Donata Kurpas

Quality of life and acceptance of illness among patients with chronic respiratory diseases

The purpose of this study was to determine quality of life (QoL) and acceptance of illness in patients with chronic respiratory diseases. The study involved 315 adult patients of the mean age of 63.9±15.7 years. The World Health Organization Quality of Life Instrument Short Form and the Acceptance of Illness Scale were used. The mean score for QoL was 2.0±1.3. The highest scores were obtained in the Social Relationship Domain (13.9±2.7) and the lowest in the Environmental Domain (10.5±2.2). The strongest correlations within QoL domains were noted between Physical and Psychological Domains: r=0.611 (p<0.001), Psychological and Social Domains: r=0.605 (p<0.001). The overall degree of illness acceptance was low (26.0±7.8). The strongest correlations were observed between illness acceptance and Physical: r=0.591 (p<0.001) and Psychological Domains: r=0.450 (p<0.001). We conclude that illness acceptance can be augmented by improving the patients clinical state and by the provision of psychological support and QoL by improving the Psychological and Environmental Domains.

Evaluation of Quality of Life of Those Living near a Wind Farm.

Objectives: Health-related quality of life (HRQoL) can serve as a multidimensional means of evaluating the relationship between the presence of wind turbines in residential areas and their consequence for health. The purpose of this study was to determine whether a relationship exists between the presence of wind farms at different stages of development and the HRQoL of people living in their vicinity in Poland. Method: The instruments employed in this study were the SF-36v2, a questionnaire measuring self-reported health problems, and a sociodemographic questionnaire. The study involved 1277 people who lived within 2 km from a wind turbine. Results: The highest overall QoL scores were obtained by respondents living the closest to wind turbines. The mental health, role emotional, and social functioning scores were significantly higher among respondents living near wind farms and wind-farm construction sites than among those living close to locations where wind farms were planned but where construction had not yet begun. Positive correlations were found between physical and mental component scores and reactions to the news of plans to construct a wind farm. Significant differences in physical and mental component scores were observed between residents who reacted calmly and those who responded with apprehension. Residents who expected the improvement of their financial standing as a result of the wind farm assessed their general health higher than those who did not expect to receive any economic benefits. The lowest QoL scores corresponded to frequent headaches, stomach aches, and back pain over the previous three months, as well as recurrent problems with falling asleep, anxiety, and a lack of acceptance of the project. Conclusion: The lowest overall QoL and general health scores were noted among residents of places where wind-farm developments were either at the stage of planning or under construction. In order to find ways of reducing environmental stress and its adverse effects on health, it is necessary to conduct research on residents of places where a wind farm is either planned or under construction, or has just been completed.

Comparison of Massage Based on the Tensegrity Principle and Classic Massage in Treating Chronic Shoulder Pain

OBJECTIVE The purpose of this study was to compare the clinical outcomes of classic massage to massage based on the tensegrity principle for patients with chronic idiopathic shoulder pain. METHODS Thirty subjects with chronic shoulder pain symptoms were divided into 2 groups, 15 subjects received classic (Swedish) massage to tissues surrounding the glenohumeral joint and 15 subjects received the massage using techniques based on the tensegrity principle. The tensegrity principle is based on directing treatment to the painful area and the tissues (muscles, fascia, and ligaments) that structurally support the painful area, thus treating tissues that have direct and indirect influence on the motion segment. Both treatment groups received 10 sessions over 2 weeks, each session lasted 20 minutes. The McGill Pain Questionnaire and glenohumeral ranges of motion were measured immediately before the first massage session, on the day the therapy ended 2 weeks after therapy started, and 1 month after the last massage. RESULTS Subjects receiving massage based on the tensegrity principle demonstrated statistically significance improvement in the passive and active ranges of flexion and abduction of the glenohumeral joint. Pain decreased in both massage groups. CONCLUSIONS This study showed increases in passive and active ranges of motion for flexion and abduction in patients who had massage based on the tensegrity principle. For pain outcomes, both classic and tensegrity massage groups demonstrated improvement.

FOCUS : Frailty management optimisation through EIPAHA commitments and utilisation of stakeholders’ input – an innovative European project in elderly care*

The goal of FOCUS, which stands for Frailty Management Optimization through EIPAHA Commitments and Utilization of Stakeholders’ Input, is to reduce the burden of frailty in Europe. The partners are working on advancing knowledge of frailty detection, assessment, and management, including biological, clinical, cognitive and psychosocial markers, in order to change the paradigm of frailty care from acute intervention to prevention. FOCUS partners are working on ways to integrate the best available evidence from frailty-related screening tools, epidemiological and interventional studies into the care of frail people and their quality of life. Frail citizens in Italy, Poland and the UK and their caregivers are being called to express their views and their experiences with treatments and interventions aimed at improving quality of life. The FOCUS Consortium is developing pathways to leverage the knowledge available and to put it in the service of frail citizens. In order to reach out to the broadest audience possible, the FOCUS Platform for Knowledge Exchange and the platform for Scaling Up are being developed with the collaboration of stakeholders. The FOCUS project is a development of the work being done by the European Innovation Partnership on Active and Healthy Ageing (EIPAHA), which aims to increase the average healthy lifespan in Europe by 2020 while fostering sustainability of health/social care systems and innovation in Europe. The knowledge and tools developed by the FOCUS project, with input from stakeholders, will be deployed to all EIPAHA participants dealing with frail older citizens to support activities and optimize performance.

Antibiotic Consumption Pattern in the Neonatal Special Care Unit Before and After Implementation of the Hospital’s Antibiotic Policy

Current and detailed knowledge of antibiotic use is essential in order to implement strategies for reducing the overuse of antibiotics. The objective of our study was to determine the effectiveness of the implementation of the hospital antibiotic policy (HAP) by assessing antibiotic consumption in the Special Neonatal Care Unit (SNCU) in Warsaw, Poland, before and after this intervention. Antibiotic use was calculated in daily defined doses (DDDs) per 100 patient-days and DDDs per 100 admissions. The antibiotics were ranked by volume of DDDs and the number of antibiotics, which accounted for 90 % and 100 % of the total volume, respectively: DU90% and DU100% (where DU stands for drug use). Total antibiotic consumption increased slightly after the introduction of the HAP: the total DDDS was 707.87 and 753.12 in 2011 and 2012, while the number of DDDs/100 admissions was 352.17 and 369.12 in 2011 and 2012, respectively. After the introduction of the HAP, an increase in ampicillin and aminoglycoside use was observed, along with a reduction in the DU100% and DU90% rates (15 vs. 9 and 4 vs. 3, respectively). The introduction of the HAP resulted in changes in antibiotic consumption patterns, but the general antibiotic consumption density remained the same.

Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe

ABSTRACT Innovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family care-givers, and health and social care professionals. Thematic analysis identified four themes: synchronicity between the physical and the psychological in frailty, living with frailty in the social world, the need for a new kind of care, and screening for and preventing frailty. Findings emphasised the need for a holistic approach to frailty care and early intervention. Integrated care services and advocacy were important in the organisation of care. Central to all stakeholders was the significance of the psychological and social alongside the physical elements of frailty and frailty prevention. Support and care for older adults and their family care-givers needs to be accessible and co-ordinated. Interventions to prevent frailty must encompass a social dimension to help older adults maintain a sense of self while building physical and psychological resilience.

Is a practice-based rural research network feasible in Europe?

Abstract Research in family medicine is a well-established entity nationally and internationally, covering all aspects of primary care including remote and isolated practices. However, due to limited capacity and resources in rural family medicine, its potential is not fully exploited yet. An idea to foster European rural primary care research by establishing a practice-based research network has been recently put forward by several members of the European Rural and Isolated Practitioners Association (EURIPA) and the European General Practice Research Network (EGPRN). Two workshops on why, and how to design a practice-based research network among rural family practices in Europe were conducted at two international meetings. This paper revisits the definition of practice-based research in family medicine, reflects on the current situation in Europe regarding the research in rural family practice, and discusses a rationale for practice-based research in rural family medicine. A SWOT analysis was used as the main tool to analyse the current situation in Europe regarding the research in rural family practice at both meetings. The key messages gained from these meetings may be employed by the Wonca Working Party on research, the International Federation of Primary Care Research Network and the EGPRN that seek to introduce a practice-based research approach. The cooperation and collaboration between EURIPA and EGPRN creates a fertile ground to discuss further the prospect of a European practice-based rural family medicine research network, and to draw on the joint experience.

Immunopathology of exercise-induced bronchoconstriction in athletes — A new modified inflammatory hypothesis

Elite athletes have a higher prevalence of exercise-induced bronchoconstriction than the general population. The pathogenesis of exercise-induced bronchoconstriction is not fully elucidated. Increasing evidence suggests that airway inflammation plays a major role in the immunopathogenesis of exercise-induced bronchoconstriction. The aim of our review is to discuss existing evidence and to present a new, modified inflammatory hypothesis of exercise-induced bronchoconstriction. Exercise alters the number and function of circulating immune cells. Episodes of upper respiratory symptoms in elite athletes do not follow the usual seasonal patterns. Moreover, they have an unusual short-term duration, which suggests a non-infectious etiology. If the pro-inflammatory response to exercise has the potential to induce symptoms that mimic respiratory tract infection, it definitely up-regulates pro-inflammatory cytokine expression in the airways. We can conclude that exercise up-regulates airway cytokine expression in a way that favors inflammation and allergic reactions in bronchi and lowers the threshold for bronchoconstriction to different stimuli like cool, dry air, allergens, and pollutants.

Massage-induced morphological changes of dense connective tissue in rat’s tendon

The aim of the experiment was to determine if possible changes in connective tissue induced by massage could have a positive effect justifing the use of massage in all post-traumatic connective tissue conditions, e.g. tendon injuries. The investigations were performed in a group of 18 Buffalo rats. The rats were divided into two groups (experimental and control). To standardize the massage procedure, it was performed with an algometer probe of 0.5 cm2 with constant pressure force of 1 kG (9,81 N). To analyse the number and diameter of collagen fibrils, two electron micrographs were performed for each rat of the collected segments of tendons of rat tail lateral extensor muscle. After image digitalization and calibration, the measurements were carried out using iTEM 5.0 software. The number of fibrils, their diameter and area were measured in a cross-sectional area. An increase of the number of collagen fibrils was observed in the tendons of massaged animals compared to the control group. Our study demonstrated that massage may cause a beneficial effect on metabolic activity of tendons fibroblasts and, in consequence, may be applied for more effective use of massage for the prevention of tendon injury as well as after the injury has occurred. (Folia Histochemica et Cytobiologica 2013, Vol. 51, No. 1, 103-106).

Health behaviors and quality of life among patients with chronic respiratory disease.

The purpose of this study was to analyze health behaviors of patients with chronic respiratory disease and the correlations between health behaviors (HB) and quality of life (QoL). The study involved 256 adult patients (135 women and 121 men), mean age was 62.6 ± 16.1 years, with chronic respiratory disease. The research tools consisted of the Health Behavior Inventory (HBI) and the World Health Organization Quality of Life Instrument Short Form. The mean general score for HB was 85.6 ± 17.8. Most patients (74 persons) obtained high scores (7-10 stens). The strongest correlations between QoL and HB were as follows: Psychological Domain correlated with positive mental attitude (r = 0.308, p < 0.001), healthy eating habits (r = 0.224, p = 0.001), and with the level of health behaviors (r = 0.222, p = 0.003); Social Relationship Domain correlated with positive mental attitude (r = 0.282, p < 0.001) and healthy eating habits (r = 0.238, p < 0.001). We conclude that QoL in patients with chronic respiratory diseases is significantly shaped by their health behaviors.