bluuebunny/crossref_metadata_2025 huggingface dataset:
تقويم برنامج إعداد معلم الفيزياء كلية التربية – جامعة تعز في ضوء الاتجاهات التربوية الحديثة
Authors: طالب د. عبدالله عبده أحمد
Published: July 2023

يهدف البحث إلى تقويم برنامج إعداد معلم الفيزياء في كلية التربية ومدى أهمية تلك المقررات، والتعرف على مدى ملاءمة برنامج إعداد معلم الفيزياء في كلية التربية - جامعة تعز للاتجاهات التربوية الحديثة، وتوفير قاعدة علمية لاتخاذ قرارات تطوير برنامج إعداد معلم الفيزياء بما يتناسب مع الاتجاهات التربوية الحديثة. ويقتصر البحث على طلبة قسم الفيزياء –كلية التربية – جامعة تعز - المستوى الرابع – الفصل الدراسي الثاني للعام الجامعي 2005/2006م. ومعلمي ومعلمات وموجهي وموجهات مادة الفيزياء في المرحلة الثانوية بمدينة تعز، والاتجاهات التربوية الحديثة التي تضمنتها الأداة المكونات من (35) اتجاها يشتمل على (مدخل المعلم والتكنولوجيا، التنور العلمي، المستحدثات العلمية وأخلاقيات العلم، إعداد معلم الفيزياء القائمة على معايير الأداء أو الإنجاز). وقد اعتمد البحث المنهج الوصفي التحليلي، واشتمل مجتمع البحث جميع طلاب قسم الفيزياء المستوى الرابع بكلية التربية - جامعة تعز البالغ عددهم (165) طالبا وطالبة، كما اشتمل أيضا على (120) معلما ومعلمة، و(40) موجها وموجهة لمادة الفيزياء بالمدارس الثانوية بمدينة تعز للعام الدراسي 2005/2006م. وتوصل البحث إلى قصور وضعف في إعداد الطالب/المعلم بالنسبة إلى جوانب الإعداد الأكاديمي كرابط الجانب النظري للمادة العلمية بالجانب العلمي، كما لا تتوفر الأدوات والتجارب اللازمة للتجريب، كما أن الجانب المعني يوجد به قصور، إذ إنه لا يفي باحتياجات أو متطلبات التغيير وتعميق المعرفة.
Synthesis of Liquid crystals with terminal polar groups and study their mesomorphic and spectroscopic properties
Authors: AL - Hamdani Ahood J . , Majeed Nezar L. S. AL - Dain and Ahmed
Published: July 2023

Synthesis new Schiffs bases substituted with polar groups CI . Br , F , N02, CH3 , OCH3 , COCH3 in para position or aniline moiety, and derived Cu ( II ) complex from the Schiff base which substituted with COCH3. The Schiffs bases substituent with CH3 , OCH3 exhibited Nematic phase but the other Schiff bases and Cu ( II ) complex exhibited Smectic phase ( Sc ) only. Molecular complexes of Cu (II) complex

with various nitrogen bases were studied spectrophotometrically in benzene solvent at

different temperatures. These entire complex show a new broad charge transfer band in the visible region of the electromagnetic spectrum.

All the donors are known to form I: I complex with the acceptor and their

stoichiometry was unaffected by the variation of temperature over a small interval. The thermodynamic and spectroscopic parameters were evaluated. The order of donor strength followed the sequence:

Butyl amine> 4 - methyl pyridine > N,N –

dimethyl aniline.
Constitutional MLH1 Methylation Is a Major Contributor to Mismatch Repair–Deficient, MLH1-Methylated Colorectal Cancer in Patients Aged 55 Years and Younger
Authors: Hitchins Megan P. , Dámaso Estela , Alvarez Rocio , Zhou Lisa , Hu Yajing , Diniz Marcio A. , Pineda Marta , Capella Gabriel , Pearlman Rachel , Hampel Heather
Published: July 2023

Background: Most mismatch repair–deficient (MMRd) colorectal cancer (CRC) cases arise sporadically, associated with somatic MLH1 methylation, whereas approximately 20% have germline mismatch repair pathogenic variants causing Lynch syndrome (LS). Universal screening of incident CRC uses presence of MLH1 methylation in MMRd tumors to exclude sporadic cases from germline testing for LS. However, this overlooks rare cases with constitutional MLH1 methylation (epimutation), a poorly recognized mechanism for LS. We aimed to assess the frequency and age distribution of constitutional MLH1 methylation among incident CRC cases with MMRd, MLH1-methylated tumors. Methods: In retrospective population-based studies, we selected all CRC cases with MMRd, MLH1-methylated tumors, regardless of age, prior cancer, family history, or BRAF V600E status, from the Columbus-area HNPCC study (Columbus) and Ohio Colorectal Cancer Prevention Initiative (OCCPI) cohorts. Blood DNA was tested for constitutional MLH1 methylation by pyrosequencing and real-time methylation-specific PCR, then confirmed with bisulfite-sequencing. Results: Results were achieved for 95 of 98 Columbus cases and all 281 OCCPI cases. Constitutional MLH1 methylation was identified in 4 of 95 (4%) Columbus cases, ages 34, 38, 52, and 74 years, and 4 of 281 (1.4%) OCCPI cases, ages 20, 34, 50, and 55 years, with 3 showing low-level mosaic methylation. Mosaicism in blood and normal colon, plus tumor loss of heterozygosity of the unmethylated allele, demonstrated causality in 1 case with sample availability. Age stratification showed high rates of constitutional MLH1 methylation among younger patients. In the Columbus and OCCPI cohorts, respectively, these rates were 67% (2 of 3) and 25% (2 of 8) of patients aged <50 years but with half of the cases missed, and 75% (3 of 4) and 23.5% (4 of 17) of patients aged ≤55 years with most cases detected. Conclusions: Although rare overall, a significant proportion of younger patients with MLH1-methylated CRC had underlying constitutional MLH1 methylation. Routine testing for this high-risk mechanism is warranted in patients aged ≤55 years for a timely and accurate molecular diagnosis that will significantly alter their clinical management while minimizing additional testing.
Envejecer en casa sí, pero con los recursos adecuados y en el territorio. Estudio de caso de La Vall dels Alcalans (Ribera Alta, Valencia)
Authors: Pinazo Hernandis Sacramento
Published: July 2023

El envejecimiento de la población en la Comunidad Valenciana plantea retos que se deben abordarcon urgencia, sobre todo en las zonas rurales. 297 municipios del interior tienen una tasa de envejecimientomayor del 20 %. De entre estos, 52 municipios están en riesgo de despoblación.La clave del envejecimiento exitoso es mantener el equilibrio entre capacidades y limitaciones dela persona que envejece y recursos en el entorno. Espacios amigables, adaptados y recursos sociales ysanitarios adecuados permiten envejecer con calidad de vida. Envejecer en casa es un objetivo deseadopor la mayoría de las personas y ayuda a mantener la continuidad del curso de la vida, a vivir de maneraautónoma, pero los recursos comunitarios y sociales deben proporcionar los apoyos necesarios para queesto sea posible.El objetivo de esta investigación es conocer las necesidades derivadas de la situación de dependenciaen personas mayores de 65 años que precisan cuidados, las necesidades expresadas por sus cuidadores ylos recursos existentes, analizando el caso de La Vall dels Alcalans (Ribera Alta, Valencia), con 1.849personas mayores de 65 años (784 en situación de dependencia, 42,4 %), 668 de más de 80 años, ymayoritariamente mujeres.El artículo reflexiona sobre la necesidad de cuidar los cuidados que se precisen en el lugar dondeviven las personas. La longevidad conlleva una mayor demanda de cuidados de larga duración, recursosy servicios adecuados, acciones territorializadas y sostenibles. Se trata de un problema transversal querequiere de un esfuerzo conjunto de diferentes Administraciones autonómicas y municipales.
Formentera, insularitat hivernal i sobresaturació estival
Authors: Rullan Salamanca Onofre
Published: July 2023

La menor de les illes poblades de l’arxipèlag balear és, també, l’única illa espanyola poblada senseaeroport. Aquesta circumstància, afegida al fet de ser l’illa més al sud les Balears, la singularitza fent-lapartícip de les característiques mediterrànies més meridionals: poca precipitació, molta lluminositat...Sobre aquestes condicions, les seves praderies de posidònia han produït l’arena d’unes platges que hanmeravellat l’observador del plujós i poc lluminós nord europeu. Tot plegat ha conformat un dels destinsmés selectes i singulars de la mediterrània occidental amb efectes ambientals, socials i econòmics nosempre tant positius com mostren segons quines estadístiques. Algunes iniciatives locals intenten contrarestarels efectes negatius d’una explotació turística que podrien fer que l’illa morís d’èxit.
La europeización de las grandes infraestructuras nacionales: hacia una soberanía compartida (2011-2021)
Authors: Boira Maiques Josep Vicent , Berzi Matteo
Published: July 2023

Tradicionalmente, los planes de financiación, construcción y gobernanza de las infraestructurasde transporte y comunicación han sido actividades reservadas al Estado-nación. Sin embargo, elavance de la unificación europea ha influido también en esta materia con progresos en políticas yreglamentos de alcance comunitario. La reforma de 2011 de la Red de Transportes Transeuropea(TEN-T en sus siglas en inglés), su desarrollo legal en sendos reglamentos (2013) y el mecanismo definanciación Connecting Europe Facility (CEF, 2014) son hitos novedosos que retan al principio desoberanía estatal a la hora de planificar, construir, financiar y gestionar las grandes infraestructuras.En este artículo, tras repasar el proceso general que comenzó hace décadas y debatir su interpretación,nos centramos en el cambio que marcaron los reglamentos de 2013 y sobre todo en la propuesta derevisión de diciembre de 2021 de la red TEN-T, que supone un avance claro en la europeización de lasgrandes infraestructuras. En esta línea, mostraremos también el importante papel de la financiacióneuropea asociada a los Fondos de Resiliencia y Recuperación contra los efectos de la pandemia deCOVID-19 (marzo de 2020).
CONTAMINATING SUBSTANCES AS THE MAIN CONCEPT FOR RESEARCHING QUALITY AND WATER MANAGEMENT IN CONTEMPORARY SYSTEMS
Authors: Stevović Svetlana , Marković Jelena
Published: July 2023

Water on Earth is a vital element of living systems. Water is a medium that enables life and at the same time a medium in which a diverse eco systems exist. Natural waters contain dissolved gases, dissolved organic and inorganic substances and solid suspended materials. The quantities of dissolved and suspended substances are affected by: water temperatures, contact of water with the atmosphere, types of sediment the water is in contact, quantities of rainwater entering surface waters and quantities of waste substances, which are of anthropogenic origin. The results of water quality, according to the methodology of Eurowaternet - Lakes Aggregation of station data, were investigated and presented in a table form and by the location. The estimated value of water quality was obtained, expressed by the appropriate Water Quality Index. Water quality indicators are determined by the Serbian Water Quality Index method. The analyzes are presented by the frequency distribution of the indicators SWQI, nitrate, total phosphorus, ammonium and BOD5. Related to that research, as a result of the applied methodology and the fact that modern water supply systems in the Republic of Serbia have predominantly relied on groundwater reserves, and lately more and more on water abstraction from reservoirs and their use after treatment, a proposal for the management of raw water quality was given.
APPLICATION OF INFORMATION TECHNOLOGIES IN FOOD PROCESSING
Authors: Grujić Igor , Latinović Branko
Published: July 2023

Information technologies (IT) have become an important part of modern peoples activities. Many activities in food production processes are supported by different types of IT. The aim of this paper is to determine share of companies in Bosnia and Herzegovina (BiH), Serbia (SRB), North Macedonia (MKD) and Montenegro (MNE) that use some form of IT in their operations. Research was conducted in companies from the food sector in four countries in the Balkans. The research included 42 companies from BiH, 30 companies from Serbia, 14 companies from MKD and 6 companies from MNE. A special questionnaire was designed for the purposes of this research. The distribution of the questionnaire was done by e-mail, with a digital link for the users according to the form of the survey questionnaire that they should fill out (Microsoft Forms). The obtained results were statistically processed using IBM SPSS Statistics 26.During the research, authors determined areas in which companies already use IT, their plans related to the development of IT in the coming period and possibly for integration of existing and new IT solutions into a single information system. In their answers, the companies declared about the business areas in which they most often apply IT. Companies have developed and use several e-databases (the share of companies from each country is shown in relation to the number of companies that submitted complete survey questionnaires in the order of BiH, SRB, MKD and MNE): e-database of employees (88.1%); 96.7%; 100% and 100%, respectable), supplier base (73.8%; 100%; 100% and 83.3%, respectable), e-customer base (76.2%; 96.7%; 100% and 100%, respectable), e-base of resources for work (35.7%; 60.0%; 42.9% and 50.0%, respectable), e-base of reports on performed laboratory analyzes (35 .7%; 43.3%, 50.0% and 50.0%, respectively) etc. In the development of IT solutions, companies use different programming languages, mostly JAVA (59.3% of all companies surveyed) and C++ (37.4% of the total number of companies surveyed). The research showed that companies in the food sector in 4 Balkan countries use different forms of IT and that they have clear plans for their development and application in their business. It encourages the view that most companies are working on development of an integrated information system.
O Papel do Programa Lince (LPN/FFI) na Recuperação do Habitat e Presas do Lince-Ibérico no Sul de Portugal
Authors: Loureiro Filipa , Martins Ana Rita , Santos Eduardo , Lecoq Miguel , Emauz Ana , Pedroso Nuno M. , Hotham Paul
Published: July 2023

The Iberian lynx Lynx pardinus (Temminck, 1827) is currently considered the most endangered feline in the world. For this reason, in 2004, the Liga para a Protecção da Natureza (LPN) and Fauna & Flora International (FFI) launched the Lynx Programme whose main objective is to contribute to the conservation and long-term management of a corridor of priority habitats for the conservation of the Iberian lynx in Portugal. Here we present some results of this work relating to the recovery of wild rabbit populations at Serra do Caldeirão and the Moura/Barrancos Site – in this latter place, the work concerns the LIFE Lince Moura/Barrancos project, cofunded in 75% by the European Commission. The main objectives were: i) the establishment of management agreements with local stakeholders, and ii) the recovery of wild rabbit populations. Twenty four contacts were made with landowners/game managers, which resulted in nine management agreements with management plans to improve habitat and wild rabbit populations. Under the scope of these management agreements, 128 artificial shelters, 160 food suppliers and 116 water suppliers were implemented in different estates/hunting areas. Although still preliminary, these results were quite positive. In general, all the implemented structures (artificial shelters, food and water suppliers) were used by wild rabbits, indicating their suitability for this species. Given the results achieved, it is expected that, gradually, landowners and game managers will be more receptive to nature conservation, particularly of this Mediterranean habitat.
Os morcegos da Mata Nacional do Bussaco, centro de Portugal
Authors: Matos Milena , Lopes-Pinto Nuno , Fonseca Carlos
Published: July 2023

Bats constitute a generally little known group of mammals, but with enormous ecological and economic importance. There are 25 bat species identified in mainland Portugal, representing almost 40% of the terrestrial mammals of the country. Some species are very abundant, but a considerable proportion of them, notably cave-dwelling species, exhibit reduced and vulnerable populations. Bussaco National Forest (wall fenced area of approximately 105 ha) constitutes an exclusive heritage in Portugal and in the World, due to its history, architecture and natural values. Biologically, it represents one of the best dendrological collections in Europe and shelters quite a diverse fauna, with the vertebrates being studied only recently. An inventory of bats has been conducted since 2007 by means of ultrasound identification. Ultrasound calls were recorded during bats’ activity periods and identified to the species based on acoustic characteristics, literature and comparison with a database. Up to the present time, 14 bat species have been identified in Bussaco. Probably there are more, though echolocation identification presents some constraints that make it difficult to reach species level. Considering the lack of information about this vertebrate group, any study, even a simple one, can contribute to knowledge of these species and the designing of protection and conservation measures.
Stage III/IV Melanoma in Poland: epidemiology, standard of care and treatment related costs
Authors: Lugowska Iwona , Niewada Maciej , Jakubczyk Michał , Barszcz Elżbieta , Wysocki Piotr , Ziobro Marek , Szkultecka-Dębek Monika
Published: July 2023

Objectives: Melanoma is the most serious type of skin cancer. New methods offering significant benefits for advanced melanoma treatment are needed and in order to assess their cost-effectiveness reliable data on epidemiology, standard of care, adverse events and costs are required. The aim of this project was to collect such information using surveys in Poland. Methods: A questionnaire focused on the disease characteristics, treatment patterns, health care resources utilization and costs among melanoma patients (stage III/IV) was designed. Direct medical costs from Polish Public Payer perspective (National Health Found) were computed using data from the survey. Results: Increase in incidence and mortality rates due to melanoma in subsequent years is observed. Regardless of the disease stage about ¾ of the patients had a surgical procedure in the past. The most commonly used drug in 1st and 2nd line treatment is dacarbazine (alone or as a component of multidrug therapy).In 3rd line paclitaxel is used. Total yearly cost (including drugs costs, resources used) for 1st, 2nd and 3rd line therapy is respectively 6 522.99 PLN, 12 627.25 PLN and 9 267.39 PLN. Conclusions: An increase in incidence and mortality rates of melanoma in subsequent years is expected. Costs related to advanced melanoma treatment compared to other oncological indications seem to be moderate. This reflects lack of major advances in melanoma treatment for many years with a steady, high mortality and short survival of patients with advanced disease.
Risk of severe hypoglycaemia for various treatment regimens – a systematic review and meta-analysis of observational studies
Authors: Jakubczyk Michał , Niewada Maciej , Rdzanek Elżbieta , Czech Marcin
Published: July 2023

Background: Previous publications show that diabetes mellitus (DM) is a grave medical and economic problem, largely due to complications. The objective is to evaluate real-life risk of severe hypoglycaemic events (SHEs) among diabetic patients (type 1 and 2, T1&2) for various therapies. Methods: We conducted a systematic review of observational studies in MEDLINE, Embase, and The Cochrane Library databases. Observational, retrospective or prospective, studies (with at least 100 participants) in children and adults were included, with focus on: time horizon, number of patients, number of SHEs, and number of patients experiencing SHEs. In T1 DM we distinguished basal-bolus/pre-mix insulin and insulin pump, and in T2 DM we singled out basal-bolus/pre-mix insulin, basal supported oral therapy with insulin as the basal component, sulfonylurea, and other antidiabetic medications. We used a Poisson model implemented in Bayesian framework in WinBugs to estimate the SHE. Results: We identified 55 relevant studies encompassing 245,028 patients (103,741.81 patient-years). Annual SHE rates varied in T1DM from 0.18 (95%CI: 0.13–0.25) for insulin pump up to 1.1 (0.57–2.71) for basal-bolus with human basal insulin, and in T2DM from 0.006 (0.001–0.008) for oral antidiabetic drugs (excl. SU) up to 0.56 (0.16–9.65) for basal-bolus with human insulin as the basal component. Conclusions: Our results confirm that available treatment regimens differ in SHEs risk in real-life setting. Still SHEs are also driven by other factors, e.g. lifestyle, which may impact treatment selection.
„Pay-back” mechanism in the Polish reimbursement system - analysis and appraisal
Authors: Skrzekowska-Baran Iwona
Published: July 2023

The text of this review has been based on a diploma thesis, prepared by Mr Borys Podgorny under the supervision of Dr Iwona Skrzekowska-Baran, as part of the XXII Edition of the Advanced Management Training in Pharmacoeconomics, HTA, Pharma Marketing and Law of the Warsaw University Of Technology Business School. The presented review has employed a detailed analysis of appropriate provisions of the Reimbursement Act, while benefiting from the practical experience of the authors, regarding the implementation of the Act and the practical application of its principles. The results of the conducted analysis indicate a number of significant drawbacks in the current version of the pay-back mechanism, which either prevent any correct calculation of the amounts to be paid back or which may become a breeding ground for disputes and conflicts with marketing authorisation holders, as regards the administrative and legal aspects of the process. In consequence, should the pay-back mechanism remain an integral part of the Polish reimbursement system, it will need urgent legislative amendments to ensure its effective management and, first of all, to streamline the calculation of reimbursable amounts, based on available and verifiable data. Above all, however, it seems still reasonable and appropriate to ask about the sensibleness of and reasons for further existence of such a solution in the Polish legal system, where other legal mechanisms successfully execute the systemic goals in terms of reducing the payer’s expenses.
Estimation of stress resistance of medical students in Lviv, Ukraine
Authors: Lototska Lesya , Blavatskyj Ihor
Published: July 2023

High demands for speed and amount of students’ trainings in health care education are among the stress causes. Presence of stress can negatively affect the state of progress and level of physical health of medical students. We have tested 275 students of II-IV years of the medical faculty (145 women, 130 men) using methods of Friedman and Rosenman modifications «tendency to stress» and «self-rating of stress resistance». Test results revealed: 34% of women and 29% of men showed below average level self-rating of stress resistance, including the group tendency to stressful situations. Average level was characterized for 39% of women and 27% of men. This indicates the sufficient resistance to stress and rejection as failure stress. Higher average level of stress resistance was observed for 15% of women and 26% of men. These students, despite the negative influence of different factors, fight stress and try to prevent it. High aptitude was recorded for 11% of women and 7% of men. Relatively high frequency of getting into stress was inherent for 25% of women and 21% of men. Presence of stress and attempts to avoid it were found for 29% of women and 40% of men. For 22% of women and 26% of men was found the ability to resist stress due to communicability and harmonic lifestyles. High level of self-regulation, the ability to achieve goals as the result of low aptitude to stress was inherent for 10% of women and 7% of men. Reducing adaptation to stress among medical students was registered. Formation of skills for stress resistance by implementation of health-saving technologies in student lifestyle is necessary.
Assessment of thrombocytopenia symptoms using vignettes. Preliminary report on the development and implementation of a new instrument
Authors: Szkultecka-Dębek Monika , Bem Marta , Wiśniewska (Kiepurska) Nina , Mazur Joanna
Published: July 2023

Objective: Our aim was to create a vignette enabling the assessment of the impact of thrombocytopenia symptoms on patients’ quality of life. Methods: The vignettes which we created are focused on thrombocytopenia symptoms which may influence the quality of life of the patients. The vignettes designed in Polish language are to be used by adult patients and children caregivers and to be administered by an interviewer. There are separate vignettes for adult males and females as well as for children caregivers. Each vignette consists of two parts: the objective of the first one is to collect qualitative information about the major health problems related to the thrombocytopenia symptoms in each studied group, the second is related to specific symptoms and aims at measuring the intensity of impact on the quality of life in a quantitative way. Results: We have created the vignettes with special focus on the most frequent thrombocytopenia symptoms and those which are most life threatening. The vignettes describe a hypothetical patient with thrombocytopenia and the symptoms which may impact the quality of life in their daily functioning. In the first part the patients are asked to provide qualitative information in a descriptive way about symptoms influencing their daily functioning or the most threatening ones. The second part is using the Likert scale to assess quantitatively the impact of specific symptoms on patients’ life. Conclusions: The vignettes need to be tested in adult patients with thrombocytopenia and children caregivers in order to allow further comparisons.
The assessment of the impact of thrombocytopenia symptoms on the patients’ daily activities with the use of TSIDAV vignette.
Authors: Szkultecka-Dębek Monika , Nowakowska Małgorzata , Bem Marta , Wiśniewska (Kiepurska) Nina , Mazur Joanna
Published: July 2023

Objective: Assessment of the impact of thrombocytopenia symptoms on patients’ daily activities using vignettes. Methods: Vignettes were used to collect information from adult patients and children’s caregivers in order to assess the impact of thrombocytopenia symptoms on patients’ daily activities. Each vignette consisting of two parts aimed at collecting qualitative information about major health problems related to thrombocytopenia symptoms and at measuring the intensity of the symptoms’ impact on daily activities in a quantitative way. Descriptive part collected patients’ qualitative information about symptoms influencing their daily functioning or those bothering them the most. Quantitative part using Likert scale assessed the impact of specific symptoms on patients’ lives. Results: We collected 61 questionnaires from 31 women, 17 men, 13 children’s caregivers. Among men the biggest impact on activities was observed in relation to petechiae and easy bruising (both symptoms were declared as significant by 29% of respondents). 68% women considered skin and mucosa petechiae, 65% indicated easy bruising and 52% bleeding from gums and nose as having significant impact on daily activities. 62% of parents or caregivers believed that petechiae and mucosa had significant impact on the performance of the children’s daily activities, same significance was referenced to easy bruising (54%) and bleeding from gums and nose (42%). Conclusions: Thrombocytopenia symptoms influence patients’ daily activities and the most frequently mentioned symptoms influencing those across all groups were petechiae and easy bruising. According to the calculated vignettes values the highest impact on daily activity of the symptoms was indicated for children.
Thrombocytopenia Symptoms and their Impact on Patients Daily Activities assessment Vignette (TSIDAV) – validation of the vignette
Authors: Drozd Mariola , Bem Marta , Wiśniewska (Kiepurska) Nina , Mazur Joanna
Published: July 2023

Objective: Our aim was to validate the TSIDAV vignette in thrombocytopenia patients. Methods: The vignettes validation was performed during a study on adults and children with thrombocytopenia. The data were collected among Lublin hospital patients within the period from1st March to 30th April 2016. Results: We have validated the vignette based on the 61 questionnaires collected among thrombocytopenia patients and children’s caregivers. 31 vignettes were from female patients, 17 from male patients and 13 from children’s caregivers. The most frequently mentioned symptom influencing daily activities in all groups was petechiae and easy bruising. Among men 29% declared it as significant, 68% of women also considered petechiae on their skin and mucosa as having significant impact on their daily activities and 65% declared a significant impact of easy bruising. Among parents and caregivers 62% of them also indicated petechiae as having significant impact on their daily lives and 54% also declared significant easy bruising. We have used a developed special scale for the numerical presentation of the obtained results allowing their interpretation. Conclusions: The properties of the vignette make it appropriate to assess the impact of the thrombocytopenia symptoms on patients daily activities. TSIDAV and its dual construction lets us collect the catalogue of different symptoms of thrombocytopenia and their impact of daily life, which could be very helpful in working with thrombocytopenia patients from the psychological and medical point of view.
The adaptation of new methodology of quality of life assessment in patients with thrombocytopenia in Ukraine as a result of Polish-Ukrainian collaboration
Authors: Boretska Olga , Szkultecka-Dębek Monika , Drozd Mariola
Published: July 2023

Objective. Our aim was linguistic adaptation the Thrombocytopenia Symptoms and their Impact on patients Daily Activities Assessment Vignette (TSIDAV) into Ukrainian. Methods: In the translation process were involved two translators who took into account the cross-cultural aspects during translation of the vignette. The translation was done from Polish to Ukrainian and then was translated back into Polish. The translated version was validated by the vignettes’ Polish authors in order to verify the maintains the content, purpose and estimated tool properties of translated version. Results: Vignettes were adapted according to the algorithm described in the methodology of the research. The adaptation algorithm of the vignettes into Ukrainian language follows ISPOR recommendations for translation. The obtained Ukrainian version of the vignettes was tested on a small group of lay people (n=9) in order to test alternative wording and to check understandability, interpretation, and identify potential cultural issues related to the translation. Thus, the last step of vignettes adaptation, such as a review of cognitive debriefing results, finalization and proofreading occurred with involving an Ukrainian professional philologist. As the final result, it was obtained a tool for evaluating the thrombocytopenia symptoms impact on patients’ daily activities in Ukraine. Conclusions: The obtained Ukrainian version of the vignette is a simple and fast instrument to assess the impact of symptoms of thrombocytopenia in patients’ daily activities. The next step is the process of validating the instrument in Ukraine.
Assessment of quality of life, disease activity and productivity loss of patients with ulcerative colitis in Poland
Authors: Kawalec Paweł , Mossakowska Małgorzata
Published: July 2023

Purpose: The aim of the study was to assess the relationship between the disease activity and both indirect costs and health-related quality of life among ulcerative colitis (UC) patients in Poland. Methods: A questionnaire-based, self-report survey was conducted using th (P-SCCAI) to assess disease activity, and the Work Productivity and Activity Impairment Questionnaire (WPAI) to assess productivity loss. The quality of life was presented as utility calculated using the EQ-5D-3L questionnaire. Additionally, the reduction of usual activities, other than paid work and the need of assistance were assessed. Indirect costs were assessed with the Human Capital Approach and were expressed in euros (€). Correlations were presented using the Spearman’s coefficient, the between-group difference was assessed with Mann-Whitney U-test and Pearson c2 test. Results: 305 full questionnaires were collected. Indirect cost due to absenteeism and presenteeism per year per working patient with disease in remission was €2,559 (95%CI:1,283-3,835) and due to informal care was €10.38 (95%CI:0-31.20). The corresponding values for patients with active disease were €5,605 (95%CI:4,744-6,466) and €645.36 (95%CI:333.77-956.96). The between-group differences in above values was statistically significant (p<0.05). The difference in utility values between patients with disease in remission (0.934, 95%CI:0.919-0.949) and patients with active disease (0.826, 95% CI:0.807-0.845) was statistically significant. Conclusions: The statistically significant difference was identified in productivity loss and health related quality of life among patients with active disease and patients with disease in remission. The significant difference was also observed in the average reduction of usual activities and the need for assistance in performing usual activities.
Primary immunodeficiencies – epidemiology, spending on therapy, diagnostic and therapeutic needs in Poland.
Authors: Jahnz-Różyk Karina , Bernatowska Ewa , Roliński Jacek , Pac Małgorzata , Więsik-Szewczyk Ewa , Dylewska Magdalena , Żmiejko Sylwia , Mikułowksa Magdalena , Falkiewicz Bogdan
Published: July 2023

Primary immunodeficiencies (PID) are a heterogeneous group of over 300 diseases of the immune system characterised by its disfunction, and in consequence by chronic or recurrent infections, autoimmunity, allergy, neoplastic diseases or autoinflammation (1). One of the key problems at the international level is low awareness of symptoms and course of primary immunodeficiency. Based on the epidemiological data on the disease incidence, it can be estimated that ca. 70-80% of PID cases have still not been diagnosed (2). The main issue on the country level is the lack of large scale analyses concerning the actual number of PID patients in Poland, which limits the potential to streamline the disease diagnostic and therapeutic process. The following paper is an attempt to prepare a synthetic summary of epidemiological data and main problems related to PID diagnostics and therapy in Poland and to present the costs of reimbursed healthcare services related to this group of patients.
Environmental Determinant of Acute Diarrheal Disease among Under five Children: Unmatched Case Control Study in Babile District, East Hararghe Zone, Oromia Region, East Ethiopia
Authors: Gudeta Sisay
Published: July 2023

Introduction: Diarrhea is defined as passing of loose or watery stool for three or more times during a 24 hours period. Diarrhea is one of the leading causes of mortality in developing countries, especially among children under the age of five years. The objective of the study was to assess environmental determinant of acute diarrheal disease among under five children in Babile district, East Hararghe Zone, Oromia Region, East Ethiopia. Methods: A community based unmatched case control study design was used and data collection period was from May 10-30, 2016. Multi-stage sampling procedure was employed to select four kebeles. Then; Proportionate sample was drawn from each kebele by simple random sampling . Analyses were performed using SPSS software and ethical clearance was obtained. Result: A total of 396 sample(132 cases and 264 controls) were interviewed in this study making 100% response rate. Occurrence of Acute diarrhea in under five children in Babile district was significantly associated with non improved toilet facility (AOR=3.363,95% CI: 1.701-6.647), improper disposal of solid waste (AOR=9.196, 95% CI: 4.623-18.294) and unimproved water source (AOR=5.164,95% CI: 2.798-9.531). Conclusion: Environmental predictors of acute diarrhea in under five children were non improved toilet facility, absence of solid waste disposal pit and unimproved water source. Therefore; the recommendations forwarded were community led total sanitation, safe & adequate water supply.
Nutritional management in patients with gastrointestinal tumors in the surgical department
Authors: Michalczewska Agnieszka
Published: July 2023

The last quarter of 25 years is undoubtedly a milestone in clinical nutrition in Poland. The current years have shown the growing importance of this medical area, which is now a component of many therapies. A better nourished patient means more effective pharmacotherapy, faster wound healing, less fewer complications - especially in the postoperative time, a shorter period of hospitalization, and, consequently, lower costs of treatment. Nutritional treatment is particularly important in surgical departments and for many years has been one of the basic procedures for care of the patient. In the present time, this is the basic skill of a doctor. The choice of treatment method should justify the patient's clinical condition, type and degree of malnutrition and the duration of therapy. The duty of each doctor treating oncological patients (surgical, chemotherapeutic or radiotherapeutic) is a particularly thorough assessment of the nutritional status of the patients and, if appropriate, the implementation of the nutritional intervention as quick as possible. The earlier the metabolic actions are taken, the more comfortable the patient lives becomes and the better the results of the treatment are observed.
Cancer immunotherapy in second-line treatment of non-small cell lung cancer – is there a need to change the approach to the assessment of clinical benefits?
Authors: Panasiuk Anna , Budasz-Świderska Małgorzata , Kaczor Marcin
Published: July 2023

Background: The mechanism of action distinctive for immunotherapy leads to the specific pattern of tumour response, different form the one observed with cytotoxic therapy. To enable a complete assessment of immunotherapeutic agents modified criteria for the evaluation of antitumour responses were developed, mainly on the basis of the ipilimumab trials in melanoma. Methods: We conducted a review of RCTs that assessed PD-1/PD-L1 checkpoint inhibitors in previously treated patients with NSCLC, to describe the overall survival results in comparison to the progression-free survival outcomes, as assessed with conventional RECIST and/or with modified criteria of tumour response. Results: Five RCTs were eligible. The studies were heterogeneous with respect to population characteristics and other methodological features. All of the trials showed significant OS improvement in the immunotherapy arms, with the results in the histology and PD-L1-expression subgroups consistent with ITT analyses. The OS gain was not accompanied with the evidence of PFS prolongation. The use of the modified criteria resulted in prolonged median PFS estimates in the immunotherapy-treated patients. Conclusion: Our results in second-line NSCLC population are in line with the previous findings, that the conventional RECIST criteria do not fully capture the benefit of the immunotherapy. In the routine practice the premature diagnosis of a progressive disease may result in treatment withdrawal in patients that might benefit from the continuation of the immunotherapy. Further research and the agreement on the relevant modified criteria are needed for the use in the future immunotherapy clinical trials and to inform real-world clinical decisions.
The combination of angiotensin converting enzyme inhibitors, diuretics and non-steroidal anti-inflammatory drugs in the routine community pharmacy settings in Poland: The unrecognized problem of ‘Triple Whammy’. A pilot analysis.
Authors: Piekarska Magdalena , Harężlak Tomasz , Krysiński Jerzy , Cwalina Natalia , Zdanowski Szymon , Jaguszewski Miłosz , Merks Piotr
Published: July 2023

Background: ‘Triple Whammy’ defined as a combination of angiotensin converting enzyme inhibitors/angiotensin receptor antagonist, diuretics and non-steroidal anti-inflammatory drugs remains an important clinical problem, particularly in patients with risk of renal impairment. Community pharmacy settings are considered to be an appropriate place for detection and solving of this drug-related problem. Objectives: To estimate the frequency of ‘Triple Whammy’ in a routine community pharmacy setting in Poland by analysis of data obtained from refilled prescriptions. Methods: We conducted anon-interventional, observational retrospective study to assess the rate of ‘Triple Whammy” cases in a community pharmacy setting in Poland. We reviewed 14243 prescriptions to find ‘Triple Whammy’ cases. The analyzed prescriptions were refilled between the 1.01.2016 and 31.05.2016 in one single community pharmacy in Poland. Results: The average age of all patients identified with ‘Triple Whammy’ was 68 (range, 56-91). We identified 12 prescriptions with ‘Triple Whammy’ among all cases, receiving most frequently ramipril (n=8 patients), diclofenac (n=6) and ketoprofen (n=5). Moreover, other medications that were prescribed to patients during the study analysis time period included proton pump inhibitors such as pantoprazole (n=3) and omeprazole (n=2), opioid analgesics – tramadol (n=1) in the fixed-dose combination with paracetamol, and one antihyperglycemic medication – metformin (n=1). Conclusions: ‘Triple Whammy’ should be considered as a potential drug-related problem in Poland. Our study suggests that geriatric population is particularly affected by this drug-related problem, and, consequently, pharmaceutical care is predominantly necessary among this cohort.
Aging society: organization of long-term care for the elderly in Poland.
Authors: Schubert Agata , Skrzekowska-Baran Iwona
Published: July 2023

Background: Aging society is one of the main challenges of the organization and provision of health care in XXI century. In 2030 more than one third of Polish population will be older than 65 years old and every tenth person will be more than 80 years old. Ageing of the population and dependency trends fuel the demand for long-term care. This raising demand is challenging for both finance and organization of health and social care. Despite of existing reports and publication on long term care or elderly care in Poland, there is a lack of publications that include all forms of available support that are scattered in various provisions systems. A robust overview is needed for accurate planning of required changes to prepare the system for future demographic challenges. Goal: description of organization of formal and informal long-term care for the elderly in Poland considering various financial systems. Methods: Review of available reports, publications and legal bills related to long term and/or elderly care in Poland. A non-systematic literature review in English and Polish sources has been conducted in March 2018. Results: Long term care of elderly patients in Poland is scattered through various financial and provisions systems. Population aging and growing dependency ratio requires to prepare the system for growing demand for long term care.
The combination of angiotensin converting enzyme inhibitors, diuretics and non-steroidal anti-inflammatory drugs in the routine community pharmacy settings in Poland: The unrecognized problem of ‘Triple Whammy’. A pilot analysis.
Authors: Antolić Sinisa
Published: July 2023

Background- The aim is to analyze how the legal system in the European Union that deals with the public health emergencies in terms of organization and readiness to respond to public health emergencies. Methods - The method used is desk research, based on the current secondary scientific literature, both from the online resources and from the variant publications. Results - The primary responsibility for responding to public health emergencies falls within the domain of the EU Member States, while the EU action is intended to complement the national policies of the EU Member States and to coordinate and support their actions. The Commission plays a vital role, both in coordinating and in exchanging the information among the EU Member States. Based on the experience with the public health emergencies the Commission initiated new legislation in 2011 which resulted in a new Decision No. 1082/2013 on Serious Cross-Border Threats to Health. The national authorities are required to send to all authorities connected through the network data related to serious threats to public health. Conclusion - There is still a room for collaboration improvement. Further actions should be undertaken to bring the coordination and network for the public health emergencies surveillance, preparedness and response planning to a higher level.
Patient claims resulting from medical events — case reports
Authors: Leśniak Tomasz , Sierocka Aleksandra , Marczak Michał
Published: July 2023

Health care entities are institutions which are and will be at risk of adverse events, due to their specifics and character. The number of patient claims is growing. Learning the causes of an event, its component elements and variables which have led or may have led to its occurrence enables learning from mistakes and drawing conclusions for the future. The 3 selected cases of patient claims presented herein indicate not only the causes, but also describe in detail the course of an event, its medical consequences for the patient, as well as the financial consequences for the medical entity.
Treatment of patients with psoriasis resulting from a review of previously unmet needs, with particular reference to the new line of treatment with dimethyl fumarate (DMF): experts' recommendations
Authors: Owczarek Witold , Niewiedzioł Marta , Kalinowska Agnieszka , Pruszko Cezary , Narbutt Joanna
Published: July 2023

Psoriasis has a significant impact on patients’ physical and mental state. Their quality of life is often impaired. What is more, despite the involvement of a significant number and type of health care services and significant financial outlays, psoriasis patients in Poland are treated suboptimally and non-cost-effectively (large percentage – 11.1% – of hospitalizations because of psoriasis, the longest hospitalization of patients with psoriasis among other dermatological patients – 8.6 days, treatment outside their administrative region – 58.1% of hospitalized patients). Psoriasis management is based on a sequential therapy. Biological treatment is available only to a limited group of patients with the most severe disease, what indicates the desirability of widening prescription-based systemic treatments that could be used prior to biological treatment. This would increase the possibility of treatment individualization by all dermatologists. In order to achieve optimal treatment results, patients should be offered to be treated with several treatment lines because it is not known which drug will be effective in their case. Dimethyl fumarate (DMF) is the one of new drugs, that meets the criteria for an additional systemic treatment option, prior to biological treatment. DMF therapy is associated with significant health benefits, which include improving the quality of life and lengthening the time with an adequate response to treatment. This therapy allows the patients to obtain greater benefits from treatment and to prolong the time without symptoms of the disease (symptoms-free).