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Background: Due to multiple morbidities, patients experience various symptoms that may be of psychogenic or somatic origin. Anxiety and depression can induce somatization and the feeling that ailments require urgent medical intervention. Aim of the study: This study aimed to: (1) identify which symptoms self-referral patients most commonly report at the emergency department (ED) and which medical diagnoses they are discharged with; and (2) determine whether the type and severity of symptoms, as well as, sociodemographic variables are related to anxiety and depression levels. Material and methods: The study included 110 patients who self-referred to the ED at the University Clinical Hospital in Opole. Diagnostic surveys and questionnaires were used, including the Hospital Anxiety and Depression Scale and an original questionnaire developed by the authors. Results: Among those suffering from chronic diseases (n = 53; 48.62%), 12 patients (22.64%) did not complete a single visit to the PHCF (Primary Health Care Facility), and 30 patients (56.60%) did not complete a visit to OSC (Outpatient Specialist Care) during the previous 12 months. The most common cause of reporting to the ED were pain and a burning sensation in the chest (n = 29; 27.10%). During discharge, the most common diagnosis was “other chest pains” (n = 22; 20.00%). 82.73% (n = 91) of patients had clear anxiety disorders, and 68.18% (n = 75) had clear depressive disorders. Conclusions: In case of somatic symptoms without a discernible cause in patients, it is necessary to implement comprehensive measures within PHCF, such as periodic measurements of anxiety and depression severity, psychological consultation, and an in-depth medical interview. These data also suggest that proper clinical monitoring should be implemented, including clinical parameters relevant for chronic diseases and the number of visits to the PHCF and OSC.
Personalised medicine (PM) is the adaptation of medical treatment to an individual patient. More importantly, PM offers the potential to detect disease earlier when it is easier to treat effectively. PM is beginning to overcome the limitations of traditional medicine. In PM there are many potential benefits and facilitators but also many barriers. The goals of the Regions4PerMed project are to set up the first interregional cooperation on PM, align strategies and financial instruments, and most importantly, identify primary barriers in personal medicine adoption in the health care system and systematic actions to remove as many of them as possible to create a future where PM is fully integrated into real life settings. Each key action activity will be followed by a focus group or semi-structured qualitative interview. The questions asked during the research will concern barriers and facilitators of PM implementation in the country of a subject and will concern: medical big data and electronic medical records; health technology in connected and integrated care; the health industry; facilitate the innovation flow in health care; socio-economic aspects. The qualitative study outcomes are supposed to bring more qualitative data to the discussion. They could be implemented to the daily practice of the health care system’s stakeholders through the best practices transferred to all five key strategic areas of the Regions4PerMed project.
Background: In Russia, there is an active ongoing process of national revival of the indigenous small-numbered peoples of the North Siberia, such as the Evenks. Revival of the younger generation, in particular, remains a priority. The state helps to solve the problems of education and adaptation of Evenk children to modern life. This is necessary because parents, hunters, and reindeer herders have a nomadic lifestyle. The educational feature of Evenk children is to study and live in a boarding school after elementary school graduation. Success of adaptation largely depends on the ability to account for the ethnopsychological specificity of Evenk children. Aim of the study: To study characteristics of the psychoemotional sphere and identify ethnospecific indicators for the adaptation of Evenk children to a boarding school. Material and methods: Pupils (N = 409) aged 10–16 from the village boarding school of Evenkia, Krasnoyarsk Territory, Russia were examined. Pupils consisted of 132 Evenk children and 277 Russian children. The emotional sphere was evaluated according to Eysenck Personality Inventory (EPI) and lateral phenotype was evaluated according to Bragina & Dobrokhotova. Results: We found that Evenk children show a predominant pattern of left laterality (p = 0.024). In addition, relative to Russian children, Evenk children are more likely to show the introverted personality type (p = 0.035). Relative to Russian children, Evenk children are more restrained in their emotional manifestations, have greater difficulty in communicating with strangers, answer with monosyllables, and show a less vivid emotional reaction to praise. Further, relative to Russian children, Evenk children are more likely to show a high level of emotional stability (i.e., 9–10 points; p = 0.001). Conclusions: The present study examined the psychoemotional characteristics of Evenk children. We identified ethnospecific indicators, including an introversion personality type combined with emotional stability and left laterality. Identification of these characteristics allowed us to form a risk group of children in adaptation. Ethnospecific indicators of the psycho-emotional sphere should be considered for effective management of the adaptation of children in a boarding school.
Background: The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study: The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Material and methods: Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results: 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions: A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.
Consumer and system-wide gains remain limited by an outmoded policy regime. With scientific innovation running far ahead of public policy, physicians, researchers and patients are not receiving full advantage of the latest developments. European health systems require a seamless and rapid flow of digital information, including genomic, clinical outcome, and claims data. Research derived from clinical care must feed back into assessment, in order to advance care quality for consumers. National health systems are heterogeneous; the solutions and required fundamental approaches differ between the European member states and are not entirely portable and scalable. To date, this applies not only to general systemic aspects but particularly to cross-border reimbursement issues and the exchange of treatment and patient data. To answer those needs, an international consortium was established to implement the project “Interregional coordination for a fast and deep uptake of personalised health”: Regions4PerMed. A cycle of international events, such as conferences, in situ visits and workshops, has been planned. Interdisciplinary groups of experts will exchange thoughts and experiences to design solutions that could be implemented in the various healthcare systems. Regions4PerMed aims to coordinate regional policies and innovation programmes in personalised medicine and personalised health to accelerate the deployment of personalised health for patients. Key Action 2 is dedicated to health technologies and smart and integrated care.
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Health impact of wind farms

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Introduction and objective: Wind power is employed worldwide as an alternative source of energy. At the same time, however, the health effects of wind turbines have become a matter of discussion. The purpose of this study is a critical review of available reports providing arguments both for and against the construction of wind farms. The authors also attempt to propose recommendations in accordance with the Evidence-Based Medicine (EBM) guidelines. In the case of exposure to wind farms, a randomized controlled trial (RCT) is impossible. To obtain the highest-level recommendations, analysis of case-control studies or cohort studies with control groups should be performed. Preferably, it should include geostatistical analysis conducted with the use of variograms and the kriging technique. Combinations of key words were entered into the Thomson Reuters Web of KnowledgeSM and the Internet search engine Google. Short description of state of the art: The nuisance caused by wind turbines is stereotypically linked with the noise that they produce. Nevertheless, the visual aspect of wind farms, opinions about them, and sensitivity to sound seem to be of the greater importance. To date, the direct correlations between the vicinity of modern wind farms, the noise that wind turbines make, and possible consequences to health have not been described in peer reviewed articles. Health effects are more probably associated with some environmental factors leading to annoyance or frustration. All types of studies share the same conclusion: wind turbines can provoke annoyance. As with any project involving changes in the local environment, a certain level of irritation among the population can be expected. There are elected officials and government representatives who should decide what level of social annoyance is acceptable, and whether wind power advantages outweigh its potential drawbacks. The influence of wind turbines on human emotional and physical health is a relatively new field of research. Further analyses of these issues are justified, especially because none of the studies published in peer-reviewed journals so far meet the criteria for cohort or case-control studies. Summary: Due to methodology, currently available research results do not allow for higher than C-level recommendations. In the case of wind farms, the ideal types of research would be: a retrospective observation of a particular group of residents before and after the wind farm construction, case-control studies or cohort studies with control groups matched in respect of socioeconomic factors, predisposition for chronic diseases, exposure to environmental risk factors, and only one variable which would differentiate cases from controls – the distance between place of residence and a wind farm.
Background: Multiple sclerosis is a chronic and highly debilitating disease with very high economic and social consequences. Designing changes to improve the functioning of the healthcare model primarily requires learning about the needs of beneficiaries. Aim of the study: The purpose of our study is the results’ description and summary of conclusions of the research conducted in the past years. These results are currently being used for the construction of a coordinated care model for MS patients. Material and methods: One questionnaire survey addressed to MS patients, carried out between 01.12.2013 and 01.02.2014 and the second one addressed to Polish and European medical professionals, carried out between 01.09.2016 and 04.10.2016 performed in 51 European centers and 2 branches of the Turkish Association of patients with MS. Results: In the first survey 84.4% patients declared that during the illness they received mental support mostly from their family: 48.5% received it from physicians; 42.1% from a nurse. 64.8% of the respondents declared that they received no support from social organizations and 77.6% received no support from religious organizations. According to the results of the survey for healthcare professionals in Poland and Europe, in 54.9% of the European institutions and in 22.4% of the Polish institutions, dedicated IT systems are used for processing MS patients’ data. Among institutions using IT, 52.9% of the European and 10.1% of the Polish ones keep the patient’s entire documentation, as well as a patient satisfaction survey, in an IT system. Conclusions: Based on our studies described above, the patients’ needs, resources and capabilities seem to indicate that the scale of system inefficiencies is such that remodeling care for this well-defined group of patients is justified and feasible.
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Background: In pregnant women, changes in body posture and higher pelvic anteversion and increase lumbar lordosis are observed. Changes in the arrangement of bony elements result in an alteration in the pelvic floor soft tissue tension, increased resting muscles and ligaments tone in the lumbosacral region and sacral bone. The negative consequences of posture changes in pregnant women is lower back pain. The literature describing a lot of physiotherapeutic procedures and various of type massage which can use in pregnant women. In this study, we present applications of tensegrity massage combined with point manipulation of selected muscle attachments. Aim of the study: The aim of the study was to determine the effectiveness of tensegrity massage combined with point manipulation of selected muscle attachments in pregnant women. Material and methods: Two 30-year-old pregnant women received tensegrity massage were qualified for the study. The patients were subjected to a series of nine massage sessions of 45 minutes each, performed three times a week. Pain levels were assessed in both patients using the VAS. Results: The procedure involved normalization of the tone of the system of ligaments, fascia, and muscles in the lumbar spine region, the pelvic girdle, and the lower limbs. The therapy brought pain relief and reduced muscle tone in the lumbosacral region of the spine, as well as in the pelvic girdle and the lower limbs. Conclusions: Tensegrity massage combined with point massage is an effective therapy for pain problems and incorrect resting muscle tone caused by pregnancy-related posture changes within the pelvis and spine.
Personalised medicine (PM) represents a paradigm shift away from the ‘one size fits all’ approach to the treatment and care of patients with a particular condition, to one which uses emergent technologies such as diagnostic tests, functional genomic technologies, and molecular pathway profiling to better manage patients’ health and employ target therapies. The current challenge for national and regional authorities is to facilitate the shift from a reactive healthcare system based on episodic and acute care models to a personalized health (PH) system that uses preventive and predictive measures, where at-risk individuals are stratified to intervene before the onset of symptoms or risk is predicted using cutting-edge technologies before symptoms appear. While PH is paving the way toward better and more efficient patient care, it still lacks the cooperation and coordination needed to organise the fragmented field, which is a severe drawback to its development and to the placement of effective financial investments. For this reason, it is crucial to direct major efforts towards coordinating and aligning relevant stakeholders across Europe and beyond, creating a participatory approach, building trust, enabling a multi-stakeholder process, and channeling investments towards PH. Thus, Regions4PerMed aims to coordinate regional policies and innovation programmes in PM and PH to accelerate the deployment of PH for patients.
Background: Medical assistants/care coordinators play a crucial role in the coordinated care system. The tasks of nurses and some qualified supporting staff have been extended to include this role along with the implementation of the pilot program POZ Plus in Polish primary healthcare. A personalized approach to the patient is especially important during the implementation of large-scale prevention programs. Aim of the study: To assess who has the greatest influence on the patient’s decision to undergo screening colonoscopy and outline the current and potential roles of nurses in this process. Material and methods: This questionnaire-based study was conducted at the coordinated care facility Medical and Diagnostic Center (CMD) in Siedlce, Poland between March 1st and June 15th, 2017. Results: 138 patients participated in the study. The majority (75; 54.4%) reported they were directly convinced to undergo colonoscopy by a primary care physician. 18 (13.0%) were convinced by a nurse, and 22 (15.9%) by another specialist. The remaining (23; 16.7%) patients indicated other factors. The majority of patients (74; 53.6%) responded saying that all necessary information about the entire test course was provided by the nurse, while 35 (25.4%) shared that this information had come from the primary care physician, 8 (5.80%) from the specialist doctor, 3 (2.17%) from the receptionist and 18 (13.0%) from other sources of information, such as the Internet, leaflets and notice boards. Conclusions: We found that primary care physicians at this institution have an important role in convincing patients to undergo preventive colonoscopy, while nurses provide key information to patients on the preparation and the course of this procedure. Although the current model seems to be effective in a coordinated care setting, there may be still a place for nurse care coordinators to take on some tasks previously performed by doctors.
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