Joanna Woźniak-Holecka

Nutritional education in the primary prevention of osteoporosis in perimenopausal and postmenopausal women.

Osteoporosis affects millions of people in the whole world and brings about far-reaching physical and psycho-social consequences for patients and financial ones for the health care system, and therefore it is classified as one of public health problems and treated as a social disease. Women belong to the increased osteoporosis illness risk group due to lower top bone mass reached earlier in life as compared to men and due to hormonal changes occurring in the menopausal period, which affect loss of the bone mineral density (BMD). Limitation of the osteoporosis-related financial and social costs increase requires efficient preventive actions on the level of early, primary, secondary or tertiary prevention. At all the four osteoporosis prevention phases, the crucial role is played by health education and nutrition education, the latter being the key element of the former one. The nutritional education purpose is to acquaint patients with nutrition recommendations that are the basic element of the osteoporosis prevention and to make them change their nutrition habits, which will improve their osseous metabolism. The education should be based on results of the latest scientific researches and focus on recommendations relating to proper supplementing of calcium and vitamin D, simultaneously including all the other nutrition components, necessary to decrease the osteoporosis risk. The primary prevention oriented to a specific group at risk for osteoporosis, including peri- or postmenopausal women, should be provided in cooperation with the different levels’ medical professionals and it should focus on causing positive changes in patients both as regards nutrition habits and physical activities.

Health Promotion Development in the Spa Treatment. Perspectives for the European Countries Learned from Poland's Experiences

The main aim of the paper is to outline the perspective for future developments of the spa treatment in light of demographic transitions characterized by the increasing number of seniors, as well as changing expectations and health needs of younger population. We made a systematic review of literature referring to the experience of Poland, and similar experiences of other countries in Central Europe. Based on the existing knowledge we conclude that spa treatment should become one of the preferred directions of development of health systems in European countries. Moreover, we state that a desirable direction to modify the therapeutic paradigm used in spa treatment is to put a far-reaching greater emphasis on the provision of innovative health promotion, which is justified by both its effectiveness, and strongly good foundation for its provision in spas. For this purpose it is necessary to extend the specialized health sector personnel with qualified health educators, which will enable an effective implementation of health promotion actions and their proper alignment to the specific target groups. Developing this category of specialists will also enable other professionals to concentrate on therapeutic activity fitting their competence.

The Systemic Changes to Improve Efficiency in Polish Primary Health Care

Primary health care is an important part of any health care system. In highly developed countries it secures the populations most elementary health needs, with particular emphasis on preventive care and early intervention. Polish PHC model is currently undergoing a thorough transformation, associated with the need to adapt to standards designated based on the WHOs criteria, and with reference to the experience of other European countries. The paper describes the process of changes being carried out, in the context of previous experiences of reform relating to the sphere of organization, processes and efficiency. A review and systematization has been made, with regard to the undertaken activities in the field of deregulation and change of legal provisions, which are aimed at achieving the improvement of the efficiency of treatment and resource allocation. A set of recommendations based on experts discourse have also been provided, with respect to future directions of Polish PHC transformation.

Mapping Health Needs to Support Health System Management in Poland

In Poland, following the example of other EU countries, the first maps of health needs prepared by the Ministry of Health were presented in 2016. The maps constitute a foundation for rational decision-making in the management of health care resources, being potentially useful for all actors in health system. This refers in particular to the institutions responsible for distribution of funds and contracting health service, but also for decision-makers, who determine the scope of funds to be utilized in the health system, or the structure of benefits provided to patients. Service providers are also addressees of the maps, to give them a basis for planning future activities. The article presents a structured assessment of the current state of affairs, based on recent experience and sets out likely directions for the development of health needs in mapping in Poland in the future. We discuss the criticism addressed toward maps by representatives of various groups acting in health care. It includes the lack of recognition of some of the key health needs, or wrong emphases, where much more attention is paid to the recognition of current resources in the health system, instead of making prognoses regarding the future developments of health needs. Nonetheless, we find that this instrument is potentially of high usability, in case of elimination of the existing weaknesses.

Using New Instruments of Clustering Policy in the Health Care System. The Case of Poland

The issue of clusters as a form of organization of market entities has recently attracted an increasing attention of health care management theoreticians and practitioners. In our opinion the existing theoretical basis gives a foundation for considering clusters as a source of potential for increasing the effectiveness of health policy and health care organizations. It can be assumed that in case of health care clusters there is a possibility of interregional diffusion of innovation, based on ventures undertaken on the health care market, increasing not only the potential of the entities in the cluster, but also of its surroundings and subcontractors. It is possible to realize the idea of a flexible health care implemented regionally with the use of modern techniques of communication, knowledge transfer and high specialization. Nonetheless, in case of Poland the potential of clustrification remains untapped, being characterized by a limited actions of public and private bodies, marginal role of non-profit sector organizations and limited engagement of R&D sector. This is because a general distrust in the cluster formula, and the lack of relevant knowledge among local officials and health business leaders. For this reason the process of clustrification among health care entities requires external support through the increased efforts to create a system of legal and tax preferences for cluster initiatives and provision of organizational support in terms of know-how, targeted particularly at bodies and individuals, who may act as cluster leaders.

Znaczenie profilaktycznych zabiegów weterynaryjnych w zdrowiu publicznym

Introduction. Activities within the scope of veterinary treatment are commonly associated with help for animals in the vicinity of man, and free living animals. It is frequently forgotten that veterinary medicine covers also qualified activities in the service of public health. People should be aware that veterinary measures (vaccinations, deworming, protection against insects) are a form of health care not only for animals but also for humans. Objective. The objective of the study was an analysis of awareness among dog owners concerning health risks resulting from having a dog at home, and observance of prophylactic veterinary procedures. Material and methods. During the period 1 November 2011–29 February 2012, a survey was conducted which covered 300 dog owners from urban areas. The information collected by means of a questionnaire were subjected to statistical analysis using software Statistica 10. The non-parametric chi-square test was applied (p=0.05) for qualitative characteristics, with V Cramer’s coefficient to assess dependence. Results. The results obtained showed that females, more frequently than males, are concerned about the health of their dogs. Nearly 78% of respondents vaccinate their dog against rabies once a year, 61% – deworm their dog at least twice a year, and less than 4/5 of the respondents protect their dog against eco-parasites. Conclusion. The study showed that prophylactic veterinary procedures are a generally accepted and common form of zoonoses control; however, despite this fact, there is a need for the constant education of society in order to prevent diseases transmitted by domestic dogs.