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EN
The aim of this study was to analyze possible links between paternal involvement and children’s competence in coordinated joint attention (CJA) in preterm versus full-term 12-month-old babies. Paternal involvement was measured through the amount of time fathers allocated to different activities with their infants, whereas children’s capacity for CJA was inferred on the basis of episodes of joint attention (EJA), empirically derived from father-infant interactions. Fifty-nine father-infant dyads participated in the study. Fatherinfant interactions in free-play situations, diaries of infant activities, and semi-structured family interviews were analyzed. Episodes of joint attention were more frequent in interactions of fathers with full-term babies in comparison to extremely premature babies, and in the case of preterm infants, in dyads with highly involved fathers as compared to those with a relatively low level of involvement.
EN
Introduction. The threshold of compulsory schooling for prematurely born children is of particular importance. It’s a period of intense physical development which may increase the risk of scoliosis. Aim. The aim of this research is to determine whether age, gender, BMI value and selected elements of perinatal interview discriminate the results of screening test aimed at detection of scoliosis and flexibility disorders in group of preterm children at the beginning of school age. Material and methods. The study population consisted of 61 preterm children aged 5-8 years. The study included perinatal interview, BMI assessment, screening tests to detect scoliosis and flexibility. Results. Statistically significant dependence was obtained between age and normal and abnormal results of the screening test aimed at detection of scoliosis and between the result of the screening test for detecting flexibility disorders and: age, number of foetuses, assessment on the Apgar scale. Conclusion. The results of screening test aimed at occurrence of scoliosis in group of preterm children are significantly correlated with the age and screening test aimed at occurrence of the flexibility disorders are discriminated by age, origin from monoor multi-foetus pregnancy and assessment on the Apgar scale
PL
Poród przedwczesny jest jednym z największych problemów współczesnego położnictwa, ponieważ 85% zgonów noworodków w okresie okołoporodowym spowodowanych jest wcześniactwem. W Polsce wprowadzony jest system trójstopniowej opieki perinatologicznej, głównym założeniem tego programu jest dążenie do obniżenia wskaźnika umieralności noworodków z niską masą urodzeniową. Tak funkcjonujący logistycznie system wymaga odpowiedniego fiansowania. W celu właściwej wyceny procedur konieczne jest przedstawienie specyfii organizacji opieki na dziećmi przedwcześnie urodzonymi. Poziom fiansowania opieki nad dzieckiem przedwcześnie urodzonym w Polsce jest zbyt niski. Jest to zjawisko niepokojące ze względu na to, iż koszty opieki i leczenia nad dzieckiem przedwcześnie urodzonym ciągle wzrastają. Dotyczy to zarówno leków, materiałów opatrunkowych, sprzętu, jak i opieki specjalistycznej wraz z konieczną następową rehabilitacją. Natomiast nakłady ich fiansowania nie wzrosły, co może spowodować obniżenie się poziomu opieki.
EN
The preterm birth is the one of the biggest problem of the modern perinatology, because 85% of newborn mortality is caused by prematurity. Three-level of the perinatology system is introduced in Poland. The main objective of this system is to pursuit to reduce mortality rate of newbornbabies with low birth weight. Logistics system activity in that manner needs appropriate funding. In order to proper valuation of the procedures, there is a need to depict preterm infants care specifi organization. The fiancing level of the preterm infants care in Poland is too low. This is a worrying phenomenon due to the fact that the care and treatment costs of preterm infants are constantly growing. This applies not only to medications but also wound care products, equipments and specialized care. On the other hand, the fiancial expenditures have not increased, which can cause a decrease in the level of care.
EN
The aim of the study was verifying, whether speech development is conditioned by a preterm birth, multiple pregnancy or pregnancy complicated with TTTS. We examined 52 preterm children, 15 of which were born after a single pregnancy and 42 after a multiple pregnancy. 23 children came from a pregnancy complicated by TTTS. The average age of the subjects was 32.5 months (SD=5.54). The research methods used in our study were as follows: analysis of medical documentation, a structured clinical interview and psychological conversation. Speech development of a child was assessed using BSID-III. An analysis of the results we obtained showed that there was a lower level of EC in the TTTS children in comparison to multiple-birth children without TTTS and single-birth children. We also found statistically signifi cant relations between the EC scores and gender, age at the time of testing, disability, gestational age, birth weight.
PL
W Polsce wcześniaki stanowią ok. 6–7% wszystkich rodzących się dzieci. Chociaż gwałtownemu rozwojowi technologii medycznej i neonatologii zawdzięcza się zdecydowany wzrost przeżywalności dzieci urodzonych skrajnie przedwcześnie, to coraz częściej są podnoszone pytania o ich dalszy rozwój zarówno w rozumieniu indywidualnym, jak i oddziaływania na system rodzinny. Według badań dzieci zarówno urodzone przedwcześnie, jak i z wewnątrzmacicznym zahamowaniem wzrostu częściej doświadczają różnych form przemocy ze strony opiekunów lub innych dorosłych w porównaniu z rówieśnikami urodzonymi o czasie. Wiadomo także, że matki dzieci urodzonych przedwcześnie znacznie częściej niż matki dzieci urodzonych o czasie przejawiają duże nasilenie lęku, niepokoju, a nawet objawów zespołu stresu pourazowego. Rozczarowanie, wynikające z bardzo dużej rozbieżności między oczekiwanym macierzyństwem a sytuacją przedwczesnego porodu, wzmacnia negatywny stan psychiczny rodzica. Kształtujące się na takiej bazie postawy rodzicielskie i stosowane metody wychowawcze mogą nie sprzyjać optymalnemu rozwojowi wcześniaka. Trudne zachowania dziecka i konieczność większych poświęceń rodziców – przy niesprzyjających warunkach społeczno-ekonomicznych – mogą stanowić znaczny czynnik ryzyka przemocy w rodzinie. W artykule poruszono problematykę wcześniactwa jako czynnika ryzyka krzywdzenia oraz opisano przykładowe programy profilaktyczne o charakterze prewencyjnym i interwencyjnym, uzupełnione o przykłady pochodzące z praktyki własnej.
EN
Premature children represent about 6–7% of all babies born in Poland. Although the rapid development of medical technology and neonatology owes a definite increase in survival rate of children born extremely prematurely, more and more frequently questions about further development of these children are raised, both in terms of a child’s individual development and its impact on the whole family system. According to research, children born prematurely and children with a diagnosis of intrauterine growth restriction more often experience various forms of violence from caregivers and/or other adults, than children born at term. It is known that mothers of children born prematurely more often, compared to the mothers of children born at term, present with a high level of fear, anxiety and even symptoms of post-traumatic stress disorder. Disappointment resulting from a very large discrepancy between the expected motherhood and the situation of premature labor strengthens the negative psychological state of a parent. The parental attitudes formed on this basis and the educational methods, used by parents, may not be conducive to the optimal development of a premature child. Difficult behaviors of the child, the need for greater sacrifices of parents, under unfavorable socio-economic conditions, may constitute a significant risk factor of child abuse. This publication deals with the issue of prematurity as a risk factor for abuse and describes exemplary prevention and intervention programs, supplemented with examples from our own practice.
EN
Music therapy has been internationally recognized as a health-promoting profession since the end of World War II, and music therapists have been conducting research in neonatal intensive care since the 1990s. Music therapy professional training was established in Poland in 1973 at the Music Academy in Wrocław, and Polish music therapists have recently begun to seek specialization to work within neonatal intensive care. The commencement of the multi-site international randomized controlled trial LongSTEP, Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers, has provided the impetus for Polish music therapists to begin offering music therapy services in neonatal intensive care. Thus, engagement in research marks the critical first step in the development of music therapy in neonatal care in Poland. This perspective article examines the current state of experimental research on music therapy in neonatal care and explores its implications for future research in Poland by (1) presenting the clinical aspects of prematurity; (2) summarizing experimental research on music therapy in neonatal intensive care; (3) identifying gaps in the related evidence base; (4) discussing recent developments in international music therapy research; (5) contextualizing music therapy in the Polish neonatal health care system; (6) presenting advanced training in neonatal music therapy, and (7) discussing how culturally relevant aspects of neonatal settings in Poland might impact future research. There is preliminary evidence that music therapy plays a beneficial role for preterm infants and their primary caregivers during the neonatal period; however, research examining long-term impacts and longer-term intervention is needed. Researchers in Poland are poised to make a significant contribution to the international evidence base related to music therapy in neonatal care, and further exploration of particular facets of the Polish neonatal health care system that will impact the delivery of music therapy is warranted.
7
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Poczęcie naturalne, in vitro i „NaPro”

71%
EN
Infertility has been a big problem since the beginning of human existence. Some causes of infertility have always been present, other called ‟civilization causes” ap peared recently, causing an increased need for treatment, hence the assisted reproductive technologies (ART), including “in-vitro”, have been introduced. Most children conceived with this method are healthy, but there is no doubt that it is a group of increased risk of various diseases. These methods are not accepted by the Catholic church, mainly because they involve killing or freezing of embryos regarded as human beings, but also for other reasons. An alternative to ‟in vitro” are procreation methods defi ned as naprotechnology, free from the negative impact on the health of the newborn and mother, accepted by the Catholic church. In the author’s opinion, in the current situation, married couples who want to be treated for infertility should receive reliable and honest medical information about ART (“in vitro”) –assisted reproductive methods and ‟NaPro” – assisted procreation methods. Believers should advise the priest. Ultimately, the decision which procedure they will choose belongs to them.
PL
Infertility has been a big problem since the beginning of human existence. Some causes of infertility have always been present, other called ‟civilization causes” appeared recently, causing an increased need for treatment, hence the assisted reproductive technologies (ART), including “in-vitro”, have been introduced. Most children conceived with this method are healthy, but there is no doubt that it is a group of increased risk of various diseases. These methods are not accepted by the Catholic church, mainly because they involve killing or freezing of embryos regarded as human beings, but also for other reasons.
EN
A premature birth is still a topical issue around the world. Despite advanced health care, prema-ture infants show a wide range of health com-plications that affect their development with varying degrees of intensity. The problems most associated with cognitive and motor develop-ment include sensory organs and brain dam-ages. However, the psychomotor development of premature infants may be impaired even if such neurosensory impairment is not present and it may go in different directions. The aim of this work is to provide an overview of possible trajectories of cognitive and motor development in premature children and to point out the need for interdisciplinary long-term care for these in-dividuals.
CS
Problematika předčasného porodu je ve světě stále stěžejním tématem, protože i navzdory pokročilé zdravotní péči vykazují předčasně narozené děti široké spektrum zdravotních kom-plikací, které s různou mírou intenzity ovlivňují jejich vývoj. K problémům nejčastěji spjatým s kognitivním a motorickým vývojem se řadí poškození smyslových orgánů a mozku. Psycho-motorický vývoj nedonošených dětí může však být narušen i v případě, že není takovéto neuro-senzorické postižení přítomno a může se ubírat různými směry. Cílem této práce je poskytnout přehled možných trajektorií kognitivního a mo-torického vývoje u předčasně narozených dětí a poukázat tak na nezbytnost interdisciplinární dlouhodobé péče o tyto jedince.
EN
Functioning of a family, in terms of premature birth and potential developmental disorders related to prematurity, disease and/or disability of a child, is conditioned by a configuration of the following factors: premature birth, giving birth to a premature baby (especially with extremely low birth weight), the onset of a disease, its course, the child's disability resulting from the disease and family resources. Difficult parenting, which is the subject of the following analysis, can begin already during the pregnancy, from the moment parents hear the diagnosis that the pregnancy belongs to the high perinatal risk group. Currently one of the most frequent reasons of qualifying pregnancy to the risk group is the threat of premature birth. Therefore the article is focused on difficult parenting resulting from the sole fact of prematurity (e.g. long-term health problems, for example respiratory, sensory, motor disorders), and premature birth (considered in terms of a distressing and traumatic event). The article was illustrated with casuistic cases, referring to: 1. the difficulty of being a parent of a child born prematurely with cerebral palsy, 2. the inaccurate (detrimental) perception of a prematurely born child by its mother in the period of early childhood. The article presents phases of adaptation to the chronic disease, both of the child and of its parents. The significant role of the parents' adaptive abilities was emphasized. Depending on the way the parents perceive the situation (as harm, threat or challenge), they are featured by different emotions, parental attitudes, perception of prematurity and illness, and the quality of life.
PL
Funkcjonowanie rodziny w kontekście porodu przedwczesnego i ewentualnie wynikających z wcześniactwa problemów rozwojowych, choroby i/lub niepełnosprawności dziecka uwarunkowane jest konfiguracją następujących czynników: porodem przedwczesnym, urodzeniem dziecka wcześniaczego (szczególnie o ekstremalnie niskiej masie urodzeniowej), początkiem choroby, jej przebiegiem, niepełnosprawnością dziecka wynikającą z choroby oraz zasobami rodziny. Trudne rodzicielstwo, które jest tematem niniejszej analizy, może pojawić się już w czasie ciąży od momentu uzyskania przez rodziców diagnozy, że ciąża należy do grupy wysokiego ryzyka perinatalnego. Aktualnie jedną z najczęstszych przyczyn zakwalifikowania ciąży do grupy ryzyka jest zagrożenie porodem przedwczesnym. Stąd w artykule skupiono się na trudnym rodzicielstwie wynikającym z samego faktu wcześniactwa (np. długofalowe problemy zdrowotne, jak zaburzenia oddechowe, sensoryczne, ruchowe), jak i z porodu przedwczesnego (traktowanego w kategoriach wydarzenia stresogennego i traumatogennego). Artykuł został zilustrowany przypadkami kazuistycznymi: 1) odnosi się do trudności bycia rodzicem dziecka urodzonego przedwcześnie z mózgowym porażeniem dziecięcym, 2) do braku trafności spostrzegania umiejętności dziecka urodzonego przedwcześnie przez matkę dziecka w okresie wczesnego dzieciństwa (na jego niekorzyść). Pokazano fazy przystosowania się do przewlekłej choroby dziecka, jak również przewlekle chorego dziecka do choroby. Podkreślono istotną rolę zdolności przystosowawczych rodziców w procesie przystosowania się do choroby dziecka. W zależności od przyjętego przez rodziców sposobu percepcji sytuacji (jako krzywda, jako zagrożenie lub jako wyzwanie), dominują u nich inne emocje, postawy rodzicielskie, percepcja sytuacji wcześniactwa i choroby oraz jakość życia.
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