Expectations of Patients Recovering from SARS-CoV-2 towards New Forms of Pulmonary Rehabilitation.

The purpose of this study was to explore the experiences of patients attending an innovative technology-enhanced pulmonary rehabilitation program of National Health Found Program in Poland. The study included two groups of patients participating in post-COVID-19 stationary rehabilitation. Patients from group I (127 individuals) contracted COVID-19 in 2020, while patients from group II fell ill in 2021 (68 individuals). The study used a self-administered questionnaire. This study was designed as an acceptability study. In the experience related to COVID-19 in both groups of the respondents, the possibility of undertaking inpatient rehabilitation in a hospital ward played an important and positive role. Patients who experienced COVID-19 symptomatically expected that rehabilitation would eliminate the related dysfunctions, such as reduced respiratory efficiency of the lungs, disorders of the nervous system, and cognitive disorders (the so-called brain fog). All respondents who experienced symptomatic COVID-19 positively assessed the rehabilitation program offered. Among the highest-rated rehabilitation, elements were identified: exercise on a cycle ergometer implemented with video stimulation, group fitness exercises, and breathing exercises. Other innovative forms of rehabilitation were positively evaluated by 10% to 25% of patients.

[Historical context of parasitological studies in tropical area, malaria as an example]. / Historyczne konteksty parazytologicznych badan w tropiku, na przykladzie malarii.

Review paper deals with the historical analysis of intellectual activity of some famous parasitologists working in tropics on malaria in the XIX/XX century: A. Laveran (1845-1922), R. Ross (1857-1932), P. Manson (1844-1922), B. Grassi (1854-1925), and other Nobelprize researchers: P. H. Müller (1899-1965) and J. W. von Jauregg (1857-1940). Those chief investigations are interpreted from the point of view of the so-called anthropology of knowledge based on L. Fleck's (1896-1961) philosophy and sociology of science. Parasitological investigations, especially in the field of malaria, were undertaken in the developed economically countries in answer to the social demands. It was connected with development of colonies and the needs of stabilization of epidemiological situation in tropics. To mid of the eigthies of 19th century the lack of positive effects resulted from the theoretical barriers and conservative thinking style of the European academic society. It caused that great parasitological discoveries of the etiological agents of parasitic diseases (like plasmodia, life cycle in malaria) took place behind university circles. They were done by the physicians - general practitioners--in the colony areas. Doctors A. Laveran, P. Manson and R. Ross were not restricted by traditional standards and the obliging normative concepts in the academic naturalism. Those medical men worked out a new impulse for parasitology and supported an idea based on the rule that each disease should be assigned with the materialistic biological factor (pathogen). In the years 1800-1900 the old and a new concepts were competed in the natural sciences and medicine. Near year 1900 a new way in the context of modern interpretations was brought into general use. It was proved experimentally that etiological theory of parasitic disease was more practically usuful. It resulted in the formation of the effective prophylactic theory as well as the development of research in the field of chemotherapy. For that reason this thinking style was accepted by the state authorities and armies interested in possessing colonies. The governments organized and financed scientific institutes of tropical medicine and the hygienic parasitological journals. Also the researchers (A. Laveran, R. Ross, P. Manson) were rewarded for their epoch-making investigations in tropical disease problems. At the same time the progress in parasitology was prompted and the old theories in old thinking style were eliminated as false because of their practical uselessness. Their followers lost status of authorities. This analysis proved that external factors of science, i.e. social needs in historic periods play real role in the promoting of changes of scientific standards in the perception of new standards. Social needs form the broad social-cultural context of scientific activity and they influence seriously the way of thinking and investigations practice.

[Scientific standards in parasitology in historical perspective]. / Standardy naukowe parazytologii w kontekscie historycznym.

An analysis of scientific standards in parasitology was carried out from the perspective of anthropology of knowledge - a new discipline that emerged from non-classical history science in the 1990s. The history of parasitology, its development and limitations, are presented in a broad socio-cultural context, as the answers of scientists to different social needs in historical periods. In parasitological history there are some periods characteristic for all newly emerging disciplines of natural science. The first systematic account of natural phenomena and their interpretations was initiated in the 16th century and continued till the mid 18th century. It was a period when the phenomena could not be explained in a proper way by the existing and accepted theories. The epidemic diseases were one of these phenomena which were interpreted based on ancient ideas, mostly humoral pathology. In the 16th century a new contagium concept of material factors (pathogenes) that could be spread by contact among humans or close association was formed. This hypothesis, however, was not widely accepted because it contradicted the well-established normative concepts in the European academic naturalism. The development of parasitology was stopped because of theoretical barriers and interpretation difficulties (non-materialistic standard of naturalism, humoral pathology and spontaneous theory). In the second half of the 18th century, the theoretical crisis in natural sciences gave a new impulse for many disciplines; among others, parasitology entered in its second stage of development. The collected observations were classified in a new way and in the context of new interpretations. The progress in parasitology was prompted by the intensified urbanization, rapid increase of European population as well as by wars connected with infections and epidemics. It resulted in two competitive research programs (the French and the German). On the basis of the same observations, they advanced different theoretical interpretations. The third period in the history of parasitology lasted from the mid 19th century to the end of World War I. At that time a common agreement was established in all Europe, with regard to interpretation of standards inspired by positivism, i.e. verification of empirical statements through observation. Parasitology emerged as a separate discipline. Theoretical barriers limiting its progress and setting the questions were overcome. The contagion concept was reinstated. The colonial conquests solving demography problem provided the most important social impulse for the progress in parasitology. It was supported by governments interested in having their colonies free from diseases, mainly malaria and other tropical diseases, and thus safe for the European pioneer settlers. There was also development of parasitological scientific institutions (institutes of tropical medicine) and didactics. After World War I parasitology entered the fruitful stage of discipline development which resulted in a division into subdisciplines and a progress of new scientific fields. Its theoretical standards have become fixed and provided a basis for preventive programmes against parasite diseases, supported financially by European goverments, USA and some other countries. Those programmes were executed both in the home countries and in the colonies. After World War II, in the fourth stage of parasitology development, attention was mainly paid to local natural environment in order to diagnose parasites and their vectors. At the same time, parasitology became an applied science practiced in many specialized centres not only at universities. Presently, the main aims of parasitology are studies on biodiversity of parasites and environmental protection in the developed countries, and within tropical medicine as the travel medicine, because of rapid increase of tourism.

[The influence of changes in the human subjectivity concept of formation of physician-patient relations]. / Wplyw zmian koncepcji podmiotowosci czlowieka na ksztaltowanie sie relacji lekarz-pacjent.

Changes in the human subjectivity concept, expressing influences of cultural and outlook elements on formation of object of the European medicine, have so much affected evolution of the discipline, that it is currently directed to bring an image of a human body to anatomy, to treat a course of a disease in medical aspect and to give to diagnostic processes and therapy a character of means which can be verified in an empirical way. The changes are also reflected in a patient - physician relation, which develops in that time. A direct nature of contacts between the treated and the treating persons was taken as grounds of the relation. But reasons of the privileged position of therapists in comparison to patients have changed. The paper aims to show main trends in development of the patient -physician relationship and to represent the changing reasons for superiority of the treating persons who are in a therapeutic relation with a patient.

[Anti-positivist inspiration in European medical historiography in the 20th century]. / Inspiracje antypozytywistyczne w Europejskiej historiografii medycyny w XX stuleciu.

The article presents the most important anti-positivist (the neo-romantic, socio-cultural and relativistic) currents in 20th century European medical historiography. The author discusses the genesis of the anti-positivist opposition in the medical historiography, starting with a presentation of the main points of the positivist programme, and shows the reasons behind the earlier broad reception of this programme by medical historians from the medical profession. The author attributes the emergence of an anti-positivist opposition in this milieu mainly to the medical progress which occurred in the first half of the 20th century and which induced some doctors, engaged in research into medical history, to reject the positivist model of teaching and replace it wit another. This factor played a leading role in the formation of the socio-cultural and relativist currents. According to the author, the second important factor in the birth of this opposition is the 20th century progress in the methodology of historical research, which freed itself from the constraints of positivist scientism as the only acceptable method of interpreting facts. The author also discusses the socio-cultural and political conditions which led to the formation and spread of the neo-romantic movement solely in Germany. The article presents the programme principles and the most important representatives of anti-positivist currents in European (mainly German) and the circumstances behind the reception of each current by the community of medical historians, and presents the development prospects of Polish medical historiography on the treshold of the 20th and 21st centuries, in connection with the research into this field of science undertaken by a large and continuously growing number of university-educated researchers.