Vaccination is one of the greatest healthcare achievements and one the most important scientific developments of the human civilization. Epidemiological status and population’s attitude towards vaccination has been evolving rapidly in recent years. The main goal of this article is to assess and compare people’s approach towards influenza and COVID-19 vaccines, in addition to identifying the most prevalent information sources concerning both the former and the latter. As a research method, data obtained from 150 online surveys submitted by respondents were analysed. The results suggest connection between COVID-19 and influenza vaccinations. The study was designed to provide a better understanding of public attitudes in favour as well as against the vaccinations. The results obtained regarding the public views on influenza and COVID-19 vaccinations can be pointed out as an additional value derived from the research.

Intuition is understood in the article as the intelligence of the unconscious, taking into account all the information possessed by the subject as well as individual abilities and preferences. Intuition makes itself felt in various ways. It cooperates with consciousness when more important decisions are to be made or directly controls the behavior of an individual (in case of so-called operational intelligence). The author reflects on the role of intuition in the digitalized world and comes to the conclusion that digital technology partially replaces intuition’s function but at the same time limits and blocks its development. He also notes that the concept of intuition in experimental psychology has been wrongly narrowed to spontaneously used heuristics in response to irrelevant questions, which usually leads to biased, inaccurate assessments. Finally, the suggestion appears that there is an analogy between human intuition, treated as the intelligence of the unconscious, and the direction of development of artificial intelligence. The use of the deep machine learning means that we know less and less about the processes taking place in the “black box,” which often leads to spectacular [? disastrous/bad] results. The term digital intuition seems to be an adequate description of this state of affairs. The common denominator of human and digital intuition is that information processing – although it leads to the desired effects – remains inaccessible to both the subject’s consciousness and the user (or even the designer) of the intelligent machine.

Intuition is understood in the article as the intelligence of the unconscious, taking into account all the information possessed by the subject as well as individual abilities and preferences. Intuition makes itself felt in various ways. It cooperates with consciousness when more important decisions are to be made or directly controls the behavior of an individual (in case of so-called operational intelligence). The author reflects on the role of intuition in the digitalized world and comes to the conclusion that digital technology partially replaces intuition’s function but at the same time limits and blocks its development. He also notes that the concept of intuition in experimental psychology has been wrongly narrowed to spontaneously used heuristics in response to irrelevant questions, which usually leads to biased, inaccurate assessments. Finally, the suggestion appears that there is an analogy between human intuition, treated as the intelligence of the unconscious, and the direction of development of artificial intelligence. The use of the deep machine learning means that we know less and less about the processes taking place in the “black box,” which often leads to spectacular [? disastrous/bad] results. The term digital intuition seems to be an adequate description of this state of affairs. The common denominator of human and digital intuition is that information processing – although it leads to the desired effects – remains inaccessible to both the subject’s consciousness and the user (or even the designer) of the intelligent machine.

The development of transplantology is undoubtedly a spectacular success of the 21st century medicine. Transplantation is the best treatment for the end-stage kidney, liver, heart or lung failure. The aim of this article is to provide reliable, scientific knowledge about transplantology as well as legal regulations regarding the transplantation of human cells, tissues and organs. The principles of transplantation are specified in the Act of 1 July 2005 on the collection, storage and transplantation of cells, tissues and organs. Proceedings related to the determination of the permanent irreversible cessation of brain functions (brain death) and the irreversible circulatory arrest prior to the organ procurement are outlined in Announcement of the Minister of Health of December 4, 2019 on the method and criteria for determining permanent irreversible cessation of brain function (M.P. 2020, poz. 73). In case of retrieving biological material from human corpses, the legislator introduced the principle of implied consent, also known as tacit consent (in the so called opt-out system).

This paper discusses the issue of the development of nursing staff ’s salaries employed in healthcare institutions in the years 2015–20222. The aim of the study was to analyze the changes in legal regulations taking place during this period and to point out the problem of interpreting these regulations, which is inherent to determining nurses’ salary in healthcare institutions. The article indicates problems and differences resulting from the arbitrary interpretation of legal provisions in this area. The issue is presented from the legal and managerial perspective on health care; also based on the authors’ own observations resulting from scientific work and professional experience.

Due to changing social and legal circumstances, increasingly more people choose to disclose their transgender and gender diverse status. Caring for this group of patients is a major challenge for medical facilities. The aim of this paper is to present general principles of care for transgender and gender diverse individuals. The paper is based on the analysis of available studies. The literaturę analysis confirms that the issue of transgender and gender diverse patients is addressed by many authors. Given the prevalence of reporting transgender identity and the resulting health problems/ needs, it becomes necessary to provide holistic care and educate medical personnel in this area.

The extreme physical effort and psychological stress are everyday challenges faced by athletes. The regular training results in adaptation to increasing physical effort. It contributes to changes in various organs and metabolic processes. Intense physical training has been shown to affect numerous body systems including the immune system. The aim of this paper is to present the influence of extreme physical activity on various aspects of immune response. The changes in the immune system of athletes include not only those related to blood leukocytes, but those in connection to respiratory and gut associated lymphoid tissue as well. Moreover, the immune cells play an important role in muscle regeneration after sustaining training injury. The mmunology of physicial activity – mainly extreme physical activity – is a new, not fully recognized yet field of research. The understanding of these interactions facilitates a proper training planning for different groups of athletes.

The aim of the research was to assess the relationship between self-efficacy, life satisfaction and the occurrence of orthorexia nervosa in the group of medical students. The survey was conducted in 2021 among 304 students of medical faculties. A diagnostic survey method using standardised questionnaires – ORTO-15, SWLS and GSES – was chosen. The performed statistical analysis showed a strong positive correlation between life satisfaction and self-efficacy. The risk of orthorexic behaviour was related to the BMI level, the field of studies and the region where the students studied. Students with an abnormal BMI are more prone to the orthorexia disorder compared to students with a normal BMI. The highest risk of developing orthorexia was presented by students of dentistry and physiotherapy from the Lower Silesia region while the lowest risk of orthorexic behaviour was presented by students of public health from the Silesian region.

The author analyzes relation between the expansion of artificial intelligence (AI) and the issue of values. In particular, he points out the difficulties associated with “agreeing on values” in an algorithm vs during a human interaction. The article highlights the obstacles of taking human values into account while designing complex algorithms, which result from the fact that the preferred values are inconsistent, contextual and therefore variable. The values depend on cultural conditions and individual differences as well. In addition, the sentimental values are also difficult to predict and take into account. All this makes it almost impossible to unambiguously define the values to be respected by the algorithm. Currently, an attempt is being made to include “emotional computing” into a design of artificial systems, which, according to many researchers, may turn out to be a breakthrough in the development of AI. There are already advanced attempts being made to model one of the aspects of emotional intelligence, which is to recognise other people’s emotional states based on the analysis of their facial expressions. According to the author, developments in the field of artificial emotional intelligence should rather worry than satisfy the users of the internet. They will contribute to greater control exercised by the institutions that use them, and consequently to further limitation of personal freedom of the individual users. The author suggests that the expansion of digital technology (contrary to the initial hopes) contributes to increased centralization of power and socio-economic inequalities. In the words of Norbert Wiener (1950), the development of digital technology contributes to “the human use of human beings”.

The author analyzes relation between the expansion of artificial intelligence (AI) and the issue of values. In particular, he points out the difficulties associated with “agreeing on values” in an algorithm vs during a human interaction. The article highlights the obstacles of taking human values into account while designing complex algorithms, which result from the fact that the preferred values are inconsistent, contextual and therefore variable. The values depend on cultural conditions and individual differences as well. In addition, the sentimental values are also difficult to predict and take into account. All this makes it almost impossible to unambiguously define the values to be respected by the algorithm. Currently, an attempt is being made to include “emotional computing” into a design of artificial systems, which, according to many researchers, may turn out to be a breakthrough in the development of AI. There are already advanced attempts being made to model one of the aspects of emotional intelligence, which is to recognise other people’s emotional states based on the analysis of their facial expressions. According to the author, developments in the field of artificial emotional intelligence should rather worry than satisfy the users of the internet. They will contribute to greater control exercised by the institutions that use them, and consequently to further limitation of personal freedom of the individual users. The author suggests that the expansion of digital technology (contrary to the initial hopes) contributes to increased centralization of power and socio-economic inequalities. In the words of Norbert Wiener (1950), the development of digital technology contributes to “the human use of human beings”.

The notion of medical error hasn’t been defined clearly enough in legal terms. Numerous authors have presented various definitions of a medical error – the essence of the concept and the common element of the definitions is the action of a healthcare worker that is incompatible with the requirements of current medical knowledge. Unfortunately, the phenomenon of medical error is becoming more and more common. A large percentage of patients declare that they have been harmed by a medical error and there is an upward trend in the number of medical malpractice cases investigated by the prosecutor’s office. There are different types of medical error, which can be classified as follows: diagnostic, therapeutic, technical, prognostic, organizational and informational error. A healthcare worker is subject to criminal, civil and professional liability for committing a medical error. According to the criminal law, a medical error is usually a criminal offence of failure to act, because the healthcare worker is liable for patient’s health and life. A healthcare worker may be convicted by criminal court after fulfilling the characteristics of one of the prohibited acts specified by the penal code.

The professional secrecy of a doctor and a physiotherapist is a guaranteed confidentiality in the relationship with the patient. After the patient’s death, professional secrecy is a proof of respect for their privacy. Professional secrecy is regulated by the Act on Patient Rights as well as legal acts regarding the relevant medical professions, and supervised by the Patient’s Rights Ombudsman. After the patient’s death, close relatives become the holders of his medical information. A relative has the right to release a healthcare worker from the professional secrecy and define the exact scope of its disclosure. A dispute occurs when close relatives disagree or their opinion differs from that of the patient. In such a case, disputes are resolved by a civil court.

The vast majority of Poles have modern smartphones or smartwatches. These devices are equipped with a number of sensors that can provide a lot of information interesting from a biomedical point of view. According to the concept of Marc Lalond, the most important factor affecting human health is their lifestyle. The purpose of this article is to present widely available and easy-to-use mobile tools that can be utilised to monitor health and the level of physical activity. Dedicated applications tracking physical activity, diet and the calorie intake, sleep patterns or helping to control or stop using stimulants should be an important element of health promotion. The authors postulate the deliberate use of devices owned by majority of the society to improve habits, the general condition of the body and their self-awareness.

For centuries, there has been a belief that mourning occurs only after the death of a person close to us. This traditional mourning perception was expanded by S. Freud in the first half of the 20th century. According to him, the mourning may also be vested upon us when we irretrievably lose some important objects of attachment of our selves. This can be either another person or personal properties, capabilities, ideals, values, dreams, physical appearance, work, homeland, health, interpersonal relationships, etc. This kind of mourning frequently induces deep mental trauma and pushes a person to the brink of existential abyss. Culture provides support for those who are orphaned in struggling with it. Philosophical or religious systems of reference are of significant importance in this case. Many valuable guidelines can be found in the philosophy of dialogue by Martin Buber, which was inspired by the Hassidic wisdom. The result of these thoughts can lead to the conclusion that mourning may be converted into a possibility of human self-development and its ontic growth.

Introduction. The causes of malignant neoplasms occurring in both children and adolescents remain unknown, but epidemiological and genetic studies have partially elucidated the origin of these tumors. Brain tumors are most common in children under 5 years of age. Mostly adolescents aged 10-14 years develop lymphomas and bone tumors.

Objective. The aim of the article is to discuss the incidence of selected neoplastic diseases in children and adolescents from the Silesian Voivodeship in 2010-2019. The article includes: lymphocytic leukemia (C 91), myeloid leukemia (C 92), cancer of the brain and central nervous system (D 43) and non-Hodgkin's lymphoma (C82-85).

Materials and methdos. In March 2022, data on the incidence (absolute numbers) of selected neoplastic diseases among children and adolescents from 0 to 19 years of age (divided into age groups: under 1, 1 to 4, 5 to 14 and 15 to 19) life) from the Silesian Voivodeship.Then, appropriate tables illustrating the incidence of the diseases in question were drawn up.

Results. In the age group between 5 and 14 years of age, the incidence of lymphocytic leukemia increased between 2010 and 2013 and amounted to 30 in 2010 and 39 in 2013, respectively. tumors of the brain and central nervous system in 2011, in the years 2012-2014 the incidence was 7 cases per year, and from 2015 to 2019 the nature of the incidence increased and amounted to 8 in 2015 and 19 in 2019, respectively.

Conclusions.One of the reasons adversely affecting the diagnostic and therapeutic process is the rarity of these diseases in the pediatric population, which makes it difficult for GPs to acquire their own professional experience in a short time. The second diagnostic difficulty is the different histological structure of tumors in children and adolescents.

First, the author cites several definitions of wilful ignorance and analyzes the concept in relation to related terms such as “voluntary blindness”, “information avoidance” and “negative knowledge”. Then he presents the six groups of motives distinguished by Engel and Hartwig, provoking the occurrence of the phenomenon of deliberate ignorance. The author proposes to reduce this division to three more general motives, i.e. emotional, pragmatic and moral category, and characterizes their specificity. Referring to psychoanalytic tradition and the role attributed by the modern experimental psychology to unconscious processes, he notes that not every type of motivated ignorance is preceded by a “deliberate”, conscious decision. Many manifestations of ignorance are spontaneous (but not accidental) products of the activity of unconscious processes. More or less “deliberate” ignorance is a frequent reason for potential patients to avoid or delay medical examination. The practical problem is how to counteract this unfavorable tendency.

First, the author cites several of wilful ignorance and analyzes the concept in relation to related terms such as “voluntary blindness”, “information avoidance” and “negative knowledge”. Then he presents the six groups of motives distinguished by Engel and Hartwig, which may lead to the phenomenon of deliberate ignorance. The author proposes to reduce The author proposes to reduce this taxonomy to three more general motives, i.e. emotional, pragmatic and moral category, and characterizes their specificity. Referring to psychoanalytic tradition and the role attributed by the modern experimental psychology to unconscious processes, he notes that not every type of motivated ignorance is preceded by a “deliberate”, conscious decision. Many manifestations of ignorance are spontaneous (but not accidental) products of the activity of unconscious processes. More or less “deliberate” ignorance is a frequent reason for potential patients to avoid or delay medical examination. The practical problem is how to counteract this unfavorable tendency.

Human health and life are the most important values, which is why all means are used to protect them. In certain situations, in the case of mentally ill people, the protection of these legal interests is in direct conflict with the protection of the constitutional right to freedom. The Act of 19 August 1994 on the protection of mental health provides for the possibility of using coercion against people with mental disorders who, due to their illness, pose a threat to their own life or other persons’ health or life or significantly paralyze the work of a medical unit. In some cases, it is also possible to admit and treat a mentally ill person in a psychiatric hospital without their consent, if there is a legal basis for such action.

The article presents current legal regulations in Poland that define the conditions for monitoring by medical care providers. The issue is presented both from the legal perspective and from the perspective of health care management, while referring to author’s own observations, resulting from his scientific work and professional experience. On this basis, an attempt was made to formulate the legal and practical implications of the issue of the legal use of monitoring when providing health services to patients.

Modern pharmacology is used not only in therapy, but also in many areas of everyday life, such as sports or science. Just as doping agents increase efficiency and strength, nootropic drugs affect the ability to concentrate and memorize, and therefore enjoy growing interest of the academic community. Most commonly used are stimulants, including amphetamine, methylphenidate, modafinil, caffeine and nicotine. Many substances commonly considered to be so-called smart drugs improve cognitive abilities, but their pro-health value is questionable. The aim of the study is to analyze various aspects of the phenomenon of using stimulants by students during studying, i.e. mechanisms of action and effectiveness, side effects and users’ awareness of the potential threats.

Professional burnout is a common problem occurring among employees whose job is related to other people, and additionally involves providing them with assistance. Therefore, one of such risk groups is the medical personnel, especially nurses and midwives. Scientific research shows that various factors have a different effect on the occurrence of professional burnout. The aim of the study was to review Polish and foreign scientific literature on the syndrome of professional burnout among nurses and midwives. On the basis of the literature review, it has been shown that the occurrence of professional burnout depends not only on education, seniority and salary, but also on human interactions at the workplace, level of social competence, and methods of coping with stress. It would not be possible to identify these factors if it wasn’t for the use of research tools in form of various types of questionnaires, e.g. Maslach Burnout Inventory (MBI) and Copenhagen Burnout Inventory (CBI). It is extremely important to undertake preventive and prophylactic activities to protect the medical personnel against this phenomenon.

Learning how to perform an examination of a patient, we have to collect an anamnesis according to the principles of propaedeutics (main ailments, previous course of the disease and ailments from other organs). Next the researcher has to perform a visual examination of the patient and furthermore palpation, percussion, speculum, etc. These examinations have the fundamental value of an objective examination. Then we may perform additional tests (e.g. imaging, enzymatic tests and others). Therefore, in a narrative form, I would try to remind readers of the importance of attentive and thorough examination of the patients.

Recent studies have suggested that the inequality problem seems to be legitimated by meritocratic attitudes. Whilst it is argued that meritocracy justifies socio-economic inequalities by defining individual achievements and efforts as causes for inequality, it is often overlooked how underlying mechanisms work. This study investigates how meritocracy sustains inequalities. In its mixed methods explanatory sequential design, it first builds on quantitative data from an International Social Survey Programme (ISSP) questionnaire, finding a significantly positive and inelastic relationship between inequality acceptance and meritocratic beliefs. Subsequently, a qualitative systematic literature review is conducted, suggesting that the relationship between meritocracy and inequality may be more circular than previously assumed. Furthermore, the results suggest that people’s meritocratic attitudes depend more on their social context than on their endorsement of meritocracy.

This paper presents the preliminary results of the study of foreigners’ experiences with healthcare institutions in the Polish city of Poznań, as shared during 40 narrative interviews with addressed people with no or weak knowledge of Polish. The selected fragments were analysed qualitatively to determine the ways in which the participants discursively constructed their experience of regular check-ups and consultations as well as various (emergency) situations, when they sought medical advice or help but could not communicate (effectively). The analysis confirms the results obtained in the few similar studies conducted either in Poznań or in Poland in general, which point to a number of obstacles in accessing medical services on the part of these patients. The interviews feature accounts labelled as nightmares, massacres or traumas and include different themes. Discourse-wise, these are small stories, accompanied by emotional expressions in which they convey essness, frustration and of being out of place.

Introduction . Osteoporosis is a skeletal disease characterized by reduced bone mineral density (BMD) and increased risk of pathological fractures. Physical activity, regardless of the type of training used, has a beneficial effect on bone homeostasis, as well as on the entire musculoskeletal system in patients with osteopenia or osteoporosis.

The aim of the study was to assess the level of knowledge of the respondents about osteoporosis and the impact of physical activity on the prevention and treatment of osteoporosis.

Material and method . The study group consisted of 150 respondents, including 117 women (78%) and 33 men (22%) aged 35.86 ± 15.89 years. The method of a diagnostic survey made available via the Internet was used for the study. The results were developed using IBM SPSS Statistics 26 software and the statistical significance level was p = 0.05.

Results . Statistically significant relationship was observed between the age of the subjects and the level of knowledge about physical activity in the context of osteoporosis (p = 0.003). The level of knowledge about osteoporosis in the study group was higher in women than in men (p = 0.001). The level of knowledge of the surveyed population living in cities did not differ from the level of knowledge of the respondents who lived in villages (p = 0.5).

Conclusions . Due to the low level of knowledge about physical activity and its beneficial impact on the prevention and treatment of osteoporosis in older age group and among people, educational and preventive actions should be implemented to popularize activity and thus reduce the risk of in the adult population.

Narrative and narrative care enables the integration of a humanistic perspective into everyday clinical practice, referring to the stories (narratives) of patients and their relatives, as well as medical personnel. The combination of knowledge derived from narrative and the clinical context and determinants of the care provided allows to focus on the individual needs and uniqueness of each person. Narrative can also be perceived as a form of ethics. At the core of narrative ethics is the assumption that narrative is an essential element that influences decisions made in clinical  situations, including those related to resolving ethical dilemmas. Narrative ethics helps to appreciate the impact of stories (storytelling) on the self and to understand the richness and complexity of individual lives, and thus can provide a basis for ethical reasoning. Given the specificity of the professional nurse’s role, narrative ethics can be an important value used in teaching professional ethics. The aim of this paper is to present selected issues related to narrative ethics in the professional education of nurses.

The current global situation – the pandemic of COVID-19 which has persisted for two years, and the war in Ukraine lasting from the end of February 2022 – led to the increase of anxiety and fear, and the loss of complacency. The violation of stability and difficulties in addressing needs foster the endurance of excessive, destructive stress, which, in turn, contributes to the development of mental disorders and stress-related illnesses. This article is intended to describe the role of cognitive-behavioral therapy in the context of treating disorders related to excessive stress, and to present some techniques helpful in coping with psychophysical tension, which may be either used during psychotherapy, or as part of one’s individual healthcare. This paper presents not only the mechanisms and components of stress, and its characteristics, but it also describes cognitive-behavioral psychotherapy as an approach of scientifically proven effectiveness, offering various methods of treatment for many mental disorders, and rich in specific, structured and empirical work techniques.

Hunger continues to be a serious and pressing problem in the world. Even during the COVID-19 pandemic, more people are dying of hunger than of the coronavirus. So, are we going to face a new epidemic, this time of hunger, in the world? The aim of the study was to present the current situation related to the lack of food security in the world in the context of the ongoing COVID-19 pandemic. It is to be expected that in the coming years we may face a huge humanitarian crisis and that all mankind is facing a sentence today aimed at preventing the spread of the hunger epidemic in the world.

Osteoarthritis is the most common disease of the musculoskeletal system. It is a progressive disease that primarily affects the articular surfaces. Degenerations cause pain and stiffness in the joints, which leads to difficulties in everyday life and has a negative impact on the psychophysical comfort of the patient. The aim of the study was to assess the impact of a two-week rehabilitation programme on psychophysical fitness and the level of pain experienced in joints affected by degenerative changes in patients over 60 years of age suffering from osteoarthritis. The study group consisted of 35 people (25 women and 10 men) aged 60 to 85 years. The following methods were used to assess the impact of a two-week rehabilitation programme on psychophysical fitness and the level of perceived pain in joints affected by degenerative changes in people with osteoarthritis: Senior Fitness Test (SFT), Yesavage Geriatric Depression Rating Scale (GDS), Pain Assessment Scale (VAS). The results of the research indicate a significant improvement in the psychophysical condition of patients with osteoarthritis who benefited from the two-week rehabilitation programme. Research has shown that participation in a rehabilitation programme for people over 60 years of age struggling with osteoarthritis contributes to the reduction of pain levels, increases the muscle strength of the lower limbs and arms, and has a positive effect on the well-being of patients.

Avascular necrosis is a disease characterized by the formation of necrotic changes in the bone tissue without the involvement of pathogenic microorganisms. This disease mainly occurs in the area of the femoral head, tibial tuberosity, and heel tumor. One of the elements of treatment is the surgical removal of dead tissue, followed by physical therapy to restore the lost function. The aim of the study was to presented the model of rehabilitation of the patient diagnosed with avascular necrosis in atypical area – the area of the medial femoral condyle in the left knee joint.

Material and methods: A 24-year-old patient after the removal of medial condyle necrosis of the femur. Accompanying symptoms: severe pain, swelling, difficulty in movement and limited mobility in the left knee joint. An individually tailored physiotherapeutic procedure was implemented with a variety of techniques in the field of physical therapy, kinesiotherapy and manual therapy, in some cases deviating from the accepted norms. Results: The proposed rehabilitation procedure led to the restoration of the proper joint homeostasis.

The Patient-Centered Care (PCC) model has been recognised in many countries as a standard approach in healthcare to improve its quality. The essence of PCC is to respect the values, experiences, needs and preferences of the patient in planning, coordinating and providing care. Therapeutic relationship between the patient and the healthcare providers is at the core of this model. Numerous studies have shown that implementing PCC into the practice contributes to improved care results, better use of resources, lower costs and increased satisfaction of patients with healthcare. The aim of this article is to present the assumptions of the patient-centered care model as well as the benefits and barriers in implementing this model into the health care system. 

People with intellectual disabilities experience stigma and discrimination. In caring for people with intellectual disabilities, special attention should be paid to respecting their dignity and subjectivity. The aim of this study is to emphasize the importance of respecting the dignity and subjectivity of adults with intellectual disabilities and the importance of communicating with them. The paper is based on a literature analysis of intellectual disability issues. The literature analysis indicates that the subject of intellectual disability concerns the subjectivity and the dignity of the people as well as the barriers to communication with the environment and medical personnel. It is fundamental to conduct research into care of people with intellectual disabilities. In addition, there is a need to organize training for all members of the therapeutic team, especially in the area of communication issues with people with intellectual disabilities.

This article presents the history of Prof. Kazimierz (Kaz) Jankowski M.D., Ph.D. ideas and their implementation, on the 50th anniversary of him creating the “Synapsis Center.” Subsequent modifications, expansion of therapeutic methods and projects for measuring their effectiveness, as well as their conceptual development are presented. The path from the therapy focused on the individual through one expanding the focus to the family as well, and finally –to the environment is delineated. Moreover, the comprehensive environmental prevention system of Jankowski and the “Synapsis”team which was innovative in the 1970s is shown. Simultaneously, a way from in-patient to out-patient model of therapy is documented.

Pregnancy in the scar after cesarean section is a serious medical problem, threatening woman’s life.Despite the wide development of diagnostics, ectopic pregnancies in the scar are relatively common. The diagnosis of cesarean scar ectopic pregnancies is usually made at seven weeks of gestation. It may be asymptomatic or characterised by sharp pain in the lower abdomen. The prevalence of ultrasound reflects the increased diagnosis of pregnancies implanted in the cesarean section scar. During the routine ultrasound examination of the nonpregnant uterus in women with a history of at least one cesarean section, an abnormality in scar occurs with a frequency of 24–70%. Given the total number of cesarean sections and the rate of abnormal cesarean scar formation, this problem affects a large group of patients. Expectant management is not recommended because of the high schock risk. For the treatment of cesarean scar ectopic pregnancy, methotrexate is the drug of choice.