Assessment of physicians' career satisfaction in the Silesian Voivodeship, Poland.

OBJECTIVE: Aim: To assess the career satisfaction of physician's in the Silesian Voivodeship, Poland, in relation to selected factors. PATIENTS AND METHODS: Materials and Methods: The questionnaire survey was conducted among 701 physicians and dentists from the Silesian Voivodeship, Poland, in the period from January to December 2018, using the PAPI (Paper and Pencil Interview) method. Physicians' Career Satisfaction was measured and basic socio-demographic, economic and occupational data, concerning lifestyle and health, and also the level of life satisfaction according to the SWLS (Satisfaction with Life Scale) were collected. Moreover, the occurrence of anxiety and/or depressive symptoms according to the HADS (Hospital Anxiety and Depression Scale) were included in the analyses. RESULTS: Results: The career satisfaction of the surveyed Silesian physicians and dentists was moderate. Wages and combining personal life with work were rated the lowest, while interpersonal opportunities were rated the highest. The predictors: age, economic status and body mass index (BMI) were significant; in addition, in younger age group (25-49 years) - practicing sports and chronic fatigue, and in older age group (50-80 years) - the presence of a chronic disease. A moderate correlation between the level of career satisfaction and life satisfaction was revealed, as well as a lower score in people with the occurrence of anxiety and/or depression symptoms. CONCLUSION: Conclusions: The diversified level of career satisfaction of physicians in separated aspects makes it necessary to verify them both at the level of health care units and at higher levels.

Socioeconomic and Health Determinants of the Prevalence of COVID-19 in a Population of Children with Respiratory Diseases and Symptoms.

BACKGROUND: Most epidemiological studies indicate that bronchial asthma is not a risk factor for COVID-19, but previous analyses have not additionally focused on the socioeconomic determinants of SARS-CoV-2 infection in children with asthma, bronchitis, and respiratory symptoms. AIMS: This research aimed to investigate the correlation between the socioeconomic status of families and the prevalence of respiratory conditions such as asthma, bronchitis, and respiratory symptoms in children, in addition to exploring their association with the prevalence of COVID-19. The study involved a cross-sectional epidemiological investigation conducted in 2022, encompassing 2454 students from elementary schools in Poland. The parents of the students completed a questionnaire modeled after the International Study on Asthma and Allergies in Childhood (ISAAC). Socioeconomic status (SES) indicators were determined based on parental education, self-reported economic status, and housing conditions. To assess the impact of social factors and health on the occurrence of COVID-19, odds ratios (ORs) were calculated. The findings revealed several COVID-19 risk factors, including higher maternal (OR 2.2; 95%CI: 1.3-3.0) and paternal education (OR 1.9; 95%CI: 1.3-2.4), urban residence (OR 1.7; 95%CI: 1.3-2.1), the presence of mold in residences (OR 1.7; 95%CI: 1.0-2.3), bronchitis (OR 1.5; 95%CI: 1.2-2.0), and chronic cough (OR 1.8; 95%CI: 1.3-2.4). Further analysis, stratifying children based on their baseline health status (i.e., presence or absence of asthma, bronchitis, and chronic cough), indicated that higher parental education increased the risk of COVID-19 solely for children without pre-existing conditions. The occurrence of SARS-CoV-2 infections was found to be notably associated with mold exposure in children who did not have bronchial asthma. Rigorous multivariate analyses substantiated the collective impact of factors such as residential environment, the existence of mold and moisture, and a history of bronchitis. This study's conclusions highlight a higher frequency of SARS-CoV-2 infections in cases where bronchitis had been diagnosed previously and chronic cough was prevalent. Interestingly, the initially hypothesized higher prevalence of COVID-19 among children with bronchial asthma did not receive confirmation in our findings. This study highlights the importance of urban residence, exposure to mold or dampness, and higher parental education in the incidence of COVID-19. Higher parental education was a significant factor in increasing the risk of COVID-19 among children without bronchitis, chronic cough, and asthma.

Emotional control and factors differentiating it in the adult population of Poland during the COVID-19 pandemic.

Introduction: The public health crisis related to the COVID-19 pandemic has had a negative impact on the mental health of both individuals and entire populations. The source of stress was not only the fear of getting sick, but also the restrictions introduced, such as: mass lockdown, the need to maintain social distance, quarantine or the mandatory use of personal protective equipment. Their introduction and maintenance caused various emotional reactions which often resulted in undesirable behavior leading to infections spreading. The aim of the study: The aim of the study was to analyze the level of emotional control depending on selected factors related to the pandemic and the introduced restrictions. Materials and methods: The study covered 594 adult Poles. To evaluate knowledge about COVID-19 and attitudes toward the implemented restrictions, the questionnaire prepared by the authors was used. To determine the level of control of anger, depression and anxiety the Courtauld Emotional Control Scale (CECS) was used, and to estimate the level of perceived stress the Perceived Stress Scale (PSS-10) was applied. Results: In the entire analyzed group, the general level of emotional control was 51.82 ± 12.26, with anxiety being the most suppressed emotion (17.95 ± 4.99), whereas the least suppressed emotion was anger (16.35 ± 5.15). The average stress level in the studied group was 20.5 ± 5.3. The level of perceived stress did not differentiate the level of emotional control. It was found that the higher level of the knowledge about the pandemic and methods of prevention, the higher emotional control, especially in the anxiety subscale (high level of knowledge - 18.26 ± 5.36 vs. low level of knowledge - 15.09 ± 3.6; p = 0.02). People reporting difficulties in reconciling remote work with home duties were less able to control anger (14.63 ± 4.98) than people without such problems (16.71 ± 4.12; p = 0.007). Conclusion: Proper education improving knowledge about COVID-19 and methods of prevention may enhance the control of emotions in the population. Possible future preventive measures aimed at limiting the spread of SARS-CoV-2 infections or other infectious diseases should also take into account possible excessive mental burden caused by private and professional duties.

Risk factors for reoperation after surgical treatment for degenerative spinal disease in Poland: a nationwide retrospective study of 38,953 hospitalisations.

INTRODUCTION: Degenerative spinal disease (DSD) is one of the most common musculoskeletal conditions and a leading cause of sickness absence. It also contributes significantly to the global burden of disease. The aim of this study was to assess the frequency of reoperation after surgical treatment of DSDs in Poland, and to identify risk factors for reoperation. MATERIAL AND METHODS: A retrospective analysis of hospitalisations for DSD in 2018 that were reported to Poland's National Health Fund (NHF) was performed. Reoperations reported within 365 days of hospital discharge were identified. Demographic factors and multimorbidities were included in the analysis. A logistic regression model was then performed to assess risk factors for reoperations. RESULTS: In 2018, 38,953 surgical hospitalszations for DSD were reported. A total of 3,942 hospitalised patients (10.12%) required reoperation within 365 days. Patients requiring reoperation were predominantly female (female-to-male ratio 1.34:1) and elderly (mean age of reoperated patients 56.66 years, mean age of other patients 53.24). The percentage reoperated upon correlated with multiple diseases (from 8.81% in the group of patients without comorbidities to 15.31% in the group of patients with three or more comorbidities). The risk of reoperation was most increased by comorbid depression, neurological diseases, obesity, and older age. The risk of reoperation was reduced by instrumented spinal surgery, surgery in a neurosurgical unit, and hospitalisations other than same-day surgery. CONCLUSIONS: Reoperations within a year after DSD surgical treatment are common. Identifying risk factors for reoperation, including those related to the presence of comorbidities and the phenomenon of multimorbidity, can be an important tool in reducing reoperation rates.

Pre- and Postnatal Determinants Shaping the Microbiome of the Newborn in the Opinion of Pregnant Women from Silesia (Poland).

Pre- and postnatal factors influence the formation of the newborn's microbiome as early as birth and the intrauterine period has a substantial impact on the composition of the baby's gastrointestinal microbiota and its subsequent development. This study intends to measure pregnant women's knowledge of the importance of microbiota for the health of the newborn. The sample was selected based on defined inclusion and exclusion criteria. The assessment of women's knowledge was assessed by the Kolmogorov-Smirnov and Kruskal-Wallis statistical tests. This study population comprised 291 adult pregnant women with a mean age of 28.4 ± 4.7 years. A total of 34% (n = 99), 35% (n = 101), and 31.3% (n = 91) were at the 1-3 trimester, respectively. The results showed that 36.4% of the women were aware that the intrauterine period changes the makeup of the gastrointestinal microbiota, whereas 5.8% exhibited awareness of the composition of the child's normal gut microbiota. Most of the women surveyed-(72.1%)-know that colonization of the tract occurs as early as the birth period. Women with student status (those who will pursue higher education in the future) and those who had given birth to the most children exhibited higher levels of knowledge.

Impact of the COVID-19 Pandemic on Nutrition, Sleep, Physical Activity, and Mood Disorders of Polish Children.

The harmful consequences of the COVID-19 pandemic on children are its impact on eating habits, physical activity, sleep, and mood disorders. In the future, this may result in a higher prevalence of obesity and diet-related diseases. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on children's eating behavior and lifestyle. The study was conducted using a proprietary questionnaire on dietary and lifestyle habits before and during the pandemic, and the reasons for changes due to the pandemic. The study involved 294 parents of children in grades 1-8 in elementary schools in two regions of Poland. The survey showed that during the pandemic, the percentage of children eating five regular meals daily, including fruits and vegetables, and engaging in daily physical activity decreased. However, the percentage of children spending more than 4 h a day in front of a screen increased (p < 0.05). The main reasons for changes in eating habits and physical activity were less eating out, lack of motivation, obstruction, and lack of access to sports facilities (p < 0.05). The pandemic had a significant impact on reduced levels of physical activity and increased time spent in front of a screen. In summary, among the reasons for changes in children's dietary and lifestyle habits, factors related to the pandemic itself, i.e., social restrictions, restrictions, closure of schools and other facilities, and fear of coronavirus infection, had the greatest impact.

Assessment of Life Satisfaction of the Physicians of the Silesian Province, Poland.

BACKGROUND: The medical profession is associated with a heavy psychological and physical burden. Specific working conditions can negatively affect the assessment of physicians' quality of life. The lack of current studies prompted us to evaluate the life satisfaction of the physicians in the Silesian Province in relation to the selected factors (health status, professional preferences, family and material status). MATERIAL AND METHODS: The study included 701 physicians and dentists from the Silesian Province aged between 25 and 80 years. It was conducted in 2018 using the Paper and Pencil Interview technique by obtaining non-personalized demographic, anthropometric, socioeconomic, occupational, health and lifestyle data. The following measures were used: the Satisfaction with Life Scale (SWLS), Occupational Satisfaction and the Hospital Anxiety and Depression Scale (HADS). Considering the environmental conditions, the total SWLS scores were analysed in terms of the significance of differences in the groups. Moreover, the SWLS scores underwent multivariate analysis of variance and the correlation analysis of job satisfaction and the presence of anxiety and/or depressive symptoms. RESULTS: Life satisfaction among the physicians and dentists from the Silesian Province was at an average level. Significant predictors included age and economic status. Additionally, significant predictors in the younger subjects (25-50 years) included the Body Mass Index and practising sports. In turn, in the older subjects (50-80 years), these predictors were related to hospital work and being on sick leave. The study found a significant moderate association between life satisfaction and professional satisfaction. Additionally, a significantly lower level of life satisfaction was reported in the subjects who presented with anxiety and/or depressive symptoms. CONCLUSIONS: Due to its association with the profession, the mean level of life satisfaction among physicians and dentists prompts verification of crucial spheres related to the physical, emotional, social and material well-being and the activity of the professional group.

Active and Happy? Physical Activity and Life Satisfaction among Young Educated Women.

BACKGROUND: Physical activity belongs to the group of health-promoting behaviors. It also affects emotional well-being, which is linked to a higher quality of life. Individuals who participate in physical activity practice regardless of age reap several positive health benefits that affect both body and mind. The aim of this study was to assess the life satisfaction of young adults in the context of physical activity undertaken. MATERIAL AND METHODS: Study material was collected via anonymous questionnaire surveys among 328 young women (between the ages of 18 and 30 with secondary or higher education) in Poland. Satisfaction with life was assessed using The Satisfaction with Life Scale (SWLS). Statistical calculations were performed using the STATISTICA 13.3 program, Stat Soft Poland. Interdependence of unmeasured characteristics was assessed using the X2 test. Multivariate analysis for the direct effect of physical activity on life satisfaction (LS) and the influence of frequency of physical fitness on life satisfaction was performed based on regular OLS multiple regression. RESULTS: The majority of respondents (74.7%) reported engaging in physical exercise. The mean level of life satisfaction was 4.5 ± 1.1 (on a scale of 1 to 7). Multivariate analysis showed no statistically significant relationship with life satisfaction in the physically active and inactive groups. It was observed that significantly higher levels of life satisfaction were found among respondents: married 5.1 ± 1.1, median = 5.2 (4.5-5.9) compared to single 4.4 ± 1.2, median = 4.6 (3.6-5.2) and in informal relationships 4.5 ± 1.0, median = 4.4 (3.8-5.2); p = 0.02; declaring rather good 4.5 ± 1.0, median = 4.6 (3.8-5.2) or very good health 4.8 ± 1.1, median = 5.0 (4.2-5.6) compared to rather poor 4.1 ± 1.0, median = 4.1 (3.4-4.8) and poor health 3.6 ± 1.4, median = 3.1 (2.6-4.4); p = 0.0006; rating their physical condition moderately 4.7 ± 1.1, median = 4.8 (4.0-5.6) or highly 4.9 ± 1.0, median = 5.0 (4.3-5.4) compared to rating their fitness low 4.2 ± 0.9, median = 4.2 (3.6-4.8); p < 0.0001. Multivariate analyses confirmed a significant effect of marital status and subjective assessment of physical condition on the average level of life satisfaction. CONCLUSIONS: Physical activity does not differentiate the level of life satisfaction in the studied group of young women. Marital status and the subjective assessment of physical condition are factors that have a significant impact on the level of satisfaction with the life of young women. Given the beneficial effect of physical activity on the sense of satisfaction with life, which can lead to an increase in its quality, physical activity should be promoted, not only among children but also in the group of young adults.

Properties of Polyunsaturated Fatty Acids in Primary and Secondary Prevention of Cardiovascular Diseases in the View of Patients (Silesia, Poland).

BACKGROUND: Cardiovascular diseases are a major cause of morbidity and mortality in Europe. Lifestyle plays an important role in the primary and secondary prevention of cardiovascular diseases, apart from pharmacotherapy and diagnostics. Numerous studies confirm that the type and quality of fat consumed in the diet have a huge impact on the risk of cardiovascular diseases. Reducing the risk of cardiovascular disease can be helped by minimizing the proportion of saturated fatty acids in the diet and replacing them with polyunsaturated fatty acids. These acids and, above all, their long-chain forms have a positive effect on health. AIM: This study aims to assess the awareness of the properties of polyunsaturated fatty acids in the primary and secondary prevention of cardiovascular diseases in the opinions of patients of the Cardiology Department of the Racibórz Medical Center. MATERIAL AND METHODS: The analysis included 302 patients (113 women and 189 men) hospitalized in the Cardiology Department. The research method was the authors' questionnaire consisting of the patients' record and thirty closed questions. To answer the research questions posed and test the hypotheses, statistical analyses were carried out using the IBM SPSS Statistics version 25 package. RESULTS: Among the respondents, the least frequently used healthy eating habit was the infrequent eating of fried foods. A total of 18.2% of respondents had such a habit. The most commonly used healthy eating habit was checking the fat content in products, which was performed by 67.2% of respondents. Among the respondents, 58.3% said that butter and margarine increase serum cholesterol. CONCLUSIONS: The analysis of the data shows that the place of residence, education, sex, and reason for hospitalization of the respondents did not affect the frequency of healthy eating habits. In addition, the subjects had a low amount of healthy eating habits.

Microplastic in Food and Water: Current Knowledge and Awareness of Consumers.

In recent years, the widespread of microplastics in the food chain and environment became a topic of much research. This article focused on the knowledge and awareness of people with higher education levels-mostly young ones. The aim of this study is to analyze to what extent consumers know about and are aware of the source of microplastics, the level of exposure, and potential health hazards connected to the contamination of food and water with microplastics. The test group, consisting of 410 people, is mostly able to correctly characterize what microplastics mean and knows its sources. A majority of the group is aware of potential presence of microplastics in water; however, the knowledge about contamination of other elements of the environment seems to be gradually lowering. The majority of the people taking part in the research know that microplastic might be present in foods, and they are aware that after entering the human body, it might accumulate in internal organs. Moreover, when asked about potential health hazards, the group chose mostly tumors and gastrointestinal disorders, while disorders of the reproductive system were chosen less frequently. Consumers' knowledge regarding the sources and health hazards of microplastics seems to be more common among women, in groups living in cities and among people who studied physics-related subjects and medicine.

Social Inequalities: Do They Matter in Asthma, Bronchitis, and Respiratory Symptoms in Children?

Background: Social inequalities (e.g., poverty and low level of education) generate inequalities in health. Aim: The aim of the study was to determine the relationships between indicators of social inequalities and the frequency of respiratory symptoms, asthma, and bronchitis in children. Material and Methods: In 2019, an epidemiological cross-sectional study on 3237 students from elementary schools in Silesia Voivodships (South Poland) was conducted. The students' parents completed a questionnaire based on the International Study on Asthma and Allergies in Childhood (ISAAC). Social inequalities in the children's families were determined according to parents' education and professional status (working vs. unemployed), self-assessment of economic status, and housing conditions. To determine the influence of social factors on the occurrence of asthma, bronchitis, and respiratory symptoms, the odds ratio (OR) was calculated. Results: Children living in apartments with traces of mold had a higher risk of developing asthma (OR = 1.5, 95%CI: 1.17-1.96; p = 0.002) or bronchitis (OR = 1.4, 95%CI: 1.13-1.72; p = 0.002), wheezing attacks at nights (OR = 1.4; 95%CI: 1.01-1.93), wheezy in the last 12 months (OR = 1.6; 95%CI:1.24-2.08; p < 0.001), and chronic cough (OR = 1.9; 95%CI: 1.49-2.46; p < 0.001). Exposure to environmental tobacco smoke (ETS) was associated with higher risk of cough (OR = 1.5 95%CI: 1.22-1.96; p < 0.001) and dyspnea in the last 12 months (OR = 1.4; 95%CI: 1.04-2.00; p = 0.02). Low socioeconomic status (SES) was associated with increased risk of chronic cough (OR = 1.5; 95%CI: 1.09-2.03; p = 0.009) and increased risk of wheezy in the last 12 months (OR = 1.4; 95%CI: 1.06-1.97; p = 0.008). Asthma and bronchitis were not dependent on parents' education or professional status. Conclusions: Social inequalities have significant impacts on the occurrence of respiratory symptoms, bronchitis, and asthma in children. Interventions aimed at preventing bronchitis and childhood asthma should also focus on social health determinants.

The Physical and Mental Well-Being of Medical Doctors in the Silesian Voivodeship.

Physical and mental well-being are important determinants of medical doctors' lives, including their professional activity, which has a direct impact on the health and lives of patients. The aim of the study was to assess the health condition of medical doctors from the Silesian Voivodeship. The physical health condition, including the prevalence of chronic diseases, drug therapy, and pro-health activities, was assessed. Data on mental health according to the HADS scale (hospital anxiety and depression scale) referred to the selected socio-economic and professional aspects of life, as well as life and job satisfaction. The doctors most often reported diseases of the circulatory system and diseases of endocrine system, nutritional status and metabolic changes, allergies, and degenerative changes in the musculoskeletal system and connective tissue. Chronic diseases and anxiety or depressive disorders affected doctors aged 50-80 years more frequently, and those doctors undertook preventive pro-health activities more often. The higher risks of anxiety and depression were related to their social and professional roles, lower economic status, overweight or obesity, chronic diseases, pharmacotherapy, diets, and chronic fatigue. On the other hand, frequent physical activity, a longer sleep duration, smaller weekly workload, type of rest, a higher sense of job satisfaction, and a higher level of life satisfaction reduced the risk of disorders. The health condition of medical doctors in the Silesian Voivodeship requires decisive remedial actions in the professional and non-professional spheres.

Asthma, bronchitis respiratory symptoms, allergies and home environment: how are they related?

Introduction: Home environmental conditions can affect the prevalence of childhood asthma and allergies. Aim: To assess the relationship between the prevalence of childhood asthma, bronchitis, and allergies and the condition of the home environment. Material and methods: In 2018 and 2019, a cross-sectional study on 2932 children from elementary schools in the Silesian Voivodship (Southern Poland) was conducted. The questionnaire was based on the International Study of Asthma and Allergies in Childhood (ISAAC). In order to determine the association between the home environment (presence of moulds, furry pets) and respiratory symptoms and diseases, a logistic regression analysis was performed by calculating the odds ratio (OR), determining p < 0.05 as the level of significance. Results: Asthma risk factors were male sex, heating with solid fuel and presence of moulds. The prevalence of respiratory symptoms, bronchitis, and allergic diseases is statistically more common with the presence of moulds in dwellings. A protective effect of the presence of pets on the prevalence of asthma (OR = 0.77; 95% CI: 0.59-0.99), allergy to pet allergens (OR = 0.59; 95% CI: 0.45-0.76), allergy to house dust mite (OR = 0.70; 95% CI: 0.56-0.87) and wheeze in the last 12 months (OR = 0.70; 95% CI: 0.54-0.91) and ever (OR = 0.85; 95% CI: 0.70-1.02) was observed. Conclusions: The study confirmed the known adverse influence of the presence of moulds and heating with solid fuel on the prevalence of asthma, bronchitis, respiratory symptoms and allergic diseases. The protective influence of pets on the occurrence of the health disorders under study was demonstrated.

Respiratory Symptoms, Allergies, and Environmental Exposures in Children with and without Asthma.

BACKGROUND: Epidemiological data concerning the level of asthma morbidity indicate that in Poland, asthma is diagnosed in 5-10% of the pediatric population. Aim The purpose of this study was to compare the prevalence of respiratory symptoms and allergies in a group of children with and without asthma and to evaluate the association between exposure to environmental factors and the prevalence of bronchial asthma in a pediatric population. MATERIAL AND METHODS: A cross-sectional study was conducted on a group of 995 children attending primary schools in the province of Silesia in 2018-2019. The research tool was an anonymous questionnaire developed based on the form used in The International Study of Asthma and Allergies in Childhood (ISAAC). Children's health status, the prevalence of bronchial asthma, and the performance of allergic skin tests were assessed based on parents' indications in a questionnaire. Environmental exposures such as mold and dampness in apartments or ETS were similarly assessed. Analyses were performed using Statistica 13.0; p < 0.05. RESULTS: A total of 88 subjects (8.8%) suffered from bronchial asthma. Parents of children with asthma, compared to parents of children without the disease, were more likely to rate their children's health as rather good (43.2% vs. 38.0%) or average (21.6% vs. 3.1%). All analyzed respiratory symptoms, as well as allergies, were statistically more frequent in children with bronchial asthma. CONCLUSIONS: The parent's subjective assessment of the child's health varied significantly according to the asthma diagnosis. Asthma is also associated with other diseases: allergic reactions to pollen, house dust, hay fever, and AD (atopic dermatitis) were statistically significantly more frequent among children diagnosed with bronchial asthma.

The Concept of Intrauterine Programming and the Development of the Neonatal Microbiome in the Prevention of SARS-CoV-2 Infection.

The process of intrauterine programming is related to the quality of the microbiome formed in the fetus and the newborn. The implementation of probiotics, prebiotics, and psychobiotics shows immunomodulatory potential towards the organism, especially the microbiome of the pregnant woman and her child. Nutrigenomics, based on the observation of pregnant women and the developing fetus, makes it possible to estimate the biological effects of active dietary components on gene expression or silencing. Nutritional intervention for pregnant women should consider the nutritional status of the patient, biological markers, and the potential impact of dietary intervention on fetal physiology. The use of a holistic model of nutrition allows for appropriately targeted and effective dietary prophylaxis that can impact the physical and mental health of both the mother and the newborn. This model targets the regulation of the immune response of the pregnant woman and the newborn, considering the clinical state of the microbiota and the pathomechanism of the nervous system. Current scientific reports indicate the protective properties of immunobiotics (probiotics) about the reduction of the frequency of infections and the severity of the course of COVID-19 disease. The aim of this study was to test the hypothesis that intrauterine programming influences the development of the microbiome for the prevention of SARS-CoV-2 infection based on a review of research studies.

Caesarean delivery and risk of childhood asthma development: meta-analysis.

INTRODUCTION: Several studies indicate that delivery by caesarean section may be one of the risk factors for the development of childhood asthma. AIM: A meta-analysis was carried out to establish the relationship between delivery by caesarean section and asthma in children. MATERIAL AND METHODS: After a review of bibliographic databases, 41 articles were obtained and 12 of which were accepted for further analysis. The odds ratios (OR) included in the analysis were specified on the basis of data from the presented studies or were calculated using reported prevalence. The analysis took into account unadjusted OR. The heterogeneity of results was assessed using the χ2 test, determining p < 0.05 as the level of significance. The analysis was performed using Statistica 13.3 and kit 4.0.67. RESULTS: Caesarean delivery was associated with an increased risk of development of childhood asthma (OR = 1.41); however, significant heterogeneity of results was demonstrated. A significantly higher risk of asthma was found in children born by caesarean section in the case where the disease was confirmed in a questionnaire-based study (OR = 1.26, 95% CI: 1.05-1.5), and the results of that study were homogeneous. CONCLUSIONS: In the case of the diagnosis of asthma declared by parents in the questionnaire-based study, a significantly higher risk of disease occurrence was observed in children born by caesarean section. Due to the significant heterogeneity of the results of the studies, it cannot be clearly stated that caesarean delivery is a risk factor for the development of bronchial asthma.

Health inequalities among students of lower secondary schools in Bytom, Poland.

INTRODUCTION AND OBJECTIVE: Poverty and low level of education pose the biggest threats to public health. Moreover, they generate inequalities in public healthThe aim of the study was to check if there are any inequalities in health among teenagers living in Bytom, Poland. MATERIAL AND METHODS: In 2011 and 2012, an epidemiological cross-sectional study was conducted on 1,099 students from lower secondary schools from Bytom. The students completed a questionnaire which was based on an earlier Health Behaviour in School-aged Children study (HBSC). Socio-Economic Status of teenagers (SES) was determined according to the Family Affluence Scale (FAS), the intensity of possible problems in the place of residence and on parents' education. Impact of SES on health self-assessment, asthma, pneumonia, bronchitis with addition to spinal deformities were also investigated. RESULTS: A good or very good level of health was declared by students from families representing a high level of FAS and residing in a more peaceful, less troubled neighbourhood. The highest level of asthma prevalence (10.9%) occurred among students from families with a low level of FAS. The students from families with high FAS were less affected by spinal deformities (34.6%). Students living in a troubled neighbourhood more often suffered from bronchial asthma, pneumonia, bronchitis and spinal deformities. CONCLUSIONS: The level of family affluence depends on the parents' education and all the analysed health problems occurred more frequently in children whose parents had completed at least general secondary education. A high economic standard of living and a peaceful neighbourhood determined good or very good health self-assessment among the surveyed students.

Environmental risk factors for respiratory symptoms and childhood asthma.

The presented cross-sectional study, comprised a group of 1,130 children from 13-15 years of age living in Upper Silesia, Poland, was undertaken to ascertain the role of environmental factors in the development of adverse respiratory health outcomes. To estimate the prevalence of these effects, the ISAAC questionnaire supplemented by questions related to risk factors was used. Bronchial asthma was identified in 4.5% of the children, asthma diagnosed by physicians in 8.7%, and prevalence of wheezing in the previous 12 months in 12.6%. The highest probability of wheezing was found in children with maternal genetic propensity (such as asthma, allergy), exposed to maternal smoking, or was connected with household risk factors such as the presence of dampness/mould or living in 50-year-old building. Female gender and attendance at nursery school were shown to be protective factors against wheezing. The probability of asthma was nearly twice as high in children residing in damp/mouldy dwellings, heated by coal-fired furnaces and living in the immediate vicinity of a road with heavy traffic. This study revealed that exposure to indoor (tobacco smoke, coal stove emission, mould or dampness in dwelling) and outdoor (traffic pollution) air contaminants are major environmental factors responsible for adverse respiratory health effects in children.