and campaigns carried out in Poland by 24.5%. Among boys, an increase was observed only with respect to the knowledge of anti-tobacco actions and campaigns - by 10.7%. Considering the attitudes of girls after the completion of the programme, changes were noted with respect to three from among the six elements analyzed. However, among boys, after completion of the project, no changes were noted in any of the analyzed elements of attitude. In girls who participated in the anti-nicotine programme, the percentage of smokers did not increase, while an increase in this percentage was observed among girls of the control group and boys in both groups., Conclusions: Different effects of the 2-year anti-tobacco programme obtained in the area of knowledge, attitude and behaviour should constitute a premise for the modification of educational programmes from the aspect of the variety of methods, techniques and instruments which would be adequate for adolescents' predispositions resulting also from their gender.

Introduction: The results of breast cancer treatment depend mainly on better detection in mammography screening and, consequently, a higher proportion of women with early stage of the disease. They depend also on a better access to health care services and the effectiveness of oncological treatment. One of the methods of breast cancer control is a breast-conserving surgery. With a proper patients' classification for the treatment, the results of the breast-conserving surgery do not differ in relation to mastectomy. That's why, the availability of breast-conserving surgical methods is particularly important, especially in a population in which a population screening is conducted., Objective: The analysis of the selected aspects of the breast cancer treatment's standard in Podlaskie Voivodeship., Patients and Methods: In years 2001-2002, 709 cases of women with breast cancer were reported to the Voivodeship Cancer Registry in Bialystok. 659 women were diagnosed with a primary invasive breast cancer. Based on a cohort of 499 women treated with radical methods the following indicators, recommended by WHO for the evaluation of the breast-conserving surgery's availability, were calculated: a percentage of patients with whom breast-conserving surgery was used, a proportion of breast cancer cases receiving post-operative breast radiotherapy after breast-conserving surgery and a proportion of breast-conserving surgery in pT1 cases., Results: The breast-conserving surgery has been used much less frequently in Podlaskie Voivodeship than in Western Europe, but more frequently than in Poland in general., Conclusion: It should be aimed to provide a surgical treatment with the use of breast-conserving surgical methods to the highest possible percentage of patients. The increase of the percentage of patients treated with breast-conserving surgery methods can be a result of an effective screening realisation.