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Michalina Krzyżak, Dominik Maślach, Martyna Skrodzka, Katarzyna Florczyk, Anna Szpak, Bartosz Pędziński, Paweł Sowa and Andrzej Szpak

Abstract

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.

Open access

Paweł Sowa, Bartosz Pędziński, Michalina Krzyżak, Dominik Maślach, Sylwia Wójcik and Andrzej Szpak

Abstract

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.

Open access

Magdalena Zalewska, Jacek Jamiołkowski, Agnieszka Genowska, Ewa Rodakowska, Andrzej Szpak and Elżbieta Maciorkowska

Abstract

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.

Open access

Dorota Huzarska, Joanna Huzarska, Leonard Pędziński, Paweł Sowa and Andrzej Szpak

Abstract

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.

Open access

Magdalena Zalewska, Agnieszka Genowska, Jacek Jamiołkowski, Rafał Nowak, Andrzej Szpak and Elżbieta Maciorkowska

Abstract

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.

Open access

Agnieszka Genowska, Jacek Jamiołkowski, Magdalena Zalewska, Ewa Rodakowska, Kamila Kurpiewska, Andrzej Szpak and Elżbieta Maciorkowska

Abstract

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.

Open access

Bartosz Pędziński, Paweł Sowa, Waldemar Pędziński, Michalina Krzyżak, Dominik Maślach and Andrzej Szpak

Abstract

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.

Open access

Jadwiga Żebracka-Gala, Janusz Waler, Jacek Gawrychowski, Kornelia Hasse-Lazar, Małgorzata Kowalska, Andrzej Niemiec, Sylwia Szpak-Ulczok, Beata Jurecka-Lubieniecka, Grzegorz Buła, Witold Truchanowski, Elżbieta Gubała and Barbara Jarząb

Jun Gene Expression is Decreased in Parathyroid Adenoma

The aim of the study was to analyze the gene expression of JUN and CCND1 in a group of parathyroid tissues obtained from patients with primary hyperparathyroidism in comparison to hyperplastic parathyroid and normal/atrophic parathyroid tissues by real-time quantitative PCR. Our goal was to validate the conclusion of Forsberg et al (2005) who reported overexpression of JUN in parathyroid adenomas by a joint microarray and QPCR study.

Material and methods. The analysis of JUN, CCND1 was carried out by QPCR in 14 parathyroid adenomas, 8 hyperplasia cases and 50 normal/atrophic parathyroid samples taken intraoperatively. Expression of the examined genes was normalized to the reference index (geometric mean of reference genes expression: EIF3S10, UBE2D2, ATP6V1E).

Results. We observed a decrease of JUN expression in parathyroid adenomas in comparison to both normal/atrophic and hyperplastic parathyroids. The fold change value was 0.71 in comparison of adenomas to normal/atrophic samples (p = 0.044) and 0.75 to hyperplastic glands (p = 0.003). For CCND1 we observed one case of parathyroid adenoma with a very clearly increased expression, while 3 adenomas (21.4% of all adenomas) exhibited the increase over the highest value seen in normal parathyroids (fold change = 3.52).

Conclusions. In parathyroid adenomas we were not able to confirm any overexpression of JUN gene, as suggested by the previous study. On the contrary, we observed a distinct inhibition of JUN RNA expression in comparison to non-neoplastic parathyroids. For CCND1 gene overexpression in parathyroid adenomas, we report the frequency of 21.4%.