European trends in ovarian cancer mortality, 1990-2020 and predictions to 2025.

INTRODUCTION: Over the last decades, ovarian cancer mortality in Europe has been decreasing, but disparities in trends were observed. In this paper, we analysed ovarian cancer mortality trends in Europe over the period 1990-2020 and predicted the number of deaths and rates by 2025. METHODS: We extracted population and death certification data from ovarian cancer in women for 31 European countries, between 1990 and 2020 from the World Health Organization database. We computed age-standardised mortality rates (ASMR) per 100,000 women-years, based on the world standard population. We also obtained predictions for 2025 using a joinpoint regression model and calculated the number of avoided deaths over the period 1994-2025. RESULTS: Over the observed period, mortality from ovarian cancer showed a favourable pattern in most countries. In the EU-27, rates declined by 5.9% from 2010-2014 to 2015-2019, reaching an ASMR of 4.66/100,000. During the same period, the decline in ovarian cancer mortality was more pronounced in the EU-14 countries (-7.0%) compared to Transitional countries (-2.1%). Declines were also observed in the United Kingdom, to reach an ASMR of 5.29. Decreases in mortality from ovarian cancer are predicted until 2025, to 4.17/100,000 for the EU-27. CONCLUSIONS: Favourable trends in ovarian cancer mortality are expected to persist in Europe and can be mainly attributed to the increased use of oral contraceptives in subsequent generations of European women. Decreased use of menopausal Hormone Replacement Therapy and improved diagnosis and management may also have played a role.

Excessive Gestational Weight Gain and Pregnancy Outcomes.

Adequate weight gain during pregnancy is one of the factors for its proper course. Excessive weight gain during this period of a woman's life is associated with adverse pregnancy outcomes. In this study, we determine the impact of excessive gestational weight gain on pregnancy outcomes. The study is based on the results of a Polish national survey performed between 2011 and 2017 on a group of 10,319 women and 6930 children. Excessive weight gain during pregnancy was associated with higher birthweight and higher prevalence and risk of birthweight over 4500 g (OR 6.92; 95% CI 3.10-15.42), cesarean section/assisted delivery (OR 2.71; 95% CI 1.63-4.49), pregnancy induced hypertension (OR 5.85; 95% CI 3.24-10.57), hospitalization during pregnancy (OR 1.85; 95% CI 1.12-3.04), and the Apgar score in the first minute of neonate's life in the range of 0-7 (OR 2.65; 95% CI 1.36-5.2). We did not observe the significant difference in premature rupture of membranes and labor inductions. Our study indicates that excessive gestational weight gain is associated with higher risk for adverse pregnancy outcomes.

Smoke-free homes in Poland during the COVID-19 pandemic - a nationwide cross-sectional survey.

OBJECTIVES: Secondhand smoke exposure causes serious health problems. Banning smoking in public venues decreases exposure to secondhand smoke. However, the implementation of smoke-free rules in a private setting (including homes) is largely voluntary. This study aimed to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland during the COVID-19 pandemic as well as to identify factors associated with the voluntary implementation of smoking bans at home. MATERIAL AND METHODS: This cross-sectional survey was conducted in March 2022 with a nationally representative sample of 1090 individuals aged ≥18 years in Poland. Data were collected using a computerassisted web interviewing (CAWI) technique. The research tool was an original questionnaire developed for the purpose of this study. RESULTS: Nationally, 60.6% of individuals had total ban on smoking in home (100% smoke-free home rules), 34.0% had implemented a partial smokefree home rule and 5.4% had not implemented any smoke-free home rules. Over three-quarters of non-smokers (76.8%) and only one-fifth of smokers (20.7%) had adopted a full smoke-free home rule. In multivariate logistic regression analysis, males (OR = 1.65, 95% CI: 1.22-2.22, p < 0.01), non-smokers (OR = 13.78, 95% CI: 9.80-19.38, p < 0.001), respondents who had higher education (OR = 1.57, 95% CI: 1.15-2.14, p < 0.01) as well as those who lived alone (OR = 2.44, 95% CI: 1.52-3.90, p < 0.001) had higher odds of having a 100% smoke-free home rule. CONCLUSIONS: This study demonstrated the negative impact of the COVID-19 pandemic on the implementation of smoke-free home rules in Poland. Less than two-thirds of the Polish population has adopted a total smoke-free home rule, with significant gaps between smokers and nonsmokers. Information on current voluntary smoke-free rules will be useful for further implementation of the smoke-free law in Poland. Int J Occup Med Environ Health. 2023;36(1):84-95.

Awareness of Tobacco-Related Diseases among Adults in Poland: A 2022 Nationwide Cross-Sectional Survey.

Warning about the dangers of tobacco use is a key element of tobacco control policy. The COVID-19 pandemic may impact public perception of the health risks of tobacco use. The aim of this study was to assess the level of knowledge of tobacco-related diseases among adults in Poland, as well as to identify sociodemographic factors associated with awareness of tobacco-related diseases. This cross-sectional survey was carried out in March 2022 on a representative nationwide sample of 1090 adults in Poland using the computer-assisted web interview (CAWI) technique. Lung cancer was the most recognized tobacco-related disease (92.7%), followed by COPD (89.7%) and myocardial infarction (84%). Three-quarters of the respondents (76.8%) were aware that smoking causes stroke and 51% were aware that smoking increases the risk for type 2 diabetes. Out of 9 factors analyzed in this study, female gender, an age of 50 years and over, and being a non-smoker were significantly associated with a higher awareness of tobacco-related diseases. This study showed an increase in public awareness of smoking-related diseases during the COVID-19 pandemic. While awareness of lung cancer and COPD was very high, there are still significant gaps in the awareness of the non-respiratory effects of tobacco use.

The Prevalence of Tobacco, Heated Tobacco, and E-Cigarette Use in Poland: A 2022 Web-Based Cross-Sectional Survey.

Monitoring tobacco use on a regular schedule is a basic tool of tobacco control policy. This study aimed (1) to assess the current prevalence and patterns of tobacco and e-cigarette use, as well as (2) to identify socioeconomic factors associated with smoking behavior among adults in Poland. This cross-sectional study was carried out in March 2022 on a nationwide, representative sample of 1090 adults in Poland. The computer-assisted web interview (CAWI) technique was used. Daily tobacco smoking was declared by 28.8% of respondents (27.1% of females and 30.8% of males; p = 0.2) and 4.2% were occasional smokers (4.2% of females and 4.3% of males; p = 0.8). Most of the current smokers (62.1%) smoked regular cigarettes and 25.2% smoked hand-rolled cigarettes. The prevalence of daily e-cigarette use was 4.8% (4.0% among females and 5.6% among males; p = 0.2). Daily heated tobacco use was declared by 4.0% of respondents (5.1% of females and 2.9% of males; p = 0.07). Age, having children, and educational level were significantly associated with current daily tobacco smoking. This study revealed a high prevalence of tobacco and e-cigarette use among adults in Poland. The presented data underscore the importance of further improvements in adopting a comprehensive tobacco control strategy in Poland.

Health policy programs realised in Poland in 2016-2017

Background: Health Policy Program (Program Polityki Zdrowotnej ­ PPZ) is a state policy tool for engaging local government units into the mechanism of granting provision of health services. Authors show areas in which self-governments most often took preventive health care actions and describe legislative changes in the Act on provision of health services. Objective: The aim of the article is to quantitative and qualitative statement of PPZ prepared in Poland in 2016 and 2017, as well as presenting changing legal situation in the scope of evaluation of these projects. Materials and methods: Authors use descriptive method, presenting changes of legal status. The article includes data available in the Bulletin of Public Information by The Agency for Health Technology Assessment. 590 programs were analyzed (239 from 2016 and 351 from 2017). Results: In 2016 ­ 67% of submitted programs were given a positive opinion and in 2017 ­ 71%. The most of positively evaluated PPZ submitted by local government units (53% in 2016; 47% in 2017) referred to prevention of infectious diseases by vaccines. On the basis of analyses conducted, significant differences were observed in the implementation of the PPZ in various regions of Poland. Conclusions: In the recent years a big improvement in the quality of planned self-government health programs is observed. It is suggested that due to the regulation defining the model of the health policy program and the model of the final report, this trend will continue.

The influence of aripiprazole and olanzapine on the anxiolytic-like effect observed in prenatally stressed rats (animal model of schizophrenia) exposed to the ethyl alcohol.

BACKGROUND: Schizophrenia is a common disease which affect about 1% of global population. In that point of view animal model of schizophrenia seem to be an important tool for better understanding the key theories related to the disease. The aim of the study was to find whether anxiety-like behavior is found in prenatally stressed rats (animal model of schizophrenia) and whether aripiprazole (ARI, 1.5mg/kg) and olanzapine (OLA, 0.5mg/kg) modify those functions. We also were able to determine whether ethyl alcohol consumption has an impact on ARI's and OLA's efficacy as well as anxiety-like behavior of animals. METHODS: The anxiolytic effects of ARI, OLA and ethyl alcohol were determined in a two compartment exploratory test. The anxiolytic effect was studied in the NSCG (non-stressed control group), NSAG (non-stressed alcohol group), and PSG (prenatally stressed group), PSAG (prenatally stressed alcohol group). RESULTS: Single and chronic treatment of both ARI and OLA produced a statistically significant increase in the number of entries in the white compartment of the two compartment exploratory test in the NSCG rats. In turn in the PSG rats only ARI showed the anxiolytic effect. Moreover ethyl alcohol intake showed anxiolytic effect in both NSAG and PSAG rats. Results also indicate that after prolonged administration of drugs, tolerance related to the anxiolytic effect was observed. CONCLUSION: ARI and OLA can reduce the level of anxiety which proves drugs effectiveness in course anxiety-like behavior. On the other hand only ARI generated anxiolytic effect in exposure to ethyl alcohol conditions.

Biochemical and cognitive impairments observed in animal models of schizophrenia induced by prenatal stress paradigm or methylazoxymethanol acetate administration.

The aim of the study was to find whether spatial memory impairment and disruption in locomotor activity were found in prenatally stressed rats (PSG) or prenatally methylazoxymethanol acetate-treated rats (MAMG). In addition to this, we examined basal plasma corticosterone level as well as brain-derived neurothropic factor (BDNF) in the PSG and MAMG rats. The effect of prenatal stress (stress paradigm between 14 and 21 day of gestation) and methylazoxymethanol acetate (MAM) administration (17 day of gestation) to the female Wistar rats were studied on the male offspring in the Morris Water Maze (spatial memory) and locomotor activity test. Through Morris Water Maze rats were injected with saline 4 times (on 1, 7, 14 and 21 day of testing) while in locomotor activity test saline was injected only once. Corticosterone level was measured using ELISA Kit while BDNF levels were assessed using ELISA Chemikine TM BDNF kit. Results indicate that both PSG and MAMG rats deteriorate spatial memory as well as increase locomotor activity compared to the control group. Biochemical studies indicate that basal plasma corticosterone level increased in both PSG and MAMG rats compared to the control group. Analyses of the BDNF level, on the other hand, have shown decrease of the neurothropin level in both hippocampus and prefrontal cortex (PFC) in both PSG and MAMG groups of rats. As shown by the obtained results, both the prenatal stress model and prenatal MAM administration model generate a number of behavioural (e.g. spatial memory disorders, increased locomotor activity) and biochemical (e.g. increased corticosterone and decreased BDNF levels) changes in the examined offspring, Thus, these models can be successfully used in the efficacy analysis of the pharmacotherapy applied.

[Impact Reimbursement Act on the pharmaceutical market in Poland]. / Wplyw ustawy refundacyjnej na rynek farmaceutyczny w Polsce.

According to 12 may 2011 Reimbursement Act, the new regulations were introduced related to changes in so far in force rules on refunds of official prices and margins for drugs, foodstuffs of special purpose and medical products. After year of functioning of this regulation, in evaluation of the government, law gave measurable financial effects for public payer, sometimes through drastic actions, connected the of reduction of existing profits of manufacturers sector and importers drugs, as well wholesale and retail, both in treatment open and closed. Parallel to research and analysis of effects introduction in life act refund, conducted by government, to target current regulation possible negative phenomena can to be after-effects to regulation, systematically there are conducted analogous study to reputable companies specialized in evaluation and updating market Polish pharmaceutical, such as IMS Health Polska, Pharma Expert, Kamsoft, WHO and European a law firm. In their opinion to reimbursement act is the most serious regulation control system to introduced into Polish order legal, and first time for many years on such a large scale. Thoroughly changed policy of drugs State have important influence for all participants Polish pharmaceutical market, both those directly related to the drug trade, as the functioning doctors and health condition and financial Polish patient. Change in the way prices of drugs is determined as flexible to price formation mechanism, combining drugs similar profile pharmacological in so group limits and dependence of the level of refunds from application drug accordingly characteristics medicinal product, adaptation solutions to new law refund to the existing law about health services, gave measurable financial effect for the public payer. Rationalization expenses to NFZ, as main premise introduction refund act, created to broader than so far possibility to use new molecules of drugs, and the latest medical technology, even if in the revised or new drug programs. Important implications for even Polish image in Europe, especially from the point of view of cohesion policy and application to directive transparency EU have introduction refund act in context to introduction clear, transparent and verifiable procedures used with creating drug pricing mechanisms, foodstuffs of special purpose and medical product.

[Health care financing models]. / Modele finansowania opieki zdrowotnej.

The functioning of health care depends mainly on the level and method of financing. Countries choose between different models. Bismarck's model is financing based mainly on the contributions that are obligatory for employers and employees, decentralized model of managing and contracting services. Beveridge's model is financed mostly from the government taxes, it allows contributing to the cost of benefits for patients and participation by private sector. Residual model is based on the optional and private health insurances, supplemented only by National Health Service. Siemaszko's model in his assumption is based on the financing of benefits by the state budget, provides permanent control of the state and equal access to all the benefits for citizens. Choice of a specific financing model entails certain impact on all of the system's participants. The purpose of this article is to introduce subject of health care financing based on the literature and the authors' own thoughts.