COVID-19 Pandemic and Healthcare Communication: A Patient-Centric Evaluation of Treatment and Diagnostic Procedures in Poland.

BACKGROUND The COVID-19 pandemic necessitated swift and often abrupt changes in healthcare practices, significantly influencing treatment and diagnostic procedures. This study aimed to gauge patient perceptions regarding these changes and their overall impact on the treatment and diagnosis process (ITDP). MATERIAL AND METHODS In March 2022, we conducted a cross-sectional online survey among 1860 Polish residents (mean age: 48.82±16.57 years), who had accessed medical services within the preceding 24 months. We employed a binary logistic regression model to pinpoint independent factors contributing to a wholly negative perception of the pandemic's influence on the ITDP. RESULTS Around 64.3% of respondents perceived the ITDP during the pandemic negatively, with 20.8% reporting mixed impacts. Of 22 factors considered, 16 were significantly associated with ITDP perceptions in univariate analyses, and 8 qualified for the final multivariate model. The most potent predictors of negative ITDP perceptions included impeded communication with medical personnel due to the emphasis on COVID-19 (OR=2.82; 95% CI: 2.04-3.90) and worsening family financial circumstances during the pandemic (OR=2.03; 95% CI: 1.26-3.27). Other significant predictors comprised viewing remote services as a hindrance to medical communication, higher education, and use of self-funded private healthcare. CONCLUSIONS Our findings confirm that negative perceptions of the ITDP during the COVID-19 pandemic are associated with the remote delivery of medical services and communication challenges. These insights underscore the need to improve these domains for better healthcare delivery amid ongoing or future health crises.

Making the best out of youth-The Improve the Youth project.

Adolescents' mental health determines their general health and their mental health as adults. Improve the Youth project (ITY) was created and implemented among Polish and Portuguese adolescents. The aim of the project was to investigate the well-being of Portuguese and Polish adolescents, and to evaluate differences between them in self-rated health, life satisfaction and perceived psychosomatic health. A mixed-method approach was applied. The quantitative part was based on Health Behaviour in School-aged Children (HBSC) 2014 data, including adolescents aged 11-15 years (6026 in Portugal; 4545 in Poland). This study meets the issues raised by the HBSC results, regarding mental health in adolescence, and it is aimed to improve adolescents' social participation and active citizenship. In most study areas, findings in Poland were less favourable than in Portugal. The qualitative part was developed to recognize the main threats for adolescent's well-being. In this, they emphasised that every opportunity to talk about their feelings and needs resulted in improvement of their mental health. Elevated levels of stress were connected to environmental pressure and high expectations that they were often unable to cope with. Nervousness, perceiving that it was impossible to meet expectations, the desire to keep up with their peers, fatigue, and uncertainty of the future increased the feelings of frustration. The differences found between countries may be due to cultural roots, surfacing the relevance of assessing adolescents' mental health needs in the social context of family, school and peers. This study also aims to raise awareness among educators and stakeholders to the importance of youth engagement.

Changes in physical activity of adolescent girls in the context of their perception of the Healthy Me programme.

BACKGROUND: An assumption was made that results of programme evaluation lead to better understanding for whom this intervention may work. The aim of the article is to compare the changes in physical activity of the intervention programme participants depending on subjective assessment of its impact. METHODS: The data were obtained from 14- to15-year-old Polish girls (N = 1120) from 48 random selected secondary schools participating in the 1-year Healthy Me programme in the 2017/2018. Schools were randomly assigned to one of two types of intervention or to a control (null) group. Satisfaction with the programme according to 21 criteria was measured retrospectively just after the intervention. Change in MVPA (moderate-to-vigorous physical activity) during the programme implementation was assessed in relation to satisfaction level, and adjusted for initial MVPA. RESULTS: In total, the MVPA did not change significantly comparing pre- and post-intervention surveys (3.94 ± 1.94 vs. 3.87 ± 1.93)-P = 0.093. However, the perceived notable improvement of functioning in 10 out of 21 areas was related to the unquestionable increase in MVPA (P ≤ 0.001). With respect to the four impact areas, an interaction was demonstrated between an intervention group and an improvement in the domain-specific functioning. The beneficial impact of the programme on these areas was associated with the improvement of physical activity only in case of full and null intervention. CONCLUSIONS: Indicators related to the implementation process and the results obtained during the Healthy Me programme evaluation could represent a change in motivational and environmental factors that indirectly affects adolescent girl's physical activity.

The relationship between periodontal status and rheumatoid arthritis - systematic review.

There have been numerous publications investigating the relationship between periodontitis (PD) and rheumatoid arthritis (RA) so far. This publication presents the common risk factors for the development of PD and RA. The major impact of the pathological bacterial factor and cigarette smoking with chronic inflammation playing the key role in both diseases has been confirmed by numerous studies in various populations over the years. More research focuses nowadays also on the role of improper diet and obesity. Pathophysiological pathways, such as increased concentration of proinflammatory cytokines, indirectly affecting the cardiovascular complications and coagulation disorders, which has an impact on function disorders of tissue metalloproteinase inhibitors and the plasminogen activation system, were also researched. This systematic review of current literature has shown numerous discrepancies in previous analyses and the need for further detailed research on the relationship between periodontal status and RA.

Dietary Patterns of Children Aged 1-3 Years in Poland in Two Population Studies.

BACKGROUND: The levels of nutrition that children receive in their first years of life greatly determine their psychosomatic development. AIM: The study was to identify dietary patterns of children aged 1-3 years based on data on food consumption structure from 2 population studies performed in Poland (2011 and 2016) and to assess changes in product selection in the children's diets with respect to their nutritional status. METHODS: Both studies were performed on nationwide representative samples (2011: n = 400; 2016: n = 612) using questionnaire surveys. Nutritional status was estimated using body weight-to-height z-score. Feeding practices were evaluated based on 3-day dietary/food records, including 1 weekend day. RESULTS: Four dietary patterns of toddlers were identified and changes in the distribution of these patterns in the population after 5 years were analysed and compared. Diets of children in the second year of life were better balanced in terms of energy and nutritional value owing to young child formula content. Diets of children in the third year of life were higher in energy and protein, with a higher percentage of energy derived from saccharose. Diets of all groups of children were deficient in long-chain polyunsaturated fatty acids, vitamin D and potassium but excessive in sodium. CONCLUSIONS: Over 5 years, the percentage of children on a diet with high intake of formula for young children significantly decreased but increased on a diet with high dairy content. Dietary patterns of toddlers were associated with their weight by height z score and nutrient profile.

The cross-national measurement invariance of the health literacy for school-aged children (HLSAC) instrument.

BACKGROUND: Health literacy (HL) is an important determinant of health and health behaviours, and there is a need to monitor HL levels among all population groups. It is therefore essential to develop instruments to assess HL during childhood and adolescence. The aim of this study was to examine the cross-national measurement invariance of the instrument Health Literacy for School-aged Children (HLSAC) in four European countries. METHODS: The data were collected via standardized self-administered anonymous questionnaires within classrooms in Finland, Poland, Slovakia, and Belgium. There were in total 1468 respondents (aged 13, N = 690; aged 15, N = 778). The HLSAC instrument was used to measure the subjective HL of adolescents in each country. A multigroup confirmatory factor analysis was applied to test measurement invariance. RESULTS: Configural and metric invariance was established, but scalar invariance did not hold. However, the instrument exhibited high internal consistency (α = 0.85) and showed adequate fit with the data. Moreover, the partial invariance allowed comparison of mean values across the countries in question. There were significant mean value differences between countries and age-groups. CONCLUSIONS: HL mean values (as assessed via the HLSAC instrument) can be compared across countries. The instrument has utility for large-scale international HL studies on adolescents.

The Association Between Physical Activity and General Life Satisfaction in Lower Secondary School Students: The Role of Individual and Family Factors.

The objective of the paper was to investigate the association between PA and general life satisfaction in adolescents, taking into account family affluence and selected psychological, family and school factors. The survey (2015) involved 4085 Polish lower-secondary school students. Life satisfaction was measured with the abridged Students' Life Satisfaction Scale (SLSS). Vigorous Physical Activity, self-esteem, family affluence, family relations and the perception of the school environment were considered as independent variables. Hierarchical and path models were applied. The mean SLSS score was M = 4.66 (SD = 2.23), and 36.9% of its variability was explained-mainly by self-esteem. The impact of PA on self-esteem became stronger when family affluence decreased, which led to the conclusion that material status may modify the impact of behavioural factors on the SLSS scores' variability in adolescence.

[Causes of death in children and adolescents aged 1-19 in poland in the light of international statistics since 2000].

BACKGROUND: Analyses of children and young people mortality continue to be an important component of health monitoring of this population. Such analyses provide the basis to assess the overall trends, the structure of the causes of death over longer periods, and the differences between Poland and other countries. PURPOSE: The purpose of the current study is to present the current status and the direction of changes since 2000 with regard to the level and underlying causes of mortality in children and adolescents aged 1-19 years in Poland on the background of statistics for leading European countries. MATERIAL AND METHODS: Interactive databases available online: the National Demographic Database provided by the Central Statistical Office and the International WHO-MDB Database were used. Poland, constantly belonging to Eur-B category, was compared with the combined group of 27 leading countries, classified as a very low total mortality group (Eur-A) according to WHO. Linear trends of overall and cause-specific mortality in 2000-2013 were estimated. The causes of death have been presented according to the main classes of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). External and other causes were adopted as the two principal categories. RESULTS: In 2015, 1471 deaths of persons aged 1-19 were recorded in Poland (19.9 per 100 000, 25.4 and 14.2 for boys and girls, respectively). Changes in children and adolescents mortality by age have a non-linear nature (U-shaped), and the lowest level is recorded at the age of 5-9 years. According to 2014 data, 50.2% of deaths of children and adolescents aged 1-19 years occurred due to external causes, including non-intentional and intentional ones. This percentage increased from 18.4% in the 1-4 age group to 68.6% at the age of 15-19 years. Apart from external causes, the dominating causes of death are malignant neoplasms, congenital defects, or nervous system and respiratory system diseases. The ranking of those causes of death changes in successive age groups and over time. When age is considered, a higher proportion of congenital defects and respiratory system diseases was found in mortality younger children and a higher proportion of circulatory system diseases and undefined cases in mortality of adolescents. When trends were studied, a continuing elimination of infectious diseases was observed together with growing impact of rare diseases in all age groups. The excess mortality of Polish population at age 1-19 by comparison to Eur-A countries increased from 21% in 2000 to 56% in 2013, mainly due to unfavourable trends in adolescents. The rate of decline in the mortality of young children (1-4 years) was greater than in Eur-A countries, both in case of external and other causes. In the age group 5-14 years the higher rate of change was sustained only with regard to external causes. Among adolescents and young adults, the distance between Poland and Eur-A countries increased during the studied period. The shape of trend in the 15-24 age group was unfavourable for Poland, mainly with respect to external causes. This observation could be in part explained by increasing suicide trend in Poland since 2008, coexisting with rather constant level in Eur-A countries. CONCLUSIONS: The mortality rate among the population aged 1-19 years in Poland is systematically decreasing, but it still exceeds the average level recorded in leading European countries, particularly in relation to adolescents. When assessing the ability to reduce mortality in Poland to the level of Eur-A countries, attention must be paid to the causes considered as avoidable. Further studies ought to focus on the trends and international comparisons only foreshadowed in this study with regard to individual diagnoses, discussing possible preventive measures. Introduction of an ICD-11 classification will enable more accurate coding of causes of death, including a more precise analysis of the burden of rare diseases, which are an increasing challenge to public health in the population at the developmental age.

Physical activity, BMI and body weight perception among 15-year-old boys and girls in Poland in the light of international comparisons.

BACKGROUND: The wrong subjective assessment of body mass may have consequences for the health, quality of life and proper functioning of adolescents in society. AIM: The purpose of the study is to provide a detailed analysis of the discrepancies between the objective and subjective assessment of body mass by 15-year-old boys and girls in Poland against the background of international statistics and to assess the effect of physical activity on the level and directions of these discrepancies. MATERIAL AND METHODS: The data concerned 72037 schoolchildren from 42 countries, including 1484 in Poland. The measure of objective body mass was the BMI categorized according to Cole's criteria. Research focused on the relation between the mean BMI and the subjective perception of their body mass by adolescents and the discrepancy in this assessment. In addition, the level of physical activity (MVPA) was taken into account. RESULTS: In Poland the percentage of adolescents with overweight was lower than the international average and amounted to 12.3% vs. 15.2%. The percentage of 15-year-old boys with overweight in Poland is nearly three times higher than girls of the same age (18.7% vs. 6.5%) and is at the mean level for Health Behaviour in School-aged Children (HBSC) countries. According to international statistics, the percentage of adolescents who consider themselves overweight is 32.7%, which is two times higher than the percentage of actual excess body weight. Polish girls are systematically first in the ranking of those who consider themselves too fat. It was demonstrated that Polish girls with a normal BMI for their age who consider themselves too fat are on average slimmer than their peers in other countries. There is a correlation between Moderate-to-Vigorous Physical Activity (MVPA) and the accuracy of self-assessment of body mass and the type of mistakes made in that assessment, which is more clearly marked among boys. CONCLUSION: There are clear geographical and cultural differences in the level of discrepancies between the objective and subjective assessment of body mass among teenagers. Physical activity modifies these discrepancies.

Perceived barriers for physical activity in overweight and obese adolescents and their association with health motivation.

THE AIM: to identify the barriers to engaging in physical activity that are perceived by adolescents with overweight and obesity, and to establish whether a correlation exists among the barriers they perceive and the health-oriented motivation for undertaking physical activity. MATERIAL AND METHODS: The study was conducted on a representative sample of 2,300 students aged 13-16 years. The data was collected through an anonymous survey. Young people were asked about their body weight and height, the barriers to physical activity and the health-related motives to engaging in it. The IOTF (International Obesity Task Force) standard by T. J. Cole was used to categorise overweight and obesity, while the PCA - Principal Component Analysis - to assess the motivation for physical activity. Logistic regression was used in the analyses of the correlations among the body weight, the level of health-oriented motivation and the occurrence of accumulated barriers to physical activity. RESULTS: Overweight and obesity was found in 12.4% of the respondents; more often in boys (17.8%) than in girls (7.8%). The most frequently perceived barriers to undertaking physical activity among overweight adolescents include deficiencies in energy, time and support. Three barriers (lack of energy, skills and willpower), as well as the perception of several barriers occurring simultaneously, were reported more frequently by overweight students in comparison with their peers with a normal weight. Among the health-oriented motivation for physical activity in the group of adolescents with overweight and obesity, the most important one was the need to improve health, while the least important the need to look good. The excess of body weight turn out to be an important predictor of the perception of cumulative barriers to physical activity only among adolescents with a weak motivation to undertake physical activity [OR 2.51; CI (1.43-4.42), <0.001]. CONCLUSIONS: Young people with overweight and obesity, but with a strong health-oriented motivation, perceive barriers to physical activity similarly to their peers with a normal weight. Thus, motivation is a key element shaping the physical activity of overweight and obese young people by changing their perception of the barriers. In overcoming the barriers to physical activity in obese adolescents, one should aim to comprehensively reduce body weight and to support health-oriented motivation.

Polish Adaptation And Validation Of The Physical Appearance Comparison Scale (Pacs) - An Analysis Among Young People In Late Adolescence In The Context Of Obesity.

INTRODUCTION: The PACS scale is a tool which is widely used in foreign studies to evaluate the tendency towards appearance comparisons in social situations. People inclined to make such comparisons reveal a higher level of dissatisfaction with their body and a higher inclination towards problem eating. PURPOSE OF THE STUDY: The main purpose of the study was to adapt the PACS scale. A factor structure assessment and reliability analysis of the Polish version was carried out. The correlation between PACS and pubertal development indicators, the body mass index and psycho-social factors and eating behaviours were evaluated as part of the validity analysis. MATERIAL AND METHODS: The data were derived from the Internet-based study of problem eating behaviours conducted by the Institute of Mother and Child during the 2014/2015 school year. The analyses covered 1285 second grade upper secondary school students (47.2% boys). The mean age was 17.59 years (SD=0.39). An exploratory and confirmatory factor analysis of the PACS questionnaire was performed. Using the Kruskal-Wallis test or the Pearson's r correlation, the association between (PACSPL) and perceived pubertal timing, BMI, the body image (BIS), self-perception of body mass, self-esteem (RSES), self-esteem in social relations (SPPA-SSE), problem eating behaviours (TFEQ-13) were evaluated. The linear regression method was used to estimate the impact of PACS-PL on selected variables in the BMI groups in order to investigate of the moderation effect. RESULTS: The shortened 3-item Polish version of the scale (PACS-PL) was considered optimal. It is characterized by high reliability (Cronbach's α=0.868), and the main factor explains 79.1% of the variance of the scale results. The model also shows high values of fit indicators: χ2 = 1.144 (df=1, p=0.285), GFI=0.999, AGFI=0.996, CFI=1.000, NFI=0.999, TLI-1.000, RMSEA=0.011. Girls display a stronger tendency to compare their appearance with others. The PACS-PL scale demonstrates the expected correlations with developmental, psycho-social and behavioural factors, this correlation being stronger among girls. It was also shown that the PACS-PL index is a stronger predictor of dissatisfaction with the body and lower self-esteem in the group of obese adolescents. CONCLUSIONS: The Polish version of the scale, PACS-PL, is a reliable and valid tool for evaluating the tendency to compare one's appearance with others in late adolescence. The subject of social comparison ought to become an element of prevention activities associated with acceptance of one's body and selfesteem, especially among young people with excess body weight.

Semantics bias in cross-national comparative analyses: is it good or bad to have "fair" health?

The Health Behavior in School-aged Children is a cross-national study collecting data on social and health indicators on adolescents in 43 countries. The study provides comparable data on health behaviors and health outcomes through the use of a common protocol, which have been a back bone of the study sine its initiation in 1983. Recent years, researchers within the study have noticed a questionable comparability on the widely used item on self-rated health. One of the four response categories to the item "Would you say your health is….?" showed particular variation, as the response category "Fair" varied from 20 % in Latvia and Moldova to 3-4 % in Bulgaria and Macedonia. A qualitative mini-survey of the back-translations showed that the response category "Fair" had a negative slant in 25 countries, a positive slant in 10 countries and was considered neutral in 9 countries. This finding indicates that there are what may be called semantic issues affecting comparability in international studies, since the same original word (in an English original) is interpreted differently across countries and cultures. The paper test and discuss a few possible explanations to this, however, only leaving to future studies to hold a cautious approach to international comparisons if working with the self-rated health item with four response categories.

Social support and family communication as factors protecting adolescents against multiple recurrent health complaints related to school stress.

INTRODUCTION: One reason of increased psychological and somatic health problems in adolescence is intensification of stress in school and everyday life. There is little evidence to what extent the level of school achievements shapes this relationship. AIM: The aim of the study was to investigate determinants of subjective health complaints in schoolaged children, taking into account the interaction effects. METHODS: Anonymous survey was conducted in Poland in 2013/2014 on the sample of 4,545 students, as a part of the HBSC (Health Behaviour in School-aged Children) study. On the basis of prevalence of eight symptoms in the past 6 months, a standardized index of health complaints (SCL - Subjective Complaints Checklist) was calculated (0-100). To predict its variability three hierarchical linear models (five blocks) were estimated, separately for three levels of school achievements. Support from family, classmates and teachers as well as family communication were considered as protective factors, which can reduce the negative impact of stress. All analyses were adjusted for age, gender and family affluence. RESULTS: The standardized SCL index was equal to 23.2 in boys and 32.5 in girls. The high level of school stress was reported by 28.5% boys and 35.6% girls, respectively. Regarding these two measures, similar patterns of change were observed, increase with age and with deterioration of academic achievement. Final multivariate models explained 22-25% variability of SCL, slightly more among worst students. Accumulation of low family support and high level of school stress caused the highest increase in the SCL index in very good students. CONCLUSIONS: School performance is an important determinant of subjective health complaints in adolescence, also modifying the impact of other risk and protective factors.

Behavioural factors enhancing mental health - preliminary results of the study on its association with physial activity in 15 to 16 year olds.

INTRODUCTION: Reliable information on the influence of behavioural factors on adolescent mental health may help to implement more effective intervention programmes. OBJECTIVE: The objective of the study was to determine whether physical activity influences the variability of selected indices of mental health. METHODS: The study comprised 2,015 students aged 15-16, who were investigated as part of the HBSC survey (Health Behaviour in School-aged Children) in the 2013/14 school year. The dependent variable was the mental health index GHQ-12 (0-36 points) and its two domains (social dysfunction, anxiety and depression). Physical activity was measured with the MVPA (moderate-to-vigorous physical activity). Multivariable linear models were estimated, with overall GHQ index and partial indices as dependent variables. RESULTS: Adolescents reported a mean GHQ-12 score of 12.57 (±7.06). In a multivariable analysis, the pressure with school work along with gender resulted to be the main GHQ-12 predictors. School achievements and a high level of physical activity were identified as strong protective factors. Taking into account other factors, the GHQ-12 index falls by 2.13 points when comparing adolescents with an extremely low and high MVPA. Protective effect of physical activity appeared to be stronger in small towns and villages than in big cities and was more visible in the domain of social dysfunction. CONCLUSIONS: Physical activity remains an important predictor of mental health, even when the impact of sociodemographic and environmental factors as well as the respondents' school achievements are considered. Researches of such types, taking into account more complex determinants, wider behavioural factors' spectre as well as other outcome measures connected with teenagers' mental condition, should be continue.

[School performance as a mediator of the association between family affluence and risk behaviour in adolescents in Poland].

It can be assumed that family socioeconomic status does affect the frequency of undertaking risk behaviours by adolescents directly or indirectly, i.e. by having impact on other proven risk factors. The objective of the study was to show the combined influence of family affluence and school performance on alcohol consumption and tobacco and marijuana smoking, defined as risk behaviour syndrome. Material and Methods: The survey was conducted on a nationwide sample of 1,202 adolescents aged on average 15.6 years (SD=0.31), who participated in the HBSC (Health Behaviour in School-aged Children) survey. Structural equation models were used in the analysis in order to test the hypothesis that school performance is a mediator of the association between family affluence and risk behaviour. Results: It was found that 23.0% of adolescents smoked tobacco; 40.8% drank alcohol; 10.2% smoked marijuana. One fifth of the respondents used one of those substances frequently, i.e. more than 5 days in the last month. It was shown that family affluence is strongly correlated with school performance (p<0.001), however, there was no direct relationship with the general level of psychoactive substance use (p=0.481). In analysing individual substances, only with regard to marijuana it was found that it was used less frequently in more affluent families. School performance resulted to be a stronger mediator of the relationship between family affluence and risk behaviour in girls (Sobel's test: p=0.013) than in boys (p=0.111). In the analysis of the social determinants of the health behaviour of adolescents, indirect correlations and confounding variables should be considered. Worse school performance may be the cause or effect of a more frequent psychoactive substance.

Current trends in tobacco smoking among 15-year-old adolescents in Poland in the background of 30 countries.

The international HBSC (Health Behaviour in School-aged Children) survey has enabled the comparison of the patterns of changes with respect to a number of health indicators in adolescence. The aim of the study was to show international trends and how the position of Poland in international rankings of smoking prevalence has changed since 2002. Material and Methods: The study comprised 30 countries for which data was available from four rounds of HBSC survey (2002-2014). In total, 218 759 15-year-olds were surveyed, including 7289 in Poland. For each country a linear trend was estimated, separately for boys and girls, to describe changes in regular smoking (daily or at least once a week). Results: In the investigated period, the percentage of 15-year-old boys who smoke every week fell in Poland from 26.2% to 15.5%, and the respective percentage in girls decreased from 17.2% to 14.7%. This means annual decrease of 0.88% in boys and 0.24% in girls. In a combined international sample, exactly the same as in Poland rate of change was noted in boys; however, a definitely faster in girls (0.95% a year). The highest rate of change was observed in Ukraine, Germany and Norway, while the lowest in Greece, Croatia and Israel. Poland's position in the international ranking moved from 8th to 24th, providing that the countries are listed according to the growing percentage of 15-year-olds of both genders who smoke regularly. Conclusions: Decrease in the prevalence of smoking among Polish adolescents, observed from the beginning of this century, has been undoubtedly a success related to the implemented preventive measures. However, attention should be drawn to the strategies launched in countries which achieved better results than Poland, as well as to the reasons of less positive trends among Polish girls.

[Serum concentrations of visfatin and oxidative stress markers in tobacco smoking pregnant women].

Tobacco smoking during pregnancy increases the risk of severity of oxidative stress, which can affect adipokines expression in adipose tissue. The aim of the study was to assess the effects of smoking on the level of visfatin and selected markers of oxidative stress (ox-LDL- oxidized low density lipoprotein, TOC - total oxidant capacity, TAC - total antioxidant capacity) and the association between them in pregnant women. Material and Methods: The research material was the venous blood of healthy women admitted to given birth in the Department of Obstetrics and Gynecology Institute of Mother and Child in the years 2015 - 2016. Based on an interview and determination of serum cotinine, women were divided into following groups: smoking (n=41) and non-smoking group (n=43). Concentrations of biochemical parameters were determined by enzyme immunoassay using commercial kits. Results: In serum of smoking pregnant women concentrations of visfatin, ox-LDL, and TOC were significantly higher while level of TAC was lower than observed in nonsmoking group (p<0.001). We found important association between number of cigarettes daily consumed and serum level of visfatin (r=0.43; p<0.01), ox-LDL (r=0.36; p<0.05), and TOC (r=0.39; p<0.05). Multivariate regression analysis showed a positive correlation between concentration of visfatin and level of ox-LDL as well as TOC both in the smoking women (ox- LDL: ß=0.381; TOC: ß=0.388; p<0.05), and in tobacco abstinent group (ox- LDL: ß= 0.470; TOC: ß=0.326; p<0.05). Conclusions: These results indicate that smoking during pregnancy adversely affect the oxidant/ antioxidant balance. The association between visfatin concentrations and markers of oxidative stress may suggest prooxidant tendency of this adipokine.

Trends in self-rated health in European and North-American adolescents from 2002 to 2010 in 32 countries.

BACKGROUND: Self-rated health (SRH) in adolescence is known to be associated with health outcomes in later life. We carried out a trend analysis on data coming from three waves of data collected in 32 countries (mostly European) from 2002 to 2010 coming from the Health Behaviour in School-Aged Children surveys. METHODS: SRH in adolescents was assessed using a Likert scale (excellent, good, fair and poor). Responses were dichotomized into 'excellent' vs. 'rest'. Country, age and gender groups were compared based on the odds ratio of declaring excellent SRH in 2010 with respect to 2002 and 2006. RESULTS: The trend for European adolescents indicates an improvement over the last decade, although, in the majority of countries, a higher proportion of adolescents rate their health as excellent during the period 2002-06 with respect to the second half of the decade (2006-10).Girls were found to constantly rate their health as poorer, compared to their male peers, in all countries. Age has also a very stable trend towards a decreasing rating of health with increasing age. CONCLUSION: Decreased rating of health in the period 2006-10 may be a signal of the socio-economic difficulties of Europe in the last part of this decade.

Trends in life satisfaction in European and North-American adolescents from 2002 to 2010 in over 30 countries.

BACKGROUND: Life satisfaction (LS) is an indicator which is widely used for assessing the perception of a child's feeling about his life. METHODS: LS is assessed in Health Behaviour in School-aged Children via the Cantril ladder with 10 steps indicating the worst and best possible life. This range of values (0-10) was dichotomized into 'low' (0-5) vs. 'high' (6-10). Countries, age groups and genders were compared based on the odds ratio (OR) of declaring a higher LS in 2010 with respect to 2002. RESULTS: Analyzing the difference between 2002 and 2010, six countries from Western Europe show decreasing LS: Austria, Canada, Switzerland, Denmark, Finland and Greenland. In contrast, a group of Eastern European Countries, that is, Estonia, Croatia, Lithuania, Latvia, Russia and Ukraine, show a significant increase in LS. Data on gender and age differences confirm the lower rating of LS in girls and a decreasing rating with age. CONCLUSION: The LS scale appears to be a tool capable of discriminating the level of wellbeing of adolescent population among countries.

Trends in multiple recurrent health complaints in 15-year-olds in 35 countries in Europe, North America and Israel from 1994 to 2010.

BACKGROUND: Health complaints are a good indicator of an individual's psychosocial health and well-being. Studies have shown that children and adolescents report health complaints which can cause significant individual burden. METHODS: Using data from the international Health Behaviour in School-aged Children study, this article describes trends in multiple recurrent health complaints (MHC) in 35 countries among N = 237 136 fifteen-year-olds from 1994 to 2010. MHC was defined as the presence of two or more health complaints at least once a week. Logistic regression analysis was performed to evaluate trends across the five survey cycles for each country. RESULTS: Lowest prevalence throughout the period 1994-2010 was 16.9% in 1998 in Austria and highest in 2006 in Israel (54.7%). Overall, six different trend patterns could be identified: No linear or quadratic trend (9 countries), linear decrease (7 countries), linear increase (5 countries), U-shape (4 countries), inverted U-shape (6 countries) and unstable (4 countries). CONCLUSION: Trend analyses are valuable in providing hints about developments in populations as well as for benchmarking and evaluation purposes. The high variation in health complaints between the countries requires further investigation, but may also reflect the subjective nature of health complaints.