The impacts of the COVID-19 pandemic on indirect costs of mental illness and behavioral disorders in Poland.

Introduction: In various research, the estimation of the disease's economic burden has been taken into consideration. But given the fact that different settings will have distinguished consequences, determining the economic burden of COVID-19 in the studied environment is of great importance. As a result, this study aimed to show the change in indirect costs of mental health problems due to the COVID-19 pandemic in Poland. Methods and Results: Indirect costs related to mental health problems were analyzed from the perspective of the Social Insurance Institution in Poland. In 2021, they amounted to about 285.8 billion PLN (Polish currency) [61.1 billion EUR (European currency)], up 6% from the previous year. A large increase in spending on disability benefits was observed for 2019-2021 (+14.7%). Disease groups generating the highest expenditures in the structure of total expenditures on incapacity benefits in 2021 in Poland were mental health problems (16.7% of total expenditures). Expenditures on disability benefits related to mental health problems incurred by Social Security in 2021 amounted to about 7.42 billion PLN [1.6 billion EUR] and were 19.4% higher than in 2019 (before the pandemic). In the 2012-2019 period, there was a significant decrease in expenses related to inpatient rehabilitation (41.3%), while in 2020-2021, these expenses decreased several times as the epidemiological situation related to the COVID pandemic reduced access to such services. Discussion: This is the first study on the economic burden of COVID-19 indirect costs in Poland. Calculating the economic impact is crucial, particularly when there is a large disease outbreak and countries are severely constrained by financial resources. Doing so could aid in the development of effective social security policies. As shown in this study, the indirect costs of absenteeism expenses due to mental health problems increased significantly during the COVID-19 pandemic. It is necessary to take all possible measures, both in the field of primary and secondary prevention, to prevent disability and exclusion from the labor market of people affected by mental health problems, which is justified by epidemiological data and financial data on the expenses incurred by Social Security for social insurance benefits.

Proper Dietary and Supplementation Patterns as a COVID-19 Protective Factor (Cross-Sectional Study-Silesia, Poland).

BACKGROUND: The COVID-19 pandemic has become a challenge for the world today, so it is very important to create healthy eating habits in society to support immunity and raise awareness of the benefits of supplementation. OBJECTIVE: The purpose of this study is to evaluate diet and dietary supplementation, since previous studies indicate the protective nature of these in building immunity during the pandemic and post-pandemic period (COVID-19). The hypothesis of the study is whether the dietary regimen presented by the COVID-19 respondents can be considered protective in building immunity against SARS-CoV-2. MATERIAL AND METHODS: The study included 304 subjects, with an average age of 39.04 ± 23.59. The main criteria for inclusion in the study were that the respondent was ≥18 years old and participated voluntarily. The study was conducted using an original questionnaire. RESULTS: In the study group, no change was noticed in the previous diet during the COVID-19 pandemic, while the level of physical activity among the respondents decreased. Too low a percentage of people regularly consumed, among other foods. legume seeds-only 10.5% of respondents consumed them several times a week-and citrus fruits-the largest number of respondents, as many as 39.8%, only consumed them several times a month. The largest percentage of respondents with mild/scanty COVID-19 disease regularly took vitamin C-containing preparations (n = 61; 59.80%). Statistical analysis showed that there was a correlation between the incidence of mild/scanty COVID-19 and the regularity of taking vitamin C-containing preparations (T = 11.374; r = 0.611; p = 0.04603). A statistical significance level was also obtained for the regularity of supplementation of multivitamin preparations, which were taken by 68% (34) of respondents affected by mild/scanty COVID-19 (T = 13.456; r = 0.711; p = 0.02191). CONCLUSIONS: The study's hypothesis was supported. Respondents characterized by a normal dietary pattern and taking supplements commonly recognized as immune "boosters" were more likely to mildly survive COVID-19. Moreover, it was shown that the pandemic in most of the respondents did not significantly affect their dietary strategy. It is reasonable to conclude that the dietary patterns adopted may be a common way to prevent SARS-CoV-2 infections and their possible complications.

Postpandemic Stress Disorder among Health Care Personnel: A Cross-Sectional Study (Silesia, Poland).

Background: Postpandemic stress disorder (PPSD) is an unofficial term that refers to posttraumatic stress disorder (PTSD), a mental disorder resulting from increased stress, anxiety, and trauma associated with unpleasant life experiences. Many scientific studies indicate that symptoms of increased stress, job burnout, anxiety, and depressive disorders are associated with medical personnel performing their professional duties around COVID-19 patients. Objective: The purpose of this study was to assess the prevalence of symptoms that may indicate the presence of PPSD symptoms-depression, anxiety, and stress-in medical personnel. Material and Methods. The survey included 300 people, representatives of medical personnel. The group was divided into two sections. The first section numbered 150 and consisted of personnel in direct contact with COVID-19 patients (FR); the second group also consisted of 150 medical professionals, who but no longer directly involved in helping with COVID-19 cases (SR). The survey was conducted by indirect survey method using CAWI (computer-assisted web interview). The survey used a questionnaire technique. A proprietary tool enriched with standardized psychometric scales: BDI, GAD-7, FCV-19S, and PSS-10 was used. Kruskal-Wallis and Mann-Whitney U statistical tests were used in the statistical processing of the data. The probability level was 0.05. Results: Statistical inference made it clear that mental health problems that may indicate trauma are mainly present in the FR group. These symptoms decreased slightly in comparison between periods 2020 and 2021 (p < 0.05). Conclusions: The COVID-19 pandemic significantly increased the prevalence of depression, anxiety, and stress among first responders. To ensure the psychological well-being of first responders, early assessment and care of mild depression, anxiety, and stress should be promoted to prevent the development of moderate and severe forms.

Polish Adaptation of the Modified Tampa Scale of Kinesiophobia for Fatigue (TSK-F) and the Revision of the Tampa Scale in Terms of Pain for Cancer Patients.

The aim of this study was to create a Polish adaptation of the Tampa Scale of Kinesiophobia considering fatigue, and to verify the usefulness of the scale in the context of pain in cancer patients. The study was conducted at the Breast Cancer Unit, operating at the Greater Poland Cancer Centre, and at the Poznan Centre for Specialist Medical Services in Poznan. After considering the exclusion criteria, 100 people qualified for the interviews for the final study: 50 breast cancer patients and 50 healthy respondents (without cancer). Statistical analysis of the CFA score showed that the chi-square test was not significant (χ2 = 10.243, p = 0.332), indicating an acceptable fit of items across scales. The reliability of the internal consistency of the scales was tested by examining the Cronbach's alpha scores for each question/statement. The mean values for this indicator were 0.74 for the pain-related scale and 0.84 for the fatigue-related scale. Construct validity was confirmed for the scales; AVE for the pain-related scale was 0.64 and for the fatigue-related scale was 0.68. The results suggest the validity of examining kinesiophobia in the context of pain- and fatigue-related mobility anxiety among breast cancer patients in Poland, and that the Tampa Scale of Kinesiophobia can be adapted for different dimensions of the condition. Both versions of the scale demonstrated adequately prepared parametric constructs, and all correlations showed a statistically significant relationship (p < 0.05). The use of the Tampa Scale of Kinesiophobia in oncology patient studies in Poland may ultimately improve rehabilitation programs and enable the development of strategies to assist patients in supporting treatment to reduce movement anxiety.

Local Governments Spending on Promoting Physical Activity during 2015-2020: Financial Data and the Opinion of Residents in Poland.

INTRODUCTION: The COVID-19 pandemic has significantly affected local governments involved in sports and recreation in designated areas. The unprecedented scale of the spread of the disease has led to increased research in the area of the disease, considering various correlations. However, little has been written about the impact of the pandemic on local government spending on recreation and sports services in Poland. OBJECTIVE: The purpose of the article is to assess the level of local government involvement in the implementation of sports and recreation in Poland compared to other European Union countries, as well as changes in this level in connection with the emergence of the COVID-19 pandemic in the opinion of respondents. METHODOLOGY: In the study, the data regarding expenditures of local government units on recreational and sporting services collected in the Statistical Office of the European Union (EURO-STAT) for 2015-2020 were used. The survey portion was conducted among 1600 respondents who provided answers on a 5-item scale that addressed local government involvement in promoting physical activity among residents during COVID-19. RESULTS AND CONCLUSION: Local government spending on recreational and sporting services in Poland between 2015 and 2019 increased by about 38%, from EUR 1524.7 million in 2015 to EUR 2103.5 million in 2019. This spending in 2019 was about 40% higher than the average for European Union countries. In contrast, in 2020 it amounted to more than EUR 1886 million and was more than 10% lower compared to the previous year (2019)-the pre-pandemic period. Despite the obstacles caused by the COVID-19 pandemic and budgetary constraints, cities in Poland took several measures in 2020 to maintain the current pace of development and strived to maintain the status of modern, green, and open, betting on balanced development also in aspects related to sports or culture. It was shown that the opinion of respondents mostly coincided with the existing financial state-in voivodeships where there had been a decrease in spending related to sports and recreation compared to the pre-pandemic period, residents are worse at assessing the activities of local governments related to promoting physical activity.

Nutrition and mental health: A review of current knowledge about the impact of diet on mental health.

Applied psychopharmacotherapy and psychotherapy do not always bring the expected results in the treatment of mental disorders. As a result, other interventions are receiving increasing attention. In recent years, there has been a surge in research on the effects of nutrition on mental status, which may be an important aspect of the prevention of many mental disorders and, at the same time, may lead to a reduction in the proportion of people with mental disorders. This review aims to answer whether and to what extent lifestyle and related nutrition affect mental health and whether there is scientific evidence supporting a link between diet and mental health. A review of the scientific evidence was conducted based on the available literature by typing in phrases related to nutrition and mental health using the methodological tool of the PubMed database. The literature search yielded 3,473 records, from which 356 sources directly related to the topic of the study were selected, and then those with the highest scientific value were selected according to bibliometric impact factors. In the context of current changes, urbanization, globalization, including the food industry, and changes in people's lifestyles and eating habits, the correlations between these phenomena and their impact on mental state become important. Knowledge of these correlations creates potential opportunities to implement new effective dietary, pharmacological, therapeutic, and above all preventive interventions. The highest therapeutic potential is seen in the rational diet, physical activity, use of psychobiotics, and consumption of antioxidants. Research also shows that there are nutritional interventions that have psychoprotective potential.

The Level of COVID-19 Anxiety among Oncology Patients in Poland.

Cancer patients tend to have a high psychological burden. Half of cancer patients suffer from severe affective disorders and anxiety disorders, while one-third struggle with mild forms of these. The COVID-19 pandemic is damaging the mental health of the population due to social restrictions. A growing number of studies note the role of COVID-19 anxiety in the health and quality of life of cancer patients. The purpose of this study is to estimate the level of COVID-19 anxiety among oncology patients and to test the utility of the FCV-19S scale in a population study of cancer patients. The study included 600 respondents (300 oncology patients and 300 control subjects not undergoing oncological treatment). The FCV-19S scale and the GAD-7 scale were used in the study. The results were interpreted according to the following verbal scale: 76-100%, high anxiety; 56-75%, moderate anxiety; 26-55%, low COVID-19 anxiety; <25%, no COVID-19 anxiety. In the analysis of the GAD-7 questionnaire results, the mean score obtained was 8.21 (min. 0; max. 21; SD 5.32). For 81% of respondents in the group of oncology patients, the total score indicated the presence of anxiety symptoms with varying degrees of severity; in the control group, this proportion was 55% of respondents. The FCV-19S scale score as a percentage was 57.4% for oncology patients, indicating a moderate level of fear of the SARS-CoV-2 virus, and 30.3% for the control group, indicating a low level of fear of the SARS-CoV-2 virus. One-fifth of oncology patients were afraid of losing their lives due to the SARS-CoV-2 virus; in the control group, this proportion was 13% of respondents. Oncology patients were characterized by a higher prevalence of sleep disturbance than control group respondents, which was associated with greater anxiety. The study, therefore, shows that oncology patients have moderate levels of anxiety associated with the COVID-19 pandemic, and non-oncology patients show lower levels of anxiety.

Does Maternal Obesity Affect Preterm Birth? Documentary Cohort Study of Preterm in Firstborns-Silesia (Poland).

In addition to low birth weight and intrauterine growth restriction, prematurity is a major problem in modern neonatology. The etiology of premature delivery is multifactorial, but maternal obesity has been indicated as an important risk factor for preterm birth. This study aimed to assess the relationship between early pregnancy body mass index (BMI) and the risk of preterm delivery according to gestational age. In the cohort of 2794 firstborns, preterm deliveries accounted for 9.1%. Of all deliveries, 16, 48, and 189 were classified as extremely preterm, very preterm, and moderately preterm deliveries, respectively. The risk of extremely, very, and moderately preterm deliveries increased with the increasing BMI, with the highest overweight and obesity-related risk for extremely and very preterm delivery. The rate of extremely and very preterm delivery among normal-weight women (BMI 18.5 ≤ 25) was 1.8%, while that among overweight and obese women (BMI ≥ 25) was 2.36%. The rate of all preterm deliveries (22 ≤ 37 weeks) was 8% for normal-weight women and 10.3% for overweight and obese women. Compared with normal-weight women, the adjusted odds ratio (95% CI) for preterm delivery in overweight and obese women was 1.33 (0.98-1.79). In Poland, being overweight and obese during pregnancy was associated with an increased risk of preterm delivery, especially extremely and very preterm delivery. This relationship should be assessed in other populations.

Global Elderly Migrations and Their Impact on Health Care Systems.

Demographic transitions that occur in decreased dynamics of natality and rising number of elderly in population structures constitute a challenge for all national economies. Another global phenomena are large-scale migration processes driven by intensification of globalization process, development of technologies, and telecommunications. Although both these phenomena were vastly addressed in many ways in scientific literature, a notifiable fact is that there are only few researches that would investigate them in connection and consider migration of older people and its consequences, especially for health systems. Despite the fact that generally the likelihood of migrations reduces along with age, in some countries a higher share of migrants older than 65 years in reference to the entire group of migrants are being observed. It is the more essential that groups of seniors represent an increasing percentage of people. There are also differences in between standard reasons for migrations in young people and the factors affecting migrations in elderly ones. Many variables can influence migration decisions among older people, and they can be affected by seniors' health conditions, levels of health care within the target countries they migrate to, and the living standards. Such factors as population aging, reduced fertility, and international migration have affected the changes in demographic profiles of many countries. The consequence of migration decisions in the group of seniors is, among others, the impact on health care systems of single nation states, which are more and more important elements of economic, social, and financial systems.

Oncological Diseases and Social Costs Considerations on Undertaken Health Policy Interventions.

The growing incidence and prevalence of civilization diseases is prompting national and transnational entities to seek instruments that would reverse epidemiological trends. Not without significance is the need to design such solutions that are going to provide an improved relation between the costs incurred to maintain health or recovery and the profit for citizens of continuing to function in good health. In its strategic documents, the European Union indicates the most important development goals in each financial perspective and the tools necessary to achieve them. In the Europe 2020 strategy, a cohesion policy was indicated as an important tool for the implementation of development goals, focusing on supporting activities leading to the equalisation of economic and social conditions in all regions of EU countries. The implementation of one of the three basic priorities of the Europe 2020 strategy, which is inclusive growth-supporting an economy with a high level of employment and ensuring social and territorial cohesion-assumes, among others, that in 2020, the population at risk of poverty and social exclusion will decrease by 20 million and that the employment rate in the EU will increase to 75%. Meeting the objectives will not be possible without a holistic coordinated approach to healthcare at the national and regional level in accordance with the principle of "health in all policies". It also requires the involvement of various sources of financing, including structural funds. The EU's prioritisation of the problems related to ensuring decent conditions for achieving health resulted in the mobilisation of structural funds for actions taken in the healthcare sector. Of particular importance are those actions which are taken to prevent, alleviate, and prevent oncological diseases. An additional contribution to undertaking actions aimed at preventing oncological diseases are the high and often neglected social costs incurred by societies. The goal of the article was to identify and evaluate actions taken in this area in Poland. It was achieved by analysing the literature on the subject and statistical data, and conducting induction based on the above-mentioned sources.

Electrocardiographic criteria for left ventricular hypertrophy in aortic valve stenosis: Correlation with echocardiographic parameters.

BACKGROUND: Aortic valve stenosis (AS) generates a chronic pressure overload that induces left ventricular hypertrophy (LVH). The aim of this study was to assess the prevalence of the electrocardiographic criteria for LVH in patients with clinically significant AS and to evaluate the relationship between the ECG criteria for LVH and echocardiographic parameters. METHODS: The clinical data of 95 patients with moderate to severe AS were retrospectively analyzed. Eight ECG criteria for LVH were used and compared to the results of transthoracic echocardiography (TTE). RESULTS: In 59% of patients, at least one of the ECG criteria for LVH was found. These patients had a greater LVMI (142.1 ± 35.6 vs. 124.1 ± 22.5 g/m2 , p = 0.01) and peak aortic jet velocity (4.2 ± 0.8 vs. 3.8 ± 0.9 m/s, p = 0.01) along with smaller aortic valve area (0.72 ± 0.28 vs. 0.86 ± 0.22 cm2 , p = 0.02) compared to patients with a negative ECG for LVH. The ECG parameters had a low sensitivity (6%-36.9%) with a specificity of up to 100%. The Cornell Voltage criteria had the best sensitivity with a specificity of 63.6% and the highest correlation with the LVMI (r = 0.38, p < 0.001). All of the ECG parameters correlated positively with the peak aortic jet velocity as well as with the mean aortic gradient. CONCLUSION: The electrocardiographic criteria for LVH in patients with moderate or severe AS have a poor sensitivity in identifying LVH confirmed by TTE. The values of the selected ECG criteria for LVH correlate weakly with both the TTE indices of LVH and the markers of AS severity.

The organization and financing of cervical cancer prevention carried out by midwives in primary health care.

OBJECTIVE: The main objective of the project was the evaluation of the organizational and financial aspects of midwives in primary health care (PHC), functioning under The Population Program for the Early Detection of Cervical Cancer two years after the implementation of new law regulations, which enable this occupational group to collect cytological material for screening. MATERIAL AND METHODS: Under this project, the data of the Program's Coordinating Centre, affecting midwives' postgraduate education in the field of pap smear tests, was taken into analysis. Furthermore, The National Health Fund (NFZ) reports on contracts entered in the field of the discussed topics, taking into consideration the value of health services performed within the Program in respect of ambulatory care and primary care units. RESULTS: NFZ concluded contracts for the provision of PHC service with 6124 service providers in 2016, including the contracts in the field of providing health services under the cervical cancer prevention program by PHC midwifes, which were entered into by 358 institutions (5.85%). The value of the basic services under the Program, carried out under NFZ contracts in 2014, amounted to approx. PLN 12.3 million, while the value of services performed by PHC midwives represented only 0.38% of this sum. CONCLUSIONS: The introduction of legislative changes, allowing PHC midwives to collect cytological material for screening, did not cause, in the period of the observation on a national scale, the expected growth of availability of basic stage services within the cervical cancer prevention program.

[Treatment costs of malignant cervical cancer in Poland in 2011-2012--the case of Silesian Voivodeship]. / Koszty leczenia nowotworów zlosliwych szyjki macicy w Polsce w latach 2011-2012 na przykladzie województwa slaskiego.

OBJECTIVES: As far as health economics is concerned, it is hard to determine the only useful tool which would disclose the actual costs associated with cancer. We analyzed hospitalization costs, which create the highest rate among all malignant cervical cancer-related medical costs. The main aim of the study was to evaluate the real costs of medical treatment in the case of patients diagnosed with cervical cancer based on the group with the primary and coexisting diagnoses. MATERIAL AND METHODS: The analyzed data from 2011-2012 were obtained from the Silesian branch of the National Health Fund, which financed medical expenses due to the diagnosis of cancer in health facilities which have the agreement for such treatment. RESULTS: A total of 4 540 hospitalization-related health benefits were realized, with the final total cost was PLN 8 766 547, in the presented group of 2261 patients. The most popular procedures in patients with the diagnosis from the C53 group, included chemotherapy together with oncological hospitalization (over 62%). The vast majority of the realized procedures were treatments of the reproductive system (38%) and teleradiotherapy (about 31%). CONCLUSIONS: Lack of efficient procedures of data collection for cancer advancement hinders the economic analyses, which should constitute the foundation for the discussion about cost effectiveness of selected procedures. Adequate methods for the monitoring of direct and indirect costs associated with cervical cancer treatment ought to be created.

Nutritional education in the primary prevention of osteoporosis in perimenopausal and postmenopausal women.

Osteoporosis affects millions of people in the whole world and brings about far-reaching physical and psycho-social consequences for patients and financial ones for the health care system, and therefore it is classified as one of public health problems and treated as a social disease. Women belong to the increased osteoporosis illness risk group due to lower top bone mass reached earlier in life as compared to men and due to hormonal changes occurring in the menopausal period, which affect loss of the bone mineral density (BMD). Limitation of the osteoporosis-related financial and social costs increase requires efficient preventive actions on the level of early, primary, secondary or tertiary prevention. At all the four osteoporosis prevention phases, the crucial role is played by health education and nutrition education, the latter being the key element of the former one. The nutritional education purpose is to acquaint patients with nutrition recommendations that are the basic element of the osteoporosis prevention and to make them change their nutrition habits, which will improve their osseous metabolism. The education should be based on results of the latest scientific researches and focus on recommendations relating to proper supplementing of calcium and vitamin D, simultaneously including all the other nutrition components, necessary to decrease the osteoporosis risk. The primary prevention oriented to a specific group at risk for osteoporosis, including peri- or postmenopausal women, should be provided in cooperation with the different levels' medical professionals and it should focus on causing positive changes in patients both as regards nutrition habits and physical activities.