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.

Hospitalization for dog bites in Poland between 2006-2020.

INTRODUCTION AND OBJECTIVE: Owning a dog or spending time around a dog have many benefits, but also pose a risk of being bitten or attacked. Currently, publications on dog bites and related factors come from both high-income countries and low- and middle-income countries. So far, no attempt has been made to assess this phenomenon in Poland. The aim of this study was to determine the number of such events and evaluate hospital medical assistance provided to dog bite victims in Poland in the period of 15 years between 2006-2020. MATERIAL AND METHODS: This cross-sectional study was based on the data from the Nationwide General Hospital Morbidity Study and cases with the code W54 (ICD-10) as the cause of hospitalization. As part of the analysis, victim demographical data, with an emphasis on city- and country-dwellers, as well as treatment variables were assessed. RESULTS: Between 2006-2020, 4,145 cases of hospitalizations for dog bites were found, of which approx. 42% occurred in 2020 during the COVID-19 pandemic and lockdowns. Most of the victims were children aged 0-9, and this is especially common among boys living in the countryside. It was found that regardless of the place of residence, there was a systematic decrease in hospitalization of men as they were older. In women, however, the decrease in hospitalization concerned only the age groups 0-39. Among older women, the percentage of hospitalization increased, especially among rural women aged 60 and over. CONCLUSIONS: Hospital discharge records report a small number of dog bites. These are only the tip of the iceberg. The problem has a multi-factorial nature and requires epidemiological monitoring and further research on correlates and determinants, as well as preventive measures.

Dichotomy of lay people and health professionals perception of physical activity is a challenge for activity education and promotion within primary health care - a qualitative study.

INTRODUCTION: According to the WHO, healthy adults aged 18-64 should perform at least 150 min of moderate-intensity aerobic physical activity (PA), or at least 75 min of vigorous-intensity PA, throughout the week, or an equivalent combination of moderate and vigorous activity. These recommendations should be promoted and involved in primary health care (PHC) staff daily practice. Tailoring the education message depends on peoples' perspective on PA, but in Poland there is no research on the subject. OBJECTIVE: The aim of the study was to explore and compare the perception of lay people (LP) and health professionals (HP) of PA to find similarities and differences in their perspective - as this may have an impact on PHC-based education on PA (favourable or unfavourable). MATERIAL AND METHODS: Six mini FGIs were carried out. Research sample consisted of 16 LP from urban settings and 10 HP (doctors, nurses). RESULTS: LP and HP appreciated PA as important and considerably controllable health determinant. LP attributed the main gains of PA to psycho-social benefits, and HP strictly to diseases risk reduction. Both groups had difficulties in defining PA and doubts abounded about PA and exercise. Optimal dose (volume) of PA was generally unclear and the WHO recommendation were unknown. HP seemed to be more eager than LP to appreciate simple forms of PA, e.g. walking. Barriers to PA perceived by LP were described in terms of 'real life' factors (sportswear, access, job), and HP mostly by cognition (knowing, judging) and social status. LP preferred positive, rewarding motivation for PA, but HP one that was negative and fear-based. CONCLUSIONS: Referring to activity, LP and HP were like travellers in parallel universes. This created challenges in PHC-based education. Some suggestion for PA education were given. More qualitative and quantitative research are needed.

Monitoring of community-acquired pneumonia hospitalisations before the introduction of pneumococcal conjugate vaccine into Polish National Immunisation Programme (2009-2016): A nationwide retrospective database analysis.

PURPOSE: Community-acquired pneumonia (CAP) is a common infection with significant morbidity and mortality. In January 2017, Poland introduced pneumococcal conjugate vaccine (PCV) into their national immunisation programme to protect children against invasive pneumococcal disease. This study was designed to investigate pneumonia-related hospitalisation rates and trends from 2009 to 2016 prior to the introduction of nationally funded PCV vaccination. METHODS: Using national public statistic data available from the National Institute of Public Health - National Institute of Hygiene, annual hospitalisation rates for pneumonia were analysed, categorised by aetiology and age (<2, 2-3, 4-5, 6-19, 20-59, 60+ years). Trends over time were assessed, as well as in-hospital mortality. RESULTS: The overall hospitalisation rate due to pneumonia varied between 325.9 and 372.2/100,000 population. Higher rates of hospitalisation were seen in older adults and children ≤5 years. Trends were observed when analysing hospitalisations by pneumonia aetiology within age groups: between 2009 and 2016, Streptococcus pneumoniae hospitalisations significantly increased for children aged <2, 2-3, and 4-5 years, from 5.3 to 12.4, 5.2 to 8.2, and 1.9 to 4.6/100,000 population respectively. Whereas hospitalisations due to Haemophilus influenzae pneumonia decreased significantly from 7.8 to 1.8 and 4.8 to 1.9/100,000 children aged <2 and 2-3 years respectively. The numbers of in-hospital deaths increased from 5578 in 2009 to 8149 in 2016, with >85% of deaths in the 60+ age group. CONCLUSIONS: This is the first national study of pneumonia hospitalisations in Poland, providing the baseline data from which to investigate the impact of the change in vaccination policy on pneumonia hospitalisations in Poland.

Posting on "Nie szczepimy ("We don't vaccinate") Internet forum

INTRODUCTION: In Poland, there is a visible strengthening of hesitant attitudes towards vaccination, as well as institutionalization and politicization of hesitancy. The Internet is an important source of information about vaccinations. People who are looking for such information can find negative opinions on the web, so it is important to keep track of the content there. There is no national research on Internet anti-vaccination content. AIM: To examine posting on the online forum "Nie szczepimy" (We don't vaccinate). MATERIAL AND METHODS: The number of new users and new posts in the years 2008-2018 was examined, as well as the type of content and design of the selected 407 posts from 2009-2015. Categories according to Wolfe RM et al. (2002) were used for coding content and design of posts. RESULTS: The number of users and posts was increasing for the first four years and then started to decrease. The most frequently discussed topic was the relation between vaccination and idiopathic illnesses (26.1%). The most common design was providing links to anti-vaccine sites (29.9%) CONCLUSIONS: The content of the posts is very diverse and shows numerous users' doubts. A significant part of the posts had a strongly emotional form. It would be important to regularly monitor various services and forms of communication on the Internet in terms of the content of anti-vaccinaton information.

Functioning of the various forms of mental health care in Poland in the years 2010-2013. Organizational, economic and financial aspects. / Funkcjonowanie jednostek w róznych formach opieki psychiatrycznej w Polsce w latach 2010­2013. Analiza organizacyjna i ekonomiczno-finansowa.

OBJECTIVES: The main objective of the study was to verify the hypothesis about the high growth rate of expenditure on the provision of mental health in the past few years. High dynamics of the expenditure increase will result in the development of a model of community psychiatry and a gradual move away from the hospital psychiatric treatment towards mental health care in the open system, including the community one. METHODS: This research is based on data on the implementation of services for mental health care in the framework of agreements with the National Health Fund, which has been collected in the NFZ IT system. Some information is from 2010, which was adopted as the base date for the implementation of the principles of the National Mental Health Program in 2011. The data from the implementation of individual benefits in 2013 were used for the comparison. In addition, other selected organizational, economic and financial elements of the psychiatric care system were analyzed. RESULTS: In 2013, compared to 2010, increased the number of mental health care organizations: outpatient mental health clinics (an increase of 37 clinics), outpatient mental health day hospital wards (an increase of 25 wards) and community psychiatric treatment teams (an increase of 74 teams). The largest increase in the value of contracts (approx. 150%) was related to community treatment teams. CONCLUSIONS: Between 2010 and 2013 there was an increase in the value of cleared contracts in psychiatric care, in general and in each of the three forms of psychiatric care (i.e., in day wards, outpatient mental health clinics and in community teams). The highest increase in investments included community treatment teams, to a lesser extent day wards and outpatient clinics. The adopted organizational, economic and financial solutions in the mental health care system are in line with the objectives of the National Mental Health Program, including the assumed structure of Mental Health Centers.

Public health physicians and dentists in Poland: results from public health workforce pilot study

Background: Monitoring public health workforce is one of the essential functions of the public health system. Objective: The aim of the study was to identify the specialities for physicians and dentists related to public health in the years 1951-2013, and analyse of available data on physicians and dentists certified as public health specialists (PHS) in 2003-2015. Material and Methods: The historical analysis covers a relevant regulations of a minister in charge of health. The data on PHS were obtained from the Centre of Medical Exams and included: the number of specialists and their demographic characteristics, professional background, spatial distribution. Density was also calculated. Results: The public health specialty was introduced in 1999. Before there were specialties in disciplines related to public health. In the years of 2003-2015, 360 physicians and dentists were certified as PHS. The majority of them had former background in another discipline, mostly related to clinical medicine. The average age of specialists was 47.2. Currently, the average age of specialists is ca. 57.6 years, with a prevalence of people aged 61-70 years (36.9%). PHS tend to be older than specialists in other disciplines. Over three fourths of PHS were certified in 2004. With the exception of that year, the public health specialist title was annually obtained by an average of 9 persons. The density of PHS in Poland was 0.94 per 100 thousand inhabitants, ranging between 0.16 and 3.12 in a given voivodeship. Conclusions: The analysis has revealed numerous obstacles in estimation of the number of PHS and indicated a lack of relevant mechanisms aimed at workforce development. A relevant policy for developing public health workforce is urgently needed.

Hospitalization of injured immigrants in Poland - Demographic profile and diagnosis.

INTRODUCTION AND OBJECTIVE: More and more immigrants gradually come to Poland. Little is known, however, about their health situation or their injuries. The objective of this study was to analyse the cases of hospitalization of immigrants due to injuries in 2008-2010, including the number and demographic characteristics of the patients, as well as the nature of injury according to ICD-10 (S00-T98). MATERIAL AND METHODS: The analysis was conducted on the basis of data from the General Hospital Morbidity Study. All the cases of hospitalization due to injuries were covered by the analysis, and a group of foreigners was compared to the general population. RESULTS: The number of foreigners hospitalized due to injuries ranged from 4.6-21.2 thousand in the subsequent years. The share of hospitalization due to injuries equalled 8.2-11.9% of all foreigners' hospital stay. The majority were males, but the proportion of females gradually increased up to 36.7% in 2010. The average age of the hospitalized gradually decreased to the age of 35.2 in 2010. The structure of the nature of injury was different from that of the general population. Prevailing types of injuries were minor injuries of wrist, hand, ankle and foot. Open wounds of the head were also common. CONCLUSIONS: Results of the analysis indicate the most important tendencies related to immigrants' injuries. Further research, as well as monitoring the foreigners' health status is necessary. Taking preventive measures is essential among the most vulnerable group - male immigrants aged 15-19.

Hospitalization of injured immigrants in Poland - Utilization of in-patient services.

INTRODUCTION AND OBJECTIVE: In 2008-2010, the number of foreigners hospitalized due to injuries in Poland ranged from approximately 5-21 thousand. The aim of this study was to analyse the utilization of in-patient services by injured immigrants in 2008-2010, including mode of admission (i.e. referral), mode of discharge, average length of patient stay, seasonality and spatial distribution of hospital admissions. MATERIAL AND METHODS: Analysis was conducted on the basis of data from the General Hospital Morbidity Study. All cases of hospitalization due to injuries were covered by the analysis, and a group of foreigners was compared to the general population. RESULTS: The percentage of immigrants admitted by acute admission through self-referral increased to 80.9% in 2010. The great majority (79.4%) were discharged to in-patient care. The immigrants' stay in the hospital was approximately twice as short than that of an average patient with injury. Immigrants and the rest of the patients were admitted to hospitals in different seasonal rhythm. The great majority of foreigners were treated in hospitals located in two (out of 16) provinces. CONCLUSIONS: This study supports the need for understanding the immigrant experience when accessing health care, as well as the need for further research and contribution of public health.

Is there the gap in public health literature in Europe?

INTRODUCTION AND OBJECTIVE: The growing expectations for the effectiveness of public health increase the demand for scientific literature, concerning research, reviews and other forms of information. The bibliographic databases are of crucial importance for researchers and policy makers. The objective of this study is to estimate the supply of scientific literature related to public health in selected European countries, which are available to a wide range of users. MATERIALS AND METHODS: Analysis of the number of bibliographic records on topics related to public health was based on searches in Ovid MEDLINE (R) in May and June 2011. According to MeSH terms, 11 keywords and names of 13 European countries were used in the search. Publications from the years 2001-2010 were analyzed. A number of publications indexed under 'public health', and related to selected countries were compared with the size of the population of those countries, GDP, total expenditure on health and burden of disease (DALYS's). RESULTS: The most popular topic was 'health policy', whereas the topics 'occupational health' and 'environmental health' were less prevalent. There were no significant changes in the number of publications in 2001-2010. The number of articles indexed under 'public health' had significant positive correlation with national GDP, expenditure on health and population size, and negative with DALY's. CONCLUSIONS: According to the criteria accepted in this study, the Nordic countries--Finland, Sweden and Norway--were very productive in this respect. Poland and other Central European Countries were less productive.

Associations and foundations in the field of health care and their role in the health system of Poland.

The article presents data on associations and foundations active in health care field in Poland, on the basis of a review of research done by Klon/Jawor Association and the Central Statistical Office. The article also applies to the issue of cooperation between NGOs and governmental adminstration in the health area and identifies lacking information that is necessary for better planning of national health policy. In Poland there are about three thousand associations and foundations whose main focus is the health care. In 2010, they accounted for about 7% of all non-governmental organizations. Results of representative nationwide surveys from 2008 and 2010 indicate that the NGO's active in the field of health care have, in most cases, legal form of associations. Almost half of the organizations declared national or international scope of action. Headquarters of most organizations were mainly in the cities, and only, one in twenty in the village. Most organizations were located in the mazowieckie province and a significant fraction of them was in Warsaw itself. Organizations were stood out by a relatively large number of personnel on the background of the entire NGO sector. Half of the organizations employed paid workers, the majority also collaborated with volunteers who were not members of the organization. More than a third of organizations dealt with the rehabilitation, therapy and long-term care, and about 1/3 dealt with prevention, health promotion and education, and blood donations. World Health Organization indicates the need for systematic collection of data about the role of the nongovernmental sector in health. In Poland, legal regulations require the public institutions and organizations to cooperate with NGOs to achieve health objectives. In spite of relevant data on NGOs in the field of health care in Poland, the necessary information to assess their potential are still lacking. Recognition of the capacity and limitations ofNGOs could enable better planning of national health policy.

The role of non-governmental organizations in the social and the health system.

The article presents the definitions, objectives, fields and tasks of non-governmental organizations in social life, health system and health policy. In addition, the article addresses the issue of effectiveness and quality of NGOs' activity. The term "NGOs" (Non-governmental Organizations) includes different categories of entities that operate not to obtain financial gain, and also do not belong to the government sector. Non-governmental Organizations' fields of activity were described in the International Classification of Non-Profit Organizations (ICNPO). NGOs are an integral part of a democratic society. Sociological sciences emphasize their importance in enhancing social integration, implementation of the principle of subsidiarity, building civil society, social dialogue and participatory democracy. The main tasks of NGOs in the health system are providing services and health advocacy. Provision of services includes medical, social and psychological services as well as, integration activities, care and nursing, material and financial support, educational and information services and training. Health advocacy is a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program. An important task carried out by NGOs is participation in the formation of health policy. The increasing role of NGOs in providing social services and the participation in political processes, result in the need to confirm the validity and credibility of their operation. One of the ways could be to introduce the mechanisms to assess quality and efficiency, such as registration as a part of a legal system, self-regulatory activities (card rules, codes of ethics), certification, participation in networks, monitoring and audit.

To govern the health or to make the bills of mortality--this is the question for public health in Poland.

In the article important moments in the development of public health at the global scale were presented, assuming that postwar evolution proceeded in two fundamental phases: the first--events which occurred to the proclamation of the Ottawa Charter and introduction of 'new public health' and the second--situations reported after Ottawa to the present time. The current challenges for public health in Poland were also discussed. It was proposed to differentiate two dimensions of public health capacity: internal (ad intra), which is with regard to the power centre, condition within the environment and external (ad extra), which refers to the relation with surroundings and population and enables to deliver sustain services and programmes. The possible strategies aiming at increasing ad intra capacity were also indicated.

[The role of science in policy making--EuSANH-ISA project, framework for science advice for health]. / Rola nauki w podejmowaniu decyzji politycznych--projekt EuSANH-ISA, struktura doradztwa nauki w kwestiach zdrowotnych.

Governments and other authorities (including MPs) should be well informed on issues of science and technology. This is particularly important in the era of evidence-based practice. This implies the need to get expert advice. The process by which scientific knowledge is transmitted, along with proposals how to solve the problem, is called science advice. The main aim of the article is to discuss the issue of science advice--definitions, interaction between science and policymaking, and its position in contemporary policies. The second aim is to present European Science Advisory Network for Health (EuSANH), EuSANH-ISA project, and framework for science advice for health which was developed by participants. Furthermore, the role of civil society in decision-making process and science advice is also discussed. Interaction between scientists and policy-makers are described in terms of science-push approach (technocratic model), policy-pull (decisionistic) and simultaneous push-pull approach (pragmatic). The position of science advice is described in historical perspective from the 50s, especially in the last two decades. Description relies to USA, Canada and UK. Principles of scientific advice to government (Government Office for Science, UK) are quoted. Some important documents related to science advice in EU and UN are mentioned. EuSANH network is described as well as EuSANH-ISA project, with its objectives and outcomes. According to findings of this project, the process of science advice for health should follow some steps: framing the issue to be covered; planning entire process leading to the conclusion; drafting the report; reviewing the report and revision; publishing report and assessing the impact on policy.

[Martin Kacprzak (1888-1968)--non omnis moriar]. / Marcin Kacprzak (1888-1968)--non omnis moriar.

AIM: The purpose of this study was to present a scientific profile of Professor Martin Kacprzak with particular emphasis on his relationship with national Institute of Hygiene in Warsaw--where he was working for the longest time. MATERIAL AND METHODS: Information derived from documentation from archives of National Institute of Hygiene (NIH), Medical University of Warsaw, magazine titled "Notatki Plockie", UN and WHO records, including records of the International Health Conference held in New York in 1946, and other sources. RESULTS: Martin Kacprzak was born in peasant family in Mazovia, at that time belonging to Russian Empire (Russian partition). He studied medicine at Sorbonne in Paris. In 1922-1924, as a Rockefeller Foundation Fellow, he studied the hygiene and health care organization at Johns Hopkins University in Baltimore. In 1924-1944 worked in State School of Hygiene in NIH as a head of epidemiology and statistics department. After WWII (1945-1952) he served as its director in 1954-1962 he supervised the school hygiene department in NIH. From 1948 to 1965 he worked at Medical University of Warsaw, also as dean of medical faculty (1948-1954) and president (1955-1962). He participated (1946-1948) in preparatory work to establish World Health Organization. In 1957 he was the sixth recipient of prestigious Léon Bernard Foundation prize, which is presented at World Health Assembly. The first recipient in 1951 was prof. René Sand from Belgium, the second in 1952 prof. Charles-Edward Amory Winslow, bacteriologist, not a doctor, author of the first definition of public health. Martin Kacprzak was an honorary member of American Public Health Association. He wrote over 200 articles.

[Salutogenesis--new approach to health and disease]. / Teoria salutogenezy--nowe podejscie do zdrowia i choroby.

A. Antonovsky is the creator of salutogenesis. The theory was built on the ground of many, different sciences connected with health. The article presents salutogenic assumptions including the main factors that determine health and disease i.e. stressors, generalised resistance resources and sense of coherence. Interactions between individuals, environment and culture were presented. Complexity of individual and population health and quality of life was stressed. Salutogenesis and health promotion links were indicated.

[Edward Grzegorzewski (1906-1982)--Poland's delegate to the founding conference of the World Health Organization]. / Edward Grzegorzewski (1906-1982)--delegat Polski na konferencje, która powolala Swiatowa Organizacje Zdrowia.

Early years of Edward Grzegorzewski's professional work were associated with the National Institute of Hygiene (NIH) in Warsaw, Poland. This fact and Grzegorzewski's professional achievements and uniqueness of his life lead to dedicate him a separate article. A search of archival materials was guided by information from the prof. Zbigniew Machalinski article--a historian from Gdansk. Insight into the personal files and the archives of NIH was obtained and some other attempts to find factual data were undertaken. A numerous works written by Grzegorzewski were found and read. The article is complementary to the previously described facts, especially in the context of his relationship with the NIH. Repetitions of the information resulted from the need to preserve the chronological order of events or to highlight the context. In the years 1932-1942 Edward Grzegorzewski worked in National Institute of Hygiene, at the beginning as volunteer. During this time he studied the hygiene in the USA and periodically worked in the city board in Warsaw. He worked in the Department of Social Hygiene and published approximately 30 articles and reports, and dealt with health education as well. After the WWII he served on many post, eg. he was the rector of the Medical Academy in Gdansk, director of the Department of Education and Training in the WHO and professor at Johns Hopkins University. In 1946 he signed the WHO Constitution for Poland. He was a prominent Polish hygienist.

[Position of health at international relations. Part I. Structural dimensions of health]. / Pozycja zdrowia w stosunkach miedzynarodowych. Cz. I. Zdrowie jako struktura.

In the article, the health is perceived as complex, multidimensional concept and not as absence of disease. This is consistent with public health perspective, where public health is regarded as public as well as political activity. It aims to solve health and social problems, depends on analysis of phenomena, needs the negotiations and relies on making decision on feasible directions of changes--what, why, how, where, when and by whom should be done. Public health policy developed as a result of international relations, and UN family fora especially, is regarded as significant for creating of health position. The aim of this article was: (1) the analysis of selected concepts and definitions related to structural dimensions of health, used in UN international arrangements; (2) an attempt to explain the evolution of health structure notions at worldwide agenda. The UN main bodies, programmes and funds working on the health field are mentioned and voting rules in UN General Assembly and World Health Assembly are reminded. The following structural dimensions were considered: (a) well-being, (b) human rights, (c) everyday resource, health potential, (4) equity. All were explored in WHO Constitution, Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, Ottawa Charter for Health Promotion and numerous WHA and UN GA resolutions, decisions as well as other documents. Some remarkable differences in English and Polish language versions and meanings were pointed out. It was argued that present perception of structural dimension of health is strongly derived from the preamble of the WHO Constitution adopted and signed on 22 July 1946 by the representatives of 61 States. It is an evidence of the strength of this document and wisdom of its authors. The greater progress is associated. with concepts and notion of organizational dimensions of health perceived as action and processes leading to health. Long-term efforts to strengthen the image of health was compared to positioning known in marketing as creating an identity in the minds of a target market.

[Position of health at international relations. Part II. Organizational dimensions of health]. / Pozycja zdrowia w stosunkach mii dzynarodowych. Cz. II. Zdrowie jako proces.

The aim of this article was: (1) the analysis of some concepts and definitions related with "set up of health", used in UN international arrangements; (2) an attempt to explain the evolution of organizational dimensions of health at worldwide agenda. The following organizational dimensions of health were discussed: (a) health for all, (b) health promotion, intersectoral and multisectoral actions, health in all policies, (c) health development, health as an element of human development, (d) investment for health, (e) health diplomacy and (f) mainstreaming of health. The analysis was based on World Health Assembly and UN General Assembly resolutions as well as supranational reports and statements available through conventional channels, not grey literature. It is apparent that some of notions are not in common use in Poland, some seems to be unknown. It was argued that some general and discreet thoughts and statements concerning organizational aspects of health were expressed in the preamble of WHO Constitution. Nevertheless they are not comparable with later propositions and proceedings. The first modern concepts and notions related as process were developed at late seventies. They originated from efforts to realize a vision of health for all and formulate national policies, strategies and plans of action for attaining this goal. The turning point was in 1981, when WHA adopted Global Strategy for Heath for All by the Year 2000. Since then one can observe considerable progress and new concepts came into existence, more and more precise and better reflecting the sense of health actions. The evolution of organizational dimensions of health was described in the context of brand positioning. It was assumed that first step of positioning was concentrated on structural dimensions of health. That served to awareness raise, attitudes change and motivation to action. That made a foundation to the next step--positioning based on process approach to health. Among others the following processes are described: (a) health for all, (b) health promotion, health in all policies, (c) health development, (d) health diplomacy, and (e) mainstreaming of health.

[Public health in Poland before World War II--lesson learned]. / Zdrowie publiczne w Polsce przed II wojna swiatowa--lekcja dla wspólczesnych.

The article discusses the most important legal acts regulating the activities of the institutions of public health in interwar period in Poland. Particular attention was paid to the Ministry of Public Health, municipal boards, the Office of the Extraordinary Commissioner for Combating Epidemics and the National Institute of Hygiene. The substantive scope of the Basic Sanitary Act of 19 July 1919 was presented. The scope of the Act was compared with 10 essential public health services as defined in 1994 in the U.S.A. A significant compatibility of views on public health in the past and present-day was reported. It was recalled that after World War II in Poland public health issues have been scattered into numerous acts. It was proposed to regard the Basic Sanitary Act as a hint when creating a present, a comprehensive law on the public health system.