Association of the bitter taste genes TAS2R38 and CA6 and breast cancer risk; a case-control study of Polish women in Poland and Polish immigrants in USA.

It is known that the perception of bitterness is mediated by type 2 bitter taste receptors (TAS2Rs). However, recent reports have suggested that the carbonic anhydrase 6 (CA6) gene may also influence bitterness sensing. Genetic variants in these genes could influence dietary intake of brassica vegetables, whose increased consumption has been observed in the literature, though inconsistently, to decrease breast cancer (BC) risk. We hypothesized that the estimated odds ratios (ORs) for the association between BC and taster diplotype (PAV/PAV) and/or genotype A/A, will be in the direction of increased BC risk, potentially due to reduced consumption of brassica vegetables. Using a case-control study of BC in Polish women in Poland (210 cases and 262 controls) and Polish immigrant women to USA (78 cases and 170 controls) we evaluated the association of the taster diplotypes in TAS2R38 gene and genotypes in the CA6 gene and BC risk in these two populations individually and jointly. No significant increase in risk was observed for the TAS2R38 PAV/PAV diplotype (tasters) in each population individually or in the joint population. For the CA6 gene, in the joint population, we observed an increased BC risk for the combined G/A and G/G genotypes (non-tasters) vs A/A (tasters), OR = 1.41 (95% CI 1.04-1.90, p = 0.026) which after adjustment for False Discovery Rate (FDR), was not significant at p≤0.05 level. However, for the joint population and for the combined genotype of the two genes AVI/AVI+G* (non-tasters) vs. PAV/*+A/A (tasters), we observed a significant increase in BC risk, OR = 1.77 (95%CI 1.47-2.74, p = 0.01), for the non-tasters, which remained significant after FDR adjustment. In conclusion for the joint population and the joint effect for the two bitter sensing genes, we observed an increase in BC risk for the bitterness non-tasters, association which is in the opposite direction to our original hypothesis.

Reversed urban-rural gradient in COVID-19 seroprevalence and related factors in a nationally representative survey, Poland, 29 March to 14 May 2021.

BackgroundWe anticipated that people in rural areas and small towns with lower population density, lower connectivity and jobs less dependent on social interaction will be less exposed to COVID-19. Still, other variables correlated with socioeconomic inequalities may have a greater impact on transmission.AimWe investigated how COVID-19 affected rural and urban communities in Poland, focussing on the most exposed groups and disparities in SARS-CoV-2 transmission.MethodsA random digit dial sample of Polish adults stratified by region and age was drawn from 29 March to 14 May 2021. Serum samples were tested for anti-S1 and anti-N IgG antibodies, and positive results in both assays were considered indicative of past infection. Seroprevalence estimates were weighted to account for non-response. Adjusted odds ratios (AORs) were calculated using multivariable logistic regression.ResultsThere was serological evidence of infection in 32.2% (95% CI: 30.2-34.4) of adults in rural areas/small towns (< 50,000 population) and 26.6% (95% CI: 24.9-28.3) in larger cities. Regional SARS-CoV-2 seroprevalence ranged from 23.4% (95% CI: 18.3-29.5) to 41.0% (95% CI: 33.5-49.0) and was moderately positively correlated (R = 0.588; p = 0.017; n = 16) with the proportion of respondents living in rural areas or small cities. Upon multivariable adjustment, both men (AOR = 1.60; 95% CI: 1.09-2.35) and women (AOR = 2.26; 95% CI: 1.58-3.21) from these areas were more likely to be seropositive than residents of larger cities.ConclusionsWe found an inverse urban-rural gradient of SARS-CoV-2 infections during early stages of the COVID-19 pandemic in Poland and suggest that vulnerabilities of populations living in rural areas need to be addressed.

Acceptance of Illness and Coping with Stress among Patients Undergoing Alcohol Addiction Therapy.

(1) Background: Acceptance of illness is a process in which a person with an illness accepts its presence and treats it as an integral part of their life. With regard to alcoholism, acceptance of illness is one of the important elements of the healing process. (2) Methods: The study group consisted of 104 residents in an addiction treatment ward. Questionnaires SOC-29, AIS and PSS-10 were used to check levels of coherence, stress and acceptance of illness. The analysis was based on regression analysis. Patient age was analysed as a moderator of correlations between perceived indicators. Moderation analysis was based on the simple moderation model. (3) Results: The level of perceived stress correlated negatively with all areas of the sense of coherence and with acceptance of illness. All areas of the sense of coherence correlated with acceptance of illness positively. (4) Conclusions: The acceptance of illness by the patient is a factor that can be motivating for further treatment, through a positive approach to illness and strengthening the sense of control in experiencing it. The combination of strengthening behavioural, cognitive and motivational resources can be used in the treatment of people experiencing the challenges of addiction to alcohol.

The COVID-19 Crisis and the Incidence of Alcohol-Related Deaths in Poland.

BACKGROUND Identifying risk and protective factors for excessive alcohol consumption can inform targeted health policies, reducing the impact of potential mental health crises. This study examined the validity and reliability of COVID-19-related death data and explored the correlations among age, sex, residential status, alcohol abuse, and healthcare access. MATERIAL AND METHODS This analysis of Polish residents' mortality relies on individual data from the register of deaths maintained by Statistics Poland. This study examined deviations in the number of deaths between 2020 and 2021 by analyzing specific causes of death. RESULTS Alcohol abusers had increased COVID-19 risk factors compared to the general population. F10 values were 22% higher than expected in 2020, aligning with predictions for 2021. Higher mortality rates were observed in the first year of the pandemic. In 2020, women and rural residents were more affected (31% and 25% higher than expected, respectively), while men and urban residents were less affected (21% and 20% higher than expected, respectively). In 2021, the trend reversed, with men 2% higher than predicted and women 4% lower. Urban area residents had a 77% lower than expected value, while rural area residents were similar (8% higher). Overall mortality exceeded expectations in both 2020 (13% higher) and 2021 (23% higher). In 2021, alcohol-related non-mental health problems increased by more than 40% in standardized death rates (SDRs). CONCLUSIONS Alcohol-related deaths reflect the hidden effects of the pandemic. Measuring the pandemic's impact on global excess mortality is hindered by inconsistencies in COVID-19 death reporting.

Ukraine refugee crisis: evolving needs and challenges.

This case report examines the initial experience of Poland in responding to the refugee crisis triggered by the war in Ukraine. In the first 2 months of the crisis, more than 3 million Ukrainian refugees fled to Poland. The large influx of refugees rapidly overwhelmed local services and led to a complex humanitarian emergency. The initial priorities were to address basic human needs, such as shelter, infectious disease concerns and healthcare access, but evolved to include mental health, non-communicable diseases and protection needs. This necessitated a 'whole of society' response involving multiple agencies and civil society. Emerging lessons learned include the need for ongoing needs assessments, robust disease monitoring and surveillance, as well as flexible multisectoral responses that are culturally sensitive. Finally, Poland's efforts to integrate refugees may help mitigate some of the adverse consequences of the conflict-related migration.

Influence of Selected Indicators of Healthcare System Functioning Evaluation on the Health Result.

BACKGROUND: According to the World Health Organization's statistics, 7 of the 10 main causes of death in 2019 were noncommunicable diseases. Health indicators are measures used to evaluate public health system effectiveness and functioning. Monitoring mortality rates from leading causes, life expectancy and other health indicators is essential to address their causes and adapt health systems to react adequately. The aim of this study is to present the dependencies of selected health care indicators and health outcomes. METHODS: Based on the literature review conducted, selected health indicators, along with healthcare system data, were analyzed using Pearson's r correlation. The analyses included data from the Organization for Economic Cooperation and Development (OECD) presented in statistics and the Health at a Glance 2021 report and data collected as part of the preparation of the Financing Global Health 2020 report by the Institute for Health Metrics and Evaluation. RESULTS: Health system resources are linked to health outcomes. The number of medical consultations, the number of nurses per patient or the level of financing of services under general health insurance are related to life expectancy and deaths due to causes that could have been avoided or treated. CONCLUSIONS: Life expectancy is positively correlated with access to general health insurance and public expenditure on healthcare. There is a need for all countries to provide their citizens with broad access to healthcare services.

Implementation of the Patient Counselling Service at the Cancer Hospital in Radom, Poland.

Background: Non-adherence occurs in various groups of patients, including those with chronic diseases. One strategy to increase adherence among oncological patients is to individualise treatment and expand pharmaceutical care. Pharmaceutical labels that remind patients how they should take their medications are of great importance in this respect. Objective: The main objective of this study was to evaluate medication adherence in oncological patients, and to gather their opinions on the individual medication labelling system as an element of effective treatment. Methods: The study was conducted in 2021 among 82 patients of the oncological department of the Centre of Oncology in Radom. The research tool was a questionnaire consisting of personal data and two parts relating to the patient's disease and the medication labelling system. Results: Nearly half of the respondents reported that they forget to take medications and how they should take them. These problems increased with the age of the patient and the number of administered medications. Of the respondents, 89% stated that the labels with dosing information are helpful. Over 67% agreed that these labels should be affixed to all medications. Nearly 90% of the respondents believed the labels should be available in all pharmacies. Conclusions: Non-adherence is a common phenomenon among oncological patients. Pharmacists providing a labelling service for medicinal products can play a significant role in reducing this phenomenon.

Quantitative analysis of RT-PCR test results for SARS-CoV-2 diagnostics across Poland during COVID-19 pandemic: Comparison between early stage and major pandemic waves in 2020 and 2021 with reference to SARS-CoV-2 variants.

PURPOSE: From April to September 2020, Poland was minimally affected by COVID-19 compared to other EU countries. We aimed to investigate the risks of false reverse transcription polymerase chain reaction (RT-PCR) results during the first wave (compared to later waves), that rises when cycle threshold (Ct) of positive result is close to limit of detection (LOD). MATERIALS/METHODS: We analyzed Ct values of SARS-CoV-2 positive RT-PCR results of 7726 patients in Poland from April-September 2020. SARS-CoV-2 positive RT-PCR results of 14,534 patients in the 2nd-3rd wave and 10,861 patients in the 4th-5th pandemic waves were used. Statistical analysis was based on one-way analysis of variance. To verify, 95% confidence intervals with Bonferroni correction were computed. Incidence of SARS-CoV-2 variants in Poland was analyzed using Whole Genome Sequencing from 923 (3.6%) patients. RESULTS: The mean Ct of RT-PCR positive test results analyzed ranged between 22.89 and 26.71 depending on the month of the results collection. The differences between months were significant (p â€‹< â€‹0.001). Differences in Ct were observed between age groups, with younger patients displaying higher Ct values, however, major trends over time were paralleled between age groups. CONCLUSIONS: The mean Ct of the tested RT-PCR positive test results was lower than 35 which is considered an upper borderline for reliable positive results of the assay. Therefore, most COVID-19 cases recorded in Poland from April to September 2020 were detected with minor risks of inaccuracy. Data from a single center exhibited greater consistency for both virus Ct level and SARS-CoV-2 virus variant identification.

Determinants of E-Cigarette and Cigarette Use among Youth and Young Adults in Poland-PolNicoYouth Study.

Teen use of tobacco-related products is a significant public health concern. This study evaluated the predictors of e-cigarette use among secondary school students who were never cigarette smokers and ever cigarette smokers in Poland. METHODS: This study examined a sample of Polish youths aged 13-19 (n = 19,241) attending 200 schools, 12 on average in each county. The study was a part of the National Health Program in Poland for 2016-2020. Logistic regression and multivariable logistic regression models were used to calculate crude and adjusted odds ratios. RESULTS: Of all participants, 32.5% were ever cigarette users. Among the never cigarette users, 13.6% were deemed susceptible to e-cigarette use. Among the ever cigarette users, 60.6% were deemed susceptible to e-cigarette use. Of those susceptible to e-cigarette use, 68.2% were among the 32.5% ever cigarette users. The profile of e-cigarette use among never e-cigarette users also included: pocket money available per month (more than 150 PLN) (OR = 1.7; p = 0.001), 16-17 years old (OR = 1.9; p = 0.001), parental tobacco smoking and e-cigarette usage (OR = 2.0; p = 0.01 and OR = 1.7; p = 0.001 respectively), maternal secondary education (OR = 1.1; p = 0.04), and living in big cities >500,000 inhabitants (OR = 1.4; p = 0.04). E-cigarette users among ever cigarette users were similar to never cigarette users in their opinion that e-cigarette use is less harmful than traditional smoking (OR = 1.6; p = 0.0012) and living with both parents smoking cigarettes (OR = 1.3; p = 0.02). Additionally, the determinants were: female gender (OR = 1.5; p = 0.009) in the age group less than 15 years of age (OR = 1.3; p = 0.007). CONCLUSIONS: The major determinant of e-cigarette use in this population was prior smoking. Additionally, the results revealed that fairly obvious predictors such as parental smoking and a belief in the less harmfulness of e-cigarette use are important determinants for smoking among never or ever e-cigarette users.

The Sense of Coherence and Health Behavior of Men with Alcohol Addiction.

INTRODUCTION: Alcohol dependence is one of the world's major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism. OBJECTIVE: The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol. MATERIALS AND METHODS: The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky's "SOC-29 Life Orientation Questionnaire" and Juczynski's "Health Behaviour Inventory", were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson's r test. RESULTS: A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43-65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors. CONCLUSIONS: Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.

Comparison of anti-SARS-CoV-2 IgG and IgA antibody responses post complete vaccination, 7 months later and after 3rd dose of the BNT162b2 vaccine in healthy adults.

BACKGROUND: The mRNA Covid-19 vaccine (BNT162b2) is administered in two doses with 21 days interval. On 4th October 2021 European Medicines Agency approved administration of a booster dose in at least 6 months after the second dose for people aged 18 years and older. OBJECTIVES: In the present study we compare the anti-SARS-COV-2 IgG and IgA antibody responses post complete vaccination, 7 months later and after the 3rd (booster) dose of the BNT162B2 vaccine in healthy adults. STUDY DESIGN: The levels of vaccine IgG and IgA antibodies to SARS-CoV-2 were assessed in serum samples obtained from individuals vaccinated with two doses and a booster of BNT162b2 vaccine. Samples were tested using the SARS-CoV-2 receptor-binding domain (RCB) IgG and IgA semi-quantitative commercial ELISA assay. RESULTS: The geometric mean of the anti-SARS-COV-2 IgG and IgA antibody level 7 months after vaccination of 90 healthy adults with BNT162B2 vaccine decreased significantly from 12.0 to 5.4 and 5.6 to 2.3, respectively. After the third dose of the same vaccine, the antibody level increased again, to values higher than at the beginning after the second dose. CONCLUSIONS: Significant decrease of antibody levels within a few months after full vaccination could result in the higher risk of SARS-CoV-2 infection, especially when new variants of the virus emerge. The booster could be crucial for protection against new SARS-CoV-2 variants. The antibody level seems to decrease slower in vaccinated individuals with history of COVID-19 and in younger individuals.

Pictograms for safer medication handling by health care workers: a validation study in nursing students in Poland.

BACKGROUND AND OBJECTIVE: Medication use often causes errors that are dangerous to the health of patients. Previous studies indicate that the use of pharmaceutical pictograms can effectively reduce medication errors. The purpose of this study was to determine the comprehensibility, representativeness, and recall rate of nine medication safety pictograms in a sample of nursing students in Poland in order to validate these images. METHODS: A pictogram validation study was conducted in two phases among nursing students at the Hipolit Cegielski State University of Applied Sciences, Gniezno, Poland. All experimental protocols were approved by the Children's Hospital of Eastern Ontario Research Ethics Board (REB Protocol No: 19/122X). All methods were carried out in accordance with relevant guidelines and regulations. In phase 1, the participants' first exposure to the pictograms, the students were asked to guess the meaning of the pictograms without any additional information in order to assess the pictograms' comprehensibility. To be considered valid, according to ISO standards, the pictograms had to be correctly understood by at least 66.7% of participants. After testing all pictograms, students were given explanations and meanings of the pictograms and asked to rate the representativeness of pictograms. To do so, participants were asked to select a number on a seven-point Likert-style scale to indicate the perceived strength of the relationship between the pictogram and its intended meaning for each pictogram. To be considered valid, a pictogram had to be rated at least five on this scale by at least 66.7% of participants. Phase 2 took place four weeks later, during which recall of the intended meaning and representativeness were assessed following the same procedure. RESULTS: A total of 66 third-year nursing students participated in both phases. In phase 1, of the nine pictograms, six met ISO requirements for comprehensibility and seven met ISO requirements for representativeness. In phase 2, all nine pictograms were correctly understood and rated at least 5 by at least 66.7% of participants. Therefore, all nine pictograms are considered valid. CONCLUSIONS: The nine medication safety pictograms can be deployed, but must be combined with training and a written hazard statement to improve comprehension.

Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19).

BACKGROUND During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. MATERIAL AND METHODS In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher's exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. RESULTS There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P<0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P=0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 µIU/mL, P=0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P=0.041). CONCLUSIONS Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population.

Healthcare workers highly affected during the COVID-19 epidemic wave in Poland prior to vaccination availability: seroprevalence study.

BACKGROUND: The aim of the study was to assess seroprevalence of anti-SARS-CoV-2 antibodies among healthcare workers (HCW) before introduction of vaccination, in selected areas in Poland as well as to identify potential risk factors and estimate the cumulative incidence of COVID-19 infections in this population. MATERIAL AND METHODS: The authors conducted a sero-epidemiological, cross-sectional study among HCW of 5 non-COVID-19 hospitals in Poland. The recruitment took place in December 1-23, 2020, all HCW at selected hospitals could volunteer into the study. All persons were screened with rapid SARS-CoV-2 IgM/IgG tests in capillary blood. In case of positive result, 5 ml of venous blood was drawn for confirmatory testing with ELISA assay. The authors estimated prevalence of laboratory confirmed anti-SARS-CoV-2 antibody presence and examined factors associated with positive result. Cumulative incidence was estimated applying 2-source capture-recapture method to serology results and self-report of past infection. RESULTS: Out of 1040 HCW included in the analysis, one-fourth (25.2%) received a positive result for anti-SARS-CoV-2 antibodies by ELISA test, the prevalence among women was 25.3% (95% CI: 22.5-28.4) and 24.6% (95% CI: 19-31.2) among men. The prevalence of anti-SARS-CoV-2 antibodies was the highest among respondents who declared home contact with a confirmed COVID-19 case, 43.9% (95% CI: 32.4-56.1). It was also elevated among those who indicated contact with patients with COVID-19, 32.5% (95% CI: 26.7-38.8) and business contacts, including at the workplace, 28.9% (95% CI: 22.5-36.3). The estimated cumulative incidence of COVID-19 infections in the population, using the capture-recapture method was 41.2% (95% CI: 38.1-44.2). CONCLUSIONS: Healthcare workers remained at increased risk of infection largely due to work-related contacts with infected patients, although home exposure was also common. Estimated cumulative incidence is higher than the antibody prevalence, which indicates the need to monitor HCW for possible immunity waning, also post-immunization immunity. Med Pr. 2022;73(2):109-23.

Characterization of the significant decline in humoral immune response six months post-SARS-CoV-2 mRNA vaccination: A systematic review.

Accumulating evidence shows a progressive decline in the efficacy of coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) messenger RNA (mRNA) vaccines such as Pfizer-BioNTech (mRNA BNT161b2) and Moderna (mRNA-1273) in preventing breakthrough infections due to diminishing humoral immunity over time. Thus, this review characterizes the kinetics of anti-SARS-CoV-2 antibodies after the second dose of a primary cycle of COVID-19 mRNA vaccination. A systematic search of the literature was performed and a total of 18 articles (N = 15 980 participants) were identified and reviewed. The percent difference of means of reported antibody titers was then calculated to determine the decline in humoral response after the peak levels postvaccination. Findings revealed that the peak humoral response was reached at 21-28 days after the second dose, after which serum levels progressively diminished at 4-6-month postvaccination. Additionally, results showed that regardless of age, sex, serostatus, and presence of comorbidities, longitudinal data reporting antibody measurement exhibited a decline of both anti-receptor binding domain immunoglobulin G (IgG) and anti-spike IgG, ranging from 94% to 95% at 90-180 days and 55%-85% at 140-160 days, respectively, after the peak antibody response. This suggests that the rate of antibody decline may be independent of patient-related factors and peak antibody titers but mainly a function of time and antibody class/molecular target. Hence, this study highlights the necessity of more efficient vaccination strategies to provide booster administration in attenuating the effects of waning immunity, especially in the appearance of new variants of concerns.

Prevalence and Sociodemographic Factors Associated with Overweight and Obesity among Adults in Poland: A 2019/2020 Nationwide Cross-Sectional Survey.

Detailed characteristics of the weight status of the population is necessary for the effective prevention of health disorders, e.g., through personalized nutrition education. This study aimed to characterize weight status and identify sociodemographic factors associated with overweight/obesity in a representative sample of adult inhabitants of Poland. This cross-sectional study was carried out from July 2019 to February 2020 on a representative nationwide sample of individuals aged 18+ in Poland. The study consisted of two parts: questionnaire survey and anthropometric measurements. The body mass index was calculated. Data on 1831 adults (50.3% females; mean age 51.7 ± 19.9 years) were included in this analysis. The prevalence of overweight was 42.2% (52.4% among males and 32.0% among females). Of the 1831 participants, 16.4% were obese (16.5% of males and 16.2% of females). Out of 11 factors analyzed in this study, only 5 were significantly associated with overweight/obesity. Males, older participants, occupationally active individuals, those living in rural areas and individuals with at least one chronic disease had greater odds of overweight/obesity. This study demonstrated a high prevalence of overweight and obesity among adults in Poland. This is the most up-to-date representative study on nutritional status carried out before the COVID-19 pandemic.

The Prevalence of Acute Respiratory Distress Syndrome (ARDS) and Outcomes in Hospitalized Patients with COVID-19-A Study Based on Data from the Polish National Hospital Register.

Acute respiratory distress syndrome (ARDS) is a serious complication of COVID-19. This study aimed to evaluate the prevalence of ARDS among patients hospitalized with COVID-19 in Poland as well as to characterize clinical outcomes in patients hospitalized with COVID-19-associated ARDS. This is a retrospective, secondary analysis of epidemiological data from 116,539 discharge reports on patients hospitalized with COVID-19 in Poland between March and December 2020. The overall prevalence of ARDS was 3.6%, respectively 2.9% among females, and 4.4% among males (p < 0.001). Of the 4237 patients hospitalized with COVID-19-associated ARDS, 3764 deaths were reported (88.8%). Participants aged 60 years and over had more than three times higher odds of COVID-19-associated ARDS. Men had higher odds of COVID-19-associated ARDS than women (OR = 1.55; 95% CI: 1.45-1.65; p < 0.001). Patients with COVID-19 and diabetes had higher odds of COVID-19-associated ARDS (OR = 1.16; 95% CI: 1.03-1.30; p = 0.01). Among patients with COVID-19-associated ARDS, older age, male sex (OR = 1.27; 95% CI: 1.03-1.56; p = 0.02), and presence of cardiovascular diseases (OR = 1.26; 95% CI: 1.00-1.59; p = 0.048) were significantly associated with the risk of in-hospital death. Among patients hospitalized with COVID-19 in Poland, the prevalence of ARDS was relatively low, but the in-hospital mortality rate in patients with COVID-19-associated ARDS was higher compared to other EU countries.

Aligning Best Practices: A Guiding Framework as a Valuable Tool for Public Health Workforce Development with the Example of Ukraine.

Background: At present, in Ukraine, there is an insufficient capacity for up-to-date surveillance of the health status of the general population; public health (PH) promotion and disease prevention activities are scarce. Additionally, there is an urgent need to ensure, develop and support an efficient public health workforce (PHW) and appropriately address existing health issues. Ukraine currently introduces PH system reforms in line with its current burden of disease, the epidemiological profile and the Essential Public Health Services (EPHOs). This analysis aims to propose a pragmatic framework to provide guidance and recommendations related to the development, support and planning of the PHW in Ukraine. Methods: We constructed a framework based on a previously published scoping review and analyzed various policy analysis approaches. In line with the recommendations found in the literature and the best practices used elsewhere, this method enabled the construction of a framework for facilitating successful PHW development. In addition, an expert workshop was held, serving as a reality check for identifying crucial areas of the PH system in Ukraine. Results: The proposed framework includes a country's background, the evidence and available policy options, such as the health system (including core functions, organizational resources, regulations and norms), health system capacities (including human resources; PH capacity assessment; datasets and databases; forecasting strategies; licensing, accreditation and quality assurance) and capacity building (including PH education, training, core competencies and ethical and professional codes of conduct). To facilitate and support effective implementation of the framework, we propose (1) implementing strategies to facilitate changes in attitude, behavior and practices among the citizens; (2) implementing strategies to facilitate the necessary behavioral changes in the PHW; (3) implementing strategies to facilitate the necessary organizational and institutional changes; (4) implementing strategies to facilitate system changes and (5) identification of potential barriers and obstacles for the implementation of these strategies. Conclusion: The report highlights the practical tactics and best practices for providing suggestions for PHW support and planning. The employment of prominent analytical tools and procedures in policymaking processes suggests an effective strategy for PHW development in Ukraine.

The risk of blood-borne infections in Poland - opportunities and threats to public health, nationwide qualitative research.

INTRODUCTION: The article presents the diagnosis of the problem of blood-borne infections in Poland from perspectives of experts' opinions at the voivodship level. The evaluation became the basis for subsequent analysis, aimed at creating assumptions for the proposed strategies to prevent blood-borne infections in Poland. MATERIAL AND METHODS: Diagnosis was based on the expertise of practitioners in epidemiology and service providers. Analysis covered assessment of service safety, examples, recommended practices, forms and scope of education. Also covered is information for the general public from different aspects: points of view of recipients and service providers, legislation, system organization, and finances. The SWOT method was used in analysis. The opportunities and threats concerning the risk of blood-borne diseases for the service sector are presented, as well as data gathered from 42 representative experts from across Poland. RESULTS: Databases on health indicators, covered by the reporting obligation of all diagnosed cases, are a crucial element of the surveillance system in public health (e.g. sentinel). Additional information on health care management (risk management) is not a common and routine approach. The study fills a gap in knowledge about risk management in the medical and non-medical services sector. The information also enriches education programmes (e.g. http://www.hcv.pzh.gov.pl/). CONCLUSIONS: Currently, the evidence-based approaches in medicine and in public health are standard. Experts emphasize that the opportunities for the prevention of infection risk are linked to technological advances and innovations, while threats are seen in both financial and organizational constraints, and the non-normalized, dynamically developing service market.

Characteristics and Clinical Outcomes of 116,539 Patients Hospitalized with COVID-19-Poland, March-December 2020.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19). This study aimed to characterize patients hospitalized with COVID-19 in Poland between March and December 2020, as well as to identify factors associated with COVID 19-related risk of in-hospital death. This retrospective analysis was based on data from the hospital discharge reports on COVID-19 patients hospitalized in Poland between March and December 2020. A total of 116,539 discharge reports on patients hospitalized with COVID-19 were analyzed. Among patients with COVID-19, 21,490 (18.4%) died during hospitalization. Patients over 60 years of age (OR = 7.74; 95%CI: 7.37-8.12; p < 0.001), men (OR = 1.42; 95%CI: 1.38-1.47; p < 0.001) as well as those with cardiovascular diseases (OR = 1.51; 95%CI: 1.46-1.56; p < 0.001) or disease of the genitourinary system (OR = 1.39; 95%CI: 1.31-1.47; p < 0.001) had much higher odds of COVID 19-related risk of in-hospital death. The presence of at least one comorbidity more than doubled the COVID 19-related risk of in-hospital death (OR = 2.23; 95%CI: 2.14-2.32; p < 0.01). The following predictors of admission to ICU were found in multivariable analysis: age over 60 years (OR: 2.03; 95%CI: 1.90-2.16), male sex (OR: 1.79; 95%CI: 1.69-1.89), presence of at least one cardiovascular disease (OR: 1.26; 95%CI: 1.19-1.34), presence of at least one endocrine, nutritional and metabolic disease (OR: 1.17; 95%CI: 1.07-1.28).