Monika Binkowska-Bury

Body composition as an indicator of the nutritional status in children with newly diagnosed ulcerative colitis and Crohn’s disease – a prospective study

Introduction The prevalence of nutritional status disorders in children with ulcerative colitis (UC) is much lower than in the case of Crohn’s disease (CD). The largest variability in the components of body composition occurs at the time of a new diagnosis and in periods of disease exacerbation. Aim Assessment of body composition in children with UC and CD. Material and methods The preliminary study included 59 children with inflammatory bowel disease (IBD) (34 children with UC vs. 25 children with CD) aged 4–18 years. The final analysis included 26 newly diagnosed children (16 children with UC vs. 10 children with CD). The evaluation of body composition was conducted by means of BIA-101 bioimpedance analyser. Results Decreased values of lean mass were found in children with newly diagnosed IBD (UC: 41.13 kg vs. control group: 42.06 kg; CD: 35.50 kg vs. control group: 45.50 kg). After a year interval, an increase in fat (UC 1: 7.67 kg vs. UC 2: 10.33 kg; CD 1: 7.36 kg vs. CD 2: 9.47 kg) as well as lean body mass (UC 1: 35.22 kg vs. UC 2: 39.00 kg; CD 1: 35.99 kg vs. CD 2: 42.41 kg) was found in children. Conclusions Children with newly diagnosed IBD were highly vulnerable to nutritional status disturbances. The increase in fat and lean body mass in an annual interval may be due to the treatment regime and control of the children.

Nurse prescribing in Poland: Opinions expressed by primary care doctors, nurses, and patients.

Abstract The aim of this study was to identify and examine the differences in opinions held by health care professionals and the general public concerning the right to administer and prescribe medication which has been awarded to nurses and midwives in Poland. The study was conducted from December 1, 2014 to July 1, 2015, in randomly selected primary health care clinics, among 2227 individuals, including 849 subjects representing medical personnel of primary health care and 1378 patients receiving primary care services. The study used 2 versions of a questionnaire. The relationships were examined with &khgr;2 test for independence and Kruskal–Wallis test. Health professionals do not believe the new rights awarded to nurses and midwives will reduce the waiting time for medical consultations (Pu200a<u200a0.001). Nurses’ qualifications for the new tasks were most highly rated by patients, whereas the least favorable opinion was expressed by doctors (Pu200a<u200a0.001). To introduce nurse prescribing it is necessary to develop a suitable strategy enabling implementation of the governments initiative and facilitating the process of taking up the new task by nurses.

Pro-health behaviours – a sense of coherence as the key to a healthy lifestyle in rural areas?

BACKGROUNDnHealth-related behaviours and lifestyle are related to the salutogenic concept of health, whereas the major public health problems faced in rural areas include difficulties in encouraging people to a healthy lifestyle.nnnOBJECTIVEnThe aim of the study is to explore mutual relationships between psychosocial-demographic factors and a sense of coherence.nnnMATERIAL AND METHODnTwo-stage sampling was applied. Data were collected with the use of the Juczynski Health Behaviours Inventory and Antonovskys SOC-29 (Sense of Coherence Questionnaire). The study was conducted among 668 adults. Data were statistically prepared using one-way ANOVA test, linear correlation analysis, and linear regression model.nnnRESULTSnA higher level of pro-health behaviours is associated with gender, self-rated health, sense of coherence and age. Almost half of the farmers were characterized by a low level of pro-health attitudes. A higher level of pro-health behaviours was demonstrated by less than one-fifth of the farmers.nnnCONCLUSIONSnThere is a strong association between sense of coherence and pro-health behaviours. Farmers have bad habits and pro-health attitudes to health and poorer self-assessment of their health. There is a great need to monitor health-related behaviour, increase the effectiveness of health promotion and health education in shaping a pro-health lifestyle among residents of rural areas, particularly among farmers.

Bioelectrical Impedance Phase Angle as an Indicator of Malnutrition in Hospitalized Children with Diagnosed Inflammatory Bowel Diseases—A Case Control Study

The phase angle (PhA) seems to be a reliable screening tool for the identification of malnutrition risk in hospitalized children with inflammatory bowel disease (IBD). The aim of the present study was to assess the body composition and nutritional status of hospitalized children and adolescents with IBD by using bioelectrical impedance analysis (BIA) with phase angle (PhA) calculation, which has not been evaluated in hospitalized children with IBD yet. A total of 59 children and adolescents aged 4–18 years, with IBD: 34 ulcerative colitis (UC) and 25 Crohn’s disease (CD) were included in the study. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. In both groups, BIA was performed and PhA was calculated. IBD patients had significantly lower PhA (UC: 5.34 ± 1.34 vs. 5.96 ± 0.76, p = 0.040; CD: 5.16 ± 1.18 vs. 5.90 ± 0.62, p = 0.009) compared to the control subjects. Significant changes in selected body composition parameters were observed particularly in CD, especially in fat free mass components. Lower phase angle score together with lower body composition parameters and selected nutrition indicators in children and adolescents with IBD demonstrate their worse nutritional and functional status compared to healthy subjects.

Use of negative pressure wound therapy in a chronic leg wound with coexisting rheumatoid arthritis: a case study

We present a case of a 69-year-old woman with rheumatoid arthritis. The patient’s condition was managed with steroid therapy for more than 12 years. She had a coexisting infected chronic ulceration in the left leg, which was treated with negative pressure wound therapy for 52 days. Use of this therapy within the wound reduced exudate and the bacterial count, which dramatically accelerated the process of wound healing.

Military candidate health qualification and adjudication

Introduction. This study reviews the link between personal health and military qualifications. It was found that there is evidence of a strong link between obesity levels across young individuals and military qualification adjudication. Aim. The purpose of the study was to review the literature about significance of the rules for adjudicating on the ability to perform active military service and analysis of the literature regarding the health condition of Polish citizens subject to perform obligatory military service. Materials and method. Analysis of foreign and Polish literature

Ocena przydatności testu Hand Grip we wczesnej profi laktyce nadciśnienia tętniczego wśród młodzieży szkół ponadgimnazjalnych w regionie południowo-wschodniej Polski — badanie przekrojowe

Introduction. It is assessed that the increased reaction of arterial pressure to physical exertion occurs in about 20% of healthy young people and it is connected with hyperkinetic reaction of the circulatory system. Early identifi cation inxa0young people may be of vital importance in early prophylactics and treatment of arterial hypertension (HT). The aimxa0was to assess the relation between the use of the Hand Grip Test (HGT) and early diagnosis of the primary arterial hypertensionxa0(PHT) in youth aged 16–19. Material and method. Research was carried out using a survey questionnaire among 511 people aged 16–19 and theirxa0parents. The surveyed youth had blood pressure measured in various conditions, including after a provocative stimulusxa0— HGT. In the statistical study we used the ANOVA single factor analysis of variance, χ2 independence test, the V-Kramerxa0test, the tau-b Kendall test and the method: percentages (%), arithmetical average (X) and standard deviation (SD). Results. Increased pressure rise after HGT test regarded more frequently the systolic aspect (34.8%) rather than thexa0diastolic aspect (7.0%) (p < 0.001). Increased response of systolic blood pressure was observed more frequently inxa0persons with its elevated, rather than normal values (p < 0.05). Increased response for both systolic and diastolic bloodxa0pressure was found in persons with a high HT intensity history in the family more often than in youth with low hyperxa0intensity or no propensity towards HT, with predominance of systolic pressure (p < 0.01 vs. p < 0.05). Conclusions. Our research shows that the HGT, which is used to detect hyper reactivity of the circulatory system, is a viable method for identifi cation of people susceptible to PHT. The application of the test may result in the lowered costs of treatment of people suffering from a hypertension disease.

Gotowość pielęgniarek do ordynowania leków i wypisywania recept

Wstep. Uchwalona 22 lipca 2014 roku ustawa o zmianie ustawy o zawodach pielegniarki i poloznej wprowadza mozliwośc wystawiania recept przez pielegniarki i polozne w Polsce. Cel. Ocena przygotowania pielegniarek do wypisywania recept w opiniach pielegniarek zatrudnionych w placowkach podstawowej opieki zdrowotnej (POZ). Material i metody. Badanie przeprowadzono w okresie od stycznia do lipca 2015 roku wśrod 539 pielegniarek POZ z wojewodztwa podkarpackiego. Badanie oparto na kwestionariuszu wywiadu opracowanym z wykorzystaniem 5-stopniowej skali Likerta. W analizie statystycznej posluzono sie testem Manna-Whitneya i testem Kruskala-Wallisa. Wyniki. Ponad polowa badanych (52,0%) twierdzi, ze nie ma wystarczającej wiedzy, aby sprostac nowym kompetencjom. Przygotowanie do wystawiania recept deklarują najcześciej pielegniarki ze stazem pracy 6–10 lat (p = 0,0029), ze średnich miast (p = 0,0064) oraz z wyksztalceniem wyzszym (p = 0,0388). Pielegniarki w wiekszości (76,5%) uwazają, ze nie powinny przepisywac wszystkich lekow, jedynie wyroby medyczne (72,9%), leki wcześniej zlecone przez lekarza (66,0%) i środki spozywcze specjalnego przeznaczenia zywieniowego (50,1%). Warunkiem wypisania recepty jest ocena stanu pacjenta, miedzy innymi badanie fizykalne. Wśrod badanych 43,9% osob uwaza, ze pielegniarki potrafią zbadac fizykalnie pacjenta, a 34,7% jest odmiennego zdania. Wnioski. Nalezy zwiekszyc świadomośc pielegniarek na temat nowych kompetencji, umacniac w nich przekonanie o konieczności uzyskania kwalifikacji gwarantujących mozliwośc ordynowania lekow i wypisywania recept, uświadomic znaczenie prawidlowo przeprowadzonego badania fizykalnego.