Influenza Hemagglutinin Antibody Levels in the Elderly: Impact of Sex, Age, and Influenza/COVID-19 Vaccination Status During the 2021/2022 Epidemic Season in Warsaw, Poland.

BACKGROUND The purpose of the study was to determine the level of antihemagglutinin antibodies in the serum of patients in the geriatric population in Doctor's Surgery NZOZ Nucleus Warsaw, Poland, during the epidemic season 2021/2022 using the hemagglutination inhibition assay (HAI), according to anti-influenza and anti-COVID-19 vaccination, age, and sex. MATERIAL AND METHODS Serum samples taken from 256 patients aged 65 to 99 years were examined for anti-hemagglutinin antibodies and protective levels of antibodies against antigens: A/Victoria/2570/2019 (H1N1)pdm09, A/Cambodia/e0826360/2020(H3N2), B/Washington/02/2019 (B/Victoria lineage), and B/Phuket/3073/2013 (B/Yamagata lineage) of the quadrivalent influenza vaccine for epidemic season 2021/2022. RESULTS The highest protective level, ie, the percentage of people with antibody titers ≥40 was 87.5% and was recorded for subtype A/Cambodia/e0826360/2020(H3N2), the dominant type causing infections in the epidemic season 2021/2022 confirmed by molecular biology methods. Geometric mean titer (GMT) values and protective levels for B/Washington/02/2019 (B/Victoria lineage) antigen were higher for men than women (respectively 38.4 vs 67.6; P<0.001 and 58.0% vs 74.6%; P<0.001). The protective levels of antibodies among patients vaccinated vs unvaccinated against COVID-19 were higher for B/Washington/02/2019 (B/Victoria lineage) and B/Phuket/3073/2013 (B/Yamagata lineage) antigens (64.2% vs 44.4%; P=0.023 and 78.6% vs 55.6%; P=0.004). GMT values for vaccinated against COVID-19 were also higher. There were no significant differences between younger (65-79 years) and older (≥80 years) seniors. CONCLUSIONS The analysis shows differences in the level of individual antibodies, GMT and the protective level depending on subtypes of influenza A or B virus, B/Victoria or B/Yamagata lineage, sex, and previous vaccination history against influenza and COVID-19.

Molecular Determinants of Drug Resistance and Mutation Patterns in Influenza Viruses Circulating in Poland Across Multiple Epidemic Seasons: Implications for Vaccination Strategies.

BACKGROUND According to the WHO, up to 650 000 people die each year from seasonal flu-related respiratory illnesses. The most effective method of fighting the virus is seasonal vaccination. However, if an infection does occur, antiviral medications should be used as soon as possible. No studies of drug resistance in influenza viruses circulating in Poland have been systematically conducted. Therefore, the aim of the present study was to investigate the drug resistance and genetic diversity of influenza virus strains circulating in Poland by determining the presence of mutations in the neuraminidase gene. MATERIAL AND METHODS A total of 258 clinical specimens were collected during the 2016-2017, 2017-2018, and 2018-2019 epidemic seasons. The samples containing influenza A and B were analyzed by RT-PCR and Sanger sequencing. RESULTS Differences were found between the influenza virus strains detected in different epidemic seasons, demonstrating the occurrence of mutations. Influenza A virus was found to be more genetically variable than influenza B virus (P<0.001, Kruskal-Wallis test). However, there was no significant difference in the resistance prevalence between the influenza A subtypes A/H1N1/pdm09 (4.8%) and A/H3N2/ (6.1%). In contrast, more mutations of drug-resistance genes were found in the influenza B virus (P<0.001, chi-square test). In addition, resistance mutations appeared en masse in vaccine strains circulating in unvaccinated populations. CONCLUSIONS It seems important to determine whether the influenza virus strains tested for drug resistance as part of global influenza surveillance are equally representative of viruses circulating in populations with high and low vaccination rates, for all countries. Our results suggest that countries with low levels of influenza immunization may constitute reservoirs of drug-resistant influenza viruses.

Encapsulated Mn-Saturated Lactoferrin as a Safe Source of Manganese Ions for Restoring Probiotic Lactobacillus plantarum.

The growth of Lactobacillus plantarum, a member of the Lactobacillus genus, which plays a crucial role in the bacterial microbiome of the gut, is significantly influenced by manganese ions. They can be safely delivered to the intestines by exploiting the chelating abilities of lactoferrin. The aim of this work was to encapsulate lactoferrin saturated with manganese ions (MnLf) in a system based on the Eudragit® RS polymer to protect protein from degradation and manganese release in the gastric environment. The entrapment efficiency was satisfactory, reaching about 95%, and most importantly, manganese ions were not released during microparticles (MPs) formation. The release profile of the protein from the freshly prepared MPs was sustained, with less than 15% of the protein released within the first hour. To achieve similar protein release efficiency, freeze-drying was carried out in the presence of 10% (w/v) mannitol as a cryoprotectant for MPs frozen at -20 °C. MPs with encapsulated MnLf exhibited prebiotic activity towards Lactobacillus plantarum. More importantly, the presence of equivalent levels of manganese ions in free form in the medium, as well as chelating by lactoferrin encapsulated in MPs, had a similar impact on stimulating bacterial growth. This indicates that the bioavailability of manganese ions in our prepared system is very good.

Ukrainian migrants' and war refugees' admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014-2022.

BACKGROUND: Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland. METHODS: The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022. RESULTS: In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) - 26.1%, pregnancy, childbirth and the puerperium (O00-O99) - 18.4%, and factors influencing health status and contact with health services (Z00-Z99) - 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common - 14.9%, followed by abnormal clinical and lab findings (R00-R99) - 11.9%, and infectious and parasitic diseases (A00-B99) - 11.0%. CONCLUSIONS: Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.

Tick-borne encephalitis epidemiology and surveillance in Poland, and comparison with selected European countries before and during the COVID-19 pandemic, 2008 to 2020.

BackgroundTick-borne encephalitis (TBE) is the most common viral central nervous system (CNS) infection in Poland. Previous research suggests that its incidence was underestimated in the pre-pandemic period. The COVID-19 pandemic caused a considerable burden on surveillance systems, which could further impact reporting.AimWe aimed to assess the completeness of reporting of TBE in the years 2008 to 2020 and explore the potential impact of the COVID-19 pandemic on reporting to the epidemiological surveillance system, compared with hospitalisations for TBEV and other viral neuro-infections.MethodsWe compared the Polish epidemiology of TBE and other viral infections of the CNS from national surveillance reports with data on hospitalisations from 2008 to 2020 and data from selected European countries.ResultsBetween 2008 and 2020, 3,016 TBE cases were reported to surveillance compared with 3,620 hospitalisations. There was an increasing trend in hospitalisations, while surveillance data demonstrated the opposite, with the largest discrepancy observed in the first pandemic year (354 hospitalisations vs 159 cases reported to surveillance). Serological testing for TBE was used more in the known endemic region of north-eastern Poland and less in non-endemic areas. Other European countries reported higher TBE case numbers and an increase during the COVID-19 pandemic, whereas Poland observed an opposite trend.ConclusionThe sensitivity of TBE surveillance in Poland requires improvement. There are considerable regional differences. Regions that test for TBE intensively report most cases. Policymakers should be made aware of the value of quality epidemiological data for planning prophylactic measures in risk areas.

Importance of Influenza Anti-Hemagglutinin Antibodies During the SARS-CoV-2 Pandemic in the 2019/2020 Epidemic Season in Poland.

BACKGROUND The aim of this study was to determine the level of anti-hemagglutinin antibodies in the serum of recovered patients during the SARS-CoV-2 pandemic in the 2019/2020 epidemic season in Poland, and the course of COVID-19. MATERIAL AND METHODS The material for the study consisted of the sera of COVID-19 convalescents obtained from the following 9 Regional Blood Donation and Blood Supply Centers located in 8 voivodeships. The hemagglutination inhibition reaction assay (HAI) using 8 viral hemagglutination units was used to determine antibody levels, in accordance with WHO recommendations. RESULTS This research confirms that a patient's declared severity of the course of SARS-CoV-2 infection is influenced by the patient's age and concomitant diseases. There was no statistically significant correlation between the level of anti-hemagglutinin antibodies and the severity of the course of a SARS-CoV-2 infection. Based on the serological tests conducted, it can be unequivocally concluded that both vaccinated and influenza-infected patients had a response rate in line with the requirements of the European Commission and the Committee for Medicinal Products for Human Use hemagglutinin antibodies for 4 influenza virus antigens tested. CONCLUSIONS Patients who confirmed their antibody levels with the Commission of the European Communities and the Committee for Propriety Medicinal Products (CPMP) requirements had a mild COVID-19 course. The results of our research emphasize the role of anti-hemagglutinin antibodies in the course of SARS-CoV-2 infection. COVID-19 convalescents have a higher response rate against all 4 types of anti-hemagglutinin antibodies analyzed.

Nationwide General Hospital Morbidity Study as a source of data about Polish population health

The objective of this article is description of the important source of data on hospitalised morbidity collected in Poland within the frameworks of public statistics, and also underlying the significance of the quality of data collected at the hospital level for the purpose of the practical application of them. The Nationwide General Hospital Morbidity Study has been conducted by the Department of Population Health Monitoring and Analysis of the NIPH-NIH for more than 40 years within the frameworks of the Programme of Statistical Surveys of Official Statistics. Since the year 2000, it has had a complete character, collecting individual data for all cases of hospitalisation in Poland within the scope compliant with the MZ/Szp-11 form, among others, sex, age, place of residence of a patient, data on hospital, information about the course of treatment (length of stay in hospital, principal diagnosis and comorbidity, applied medical procedures, the mode of admission and discharge). The collected data are anonymous. In the recent years, annually, more than 8 million of the cases of hospitalisation have been documented. Almost all obliged hospitals (96%) participate in the study. Some weak point is the completeness of submitted data, in particular, regarding information about the external causes of injuries and poisonings (in the year 2017, 27% of the required data were missing). Interestingly, a high level of missing data is generated by a comparatively small number of hospitals. Significant differences are observed in the quality of data depending on the voivodship of hospital location. The collected data render it possible to, among others, determine the frequency of hospitalisations due to particular causes taking under consideration the localisation of a hospital, and also the sex, age and the place of residence of patients, the analysis of the duration of hospital stay or in-hospital fatality. The aggregated results are reported to international databases (WHO, OECD, Eurostat), and support the administrative authorities of various levels. They are also a basis for numerous published scientific papers. The most important results of routine analyses are presented of the web page of the Study (http://www.statystyka1.medstat.waw.pl/).

Cerebrovascular diseases in Poland-inconsistent seasonal patterns of hospitalisation and mortality.

Background: A seasonal variation in the incidence of cerebrovascular diseases still remains inconsistently evidenced. Herein, we analyse the monthly patterns of two health phenomena: hospital admissions and deaths due to these diseases. Methods: We identified 69 511 cases of hospital admissions and 14 956 deaths due to cerebrovascular diseases (ICD10: I60-I69 and G45) among the inhabitants of five Polish voivodeship capitals in 2004-13. The method of time series analysis (exponential smoothing with linear trend and monthly additive seasonality) was applied to calculate the monthly specific seasonal indices. The monthly variation in an in-hospital fatality and nonhospital deaths were also analysed. Results: A summer season reduction in number of cases was observed for hospital admissions and deaths. Interestingly, the winter season effect is much more complex, mainly due to the contribution of December, when a high mortality is accompanied by a substantial decrease in the hospitalisation level. This unique discrepancy was observed for all the studied cities. Moreover, this month is characterised by a notably high in-hospital fatality. However, neither the number of non-hospital deaths nor the average length of hospital stay or the kind of hospitalised diseases evidenced that cerebrovascular problems were more serious in December than in any other month. Conclusion: The obtained results confirmed a seasonal variation in cerebrovascular diseases among the inhabitants of Polish cities. Habitual and administrative limitations in hospital activities observed every December do not seem indifferent from the patient health's perspective since they may lead to a low hospitalisation level and a high in-hospital fatality.

The effect of dance therapy on the balance of women over 60 years of age: The influence of dance therapy for the elderly.

Dance therapy is a physical activity that can lead to balance improvement in older adults. The aim of the study was to evaluate the effects of dance therapy on balance and risk of falls in older women. Twenty-four older women (mean age 66.4 years old) attended dance sessions for three months. Pretest/posttests were completed using the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test M-CTSIB. Results showed the Limits of Stability Test was significantly higher (17.5%) after dance classes. Regular use of dance therapy shows promise in improving balance by increasing the limits of stability.

The TFE-induced transient native-like structure of the intrinsically disordered σ47° domain of Escherichia coli RNA polymerase.

The transient folding of domain 4 of an E. coli RNA polymerase σ7° subunit (rECσ47°) induced by an increasing concentration of 2,2,2-trifluoroethanol (TFE) in an aqueous solution was monitored by means of CD and heteronuclear NMR spectroscopy. NMR data, collected at a 30% TFE, allowed the estimation of the population of a locally folded rECσ47° structure (CSI descriptors) and of local backbone dynamics ((15)N relaxation). The spontaneous organization of the helical regions of the initially unfolded protein into a TFE-induced 3D structure was revealed from structural constraints deduced from (15)N- to (13)C-edited NOESY spectra. In accordance with all the applied criteria, three highly populated α-helical regions, separated by much more flexible fragments, form a transient HLHTH motif resembling those found in PDB structures resolved for homologous proteins. All the data taken together demonstrate that TFE induces a transient native-like structure in the intrinsically disordered protein.

Accidental drownings in Poland in 2000-2012.

OBJECTIVE: Drowning is a public health problem which is poorly recognized and analyzed in the Polish literature so far. MATERIAL AND METHODS: We analyzed all available sources of information on drowning in Poland, i.e. the data of the Central Statistical Office (causes of deaths, accidents at work) and Police Headquarters (circumstances of drowning). We discussed changes in drowning frequency, analyzing both time and space perspective as well as demographic profiles of fatal drowning cases. RESULTS: In 2000-2012, an estimated 12,702 persons died due to drowning in Poland (median of crude mortality rate - 2.6 per 100,000 population). Mortality due to drowning was on downward trend. Males aged 45-59 years, especially with vocational education, were at the highest risk of drowning. In the period analyzed, the highest and the lowest mortality rates were reported in Warminsko-mazurskie (median of mortality rate - 4.7) and Slaskie voivodships (median of mortality rate - 1.2), respectively. The highest drowning frequency was noted in the period from June to August in which a total of 5,981 cases were registered, i.e. 47.1% of all recorded drownings. CONCLUSIONS: A risk of death due to drowning in Poland is higher compared to the average in other EU countries. There is a necessity for public health intervention in this field. Furthermore, reporting systems regarding drowning in Poland should be unified.

Occurrence of Circulating Antibodies against the Hemagglutinins of Influenza Viruses in the 2022/2023 Epidemic Season in Poland.

The aim of this study was to determine the level of anti-hemagglutinin antibodies in blood sera collected from patients during the 2022/2023 epidemic season in Poland. A total of 700 sera samples from patients across the country were tested. The samples were divided into seven groups according to the age of the patients, with 100 samples from each age group. The hemagglutination inhibition test (OZHA) was used to determine the level of anti-hemagglutinin antibodies. The test results have confirmed the presence of anti-hemagglutinin antibodies for antigens A/Victoria/2570/2019 (H1N1)pdm09, A/Darwin/9/2021 (H3N2), B/Austria/1359417/2021 (B/Yamagata lineage) and B/ Phuket/3073/2013 (B/Victoria lineage) present in the influenza vaccine recommended by the World Health Organization (WHO) for the 2022/2023 epidemic season. The highest geometric mean antibody titres (GMT) and protection rate values (%) were recorded for hemagglutinin A/H3N2. In Poland, in the 2022/2023 epidemic season, the percentage of the population vaccinated against influenza was 5.7%. Therefore, the test results can be interpreted as the response of the immune system in patients who have been previously infected with an influenza virus.

Prevalence of circulating antibodies against hemagglutinin of influenza viruses in epidemic season 2021/2022 in Poland.

The aim of the study was to determine the level of anti-hemagglutinin antibodies in the serum of patients during the 2021/2022 epidemic season in Poland. A total of 700 sera samples were tested, divided according to the age of the patients into 7 age groups: 0-4 years of age, 5-9 years of age, 10-14 years of age, 15-25 years of age, 26-44 years of age, 45-64 years of age and ≥65 years of age, 100 samples were collected from each age group. Anti-hemagglutinin antibody levels was determined using the haemagglutination inhibition assay (OZHA). The results obtained confirm the presence of anti-hemagglutinin antibodies for the antigens A/Victoria/2570/2019 (H1N1) pdm09, A/Cambodia/e0826360/2020 (H3N2), B/Washington/02/2019 and B/Phuket/3073/2013 recommended by World Health Organization (WHO) for the 2021/2022 epidemic season. The analysis of the results shows differences in the levels of individual anti-hemagglutinin antibodies in the considered age groups. In view of very low percentage of the vaccinated population in Poland, which was 6.90% in the 2021/2022 epidemic season, the results obtained in the study would have to be interpreted as the immune system response in patients after a previous influenza virus infection.

Encapsulation of Iron-Saturated Lactoferrin for Proteolysis Protection with Preserving Iron Coordination and Sustained Release.

Lactoferrin (Lf) is a globular glycoprotein found mainly in milk. It has a very high affinity for iron(III) ions, and its fully saturated form is called holoLf. The antimicrobial, antiviral, anticancer, and immunomodulatory properties of Lf have been studied extensively for the past two decades. However, to demonstrate therapeutic benefits, Lf has to be efficiently delivered to the intestinal tract in its structurally intact form. This work aimed to optimize the encapsulation of holoLf in a system based on the versatile Eudragit® RS polymer to protect Lf against the proteolytic environment of the stomach. Microparticles (MPs) with entrapped holoLf were obtained with satisfactory entrapment efficiency (90-95%), high loading capacity (9.7%), and suitable morphology (spherical without cracks or pores). Detailed studies of the Lf release from the MPs under conditions that included simulated gastric or intestinal fluids, prepared according to the 10th edition of the European Pharmacopeia, showed that MPs partially protected holoLf against enzymatic digestion and ionic iron release. The preincubation of MPs loaded with holoLf under conditions simulating the stomach environment resulted in the release of 40% of Lf from the MPs. The protein released was saturated with iron ions at 33%, was structurally intact, and its iron scavenging properties were preserved.

Hemagglutinin Antibodies in the Polish Population during the 2019/2020 Epidemic Season.

The aim of the study was to determine the level of antibodies against hemagglutinin of influenza viruses in the serum of subjects belonging to seven different age groups in the 2019/2020 epidemic season. The level of anti-hemagglutinin antibodies was tested using the hemagglutination inhibition (HAI) test. The tests included 700 sera from all over Poland. Their results confirmed the presence of antibodies against the following influenza virus antigens: A/Brisbane/02/2018 (H1N1)pdm09 (48% of samples), A/Kansas/14/2017/ (H3N2) (74% of samples), B/Colorado/06/ 2017 Victoria line (26% of samples), and B/Phuket/3073/2013 Yamagata line (63% of samples). The level of antibodies against hemagglutinin varied between the age groups. The highest average (geometric mean) antibody titer (68.0) and the highest response rate (62%) were found for the strain A/Kansas/14/2017/ (H3N2). During the epidemic season in Poland, only 4.4% of the population was vaccinated.

Clustering of the Adult Population According to Behavioural Health Risk Factors as the Focus of Community-Based Public Health Interventions in Poland.

Effective lifestyle health promotion interventions require the identification of groups sharing similar behavioural risk factors (BRF) and socio-demographic characteristics. This study aimed to identify these subgroups in the Polish population and check whether local authorities' health programmes meet their needs. Population data came from a 2018 question survey on a random representative sample of 3000 inhabitants. Four groups were identified with the TwoStep cluster analysis method. One of them ("Multi-risk") differed from the others and the general population by a high prevalence of numerous BRF: 59% [95% confidence interval: 56-63%] of its members smoke, 35% [32-38%] have alcohol problems, 79% [76-82%] indulge in unhealthy food, 64% [60-67%] do not practice recreational physical activity, and 73% [70-76%] are overweight. This group, with an average age of 50, was characterised by an excess of males (81% [79-84%]) and people with basic vocational education (53% [50-57%]). In 2018, only 40 out of all 228 health programmes in Poland addressed BRF in adults; only 20 referred to more than one habit. Moreover, access to these programmes was limited by formal criteria. There were no programmes dedicated to the reduction of BRF exclusively. The local governments focused on improving access to health services rather than on a pro-health change in individual behaviours.

Participation in Population Health Interventions by Older Adults in Poland: Barriers and Enablers.

BACKGROUND: The participation of older adults in population health interventions constitutes a key factor in their physical, mental and social health. The aim of this study was to determine variables considered as enablers and barriers to participation in health programmes. METHODS: The conceptual framework of the study was developed and population health interventions were operationalised as health programmes. A total of 805 older adults participated in a questionnaire survey. The questionnaire included questions about socio-demographic, health and social connectedness-related factors as well as participation in population health interventions/programmes. Multiple logistic regression was used to examine the relationship between respondents' characteristics and participation in the intervention. RESULTS: Participation in health programmes was declared by 316 respondents. The enablers of participation were general practitioner's affability (OR = 2.638 [1.453-4.791], p = 0.001), three or more social activities (OR = 3.415 [1.477-7.894], p = 0.004), taking part in support groups (OR = 4.743 [1.255-17.929], p = 0.022) and involvement in Universities of the Third Age (OR = 2.829 [1.093-7.327], p = 0.032). The barriers were primary education (OR = 0.385 [0.215-0.690], p = 0.001), infrequent general practitioner's appointments (OR = 0.500 [0.281-0.888], p = 0.018) and lack of social activity (OR = 0.455 [0.299-0.632], p < 0.001). CONCLUSION: The enablers of participation appeared to solely include variables regarding health service utilisation, patient experience and social activity, i.e., interpersonal and community relationships, not intrapersonal factors.

Investigation of the Immunogenic Properties of Ovalbumin Modified by Urban Airborne Particulate Matter.

Exposure to air particulate matter (PM) is linked to the blood oxidative stress and systemic inflammation. The aim of this study was to elucidate whether oxidative PM modification of ovalbumin (OVA), the major antioxidant serum protein, may alter its antigenicity and/or immunogenicity. Ovalbumin was exposed via dialysis to the standard urban PM (SRM 1648a) or to PM with removed organic content (encoded as LAP). Both structural changes and biological properties of PM-modified OVA were measured. T lymphocytes and dendritic cells (the major antigen-presenting cells) isolated from C57BL/6 and OT-II (323-339 epitope) OVA-specific T cell receptor (TCR)-transgenic mice were used to test the effect of PM on OVA immunogenicity. The immunogenicity of both SRM 1648a and LAP-modified OVA was significantly higher than that of control OVA, as measured by the epitope-specific T cell proliferation and interferon γ production by the stimulated cells. This effect was associated with mild oxidative changes in the carrier molecule outside the structure of the OVA epitope and with increased resistance to proteolysis of PM-modified OVA. Interestingly, dendritic cells showed enhanced capacity for the uptake of proteins when the cells were cultured with PM-modified OVA. Our results suggest that the enhanced immunogenicity of PM-modified OVA is not associated with altered antigenicity or antigen presentation. However, it may result from slower degradation and longer persistence of modified antigens in dendritic cells. Whether this phenomenon is associated with enhanced risk prevalence of autoimmune diseases observed in the areas with high urban PM pollution needs to be explained.

[Issues in conducting health education of patients by primary care physicians]. / Uwarunkowania prowadzenia edukacji zdrowotnej pacjentów przez lekarzy podstawowej opieki zdrowotnej.

INTRODUCTION: Patients' health education involves forming their knowledge, attitudes and skills as well as exercising impact on their behaviour in order to maintain or improve one's health. Here, a special role is to be played by primary care physicians. AIM OF THE STUDY: to estimate conditioning factors and frequency of undertaking health education of patients by primary care physicians. MATERIALS AND METHODS: A survey study was executed with 800 family physicians, with 520 respondents actually returning the questionnaire (response rate--65%). The instrument contained questions concerning socio-demographic and professional situation of physicians, their health state, health behaviours and undertaking health education to patients in their own professional practice. The assessment of the strength of relationships between characteristic features and attitudes of physicians and their undertaking health education to patients was conducted with multinomial logistic regression. RESULTS: Almost 60% of the respondents declare undertaking health education of patients. Facilitating factors here are family medicine specialization (OR=1.68 [1.11-2.53]), workload of under 50 hours a week (OR=1.67 [1.14-2.43]), living in a town under 100,000 inhabitants (OR=1.56 [1.08-2.27]), staying married (OR=1.55 [1.03-2.33]) and being on a diet (OR=3.22 [1.78-5.85]). Those physicians who work in their profession less than 10 years undertake health education significantly less frequently than their colleagues with a longer work experience (OR=0.57 [0.36-0.90]). CONCLUSIONS: Many physicians (40.1%), especially young inhabitants of cities, do not undertake health education of patients at all. A considerable obstacle in undertaking educational activities seems to be physicians' excessive workload. Those physicians who declare undertaking health education of patients use the knowledge acquired during specialization training (family medicine) or work experience connected with the length of work in the profession. Thus, in order to intensify and optimise primary care physicians' activities with respect to health education of patients it is essential to include this topic in the curricula ofpre- and post-diploma courses as well as family medicine specialty training.

[Determinants of health oriented physical activity among Warsaw teachers]. / Determinanty prozdrowotnej aktywnosci fizycznej Warszawskich nauczycieli.

AIM: Evaluation of the factors determining physical activity performed by teachers. MATERIAL AND METHODS: The study included 1,551 subjects. A questionnaire consisting of two parts was used. Its first concerned participation in sport for all throughout last year. The second one was the Polish short version of IPAQ. Multiple logistic regression method were used to assess the association between the activity level, socio-demographic characteristics, participation in organized sport and sport for all as well as the kind of effort. RESULTS: 25.7% of teachers did not show enough physical activity to stay healthy (according to WHO recommendations). The risk of inactivity is associated with the workplace--among academic teachers it is significantly higher than for school teachers (OR = 1.85 [1.09-1.29]). The factors favoring low activity are practicing the activity mostly in the form of walking (OR = 1.54 [1.18-2.00]) and the age of 30-59 years (OR = 1.46 [1.09-1.94]). Regular participation in sport for all significantly reduces the risk of low activity (OR = 0.59 [0.46-0.76]). 18.6% of teachers show high level of activity. Its maintenance is encouraged by participation in organized sports (OR = 3.60 [1.75-7.40]) and regular participation in sport for all (OR = 2.25 [1.72-2.93]).