Euthanasia – characteristics of legal aspects in Poland and selected European countries

This article presents the characteristics of the legal aspects of euthanasia in Poland and in selected European countries. The key element of the considerations is the presentation of the legal regulation of euthanasia in Poland against the background – often detailed and precise solutions adopted in the European countries (specially EU), which define the legal conditions for carrying out this type of “medical services”. These solutions are presented from the point of view of the legal conditions for ensuring the legality of treatments falling within the concept of “euthanasia”, which in European legislation are most often classified as “assisted suicide” treatments and are associated with the provisions of the so-called “living wills”. The authors intended the article to be part of the discussion on potential changes in Polish legislation.

Background: The study originated from the authors’ coursework in health technology assessment and rational pharmaceutical policy.

Purpose: To respond to the question of whether there is a global problem of access to medications by providing differentiated backgrounds and possible solutions or mitigation strategies for boosting the population’s access to medications.

Method: Thematic content analysis (TCA) was performed on paper-based data. Findings: 39 documents were included, including 22 articles, eleven technical reports, two books, one book chapter, and three websites. Drug accessibility issues affect four major categories – essential, innovative, orphan, and highly-priced medicines. Access to these medications is nevertheless hampered for several reasons, including patents; prohibitive costs; fluctuating production; market unprofitability for rare diseases; and delays in innovative treatments, even in developed countries.

Conclusion: Efforts to boost drug access should target all sectors – public, private, and non-governmental – and should forge ties with pharmaceutical firms and key health care institutions.

* This study arose from the authors’ coursework “Health Technology Assessment and Rational Pharmaceutical Policy” for the European Public Health Master: Europubhealth+ Studies, which was funded by the European Union’s Erasmus+ Program. 

Conditions for introducing a new medical profession (physician assistant) in the polish health care system

Shortage of medical staff is a growing problem in most countries, also in Poland. There is a growing demand for medical staff in connection with longer life expectancy and on a macro scale, the aging of society. An important idea for reducing this problem is to introduce new medical professions. However, this issue arouses controversy and opinions on it are divided. The paper presents data on the number of physicians in Poland compared to other European countries and discusses selected proposals related to attempts to improve the situation in this area. Reference has also been made to the example of the United States, where physician assistants have been functioning for many years. Moreover, the current outline of a proposal for the occupation of a physician assistant in Poland has been presented, with particular emphasis on specialization in “surgical physician assistance”. The paper also presents the results of the author’s study on the attitude of primary care physicians towards new medical professions and refers to the opinions of the medical community in this respect, mainly from websites. Finally, the paper presents conclusions and recommendations for further actions related to the introduction of new medical professions in the country.

Analysis of the hierarchy of motivational factors in the work of nurses

Introduction: Employees incentive scheme is one of the main components of human resource management in any modern organization. A properly functioning incentive system enabling an effective motivation process allows to utilize the potential and commitment of employees, which directly affects the efficient functioning of a given facility. The aim of the study was to establish the hierarchy of motivational factors and the relationships that exist between them in the group of nurses working in one of the network of healthcare centers in the city of Kraków.

Materials and methods: The survey was conducted among 79 nurses working in several healthcare centers. The study uses the method of a diagnostic survey with the use of a research technique in the form of a questionnaire. The questionnaire contained demographics questions and the “Self assesment scale of work motivators” by Stefan Tokarski. Results: The study uses the terms “dominant motive” and “meaningless motive”.The research showed that the most numerous group of respondents chose “job security” as the dominant motive. At the lowest level in the hierarchy of respondents were “possibility of promotion” and “independence”. The research also uses the term “leading motive”, which was designated as the one with the highest score in the hierarchyof respondents’ motives, but not necessarily the dominant motive. Conclussions: Research has shown a relationship between seniority and the choice of the leading motive. Among the respondents, the group with work experience over 20 years showed significant leading motives. These included “job security”, “relationships with colleagues” and “earnings”. The remaining groups did not show any visible leading motives. The research also showed a relationship between education and the classification of motivators. The group with a master’s degree assessed the relations with their superiors significantly lower compared to other motivating factors.

Evidence based public health policy and the COVID-19 pandemic

Public health has always sought to use scientific findings in health-enhancing activities. At the end of the twentieth century, a program to use scientifically validated evidence in public health – evidence based public health (EBPH) – was formulated. Rigorous application of evidence was supposed to guarantee effective and efficient interventions. When the global threats of Covid 19 pandemic appeared, it seemed to be a great opportunity for EBPH to reaffirm its value. Societies, as well as governments, could have hoped that scientifically equipped public health would be able to cope well with the threat. However, reality has brought disappointment. It turned out that public health does not have enough confirmed evidence to support policymakers. In many situations, both politicians and medical doctors had to make quick and inevitably intuitive decisions, without documented evidence. The pandemic has forced the need to search for evidence more quickly, but it has raised the question of whether the procedure for validating evidence must be as rigorous as it had been recommended in the past. Under pressure emerging needs, a number of evidence-based recommendations have been prepared and offered to decisionmakers to be used.

The knowledge of young adults on the subject of dental erosion

Dental erosion is a result of the contact between tooth surfaces and acids, processes occur that result in progressive hard tooth tissue reduction. Its characterized by progressive and irreversible changes that not only affect the aesthetics of a tooth, but also oral health. Poor eating and hygienic habits, as well as some diseases, significantly increase the risk and rate at which erosion develops.

The purpose of this study was to evaluate the knowledge of young adults on the subject of dental erosion, and specifically to assess their knowledge about the nutritional factors that may predispose them to dental erosion.

The study involved 250 individuals between the age of 18–30 who were divided into two groups. The study was conducted in 2020 using a survey, and was then statistically analyzed using the STATISTICA PL 10 program (UJ license). Differences in the distributions between the two groups were verified using the chi-squared test and the non-parametric Mann-Whitney U test at the significance level ≤0.05.

In results 13.2% of participants declared that they experience dental erosion The study has evaluated the general knowledge of the young adults as being sufficient. Most of the young adults did not differentiate dental erosion from tooth decay, and had difficulty in answering questions on nutritional and hygienic risk factors. The groups did not differ from each other in terms of general knowledge about dental erosion. Both groups had a similar frequency of consuming high dental erosion products and drinks (sweetened carbonated beverages, citrus fruits, energy or isotonic drinks). The groups also differed in terms of reported symptoms and diagnosed conditions, in which tooth sensitivity and eating disorders significantly affected young adults with dental erosion.

The young adults showed many gaps in their knowledge of dental erosion. That is why education plays a key role in this area and is extremely important, especially in regards to nutritional factors and hygienic habits.

Knowledge of adult inhabitants of Małopolska on nutritional fac tors in the development of color ectal cancer

Most cases of colorectal cancer are related to lifestyle, including eating habits. The aim of the study was to assess the level of knowledge of the inhabitants of the Małopolskie Voivodeship regarding specific food ingredients and nutritional behaviors that are important in the development of colorectal cancer depending on selected socio-demographic factors, as well as the assessment of the nutritional status of the respondents.

The study was conducted among 144 adults, residents of Krakow and the village of Gródek nad Dunajcem. The analyzes included responses from 126 people (89 women and 36 men). The diagnostic survey method was used, while the research tool was the original questionnaire. The first part of the survey concerned selected nutritional behaviors of the studied group, while the second part assessed the knowledge of nutritional risk factors for colorectal cancer. In addition, data on lifestyle, socio-economic data and participation in screening tests for the diagnosis of the lower gastrointestinal tract in the year preceding the study were collected.

In the adopted assessment scale, the level of knowledge of the respondents differed significantly, taking into account the place of residence (p = 0.0363), where 41% of Krakow’s residents found it very good, while 43.8% of rural residents found it insufficient. People living in the city have almost three times greater chance of getting a higher level of knowledge than people living in the countryside. Also, the knowledge of the respondents who declared higher consumption of portions of fruit and vegetables was 2–3 times higher than those who consumed these products less frequently.

The level of knowledge on nutritional behaviors related to the development of colorectal cancer is insufficient among rural residents. People who demonstrate favorable nutritional behavior have greater knowledge about modifiable cancer risk factors.