The Prevalence of Neck and Back Pain among Paramedics in Poland.

Neck Pain (NP) and low back pain (LBP) are ubiquitous musculoskeletal conditions and some of the major causes of disability worldwide. The aim of the study was to assess the incidence and risk factors of back pain among paramedics and their correlation with the nature of work, anthropometric features and the level of recreational physical activity. A group of 201 individuals (39 females (19.40%); 162 males (80.60%)), licensed to practice as paramedics in Poland completed a questionnaire containing the author's interview as well as the Neck Disability Index (NDI) questionnaire and the Revised Oswestry Disability Index (ODI). Among the examined paramedics, 92% of the subjects reported the presence of back pain in different parts of the spine (36% C; 17% Th; and 85% LBP). The pain intensity, determined by VAS, was on average 4.26 (SD 1.77). The level of disability, assessed by NDI, was 7.67 (SD 5.73) on average, while the ODI was 7.51 (5.90). Work-related spinal strain has a major impact on the intensity and incidence of spinal pain. Spinal pain in paramedics mainly occurs in the lower back.

Illness Perception and the Severity of Depression and Anxiety Symptoms in Patients with Multimorbidity: Observational Cohort Studies.

INTRODUCTION: Many studies have shown a correlation between the patient's engagement in treatment and their perception of the illness. AIM: The aim of this study has been to explore the link between the patient's perception of their illness with anxiety and depression, and to leverage this link to promote health education. MATERIALS AND METHODS: The study was carried out using the following tools: the Hospital Anxiety and Depression Scale and the Illness Perception Questionnaire-Revised. The study participants included N = 143 patients. RESULTS: The participants' age was statistically significantly associated with the expected duration of the illness (p < 0.01), the conviction that the treatment was effective (p < 0.01), and the perception of the severity of the disease symptoms (p < 0.05). The employment status was statistically significantly associated with the illness perception (p < 0.01). Anxiety and depression levels were statistically significantly associated with the perceived impact of the illness on life (p < 0.001) and emotional status (p < 0.001), the perceived control over the illness (p < 0.01), the potential for recovery (p < 0.001), the concern about the illness (p < 0.001), and the impact of the illness on emotional well-being (p < 0.001). CONCLUSIONS: Individuals who perceived a high severity of illness symptoms also assessed that the illness significantly impacted their life and emotional state. The authors demonstrate a strong link of a "negative" perception of the illness with depression and anxiety. A better understanding of the illness predicted a less severe depression and lower anxiety. IMPLICATIONS FOR PRACTICE: The results suggest that the study of illness perception holds significant potential to contribute effectively to educational and psychotherapeutic practices.

Managing patients on extracorporeal membrane oxygenation support during the COVID-19 pandemic - a proposal for a nursing standard operating procedure.

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is effective in a selected critically ill patient population with promising results in refractory hypoxemia related to the novel coronavirus disease (COVID-19). However, it requires specialized clinicians and resources in advanced technology. Moreover, the COVID-19 remains an ongoing global emergency, and there is no evidence-based practice in preparedness. This article proposes an innovative and optimized nursing care protocol, the Standard Operating Procedure (SOP), that regulates safety and efficiency in using personal protective equipment (PPE) during ECMO-relevant procedures while providing ECMO therapy for patients with COVID-19. METHODS: After performing a narrative literature search, we developed a high-fidelity translational simulation scenario. It included practicing appropriate donning and doffing PPE during work organization, ECMO-related procedures, and routine daily nursing care and management of ECMO over nine hours. In addition, we held supplementary constructive debrief meetings to consult international expert in the field. RESULTS: A proposal for nursing standardized operating procedures was created, divided into categories. They included work organization, workload references, competences, infrastructural conditions, cannulation equipment, daily routine nursing care, and procedures during ECMO. CONCLUSIONS: High-fidelity medical simulation can play an important role in staff training, improvement in previously gained proficiency, and development of optimal SOP for nursing care and management during ECMO in patients with COVID-19. Optimal SOPs may further guide multidisciplinary teams, including intensive care units and interventional departments.

Health education for stroke patient carers: does it affect functional status improvement in patients after ischemic stroke?

AIM: The aim of the prospective cohort study was to assess the impact of the conducted carer training on functional status improvement in patients after stroke. BACKGROUND: In recent years, the role of family in unprofessional care provision for patients in their home environment has been emphasized. METHODS: The cohort comprised 157 patients after ischemic stroke. The study group consisted of 81 patients and their carers who participated in the education program, and the control group included 76 patients. We used a repeated measures design: the patients' functional status was assessed on the day of hospital discharge and after 3 and 12 months at home. RESULTS: After 12 months the patients' functional status according to Barthel Index and Modified Rankin Scale significantly improved in both groups, but no difference between the groups was noted in the degree of improvement achieved. CONCLUSIONS: The carers' participation in the education program did not significantly affect the patients' functional improvement.

[Elevated blood pressure as cardiovascular risk factor]. / Podwyzszone cisnienie titnicze jako czynnik ryzyka sercowo-naczyniowego.

Cardiovascular diseases for decades have been and still are the main and current health problem of the Polish society and there are many reasons for these diseases. Hypertension is one of the major risk factors for developing cardiovascular disease. The factors significantly increasing risk the of cardiovascular disease are in addition to high blood pressure, smoking (also passive), high blood fats (cholesterol and its HDL, LDL fractions as well as triglyceride levels, obesity, lack of exercise, diabetes and hereditary features. Other important factors which play an important role are external factors such as e.g. environmental pollution, lifestyle, stress. Prediction of cardiovascular disease should start from the evaluation of the fetal period because low birth weight may be a risk of coronary heart disease, hypertension, obesity or diabetes in adulthood. The authors of the referred tests showed that the level of blood pressure observed during childhood is closely associated with the level of blood pressure in adults and is also dependent on the body weight. Since the issue of the effects of high pressure on the cardiovascular system is inherent in the issue of the metabolic syndrome, it should be mentioned also that another causative factor may be an irregularity in the removal of urine from the body and the amount of insulin. The control of hypertension is a complex problem, at least in view of the wide range of adverse factors affecting the human body: hypertension is often either a constituent of other lesions. Therefore, it is difficult to treat high blood pressure in the strict sense; more often it is a combination therapy based on pharmacology caused for other reasons.

[Biochemical risk factors for cardiovascular disease in children]. / Wplyw biochemicznych czynników ryzyka na rozwój chorób serca i naczyn u dzieci.

The problem of finding the biochemical markers for determining cardiovascular risk is complex, difficult and multidisciplinary. Even in a simple biochemical blood test the number of possible variables significant for indicating the negative changes in the cardiovascular system is high. The image created from a variety of factors is fuzzy, inconclusive and sometimes difficult to define and explain. Contemporary cardiology uses fixed operative levels and the presence of biochemical factors as the basis for patient diagnosis. Even a thorough and multi-biochemical analysis can not give conclusive results. Many precautions are needed in using the results of biochemical analysis. Ambiguous results may be misleading, disrupt the analytical process, or suggest probable, but not necessarily the correct, solutions. This biochemical analysis presented points to the most important prognostic factors and biochemical information used in the cardiological treatment of children and adolescents.