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The prohibition of commercialisation of the human body and its parts is not applied consistently and suffers from many exceptions in the human biological material (HBM) market. Examples include the possibility of patenting certain HBM-derived products and their commercial marketing or payments for blood donations. Thus, the current practice of marketing HBM-derived products makes the altruistic donor most vulnerable to exploitation while being deprived of benefits. There seem to be two ways to improve this state of affairs. The first is to apply consistently the prohibition of commercialisation of the body and its parts to commercially marketed tissue and cell products as well. This would require limiting the possibility of financial gain associated with the processing, distribution and sale of HBM-based products. Such a solution, however, does not seem to gain wide acceptance or have a chance of implementation in the near future. Therefore, introducing more transparent rules and greater donor empowerment seems more reasonable by exempting HBM from the ban on commercialisation under certain conditions and with clear limitations.
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Bancos de Espécimes Biológicos , Corpo Humano , Humanos , Doadores de Tecidos , Marketing , ComércioRESUMO
BACKGROUND: Previous studies of relationship between religiosity, health behaviors and well-being have showed mainly positive relationships, however, are very often limited to results of associative nature and subject to unmeasured confounding. This study focused on evaluating evidence for a positive association between religious service attendance (RSA), health behaviors and well-being in a longitudinal setting and robustness of these associations to unmeasured confounding. METHODS: Three waves (2009, 2011 and 2015) of the biennial longitudinal Polish household panel study with response from 6400 respondents were analyzed. Evidence for a positive and robust association between RSA and outcome variables was evaluated using outcome-wide regression analysis with control of all variables temporally prior to the exposure and sensitivity measures (E-values) to give information on the extent to which an unmeasured confounder would need to be associated with both the exposure and the outcomes. RESULTS: RSA is associated with reduced risk of unhealthy behaviors (smoking, alcohol use) and higher emotional well-being. These relationships are robust to substantial unmeasured confounding and difficult to explain by reference to other, unknown, variables. Evidence for a positive relationship between RSA and other well-being variables (social, physical) was less clear. CONCLUSIONS: Religiosity may play an important role in public health, particularly in prevention of non-communicable diseases. The strong and robust associations between RSA and some health behaviors (i.e. tobacco use, alcohol abuse) and emotional well-being should arguably be taken into account in health education, health promotion programs, health prevention policy and psychotherapeutic approaches, particularly in more religious populations.
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Comportamentos Relacionados com a Saúde , Satisfação Pessoal , Religião , Adolescente , Adulto , Idoso , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Polônia , Autorrelato , Adulto JovemRESUMO
Vaccinations cause controversies for numerous reasons: medical, religious, and even personal. The following paper focuses on one more, underestimated conflict between individual autonomy and public health in regard to obligatory childhood vaccinations. Every medical intervention should be preceded by informed consent; however, informed consent in the case of obligatory vaccinations cannot be voluntary and valid. Moreover, asking parents to sign an informed consent form is paradoxical in a situation where not signing it will lead to legal consequences. Our paper tries to accentuate the issue of involuntariness and invalidity of informed consent in the case of obligatory vaccination and tries to propose a solution that acknowledges requirements for vaccinations and makes parents feel safer coming in and out of a vaccination visit.
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Consentimento Livre e Esclarecido/ética , Vacinação/ética , Coerção , Humanos , Consentimento Livre e Esclarecido/normas , Pais , Autonomia Pessoal , Saúde Pública/ética , Saúde Pública/normasRESUMO
Introduction: The development of the scientific potential linked with biobanking and research on human biological material is highly dependent on the willingness of potential donors to cooperate with entities that collect the material. For this reason, it is crucial to identify the circumstances and factors that may encourage potential participants to donate their biological material. In particular, knowledge of the motivational factors that can be modified by the persons managing a biobank may prove notably important for shaping the organizational and communication policy of the biobank and other scientific institutions. Material and methods: The research was carried out on a group of 1,100 people over 18 years of age representing the adult population of Poland in 2021. Results: More than half of the respondents declared their willingness to donate a blood sample for research purposes to a biobank (57.8%). The most often indicated incentives among the factors supporting the donation of biological material were offers of: obtaining the results of genetic tests predicting the risk of diseases (77.1%), blood tests (71.3%), the possibility of obtaining a small remuneration (64.6%) and the carrying out of genetic ancestry tests (60.4%). Conclusion: Offering the possibility of performing additional diagnostic tests, especially genetic tests, may significantly increase the willingness of potential donors to cooperate with biobanks and other entities collecting human biological material for the purpose of scientific research. However, attention should also be paid to the challenges and risks linked with respecting the privacy and autonomy of research participants.
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The COVID-19 pandemic demanded changes in healthcare systems worldwide. The lockdown brought about difficulties in healthcare access. However, trauma still required further attention considering its modifications. The presented study aims to investigate the variances in epidemiological patterns of trauma during the lockdown and the previous year, with a view to better understand the modifications in healthcare provision. The authors analyzed data from the first lockdown in 2020 (12 March-30 May) and the same period in 2019 from 35 hospitals in Lublin Province. A total of 10,806 patients in 2019 and 5212 patients in 2020 were included in the research. The uncovered changes adhered to the total admissions and mortality rate, the frequency of injuries in particular body regions, and injury mechanisms. The lockdown period resulted in a reduction in trauma, requiring an altered approach to healthcare provision. Our research indicates that the altered approach facilitated during such periods is essential for delivering tailored help to trauma patients.
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OBJECTIVES: Some lawful procedures are morally controversial and this situation can sometimes provoke conflicts between patients and physicians (conscience clause problem). The aim of our survey was to collect opinions about medical procedures that are accepted by Polish law and unaccepted by the Catholic Church--dominating denomination in Poland, and analyzing conditions determining these opinions. MATERIAL AND METHODS: Cross sectional study. An anonymous survey was distributed among 528 physicians who work in public hospitals in eastern Poland (turn = 61%). The sample consist of: 51% women, 49% men; 52% work AT surgical wards, 48% at non-surgical wards; average work period: 17.03 years (SD = 10.73; min. = 1, max. = 45); 93% Catholics; average religiosity (measured by the Scale of Religious Attitudes): M = 5.47 (SD = 1.01; min. = 1.60, max. = 6.80). The questionnaire contained questions about: hormonal contraceptives, artificial fertilization, abortion in the case of rape and fetus defect. RESULTS: The majority of respondents accepts artificial fertilization (70%), about half accepts abortion in case of fetus defect (50%), almost half accepts abortion in case of rape (41%) and contraception for minors (43%). There was statistically significant differences between physicians with different religiosit--the lack of approval for above procedures correlates with increasing religiosity. CONCLUSIONS: Individual religiosity (regardless of denomination) is the most important condition influencing Polish physician's opinions and attitudes concerning contraception, abortion and artificial fertilization. Physicians with higher religiosity (about 25%) in the situation of divergence between their moral beliefs and patient's demands will choose for their beliefs, which can cause conflicts. Physician-patient relationship's models should take into account physicians'cultural beliefs and not only the cultural beliefs of the patients.
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Aborto Legal/ética , Catolicismo , Serviços de Planejamento Familiar/ética , Conhecimentos, Atitudes e Prática em Saúde , Princípios Morais , Relações Médico-Paciente , Médicos/estatística & dados numéricos , Aborto Legal/legislação & jurisprudência , Adulto , Anticoncepção/ética , Estudos Transversais , Serviços de Planejamento Familiar/legislação & jurisprudência , Feminino , Fertilização in vitro/ética , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Polônia , Vigilância da População , Inquéritos e QuestionáriosRESUMO
The willingness to donate human biological material for research purposes is shaped by socio-cultural factors; however, there is a lack of studies analysing the social perception of different human tissues, which may affect such willingness. This study aimed to distinguish different sociocultural categories of human tissues and types of potential donors based on their willingness to donate material. Quantitative research was conducted on a sample of 1,100 adult Poles representative in terms of sex, place of residence and education. According to the study, people were most willing to donate urine (73.9%), blood (69.7%), hair and tears (69.6%) and the least willing to donate post-mortem brain fragments (20%), sperm (males; 36.4%) and egg cells (females; 39.6%). A factor analysis revealed four sociocultural categories of donated tissues: irrelevant, redundant, ordinary and sensitive. Based on these sociocultural categories of tissues, four types of donors were identified: reluctant, highly cooperative, average cooperative and selectively cooperative. The willingness to donate human samples for research is shaped by the sociocultural perception of different body parts and tissues. The lower the sense of "personal relationship" with a specific type of tissue, organ or part of the body, the higher the motivation to donate such biological material for research purposes. Additionally, the willingness to donate is mostly shaped by social trust in physicians and scientists, and potential donors' engagement in charity activities.
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Over the past few decades, there has been a dynamic development of biobanks collecting human biological material and data. Advances in biomedical research based on biobanks, however, are highly dependent on the successful enrolment and participation of human subjects. Therefore, it is crucial to recognise those factors affecting the willingness of individuals to participate in biomedical research. There are very few studies pointing to the role of trust, preferred values and specific psychological factors. The aim of our study was the analysis of the most significant relationships between selected moral and psychological variables (i.e., preferred values, types of trust and personality) and willingness to donate biological material to biobanks. The research was carried out on a Polish representative national sample of 1100 people over 18 years of age. Statistical methods with regression models were used during the analyses. The willingness to donate samples to a biobank was associated with different types of trust and specific values. Based on regression analysis, the most important factors related to the willingness to donate material to biobanks seemed to be (1) trust towards scientists and doctors and (2) selected preferred values such as knowledge, self-development and tradition. Other values or personality traits did not seem to be as important in this context. The obtained results can be useful in building the social responsibility of biobankers and scientists, issuing more appropriate opinions by research ethics committees and planning better communication strategies between participants and biobanks.
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Bancos de Espécimes Biológicos , Pesquisa Biomédica , Adolescente , Adulto , Atitude , Humanos , Responsabilidade Social , ConfiançaRESUMO
Breast cancer is one of the leading forms of cancers in women worldwide. In Poland, it accounts for approx. 20% of all cancers diagnosed, with approximately 11,000 new cases and 5000 deaths from this disease annually. To prevent unfavourable statistics, Poland introduced free breast cancer screening programmes, available to women aged 50-69. Over a million women take advantage of this programme each year. The aim of the research was to assess the quality of consent women give prior to mammography screening and address the question of whether this quality is sufficient to make an informed choice. The study was conducted on a representative group of 600 Polish women over 50 years old (475 of them had undergone mammography screening), who agreed to take part in the study. Using the computer-assisted interview technology (CATI) method, all women were asked about their perception of breast cancer and screening and those who had undergone mammography were quizzed about the consent process. They will form the focus of this research. The validated tool contained items on both the benefits and risks of screening. The results indicate that the quality of informed consent was insufficient. A discrepancy was observed in the awareness between the benefits and risks of mammography screening. The main motivations to undergo screening were: prophylactic purposes and the free-of-charge nature of this health service. Population-based screening programmes for breast cancer should be reconsidered in terms of information policy, and the quality of informed consent should be increased.
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Neoplasias da Mama , Mamografia , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Consentimento Livre e Esclarecido , Programas de Rastreamento , Pessoa de Meia-Idade , PolôniaRESUMO
BACKGROUND: The dynamic character of the COVID-19 pandemic and its social consequences caused several medical and societal issues and dilemmas. The aim of our qualitative research was to capture and analyze attitudes and beliefs of convalescents who experienced mild symptoms of COVID-19 in the first wave of the pandemic and decided to donate their plasma for therapeutic purposes. MATERIAL AND METHODS: The article presents results of qualitative research conducted on the basis of grounded theory (GT) methodology. Empirical material includes 10 in-depth interviews conducted with respondents who had mild or asymptomatic disease and, after recovery, voluntarily donated their plasma to the Regional Centre for Blood Donation and Blood Treatment (RCKiK). Data were collected in May and June 2020 in Poland. Qualitative analysis was focused on the experience of convalescents who entered the social role of a sick person in individual, social, and organizational dimensions. RESULTS: The social role of the patient in the narratives of convalescents was related to three stages: (1) initiation to the role, (2) staying in the COVID-19 patient role, and (3) leaving the role. Research results enabled the distinction of three basic descriptive categories ("ontological uncertainty", "the global and individual dimension", and "being sick in the disease-infected environment"), which became epistemological framework for a detailed description of the roles played by an individual COVID-19 patient during the pandemic. CONCLUSIONS: The disease, despite its mild course, generated a number of non-medical issues, and the entire process of being ill was burdened with institutional and emotional struggles. The experience of mild COVID-19 is significantly modified by disease institutionalization. These results may contribute to a better understanding of the psychosocial dimension of COVID-19 and convalescents' motivations for plasma donation.
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COVID-19 , COVID-19/epidemiologia , Humanos , Motivação , Pandemias , Pesquisa Qualitativa , IncertezaRESUMO
Personal data protection has become a fundamental normative challenge for biobankers and scientists researching human biological samples and associated data. The General Data Protection Regulation (GDPR) harmonises the law on protecting personal data throughout Europe and allows developing codes of conduct for processing personal data based on GDPR art. 40. Codes of conduct are a soft law measure to create protective standards for data processing adapted to the specific area, among others, to biobanking of human biological material. Challenges in this area were noticed by the European Data Protection Supervisor on data protection and Biobanking and BioMolecular Resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI.ERIC). They concern mainly the specification of the definitions of the GDPR and the determination of the appropriate legal basis for data processing, particularly for transferring data to other European countries. Recommendations indicated in the article, which are based on the GDPR, guidelines published by the authority and expert bodies, and our experiences regarding the creation of the Polish code of conduct, should help develop how a code of conduct for processing personal data in biobanks should be developed.
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BACKGROUND: There is a lack of research on social image, prestige, and the position of the paramedic profession in the social structure. The main objective of the study was to determine the place of the paramedic profession in the hierarchy of prestige of professions as viewed by the public. In operationalizing the term 'prestige', we deemed the word 'respect' to best fit the sense of the subjective evaluation of prestige with regard to a profession. MATERIAL AND METHODS: The data comes from cross-sectional survey-based research. The research was carried out on a group of 600 people over 18 years of age. The sample was of a random nature, and the selection of respondents was calculated on the basis of them being representative of the Polish population. RESULTS: The median of respect declared for the paramedic profession, on a scale of 1 to 5, was 4.49, which placed the profession in fourth place in the ranking. The assessment of respect for paramedics among other medical professions placed them in third place, directly after doctors and midwifes. CONCLUSIONS: The profession of paramedic is characterized by high social prestige, locating it at the forefront of the medical profession and other examined professions, but its social position, expressed by objective measures (earnings, structural possibilities, social power), is significantly lower.
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Auxiliares de Emergência , Tocologia , Adolescente , Adulto , Pessoal Técnico de Saúde , Estudos Transversais , Feminino , Humanos , Polônia , GravidezRESUMO
This review aimed to aggregate and describe the available data about clinical nutrition in lung cancer and the role of the dietitian in multidisciplinary patient care. Scientific literature was searched in order to summarize key aspects related to clinical nutrition in lung cancer. This information can be used to arrange a proper nutritional therapy that can enhance patient treatment responses, prevent side-effects, shorten recovery time, improve prognosis and increase quality of life. An anti-inflammatory diet rich in antioxidants, immunomodulatory compounds, dietary fibre and an appropriate intake of protein can reduce the risk of initiation and progression of lung cancer, support the regeneration of tissues (also after surgery) and improve the nutritional status during the disease and after remission. A correct intake of nutrients is significant prior to disease occurrence and at every stage of treatment and recovery.
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Neoplasias Pulmonares , Desnutrição , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/terapia , Desnutrição/etiologia , Desnutrição/terapia , Avaliação Nutricional , Estado Nutricional , Apoio Nutricional , Qualidade de VidaRESUMO
BACKGROUND: The COVID-19 epidemic has affected every area of life. The greatest challenge has been to adapt the functioning of the health service to prevent the spread of the epidemic and to help infected patients. This has required the involvement of not only doctors and nurses, but also pharmacists. In the face of this pandemic, governments in many countries have granted pharmacists greater authority. OBJECTIVES: The purpose of this paper is to review the legal extension of the role of pharmacists in light of the COVID-19 pandemic. The review considers recent changes in European countries, Canada, and the United States. METHODS: A literature review was performed to summarise knowledge about the extension of the role of pharmacists during the pandemic period. Key articles were retrieved mainly from PubMed and Google Scholar, using the terms "COVID-19", "2019-nCoV", "coronavirus", and "pandemic" in combination with "pharmacist" as keywords for our search. We included scientific publications from February 1, 2019 to May 15, 2020. RESULTS: Pharmacists have been given numerous opportunities so that they can actively join in the fight against the virus. Some of the novel legal extensions aimed at aiding overloaded healthcare systems are as follows: authorisation to prepare hand and surface disinfectants, eligibility to renew chronic treatment prescriptions, as well as filling pro auctore and pro familia prescriptions by pharmacists, performing COVID-19, influenza, and Group A Streptococcus screening tests, and vaccine administration. Moreover, many countries have facilitated Internet services, such as virtual medical consultations, e-prescriptions, and home drug delivery - to promote social distancing among patients. To mitigate drug shortages, the following strategies have been implemented: alternative sourcing, strength, generic, or therapeutic substitution, and preparing compounded formulations at the pharmacy. CONCLUSIONS: Novel legal extensions have allowed exploitation of the full potential ofpharmacists worldwide, aiding the limited resources of overloaded healthcare systems.
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COVID-19/terapia , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , COVID-19/epidemiologia , Atenção à Saúde/legislação & jurisprudência , Atenção à Saúde/organização & administração , Humanos , Legislação Farmacêutica , Farmacêuticos/legislação & jurisprudência , Papel ProfissionalRESUMO
BACKGROUND: Biobanks create new opportunities for the public health (Public Health Genomics) but need some regulations. Polish biobanks are in the phase of dynamic transformations aiming at integrating their activity and adjusting them to the international standards. The aim of this article is to present the current standards held in the most important Polish institutions collecting biological samples. METHODS: A survey was conducted by the questionnaire filled by managers and directors of 24 Polish biobanks. Questions concerned obtaining patient informed consent (also a consent to some future researches and access to dates by other organizations), protection of privacy, storage of the samples and the relevant information, the opinion related to the need of establishing Polish national DNA data bank and possibilities of the scientific international cooperation. RESULTS: The written consent to carry out research on the samples is obtained almost everywhere, but 29% of biabanks does not acquire the consent for the future usage of the samples. Almost all inquired banks (93%, n = 22) declare the willingness to start an international cooperation. Most of respondents support the idea of establishing the Polish national DNA bank by the fusion of the already existing banks. CONCLUSION: The inquiry findings point that the current biobanks procedures do not differ to any relevant degree from procedures applied in the West European countries. Many of Polish biobanking organizations are willing to cooperate with foreign sites. It may enhance the European biobanking network and gene-environmental research.
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Bancos de Espécimes Biológicos/normas , Confidencialidade/normas , Consentimento Livre e Esclarecido/normas , Bancos de Espécimes Biológicos/ética , Bancos de Espécimes Biológicos/legislação & jurisprudência , Pesquisa Biomédica/ética , Pesquisa Biomédica/legislação & jurisprudência , Pesquisa Biomédica/normas , Confidencialidade/ética , Confidencialidade/legislação & jurisprudência , Pesquisas sobre Atenção à Saúde , Humanos , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Cooperação Internacional , Polônia , Padrões de ReferênciaRESUMO
Background: During the past few decades there has been a growing interest on the part of many governments in the creation of biobanks. Nevertheless, this would be impossible without participation of many donors who offer samples of their biological material for scientific research. Therefore, the aim of this paper is to provide an overview of the existing research on social attitudes towards biobanking. Material and Methods: A literature search was conducted in the database of MEDLINE (PubMed). 61 papers were included in the analysis. The retrieved articles were assessed using a thematic analysis. Results: Eight main themes were identified: (1) public knowledge about biobanks, (2) public views on biobanking, (3) willingness to donate, (4) donors' motivations, (5) perceived benefits and risks of biobanking, (6) preferred type of consent, (7) trust toward biobanks, and (8) demographic characteristics of potential donors. Conclusions: Although the public lacks knowledge about biobanking, many individuals declare willingness to donate. Their will is influenced by: their knowledge about biobanking, the type of donated tissue, research purpose, concerns over the safety of the data, preferred type of consent, and trust towards biobanks.
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Atitude , Bancos de Espécimes Biológicos , Opinião Pública , Doadores de Tecidos/psicologia , Pesquisa Biomédica , HumanosRESUMO
Background: Professional pharmacists should be directly involved in patient healthcare as members of therapeutic teams are not the only dispensers of medication. Public perceptions of the professional role of pharmacists is expressed through patients' attitudes, trust, and expectations as health and illness consultants, or qualified retailers of medicines. This perception is influenced by numerous determinants, both health-related and social. Objective: This research intends to describe the range of social roles pharmacists play from the perspective of potential pharmacy customers/patients. Methods: The data presented in the article comes from cross-sectional survey-based research, undertaken in 2018, on a representative sample of 600 Polish adults. Results: Over-the-counter medication is purchased by almost all Polish adults, but they do not tend to ask for advice at pharmacies. Most respondents consider a pharmacist to be "a person qualified to sell medicines", with some of the participants regarding pharmacists as "ordinary retailers". A small number of respondents are interested in benefiting from pharmaceutical care, but the pharmacy is still perceived to be a point of purchase for medication. Conclusions: Respondents do not treat pharmacists as health advisors and reduce its role to that of dispensing medication. Sociodemographic variables have no significant effect on social perception of pharmacists.