[Polish version of the questionnaire for measuring post-traumatic stress disorders PTSD-8 in studies of four groups of medical professions]

BACKGROUND

There are several techniques to diagnose post-traumatic stress disorder (PTSD) symptoms that correspond to the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of mental disorders. This study aimed at testing the reliability and construct validity of the Polish version of the PTSD-8. The results obtained in four professional groups of healthcare workers (physicians, nurses, paramedics, other occupations) were compared.

MATERIAL AND METHODS

The PTSD-8 questionnaire includes questions on stress reactions manifested by intrusion (4 items), avoidance (2 items), or hypervigilance (2 items). Respondents were asked about their reactions to the traumatic work-related experiences occurring during the COVID-19 pandemic. The nationwide survey conducted in 2022 included 2303 employees, among whom 746 had such an experience and completed the PTSD-8 questionnaire.

RESULTS

Based on confirmatory factor analysis (CFA) results, it was shown that a single-factor model is acceptable, but under the condition of modification by correlation of random errors at selected observable variables. The reliability of this scale is very good (McDonald's Ω = 0.890), and the goodness-of-fit of the overall CFA model is confirmed by: CMIN/DF = 3.969, NFI = 0.982, RFI = 0.964, IFI = 0.986, TLI = 0.983, RMSEA = 0.063. The model estimated for female nurses has the best psychometric properties. In the study group of 2303 respondents, 16.76% met the criteria for PTSD, accounting for 52.74% of those who were traumatized by a work-related event. The PTSD-8 index is M±SD 20.01±5.55 pts (range: 8-32 pts). The PTSD-8 index is significantly higher in women than in men, and higher in nurses compared to other professions. However, the differences between professional groups are significant only for women, and the largest when comparing female physicians and nurses.

CONCLUSIONS

The analyses confirmed the rationale of further implementation of the PTSD-8 questionnaire in Poland, both as a tool for identifying PTSD and for studying the severity of the syndrome, its determinants and health effects. Med Pr Work Health Saf. 2024;75(1):45-56.

The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument

Health literacy is an asset for and indicator of adolescents' health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87-0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context.

Quality of life in 13-year-olds depending on health status, residential neighbourhood deprivation and social capital - results from the Polish HBSC Study 2010-2018

INTRODUCTION AND OBJECTIVE

Health-related quality of life (HRQL) should be used more extensively in monitoring the health of school-aged children. The presented study aimed to evaluate trends in KIDSCREEN-10 indices, considering mean scores and the level of social inequalities.

MATERIAL AND METHODS

3,937 children aged 13 participated in three Health Behavior in School-aged Children (HBSC) cross-sectional surveys conducted in Poland between 2010-2018. Subgroups were distinguished according to gender, health status, and three social factors (family affluence, neighbourhood social capital, and local deprivation).

RESULTS

The average KIDSCREEN-10 index value was equal to: 22.36±4.54; 25.41±6.75; and 24.74±6.53 in 2010, 2014, and 2018,respectively. However, in 2018 no deterioration was recorded in boys, in poorer families or in regions with high social capital. The improvement in HRQL in 2014 was accompanied by an increase in disparities in health status and family wealth, as well as a decrease in disparities in local deprivation. An especially high increase in Glass index values was recorded for neighbourhood social capital (increasing from 0.542 in 2010 to 0.938 in 2018). The multivariate general linear model revealed the main effect of the year of the study, gender, chronic disease status, and the three social factors, as well as six significant 2-way interactions.

CONCLUSIONS

Changes in the well-being of adolescents should be tracked over time using HRQL indices with proven psychometric properties. The level of social inequalities faced by young people should be included in policies and when designing interventions. The relevant initiatives should be targeted at different populations in order to properly address the needs of different groups of children and adolescents.

Indoor radon exposure and living conditions in patients with advanced lung cancer in Lublin region, Poland

OBJECTIVE

Radon (Rn-222) is a noble gas formed in the uranium path (U-238) as a decay product of radium (Ra-226). It is estimated to cause between 3% to 14% of all lung cancers, depending on the national average radon level and smoking prevalence. Radon molecules emit alpha radiation, which is characterized by low permeability through tissues, but due to its remarkably high energy, it has a high potential for DNA damage. The aim of our research was to assess the radon concentration inside the houses of patients with advanced lung cancer and to analyze their socio-economics status.

PATIENTS AND METHODS

The measurements of radon concentration were performed in 102 patients with stage 3B or higher lung cancer in the region of Lublin, Poland. One month of radon exposure measurement was performed with alpha-track detectors. In addition, patients filled in a detailed survey about factors that might influence the concentration of radon inside their houses.

RESULTS

The average concentration of radon during the exposure of the detector in the residential premises of the respondents was at the level of 69.0 Bq/m3 [37.0-117.0]. A few significant correlations were discovered, e.g., higher levels of radon in countryside houses or in houses equipped with air conditioning.

CONCLUSIONS

As radon exposure is a modifiable risk factor for lung cancer, it is extremely important to find factors that may reduce its concentration in dwelling places. Since our research was performed in houses of people with lung cancer, taking corrective actions based on our findings could prevent new lung cancer incidence in patients' flatmates.

Gender-specific social and environmental correlates of active travel to school in four European countries: the HBSC Study

Introduction

Despite the health benefits, a large proportion of girls and boys in Europe do not travel to school actively. A better understanding of the correlates associated with this behavior could guide interventions. This study examines perceived social and environmental correlates of active travel to school (ACTS) from the 2017/18 Health Behavior in School-Aged Children (HBSC) survey in four European countries, with a special emphasis on gender differences (n = 22,023).

Methods

Logistic regression was conducted to analyze associations between the perceived importance of each correlate and ACTS behavior for 11-, 13-, and 15-year-old girls and boys from Germany, Czechia, Poland, and Slovakia. All models were adjusted for age, family affluence, and meeting World Health Organization recommendations for moderate-to-vigorous physical activity.

Results

Rates of ACTS significantly differed between girls and boys. In Czechia, 65% of girls and boys traveled to school actively, followed by Slovakia (61.4% girls and 58.4% boys), Poland (57.7% girls and 60.2% boys), and Germany (42.6% girls and 48.6% boys). Girls were less likely to actively travel to school compared to boys (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.87-0.97). Increasing age (OR: 0.95, 95% CI: 0.93-0.97) and a greater distance to school index (OR: 0.89, 95% CI: 0.88-0.90) were both negatively associated with ACTS. The perceived importance of living closer to school and of road and neighborhood safety was positively associated with ACTS, with a stronger association in boys than in girls for neighborhood safety. On the contrary, the perceived importance of having people to walk with was negatively associated with ACTS, with a stronger association in girls (OR: 0.74, 95% CI: 0.65-0.84) than in boys (OR: 0.77, 95% CI: 0.66-0.88).

Discussion

This study provides insights into perceived social and environmental correlates associated with ACTS behavior. Future research should include gender-specific perceptions and more in-depth investigations of correlates encouraging ACTS, especially considering social aspects, safety issues, and the structuring of the environment in different cultural settings.

COVID-19 Pandemic and Healthcare Communication: A Patient-Centric Evaluation of Treatment and Diagnostic Procedures in Poland

BACKGROUND The COVID-19 pandemic necessitated swift and often abrupt changes in healthcare practices, significantly influencing treatment and diagnostic procedures. This study aimed to gauge patient perceptions regarding these changes and their overall impact on the treatment and diagnosis process (ITDP). MATERIAL AND METHODS In March 2022, we conducted a cross-sectional online survey among 1860 Polish residents (mean age: 48.82±16.57 years), who had accessed medical services within the preceding 24 months. We employed a binary logistic regression model to pinpoint independent factors contributing to a wholly negative perception of the pandemic's influence on the ITDP. RESULTS Around 64.3% of respondents perceived the ITDP during the pandemic negatively, with 20.8% reporting mixed impacts. Of 22 factors considered, 16 were significantly associated with ITDP perceptions in univariate analyses, and 8 qualified for the final multivariate model. The most potent predictors of negative ITDP perceptions included impeded communication with medical personnel due to the emphasis on COVID-19 (OR=2.82; 95% CI: 2.04-3.90) and worsening family financial circumstances during the pandemic (OR=2.03; 95% CI: 1.26-3.27). Other significant predictors comprised viewing remote services as a hindrance to medical communication, higher education, and use of self-funded private healthcare. CONCLUSIONS Our findings confirm that negative perceptions of the ITDP during the COVID-19 pandemic are associated with the remote delivery of medical services and communication challenges. These insights underscore the need to improve these domains for better healthcare delivery amid ongoing or future health crises.

Dietary Intake and Circulating Amino Acid Concentrations in Relation with Bone Metabolism Markers in Children Following Vegetarian and Omnivorous Diets

Scientific studies reported that most vegetarians meet the total protein requirements; however, little is known about their amino acid intakes. We aimed to assess dietary intake and serum amino acid levels in relation to bone metabolism markers in prepubertal children on vegetarian and traditional diets. Data from 51 vegetarian and 25 omnivorous children aged 4–9 years were analyzed. Dietary intake of macro- and micronutrients were assessed using the nutritional program Dieta 5®. Serum amino acid analysis was performed using high-pressure liquid chromatography technique, 25-hydroxyvitamin D and parathormone–electrochemiluminescent immunoassay, and bone metabolism markers, albumin, and prealbumin levels using enzyme-linked immunosorbent assay. Vegetarian children had a significantly lower intake of protein and amino acids with median differences of about 30–50% compared to omnivores. Concentrations of four amino acids (valine, lysine, leucine, isoleucine) in serum varied significantly by diet groups and were lower by 10–15% in vegetarians than meat-eaters. Vegetarian children also had lower (p < 0.001) serum albumin levels compared to omnivores. Among bone markers, they had higher (p < 0.05) levels of C-terminal telopeptide of collagen type I (CTX-I) than omnivores. Correlation patterns between amino acids and bone metabolism markers differed in the vegetarian and omnivore groups. Out of bone markers, especially osteoprotegerin was positively correlated with several amino acids, such as tryptophan, alanine, aspartate, glutamine, and serine, and ornithine in vegetarians. Vegetarian children consumed apparently sufficient but lower protein and amino acids compared to omnivores. In circulation these differences were less marked than in the diet. Significantly lower amino acid intake and serum levels of valine, lysine, leucine, and isoleucine as well as the observed correlations between serum amino acids and biochemical bone marker levels indicated the relations between diet, protein quality, and bone metabolism.

Pandemic-Related Stress and Other Emotional Difficulties in a Sample of Men and Women Living in Romantic Relationships during the COVID-19 Pandemic

This study examined the extent to which relationship quality affects variability in perceived stress and other emotional difficulties associated with the pandemic. The study was conducted 2-17 March 2022 using a self-administered online survey. The sample size consisted of 1405 individuals who were in a romantic relationship. The scales used in the study included the PSS-4, ECR-RS, SLS-12 and the standardized Pandemic-ED scale (RMSEA = 0.032). Increased stress levels (U = -5.741), pandemic-related emotional difficulties (U = -8.720), worse romantic relationship quality (U = -2.564) and more frequent anxiety-related attachment (U = -3.371) were characteristic of women. A hierarchical regression model for stress showed that age (b = -0.143), financial situation (b = 0.024), the ECR-RS scores (b = 0.219) and pandemic-related emotional difficulties (b = 0.358) proved to be statistically significant predictors of stress. The hierarchical regression model for pandemic-related emotional difficulties indicated five predictors: gender (b = 0.166), education (b = 0.071), financial situation (b = 0.203), scores on the ECR-RS scale (b = 0.048) and stress (b = 0.367). The SEM model used has satisfactory fit indices (RMSEA = 0.051), romantic relationship quality scores and attachment styles interact with the variability of perceived pandemic-related stress and burdens. The determined model offers conclusions relevant to clinicians working with individuals and couples during periods of intense stress.

Occupational Burnout in Healthcare Workers, Stress and Other Symptoms of Work Overload during the COVID-19 Pandemic in Poland

This study explored the level and selected determinants of burnout among five groups of healthcare workers (physicians, nurses, paramedics, other medical and nonmedical staff) working during the COVID-19 pandemic in Poland. This cross-sectional study was conducted from February to April 2022, with the use of a self-administered mostly online survey. The BAT-12 scale was used to measure burnout, and the PSS-4 scale was used to measure stress. The sample was limited to 2196 individuals who worked with patients during the COVID-19 pandemic. A series of multivariate logistic regression models with three to nine predictors was estimated. The prevalence of burnout ranged from 27.7% in other nonmedical staff to 36.5% in nurses. Adjusting for age and gender, both physicians (p = 0.011) and nurses (p < 0.001) were at higher risk of burnout. In the final model, elevated stress most likely increased the risk of burnout (OR = 3.88; 95%CI <3.13-3.81>; p < 0,001). Other significant predictors of burnout included traumatic work-related experience (OR =1.91, p < 0.001), mobbing (OR = 1.83, p < 0.001) and higher workload than before the pandemic (OR = 1.41, p = 0.002). Only 7% of the respondents decided to use various forms of psychological support during the pandemic. The presented research can contribute to the effective planning and implementation of measures in the face of crisis when the workload continues to increase.

Similarities and Differences between Psychosocial Determinants of Bullying and Cyberbullying Perpetration among Polish Adolescents

Despite the extensive literature on the psychosocial determinants of bullying and cyberbullying among adolescents, there is not sufficient comprehensive analysis of the differences between perpetrators. This study aims to assess the psychosocial similarities and differences between bullies and cyberbullies. Data of 3650 students from two grades, K9 and K11 (47% females, mean age = 16.53), were used from a survey conducted in Poland in 2018 as part of the Health Behaviour in School-aged Children study. Perpetration was measured by questions adapted from the Olweus Bully/Victim Questionnaire. The following predictors were analyzed: demographic, socioeconomic status measured with the Family Affluence Scale-III (FAS), and individual and social factors. Multiple binary logistic regression was applied. The random sampling design was based on stratification according to the local deprivation index of the region where the school was located. Male gender, younger age, and non-intact family were associated with a higher risk of bullying and cyberbullying. Family support, empathy, school performance, and school attachment had a protective effect against both aggressive behaviors. Life dissatisfaction and high FAS were revealed as determinants of cyberbullying and local deprivation of bullying only. Bullying and cyberbullying school prevention programs should take into account these psychosocial differences and consider the economic deprivation of the region.

The Measurement of Love: Psychometric Properties and Preliminary Findings of the Short Love Scale (SLS-12) in a Polish Sample

There has been a perceived need for the development of instruments to assess relationship quality and love. The aim of this study was to describe the psychometric properties of the Short Love Scale (SLS-12) and to compare different measurement models. Data were collected using the CAWI (Computer-Assisted Web Interview) in Poland in early 2022 (18-60 years old; n = 941) among individuals living in formal or informal monogamous relationships. Both exploratory (EFA) and confirmatory factor (CFA) analyses were performed on two different subsamples obtained through random splitting of the full datafile. There were 12 items considered, which form three dimensions in accordance with the theoretical basis. CFA analysis confirmed good psychometric properties of the three-factor SLS-12 model based on EFA solution: χ²(47) = 146.802 (p ˂ 0.001); χ²/df = 3.123; CFI = 0.981, TLI = 0.973, RMSEA = 0.067 (90% CI 0.055-0.080), GFI = 0.952, AGFI = 0.921. SLS-12 subindices varied according to gender and relationship status. Based on ROC curve method, it may be assumed that scores on the SLS-12 ranging from 12 to 44 indicate a poor relationship, scores ranging from 45 to 52 a moderately good relationship, and scores of 53 to 60 a very good relationship. Improving and increasing the range of measures of love available to researchers remains an important task in supporting the progress of this area of research. Further research should be conducted among people of all ages living in both formal and informal relationships using the Short Love Scale-12 outlined in this paper.

Factors Associated with Uptake of Effective and Ineffective Contraceptives among Polish Women during the First Period of the COVID-19 Pandemic

The COVID-19 pandemic has burdened the healthcare system and influenced individuals' health-related choices. The aim of the study was to estimate the prevalence and to identify the correlates of the use of more and less effective contraceptive methods among Poles in the initial period of the COVID-19 pandemic. The cross-sectional online study was conducted among the representative sample of 642 female respondents aged 18-49. Three groups of contraception choices (only effective methods-42.2%, mixed effective and ineffective methods-26.8%, none-31.0%) were distinguished and 11 potential determinants were considered. One in ten women declared having difficulty in accessing contraception during the first months of the pandemic. A multinomial logistic regression model explained 48.7% of the variation in contraceptive method choice. Both effective and ineffective methods were more often declared by young women, and less often in case of lower education, planning children or subjective no need for contraception. In addition, factors that reduced the chance of effective contraception were poor financial situation, already having children and a relatively higher degree of religiosity. The study confirmed that a significant share of Polish women do not opt for effective methods of contraception. Their choices had strong demographic, social and cultural determinants.

Who Is Able to Resist What Is Forbidden?—The Relationship between Health Literacy and Risk Behaviours in Secondary School Students in the Broader Social and Educational Context

In the last Health Behaviour in School-Aged Children (HBSC) survey conducted in Poland in 2018, a group of 17-year-old adolescents (n = 1663; mean age 17.63 ± 0.36 years) was included outside the international protocol. This allowed an assessment to be made of their level of health literacy (HL) using the 10-point HBSC research tool. The aim of the study was to investigate the relationship between HL and risk behaviours (RB). A standardised index of RB in the last 30 days was considered as an outcome measure. This index was significantly higher in the group with low HL (0.318 ± 1.269) in comparison with the group with high HL (−0.083 ± 0.962). In a multivariate linear regression model, the strongest predictors of RB were gender, academic performance and level of regional deprivation, but the association with HL remained significant. This significant association persisted in general schools and in girls but disappeared in vocational schools and in boys. It was also shown that in rural areas, good academic performance has a less significant impact on RB if the HL level is low. The analyses led to the conclusion that when examining the relationship between HL and RB in older adolescents, it is advisable to take into account gender, the educational track and neighbourhood characteristics.

The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021

The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.

Expectations for engagement in community issues as perceived by young people

BACKGROUND

Involvement in constructive activities is an important but rarely empirically studied developmental asset.

OBJECTIVE

The aim of the study is to assess the intentions of Polish youth to undertake prosocial activities after graduating from high school, and the selected determinants of these intentions.

MATERIAL AND METHODS

Anonymous surveys were conducted in 213 schools within the last round of the HBSC (Health Behaviour in School-aged Children) survey in 2018. The nationwide representative sample included 4,972 students aged 11.1-18.5 (mean age 15.4 ± 1.73). The main dependent variable was the Expectations for Engagement in Community Issues Index (EECII), built on the basis of 3 questions and ranged 0-12 points. Its relationship with 10 demographic and socio-economic variables was studied.

RESULTS

The mean EECII score was 5.59 (SD = 2.65). Seven factors and three significant two-way interactions were indicated in the general linear model. The strongest correlation was found to be between the EECII level and recognised personal values, current participation in youth groups, and the level of social ties in the neighbourhood. Girls achieve higher EECII levels than boys. However, factors such as family social position and attitudes towards school modify the gender differences. Higher family social position measured on subjective scale increases the tendency to plan prosocial activities in the group coming from low affluence families.

CONCLUSIONS

Polish youth have an average inclination towards prosocial activities. When planning activities aimed at strengthening the involvement of young people, it is worth considering the specificity of various demographic and social groups.

What factors do young people define as determinants of their well-being? findings from the improve the youth project

BACKGROUND

The UN has recognised well-being as a main goal of The Global Strategy for Women's, Children's and Adolescents' Health (2016-2030).

OBJECTIVE

The aim was to identify the areas of mental health that are the most significant to teenagers.

MATERIAL AND METHODS

The mixed-method approach was applied. Quantitative research included adolescents aged 11-15 years (6,026 in Portugal; 4,545 in Poland). HBSC study results (2013/2014) were analysed in terms of the following variables: self-rated health, life satisfaction (Cantril Ladder, KIDSCREEN-10 Index), and psychosomatic complaints (SCL scale). Focus workshops took place in 2018, with 72 teenagers aged 14 to 16.

RESULTS

16.6% of the Polish participants and 12.7% of the Portuguese participants were concerned about their health. Polish participants were less satisfied with their life [KIDSCREEN score: 25.48 for Poland (SD=6.39), and 29.96 (SD=6.03) for Portugal]. Both nations associated mental health (MH) with the family setting and relationships with friends. An additional association among Portuguese teenagers involved social issues, whereas Polish adolescents were more focussed on relationships with various people in their environment, as well as on experiencing issues at school and in the family.

CONCLUSIONS

Adolescent MH is determined by stress, environmental pressure and high expectations. The viewpoints of adolescents are the most valuable source of knowledge for specialists, researchers and youth institutions, who can benefit greatly from taking advantage of this resource.

Influence of Oxidative Stress Generated by Smoking during Pregnancy on Glutathione Status in Mother-Newborn Pairs

Glutathione plays a key role in maintaining a physiological balance between prooxidants and antioxidants in the human body. Therefore, we examined the influence of maternal smoking as a source of oxidative stress measured by total oxidant capacity (TOC) on reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GPx-3), and reductase (GR) amount in maternal and umbilical cord blood in 110 (45 smoking and 65 non-smoking) mother-newborn pairs. Concentrations of glutathione status markers and TOC were evaluated by competitive inhibition enzyme immunoassay technique. Plasma TOC levels were significantly higher and the GSH/GSSG ratio, which is considered an index of the cell’s redox status, were significantly lower in smoking women and their offspring than in non-smoking pairs. Decreased GR levels were found in smoking mothers and their newborns compared with similar non-smoking groups. Although plasma GPx-3 concentrations were similar in both maternal groups, in the cord blood of newborns exposed to tobacco smoke in utero they were reduced compared with the levels observed in children of tobacco abstinent mothers. Oxidative stress generated by tobacco smoke impairs glutathione homeostasis in both the mother and the newborn. The severity of oxidative processes in the mother co-existing with the reduced potential of antioxidant systems may have a negative effect on the oxidative-antioxidant balance in the newborn.

Trends in multiple health complaints in Polish adolescents in light of data from 30 European countries and Canada (2002-2018)

Background

Adolescence is a sensitive period accompanied by rapid developmental changes that can result in health complaints. The aim of the study was to describe the trend of subjective health complaints (HBSC-SCL) of Polish adolescents compared to their peers from 30 other countries and to rank all countries based on a proposed standardised measure.

Material and Methods

Data from the Health Behaviour in School-Aged Children (HBSC) study collected from 2002 to 2018 were used. The overall number of respondents from 30 countries in the combined sample from five quadrennial rounds was 773,356, including 49.2% boys and 50.8% girls. The HBSC-SCL is a non-clinical measure consisting of eight health complaints, usually analysed in two dimensions of psychological and somatic symptoms. Linear regression analysis was applied to assess the significance of trends of the total index and two subindices in the combined sample and individual countries.

Results

A significant increasing trend for the eight-item index appeared in Poland only in 13- and 15-year-olds, while only among 15-year-olds in the combined sample from 30 countries. Standardised country rank varied between -1.85 and 2.48 (worst). The countries that achieved extreme negative values (>=1) are France, Hungary, Italy, and Sweden, and the rank for Italy is considerably higher than for other countries. In Poland, the standardised rank for psychological symptoms exceeded the threshold of +1 in 2018.

Conclusions

The HBSC-SCL index could be useful for monitoring change in adolescent mental health. The proposed method of ranking may allow a broader view of the differences and similarities between countries and help to identify those performing unfavourably against cross-country patterns.

Does a Vegetarian Diet Affect the Levels of Myokine and Adipokine in Prepubertal Children?

Myokines are cytokines secreted by muscle and exert autocrine, paracrine, or endocrine effects. Myokines mediate communication between muscle and other organs, including adipose tissue. The aim of the study was to assess serum myokines and their relationships with adipokines and anthropometric and nutritional parameters in children following vegetarian and omnivorous diets. One hundred and five prepubertal children were examined. Among them there were 55 children on a vegetarian diet and 50 children on an omnivorous diet. Concentrations of myokines (myostatin, irisin) and adipokines (leptin, adiponectin, omentin, visfatin) in serum were determined by enzyme-linked immunosorbent assay (ELISA). We observed comparable median values of serum myokines and adipokines (except of leptin concentration) in both of the studied groups of children. We also found several correlations between myokine and adipokine levels and certain nutritional parameters. Serum myostatin was positively correlated with omentin levels in vegetarians and omnivores (p = 0.002). Serum irisin was positively associated with omentin (p = 0.045) levels in omnivores and inversely with visfatin concentration (p = 0.037) in vegetarians. Myostatin concentration was negatively correlated with the percentage of energy from protein (p = 0.014), calcium (p = 0.046), and vitamin A (p = 0.028) intakes in vegetarians and with dietary vitamin C (p = 0.041) and vitamin E (p = 0.021) intakes in omnivores. In multivariate regression analyses, positive correlations of serum myostatin with omentin levels were revealed in both study groups (β = 0.437, p < 0.001 for vegetarians; and β = 0.359, p = 0.001 for omnivores). Consuming a lacto-ovo-vegetarian diet did not influence serum levels of myokines (myostatin, irisin) and adipokines such as adiponectin, visfatin, and omentin in prepubertal children. However, leptin levels were significantly lower in vegetarians compared with omnivores. The observed significant positive correlations between myostatin and omentin concentrations might suggest tissue cross-talk between skeletal muscle and fat tissue. Further studies, carried out in a larger group of children following different dietary patterns, could be important to fully understand the relations between muscle, adipose tissues, and nutrition.

Making the best out of youth-The Improve the Youth project

Adolescents' mental health determines their general health and their mental health as adults. Improve the Youth project (ITY) was created and implemented among Polish and Portuguese adolescents. The aim of the project was to investigate the well-being of Portuguese and Polish adolescents, and to evaluate differences between them in self-rated health, life satisfaction and perceived psychosomatic health. A mixed-method approach was applied. The quantitative part was based on Health Behaviour in School-aged Children (HBSC) 2014 data, including adolescents aged 11-15 years (6026 in Portugal; 4545 in Poland). This study meets the issues raised by the HBSC results, regarding mental health in adolescence, and it is aimed to improve adolescents' social participation and active citizenship. In most study areas, findings in Poland were less favourable than in Portugal. The qualitative part was developed to recognize the main threats for adolescent's well-being. In this, they emphasised that every opportunity to talk about their feelings and needs resulted in improvement of their mental health. Elevated levels of stress were connected to environmental pressure and high expectations that they were often unable to cope with. Nervousness, perceiving that it was impossible to meet expectations, the desire to keep up with their peers, fatigue, and uncertainty of the future increased the feelings of frustration. The differences found between countries may be due to cultural roots, surfacing the relevance of assessing adolescents' mental health needs in the social context of family, school and peers. This study also aims to raise awareness among educators and stakeholders to the importance of youth engagement.

Changes in mental well-being of adult Poles in the early period of the COVID-19 pandemic with reference to their occupational activity and remote work

OBJECTIVES

The present study focused on the relationship between occupational activity and mental health during the first COVID-19 lockdown.

MATERIAL AND METHODS

At the turn of May and June 2020, an online survey was conducted on a representative sample of 3000 Poles (age: Me = 45 years). Working persons accounted for 52% of the respondents, while 38.1% were hired workers. Two standardized (0-100 pts) indices were defined. The level of mental health symptoms index (LMHSI) concerned the incidence of 4 problems within the past 2 months, whereas the change in mental health symptoms index (CMHSI) concerned the degree of mental health deterioration.

RESULTS

The mean value of LMHSI was 40.91 (SD = 26.97), and that of CMHSI 60.51 (SD = 23.97). In both cases, a worse assessment was obtained among women than among men. In the group of working respondents, the least advantageous results were found among those who worked casually or under a commission contract. Among the non-employed respondents, jobless persons and students were the group at risk. Remote work resulted in the deterioration of mental health in the light of CMHSI; however, a threat of changes in the professional situation affected LMHSI variability to the greatest extent The results of linear regression (R² = 0.339) suggest that the increase in the CMHSI score (adjusted for LMHSI) is independently influenced by female sex, university education, remote work and a threat of the worsening of employment terms. The analysis of the interaction effect showed a stronger impact of the last factor in the group of women (p = 0.001).

CONCLUSIONS

To conclude, COVID-19 restrictions were associated with a negative impact on mental health which should be analyzed in the occupational context. Int J Occup Med Environ Health. 2021;34(2):251-62.

Radar plots facilitate differential diagnosis of acute promyelocytic leukemia and NPM1+ acute myeloid leukemia by flow cytometry

BACKGROUND

Acute promyelocytic leukemia (APL) is one of the most life-threatening hematological emergencies and requires a prompt correct diagnosis by cytomorphology and flow cytometry (FCM) with later confirmation by cytogenetics/molecular genetics. However, nucleophosmin 1 muted acute myeloid leukemia (NPM1+ AML) can mimic APL, especially the hypogranular variant of APL. Our study aimed to develop a novel, Radar plot-based FCM strategy to distinguish APLs and NPM1+ AMLs quickly and accurately.

METHOD

Diagnostic samples from 52 APL and 32 NPM1+ AMLs patients were analyzed by a 3-tube panel of 10-color FCM. Radar plots combining all markers were constructed for each tube. Percentages of positive leukemic cells and mean fluorescence intensity were calculated for all the markers.

RESULTS

APL showed significantly higher expression of CD64, CD2, and CD13, whereas more leukemic cells were positive for CD11b, CD11c, CD15, CD36, and HLA-DR in NPM1+ AMLs. Radar plots featured CD2 expression, a lack of a monocytic component, lack of expression of HLA-DR and CD15, and a lack of a prominent CD11c+ population as recurring characteristics of APL. The presence of blasts with low SSC, presence of at least some monocytes, some expression of HLA-DR and/or CD15, and a prominent CD11c population were recurrent characteristics of NPM1+ AMLs. Radar plot analysis could confidently separate all hypergranular APL cases from any NPM1+ AML and in 90% of cases between variant APL and blastic NPM1+ AML.

CONCLUSION

Radar plots can potentially add to differential diagnostics as they exhibit characteristic patterns distinguishing APL and different types of NPM1+ AMLs.

Active Transport to School May Reduce Psychosomatic Symptoms in School-Aged Children: Data from Nine Countries

It is widely proven that being physically active and avoiding sedentary behaviour help to improve adolescents' well-being and keep them in better health in general. We aimed to investigate the relationship between modes of transport to school and subjective complaints among schoolchildren. Analyses were based on the HBSC (Health Behaviour in School-aged Children) surveys conducted in 2017/18 in nine countries (N = 55,607; mean age 13.43 ± 1.64 yrs.). The main outcome showed that health complaints consisted of somatic and psychological complaints. Transport to school was characterized by mode of getting there (walking, biking, or another passive mode). A total of 46.1% of students walked and 7.3% cycled to school; 46.6% commuted by passive means. Biking to school was more frequent in Denmark (37.9%), Norway (26.5%), and Germany (26.6%). The multivariate generalized linear model adjusted for age, gender, country, and school proximity showed that biking to school is protective against reports of health complaints. The beta parameters were equal to -0.498 (p < 0.001) for the general HBSC-SCL index, -0.208 (p < 0.001) for the somatic complaint index, and -0.285 (p < 0.001) for the psychological complaints index. Young people who actively commute to school are less likely to report health complaints, especially psychological symptoms.

Psychosocial determinants of sexual norms and their impact on sexual debut in Polish adolescents

OBJECTIVES

In an attempt to describe composite scales relating to sexual norms, we present their structure, psychosocial determinants, and the association with adolescent sexual initiation.

METHODS

A representative sample of Polish students was surveyed in 2015 (n = 1024, mean age 17.8 ± 0.31). Three scales of sexual norms were identified using principal component analysis. Logistic regression and path models were applied.

RESULTS

The scales concerning stereotype gender norms, as well as restrictive and permissive sexual norms, were developed. Restrictive norms lead to later sexual initiation and were more frequent in combination with love for the first partner. The variability of all the indices was significantly correlated with the peer environment. A number of direct and indirect paths were found among the above indices, family relationships (support, communication), and socio-emotional strengths, such as the meaning of life, coherence, and self-esteem.

CONCLUSIONS

The norms of sexual morality should be included in the analysis of the determinants of adolescent sexual behaviours along with an investigation of complex causal models. The results may contribute to improvement in sexual health promotion.

Adolescents’ stress - a challenge for adults in charge - The Improve the Youth project

Background

The project was an answer to the results of the HBSC (Health Behaviour of School-aged Children) study 2013/2014 which indicated an alarming situation regarding the adolescents' mental health. The aim was to investigate mental health problems of Polish and Portuguese youth and to create tools and materials which can be a professional help in this matter. Improve the youth project consisted of two main elements: research and implementation phase. The mixed-method approach was applied in the project. Quantitative and qualitative research methods were used. 2004 pupils (aged 13-19) were surveyed in 89 schools in 2017/ 2018 in Poland. Findings form qualitative study were guidelines for quantitative research. Perception of stress among young people was selected as the leading subject. Short Form Perceived Stress Scale (PSS-4) in a shorter version of 4-statement were used. There were two advisory boards: first - practitioners (psychologists, pedagogists, teachers, social workers) and second - adolescents. Both were consulted to prepare all materials.

Results

Stress levels are higher in girls than in boys, and they increase with age: between 13 and 19 year of age the increase in the prevalence of high stress level was 5,3% in boys and 12.5% in girls. Family affluence, school achievements and school burden were identified as stress determinants of adolescents.

Materials presenting the data and giving practical information and tools on how to support adolescents in coping with stress: guide for adults, guide for youth created by youth and scenario of workshops.

20 workshops for young people run by young people were organised in both countries for about 200 adolescents

Results and materials were presented to youth organizations, social institutions and decision makers responsible for youth policy during two 'Improve the Youth' conferences in Poland and in Portugal.

Childhood Obesity Surveillance Initiative (COSI) in Poland: Implementation of Two Rounds of the Study in the Context of International Methodological Assumptions

Nowadays, childhood obesity is one of the key health problems in European countries. This article presents a study that is part of the World Health Organization (WHO) Childhood Obesity Surveillance Initiative (COSI) implemented in the WHO European Region since 2007. The main goal of the study is to monitor obesity in early school-aged children. The methodology of the study, the thematic scope of research tools, the organisational principles and the development of research carried out in Poland in the context of existing international assumptions are presented. In Poland, two rounds of the study were financed by the National Health Program, in cooperation with the WHO Office in Poland. The first study was carried out from November to December 2016 on a group of 3,408 children aged 8 years from 135 schools and 2,298 parents, in 9 voivodeships in Poland. The second round was carried out in the last quarter of 2018 in 12 voivodeships. A group of 2691 pupils aged 8 years from the 2nd grade of 140 primary schools in Poland and 2450 parents were examined. Data on body mass index distribution and lifestyle-related behaviours of children and their families were collected. Poland is the first country where blood pressure was measured in all participants of the COSI study. Considering the growing obesity epidemic, reliable monitoring of overweight and obesity in early childhood and the study of determinants of this phenomenon should be a priority for public health. The results obtained from this type of research are a reference point for the design and implementation of accurate prevention initiatives in this age group.

Changes in physical activity of adolescent girls in the context of their perception of the Healthy Me programme

BACKGROUND

An assumption was made that results of programme evaluation lead to better understanding for whom this intervention may work. The aim of the article is to compare the changes in physical activity of the intervention programme participants depending on subjective assessment of its impact.

METHODS

The data were obtained from 14- to15-year-old Polish girls (N = 1120) from 48 random selected secondary schools participating in the 1-year Healthy Me programme in the 2017/2018. Schools were randomly assigned to one of two types of intervention or to a control (null) group. Satisfaction with the programme according to 21 criteria was measured retrospectively just after the intervention. Change in MVPA (moderate-to-vigorous physical activity) during the programme implementation was assessed in relation to satisfaction level, and adjusted for initial MVPA.

RESULTS

In total, the MVPA did not change significantly comparing pre- and post-intervention surveys (3.94 ± 1.94 vs. 3.87 ± 1.93)-P = 0.093. However, the perceived notable improvement of functioning in 10 out of 21 areas was related to the unquestionable increase in MVPA (P ≤ 0.001). With respect to the four impact areas, an interaction was demonstrated between an intervention group and an improvement in the domain-specific functioning. The beneficial impact of the programme on these areas was associated with the improvement of physical activity only in case of full and null intervention.

CONCLUSIONS

Indicators related to the implementation process and the results obtained during the Healthy Me programme evaluation could represent a change in motivational and environmental factors that indirectly affects adolescent girl's physical activity.

The Polish version of the short scale measuring health literacy in adolescence

OBJECTIVE

Background: Recent years saw the development of international tools for measuring health competencies understood as health literacy (HL). One of them is the short index Health Literacy for School-Aged Children (HLSAC) implemented by the members of the Health Behaviour in School-aged Children (HBSC) network. So far, when researching the properties of this instrument, less attention has been devoted to the correlation of HLSAC with other tools related to health. The aim of the paper is to present selected psychometric features of the HLSAC index in a sample of Polish pupils, supplemented by the preliminary analysis of its association with the health locus of control.

PATIENTS AND METHODS

Material and methods: The information collected relates to 630 junior secondary school students surveyed in Poland in 2016 as part of the HLSAC questionnaire pilot study. The Multidimensional Health Locus of Control (MHLC) scale by K. Wallston was used as the additional module for Poland. It differentiates among three dimensions of health control: internal, external - dependent on other people, and external - dependent on random factors. It was checked which HLC dimension correlates most strongly with HL.

RESULTS

Results: It was demonstrated that the HLSAC scale consisting of 10 questions has a very good reliability in the Polish version (Cronbach alfa = 0.851) and a one-factor structure. Confirmatory factor analysis supported a unidimensional model (RMSEA = 0.082; CFI=0.922; TLI=0.877). The HLSAC most strongly correlates with the internal health locus of control (r=0.376; p<0.001), slightly less with the influence of other people (r=0.153; p<0.001), while the correlation with the random factor health locus of control is insignificant (p=0.947). It was found that there is a weak, however significant, positive correlation between family affluence and HLSAC (p=0.041).

CONCLUSION

Conclusions: The analyses conducted demonstrated that the Polish version of HLSAC has good psychometric features. The relatively higher correlation between HLSAC and internal rather than external health locus of control was confirmed. The practical effect of the pilot study was to develop an improved version of the HLSAC scale, which has been recommended for the mainstream HBSC 2018 survey.

P5306Changes in health-behaviours of 15-year old girls depend on satisfaction with the prophylactic intervention program. Healthy Me Study

Introduction

Healthy Me (HM) interventional study was oriented on improvement of physical activity (PA) in 15-year old girls but also included component of eating habits, smoking prevention and personal competencies. Innovative elements of the project involved usage of fitness-band with continuous monitoring of PA and special dedicated smartphone apps.

Purpose

To assess the effectiveness of 1-year prophylactic intervention with the use of mobile technology in girls between 14 and 15 year of age, in relation to the level of their satisfaction with the program.

Methods

1198 girls 14–15 years old from 48 randomly selected schools from all over Poland participated in the HM during 2017/2018 school year. Schools were randomized to full or partial intervention and control group, respectively 636, 277 and 285 girls. Questionnaire data from the beginning and the end of the HM regarding four factors (low PA, eating sweets, smoking and stress level) were analyzed. Mean changes (MC) calculated according to the definition given in table 1 were applied as outcome measure. Satisfaction with the program was assessed after 1 year of participation in the HM as low, average and high. General linear models with main effects were estimated and adjusted for initial level of each factor.

Results

At the beginning of the study 87% participants did not fulfill criteria for recommended PA, 9% smoked during last 30 days and 67% ate sweets more than ones per week. Mean stress level was 6.92±2.92 points. For the entire study group, the only significant change after 1 year intervention was lower frequency of eating sweets (p=0,007). However, the higher satisfaction with the study resulted in the significantly higher effectiveness of HM intervention (table 1).

Mean changes in the analyzed factors Analyzed factor Range Mean change in entire group (SE) Mean change by level of satisfaction p1 p2 low (SE) average (SE) high (SE) Physical activity (MVPA) 0–7 days −0.076 (0.063) −0.396 (0.137) −0.147 (0.068) 0.261 (0.119) 0.001 0.068 Smoking-past 0 – never 0.039 (0.028) 0.270 (0.066) 0.034 (0.033) −0.004 (0.057) 0.002 0.067 6–30 days or more Eating sweets 0 – never −0.296 (0.045) −0.047 (0.101) −0.285 (0.050) −0.313 (0.086) 0.069 0.016 6 – every day more than once Stress Cohen scale 0–16 points 0.105 (0.090) 0.498 (0.211) 0.138 (0.105) −0.424 (0.183) 0.003 0.823 SE: standard error; MVPA: moderate to vigorous physical activity; p1: main effect of the level of satisfaction; p2: main effect of the intervention group.

Conclusion

Program that was dedicated for improvement of PA in teenage girls could also profitably influence other factors related to health behaviours and stress level in this group but intervention must be perceived by participants as rewarding. It seems, that attractiveness of interventional program design, increased by mobile technologies, is key for its effectiveness for teens.

Acknowledgement/Funding

National Health Program, Ministry of Health

Dietary Patterns of Children Aged 1-3 Years in Poland in Two Population Studies

BACKGROUND

The levels of nutrition that children receive in their first years of life greatly determine their psychosomatic development.

AIM

The study was to identify dietary patterns of children aged 1-3 years based on data on food consumption structure from 2 population studies performed in Poland (2011 and 2016) and to assess changes in product selection in the children's diets with respect to their nutritional status.

METHODS

Both studies were performed on nationwide representative samples (2011: n = 400; 2016: n = 612) using questionnaire surveys. Nutritional status was estimated using body weight-to-height z-score. Feeding practices were evaluated based on 3-day dietary/food records, including 1 weekend day.

RESULTS

Four dietary patterns of toddlers were identified and changes in the distribution of these patterns in the population after 5 years were analysed and compared. Diets of children in the second year of life were better balanced in terms of energy and nutritional value owing to young child formula content. Diets of children in the third year of life were higher in energy and protein, with a higher percentage of energy derived from saccharose. Diets of all groups of children were deficient in long-chain polyunsaturated fatty acids, vitamin D and potassium but excessive in sodium.

CONCLUSIONS

Over 5 years, the percentage of children on a diet with high intake of formula for young children significantly decreased but increased on a diet with high dairy content. Dietary patterns of toddlers were associated with their weight by height z score and nutrient profile.

Family, school and neighborhood factors moderating the relationship between physical activity and some aspects of mental health in adolescents

The impact of physical activity on mental health is widely described in literature. Less attention is given to factors which may modify this correlation, except for gender. The aim of this study was to conduct a qualitative assessment of such papers relating to children and young people. Selected papers were evaluated with regard to additional factors related to family, school and neighborhood. Attention was drawn to the definitions of these variables, the methods of analysis, and the content of the discussion. The starting point for this study included 7 systematic reviews published in 2006-2018. A total of 161 full articles described in detail in those reviews, and representing different research patterns, were selected for qualitative analysis. They met the criteria for the type of publication, mental health outcome, the direction of association, and the age group. A supplementary section of this paper contains a review of Polish literature from the Polish Medical Bibliography, and an analysis of national studies and some more recent papers not included in the analyzed reviews. It was demonstrated that 33 papers analyzed environmental variables to a greater degree than the characteristics of the sample. Twenty-three papers containing the results of statistical analyses were considered to be of particular interest. Almost 50% of these included both the socio-economic position of the family and the characteristics of the neighborhood. However, only 1 featured stratification of the sample with regard to contextual environmental variables. The obtained results are of great practical importance. Firstly, development of the research into environmental moderators should be advocated. Secondly, the social context in which adolescents grow up should be taken into account when designing intervention programs. Int J Occup Med Environ Health. 2019;32(4):423-39 <b></b> <b></b>.

Physical Activity, Sedentary Behaviours and Duration of Sleep as Factors Affecting the Well-Being of Young People against the Background of Environmental Moderators

Mental health problems during adolescence are becoming increasingly frequent. The purpose of this study was to evaluate the total impact of selected behavioural and environmental factors on the variability of mental well-being indexes of young people aged 15 to 17 years. The survey, conducted as part of the last round of the Health Behaviour in School-Aged Children (HBSC) 2017/18 study, covered 3693 secondary school students in Poland at the average age of 16.53 years (SD = 1.09). Dependent variables: depression (CES-DC), stress (Cohen scale), satisfaction with life (Cantril's Ladder), and self-efficacy in social relations (Smith and Betz scale). Independent variables included: physical activity; sedentary behaviours; length of sleep; and perception of the environment in which the respondent was raised. The analyses were adjusted by gender, age, and occurrence of chronic disease. It was demonstrated that gender, duration of sleep, and perception of the surrounding environment proved to be significant predictors of all four mental health indicators. The protective influence of physical activity appeared to be a particular advantage in a less-supportive environment. The intervention programmes aimed at improving the mental well-being of young people should include promoting physical activity and sufficient sleep; furthermore, environmental moderators should be taken into consideration.

The Polish version of the short scale measuring health literacy in adolescence

OBJECTIVE

Background: Recent years saw the development of international tools for measuring health competencies understood as health literacy (HL). One of them is the short index Health Literacy for School-Aged Children (HLSAC) implemented by the members of the Health Behaviour in School-aged Children (HBSC) network. So far, when researching the properties of this instrument, less attention has been devoted to the correlation of HLSAC with other tools related to health. The aim of the paper is to present selected psychometric features of the HLSAC index in a sample of Polish pupils, supplemented by the preliminary analysis of its association with the health locus of control.

PATIENTS AND METHODS

Material and methods: The information collected relates to 630 junior secondary school students surveyed in Poland in 2016 as part of the HLSAC questionnaire pilot study. The Multidimensional Health Locus of Control (MHLC) scale by K. Wallston was used as the additional module for Poland. It differentiates among three dimensions of health control: internal, external - dependent on other people, and external - dependent on random factors. It was checked which HLC dimension correlates most strongly with HL.

RESULTS

Results: It was demonstrated that the HLSAC scale consisting of 10 questions has a very good reliability in the Polish version (Cronbach alfa = 0.851) and a one-factor structure. Confirmatory factor analysis supported a unidimensional model (RMSEA = 0.082; CFI=0.922; TLI=0.877). The HLSAC most strongly correlates with the internal health locus of control (r=0.376; p<0.001), slightly less with the influence of other people (r=0.153; p<0.001), while the correlation with the random factor health locus of control is insignificant (p=0.947). It was found that there is a weak, however significant, positive correlation between family affluence and HLSAC (p=0.041).

CONCLUSION

Conclusions: The analyses conducted demonstrated that the Polish version of HLSAC has good psychometric features. The relatively higher correlation between HLSAC and internal rather than external health locus of control was confirmed. The practical effect of the pilot study was to develop an improved version of the HLSAC scale, which has been recommended for the mainstream HBSC 2018 survey.

Determination of the thoron emanation coefficient using a powder sandwich technique

Thoron (²²⁰ Rn) is a natural radioactive gas, tasteless, odourless, colourless, undetectable without proper equipment. This gas is carcinogenic, just like radon (²²² Rn) but due to the short half-life (55.6s) and a small amount in the environment, its share in the absorbed radiation dose is often neglected. However, in areas rich in thorium (²³²Th), the radiation dose from the thoron can be much larger and quite significant. The problem is to measure the concentration of the thoron due to its short decay time as well as the fact that it is alpha-emitting as radon. An even greater challenge is to determine the emanation coefficient for the thoron. The method used in this experiment was developed by S.D. Kanse based on the work of D.J Greeman and adapted to the equipment used in Laboratory of Radiometric Expertise IFJ PAN. In the technique used to determine the thoron emanation coefficient, a closed loop system is used in which thoron is pushed out by means of a flow system from the sample and measured by a AlphaGuad DF2000 detector that is adapted to determine concentration of this gas. A sample of the material is placed between 2 filters in the geometry of the sandwich. This arrangement ensures that the thickness of the powder sample is significantly less than the length of the thoron diffusion, thus avoiding significant loss of the thoron due to intergranular absorption and facilitates the complete removal of this gas escaping from the powder. Using this technique, it is important to determine the concentration of ²²⁶Ra and the ²³²Th, since for the AlphaGuard detector, the ratio between thoron and radon should not exceed 5:1 for proper determination of the thoron concentration. Measurements of ²²⁶Ra and ²³²Th activity were carried out using gamma spectroscopy (HPGe detector). It was examined how the type of filter and grain size of sample affects the obtained results.

What does the Cantril Ladder measure in adolescence?

INTRODUCTION

The Cantril Scale (CS) is a simple visual scale which makes it possible to assess general life satisfaction. The result may depend on the health, living, and studying conditions, and quality of social relations. The objective of this study is to identify key factors influencing the CS score in Polish adolescents.

MATERIAL AND METHODS

The survey comprised 1,423 parent-child pairs (54% girls; age range: 10-17; 67.3% urban inhabitants; 89.4% of parents were mothers). Linear and logistic models were estimated; the latter used alternative divisions into "satisfied" and "dissatisfied" with life. In addition to age and gender, child-reported KIDSCREEN-52 quality of life indexes were taken into account, along with some information provided by parents - child physical (CSHCN) and mental (SDQ) health, and family socio-economic conditions.

RESULTS

According to the linear model, nine independent predictors, including six dimensions of KIDSCREEN-52, explain 47.2% of the variability of life satisfaction on the Cantril Scale. Self-perception was found to have a dominating influence (ΔR² = 0.301, p < 0.001). Important CS predictors also included Psychological Well-being (ΔR² = 0.088, p < 0.001) and Parent Relations (ΔR² = 0.041, p < 0.001). The impact of socioeconomic factors was more visible in boys and in older adolescents. According to logistic models, the key factors enhancing the chance of higher life satisfaction are Moods and Emotions (cut-off point CS > 5) and School Environment (CS > 8 points). None of the models indicated a relationship between the CS and physical health.

CONCLUSIONS

The Cantril Scale can be considered a useful measurement tool in a broad approach to psychosocial adolescent health.

Serum Hepcidin and Soluble Transferrin Receptor in the Assessment of Iron Metabolism in Children on a Vegetarian Diet

The aim of this study was to assess the effect of vegetarian diet on iron metabolism parameters paying special attention to serum hepcidin and soluble transferrin receptor (sTfR) concentrations in 43 prepubertal children (age range 4.5-9.0 years) on vegetarian and in 46 children on omnivorous diets. There were no significant differences according to age, weight, height, and body mass index (BMI) between vegetarian and omnivorous children. Vegetarians had similar intake of iron and vitamin B₁₂ and a significantly higher intake of vitamin C (p < 0.05) compared with non-vegetarians. Hematologic parameters and serum iron concentrations were within the reference range in both groups of children. Serum transferrin levels were similar in all subjects; however, ferritin concentrations were significantly (p < 0.01) lower in vegetarians than in omnivores. In children on a vegetarian diet, median hepcidin levels were lower (p < 0.05) but sTfR concentrations significantly higher (p < 0.001) compared with omnivorous children. In the multivariate regression model, we observed associations between hepcidin level and ferritin concentration (β = 0.241, p = 0.05) in the whole group of children as well as between hepcidin concentration and CRP level (β = 0.419, p = 0.047) in vegetarians. We did not find significant associations with concentration of sTfR and selected biochemical, anthropometric, and dietary parameters in any of the studied groups of children. As hematologic parameters and iron concentrations in vegetarians and omnivores were comparable and ferritin level was lower in vegetarians, we suggest that inclusion of novel markers, in particular sTfR (not cofounded by inflammation) and hepcidin, can better detect subclinical iron deficiency in children following vegetarian diets.

AN INTERNATIONAL COOPERATION BY USING AN ALL-ENCOMPASSING PASSIVE RADON MONITOR

The recently developed radon film-badge makes it possible to measure radon indoors, in soil, in water and/or in aqueous media (e.g. mud). As a result of its wide response linearity, this monitor has been successfully used to measure radon in-water with concentrations from 10 to ~10 000 Bq/L. By exploiting the unique characteristics of this badge, a mini-survey has been carried out by Health Canada in which radon in water was measured from 12 private wells, as well as in tap water originating from the Ottawa River. Due to the widespread interest of different laboratories in using these passive monitors, laboratories were provided with plastic films to construct their own badges by using in-house CR-39 detectors. Monitors were then irradiated by a known radon concentration at the National Institute of Radiation Metrology (ENEA)'s radon chamber and sent back to each laboratory for processing and counting. Even though these laboratories have been using different etching- and counting-procedures, the film-badge responses varied only within ~12%.

Polish Adaptation And Validation Of The Physical Appearance Comparison Scale (Pacs) - An Analysis Among Young People In Late Adolescence In The Context Of Obesity

INTRODUCTION

The PACS scale is a tool which is widely used in foreign studies to evaluate the tendency towards appearance comparisons in social situations. People inclined to make such comparisons reveal a higher level of dissatisfaction with their body and a higher inclination towards problem eating.

PURPOSE OF THE STUDY

The main purpose of the study was to adapt the PACS scale. A factor structure assessment and reliability analysis of the Polish version was carried out. The correlation between PACS and pubertal development indicators, the body mass index and psycho-social factors and eating behaviours were evaluated as part of the validity analysis.

MATERIAL AND METHODS

The data were derived from the Internet-based study of problem eating behaviours conducted by the Institute of Mother and Child during the 2014/2015 school year. The analyses covered 1285 second grade upper secondary school students (47.2% boys). The mean age was 17.59 years (SD=0.39). An exploratory and confirmatory factor analysis of the PACS questionnaire was performed. Using the Kruskal-Wallis test or the Pearson's r correlation, the association between (PACSPL) and perceived pubertal timing, BMI, the body image (BIS), self-perception of body mass, self-esteem (RSES), self-esteem in social relations (SPPA-SSE), problem eating behaviours (TFEQ-13) were evaluated. The linear regression method was used to estimate the impact of PACS-PL on selected variables in the BMI groups in order to investigate of the moderation effect.

RESULTS

The shortened 3-item Polish version of the scale (PACS-PL) was considered optimal. It is characterized by high reliability (Cronbach's α=0.868), and the main factor explains 79.1% of the variance of the scale results. The model also shows high values of fit indicators: χ2 = 1.144 (df=1, p=0.285), GFI=0.999, AGFI=0.996, CFI=1.000, NFI=0.999, TLI-1.000, RMSEA=0.011. Girls display a stronger tendency to compare their appearance with others. The PACS-PL scale demonstrates the expected correlations with developmental, psycho-social and behavioural factors, this correlation being stronger among girls. It was also shown that the PACS-PL index is a stronger predictor of dissatisfaction with the body and lower self-esteem in the group of obese adolescents.

CONCLUSIONS

The Polish version of the scale, PACS-PL, is a reliable and valid tool for evaluating the tendency to compare one's appearance with others in late adolescence. The subject of social comparison ought to become an element of prevention activities associated with acceptance of one's body and selfesteem, especially among young people with excess body weight.

Perceived barriers for physical activity in overweight and obese adolescents and their association with health motivation

THE AIM

to identify the barriers to engaging in physical activity that are perceived by adolescents with overweight and obesity, and to establish whether a correlation exists among the barriers they perceive and the health-oriented motivation for undertaking physical activity.

MATERIAL AND METHODS

The study was conducted on a representative sample of 2,300 students aged 13-16 years. The data was collected through an anonymous survey. Young people were asked about their body weight and height, the barriers to physical activity and the health-related motives to engaging in it. The IOTF (International Obesity Task Force) standard by T. J. Cole was used to categorise overweight and obesity, while the PCA - Principal Component Analysis - to assess the motivation for physical activity. Logistic regression was used in the analyses of the correlations among the body weight, the level of health-oriented motivation and the occurrence of accumulated barriers to physical activity.

RESULTS

Overweight and obesity was found in 12.4% of the respondents; more often in boys (17.8%) than in girls (7.8%). The most frequently perceived barriers to undertaking physical activity among overweight adolescents include deficiencies in energy, time and support. Three barriers (lack of energy, skills and willpower), as well as the perception of several barriers occurring simultaneously, were reported more frequently by overweight students in comparison with their peers with a normal weight. Among the health-oriented motivation for physical activity in the group of adolescents with overweight and obesity, the most important one was the need to improve health, while the least important the need to look good. The excess of body weight turn out to be an important predictor of the perception of cumulative barriers to physical activity only among adolescents with a weak motivation to undertake physical activity [OR 2.51; CI (1.43-4.42), <0.001].

CONCLUSIONS

Young people with overweight and obesity, but with a strong health-oriented motivation, perceive barriers to physical activity similarly to their peers with a normal weight. Thus, motivation is a key element shaping the physical activity of overweight and obese young people by changing their perception of the barriers. In overcoming the barriers to physical activity in obese adolescents, one should aim to comprehensively reduce body weight and to support health-oriented motivation.

[Causes of death in children and adolescents aged 1-19 in poland in the light of international statistics since 2000]

BACKGROUND

Analyses of children and young people mortality continue to be an important component of health monitoring of this population. Such analyses provide the basis to assess the overall trends, the structure of the causes of death over longer periods, and the differences between Poland and other countries.

PURPOSE

The purpose of the current study is to present the current status and the direction of changes since 2000 with regard to the level and underlying causes of mortality in children and adolescents aged 1-19 years in Poland on the background of statistics for leading European countries.

MATERIAL AND METHODS

Interactive databases available online: the National Demographic Database provided by the Central Statistical Office and the International WHO-MDB Database were used. Poland, constantly belonging to Eur-B category, was compared with the combined group of 27 leading countries, classified as a very low total mortality group (Eur-A) according to WHO. Linear trends of overall and cause-specific mortality in 2000–2013 were estimated. The causes of death have been presented according to the main classes of the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). External and other causes were adopted as the two principal categories.

RESULTS

In 2015, 1471 deaths of persons aged 1-19 were recorded in Poland (19.9 per 100 000, 25.4 and 14.2 for boys and girls, respectively). Changes in children and adolescents mortality by age have a nonlinear nature (U-shaped), and the lowest level is recorded at the age of 5-9 years. According to 2014 data, 50.2% of deaths of children and adolescents aged 1-19 years occurred due to external causes, including non-intentional and intentional ones. This percentage increased from 18.4% in the 1-4 age group to 68.6% at the age of 15-19 years. Apart from external causes, the dominating causes of death are malignant neoplasms, congenital defects, or nervous system and respiratory system diseases. The ranking of those causes of death changes in successive age groups and over time. When age is considered, a higher proportion of congenital defects and respiratory system diseases was found in mortality younger children and a higher proportion of circulatory system diseases and undefined cases in mortality of adolescents. When trends were studied, a continuing elimination of infectious diseases was observed together with growing impact of rare diseases in all age groups. The excess mortality of Polish population at age 1-19 by comparison to Eur-A countries increased from 21% in 2000 to 56% in 2013, mainly due to unfavourable trends in adolescents. The rate of decline in the mortality of young children (1-4 years) was greater than in Eur-A countries, both in case of external and other causes. In the age group 5-14 years the higher rate of change was sustained only with regard to external causes. Among adolescents and young adults, the distance between Poland and Eur-A countries increased during the studied period. The shape of trend in the 15-24 age group was unfavourable for Poland, mainly with respect to external causes. This observation could be in part explained by increasing suicide trend in Poland since 2008, coexisting with rather constant level in Eur-A countries.

CONCLUSIONS

The mortality rate among the population aged 1-19 years in Poland is systematically decreasing, but it still exceeds the average level recorded in leading European countries, particularly in relation to adolescents. When assessing the ability to reduce mortality in Poland to the level of Eur-A countries, attention must be paid to the causes considered as avoidable. Further studies ought to focus on the trends and international comparisons only foreshadowed in this study with regard to individual diagnoses, discussing possible preventive measures. Introduction of an ICD-11 classification will enable more accurate coding of causes of death, including a more precise analysis of the burden of rare diseases, which are an increasing challenge to public health in the population at the developmental age.

Determinants of Bullying at School Depending on the Type of Community: Ecological Analysis of Secondary Schools in Poland

Ecological studies, when the school is the unit of analysis, may help to design and evaluate school intervention programs. The paper discusses selected contextual determinants of bullying, using data collected in Poland in 2015 and aggregated to school level (4085 students; 70 junior high schools). The main hypothesis is related to the neighborhood social capital as protective factor and the type of community as a modifier. The main dependent variable was the combined index of bullying which included three perspectives (victim, perpetrator, bystander). Student delinquent behavior was taken into account as potential determinant, along with selected characteristics of the school and neighborhood. The analyses were adjusted for the percentage of the surveyed boys. The overall bullying index ranged, depending on the school, from 0.88 to 4.07 points (out of 12 possible); intraclass coefficient ICC = 2.8%. In the entire sample, the main predictors of bullying were student delinquent behaviors as a risk factor and the school social climate as a protective factor (R² = 56.3%). The stratification of schools due to their location influences the inference regarding those main determinants. The dominating influence of delinquent behavior is visible only in big cities where bullying index showed the highest dispersion. In smaller towns and rural areas, the neighborhood social capital becomes an important protective factor; highly correlated with the school climate. We can conclude that strong social bonds in the community are supportive for school climate and can reduce the level of bullying at schools.