Association of low physical activity with higher respiratory tract infections frequency among pre-school children.

BACKGROUND: There is no consensus on the benefits of physical activity (PA) regarding upper respiratory tract infections (URTIs) among children. This study aimed to determine an association between the PA level and URTIs in preschoolers. METHODS: In 4-7-year-old participants, URTI symptoms were monitored using the Polish version of the Wisconsin Upper Respiratory System Survey for Kids. The daily number of steps, PA intensity, and sleep duration were measured with a Garmin-vivofit pedometer. The lag effect between the initial level of daily PA and the frequency of infections was evaluated. RESULTS: The average daily step count from healthy days was a significant determinant of the total number of days with the URTI symptoms, and it accounted for 44% (p < 0.001) of this variable variance. A low level of baseline PA (initial 14-day "run-in" observation period) was associated with an increased risk of URTI. In the non-sport group, the severity of the URTI symptoms depended on the number of daily steps. No significant correlation was found between sleep duration and the number of URTI days. CONCLUSION: Low levels of PA in preschoolers result in increased susceptibility to respiratory infections. Parents should encourage children to engage in PA to prevent URTIs. IMPACT: In pre-school children, higher physical activity (PA) is associated with fewer days of upper respiratory tract infection symptoms (URTIS). Children with a higher average daily step count have fewer days with URTIS over a long-term observation period. A change in the average number of steps per day by 1000 changed the number of days with symptoms of URTI by 4 days. The severity of URTIS was inversely related to the degree of PA. Children who participate in sports 3 or more hours per week have fewer URTIS than those who do not engage in sports regularly.

Performance of portable emergency suction devices in pre-hospital conditions: a pilot study in the fire brigade.

A i m: Assessment of the effectiveness and efficiency of three mobile (portable) rescue aspirators models in the opinion of state fire service officers. Comparison with the use of the medical simulation element. MATERIAL AND METHODS: The study was conducted in organizational units of the State Fire Service (24-hour officers). The research consisted in carrying out the task with the use of three models of mobile rescue aspirators (manual, hand-foot, battery). Each participating firefighter had the task of sucking up an equal amount of fluid (100 ml, respectively) with each model of an aspirator. The test fluid was water at room temperature in a homogeneous 1:1 mixture with sugar (increased viscosity and density, simulated real conditions). Immediately after three suction attempts (with measured suction time), each officer completed a questionnaire on the three models used. Descriptive statistics were used to characterize the variables. The following measures were calculated for the variables: mean (M) and standard deviation (SD), minimum, maximum. The following measures were calculated for categorical variables: number (n) and frequency (%). RESULTS: 184 officers (182 M and 2 F) took part in the study, including commanders 18.43%, rescuers 65.22%, drivers 16.30%. In the study area 1,609 officers serve in the combat division as at the end of 2021. The studied group accounts for 11.43%. Age of respondents M 34.04 SD 8.24 Min 21 Max 52, length of service M 8.48, SD 7.20 Min 1, Max 25. The longest mean time of completing the task was recorded for model 2 (hand-foot) and it was 6.77 sec. CONCLUSIONS: SFS officers highly appreciated the usefulness and effectiveness of the battery-operated automatic aspirator. This assessment may contribute to the widespread introduction of such a model to rescue sets in the SFS. Time of performing the task by mode 1 was significantly longer by elderly people. People with experience with the model 1 during rescue and firefighting operations had a significantly shorter time of performing the task with the use of the model 2. According to the subjective assessment of firefighters, the most effective is model 3, which is confirmed by the suction time obtained at the work station.

The role of life skills in developing an authentic leadership attitude in public health students: a multicenter cross-sectional study in Poland.

BACKGROUND: Decision-making skills are considered crucial life skills that condition proper social functioning within groups (i.e., support authentic leadership skills and increasing one's chances of success and wellbeing in life). Nonetheless, the number of scientific papers addressing the role of life skills in developing authentic leadership skills in public health students is limited. The aim of the present study was to develop a theoretical model to determine the role of selected life skills in developing authentic leadership skills in public health students. METHODS: The study was conducted from January 16 through February 28, 2018. In total, 653 students undertaking in-service training in Master's degree programs qualified for the study, and complete data sets were obtained from 329 students (response rate 50.38%). The data were collected by means of a paper questionnaire. Four research tools were used in the study: The Authentic Leadership Self-Assessment Questionnaire, The Moral Foundations Questionnaire, The General Self-Efficacy Scale, and The Youth Leadership Life Skills Development Scale. RESULTS: Two subgroups were identified among the public health students in the study: 1) the extra life skills training group (N = 113) and 2) the no extra life skills training group (N = 216). Both groups of study participants did not differ significantly in terms of age (M (SD): 25.0 (3.89) vs. 25.0 (3.66); t = 0.068, P = 0.946). On the other hand, clear differences were observed in the case of the respondents' participation in voluntary service. The respondents from the extra life skills training group declared participation in voluntary activities less frequently than the respondents from the second identified group (48.7 vs. 31.9%). CONCLUSIONS: A verified theoretical model showed that course aimed at strengthening authentic leadership competences should be modular, should focus on self-improvement and critical reflection, and should be spread over time to enable and encourage each participant to grow and flourish at their own pace.

Self-assessment of Rationing and Quality of Nursing Care.

BACKGROUND: Nursing care rationing has been a widespread problem in everyday nursing practice for many years. PURPOSE: The aim of this research study was to assess the prevalence of care rationing among nurses working in Poland. METHODS: The study was conducted among a population of 1310 nurses. To examine the dependencies between the sociodemographics and unfinished nursing care, the Polish adaptation of the Perceived Implicit Rationing of Nursing Care questionnaire and an investigator-developed questionnaire were used. RESULTS: The mean level of missed care was 1.16 (SD = 0.7). The significant predictors of care rationing were associated with the quality of patient care (ßstd = -.43, P < .001) and general work satisfaction (ßstd = -.15, P < .001). CONCLUSIONS: Job satisfaction and the quality of nursing care should be constantly monitored as these factors are significantly associated with the levels of care rationing.

Incidence and Sociodemographic Correlates of Psychological Health Problems among Residents of the West Pomeranian Voivodeship during the COVID-19 Outbreak.

Background and Objectives: Psychological health problems have become an important topic of consideration for many scientists, because the epidemiology of these disorders is strongly influenced by stressful events such as the SARS-CoV-2 coronavirus pandemic. The aim of this study was to evaluate selected parameters of psychosocial functioning as well as socio-demographic correlates of depression, anxiety, sleep disorders and perceived stress among the residents of the West Pomeranian Voivodeship. Materials and Methods: An online questionnaire was completed by 323 participants, in whom the parameters of psychosocial functioning were assessed (symptoms of depression, anxiety, severity of sleep disorders and perceived stress). Results: The majority of the respondents (75.2%) scored high on the Perceived Stress Scale, and almost half of the respondents (47.1%) had sleep disorders. A total of 26% of the participants had no depressive symptoms. Age was significantly correlated with the severity of depressive symptoms and sleep disorders. There was a strong correlation between the severity of depression and anxiety (r = 0.76; p < 0.0001), a moderate correlation between depression and perceived stress (r = 0.47; p < 0.0001) and a strong correlation between depression and sleep disorders (r = 0.651; p < 0.0001). Conclusions: Age contributed to the severity of depressive symptoms and the occurrence of sleep disorders among the residents of the West Pomeranian Voivodeship during the SARS-CoV-2 pandemic. Some residents of the West Pomeranian Voivodeship showed moderate to severe depressive and anxiety symptoms, as well as high levels of stress and insomnia.

Recurrent assessment of lymphocyte subsets in 32 patients with multisystem inflammatory syndrome in children (MIS-C).

BACKGROUND: Lymphopenia is a hallmark of multisystem inflammatory syndrome in children (MIS-C). We aimed to characterize lymphocyte subsets' shifts and their correlations with other severity markers of MIS-C. METHODS: In this prospective cross-sectional study, we performed peripheral lymphocyte phenotyping in 32 patients with MIS-C. We analyzed lymphocyte subsets at three time points of the disease: the acute (A), convalescent (B), and recovery (C) phases. Based on age-normalized lymphocyte counts, we distinguished two groups of patients: "the mild" (higher lymphocyte counts) and "the severe" (lower lymphocyte counts). In addition, we examined differences between these groups regarding other severity markers. RESULTS: In phase A, 84% of children had lymphopenia. Decreased absolute counts of CD3, CD4, and CD8 cells were observed in, respectively, 88%, 72%, and 84% of patients. The natural killer cells were decreased in 63% and CD19 in 59% of children. "The severe" group had significantly higher procalcitonin and troponin I levels and lower platelets and albumin. Moreover, "the severe" group had hypotension more frequently (73% vs. 20%, p = .008). In phase B, all lymphocyte counts increased, and 32% of children had lymphocytosis. The increase of CD3, CD4, and CD8 counts correlated with some laboratory severity markers (hemoglobin, procalcitonin, D-dimer, lactate dehydrogenase, N-terminal prohormone of brain natriuretic peptide, albumin), but not with steroid use. In phase C, most children had normal lymphocyte counts. CONCLUSIONS: Substantial shifts in lymphocyte counts during MIS-C apply most to T lymphocytes and correlate with the disease severity markers, particularly hypotension prevalence. A proportion of children with MIS-C develops transient lymphocytosis during convalescence.

Restricted v. unrestricted oral intake in high output end-jejunostomy patients referred to reconstructive surgery.

The major complication of end jejunostomy is excessive fluid and electrolyte loss through the stoma, leading to hypovolaemia and dyselectrolytaemia within days and malnutrition within weeks. The aim was to compare the results of two nutritional approaches: unrestricted and restricted oral intake in patients with end jejunostomy commencing home parenteral nutrition (HPN) in terms of liver and renal biochemical markers and time to reconstructive bowel surgery with correlation to stoma output. Twenty patients with stabilised high output end-jejunostomy were divided into two groups. Group A consisted of ten patients with oral intake restricted to keep stomal output under 1000 ml. Group B consisted of ten patients with unrestricted oral intake. The following parameters were evaluated over 6 months: stomal output, self-estimation of general condition, body weight gain, plasma bilirubin and creatinine, number of hospitalisations prior to reconstructive surgery, the frequency of ostomy bag emptying, feelings of hunger and thirst in the daytime, and the time to reconstructive surgery. Stoma losses were compensated by parenteral supply. In group B, lower quality of life was observed, reflected by weakness, permanent feelings of hunger and thirst and the need for night-time emptying of the stoma bag. Patients in group B developed more complications and required more time to prepare for surgery. One death occurred in group B due to renal insufficiency followed by septic complications. Restricted oral intake seems to be more effective for prevention of HPN-related complications and shortening of time to surgery. Unrestricted oral intake appears to provoke uncontrolled losses of energy and protein, inhibiting weight gain.

Validation and clinical evaluation of a Polish translation of the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K).

BACKGROUND: The Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K) is a self-administered questionnaire developed to evaluate the severity of the common cold. It is a patient-oriented instrument that evaluates quality of life in an illness-specific manner to be used in children aged 10 years. The purpose of this study was to validate the Polish version of the Wisconsin Upper Respiratory Symptom Survey for Kids. METHODS: The validation process consisted of five stages: forward translation, backward translation, cognitive debriefing, a pilot study (Study A and Study B), and statistical analysis. The first study (Study A, n = 10, aged 5-13) was conducted in the Emergency Room and an Outpatient Clinic of the Pediatric University Hospital in Warsaw. The purpose of the study was to obtain data for testing the convergent validity of the questionnaire. The second study (Study B, n = 56), consisted of children aged four to six enrolled in three kindergartens in the Warsaw suburbs. The obtained data were subjected to detailed statistical analysis. RESULTS: The WURSS Kids Polish showed excellent reliability. The Cronbach's alpha of the 13 items was 0.791 for the six symptom items and 0.854 for the seven functional items. The Jonckheere-Terpstra trend test was used to evaluate criterion validity. Compliance of the measurement performed independently by the examined person and the doctor on the first day was high (convergent validity). Each particular item was characterized by a different sensitivity to clinical change. The Guyatt's Responsiveness index ranged from 0.083 to 0.464. CONCLUSION: The internal consistency of the measurements and cross-cultural adaptation of the Polish version of WURSS Kids was satisfactory. The WURSS Kids Polish is a reliable, valid, and responsive disease-specific questionnaire for assessing symptoms and QOL in Polish patients in the pediatric population with the common cold. It may be used both in clinical practice and for research among Polish children with URTI.

Overall Survival in Patients with Hepatocellular Carcinoma Treated with Sorafenib: A Polish Experience.

BACKGROUND The mortality caused by hepatocellular carcinoma is expected to rise in the upcoming decade. Sorafenib has become the preferred systemic treatment option in patients with unresectable HCC. This study aimed to present the median overall survival (OS) in a group of patients with advanced HCC, treated with sorafenib in Poland between 2011 and 2019. MATERIAL AND METHODS The analyzed group of patients was qualified for treatment with sorafenib, financed by the National Health Fund, based on the guidelines of the Polish Drug Program. Kaplan-Meier method was used to plot the OS curves, and the log-rank test was used for testing. Multivariate assessment of factors (sex and age) related to the time to death of the patient was done using Cox regression. RESULTS Of the 2072 treated patients, 75% were men (1556) and 25% were women (516). The minimum age of patients in the trial group was 18 years and the maximum age was 90 years. Among the 1556 analyzed cases in males, 27.44% (427) did not end with death (by the date of completing the analysis). The percentage of one-year survival for this population was 58.16%, and the 2-, 3-, and 5-year survival rates were 34.45%, 21.81%, and 9.72%, respectively. The percentage of censored cases in the 516 females was 25.78% (133). The 1-2-, 3-, and 5-year survival for this population was 59.30%, 36.27%, 22.47%, and 11.34%, respectively. Statistical tests did not reveal a significant difference in the curve profiles by sex. There were no associations between OS and age. CONCLUSIONS Systemic treatment with sorafenib in accordance with the presented criteria allows for very good results, comparable to the results of selected groups of patients presented by other authors.

Social Media Sharing of Articles About Measles in a European Context: Text Analysis Study.

BACKGROUND: Despite the existence of an effective vaccine, measles still threatens the health and lives of many Europeans. Notably, during the COVID-19 pandemic, measles vaccine uptake declined; as a result, after the pandemic, European countries will have to increase vaccination rates to restore the extent of vaccination coverage among the population. Because information obtained from social media are one of the main causes of vaccine hesitancy, knowledge of the nature of information pertaining to measles that is shared on social media may help create educational campaigns. OBJECTIVE: In this study, we aim to define the characteristics of European news about measles shared on social media platforms (ie, Facebook, Twitter, and Pinterest) from 2017 to 2019. METHODS: We downloaded and translated (into English) 10,305 articles on measles published in European Union countries. Using latent Dirichlet allocation, we identified main topics and estimated the sentiments expressed in these articles. Furthermore, we used linear regression to determine factors related to the number of times a given article was shared on social media. RESULTS: We found that, in most European social media posts, measles is only discussed in the context of local European events. Articles containing educational information and describing world outbreaks appeared less frequently. The most common emotions identified from the study's news data set were fear and trust. Yet, it was found that readers were more likely to share information on educational topics and the situation in Germany, Ukraine, Italy, and Samoa. A high amount of anger, joy, and sadness expressed within the text was also associated with a higher number of shares. CONCLUSIONS: We identified which features of news articles were related to increased social media shares. We found that social media users prefer sharing educational news to sharing informational news. Appropriate emotional content can also increase the willingness of social media users to share an article. Effective media content that promotes measles vaccinations should contain educational or scientific information, as well as specific emotions (such as anger, joy, or sadness). Articles with this type of content may offer the best chance of disseminating vital messages to a broad social media audience.

Characteristics of Antivaccine Messages on Social Media: Systematic Review.

BACKGROUND: Supporters of the antivaccination movement can easily spread information that is not scientifically proven on social media. Therefore, learning more about their posts and activities is instrumental in effectively reacting and responding to the false information they publish, which is aimed at discouraging people from taking vaccines. OBJECTIVE: This study aims to gather, assess, and synthesize evidence related to the current state of knowledge about antivaccine social media users' web-based activities. METHODS: We systematically reviewed English-language papers from 3 databases (Scopus, Web of Science, and PubMed). A data extraction form was established, which included authors, year of publication, specific objectives, study design, comparison, and outcomes of significance. We performed an aggregative narrative synthesis of the included studies. RESULTS: The search strategy retrieved 731 records in total. After screening for duplicates and eligibility, 18 articles were included in the qualitative synthesis. Although most of the authors analyzed text messages, some of them studied images or videos. In addition, although most of the studies examined vaccines in general, 5 focused specifically on human papillomavirus vaccines, 2 on measles vaccines, and 1 on influenza vaccines. The synthesized studies dealt with the popularity of provaccination and antivaccination content, the style and manner in which messages about vaccines were formulated for the users, a range of topics concerning vaccines (harmful action, limited freedom of choice, and conspiracy theories), and the role and activity of bots in the dissemination of these messages in social media. CONCLUSIONS: Proponents of the antivaccine movement use a limited number of arguments in their messages; therefore, it is possible to prepare publications clarifying doubts and debunking the most common lies. Public health authorities should continuously monitor social media to quickly find new antivaccine arguments and then create information campaigns for both health professionals and other users.

A new approach to the prevention of nursing care rationing: Cross-sectional study on positive orientation.

AIMS: To assess the effects of nurses' life satisfaction and life orientation on the level of nursing care rationing. BACKGROUND: Best practice within human resource management argues that striving for a positive orientation within the workforce may create a friendly work environment that could promote the employee's development and job satisfaction in a health care organisation. METHODS: A total of 547 nurses were enrolled and assessed using three self-report scales: the Basel Extent of Rationing of Nursing Care-R (BERCA-R), the Satisfaction with Life Scale (SWLS) and the Life Orientation Test (LOT-R). Then, the data were submitted into bivariate analyses. RESULTS: More pessimistic nurses with low and moderate levels of life satisfaction, and those with a neutral life orientation, presented with significantly higher BERCA-R scores than those who were more optimistic and who had high levels of life satisfaction. CONCLUSIONS: Nursing care rationing depends on psychological factors of life satisfaction and life orientation. Low levels of satisfaction with life and a more pessimistic life orientation negatively contribute towards a higher prevalence of nursing care rationing. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management policies, including intervention management, should consider ensuring positive orientation is in place to increase job satisfaction and optimism in health care workers.

Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements.

BACKGROUND: Consensus on evidence-based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. AIMS: To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. METHODS: A multi-phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two-round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. RESULTS: In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two-round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. LINKING EVIDENCE TO ACTION: The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students' and nurses' perception of competencies required for EBP processes.

Optimistic thinking, satisfaction with life and job and nursing care rationing: Multicentre study in Poland.

AIMS: The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses. BACKGROUND: Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care. METHODS: A cross-sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self-report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test-Revised. The results were analysed using the k-means method, Student's t test and two-way ANOVA. RESULTS: Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'. CONCLUSION: Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing.

Influence of two different methods of nutrition education on the quality of life in children and adolescents with type 1 diabetes mellitus - a randomized study.

Background. Nutrition education is one of the most important factors determining the effectiveness of treatment and maintaining an adequate quality of life (QoL) in children and adolescents with type 1 diabetes.Material and Methods. A randomized single-blind study was conducted between October 2017 and April 2019 at the Children's Clinical Hospital in Warsaw. The study included 170 patients (aged 8-17) with at least 1-year history of type 1 diabetes, treated with insulin pumps. The participants were randomly divided into two groups: a control group (C) - traditional/ informative education methods, and an experimental group (E) - modern/interactive methods. PedsQL Diabetes Module 3.0 questionnaire was used in the assessment of the QoL. Total PedsQL score was the primary outcome. The secondary outcomes included the results obtained in five subscales of the questionnaire. The relationships between selected variables and changes in scores were also verified.Results. Data obtained from 136 patients were analyzed. In both groups no significant changes regarding total PedsQL were noted 6 months after the intervention. However, a significant reduction occurred as regards the scores of 'Communication' subscale in group C. Analyzing other determinants of the QoL, significant dependencies were observed between: the level of physical activity and a change in 'Diabetes symptoms' subscale, and the level of parents' education and a change in 'Treatment barriers' subscale.Conclusions. Both methods of nutrition education exerted a comparable influence on the total QoL. However, modern methods were more effective in terms of the improvement in the aspect of communication. Additionally, moderate physical activity and parents' tertiary education constituted valid determinants of various aspects of the QoL in children and adolescents with type 1 diabetes.

Severe Depressive Episode with Psychotic Symptoms and Type 2 Diabetes: A 2010-2017 Longitudinal Study.

BACKGROUND There have been few studies published on the prevalence of severe depressive episode in people with type 2 diabetes (T2DM) or its role in adherence to dietary recommendations. We examined the Polish National Health Fund (NFZ) database estimates of all medical visits from 2010 to 2017 to determine the trend and the epidemiology of severe depressive episode in T2DM. MATERIAL AND METHODS The NFZ database was used. We defined the T2DM group diagnosed with both T2DM and severe depressive episode according to the ICD-10 codes. The annual prevalence of severe depressive episode was estimated according to the T2DM diagnosis status, and the age groups were stratified into 8 groups. RESULTS Relative risk for depression (regardless of severity of symptoms) in T2DM is 1.347 [95%CI: 1.342-1.353]. The frequency trend of severe depressive episode with or without psychotic symptoms remains relatively stable. In the case of mild and moderate depressive episode, a downward trend was noted, but they are still the most frequent mood disorders diagnosed. Patients with T2DM aged 20 to 40, for whom the peak of coexistence of these illnesses was noted, are the group particularly vulnerable to depression. Depression also remains on a relatively high but stable level for patients over 60 years of age. CONCLUSIONS The coexistence of depressive episodes in T2DM is a key challenge for medicine and public health. Measures aimed at early identification of patients with T2DM prone to depression need to be taken. Creating multidisciplinary care teams in diabetes management is also necessary.

Polish Helicopter Emergency Medical Service (HEMS) Response to Stroke: A Five-Year Retrospective Study.

BACKGROUND A stroke is a serious life-threatening emergency that requires immediate intervention in an appropriate therapeutic center. The aim of this study was to analyze the time of medical procedures at the scene and changes in the state of stroke patients during transport by HEMS in Poland. The presented research is the first nationwide study covering such a large group of stroke patients, for whom aerial support was used in the therapeutic process. MATERIAL AND METHODS A retrospective cross-sectional study of 48553 missions performed by Polish Medical Air Rescue (PMAR) during the 5-year study period resulted in 3906 stroke patients who, after medical rescue operations by HEMS crew, were transported by helicopters to hospitals. RESULTS Helicopters in 3475 (88.97%) cases were utilized as a support for Ground Emergency Medical Service (GEMS). The maximum duration of HEMS operation from activation to patient transfer to the hospital did not exceed 108 min and the median was 60 min. Over 87% of patients with HEMS reported stroke symptoms and arrived at the medical center with the possibility of implementing thrombolytic therapy. The factor that affected the deterioration of patients' condition was the drawing out of the extent of time spent by the crew at the scene. CONCLUSIONS The use of HEMS in Poland in the case of patients with stroke symptoms ensures fast and professional assistance at the site of the medical emergency as well as safe transport to specialized centers, shortening the time of proper treatment implementation.

Psychometric properties of Authentic Leadership Self-Assessment Questionnaire in a population-based sample of Polish nurses.

AIM: The purpose of the study was to adapt and evaluate the psychometric characteristics of the Polish language version of the Authentic Leadership Self-Assessment Questionnaire intended for use among Registered Nurses. DESIGN: A cross-sectional study where the Authentic Leadership Self-Assessment Questionnaire was administered to a representative group of 3,299 Polish Registered Nurses was carried out between September and November 2017. METHODS: Linguistic-cultural adaptation of the ALSAQ was carried out according to the WHO guidelines. The following psychometric properties of the ALSAQ were evaluated: content validity (content validity index), theoretical relevance (exploratory and confirmative factor analysis), unidimensionality of subscales (principal component analysis), internal consistency (Cronbach's alpha), test-retest reliability and criterion validity. FINDINGS: The content validity analysis revealed a need to reduce the original ALSAQ version from 16-23 items. The factor structure of ALSAQ differed from the original version. A three-factor model was better fitted to the data than a four-factor model. The three distinguished subscales (moral processing, self-awareness, and relational transparency) were characterized by unidimensionality. ALSAQ has a good internal consistency (Cronbach's alpha 0.84) and test-retest analysis confirmed stability of the measurement for subscales and particular items. Moreover, the ALSAQ-P criterion validity with external variables, being of key importance for shaping the leadership skills (self-efficacy and universal moral foundations) was confirmed. CONCLUSIONS: Authentic leadership skills in nursing practice are characterized by their individual specificity, which was indicated in the ALSAQ validation. The ALSAQ can be considered a reliable and valid tool for self-assessment of leadership skills in a group of nursing practitioners. The identified standards help measuring strengths and weaknesses of authentic leadership.

Nurse prescribing: Attitudes of medical doctors towards expanding professional competencies of nurses and midwives.

OBJECTIVE: To identify the attitudes of doctors regarding prescriptive competences of nurses and midwives since these have been recently regulated in several countries. . METHODS: The cross-sectional study was conducted at the Medical University of Warsaw from February 1to7, 2016 and comprised doctors working at the Prof. Jan Nielubowicz Regional Medical Chamber in Warsaw, Poland. A specially designed 36-item questionnaire that had 22 statements was used regarding the role of the reform in the healthcare system; the need of granting nurses and midwives particular competencies; and their preparation and readiness for these competencies. The respondents assessed the statements using a Likert scale (1=strongly disagree; 5=strongly agree). STATISTICA 13.2 was used for data analysis. . RESULTS: Of the 436 doctors, 245(56%) were women. The subjects presented different opinions about the reforms, especially about possible improvement in patient care with nurses prescribing, or the process getting simplified for the care-seekers. Most doctors believed that nurses and midwives were not yet equipped enough to prescribe certain medicines or issue prescriptions (1,79/5). Only in case of nurses and midwives being able to 're-order' medicines earlier prescribed by a doctor, the attitudes of primary care physicians was significantly different than those involved with hospital care (p=0.048). CONCLUSIONS: Doctors were sceptical about expanding professional competences of nurses and midwives regarding drug prescription.

Maladaptive perfectionism and authentic leadership skills in emergency medicine students

Introduction: Leadership skills can be critical in emergency medicine. However, there are no works that analyze this issue in much more details. The aim: To analyze the level of leadership skills in emergency medicine students, and also checking if despondency perfectionism is a variable that reduce the correlation between self-efficacy and leadership skills. Material and methods: The analyzed group consisted of 75.76% of all emergency medicine students taking up education at the Medical University of Warsaw in 2018 (n = 150, W = 74, M = 71). The average age was 23 years (SD = 1.7). All students were divided into two groups: Group 0 - without maladaptive perfectionism (n = 64), and group 1- with maladaptive perfectionism (n = 79). In the cross-sectional study, three standardized research tools were used: Authentic Leadership Questionnaire, Almost Perfect Scale-Revised (APS-R), and General Self-Efficacy Scale (GSES). ANCOVA analysis was used. Results: The linear regression coefficients for both comparison groups were significantly different (interaction of variables: "maladaptive perfectionism * self-efficacy": F = 4.841, p = .029). Comparing adjusted mean values for both groups (0 vs 1), it can be stated that students from group 0 had a significantly higher level of authentic leadership skills compared to group 1 (F = 4.432, p = .037). Conclusions: Studies to determine the mechanisms of a positive relationship between the self-efficacy and leadership skills in emergency medicine students with high maladaptive perfectionism are required. This will allow the development of effective programs to strengthen the leadership skills of these students.