Publications by authors named "Aleksandra Czerw"

56 Publications

Physical Activity and the Quality of Life of Female Students of Universities in Poland.

Int J Environ Res Public Health 2021 May 13;18(10). Epub 2021 May 13.

Institute of Physical Culture Sciences, University of Szczecin, 71-065 Szczecin, Poland.

Physical activity increases human health potential and has an impact on achieving a higher quality of life in society. The aim of our research was to determine the relationship between a physically active lifestyle and the quality of life of female students in the context of demographic and social factors (major, age, marital status, professional activity). The research was conducted among a group of 285 women studying physical culture and social sciences in Poznań and Szczecin (Poland). Average age: 22.7 ± 4.90. The standardized World Health Organization Quality of Life-BREF (WHQOL-BREF) questionnaire was used to assess the quality of life of female students, and the original survey technique was used to study the lifestyle of people undertaking physical activity in the context of socio-demographic factors. Nonparametric statistics were applied in the analyses of the results. The effect size was calculated for each test: E for the Kruskal-Wallis H test, Glass rank biserial correlation (rg) for the Mann-Whitney U test, and Cramér's V for the χ test. The value of p ≤0.05 was assumed to be a significant difference. In the study, it was shown that a higher overall quality of life and health satisfaction, as well as better results in the physical, psychological, and environmental domains, were achieved by female students who assessed their lifestyle as physically active in comparison to those physically inactive. Higher scores of overall quality of life and satisfaction with health were found among female students of physical education and people participating in physical recreation, who also achieved better results in the environmental domain. Female students aged 23-25 had a higher quality of life in the physical, psychological, and social domains. Having a partner or spouse had a positive effect on the quality of life of female students defined by the social domain. A higher overall quality of life and satisfaction with health were characteristic of people who were employed. In the search of factors positively influencing the quality of life of society, it seems necessary to promote a physically active lifestyle among students. The observed differences in the quality of life and health satisfaction of female students of selected majors require targeted programs and interventions that improve the quality of their lives at various stages of their studies. Such activities increase the health potential of the individual and society, not only in the biological, but also psychosocial dimension.
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http://dx.doi.org/10.3390/ijerph18105194DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153276PMC
May 2021

Assessment of Pain, Acceptance of Illness, Adaptation to Life, and Strategies of Coping With the Disease, in Patients With Bladder Cancer.

In Vivo 2021 Mar-Apr;35(2):1157-1161

Division of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Background/aim: Bladder cancer is one of the most common cancers and causes of mortality in Poland, significantly reducing the quality of life. The objective of the study was to evaluate the strategy of coping with the disease in patients suffering from bladder cancer.

Patients And Methods: Four psychometric tests were used: the beliefs about pain control questionnaire (BPCQ), the pain coping strategies questionnaire (CSQ), acceptance of illness scale (AIS), and mental adjustment to cancer (Mini-Mac) test.

Results: Patients suffering from bladder cancer assign the greatest role in controlling pain to the influence of physicians. The most frequently chosen strategy for coping with the disease was declaring coping. The average level of acceptance of the disease among patients was mean=27.25. The most often indicated manner of coping was fighting spirit.

Conclusion: Patients with bladder cancer are characterized by a constructive attitude towards the disease.
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http://dx.doi.org/10.21873/invivo.12363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045067PMC
December 2020

Readiness and Willingness to Provide Immunization Services after Pilot Vaccination Training: A Survey among Community Pharmacists Trained and Not Trained in Immunization during the COVID-19 Pandemic in Poland.

Int J Environ Res Public Health 2021 01 12;18(2). Epub 2021 Jan 12.

Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada.

Background: Immunization rates among the adult population in Poland are below desired targets, urging the need to expand this service in the community. During the COVID-19 pandemic, the ultimate goals for limiting the spread of the infection are vaccines against SARS-CoV-2. Pharmaceutical companies are in a race for the fastest possible way to deliver vaccines. Community pharmacists in Poland are recognised as an accessible yet underutilised group of medical professionals. Therefore, involving pharmacists in vaccinations may have beneficial results for the healthcare system.

Objectives: The objectives of this study were to assess the readiness and willingness of community pharmacists following the Pharmacist Without Borders project who had either been trained or not in providing immunization services, and to identify the factors that may support the implementation of such services in Poland.

Methods: This study was conducted among pharmacists between February and August 2020 in Poland. A survey was developed to determine their readiness to provide vaccination services in their pharmacies, to recognise any barriers to vaccinations, as well as the factors necessary to implement vaccination services in Polish pharmacies.

Results: A total of 1777 pharmacists participated in the study, comprising 127 (7.1%) pharmacists trained in vaccinations during the Pharmacists Without Borders project and 1650 (92.9%) pharmacists not participating in the workshops. Pharmacists participating in the workshops more often indicated that providing vaccinations in community pharmacies would improve the overall vaccination rate ( = 0.0001), and that pharmacists could play an important role in advertising and promoting vaccinations ( = 0.0001). For the pharmacists not participating in the workshops, they indicated to a much greater extent possible barriers affecting the readiness to provide vaccinations in pharmacies. They most often pointed out that vaccination services would result in a significant workload increase ( = 0.0001), that pharmacies were not adapted to immunization, and that there were not enough training courses for pharmacists ( = 0.0001).

Conclusion: The pharmacists working in community pharmacies indicated many advantages of vaccinations in pharmacies. This study identified barriers to the introduction of vaccinations and factors necessary to implement these services in pharmacies. The pharmacists trained during the immunization programme of the Pharmacists Without Borders project showed a greater readiness to provide immunization services.
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http://dx.doi.org/10.3390/ijerph18020599DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828205PMC
January 2021

Can chloroquine/hydroxychloroquine prove efficient in cancer cachexia? A hypothesis in the era of COVID-19.

Med Hypotheses 2021 Jan 26;146:110434. Epub 2020 Nov 26.

Clinical Department of Oncology and Hematology, Central Clinical Hospital of the Ministry of the Anterior and Administration in Warsaw, ul. Woloska 137, 02-507 Warsaw, Poland; Division of Cancer Prevention, Faculty of Health Sciences, Medical University of Warsaw, ul. Zwirki i Wigury 61, 02-091 Warsaw, Poland.

Cancer cachexia (CC) is a progressive loss of muscle mass (with or without a decrease of adipose tissue). Gradual deterioration of the patient's fitness is resistant to nutritional intervention. The biochemical foundation of observed catabolism, detrimental protein, and energy balance is complex. However, the generalized inflammatory response plays a vital role. It is a kind of cytokine storm, which involves increased activity of TNF-α, IL-1, IL-6, and INF-γ. Pharmacological treatment of cachexia consists mainly of progestagens and glucocorticosteroids. Still, the assessment of new options limiting the harmful impact of cachexia could be beneficial. Chloroquine (CQ) and hydroxychloroquine (HCQ) are old antimalarial agents endowed with immunomodulatory properties. Being potent autophagy inhibitors, they could lead to a form of intracellular starvation in both cytokine-releasing cells and cancer cells, thus limiting the harmful impact of CC. CQ and HCQ are also efficient in particular connective tissue disorders. They have gained special attention since the World Health Organization announced the coronavirus disease 2019 (COVID-19) pandemic. According to initial reports, people with a severe inflammatory reaction showed significant benefits. Possibly they could not be attributed to the antiviral activity alone. It is worth noting that the cytokine storm in COVID-19, connective tissue disorders, and cancer cachexia share some similarities. Therefore, we hypothesize that low doses of CQ/HCQ may prove efficient in cancer cachexia.
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http://dx.doi.org/10.1016/j.mehy.2020.110434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689313PMC
January 2021

Self-government HPV vaccination programmes in Poland, 2009-2016.

Ann Agric Environ Med 2020 Sep 3;27(3):379-383. Epub 2019 Jul 3.

Medical University, Warsaw, Poland.

Introduction: Cervical cancer is the fourth neoplasm in women with respect to incidence. In Poland, both cervical cancer incidence and corresponding mortality are gradually decreasing. Despite these improvements, the epidemiological situation significantly deviates from European standards. Poland has one of Europe's lowest five-year survival rates at 54.1% for patients diagnosed in 2000-2002, compared to the European mean value of 62.1%.

Objective: The aim of this study is to present health policy programmes related to HPV vaccinations run by local self-government units in 2009-2016.

Material And Methods: The research is based on analysis of already existing data developed by provincial governors and annual information reviews on health-policy programmes implemented by local self-government units presented to the Ministry of Health. All the programmes that included HPV vaccinations have been subjected to analysis.

Results: In 2009-2016, local government units implemented a total of 1,204 health policy programmes that covered HPV vaccinations. Under these programmes, 2.05% of girls aged 10-14 were vaccinated. Percentage-wise, these were communes that contributed the most financially to the HPV vaccination programmes, whereas the counties the least.

Conclusions: Local self-government's programmes covering HPV vaccinations conform with the trends outlined in strategic documents on fighting neoplastic diseases. It is possible that the availability of HPV vaccination was limited for girls living in rural communes. Differences in the number of programmes, number of vaccinated girls and the financial outlays allocated for the implementation of HPV vaccination programmes in particular provinces, may be determined by the epidemiological situation in a given region, measured by the incidence rate of cervical cancer.
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http://dx.doi.org/10.26444/aaem/109620DOI Listing
September 2020

αB-crystallin as a promising target in pathological conditions - A review.

Ann Agric Environ Med 2020 Sep 6;27(3):326-334. Epub 2019 Sep 6.

Department of Cancer Prevention, Faculty of Health Sciences, Medical University, Warsaw, Poland.

Introduction And Objective: αB-crystallin belongs to the ubiquitous family of small heat-shock proteins. It was discovered as a physiological protein of the eye lens, maintaining its liquid-like property. Furthermore, αB-crystallin was proved to playa bipolar role in both physiological and pathophysiological conditions. This review discusses current knowledge about the biology and genetics of αB-crystallin, and summarizes recent advances in understanding its role in ophthalmic and neurological disorders, as well as breast cancer, renal cancer and other malignancies.

State Of Knowledge: α-crystallins are established as important elements of the protein quality control network, and consequently their defects are related to multiple human diseases. New studies highlight αB-crystallin's involvement in proliferative diabetic retinopathy angiogenesis and point out its therapeutic potential in age-related macular degeneration. αB-crystallin is thought to be associated with the disease-causing protein aggregates, leading to its connection with such neurological disturbances as anaplastic astrocytoma, Parkinson disease, aging deficits in the peripheral nervous system and multiple sclerosis. In breast cancer, it was proven to be a marker of aggressive behaviur and cerebral metastases. Strong expression of αB-crystallin promoted growth and migration of clear cell renal cell carcinoma cells and was correlated with lower overall survival rate. Considering other malignancies, its various roles were established in colorectal and gastric cancers, head and neck squamous cell carcinomas and osteosarcomas.

Conclusions: Further studies concerning αB-crystallin seem to be enormously promising, as they might improve our understanding of common human pathologies as well as contemporary diagnostics and treatment.
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http://dx.doi.org/10.26444/aaem/111759DOI Listing
September 2020

Perception of cancer in patients diagnosed with the most common gastrointestinal cancers.

BMC Palliat Care 2020 Sep 17;19(1):144. Epub 2020 Sep 17.

Department of Gynaecology and Oncology, Jagiellonian University Medical College, Krakow, Poland.

Background: Gastrointestinal cancers, including colorectal cancer, stomach cancer and pancreatic cancer are among the most common cancers in Poland. Cancer patients usually assess their quality of life much worse than the general population, while negative emotions associated with the illness may affect the results of treatment.

Methods: The study involved 378 patients with colorectal cancer, stomach cancer and pancreatic cancer, treated as outpatients at the Oncology Center - Maria Skłodowska-Curie Institute in Warsaw in 2013-2018. Standardized tools were used in the study: the Beliefs about Pain Control Questionnaire (BPCQ), the Pain Coping Strategies Questionnaire (CSQ), Approval Illness Scale (AIS), Mental Adjustment to Cancer (MiniMAC). The main goal of the study was to assess pain control, pain management strategies, illness acceptance and adaptation to cancer in patients with the most common gastrointestinal cancers.

Results: Patients with gastrointestinal cancers ascribe the greatest role in controlling pain to internal factors (M = 16.84, SE = .34), and the highest score in this area was obtained by patients with colorectal cancer (M = 17.33, SE = .35). The most frequently chosen strategy is declaring coping (M = 20.95, SE = .57), although patients with pancreatic cancer obtained a high score also in the area of catastrophizing (M = 17.99, SE = 1.14). The average value of illness acceptance for patients with gastrointestinal cancers was M = 25.00 (SE = .50) and it was the lowest in the group of patients diagnosed with pancreatic cancer (M = 23.41, SE = 1.16), and the highest in a group of people with colorectal cancer (M = 27.76, SE = .51). Patients with gastrointestinal cancers obtained the highest values of the MiniMAC test in the area of the fighting spirit (M = 21.30, SE = .25), characteristic mainly for patients with colorectal cancer. Patients with pancreatic cancer were characterized by high anxiety and helplessness/hopelessness.

Conclusions: Patients with gastrointestinal cancers use different methods of pain control and pain coping strategies, with active behaviors being preferred by patients with colorectal cancer and destructive - by patients with pancreatic cancer. The majority of socio-economic variables, as well as the treatment method, affect the patients' behaviors.
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http://dx.doi.org/10.1186/s12904-020-00650-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499958PMC
September 2020

Creating healthy and active life for the elderly in programmes conducted by rural and urban-rural communes in Poland.

Eur J Public Health 2021 Feb;31(1):111-115

Department of Health Economics and Medical Law, Medical University of Warsaw, Warsaw, Poland.

Background: In Poland, between 1989 and 2018 the number of the elderly increased by over 3.9 million. Demographic changes justify a senior policy focussed on the longest possible social, professional and family activity of the elderly. Directions of undertaken actions should include health policy programmes aimed at creating conditions healthy and active life of the elderly. The programmes should be particularly important in rural areas as the health of rural and urban residents differs. The study presents programmes for creating conditions for a healthy and active life of the elderly run by rural and urban-rural communes in 2012-17.

Methods: The study was conducted on the basis of existing data analysis. Data from the summary information prepared by voivodes and provided to the Minister of Health about implemented health policy programmes were used. Data on programmes concerning a healthy and active life for the elderly conducted by rural and urban-rural communes between 2012 and 2017 were extracted from the aggregate information.

Results: Between 2012 and 2017, 354 programmes were implemented, the most in 2016, and the least in 2015. There were 171 000 people participating in the programmes. The total cost was USD 2 491 664.

Conclusion: It can be presumed that in 2016 communes implemented more diagnostic and therapeutic programmes than in 2017. A small number of programmes and a small involvement of financial resources in communes with the largest number of the elderly may indicate marginalization of the importance of an active and healthy life for the elderly.
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http://dx.doi.org/10.1093/eurpub/ckaa154DOI Listing
February 2021

Occurrence of adverse events in the activity of hospital wards in the opinions of doctors and nursing management staff.

Ann Agric Environ Med 2020 Jun 15;27(2):306-309. Epub 2019 Apr 15.

National Center for Quality Assessment in Health Care, Krakow, Poland.

Introduction: An adverse event is an incident induced while providing health care services or resulting from it, not related to the natural course of a given disease or health condition, which causes or is likely to cause negative consequences for the patient, including their death, a threat to life, the necessity of hospitalisation or its prolongation, permanent or considerable health detriment; or is a foetal disease, congenital defect or the result of foetal damage.

Objective: The aim of this analysis is to explore the problem of the occurrence of adverse events from the perspective of doctors and ward nurses who manage wards.

Material And Methods: The research on the occurrence of adverse events among doctors and nurses (the management staff) was conducted with the use of a postal survey.

Results: It was ascertained that 86.5% of the medical personnel had taken part in an adverse event, of which 20.2% took part in an occurrence associated with pharmacotherapy, 16.2% - in an event related to diagnostics and diagnosis, or an infection - 15.7%. 14.2% of respondents were involved in an occurrence linked to a medical device malfunction, and 14.1% - in an adverse event related to an operation.

Conclusions: The adverse events most often identified in the nursing professional group are occurrences associated with pharmacotherapy, and in the doctors' professional group - occurrences related to diagnostics and diagnosis. The research established that the most frequent reason for not informing patients about the occurrence of an adverse event is fear of their filing a complaint. Medical management staff show high acceptance of an adverse event reporting system as a tool for improving patient safety.
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http://dx.doi.org/10.26444/aaem/106234DOI Listing
June 2020

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis.

Ann Agric Environ Med 2020 Mar 26;27(1):123-128. Epub 2019 Mar 26.

Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland.

Introduction And Objective: Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis.

Material And Methods: Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant.

Results: Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012).

Conclusions: SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.
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http://dx.doi.org/10.26444/aaem/105925DOI Listing
March 2020

Selected factors determining outsourcing of basic operations in healthcare entities in Poland.

Health Policy 2020 04 31;124(4):486-490. Epub 2020 Jan 31.

Department of Health Economics and Medical Law, Medical University of Warsaw, Poland.

Background: In light of insufficient financial resources allocated to the functioning of the health care system in Poland, healthcare entities undertake several restructuring measures aimed at cost reduction, improvement of effectiveness and optimisation of operations. One of the elements of this restructuring is outsourcing.

Objective: The objective of the study is to determine the significance of selected factors determining the outsourcing of basic operations in healthcare entities in Poland.

Methods: The research tool was the authors' questionnaire. The study was conducted at healthcare entities using the CAWI method in 2018. The outsourcing of laboratory diagnostics, diagnostic imaging and medical personnel was examined.

Results: Out of 750 healthcare entities, 241 outsource medical personnel, 484 outsource laboratory diagnostics, 445 outsource imaging diagnostics. The use of outsourcing primarily results from the excessively high cost of maintaining own employees, the desire to gain access to the top-quality knowledge and technology as well as the need for financial savings.

Conclusions: The scale of outsourcing of medical personnel may be greater than it results from the obtained study results. Excessively high costs of maintaining own employees as the most important reason for using outsourcing is a consequence of high personnel costs occurring in the case of establishing cooperation on the basis of an employment relationship.
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http://dx.doi.org/10.1016/j.healthpol.2020.01.010DOI Listing
April 2020

Value based healthcare - principles and recommendations for organizational solutions in Poland.

Przegl Epidemiol 2020 ;74(4):707-715

Objective: The aim of this paper is is to present the assumptions of the Value Based Healthcare concept, the related benefits and examples of countries in which the concept is implemented. The article also proposes solutions based on the VBHC model that could be implemented in the Polish healthcare system.

Materials And Methods: A literature search was conducted using the PubMed via Ovid database using the following keywords: Gray literature items were also analyzed using the Google Scholar tool and other documents, eg of the European Commission. Then the work was divided into the following thematic areas: definitions and principles of VBHC, benefits and challenges related to the implementation of the model, VBHC in Europe, recommendations for solutions in Poland based on VBHC. Value Based Healthcare (VBHC) is a healthcare financing model developed by M. Porter and E. Teisberg. It is based on the assumptions of financing healthcare providers based on treatment outcomes, that is, values. This concept was created in connection with the constantly growing costs in the American healthcare system, which, however, did not translate into health indicators in the population. The aim of VBHC is to minimize the cost of the system while achieving the best result for the patient. In this model of healthcare organization, it is assumed that those healthcare providers who provide the best quality care should be best financed, thus contributing to cure or significantly improving the quality of life of patients.

Conclusions: Value Based Healthcare is the recommended method of financing due to the optimization of healthcare expenses while maintaining the appropriate quality of services provided to patients. Currently, many countries in Europe and around the world have started implementing this system solution. However, the transition from a service charge to value for money model is a complex process. In the authors' opinion, the longterm benefits of such a financing model bring a significant improvement in the quality of services and patient satisfaction.
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http://dx.doi.org/10.32394/pe.74.62DOI Listing
January 2020

Clinicopathological factors associated with novel prognostic markers for patients with triple negative breast cancer.

Arch Med Sci 2019 Oct 13;15(6):1433-1442. Epub 2018 Nov 13.

Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Introduction: Triple negative breast cancer (TNBC) is characterized by a worse prognosis than other breast cancer subtypes. TNBC is defined by lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2. The aim of this analysis was to evaluate the relationship between immunohistochemical expression of novel prognostic markers (erythropoietin (EPO) and erythropoietin receptor (EPO-R)) and clinicopathological features of TNBC and non-TNBC patients.

Material And Methods: Our analysis was conducted on a group of 162 patients with breast carcinoma with lymph node metastasis (111 TNBC and 51 non-TNBC). All statistical analyses were performed with SPSS software v 12.0.

Results: Histopathologic subtyping of the 111 triple negative breast cancers identified 89.1% invasive ductal carcinomas of no special type and 10.9% other special types of cancers. TNBC more often presented EPO-R and EPO expression (36%; 37.8%) than non-TNBC (23.5%; 29.4%). Non-TNBC subgroup showed statistically significant correlation only between Ki-67 expression and histological grade (G1-G3) ( < 0.001), while TNBC subgroup demonstrated significant correlation between Ki-67 expression and histological grade (G1-G3) and tumor size (pT1-pT4) as well ( = 0.002; = 0.042), between the EPO-R expression and histological grade (G1-G3) ( < 0.001).

Conclusions: The relationship between the expression of EPO-R and histological malignancy grade in triple negative breast cancer, suggests that the present EPO-R expression in TNBC may constitute an additional prognostic factor.
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http://dx.doi.org/10.5114/aoms.2018.79568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855147PMC
October 2019

Causes of delays in breast cancer diagnosis in Poland.

Pol Merkur Lekarski 2019 Sep;47(279):85-90

Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Breast cancer is the most common malignant tumor in women. The results of breast cancer treatment to a large extent depend on the time of the primary diagnosis of the disease.

Aim: The aim of this study was to determine the most common causes of the delay and the delay time in the diagnosis of breast cancer in Polish women.

Materials And Methods: The study was performed using a diagnostic survey and analysis of medical documentation from the Subcarpathian Regional Oncology Center, Poland. A total of 231 patients with diagnosed breast cancer were recruited to the study.

Results: Delays in diagnosing of breast cancer were found in 83.1% of all the patients. The average time from the first symptom observation by a woman to the first medical consultation was on average 61.7 days. The most common cause of the delay in medical consultation in the examined group was a fear of diagnosing cancer (31.2%).

Conclusions: The examined women require permanent health education in the field of breast cancer and the importance of early diagnosis of the disease for the effectiveness of treatment and prognosis.
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September 2019

Refusal to Take Sick Leave after Being Diagnosed with a Communicable Disease as an Estimate of the Phenomenon of Presenteeism in Poland.

Med Princ Pract 2020 3;29(2):134-141. Epub 2019 Sep 3.

Medical University of Warsaw, Warsaw, Poland.

Objective: The purpose of this study was to estimate the prevalence of presenteeism in patients with communicable diseases in Poland.

Subject And Methods: This study was based on data from the medical records of 2,529 patients aged 19-64 years. All of the patients were diagnosed with communicable diseases. The inclusion criteria were based on implementing decision concerning communicable diseases made by the Commission of the European Union. Associations between refusal to take sick leave and patients' age, gender, and diagnosis in terms of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) were tested. Linear regression analysis of the data acquired from the patients who agreed to take sick leave was further used to estimate the possible length of sick leave in patients who refused to take it.

Results: The number of patients who refused to take sick leave was 18.1%. The presenteeism rate was related to the age of patients (periods of sick leave were longer in older patients) and the ICD-10 diagnosis (largely in bacterial intestinal infections and measles). The estimated number of days spent on sick leave in patients who refused to take it, assuming that they made a different decision and complied with it, was in the range of 4-6 days.

Conclusion: The prevalence of presenteeism in the case of communicable diseases in Poland is lower than in the general population. However, as the refusals to take sick leave took place in the case of potentially contagious diseases, the negative impact on productivity may be significant.
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http://dx.doi.org/10.1159/000503052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098319PMC
January 2021

Migrations of nurses and doctors from Poland: data for the years 2014-2020 based on the sample of the capital city of Warsawγ.

Arch Med Sci 2019 May 30;15(3):811-820. Epub 2019 Apr 30.

Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

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http://dx.doi.org/10.5114/aoms.2017.70331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524182PMC
May 2019

Assessment of Pain, Acceptance of Illness, Adjustment to Life, and Strategies of Coping with Illness among Patients with Gastric Cancer.

J Cancer Educ 2020 08;35(4):724-730

Department of Oncology and Hematology, Central Clinical Hospital of the MSWiA in Warsaw, Warsaw, Poland.

Gastric cancer is the fourth leading cause of deaths in Poland. The standard treatment for non-advanced gastric cancer is surgery, which significantly reduces the quality of life of patients. The objective of the study was to evaluate the strategy of coping with pain and its control, acceptance of illness, and adjustment to living with cancer in patients suffering from gastric cancer. The analysis of the impact of socio-economic factors on the above-mentioned problems was also analyzed. The study was conducted among 93 patients diagnosed with gastric cancer, treated on an outpatient basis at the Oncology Center-Maria Skłodowska-Curie Institute in Warsaw in 2017-2018. The PAPI (paper and pencil interview) technique was used. The questionnaire interview included metric questions (socio-economic variables) and four psychometric tests: BPCQ (the Beliefs about Pain Control Questionnaire), CSQ (the Pain Coping Strategies Questionnaire), AIS (Acceptance of Illness Scale), and Mini-MAC (Mental Adjustment to Cancer) test. In the area of pain control, patients with gastric cancer assign the greatest role to internal factors (M = 16.34, SD = 4.93), although women obtained the highest value in the impact of physicians. In the area of coping with pain, patients most likely select the strategy of praying/hoping (M = 22.19, SD = 9.36). The mean value of acceptance of illness for patients with gastric cancer is M = 24.02, SD = 7.69, and it is not conditioned by any socio-economic variable. In the area of mental adjustment to illness, the highest values were obtained by positive reevaluation (M = 20.73, SD = 3.35) and fighting spirit (M = 20.68, SD = 3.98). Patients with gastric cancer control pain mainly through internal factors. The most frequently chosen strategy for coping with pain is praying/hoping, and positive reevaluation prevails in the field of mental adjustment. The results point to specific factors that can affect the patient's pain, quality of life, and treatment outcomes. Knowing the diversity of these factors, it is possible to plan specific psychotherapeutic activities for specific groups of people that could be a supplement to the standard treatment process.
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http://dx.doi.org/10.1007/s13187-019-01519-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363718PMC
August 2020

Prevention of overweight and obesity undertaken by local government units in Poland.

Health Policy 2019 05 13;123(5):499-502. Epub 2019 Mar 13.

Department of Public Health, Medical University of Warsaw, Poland.

Background: Based on the estimates of World Health Organization (WHO), in European Union countries overweight or obesity affects more than 60% of men and over 50% of women. According to the nationwide European Health Interview Survey (EHIS) survey conducted in 2014, in Poland over 62% of men and nearly 46% of women carried excess weight in 2014.

Objective: The objective of the paper is to present health policy programmes aimed at prevention of overweight and obesity developed, implemented and funded by local government units (self-governments of voivodeships, counties, municipalities) in Poland in 2010-2016.

Methods: The study was based on a desk research. It covered data from two sources, i.e. data included in annual reports formulated by voivodes and submitted to Minister of Health concerning all health policy programmes implemented by local government units and data published online as part of reviews of draft programmes by the Agency for Health Technology Assessment and Tariff System (AOTMiT).

Results: In the period under review local government units implemented a total of 333 overweight and obesity prevention programmes. 18 programmes were reviewed by AOTMiT. Most programmes have been implemented in the Zachodniopomorskie and Mazowieckie Voivodeships, whereas the least in the Podlaskie, Lubelskie and Kujawsko-Pomorskie Voivodeships. Around 99% of municipalities, 97% of counties and 86% of self-governments of voivodeships did not complete any overweight and obesity prevention programmes in the period under review.

Conclusion: Insufficient engagement of local government units in the prevention of overweight and obesity - one of the primary objectives of the National Health Programme for 2007-2015 and 2016-2020. Differences in terms of the number of programmes implemented by particular types of local government units and the financial resources employed in the implementation of the programmes. Failure to fulfil the statutory obligation to obtain a review from AOTMiT. Failure to address the actual health needs of local communities related to overweight and obesity prevention by some of the voivodeships.
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http://dx.doi.org/10.1016/j.healthpol.2019.03.006DOI Listing
May 2019

Work Ability Index (WAI) values in a sample of the working population in Poland.

Ann Agric Environ Med 2019 Mar 28;26(1):78-84. Epub 2018 Sep 28.

Department of Experimental and Clinical Pharmacology, Medical University, Warsaw, Poland.

Introduction: Ability to work is most often defined as a relationship between a person's resources and requirements specific to a particular type of work. It is the result of interaction between job requirements in terms of physical and mental strain, capabilities and skills of the employee, as well as his/her health condition and own evaluation of functioning in a given organizational and social situation.

Objective: The primary objective of the study was to evaluate the current value of the Work Ability Index (WAI) in a sample of employees in Poland.

Material And Methods: The study sample was selected purposefully from 422,000 employees covered by the largest occupational health provider in Poland. The standard WAI questionnaire provided by CAWI (Computer-Assisted Web Interview) methodology was voluntary and completed anonymously by 688 employees within 12 months (0.16% response rate). The results were statistically analyzed using the Pearson's chi-squared test and correlation coefficient, independent-sample T test and one-way analysis of variance (p<0.05).

Results: It was found that the average value of WAI was 37.5 ± 7.7, and 37% of the participants represented low to moderate ability to work. The results showed no significant correlation between the WAI value and its 7 compounds and demographic variables. Nonetheless, a dependency between WAI level and industrial branch was observed.

Conclusions: Subjects with moderate and low WAI (1/3 of the study population) had particular indications to implement prophylactic actions, especially for the health care employees and civil servants, whose ability to work may be subject to accelerated deterioration.
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http://dx.doi.org/10.26444/aaem/91471DOI Listing
March 2019

Sin tax as a public health tool – strengths and weaknesses of this economic solution

Przegl Epidemiol 2019 ;73(4):567-575

Department of Economic and System Analysis, National Institute of Public Health-National Institute of Hygiene

Objective: The aim of the paper is to present in a synthetic way the sin tax tool, the mechanisms of its functioning, challenges related to the tool and examples of the application of this tax in selected countries.

Material And Method: In accordance with Agency for Health Technology Assessment and Tariff System guidelines, a review of literature in the PubMed and Cochrane scientific databases was conducted on the basis of search searches. They searched grey literature and institutional documents of health organizations and legal acts of selected countries that introduced sin tax in the period since 2005.

Results: Sin tax is a public health tax that aims to reduce the negative health attitudes of the population through the use of a price regulation mechanism. In order to prepare an effective economic tool, it is important to model it properly. Today, 35 countries around the world have introduced an additional tax on tobacco products, which is wholly or partly used for health care. In 9 countries, targeted taxes have been introduced on a component whose excessive consumption adversely affects health (sugar, salt, fats).

Conclusions: Sin tax is a tool that, if properly implemented, can contribute to changing consumer behaviour and thus have a positive impact on the health of the population. It should be remembered that decisions taken at the central level, especially those concerning the introduction of new taxes, should be supported by reliable analyses. Although sin tax is undoubtedly an effective and increasingly widely used tool, it is not free from defects. One of its major drawbacks is its regressive character and potential negative social perception.
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http://dx.doi.org/10.32394/pe.73.53DOI Listing
October 2020

Health needs as a priority of local authorities in Poland based on the example of implementation of health policy cancer programmes.

Arch Med Sci 2018 Oct 12;14(6):1439-1449. Epub 2016 Sep 12.

Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Introduction: In developed countries, malignant tumours are the second most common cause of death after cardiovascular diseases. The estimates made by epidemiologists indicate that the incidence and death rate for malignant tumours all over the world, Poland included, will probably grow in the decades to come, specifically among patients who are over 65. The aim of the study was to evaluate how local government units address the health needs of citizens on the basis of an analysis of health policy programmes concerning malignant tumours completed in Poland in 2009-2014.

Material And Methods: The study was based on desk research. The data included in the annual reports submitted to the Minister of Health concerning completed health policy programmes were used.

Results: The most programmes were completed in the Wielkopolskie and the Mazowieckie voivodeships, whereas the fewest were completed in the Kujawsko-Pomorskie and the Podlaskie voivodeships (χ2(15) = 2121.81, p < 0.001). The most programmes were completed by municipalities, followed by counties and, finally, self-governed voivodeships (Q(2) = 1967.90, p < 0.061). The majority of programmes concerned breast cancer and cervical cancer. There was no increase in the activity of local government units in terms of the number of implemented programmes, and a decreasing size of the population covered by the programmes.

Conclusions: There is a very high degree of differentiation in the involvement of particular voivodeships in fighting cancer regarding the number of implemented health programmes. There are various degrees of involvement of particular types of local government units in the implementation of programmes in the field of cancer. The repeatability of actions undertaken at the local and national level may indicate limited effectiveness of the policy to fight cancer. It is necessary to implement more programmes in the field of oncological diseases and to increase the population covered by these programmes.
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http://dx.doi.org/10.5114/aoms.2016.62283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209714PMC
October 2018

Immunoexpression of DNA fragmentation factor 40, DNA fragmentation factor 45, and B-cell lymphoma 2 protein in normal human endometrium and uterine myometrium depends on menstrual cycle phase and menopausal status.

Arch Med Sci 2018 Oct 31;14(6):1254-1262. Epub 2017 Jul 31.

Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland.

Introduction: DNA fragmentation factors 40 and 45 (DFF40 and DFF45) are final executors of apoptosis, and B-cell lymphoma 2 (Bcl-2) is a well-recognized apoptosis inhibitor. We aimed to evaluate DFF40, DFF45 and Bcl-2 immunoexpression in the normal human endometrium with respect to the glandular and stromal layer and in uterine myometrium.

Material And Methods: DFF40, DFF45, and Bcl-2 expression was assessed via immunohistochemistry in the endometrium and myometrium collected postmenopausally and premenopausally during the proliferative and secretory phases of the menstrual cycle.

Results: Compared to the myometrium and stroma, endometrial glands showed the highest DFF40 and DFF45 expression in pre- and postmenopausal specimens. DFF45, but not DFF40, glandular expression dependent on menstrual cycle phase and DFF40 and DFF45 scoring was significantly lower in postmenopausal specimens. Significantly higher Bcl-2 expression was observed in proliferative glandular endometrium compared to secretory and postmenopausal specimens. No cycle- or menopause-dependent changes were reported for stromal or myometrial DFF40, DFF45 or Bcl-2 expression. DFF40, DFF45 and Bcl-2 expression was independent of age, age at menarche and menopause, BMI, menstrual cycle and menses lengths, parity and gravidity.

Conclusions: The study provides important evidence regarding menstrual cycle-dependent changes in the expression of DFF40, DFF45 and Bcl-2 in the normal human endometrium, especially in the glandular layer, and shows that their levels are stable in the normal uterine myometrium.
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http://dx.doi.org/10.5114/aoms.2017.69383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209718PMC
October 2018

Immunity to hepatitis A virus among working professionals in Poland - Results of a 3-year serological survey 2013-2015.

Ann Agric Environ Med 2018 Sep 25;25(3):572-575. Epub 2018 Sep 25.

National Institute of Public Health, Warsaw, Poland.

Introduction: Hepatitis A (HA) is caused by infection with the hepatitis A virus (HAV). The differential etiological diagnosis of acute hepatitis is based on a positive result of the serological test detecting IgM class anti-HAV. For epidemiological studies on past infection and seroprevalence of HAV in populations, the tests measuring IgG class anti-HAV or total anti-HAV are used. Since the 1990s, specific prophylaxis is possible by vaccination against HA. In Poland, vaccination is recommended and in majority is performed at own cost.

Material And Methods: Database was obtained from electronic medical records of the 2 major private health care providers networks (Luxmed and Medicover) operating in Poland. During a 3-year period (2013-2015), 1,124 persons with unknown status of anti-HA vaccination were tested for the presence of total anti-HAV. Objective. The aim of the study was to evaluate the seroprevalence of anti-HAV among working professionals in Poland.

Results: Anti-HAV were detected in 603 (53.6%) persons, while 521 (46.3%) tested negative. The study group was divided into 2 subgroups: 25-44 and 45-64-years-old. For detailed statistical analysis, the presence of anti-HAV was considered as a dependent variable, and its predictors were gender, age and the year of the test performance. The presence of anti-HAV was significantly more prevalent in older age group. The lack of specific antibodies was more prevalent in younger age group.

Conclusions: Results of the study show increasing susceptibility to HAV infection in the younger age group, compared with the older age group of corporate professional employees in large cities in Poland. Since the epidemiological situation of HA is currently changing with increasing number of symptomatic cases of HA, it is suggested that employers might consider including an additional procedure of vaccination against HA into their private health insurance portfolio.
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http://dx.doi.org/10.26444/aaem/91467DOI Listing
September 2018

Health needs in local government policies in Poland in the context of anti-smoking health policy programs.

Adv Clin Exp Med 2018 Dec;27(12):1651-1659

Department of Cancer Prevention, Faculty of Health Sciences, Medical University of Warsaw, Poland.

Background: According to the World Health Organization (WHO), every year tobacco smoking kills around 5.4 million people worldwide. Tobacco smoking is a major risk factor for cardiovascular diseases, respiratory diseases and cancer. In Poland, an average of 67,000 people die every year on account of smoking.

Objectives: The aim of the study was to evaluate the health security guaranteed by local governments based on an analysis of health policy programs associated with tobacco consumption, which were conducted in Poland from 2009 to 2014 by local governments.

Material And Methods: The study was based on desk research. The data was sourced from the annual reports submitted to the Minister of Health, concerning the health policy programs which were carried out. The analysis covered programs which name, objective or description of tasks indicated that they concerned tobacco smoking.

Results: The largest number of programs was completed in the West Pomeranian, Warmian-Masurian and Masovian voivodeships. The smallest number of programs were completed in Kuyavian-Pomeranian, Łódź and Opole voivodeships. The greatest number of programs were carried out by municipalities, followed by counties and county towns, and finally by self-governments of the voivodeships. The number of preventive programs was significantly greater than the number of other types of programs. The majority of programs were aimed at children; there were fewer programs dedicated to adults. The expenditure on the programs was the highest in self-governments of the voivodeships, while the lowest was in municipalities.

Conclusions: The steady growth in the number of anti-smoking programs completed 2009-2014 was one of the factors that reduced tobacco smoking. In view of the mortality rates due to cardiovascular diseases, the inhabitants of Lublin and Warmian-Masurian voivodeships had their health needs addressed most efficiently. In the case of mortality rates due to tracheal, bronchial and lung cancer, the health needs of the inhabitants of Warmian-Masurian and West Pomeranian voivodeships were addressed most efficiently.
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http://dx.doi.org/10.17219/acem/74756DOI Listing
December 2018

Refusal to take a sick leave as an estimate of the phenomenon of presenteeism in Poland.

Oncotarget 2018 Jun 15;9(46):28176-28184. Epub 2018 Jun 15.

Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Introduction: Absenteeism and presenteeism are two main phenomena related to health problems and professional activity. Presenteeism is the involvement in a professional activity despite being ill. The purpose of the current study is to estimate the prevalence of presenteeism in Poland on the basis of medical records and to explore associations between presenteeism and patients' age, gender and type of medical problem. Another purpose is to provide estimates of the length of sick leave if it was accepted.

Results: The amount of patients who refused to take a sick leave was 27.4%. There was a minor relationship between the refusals and gender (slightly higher in men) as well as strong effects of the age of patients (periods of sick leave were longer in older patients) and ICD-10 diagnosis (largely in acute diseases of the upper respiratory tract). The estimated number of days spent on sick leave in the group of patients that refused to take it, assuming that they made a different decision and complied to it, was in the range between 5 and 10 days.

Discussion: The prevalence of presenteeism in Poland is relatively high. Since the largest proportion of refusals took place in the case of potentially contagious diseases, the negative impact on productivity may be even higher. Even though the relationship between presenteeism and wages remains unclear, the remarkable increase of wages in Poland within the last 20 years may explain the propensity to work despite being ill. Further research needs to consider the simultaneous use of medical records and self-measured productivity loss.

Materials And Methods: The current study is based on data from medical records concerning 550,360 patients aged 19-64. Associations between refusals to take a sick leave and patients' age, gender, as well as diagnosis in terms of ICD-10 (International Statistical Classification of Diseases and Related Health Problems), were tested. Linear regression analysis on the data acquired from the patients who accepted to take a sick leave were further used to estimate the possible length of sick leave in the group of patients that refused to take it.
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http://dx.doi.org/10.18632/oncotarget.25592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021350PMC
June 2018

Risk assessment of night-eating syndrome occurrence in women in Poland, considering the obesity factor in particular.

Neuropsychiatr Dis Treat 2018 13;14:1521-1526. Epub 2018 Jun 13.

Katowice Faculty, SWPS University of Social Sciences and Humanities, Warsaw, Poland.

Introduction: Night-eating syndrome (NES) involves uncontrolled and most often repeated binge eating during the night. It is related with mood disorders as well as sleep disorders and it may cause obesity. Risks related to NES are obesity, binge eating disorder, bulimia nervosa, affective disorders, and sleep disorders. The objective of this study is to analyze eating habits in terms of the risk assessment of NES occurrence in the population of women in the Masovian Voivodeship (in Poland).

Patients And Methods: Six hundred and eleven women living in the Masovian Voivodeship participated in the study. The average age of the respondents was 22.7 years (median = 23.0; interquartile range = 3.0). The Night Eating Questionnaire (NEQ) was used to assess the risk of NES.

Results: In the studied group of women, 1.3% of cases (N = 12) reached a NEQ total score of ≥25, which indicates a probability of 40.7% for NES, while 0.7% (N = 4) reached a score of ≥30, which indicates a probability of 72.2% for occurrence of this syndrome. The highest average total score was observed in the group of obese people. The level of education of the participants did not significantly affect the NEQ score. A weak correlation was observed between the place of residence variable and the mood/sleep subscale ( = 0.11, < 0.01).

Conclusion: NES may be one of the causes of overweight and obesity; therefore, the need for further studies on this health issue is justified. It is worth pointing out that knowing the conditions responsible for the occurrence of NES, it is possible to suggest a prevention procedure for this condition.
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http://dx.doi.org/10.2147/NDT.S159562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005332PMC
June 2018

Breast cancer and cervical cancer prevention programmes carried out by local government units in Poland in 2009-2014.

Oncotarget 2018 Apr 24;9(31):21943-21949. Epub 2018 Apr 24.

Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Background: In 2014 the standardised incidence rate for breast cancer in Poland reached 51.6/100,000, while the mortality rate reached 14.8/100,000. The incidence rate for breast cancer in the EU was 106.6/100,000, the mortality rate - 22.4/100,000. In 2014 the incidence rate for cervical cancer in Poland was 8.8/100,000, the mortality rate - 4.5/100,000. The incidence rate in the EU was 11.3/100,000 and the mortality rate - 3.7/100,000.

Objective: The aim of the paper was to establish the number of health policy programmes concerned with breast cancer and cervical cancer in women carried out in 2009-2014 by local government units, with specification of the type of programme, type of local government units that carried out the programmes and the costs of implementation of the programmes.

Methods: The study was based on a desk research. The analysis covered data included in annual reports submitted by voivodes to Minister of Health, concerning health policy programmes implemented by local government units in 2009-2014.

Results: The greatest number of programmes concerned with prevention of breast cancer and cervical cancer were implemented in municipalities, followed by counties and finally - self-governed voivodeships. The number of programmes concerned with primary prevention was three times smaller (656) than the number of programmes concerned with secondary prevention (2,229). The greatest number of primary prevention programmes were implemented in Dolnośląskie, Wielkopolskie and Mazowieckie Voivodeships, and the greatest number of secondary prevention programmes - in Wielkopolskie, Mazowieckie and Zachodniopomorskie Voivodeships.

Conclusion: It was found that the number of programmes implemented by particular local government units and the financial resources employed in the implementation of the programmes were different. It is probable that some of the initiatives of local government units related to secondary prevention coincide with the actions undertaken under the National Programme for Fighting Cancer. The entities that carry out breast cancer and cervical cancer prevention programmes need to coordinate their actions.
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http://dx.doi.org/10.18632/oncotarget.24513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5955174PMC
April 2018

Patient mental adjustment to selected types of cancer.

Psychiatr Pol 2018 Feb 28;52(1):129-141. Epub 2018 Feb 28.

Zakład Profilaktyki Onkologicznej WUM.

Objectives: Physical symptoms related to cancer are associated with various mental conditions. An adopted attitude towards pain and disease affects the quality of life of patients and may even decide about the final outcome of therapy. The objective of the study was to assess the degree of mental adjustment of patients diagnosed with breast, lung, colorectal and prostate cancer. The analysis also covered the effect of socioeconomic factors on mental adjustment in patients in the above groups.

Methods: The study included 902 patients treated on an outpatient basis at the Center of Oncology, the Maria Skłodowska-Curie Institute in Warsaw, in the year 2013. The study participants were patients diagnosed with breast, lung, colorectal and prostate carcinoma. The Paper and Pencil Interview (PAPI) technique was applied. The questionnaire interview included demographic-type questions (socioeconomic variables) and the Mini-Mental Adjustment to Cancer (mini-MAC) scale, which measures the degree of mental adjustment to disease.

Results: The highest scores in the anxious preoccupation and helplessness-hopelessness subclasses were those of the lung, colorectal, breast and prostate cancer patients. In breast and lung cancer study participants, differences between individual categories distinguished due to socioeconomic features proved statistically insignificant. However, significant dependencies were observed between mental adjustment to disease and chemotherapy in the past year; though, the results differ with respect to the primary site.

Conclusions: The primary site affects patient adjustment to disease. Socioeconomic factors in the area of mental adaptation differentiate colorectal carcinoma patients.
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http://dx.doi.org/10.12740/PP/OnlineFirst/44732DOI Listing
February 2018

Awareness and attitudes towards clinical trials among Polish oncological patients who had never participated in a clinical trial.

Adv Clin Exp Med 2018 Apr;27(4):525-529

Department of Pharmacodynamics, Medical University of Warsaw, Poland.

Background: Participation in a clinical trial significantly shortens waiting time associated with receiving specialist care. Furthermore, it may be the case that, through clinical trials, subjects can access medicines that are not typically available in Poland.

Objectives: The aim of this study was to determine the opinions of oncological patients about clinical trials.

Material And Methods: The research has been carried out during the years 2014-2016. A proprietary questionnaire consisting of 10 closed, single and multiple choice questions about awareness and perceptions of clinical trials, and 5 questions concerning demographic information was used. A group of 256 patients with cancer (54% women, 46% men), aged 21-77 years, was surveyed.

Results: Respondents were statistically more likely to decide to participate in a clinical trial as oncological patients than the healthy volunteers (Pearson's χ2 test p = 0.00006). The desire to qualify for clinical trials in no way depends on the knowledge of side effects (Pearson's χ2 test p = 0.16796).

Conclusions: Our study found that the patients' awareness about clinical trials varied. However, a positive attitude towards research was visible. The main identified barriers to clinical trial participation were fear of possible side effects. Most patients regarded clinical trials as useful, and considered that they are conducted to introduce new treatment/new drug.
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http://dx.doi.org/10.17219/acem/68762DOI Listing
April 2018

Pain, acceptance of illness, adjustment to life with cancer and coping strategies in prostate cancer patients.

Arch Med Sci 2017 Oct 8;13(6):1459-1466. Epub 2016 Mar 8.

Department of Public Health, Medical University of Warsaw, Warsaw, Poland.

Introduction: Prostate cancer is the second most common type of carcinoma in men. The rate of prostate cancer has increased approximately fivefold lover the last 30 years. The purpose of the study was to evaluate coping strategies, pain management, illness acceptance, and adjustment to cancer in patients diagnosed with prostate carcinoma and the effect of socioeconomic variables on the above-mentioned issues.

Material And Methods: The study included 228 patients diagnosed with prostate cancer. The questionnaire interview consisted of demographic questions and four psychometric tests: BPCQ, measuring the influence of factors affecting pain management, CSQ, designed to evaluate pain coping strategies, the AIS questionnaire, measuring disease acceptance, and the Mini-Mac.

Results: Pain locus of control scores in prostate cancer patients are distributed evenly across all three BPCQ subscales. The top mean score was observed in the area of beliefs that powerful others (doctors) control pain. Increased behavioral activity was the most frequently selected coping strategy (mean score = 18.27). The average level of disease acceptance in study patients was 30.39, with a standard deviation of 8.07. The results were differentiated by education ( = 0.08) and income ( = 0.012). The most frequently indicated coping strategies were fighting spirit (mean score = 22.46) and positive re-evaluation (mean score = 22.04).

Conclusions: The main belief about pain control in prostate cancer patients is that powerful others (doctors) control pain. The study patients cope with disease constructively. The main socioeconomic variables which differentiate the scores obtained across all tests are income and education.
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http://dx.doi.org/10.5114/aoms.2016.58458DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701675PMC
October 2017