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14 pages, 3255 KiB

Open AccessArticle

Blood Culture Contamination: A Single General Hospital Experience of 2-Year Retrospective Study

by Anna Tenderenda, Monika Łysakowska, Robert Dargiewicz and Anna Gawron-Skarbek

Int. J. Environ. Res. Public Health 2022, 19(5), 3009; https://doi.org/10.3390/ijerph19053009 - 4 Mar 2022

Cited by 11 | Viewed by 4325

Abstract

In the event of blood culture contamination (BCC), blood culture (BC) needs to be repeated. This may delay appropriate treatment, prolong hospitalization and, consequently, increase its costs. The aim of the study was to assess the frequency of BCC and associated factors in [...] Read more.

In the event of blood culture contamination (BCC), blood culture (BC) needs to be repeated. This may delay appropriate treatment, prolong hospitalization and, consequently, increase its costs. The aim of the study was to assess the frequency of BCC and associated factors in a general hospital in Poland based on reports of BC in samples submitted for laboratory testing in 2019–2020. BCC is recognized when bacteria (especially those belonging to natural human microbiota) are isolated from a single sample and no clinical signs indicated infection. True positive BC is confirmed by the growth of bacteria in more than one set of blood samples with the corresponding clinical signs present. The structure of BC sets, microorganisms, and laboratory costs of BCC were analyzed. Out of 2274 total BC cases, 11.5% were true positive BC and 9.5% were BCC. Of all the BCC identified in the entire hospital, 72% was from Internal Medicine (IM) and Intensive Care Unit (ICU) combined. When single sets for BC were used in IM in 2020, the use increased to 85% compared with 2019 (p < 0.05). The predominant isolates were coagulase-negative staphylococci (84%). The estimated extra laboratory costs of BCC exceeded EUR 268,000. The BCC was a more serious problem than expected, including non-recommended using of single BC sets. Compliance with the BC collection procedure should be increased in order to reduce BCC and thus extra hospital costs. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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25 pages, 3927 KiB

Open AccessArticle

Macroeconomic and Social Indicators to Launch the PM-Based VBHC Model in the Healthcare System in Poland

by Ewelina Nojszewska and Agata Sielska

Int. J. Environ. Res. Public Health 2022, 19(3), 1712; https://doi.org/10.3390/ijerph19031712 - 2 Feb 2022

Cited by 1 | Viewed by 2249

Abstract

Global health systems face shortages of resources and, above all, money, with a simultaneous increase in health spending, as well as doubts about their effectiveness. In addition, there is a growing sense of greater achievement of the essential goal of clinical effectiveness. In [...] Read more.

Global health systems face shortages of resources and, above all, money, with a simultaneous increase in health spending, as well as doubts about their effectiveness. In addition, there is a growing sense of greater achievement of the essential goal of clinical effectiveness. In the face of these problems, many centres are working on a new system of financing healthcare providers, primarily hospitals, which provide the most expensive medical services. In the opinion of the authors, an essential element for the implementation of VBHC is a comprehensive knowledge of hospitals, health care, the economy, public finances and the behaviour of members of society, based on KPIs. The work on these is not well advanced, and it seems that without the knowledge of economic and social determinants, it will not be possible to implement an affective VBHC model. Therefore, in the present article, after presenting the current state of research regarding the VBHC, personalised medicine as a prerequisite for achieving clinical effectiveness, and KPIs as a prerequisite for achieving economic efficiency, the authors focus on economic and sociological KPIs. The knowledge gained from this study is necessary to make effective decisions for the appropriate operation of healthcare as a system, and of hospitals in particular. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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19 pages, 3765 KiB

Open AccessArticle

Recommendations for the Development of Telemedicine in Poland Based on the Analysis of Barriers and Selected Telemedicine Solutions

by Kamila Furlepa, Anna Tenderenda, Remigiusz Kozłowski, Michał Marczak, Waldemar Wierzba and Andrzej Śliwczyński

Int. J. Environ. Res. Public Health 2022, 19(3), 1221; https://doi.org/10.3390/ijerph19031221 - 22 Jan 2022

Cited by 25 | Viewed by 6727

Abstract

Technological development around the world has led to the digitalisation of the health system. Along with the digitalisation of the health sector, financial, legal, awareness-related, technological and IT barriers appeared. The aim of the article is to present recommendations for the development of [...] Read more.

Technological development around the world has led to the digitalisation of the health system. Along with the digitalisation of the health sector, financial, legal, awareness-related, technological and IT barriers appeared. The aim of the article is to present recommendations for the development of telemedicine services in Poland on the basis of a list of implementation barriers and ways of resolving them in the USA and selected European countries. A literature review was conducted in accordance with the PRISMA-ScR, using the PubMed and Google Scholar databases, Scopus and the OECD iLibrary. A total of 59 literature positions were used, which constituted the references. The article presented the implemented and effective solutions in selected countries. Based on these solutions, recommendations for the development of telemedicine in Poland were presented, as well as successes in the form of telemedicine startups, which can inspire other countries. The analysis of the publications discussed in the article shows that the implementation of telemedicine services should begin with the elimination of barriers limiting the development of telemedicine systems. An important issue in their elimination is to analyse their interconnections and implement such solutions which would have a multi-area coverage. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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14 pages, 507 KiB

Open AccessArticle

Can We Identify Patients in Danger of Complications in Retrograde Intrarenal Surgery?—A Retrospective Risk Factors Analysis

by Jakub Marek Ratajczak, Taras Hladun, Bartosz Krenz, Krzysztof Bromber, Maciej Salagierski and Michał Marczak

Int. J. Environ. Res. Public Health 2022, 19(3), 1114; https://doi.org/10.3390/ijerph19031114 - 20 Jan 2022

Cited by 6 | Viewed by 3112

Abstract

Retrograde intrarenal surgery (RIRS) is an innovative and effective method of kidney stones treatment, as it had great influence on the development of endoscopy in urology. The increasing prevalence of urolithiasis together with the rapid development of endourology leads to a rise in [...] Read more.

Retrograde intrarenal surgery (RIRS) is an innovative and effective method of kidney stones treatment, as it had great influence on the development of endoscopy in urology. The increasing prevalence of urolithiasis together with the rapid development of endourology leads to a rise in the number of procedures related to the disease. Flexible ureteroscopy is constantly being improved, especially regarding the effectiveness and safety of the procedure. The purpose of this study is to evaluate intraoperative and early post-operative complications of RIRS in the treatment of kidney stones. A retrospective analysis of medical records was performed. A series was comprised of 207 consecutive operations performed from 2017 to 2020. Complications occurred in 19.3% (n = 40) of patients. Occurrence according to the Clavien-Dindo scale was: 11.1% for grade I, 5.8% for grade II and 2.4% for grade IV. Infectious complications included SIRS (5.3%, n = 11) and sepsis (2.4%, n = 5). Statistical analysis revealed a correlation between acute post-operative infections and positive midstream urine culture, history of chronic or recurrent urinary tract infections, and increased body mass index (BMI). Furthermore, a significant correlation was observed between pain requiring the use of opioids with BMI over 25. Consequently, history of urinary tract infections, positive pre-operative urine culture, and increased BMI are considered risk factors and require appropriate management. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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15 pages, 690 KiB

Open AccessArticle

Cost-Effectiveness Analysis of Improving Nurses’ Education Level in the Context of In-Hospital Mortality

by Beata Wieczorek-Wójcik, Aleksandra Gaworska-Krzemińska, Piotr Szynkiewicz, Michał Wójcik, Monika Orzechowska and Dorota Kilańska

Int. J. Environ. Res. Public Health 2022, 19(2), 996; https://doi.org/10.3390/ijerph19020996 - 17 Jan 2022

Cited by 7 | Viewed by 3996

Abstract

(1) Background: an assessment of the cost-effectiveness of employing an increased number of nurses with higher education from the perspective of the service provider. (2) Methods: Based on a year-long study results and data collected from a large hospital, we conducted of the [...] Read more.

(1) Background: an assessment of the cost-effectiveness of employing an increased number of nurses with higher education from the perspective of the service provider. (2) Methods: Based on a year-long study results and data collected from a large hospital, we conducted of the costs of preventing one death. The study involved intervention by 10% increase in the percentage of nursing care hours provided by nurses with higher education. The measure of health effects was the cost of avoiding one death (CER). The cost-effectiveness analysis (CEA) was used as the evaluation method. (3) Results: The cost of employing a larger percentage of nurses with higher education amounts to a total of amounts to a USD 11,730.62 an increase of 3.02% as compared to the base costs. The estimated number of deaths that could be prevented was 44 deaths. Mortality per 1000 patient days was 9.42, mortality after intervention was 8.41. The cost of preventing one death by the 10% increase in BSN/MSN NCH percentage in non-surgical wards USD 263.92. (4) Conclusions: increasing the percentage of care hours provided by nurses with tertiary education is a cost-effective method of reducing in-hospital mortality. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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23 pages, 3441 KiB

Open AccessArticle

Implementation of Lean Management in a Multi-Specialist Hospital in Poland and the Analysis of Waste

by Agnieszka Zdęba-Mozoła, Anna Rybarczyk-Szwajkowska, Tomasz Czapla, Michał Marczak and Remigiusz Kozłowski

Int. J. Environ. Res. Public Health 2022, 19(2), 800; https://doi.org/10.3390/ijerph19020800 - 12 Jan 2022

Cited by 17 | Viewed by 4988

Abstract

At the beginning of the 21st century, Lean Management (LM) tools were introduced into the healthcare sector around the world. In Poland, there are still few LM implementations, and they are not of a comprehensive nature. The aim of this article is to [...] Read more.

At the beginning of the 21st century, Lean Management (LM) tools were introduced into the healthcare sector around the world. In Poland, there are still few LM implementations, and they are not of a comprehensive nature. The aim of this article is to present the application of the LM concept in a hospital in Poland as a tool for the identification and analysis of waste and its impact on the process of organizing the provision of medical services on the example of improvements in the process of patient admission. In the period from 1 July 2019 to 31 December 2019, a project of LM implementation was carried out at the Provincial Specialist Hospital in Wroclaw. The project was based on the method of value-stream mapping and 5Why. Standardized interviews (before and after the project) were conducted with people from the hospital management and middle-level managers. The implementation of LM tools resulted in the identification of a number of wastes, which have been divided into groups. The most important waste was paper medical documentation. Its change to an electronic form allowed for a better use of human capital resources; savings included 2.3 nursing positions and 1.09 medical staff positions. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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17 pages, 1112 KiB

Open AccessArticle

Application of a Novel PM Model to Assess the Risk of Clostridioides difficile Infections in Medical Facilities as a Tool for Improving the Quality of Health Services and the Safety of Patients

by Zofia Maria Kiersnowska, Ewelina Lemiech-Mirowska, Aleksandra Sierocka, Michał Zawadzki, Michał Michałkiewicz and Michał Marczak

Int. J. Environ. Res. Public Health 2022, 19(1), 441; https://doi.org/10.3390/ijerph19010441 - 31 Dec 2021

Cited by 2 | Viewed by 1920

Abstract

Infections with multi-drug resistant microorganisms associated with the provision of health services have become an acute problem worldwide. These infections cause increased morbidity as well as mortality and are a financial burden for the healthcare system. Effective risk management can reduce the spread [...] Read more.

Infections with multi-drug resistant microorganisms associated with the provision of health services have become an acute problem worldwide. These infections cause increased morbidity as well as mortality and are a financial burden for the healthcare system. Effective risk management can reduce the spread of infections and thus minimize their number in hospitalized patients. We have developed a new approach to the analysis of hazards and of exposure to the risk of adverse events by linking the patient’s health record system to the entire infrastructure of the hospital unit. In this study, using the developed model, we focused on infections caused by the Clostridioides difficile bacterium, as they constitute a significant number of nosocomial infections in Poland and worldwide. The study was conducted in a medical facility located in the central part of Poland which provides tertiary care. In the proposed PM model, a risk analysis of hospital acquired infections at the Intensive Care and Anesthesiology Unit combined with the hospital’s technical facilities and organizational factors was conducted. The obtained results indicate the most critical events which may have an impact on potential hazards or risks which may result from the patient’s stay at the specific ward. Our method can be combined with an anti-problem approach, which minimizes the critical level of infection in order to determine the optimal functioning of the entire hospital unit. Research has shown that in most situations the spread dynamics of nosocomial infections can be controlled and their elimination may be attempted. In order to meet these conditions, the persons responsible for the daily operation of the medical facility and its individual wards have to indicate potential events and factors which present a risk to the hospitalized patients. On the basis of a created spreadsheet directions for improvement may be finally established for all potential events, their frequency may be minimized, and information may be obtained on actions which should be undertaken in a crisis situation caused by the occurrence of a given phenomenon. We believe that the proposed method is effective in terms of risk reduction, which is important for preventing the transmission of multi-drug resistant microorganisms in the hospital environment. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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16 pages, 1781 KiB

Open AccessArticle

The Importance of Direct Patient Reporting of Adverse Drug Reactions in the Safety Monitoring Process

by Kamila Sienkiewicz, Monika Burzyńska, Izabela Rydlewska-Liszkowska, Jacek Sienkiewicz and Ewelina Gaszyńska

Int. J. Environ. Res. Public Health 2022, 19(1), 413; https://doi.org/10.3390/ijerph19010413 - 31 Dec 2021

Cited by 20 | Viewed by 6634

Abstract

All medicinal products authorized in the European Union are subjects of constant drug-safety monitoring processes. It is organized in a pharmacovigilance system that is designed to protect human health and life by the detection, analysis and prevention of adverse drug reactions (ADRs) and [...] Read more.

All medicinal products authorized in the European Union are subjects of constant drug-safety monitoring processes. It is organized in a pharmacovigilance system that is designed to protect human health and life by the detection, analysis and prevention of adverse drug reactions (ADRs) and other drug-related problems. The main role of the aforementioned system is to collect and analyze adverse drug reaction reports. Legislation introduced several years ago allowed patients, their legal representatives and caregivers to report adverse drug reactions, which caused them to be an additional source of safety data. This paper presents the analysis of EudraVigilance data related to adverse drug reactions provided by patients, their representatives, as well as those obtained from healthcare professionals related to medicines which belong to M01A anti-inflammatory and antirheumatic products, a non-steroid group. The objective of the study was to identify the changes in the number and structure of adverse reaction reporting after the introduction of pharmacovigilance (PV) obligations in EU. A review of scientific literature was also conducted to assess the differences in adverse reactions reported by patients or their representatives and by healthcare professionals. We also identified other factors which, according to literature review, influenced the number of adverse reaction reports provided by patients. Analysis of data collected from the EudraVigilance showed that from 2011 to 2013 the number of reports made by patients and their caregivers increased by approx. 24 percentage points, and then, from 2014, it constituted around 30% of the total of reported reactions every year, so patient reporting is an important part of pharmacovigilance system and a source of drugs’ safety information throughout their use in healthcare practice. Additionally, there was no interrelationship between the seriousness of reported adverse reactions and the overall number of patient reports when compared to reports form healthcare professionals. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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22 pages, 3328 KiB

Open AccessArticle

Increased Accessibility to Primary Healthcare Due to Nurse Prescribing of Medicines

by Dorota Kilańska, Anna Lipert, Marika Guzek, Per Engelseth, Michał Marczak, Kamila Sienkiewicz and Remigiusz Kozłowski

Int. J. Environ. Res. Public Health 2022, 19(1), 292; https://doi.org/10.3390/ijerph19010292 - 28 Dec 2021

Cited by 8 | Viewed by 3362

Abstract

Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe medicines. Consequently, Polish patients received the same opportunity as in other countries worldwide: easier access to certain health services, i.e., medical prescribing. The aim of this [...] Read more.

Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe medicines. Consequently, Polish patients received the same opportunity as in other countries worldwide: easier access to certain health services, i.e., medical prescribing. The aim of this study was to assess the impact of structural changes which increased the nurses’ competences on the accessibility to prescription visits for patients receiving primary healthcare on the example of Medical and Diagnostic Centre (MDC), and to discuss the general trend of legal changes in nursing profession regulations. We performed a detailed analysis of the data on the MDC patient population in Siedlce who received at least one prescription written by a general practitioner and/or a nurse/midwife in the years 2017–2019.The largest number of prescription visits made by nurses concerned patients aged 50–70 years, as this age range includes the largest number of patients with chronic diseases who need continued pharmacological treatment originally administered by doctors. An increasing tendency for prescription visits made by nurses was recorded, with a simultaneous downward trend in the same type of visits undertaken by doctors at MDC. Nurses’ involvement in prescribing medications as a continued pharmacotherapy during holiday seasons results in patients having continuous access to medication. An upward trend was also observed in the number of medications prescribed by nurses per patient. Structural changes in the legal regulations of the nursing profession improve patients’ access to prescription visits under primary healthcare. Further research is recommended to evaluate the dynamics of these trends and the impact of newly introduced nursing competences on the accessibility of prescription visits for patients. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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25 pages, 1189 KiB

Open AccessArticle

Managerial Responses to the Onset of the COVID-19 Pandemic in Healthcare Organizations Project Management

by Ariadna Linda Bednarz, Marta Borkowska-Bierć and Marek Matejun

Int. J. Environ. Res. Public Health 2021, 18(22), 12082; https://doi.org/10.3390/ijerph182212082 - 17 Nov 2021

Cited by 6 | Viewed by 5045

Abstract

The goal of this study was to identify and assess the impact of the COVID-19 pandemic on project management practices in healthcare organizations, taking into account, in particular, risk analysis, project performance, organization of the work of project teams, and tendencies in future [...] Read more.

The goal of this study was to identify and assess the impact of the COVID-19 pandemic on project management practices in healthcare organizations, taking into account, in particular, risk analysis, project performance, organization of the work of project teams, and tendencies in future developments in project management. In order to achieve this goal, a study was conducted on 20 project managers in selected healthcare organizations in Poland. The results indicate that a systematically conducted risk analysis as part of the implemented projects enabled rapid and effective reactions during the COVID-19 pandemic. The pandemic has also significantly altered the organization of the work of project teams and, in the opinion of the research subjects, this will significantly impact future solutions for project management in healthcare organizations. The obtained results form a basis for the increase in professionalization in project management in healthcare organizations. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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26 pages, 65468 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on the Composition of Dietary Supplements and Functional Foods Notified in Poland

by Kacper Wróbel, Anna Justyna Milewska, Michał Marczak and Remigiusz Kozłowski

Int. J. Environ. Res. Public Health 2021, 18(22), 11751; https://doi.org/10.3390/ijerph182211751 - 9 Nov 2021

Cited by 10 | Viewed by 3237

Abstract

The COVID-19 pandemic has exerted a strong impact on numerous areas of everyday life. The aim of this study was to check how the pandemic influenced the composition of dietary supplements and other functional food products placed on the market till March 2021, [...] Read more.

The COVID-19 pandemic has exerted a strong impact on numerous areas of everyday life. The aim of this study was to check how the pandemic influenced the composition of dietary supplements and other functional food products placed on the market till March 2021, compared to 2019. For this purpose, data concerning the registered products and reports of popularity of online searches of terms connected with vitamins and minerals were used. The results of the study made it possible to determine the group of ingredients especially popular during the pandemic. Their use in products after the announcement of the pandemic was significantly higher than in the preceding period. In conclusion, it can be shown that the pandemic changed the ingredients used in functional foods—mainly as far as vitamins and minerals are concerned. The highest proportional increase in its use in dietary supplements was noted for potassium. Personalized therapy has also become more popular, promoted by one of the manufacturers of dietary supplements active during the pandemic. Moreover, different phases of the pandemic were characterized by the popularity of different ingredients among the consumers—first, these were immunity-boosting ingredients, then those that improved psychological functions, and finally mixtures with universal health effects. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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16 pages, 357 KiB

Open AccessArticle

Healthcare Voucher Scheme for Screening of Cardiovascular Risk Factors: A Population-Based Study

by Junjie Huang, Chun-Ho Ngai, Man-Sing Tin, Qingjie Sun, Pamela Tin, Eng-Kiong Yeoh and Martin C. S. Wong

Int. J. Environ. Res. Public Health 2021, 18(20), 10844; https://doi.org/10.3390/ijerph182010844 - 15 Oct 2021

Viewed by 2367

Abstract

The present study aimed to evaluate the factors associated with unwillingness to join a healthcare voucher scheme for screening of cardiovascular risk factors in a Chinese population. We conducted a telephone survey by random selection of 1200 subjects who were aged 45 years [...] Read more.

The present study aimed to evaluate the factors associated with unwillingness to join a healthcare voucher scheme for screening of cardiovascular risk factors in a Chinese population. We conducted a telephone survey by random selection of 1200 subjects who were aged 45 years or above in Hong Kong. We collected data on their attitude, perception, and perceived feasibility of a healthcare voucher scheme. The overall rates of having received at least one type, two types, and all three types of screening tests are 81.1%, 80.7%, and 79.3%, respectively. Younger individuals (aOR = 0.338, p = 0.004), those of a higher educational level (aOR = 1.825, p = 0.006), being employed (aOR = 3.030, p = 0.037), and lower perception of screening as beneficial (aOR = 0.495, p < 0.001) were significantly associated with no regular screening for at least one medical condition. The overall rate of willingness to join the voucher scheme (among those aged ≥ 45) is 83.7%. Male sex (aOR = 2.049, p = 0.010) and absence of family history of cardiovascular disease (aOR = 0.362, p = 0.002) are independent predictors of unwillingness to join. Our findings highlighted the significance of sex and family history on screening of cardiovascular factors. These constructs and independent predictors identified provide evidence-based formulation and implementation targeted screening strategies that enhance the screening rate of the three cardiovascular risk factors. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

21 pages, 15725 KiB

Open AccessArticle

Process of Posthospital Care Involving Telemedicine Solutions for Patients after Total Hip Arthroplasty

by Karolina Kamecka, Anna Rybarczyk-Szwajkowska, Anna Staszewska, Per Engelseth and Remigiusz Kozlowski

Int. J. Environ. Res. Public Health 2021, 18(19), 10135; https://doi.org/10.3390/ijerph181910135 - 27 Sep 2021

Cited by 9 | Viewed by 3416

Abstract

The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and [...] Read more.

The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and implement improved procedures using telemedicine tools. The aim of the article is to develop original, improved posthospital patient care process after total hip arthroplasty (THA) with the use of telemedicine technologies. In the study, a literature review and empirical research were used. The conducted research resulted in the designing an original posthospital patient care process after THA that uses telematics technologies. Due to the use of analyzed telemedicine technologies, the designed patient care process brings a possibility to increase the patient′s safety by monitoring life parameters, allowing for regular, remote contact with specialists and to be supervised remotely. All this may contribute to shortening the convalescence time, reducing the risk of complications, as well as reducing treatment costs. The designed model is ready for further clinical research with the participation of medical staff, patients after THA and patient caregivers. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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11 pages, 344 KiB

Open AccessArticle

Improving Community Health Workers’ Attitudes toward Collaborative Practice in the Care of Older Adults: An In-Service Training Intervention Trial in the Philippines

by Kathryn Lizbeth L. Siongco, Keiko Nakamura, Kaoruko Seino, TJ Robinson T. Moncatar, Lourdes Marie S. Tejero, Shelley Ann F. De La Vega, Sheila R. Bonito, Richard Javier, Takako Tsutsui, Yuri Tashiro, Saber Al-Sobaihi, Fely Marilyn E. Lorenzo and Carmelita C. Canila

Int. J. Environ. Res. Public Health 2021, 18(19), 9986; https://doi.org/10.3390/ijerph18199986 - 23 Sep 2021

Cited by 5 | Viewed by 11236

Abstract

The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled [...] Read more.

The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled trial was adopted dividing participants into an intervention (n = 42) and a control group (n = 39). Attitudes toward, and readiness and activities for collaboration were measured using three standardized scales before and at 6 months after the training. A significant difference (p < 0.001) was observed in the Attitudes Toward Health Care Teams Scale (ATHCTS) scores between pre- and post-test in the intervention (6.3 ± 8.3 [Mean ± SD]) and control groups (0.7 ± 8.2). Multivariate linear regression analysis showed an independent positive association between the intervention and greater improvement in the ATHCTS score (Coefficient β = 6.17; 95% CI = 0.82, 11.53; p = 0.03) at follow-up, after adjustment for age, years in current occupation, and social support role of participants. The results demonstrated the efficacy of the intervention for improving the attitudes of CHWs toward collaborative practice in the care of older adults. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

10 pages, 619 KiB

Open AccessArticle

Costs Associated with the Treatment of Clostridioides Difficile Infections

by Aleksandra Sierocka, Zofia Kiersnowska, Ewelina Lemiech-Mirowska and Michał Marczak

Int. J. Environ. Res. Public Health 2021, 18(14), 7647; https://doi.org/10.3390/ijerph18147647 - 19 Jul 2021

Cited by 6 | Viewed by 2777

Abstract

Background: Clostridioides difficile, as the main cause of infectious diarrhoea in hospitalised patients, is a considerable challenge for medical personnel (hospital environment) who have direct contact with the patient, as well as being of interest to public health specialists. Financial issues related [...] Read more.

Background: Clostridioides difficile, as the main cause of infectious diarrhoea in hospitalised patients, is a considerable challenge for medical personnel (hospital environment) who have direct contact with the patient, as well as being of interest to public health specialists. Financial issues related to the occurrence of the above-mentioned micro-organism are being increasingly raised. Due to the scale of the phenomenon, we are beginning to pay attention to the significant system costs caused by the diagnosis and treatment of CDI infection and its complications. Studies indicate that the nosocomial infection of C. difficile complicates hospitalisation, by increasing the cost by more than half and extending patient’s stay by an average of 3.6 days. Material and methods: The aim of this study was to attempt to calculate the estimated costs associated with the prolonged hospitalisation of patients with nosocomial CDI infection, using the example of a hospital in Lodz. A total of 53 completed hospitalisations of patients treated in the period of January–August 2018 were analysed, during which hospital Clostridioides difficile infection was identified. For the purposes of this study, statistical data collected in the hospital’s IT system were also analysed, covering 44,868 hospitalisations in the Jan–Aug 2018 period, during which no hospital infection occurred. They was a control group, in which the analysed cases were compared. The obtained data in the study determined how long each patient with Clostridioides difficile infection stayed in the hospital (from the moment infection was diagnosed until the day of hospital discharge), and which diagnosis related groups (DRG) (according to National Health Fund guidelines) were assigned. The average length of patient stay without infection within a given DRG group in each hospital ward was also determined. The collected materials became the initial point for the final analysis of hospital costs and the length of hospital stay caused by Clostridioides difficile infection. Results: Clostridioides difficile infection extended the hospital stay by an average of almost 12 days. The average cost of prolonged hospitalisation due to CDI infection (according to the average cost per person-day) was about PLN 7148 (1664 EUR), which gave a total value of about PLN 378,860.6 (88,240.5 EUR) in the examined period. At the same time, the average expenditure from the National Health Fund for hospitalisation due to CDI infections increased by about PLN 6627 (1542.8 EUR), which in the analysed period translated into over PLN 351,232.0 (81,505.5 EUR) (according to settlements with the National Health Fund). The outcome indicates that there is a clear relation between CDI and the anticipated length of hospitalisation of patients without an infection. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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17 pages, 855 KiB

Open AccessArticle

Mental and Physical Health Problems as Conditions of Ex-Prisoner Re-Entry

by Anna Pękala-Wojciechowska, Andrzej Kacprzak, Krzysztof Pękala, Marta Chomczyńska, Piotr Chomczyński, Michał Marczak, Remigiusz Kozłowski, Dariusz Timler, Anna Lipert, Agnieszka Ogonowska and Paweł Rasmus

Int. J. Environ. Res. Public Health 2021, 18(14), 7642; https://doi.org/10.3390/ijerph18147642 - 18 Jul 2021

Cited by 10 | Viewed by 6260

Abstract

The article focuses on a less-discussed issue of social marginalization of people leaving penitentiaries, which is the prevalence of multifaceted health problems experienced by people in this category. It includes poor health status, resulting from, among others, poor housing conditions, harmful or risky [...] Read more.

The article focuses on a less-discussed issue of social marginalization of people leaving penitentiaries, which is the prevalence of multifaceted health problems experienced by people in this category. It includes poor health status, resulting from, among others, poor housing conditions, harmful or risky lifestyle, and lack of access to medical services. Data from the District Inspectorate of the Prison Service in Lodz, Poland on the health conditions of inmates was accessed. These data were supplemented by qualitative research conducted in 21 juvenile detention centers and 8 prisons across the country, conducting direct observations and In-Depth Interviews (IDI). A total of 198 IDIs were conducted with incarcerated (72) and released (30) juvenile offenders, and incarcerated (68) and released (28) adult offenders. These were complemented by IDIs with experts (50) and Focus Group Interviews (FGIs; 8) with male and female inmates in 4 Polish prisons. The study revealed that mental and physical health is a serious obstacle to social reintegration of ex-prisoners. It is rarely addressed by state institutions. There are strong associations between neglect of health issues in the prison population and increasing social exclusion after leaving prison. As Poland has a restrictive penal policy, former prisoners remain a group with social stigma and little support. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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14 pages, 953 KiB

Open AccessArticle

The Effectiveness of Active Rehabilitation Camp on Physical Performance of Disabled People Moving in Wheelchairs

by Anna Lipert, Kacper Wróbel, Michał Spychała, Paweł Rasmus, Dariusz Timler, Michał Marczak and Remigiusz Kozłowski

Int. J. Environ. Res. Public Health 2021, 18(14), 7572; https://doi.org/10.3390/ijerph18147572 - 16 Jul 2021

Cited by 9 | Viewed by 2819

Abstract

(1) Background: Regular participation in physical activity (PA) prevents many medical complications and improves the physical fitness of people with spinal cord injury, and in turn improves the functional independence, psychosocial status and quality of life. The goal of Active Rehabilitation Camps (ARCs) [...] Read more.

(1) Background: Regular participation in physical activity (PA) prevents many medical complications and improves the physical fitness of people with spinal cord injury, and in turn improves the functional independence, psychosocial status and quality of life. The goal of Active Rehabilitation Camps (ARCs) is to use various forms of PA in order for the participants to obtain the greatest efficiency and independence in everyday life. (2) Purpose: To evaluate the improvement in physical performance of people with chronic spinal cord disabilities moving in wheelchairs taking part in the Active Rehabilitation Camp depending on (a) sex, (b) type of disability, (c) the level of injury and (d) the type of wheelchair. (3) Methods: The study included 42 wheelchair users: 28 men and 14 women aged 18–65 years (34.7 ± 14.9 years) taking part in the Active Rehabilitation Camp. Finally, the study involved 27 paraplegics, 9 tetraplegics and 6 individuals with myelomeningocele. The participants took part in four fitness tests: (1) sprint test (SP)—individual time to cover a distance of 15 m in the wheelchair; (2) slalom test (SL)—time to ride between four cones front and back; (3) basketball ball throw at a distance (BT), (4) zig-zag test (ZZ)—riding continuously for 6 min on the designated track. The tests were performed at the beginning and at the end of the ACR. Active wheelchairs were used by 32 participants, and 10 participants used the classic wheelchairs. (4) Results: Paraplegics achieved the best average results in all the tests and the best improvement in physical performance in comparison to individuals with myelomeningocele and tetraplegics. People in active wheelchairs achieved a statistically significant improvement in the results of SL and ZZ (p < 0.001). People with injury above Th-9 level of the spinal cord achieved a statistically significant improvement in the results of SP (p < 0.01), SL and ZZ (p < 0.01). People with injury below Th6 achieved a statistically significant improvement (p < 0.05) in SP, SL and ZZ. (5) Conclusions: Regular PA during the Active Rehabilitation Camp improves the physical performance of disabled people in wheelchairs, but the scale of improvement of physical performance fitness depends on the type of wheelchair used and the level and the type of injury. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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17 pages, 819 KiB

Open AccessArticle

Level of Knowledge of Medical Staff on the Basis of the Survey in Terms of Risk Management, Associated with Clostridioides difficile Infections

by Zofia Maria Kiersnowska, Ewelina Lemiech-Mirowska, Katarzyna Semczuk, Michał Michałkiewicz, Aleksandra Sierocka and Michał Marczak

Int. J. Environ. Res. Public Health 2021, 18(13), 7060; https://doi.org/10.3390/ijerph18137060 - 1 Jul 2021

Cited by 6 | Viewed by 2928

Abstract

Infections caused by the toxigenic strains of Clostridioides difficile in the hospital environment pose a serious public health problem. The progressive increase in hospital infections in Poland indicates that risk management is a tool that is not used in an effective way and [...] Read more.

Infections caused by the toxigenic strains of Clostridioides difficile in the hospital environment pose a serious public health problem. The progressive increase in hospital infections in Poland indicates that risk management is a tool that is not used in an effective way and significantly differs from the goals set by the Leading Authorities, the Ministry of Health and its subordinate units. Systematic education of medical personnel constitutes the basic element of rational risk management aimed at reducing the number of infections as it allows for the transfer of knowledge, development of appropriate organizational procedures, and improves internal communication. This paper presents the results of a survey conducted in hospital facilities throughout Poland. The study dealt with what medical personnel know about channels of transmission and prevention of Clostridioides difficile infections in the hospital setting, professional training and risk management in terms of reducing the number of infections. The survey reveals that Clostridioides difficile continues to be a serious problem in the inpatient care system. Procedures and management strategies implemented by hospitals in order to limit the spread of the pathogen are predominantly focused on short-term action, which does not lead to a real improvement in terms of hospitalized patients’ safety. The infection risk management system was assessed at a fairly low level. The obtained research results confirmed the research hypotheses that had been formulated. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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13 pages, 883 KiB

Open AccessArticle

The Impact of Introducing Successive Biosimilars on Changes in Prices of Adalimumab, Infliximab, and Trastuzumab—Polish Experiences

by Olga Barszczewska and Anna Piechota

Int. J. Environ. Res. Public Health 2021, 18(13), 6952; https://doi.org/10.3390/ijerph18136952 - 29 Jun 2021

Cited by 7 | Viewed by 3193

Abstract

Biosimilars are cheaper than original drugs and are thus of interest to the public. The aim of this article is to assess the benefits of introducing more than one biosimilar for the same substance (active pharmaceutical ingredient, API). The hypothesis is that the [...] Read more.

Biosimilars are cheaper than original drugs and are thus of interest to the public. The aim of this article is to assess the benefits of introducing more than one biosimilar for the same substance (active pharmaceutical ingredient, API). The hypothesis is that the introduction of successive biosimilars of a specific original drug reduces the price of the selected API. The study focuses on drug prices varying with the successive arrival of new biosimilars. Three drugs that have at least three reimbursed biosimilars on the market were selected, two from the same therapeutic group (adalimumab and infliximab) and one (trastuzumab) representing another class of drugs. The following data were analyzed: price variation after the introduction of the first, second, and third biosimilar, and the average price reduction for all three biosimilars. Additionally, a literature review was conducted. The reimbursement of each new biosimilar is beneficial since it is associated with a price reduction in percentage terms. However, the first biosimilar brought about the greatest savings due to the higher initial prices of the original drugs and to Polish reimbursement rules. This article is helpful for when taking healthcare decisions regarding the pricing of and reimbursement for new biosimilars. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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13 pages, 810 KiB

Open AccessArticle

Sleep Quality and Performance in Professional Athletes Fasting during the Month of Ramadan

by Anna Lipert, Remigiusz Kozłowski, Paweł Rasmus, Michał Marczak, Małgorzata Timler, Dariusz Timler, Ewa Kaniecka, Abedelmajid Nasser, Mohammad Ghaddar and Ali Ghaddar

Int. J. Environ. Res. Public Health 2021, 18(13), 6890; https://doi.org/10.3390/ijerph18136890 - 27 Jun 2021

Cited by 11 | Viewed by 4103

Abstract

Background: Maintaining physical performance during Ramadan Diurnal Fasting (RDF) is a challenge for professional athletes. The literature shows that sleep disturbances experienced by athletes during RDF are associated with reduced physical performance. The effect of sleep quality on physical performance, and the effect [...] Read more.

Background: Maintaining physical performance during Ramadan Diurnal Fasting (RDF) is a challenge for professional athletes. The literature shows that sleep disturbances experienced by athletes during RDF are associated with reduced physical performance. The effect of sleep quality on physical performance, and the effect of work status on physical performance during RDF among athletes, besides engaging in trainings, have been little investigated. This study aims to evaluate the effect of RDF on the physical performance of professional athletes taking into consideration their sleep quality and work status. Methods: Professional medium-distance male runners (n = 32) participated in our study in the summer of 2019. Data about socio-demographics, training characteristics, sleep quality (Pittsburg Sleep Quality Index: PSQI), physical performance (Cooper Test; Harvard step test) were collected before and during Ramadan. Student’s-test and Welch and Wilcoxon tests were used for data analysis. Results: Both quality of sleep and physical performance of athletes deteriorated during Ramadan. People with better quality of sleep had better physical fitness/performance both before and during RDF. Athletes who worked beside trainings achieved worse physical fitness test results and had worse quality of sleep. Conclusions: Policies aimed to improve physical performance in RDF should consider the quality of sleep and the work status of athletes. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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12 pages, 339 KiB

Open AccessArticle

Risk Factors of Early Adolescence in the Criminal Career of Polish Offenders in the Light of Life Course Theory

by Krzysztof Pękala, Andrzej Kacprzak, Anna Pękala-Wojciechowska, Piotr Chomczyński, Michał Olszewski, Michał Marczak, Remigiusz Kozłowski, Dariusz Timler, Łukasz Zakonnik, Kamila Sienkiewicz, Elżbieta Kozłowska and Paweł Rasmus

Int. J. Environ. Res. Public Health 2021, 18(12), 6583; https://doi.org/10.3390/ijerph18126583 - 18 Jun 2021

Cited by 6 | Viewed by 3564

Abstract

Life course theory (LCT) diagnoses childhood and adolescent factors that determine an individual’s involvement in crime in the future. Farrington lists eight key correlates identified by empirical analyses of criminal careers. In this paper, we seek to discuss the inconsistencies with LCT that [...] Read more.

Life course theory (LCT) diagnoses childhood and adolescent factors that determine an individual’s involvement in crime in the future. Farrington lists eight key correlates identified by empirical analyses of criminal careers. In this paper, we seek to discuss the inconsistencies with LCT that we observed in our three empirical studies of the criminal careers of Polish offenders. During 12 years of qualitative research, we conducted direct observations and in-depth interviews in juvenile correction institutions (21) and prisons (8) across the country. We gained access to incarcerated (102) and released (30) juvenile offenders, as well as to incarcerated (68) and released (28) adult offenders. We also conducted in-depth interviews (92) with experts working with young and adult offenders. We similarly accessed some offenders’ criminal records and psychological opinions. Our study revealed the strong presence of family and neighborhood influences on early criminality. Contrary to LCT assumptions, state-dependent institutions (military, work, family) were not strong enough determinants of delinquency. Polish offenders generally experience criminal onset later than LCT-oriented criminologists indicate. Based on our data, we also agree with the thesis that the onset of crime should be discussed as different age-related periods rather than just a general onset. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

15 pages, 1910 KiB

Open AccessArticle

Framing Sustainable Healthcare Services

by Per Engelseth, Remiguisz Kozlowski, Karolina Kamecka, Lukasz Gawinski and Richard Glavee-Geo

Int. J. Environ. Res. Public Health 2021, 18(12), 6336; https://doi.org/10.3390/ijerph18126336 - 11 Jun 2021

Cited by 2 | Viewed by 2810

Abstract

This paper develops an analytical framework using process thinking to achieve sustainable healthcare services. Healthcare is characterised by low economic efficiency. At the same time, it is embedded in ethical concerns related to society and nature. Healthcare is thus conceptualised as functionality in [...] Read more.

This paper develops an analytical framework using process thinking to achieve sustainable healthcare services. Healthcare is characterised by low economic efficiency. At the same time, it is embedded in ethical concerns related to society and nature. Healthcare is thus conceptualised as functionality in an ecosystem. The patient is woven into both nature and society. Given the complex nature of healthcare services, we seek an alternative way to understand healthcare services, focusing on the exchange aspect of the economy. We offer a conceptual model that helps build an analytical framework focusing on how practitioners and leaders in healthcare frame their activities. This framing provides guidance in healthcare practice. Furthermore, framing is associated with both healthcare service providers as well as patients and next of kin—the recipients. This framework aims to guide practical research and development activities in healthcare. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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8 pages, 727 KiB

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The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department

by Łukasz Bilaszewski, Wojciech Timler, Katarzyna Budrewicz, Michał Marczak, Remigiusz Kozłowski, Joanna Wizowska, Małgorzata Timler, Dariusz Jagielski, Michał Dudek, Paweł Rasmus, Dorota Zyśko and Dariusz Timler

Int. J. Environ. Res. Public Health 2021, 18(11), 6048; https://doi.org/10.3390/ijerph18116048 - 4 Jun 2021

Cited by 4 | Viewed by 2750

Abstract

Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 [...] Read more.

Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. Materials and Methods: A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July–December 2019 (pre-pandemic period) versus July–December 2020 (pandemic period) was performed. Results: During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/−13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5–30 h) during the pandemic period vs. 5 h (3–24 h) during the non-pandemic period (p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital (p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. Conclusions: 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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11 pages, 332 KiB

Open AccessArticle

Age-Graded Transitions and Turning Points in Polish Offenders’ Criminal Careers from the Standpoint of Life Course Theory

by Krzysztof Pękala, Andrzej Kacprzak, Piotr Chomczyński, Jakub Ratajczak, Michał Marczak, Remigiusz Kozłowski, Dariusz Timler, Anna Pękala-Wojciechowska and Paweł Rasmus

Int. J. Environ. Res. Public Health 2021, 18(11), 6010; https://doi.org/10.3390/ijerph18116010 - 3 Jun 2021

Cited by 6 | Viewed by 3686

Abstract

Both juvenile and adult criminal careers show regularities in the origins of delinquency, the dynamics of the criminal pathway, and the turning points that lead to desistance/persistence in crime. Research shows that family, education, and friendship environments contribute significantly to the individual choices [...] Read more.

Both juvenile and adult criminal careers show regularities in the origins of delinquency, the dynamics of the criminal pathway, and the turning points that lead to desistance/persistence in crime. Research shows that family, education, and friendship environments contribute significantly to the individual choices that create criminal biographies. Our aim was to apply core aspects of life course theory (LCT): trajectory, the aged-graded process, transitions, institutions, and ultimately how desistance/persistence factor into explaining the criminal careers of Polish offenders. The research is based on in-depth interviews (130) carried out with both offenders (90) and experts (40). The offenders were divided into two groups: 30 were juveniles, and 60 were adults of whom half were sentenced for the first time (30) and half were recidivists (30) located in correctional institutions or released. The experts group (40) includes psychologists, educators, social rehabilitators, and prison and juvenile detention personnel working with offenders. We used triangulation of researcher, data, and methodology. Our data revealed that similar biographical experiences characterized by an early socialization, family and friends-based circles laid the groundwork for their entry and continued participation in criminal activity. Juvenile and adult first-time sentenced offenders led criminal careers significantly different from those of recidivists, who faced problems with social adaptation caused by lack of family and institutional support. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

11 pages, 1653 KiB

Open AccessArticle

Physical Activity as a Predictor of the Level of Stress and Quality of Sleep during COVID-19 Lockdown

by Anna Lipert, Remigiusz Kozłowski, Dariusz Timler, Michał Marczak, Kamila Musiał, Paweł Rasmus, Karolina Kamecka and Anna Jegier

Int. J. Environ. Res. Public Health 2021, 18(11), 5811; https://doi.org/10.3390/ijerph18115811 - 28 May 2021

Cited by 20 | Viewed by 4482

Abstract

Background: The coronavirus pandemic and the government restrictions significantly disturbed the daily functioning of people, thereby influencing healthy behaviors, such as physical activity—the core indicator of well-being. This study evaluates the associations between physical activity (PA), the level of stress and quality of [...] Read more.

Background: The coronavirus pandemic and the government restrictions significantly disturbed the daily functioning of people, thereby influencing healthy behaviors, such as physical activity—the core indicator of well-being. This study evaluates the associations between physical activity (PA), the level of stress and quality of sleep during the COVID-19 pandemic lockdown. Methods: An online survey was distributed during the governmental lockdown in April 2020 and included measures for assessing physical activity, stress and sleep. The surveyed participants included all adults aged 18 years and over. The final data were collected from the 1959 respondents using: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI). Findings: Almost half of the respondents indicated a low level of PA, performing only 60 min of PA daily. Most of the participants reported a moderate or high level of stress (57% and 29%, respectively) and 64% of them reported poor quality of sleep. People with low levels of stress performed on average 85.1 min/day of walking (WPA), 40.9 min/day of moderate PA (MPA) or 52.6 min/day of vigorous PA (VPA). People with good quality of sleep performed 82.9 min/day of WPA, 43.6 min/day MPA and 40.5 min/day VPA. Interpretation: The results from the study indicate that the volume of daily PA may be a predictor of the level of stress and sleep quality in adults during the COVID-19 pandemic lockdown. To retain a low level of stress and good quality of sleep, a lifestyle that allows to achieve a moderate level of physical activity should be maintained. The optimal daily dose of PA is at least 70 min per day, involving different intensities. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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10 pages, 315 KiB

Open AccessArticle

Frequency and Characteristics of Injuries and Rehabilitation Procedures in Rugby Players in Poland and France

by Anna Lipert, Paweł Rasmus, Michał Marczak, Remigiusz Kozłowski, Anna Jegier, Małgorzata Timler and Dariusz Timler

Int. J. Environ. Res. Public Health 2021, 18(9), 4835; https://doi.org/10.3390/ijerph18094835 - 30 Apr 2021

Cited by 2 | Viewed by 3034

Abstract

Objectives: Rugby is sport with a high risk of injury. Repeated changes in exercise intensity and the high training intensity may cause to overuse injuries and long-term disability. The aim of the study was to analyze the prevalence of injuries during trainings [...] Read more.

Objectives: Rugby is sport with a high risk of injury. Repeated changes in exercise intensity and the high training intensity may cause to overuse injuries and long-term disability. The aim of the study was to analyze the prevalence of injuries during trainings and forms of rehabilitation procedures performed after their occurrence among elite and sub-elite rugby players. Methods: The data was obtained from 60 professional rugby males from France and Poland. Data were collected using paper-based recording form. It was a specially designed questionnaire which concerned specific details of the injury, including body location, type of injury, treatment and number of days off lost from playing rugby and on forms of rehabilitation procedures performed after their occurrence among elite and sub-elite rugby players. Results: During the study period, the overall incidence rate for injury suggested a 1.04 times more often injury occurrence (IRR = 1.04, 95% CI: 0.08; 2.00) among Polish players compared with French players; however, the distribution of injuries varied by country. The training injury incidence (TII) and incidence proportion (IP) were also higher in Poland than in France (p < 0.05) with the sprain as the most frequent type of injury in all rugby players. France was 7.8 times (IRR = 7.88, 95% CI: 1.29; 3.21) more likely to sustain a fracture than Poland, which much often experienced less serious injuries (bruise, rapture of muscle and ligament) (IRR = 3.02, 95% CI: 2.06; 3.98). Polish players were provided with various forms of physiotherapy while Franch players often worked with a physiotherapist with a therapeutic method (p < 0.005). Poland and France reported experiencing side effects after an injury and the most frequent was pain. In their opinions, the reasons influencing the effectiveness of rehabilitation are too quick return to the game and too short time of rehabilitation. Conclusions: The competitive level of the rugby player influences not only the frequency and type of injury occurrence, but also access to the different forms of rehabilitation. Nonetheless, the side effects occurring after injury and the causes of ineffective rehabilitation are still similar. Further studies are needed to gather significant data to accurately formulate future injury prevention protocols or recommend modifications to game laws or competition formats, aiming at players’ welfare. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

11 pages, 1050 KiB

Open AccessArticle

The Influence of a Psychosocial Rehabilitation Program in a Community Health Setting for Patients with Chronic Mental Disorders

by Paweł Rasmus, Anna Lipert, Krzysztof Pękala, Małgorzata Timler, Elżbieta Kozłowska, Katarzyna Robaczyńska, Tomasz Sobów, Remigiusz Kozłowski, Michał Marczak and Dariusz Timler

Int. J. Environ. Res. Public Health 2021, 18(8), 4319; https://doi.org/10.3390/ijerph18084319 - 19 Apr 2021

Cited by 4 | Viewed by 4111

Abstract

Purpose: To examine (a) the amount of health-related behavior, (b) the level of generalized optimism, (c) the belief about patients’ abilities to cope with difficult situations and obstacles and (d) the subjective sense of social exclusion at baseline and at follow-up among [...] Read more.

Purpose: To examine (a) the amount of health-related behavior, (b) the level of generalized optimism, (c) the belief about patients’ abilities to cope with difficult situations and obstacles and (d) the subjective sense of social exclusion at baseline and at follow-up among patients with chronic mental health issues participating in a psychosocial rehabilitation program in a community mental health setting. Materials and Methods: This prospective study involved 52 participants aged 18–43 years and diagnosed with mental illness who participated in a 6-month psychosocial rehabilitation program, organized within a special community setting. Different questionnaires were used: the Health-Related Behavior Questionnaire, the Revised Life Orientation Test, the General Self-Efficacy Scale, the Personal Competence Scale and a self-made questionnaire concerning social exclusion problems. Results: Statistical analysis of the questionnaire results taken at the beginning and end of the six-month course, running from November 2015 to May 2016, revealed significant increases in health-related behavior (p = 0.006) and general self-efficacy (p = 0.01). Conclusions: Psychosocial rehabilitation programs offered by community mental health settings might serve as an easy, accessible strategy to deal with different interpersonal and intrapersonal problems and as a potential way to improve health behavior. Further research is required to evaluate other psychosocial rehabilitation programs in different community mental health settings in Lodz Voivodeship, Poland. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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14 pages, 1077 KiB

Open AccessArticle

Informal Dementia Caregivers: Current Technology Use and Acceptance of Technology in Care

by Daniel Wójcik, Katarzyna Szczechowiak, Patrycja Konopka, Mateusz Owczarek, Agata Kuzia, Izabela Rydlewska-Liszkowska and Małgorzata Pikala

Int. J. Environ. Res. Public Health 2021, 18(6), 3167; https://doi.org/10.3390/ijerph18063167 - 19 Mar 2021

Cited by 26 | Viewed by 4690

Abstract

(1) Background: Given the increased social isolation caused by the COVID-19 pandemic, the challenges faced by informal dementia caregivers have increased. An increasing use of technology, both in care and dementia clinical trials, depends upon caregivers’ abilities as a user. Accordingly, the [...] Read more.

(1) Background: Given the increased social isolation caused by the COVID-19 pandemic, the challenges faced by informal dementia caregivers have increased. An increasing use of technology, both in care and dementia clinical trials, depends upon caregivers’ abilities as a user. Accordingly, the aim of our study was to verify the current technology (smartphone and computer) use and acceptance in care, regarding socio-demographic variables; (2) Methods: Questionnaires were distributed to 102 dementia caregivers, mostly of patients with moderate dementia; (3) Results: The majority of participants were women (63%), and large number of them used technological devices such as a smartphone (91%) or computer (81%). Results revealed differences between age, gender, and education level on technology acceptance. Interestingly, smartphone use and acceptance seemed to be feasible, regardless of age, whereas computer use was negatively correlated with age. Technology was perceived by respondents as most useful for patients’ activities including locomotion, toileting, and meals; (4) Conclusions: The future of technology use in dementia care should indicate solutions tailored to individual characteristics such as new technology solutions (GPS trackers, smartphone apps, dietary intervention, and meal planning apps). Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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14 pages, 1059 KiB

Open AccessArticle

Respiratory Burst and TNF-α Receptor Expression of Neutrophils after Sepsis and Severe Injury-Induced Inflammation in Children

by Janusz P. Sikora, Jarosław Sobczak, Dariusz Zawadzki, Przemysław Przewratil, Anna Wysocka and Monika Burzyńska

Int. J. Environ. Res. Public Health 2021, 18(4), 2187; https://doi.org/10.3390/ijerph18042187 - 23 Feb 2021

Cited by 7 | Viewed by 2985

Abstract

Systemic inflammatory response syndrome (SIRS) is defined as the systemic host response to infection or a non-infectious factor. The purpose of this study was to evaluate the involvement of reactive oxygen species (ROS) in severe inflammation and to assess the discrimination strength of [...] Read more.

Systemic inflammatory response syndrome (SIRS) is defined as the systemic host response to infection or a non-infectious factor. The purpose of this study was to evaluate the involvement of reactive oxygen species (ROS) in severe inflammation and to assess the discrimination strength of the neutrophil BURSTTEST assay regarding its etiology in three groups of patients (sepsis, burns, and bone fractures) who met the SIRS criteria. The neutrophil activation (respiratory burst of granulocytes as well as p55 and p75 tumor necrosis factor (TNF-α) receptor expression) was evaluated twice using flow cytometry, and the results were compared with healthy controls and among SIRS subjects. A decreased oxygen metabolism in neutrophils after E.coli stimulation and increased TNF-α receptor expression were found in septic and burned patients on admission, while ROS production augmented and TNF-α receptor expression diminished with the applied therapy. The significant differences in neutrophil respiratory burst intensity among septic and burned patients and those with sepsis and bone fractures were found (however, there were not any such differences between patients with thermal and mechanical injuries). This study indicates that the neutrophil BURSTTEST evaluation might be a clinically reliable marker for differentiating the SIRS etiology. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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20 pages, 401 KiB

Open AccessArticle

Assessment of the Selected Health Factors by Polonia in the Greater Toronto Area in the Relation to Their Quality and Standard of Living

by Kamila Ziółkowska-Weiss

Int. J. Environ. Res. Public Health 2021, 18(3), 1296; https://doi.org/10.3390/ijerph18031296 - 1 Feb 2021

Cited by 5 | Viewed by 2433

Abstract

Quality of life constitutes an indicator of well-being, satisfaction or happiness resulting from one’s existence. It is often referred to as a standard of living. In general, it is contentment with the fulfilment of one’s needs. The main objective of the article is [...] Read more.

Quality of life constitutes an indicator of well-being, satisfaction or happiness resulting from one’s existence. It is often referred to as a standard of living. In general, it is contentment with the fulfilment of one’s needs. The main objective of the article is to describe the selected components of the living standards and quality of life within the Polish community of the Greater Toronto Area which includes four regions: Halton, Peel, York and Durham. The model of mutually affecting objective factors (standard of living) and subjective factors (quality of life) will be presented. The specific factors (demographic, social, cultural, economic, legal, educational, geographical and health-related) included in field studies among the respondents and based on assigned indices influencing the quality of life in the Polish community of the Greater Toronto Area, will be demonstrated. The major goal of the paper is to present an assessment of aspects related to health factors, both in terms of objective factors (standard of living) and subjective ones (quality of life) by Polonia living in the Greater Toronto Area. Results will be shown on the basis of the survey questionnaire completed by 583 respondents. The questions focused on, among other issues, access to the healthcare system, competence of medical staff and access to sports facilities. Respondents also evaluated their satisfaction with their general health, both physical and mental, as well as the possibility of practicing sports associated with healthy lifestyle. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

8 pages, 303 KiB

Open AccessArticle

Priority Setting in the Polish Health Care System According to Patients’ Perspective

by Anna Rybarczyk-Szwajkowska and Izabela Rydlewska-Liszkowska

Int. J. Environ. Res. Public Health 2021, 18(3), 1178; https://doi.org/10.3390/ijerph18031178 - 28 Jan 2021

Cited by 2 | Viewed by 2274

Abstract

Identification of health priorities is concerned with equitable distribution of resources and is an important part of strategic planning in the health care system. The aim of this article is to describe health priorities in the Polish health care system from the patients’ [...] Read more.

Identification of health priorities is concerned with equitable distribution of resources and is an important part of strategic planning in the health care system. The aim of this article is to describe health priorities in the Polish health care system from the patients’ perspective. The study included 533 patients hospitalized in the Lodz region. The average age of the respondents was 48.5 years and one third (36.6%) had university education. Most of the respondents (64.9%) negatively assessed the functioning of the health care system in Poland. Most of them claimed the following aspects require improvements: financing health services (85.8%), determining priorities in health care (80.3%), the role of health insurance (80.3%), and medical education (70.8%). Over 70% of the respondents agreed the role of politicians in designing and implementing health system reforms should be limited. The fact that the respondents so negatively assessed the Polish health care system implies there is a need for full discussion on redefining health priorities. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

Review

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28 pages, 444 KiB

Open AccessReview

Application of Modern Clinical Risk Scores in the Global Assessment of Risks Related to the Diagnosis and Treatment of Acute Coronary Syndromes in Everyday Medical Practice

by Lukasz Gawinski, Per Engelseth and Remigiusz Kozlowski

Int. J. Environ. Res. Public Health 2021, 18(17), 9103; https://doi.org/10.3390/ijerph18179103 - 28 Aug 2021

Cited by 4 | Viewed by 2769

Abstract

This article presents an overview of contemporary risk assessment systems used in patients with myocardial infarction. The full range of risk scales, both recommended by the European Society of Cardiology and others published in recent years, is presented. Scales for assessing the risk [...] Read more.

This article presents an overview of contemporary risk assessment systems used in patients with myocardial infarction. The full range of risk scales, both recommended by the European Society of Cardiology and others published in recent years, is presented. Scales for assessing the risk of ischemia/death as well as for assessing the risk of bleeding are presented. A separate section is devoted to systems assessing the integrated risk associated with both ischemia and bleeding. In the first part of the work, each of the risk scales is described in detail, including the clinical trials/registers on the basis of which they were created, the statistical methods used to develop them, as well as the specification of their individual parameters. The next chapter presents the practical application of a given scale in the patient risk assessment process, the timing of its application on the timeline of myocardial infarction, as well as a critical assessment of its potential advantages and limitations. The last part of the work is devoted to the presentation of potential directions for the development of risk assessment systems in the future. Full article

(This article belongs to the Special Issue Interdisciplinarity in Health and Health Care: Management–Education–Prevention)

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