Autism Spectrum Disorders: Etiology, Epidemiology, and Challenges for Public Health.

Autism spectrum disorder (ASD) is a growing public health problem. American psychiatrist Leo Kanner is considered the "father of autism." ASD encompasses a range of neurodevelopmental disorders that last throughout life. Symptoms of ASD include impairments in social skills, including specific repetitive behaviors, as well as abnormal sensory responses. The clinical symptoms of ASD vary among patients. Their severity also differs, both in the area of social communication and cognitive functioning. The etiology of ASD is still unclear, although a role is attributed to both genetic and environmental factors. According to the World Health Organization, 1/100 children have ASD, but these estimates vary depending on the methodology used. Nevertheless, early detection of ASD and initiation of appropriate therapy may be essential in the continued functioning of patients and their families. The purpose of this article is to provide an overview of current knowledge about autism spectrum disorders. We discuss factors associated with autism and the prevalence of ASD in various parts of the world, and identify the most common diseases comorbid with ASD, pointing to limitations in the quality of life of patients with ASD and their families.

Enhancing Patient Adherence to Newly-Prescribed Medicine for Chronic Diseases: A Comprehensive Review and Cost-Effective Approach to Implementing the New Medicine Service in Community Pharmacies in Poland.

New Medicine Service (NMS) components are an important element to improve patient compliance with medical recommendations. NMS provides support to patients prescribed new medicines, helping them to manage long-term conditions. The purpose of this service is to provide patients with advice, guidelines, and educational materials regarding the use of new medicines to increase patient compliance and therapy safety. The NMS has already been introduced in many European countries. This review aims to identify the benefits and potential barriers to implementing the NMS in community pharmacies and to suggest solutions that would increase its effectiveness. Previous studies have primarily shown that the NMS improves patient compliance with therapy, accelerating the expected effects of the therapy. Pharmacist support during implementation of a new drug therapy substantially increases patient safety. As the experience of numerous countries shows, both pharmacists and patients express positive opinions on this service. Therefore, it seems that NMS should be an indispensable part of pharmaceutical patient care in any healthcare system. This article aims to review the implementation of the New Medicine Service (NMS) for community pharmacists in Poland and the provision of a cost-effective approach to improve patient adherence to newly-prescribed medicine for chronic diseases.

A National Registry-Based Epidemiological Study to Evaluate 395 646 Patients Hospitalized Due to Eye Diseases in Poland in 2019.

BACKGROUND The Nationwide General Hospital Morbidity Study Registry collects demographic, health, and medical data on patients hospitalized throughout Poland, and acts as a registry for epidemiological, public health, and hospital administrative studies. This epidemiological national registry-based study aimed to evaluate the characteristics of 395 646 patients hospitalized due to eye diseases in Poland in 2019. MATERIAL AND METHODS This study is a retrospective nationwide registry-based analysis. Data on all patients hospitalized due to eye diseases in 2019 were obtained from the Nationwide General Hospital Morbidity Study Registry. Demographic characteristics of patients hospitalized due to eye diseases as well as the hospitalization course were analyzed using descriptive epidemiology tools. RESULTS Disorders of the lens accounted for 68.6% of all hospital admissions, and disorders of the choroid and retina were the second most common (13.9%) cause of hospital admission due to eye diseases in 2019. Over three-quarters of hospital admissions (77.4%) lasted less than 24 h, and 86.8% were scheduled admissions. Most of the patients hospitalized due to eye diseases were females (59.9%) and over 70% lived in urban areas. There were regional differences in the hospital admissions rate per 100 000 inhabitants. According to the data presented in the registry, less than one-third of patients had comorbidities. CONCLUSIONS Hospital ophthalmological care in Poland is based mainly on planned hospitalizations lasting less than 24 h and related to ophthalmological surgery. Data on the comorbidity of ophthalmologic patients suggest that ophthalmologists do not pay enough attention to identifying and recording the patient's health status.

An Online Questionnaire-Based Survey of 1076 Individuals in Poland to Identify the Prevalence of Ophthalmic Symptoms in Autumn 2022.

BACKGROUND Vision health affects functioning in society, and the ability to learn and work. Ophthalmic symptoms may be caused by eye diseases, but also by environmental or lifestyle factors. This online questionnaire-based survey aimed to identify the prevalence of ophthalmic symptoms in 1076 individuals in Poland, as well as to identify factors associated with the presence of ophthalmic symptoms. MATERIAL AND METHODS An online questionnaire-based survey was carried out in December 2022 on a representative sample of 1076 adult Poles. Non-probability quota sampling was used. Respondents were asked about the presence of 16 different eye symptoms and vision problems in the last 30 days. The presence of ophthalmic symptoms was self-declared. Data were analyzed with IBM SPSS package version 28. RESULTS More than half of the respondents (57.8%) had at least 1 ophthalmic symptom in the last 30 days. Burning and stinging eyes (21.6%) and dry eyes (18.9%) were the most common ophthalmic symptoms declared by the respondents. Moreover, 21.3% of respondents reported vision deterioration in the last 30 days. Out of 10 different factors analyzed in this study, female gender, living in rural areas or small cities (below 100 000 inhabitants), living with at least 1 other person, having low economic status, having chronic diseases, and wearing spectacles/contact lenses were significantly associated (P.

Clinical Characteristics and Factors Associated with In-Hospital Mortality in 66 755 Patients Hospitalized Due to Diabetes in Poland, January to December 2019.

BACKGROUND The global burden of diabetes mellitus is increasing, and diabetes poses a serious problem for the healthcare system. We aimed to characterize patients hospitalized due to diabetes in Poland in 2019 and identify factors associated with the risk of in-hospital death and prolonged hospitalization. MATERIAL AND METHODS Data on all patients hospitalized due to diabetes in Poland in 2019 were taken from hospital discharge records collected by the National Institute of Public Health, Warsaw, Poland. The presence of comorbidities, in-hospital mortality rate, and duration of hospitalization were analyzed separately for type 1 and type 2 diabetes. RESULTS In 2019, a total of 28 617 patients were admitted to the hospital due to type 1 diabetes and 38 138 patients due to type 2 diabetes. The prevalence of comorbidities was 55.2% among patients with type 1 diabetes and 78.9% among those with type 2 diabetes. The in-hospital mortality rates were 2.1% and 3.3%, respectively. For emergency admissions, the in-hospital mortality rate was 4.0% and 4.5%, respectively. Over 30% of patients were hospitalized for more than 7 days. Older age and respiratory diseases were the most critical factors associated with higher risk of in-hospital death in patients with type 1 or type 2 diabetes (P<0.001). Male sex, age, and presence of at least 1 comorbidity were associated (P<0.001) with a higher risk of prolonged hospitalization. CONCLUSIONS Effective management of respiratory diseases in patients hospitalized due to diabetes, especially those admitted in an emergency, seems crucial to reduce the risk of in-hospital death.

Epidemiological Analysis of the First 1389 Cases of COVID-19 in Poland: A Preliminary Report.

BACKGROUND The World Health Organization has declared COVID-19 a global pandemic. This paper presents an epidemiological analysis of the first phase of the COVID-19 epidemic in Poland. MATERIAL AND METHODS This cross-sectional study was carried out between 3 and 27 March 2020 on a sample of 1389 laboratory-confirmed COVID-19 cases in Poland. Data were obtained from epidemiological reports collected by the Chief Sanitary Inspectorate. Analysis includes the number of COVID-19 cases, number of deaths, number of hospitalizations, number of people quarantined, and number of laboratory tests performed. RESULTS The first case was confirmed on 4 March 2020. Over 24 days after the first case, the total number of confirmed infections rose to 1389 (34,000 laboratory tests were performed). The highest incidence rates (over 5 per 100,000) were observed in the 2 central administrative regions (Mazowieckie and Lódzkie) and in the south-western region of Dolnoslaskie, which borders the Czech Republic and Germany. Based on available data about age and sex, a clearly higher incidence was observed in the 20-29 years (4.0 per 100,000), 40-49 years (4.1 per 100,000), and 50-59 years (4.3 per 100,000) age groups. In the period analyzed (24 days), there were 16 confirmed deaths (average age 65.5 years; 81.2% males). CONCLUSIONS The proportion of women and men with confirmed COVID-19 infection was similar to the sex ratio in the general population. Infections were relatively less common in those aged under 20 years. The largest numbers of confirmed cases were detected in 3 of the 4 largest cities, each of which has an international airport.

Public Health Interventions to Mitigate Early Spread of SARS-CoV-2 in Poland.

This study aimed (1) to present public health interventions to mitigate the early spread of SARS-CoV-2 implemented in Poland between January 9 and March 29, 2020, and (2) to analyze the potential impact of these regulations on the early phase of the COVID-19 outbreak in Poland. All legal regulations published in the Journal of Laws between January 9 and March 29, 2020, were analyzed. Out of 406 legal regulations identified, 56 were related to the COVID-19 outbreak. Moreover, the official announcements published on the governmental websites dedicated to the coronavirus and health issues were analyzed. On March 4, Poland reported the first laboratory-confirmed COVID-19 case. On March 9, Poland introduced border sanitary control. Six days after the first laboratory-confirmed COVID-19 case, all mass events in Poland were banned. All schools and universities were closed 8 days after the first COVID-19 case. All gastronomic facilities and sport and entertainment services were limited starting on March 14. Eleven days after the first COVID-19 case, controls at all Polish borders were introduced, and a ban on entry into Poland by foreigners (with some exemptions) was implemented. Starting on March 15, all citizens returning from abroad had to undergo compulsory 14 days self-quarantine. On March 20, a state of epidemic was announced, which resulted in new social distancing measures starting on March 25. In Poland, compared to other European countries, far-reaching solutions were implemented relatively early to reduce the spread of infection.

Knowledge and Beliefs of E-Cigarettes Among Physicians in Poland.

BACKGROUND Electronic nicotine delivery systems, including electronic cigarettes (e-cigarettes) are gaining popularity. The objectives of this study were to assess the knowledge and beliefs about e-cigarettes among physicians in Poland. MATERIAL AND METHODS A questionnaire-based survey was conducted among physicians attending mandatory courses delivered at the School of Public Health, Centre of Postgraduate Medical Education (Warsaw, Poland). The questionnaire included 24 questions concerning beliefs and attitudes about e-cigarettes. RESULTS Data were obtained from 412 physicians (64.3% females; aged 31.9±5.7 years) with a response rate of 82.4%. Among participants, 99.8% were aware of e-cigarettes. The main sources of information about e-cigarettes were: news stories (67.2%) or points of sale of e-cigarettes (67.6%). Approximately half of respondents (50.2%) declared moderate knowledge about e-cigarettes, and over three-quarters (78.1%) declared willingness to learn more about e-cigarettes. The majority (96.5%) of participants agreed with the statement that e-cigarette use is harmful to the user's health, and most (80.5%) agreed that exhaled e-cigarette aerosol is harmful to bystanders. The statement that e-cigarettes could be "gateway" to conventional smoking was supported by 87% of participants. Only 11.5% of physicians agreed that e-cigarettes should be recommended as a smoking cessation method. CONCLUSIONS Physicians in Poland perceive e-cigarettes as harmful and addictive. Physicians' knowledge about e-cigarettes is mostly based on non-scientific sources, which points out the urgent need to develop national smoking cessation guidelines regulating the issue of e-cigarettes based on scientific evidence.

Analysis of National Health and Insurance Registers for All-Cause Mortality in Patients with Heart Failure with and without Diabetes Mellitus in Poland in 2012.

BACKGROUND This retrospective study aimed to analyze all-cause mortality in patients with heart failure with and without diabetes mellitus in 2012 in Poland using data from the National Health Fund [Narodowy Fundusz Zdrowia] (NFZ), the Central Register of the Insured [Centralna Baza Ubezpieczonych] (CBU), and the Polish Universal Electronic System for Registration of the Population (PESEL). MATERIAL AND METHODS Between 1st January 2012 and 31st December 2012, data were analyzed from the NFZ, CBU, and PESEL to include all patients with a primary diagnosis of heart failure, with and without diabetes mellitus and all-cause mortality data. Structured Query Language (SQL) was used to retrieve and manage data from NFZ, CBU, and PESEL. RESULTS In Poland, 32.58% of 201,586 patients with a primary diagnosis of heart failure who died in 2012 also had a diagnosis of diabetes mellitus. The overall mortality rate in men with heart failure and diabetes was eight times higher than for men with heart failure without diabetes. The overall mortality rate in women with diabetes and heart failure was 5.5 times higher compared with women with heart failure without diabetes. More than 90% of deaths in female patients with heart failure, with or without diabetes, occurred in women >60 years. For male patients with heart failure with or without diabetes, 70% of deaths occurred in men >60 years. CONCLUSIONS These findings support the need for continued prevention programs, early diagnosis, and treatment of diabetes, and highlight the increase in mortality for patients with heart failure and diabetes.

Serum Lipid, Vitamin D Levels, and Obesity in Perimenopausal and Postmenopausal Women in Non-Manual Employment.

BACKGROUND Increasing age, increased body mass index (BMI), and abnormal lipid profiles contribute to an increased risk of vitamin D deficiency. Women who have a perimenopausal and postmenopausal reduction in estrogen levels are a high-risk group for vitamin D deficiency. The aims of this study were to compare the serum vitamin D levels, lipid profile, and BMI between perimenopausal and postmenopausal women in non-manual employment, and to determine whether there were any interdependent factors. MATERIAL AND METHODS Three hundred women in non-manual employment, aged between 44-66 years, were divided into three groups: early perimenopausal; late perimenopausal; and postmenopausal. Laboratory tests included measurement of serum lipid profiles and vitamin D levels, the BMI, waist-hip ratio (WHR) and body fat were measured. Statistical analysis included F-test analysis of variance and the least significance difference (LSD) test was used for multiple comparisons. RESULTS For the 300 women who were in non-manual employment, and in the early and late perimenopausal and postmenopausal periods, serum vitamin D levels were reduced (mean 16.8±8.7 ng/mL); 29% of women had abdominal obesity; 41% had excessive body fat accumulation; and 56% had an increased body mass index (BMI) (>25 kg/m²) with raised total cholesterol, low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein (HDL), and total cholesterol/HDL ratios (p<0.05). CONCLUSIONS The findings of this study showed that in perimenopausal and postmenopausal women in non-manual employment, serum vitamin D levels were associated with serum lipid profile and degrees of obesity.

The duration of pregnancy in ecologically-challenged area. The effects of environmental pollution with aromatic hydrocarbons on the angiogenesis and elements of the mesenchymal tissue of the human placenta.

INTRODUCTION: The literature presents only few reports regarding the effects of elevated levels of aromatic hydrocarbons (AH) on the functions of the human placenta. The effects of environmental contamination with AH (including phenol and 1-hydroxypyrene) have certain negative effects on parenchymal organs such as human placenta. OBJECTIVE: The paper aimed to assess the effects of elevated levels of AH on the placental angiogenesis and elements of the mesenchymal tissue of the placenta. MATERIAL AND METHODS: Tissue material from 50 afterbirths from Plock constituted a study group, whereas 50 afterbirths from Kutno constituted a control group. Immunohistochemical reactions with the peroxidase method using LSAB kits (DAKO) were performed. The extent and intensity of reactions were analysed. The levels of phenols and 1-hydroxypyrene in the excreted urine of pregnant women (undergoing delivery) were detected using gas chromatography and colorimetry. RESULTS: The levels of phenol and 1-hydroxypyrene in the excreted urine were demonstrated to be statistically significantly higher in patients living in the area of Plock. Statistically significantly higher expression of antibodies indicating placental angiogenesis was observed in the placentas in the Plock group (p < 0.01). Moreover, lower expression of vimentin indicating reactions with proteins in mesenchymal cells was observed in the Kutno group (p < 0.01). CONCLUSIONS: Pregnancy in the environment with elevated levels of aromatic hydrocarbons has detrimental effects on the human placenta. The foetus is protected by activation of adaptation and compensation mechanisms that are manifested as significant angiogenesis and greater development and differentiation of mesenchymal cells compared to the control group.

Proliferation and apoptosis of human placental cells exposed to aromatic hydrocarbons.

OBJECTIVES: The objective of this study is to assess the effect of elevated urinary levels of aromatic hydrocarbons (AH) on the proliferation and apoptosis of human placental trophoblast cells obtained in the course of normal pregnancy in an AH-polluted region. MATERIAL AND METHODS: Tissue material was obtained for study purposes from 50 afterbirths from Plock as the study group and 50 afterbirths from Kutno as the control group. The extent and intensity of reactions were analyzed. The levels of phenol and 1-hydroxypyrene in the excreted urine of pregnant (in labor) patients were determined by gas chromatography and colorimetry. The proliferative activity of trophoblast cells was assessed using MPM-2 antibodies against phosphoprotein synthesized upon mitotic induction and Ki-67 antigen while the intensity of apoptosis in trophoblast cells was assessed using p53 and bcl-2 oncoproteins involved in apoptosis-regulating mechanisms. The immunohistochemical reactions were assessed for their extent and intensity. RESULTS: The levels of phenol and 1-hydroxypyrene excreted in the urine were statistically significantly higher in patients from Plock region. The proliferative activity of trophoblast cells was statistically significantly higher in the study group (p < 0.05). The activity of oncoprotein bcl-2 was significantly higher in the study group while the activity of p53 was sig¬nificantly higher in the control group. Pregnancy in an aromatic hydrocarbon-polluted environment has a significantly negative impact on placental tissue. Ad¬aptation mechanisms are induced as manifested by increased proliferative activity within the trophoblast and extensive inhibition of apoptosis in the study group.

Gestational diabetes mellitus/hyperglycaemia during pregnancy in Poland in the years 2010-2012 based on the data from the National Health Fund.

OBJECTIVES: The incidence of gestational diabetes varies depending on a country and it is extremely difficult to analyse. The aim of the study was to assess the incidence of gestational diabetes in Polish population. MATERIAL AND METHODS: Based on the data from the National Health Fund (NHF) the authors analysed reports regarding deliveries performed and then, determined the rates of gestational diabetes/hyperglycaemia during pregnancy and pregestational diabetes in Poland in the years 2010-2012. RESULTS AND CONCLUSIONS: In Poland, the incidence of gestational diabetes was estimated to be 4.665% in 2010, 6.918% in 2011 and 7.489% in 2012. The incidence of pregestational diabetes was 1.067% in 2010, 1.116% in 2011 and 0.932% in 2012.

The assessment of overall survival (OS) after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland.

OBJECTIVES: In 2013 malignant endometrial cancers have amounted to 7.3% of all cancers diagnosed among women in the report by the Polish National Cancer Registry Raw prevalence rate amounted to 28.7, whereas standardised prevalence rate 15.6 per 100 000 population. Among the causes of death, these cancers amounted to 3% and were ranked ninth on the list of the most common causes of oncologic mortality of women. In the year 2013 a total of 1243 women died of malignant endometrial cancers. A stable increase of malignant endometrial cancer incidence has been observed for 2 decades. Despite that fact, the increase of the mortality incidence is at a much lower level, which demonstrates the much higher effectiveness of the treatment of such cancers. The recording rate of the malignant endometrial cancer mortality amounts to 95%, so the presented absolute numbers are reliable. Examining the clinical stages of malignant endometrial cancers, we can establish that approx. 85% of them are diagnosed at stage I or II according to the FIGO classification. Patients with advanced stages of cancer represent less than 15%. MATERIAL AND METHODS: retrospective analysis of endometrial body cancer prevalence data for the entire population of Poland, assessment of malignant endometrial cancer prevalence in the years 2008-2015 and overall survival probability in the population of patients undergoing adjuvant chemotherapy. RESULTS: The number of patients with a diagnosed malignant endometrial cancer within the studied period in Poland remains on a stable level (2008 - 30.6 thousand patients, 2015 - 40.2 thousand patients). Among all listed patients with the indica-tion of C54 each year approx. 20% enters hospital treatment. System therapy with chemotherapy drugs was used in approx. 1-2% of patients treated in hospitals. The average age of the patients was 64.9 years, and the median age 65 years. The num-ber of observations was 2085, including 1088 censored observations. The average survival for the sample under study was 30.67 month (SD = ± 0.6); median survival time was 23.93 month. The number of censored observations was 1088 (52.16%). Probable survival of 1 year is achieved by 67.57% of patients, 2 years by 49.73%, 3 years by 40.68%, above 5 years 30.77%. CONCLUSIONS: The incidence of endometrial cancer in Poland in the years 2008-2015 continues to grow at 5% upward trend (in Europe 3.4-5.9). In Poland in 2012, crude incidence rate for cancer of the uterus was 29.8 and did not differ significantly from the results in countries such as Finland, Slovakia, Sweden, Belgium and Bulgaria. The overall survival after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland shows considerable differences depending on the region of the country.

Anaphylaxis in Poland: the epidemiology and direct costs.

INTRODUCTION: Epidemiological data on anaphylaxis have been underestimated both in Poland and worldwide. AIM: To evaluate the prevalence of anaphylaxis in Poland, including a classification by gender, age and residential region. MATERIAL AND METHODS: The data used in the analysis were derived from two sources, the National Health Fund records of healthcare services for 2008-2015 (official statistics) and a questionnaire-based survey conducted in 2015 on a sample of 305 allergists practicing in different regions of Poland. RESULTS: In 2015, 3144 people received treatment for anaphylactic shock (T78.0, T78.2, T80.5, T88.6) with an estimated prevalence rate of anaphylaxis of 8.2 per 100,000 (8.4 for females and 7.9 for males). The highest prevalence rate was found for women aged 50-54 years (14.5 per 100,000). There was a very large difference in the prevalence of anaphylaxis between rural and urban areas (13.1 vs. 0.8 per 100,000). In 2015, the Polish NHF spent PLN 3.5 million (EUR 835,000) on the management of anaphylaxis. Of the allergists surveyed, 73% had been currently managing patients who had experienced anaphylactic shock. The most common causes of anaphylaxis included insect venom (41.4%), food (29.8%) and drugs (17.4%). CONCLUSIONS: A central anaphylaxis registry should be established in Poland. This is the only approach that would allow collecting a wide range of reliable information on the cases, management and consequences of anaphylaxis. Ongoing management of patients who have experienced anaphylactic shock should be improved.

Cognitive Functions, Concentration of Endogenous Estradiol, Estrogen Receptor α (ERα) Polymorphism in Postmenopausal Women.

BACKGROUND The goal of this study was to investigate the relationship between cognitive functions and the level of endogenous estradiol in postmenopausal women, according to which estrogen receptor α (ERα) polymorphism the woman carries. MATERIAL AND METHODS The study group consisted of 210 women. The inclusion criteria were: minimum 2 years after the last menstruation, FSH concentration 30 U/ml, and no dementia signs on Montreal Cognitive Assessment (MoCA). A computerized battery of Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. Genotyping of the ERa polymorphism was performed using a polymerase chain reaction and restriction enzymes (PCR-RFLP). Blood plasma was tested for FSH and estradiol (E2). Statistical analysis was performed using STATISTICA software. RESULTS A relationship was confirmed between standard scores for 3 cognitive functions: general memory, verbal memory, and processing speed, and the XbaI polymorphism in the women in the study. In the group of women with genotype TT PvuII, significant positive relationships were observed between the concentration of E2 and the standard scores of 3 cognitive functions: general memory, verbal memory, and processing speed. In the group of women with genotype TC PvuII, significant negative correlations were found between the concentration of E2 and the standard scores of 4 cognitive functions: NCI, general memory, verbal memory, and processing speed. CONCLUSIONS ERα polymorphism exerted an effect on the interaction between the concentration of estradiol and the results for cognitive functions. The concentration of estradiol did not depend on Xba1 and PvuII polymorphisms. The results for cognitive functions depended on which Xba1 polymorphism the woman carried.

State of Health and Quality of Life of Women at Advanced Age.

BACKGROUND Evaluation of the state of health, quality of life, and relationship between the level of the quality of life and health status in a group of women at advanced age (90 and more years) in Poland. MATERIAL AND METHODS The study was conducted in 2014 in an all-Polish sample of 870 women aged 90 and over. The research instruments were: the author's questionnaire, and standardized tests: Katz index of independence in Activities of Daily Living (ADL), Abbreviated Mental Test Score (AMTS), The World Health Organization Quality of Life (WHOQOL) - BREF. The results of the study were statistically analyzed using significant t test for mean and regression analysis. RESULTS The majority of women at advanced age suffered from chronic pain (76%) and such major geriatric problems as hypoacusis (81%), visual disturbances (69%) and urinary incontinence (60%), the minority - fall and fainting (39%) as well as stool incontinence (17%), severe functional and cognitive impairment (24% and 10% respectively). Women at advanced age assessed positively for overall quality of life (mean 3.3 on 1-5 scale), social relationships (3.5) and environment (3.2), but negatively - general, physical and psychological health (2.7, 2.7 and 2.8 respectively). The presence of chronic pain and major geriatric problems: urinary and stool incontinences, falls and fainting, visual disturbances and hypoacusis significantly decreases overall quality of life, general, physical and psychological health, social relationships and environment of women at advanced age. Overall quality of life, general, physical and psychological health, social relationships and environment correlate to functional and cognitive impairments of women at advanced age. CONCLUSIONS Quality of life of women at advanced age decreased if chronic pain, major geriatric problems as well as functional and cognitive impairments occur.

Preferred sources of information on diabetes prevention programmes: a population-based cross-sectional study in Poland.

OBJECTIVE: This study aimed to analyse preferred sources of information on diabetes prevention programmes and to identify sociodemographic determinants influencing these preferences among adults in Poland. DESIGN: A cross-sectional survey was carried out between 15 and 18 September 2023 using a computer-assisted web interview. A self-prepared questionnaire included 10 questions on sources of information on type 2 diabetes prevention. PARTICIPANTS: Data were obtained from 1046 adults (18-82 years); 53.4% were females. RESULTS: Most respondents preferred email communication (46.4%), followed by a doctor or nurse (33.5%), and a letter or leaflet directly delivered to the mailbox (25.8%) for type 2 diabetes mellitus (DM2) prevention information. Younger respondents were more likely to indicate mass media (OR=1.81, 95% CI=1.12 to 2.95, p=0.01) and digital media (OR=1.65, 95% CI=1.02 to 2.67, p=0.04) as a source of information on DM2 prevention. Those who had higher education (OR=1.51, 95% CI=1.16 to 1.96, p=0.002), as well as those with chronic diseases (OR=1.50, 95% CI=1.14 to 1.97, p=0.004), were more likely to indicate digital media. Out of 10 different variables analysed in this study, passive occupational status (OR=1.43, 95% CI=1.04 to 1.96, p=0.03) as well as having chronic diseases (OR=1.51, 95% CI=1.16 to 1.96, p=0.002) were associated with higher odds of indicating healthcare workers as a preferred source of information. Marital status, having children, place of residence, household characteristics and financial status do not significantly decide communication preferences. CONCLUSION: Communication on DM2 prevention should be adjusted to public preferences and expectations. Tailoring interventions to different demographic groups can enhance outreach and engagement. Email emerged as a popular choice, suggesting the potential of digital communication in preventive health programmes.

Public Expectations and Needs Related to Type 2 Diabetes Prevention: A Population-Based Cross-Sectional Study in Poland.

Objective: This study aimed to understand the public's expectations regarding type 2 diabetes prevention and to identify factors associated with willingness to participate in preventive activities among adults in Poland. Methods: A cross-sectional survey was carried out using a computer-assisted web interview (CAWI) on a representative sample of 1,046 adults in Poland. A non-probability quota sampling method was used. A study tool was a self-prepared questionnaire. Results: Most respondents (77.3%) declared willingness to participate in preventive activities. Consultation with a diabetologist (75.1%) or family doctor consultation (74.9%) were the most often selected. Lifestyle interventions in the form of dietary and culinary workshops (58.1%) were the least chosen. Having higher education (OR = 3.83, 1.64-8.94, p = 0.002), chronic diseases (OR = 1.36, 1.01-1.85, p = 0.04), and a history of diabetes in the family (OR = 1.67, 1.21-2.30, p = 0.002) were significantly associated with a higher interest in type 2 diabetes prevention. Conclusion: The adults in Poland are keen on participating in diabetes prevention programs, mostly those based on medical counselling rather than lifestyle-oriented interventions. Educational level was the most important factor associated with willingness to participate in type 2 diabetes prevention.

Significant COVID-19 burden in Polish children.

Introduction: COVID-19 cases have rarely been reported in children. We sought to analyse the attack rate in paediatric population in Poland, focusing on local variations among the provinces, correlation with the number of tests per capita, and test positivity rate. Material and methods: This cross-sectional study involved the 38.38 million population and detected 17,921 cases (age known in 17,822). Data were collected from publicly available registries and were analysed by age group and province of the country. Results: Children constituted 6.68% of cases (n = 1,191). The attack rate reached 15.49/100,000 children, increasing with age (10.79/100,000 in < 4 y.o. to 21.59/100,000 in 15-19 y.o.). Significant variations in the attack rates were observed: a 9.52-fold ratio between the highest and the lowest attack rates in provinces. The provinces from the first and fourth attack rate quartiles differed in the test positivity rate (4.96% vs. 1.98%, p < 0.05), but not in the number of tests per capita. The lowest quartile provinces showed 1.87- to 5.78-fold lower attack rates, compared to the directly neighbouring provinces, without any known population susceptibility differences. The attack rates in children and adults correlated very strongly (rho = 0.81). The attack rate correlated with the test positivity rate (rho = 0.64 in children and rho = 0.71 in adults) but not with the number of tests per capita. Conclusions: COVID-19 burden in children is significant. The local differences highlight various testing strategies, but the awareness of SARS-CoV-2 in children is essential. The correlation between attack rates in children and adults shows that the outbreak in children is parallel to the one observed in adults.