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EN
The results of research on the social genesis of coronary artery disease (CAD) based on life-cycle approach indicate that low socioeconomic status during early phases of ontogenesis is connected with increased risk of developing CAD in adulthood. It means that genesis of social health inequalities, concerning unequal social distribution of CAD, should be considered including early-life social influences. Scientific data concerning the developmental origins of non-communicable chronic diseases, especially those well described regarding CAD, constitute a significant complement to traditional research approach to social health inequalities, focused on middle-aged populations and socioeconomic influences in adulthood, and put emphasis on the role of assessment of the cumulative psychosocial risk of somatic diseases throughout the human life-cycle. This approach is particularly useful in understanding the social processes related to etiopathogenesis of chronic diseases with long latency periods, especially atherosclerosis. Health policy actions, aimed at effective diminishing of social health inequalities, should take into account the above mentioned data and should be directed not only at standard, behavioral coronary risk factors, but also at poor families and their children, who, in the light of the current knowledge, are highly predisposed to suffer from CAD in adulthood.
Przegląd Socjologiczny
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2012
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vol. 61
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issue 2
155-172
PL
Artykuł jest próbą namysłu nad genezą i poznawczą tożsamością niemedykocentrycznej orientacji badawczej w socjologii medycyny, a także konsekwencjami wyłonienia się tego nurtu dla pola badań subdyscypliny oraz jej nazewnictwa. Przedmiotem analizy jest rozwój tej orientacji badawczej w perspektywie historycznej, z uwzględnieniem roli m.in. Ch. McIntire’a, R. Strausa i D. Mechanica koncepcji badań socjomedycznych, a także wkładu badaczy odwołujących się do socjologii humanistycznej na terenie amerykańskiej (F. Davis, E. Freidson, E. Goffman, A.Strauss) i brytyjskiej socjologii medycyny (M. Bury). Przedmiotem analizy są szczegółowe nurty badawcze, składające się na niemedykocentryczną orientację badawczą socjologii medycyny, z uwzględnieniem socjologii doświadczenia choroby oraz socjologii zdrowia. Autor stawia tezę, że silna w socjologii medycyny orientacja na laickie interpretacje i działania, podejmowane w stanie zdrowia i choroby nie powinna prowadzić do wykluczenia instytucjonalnej medycyny poza zasięg jej zainteresowań badawczych, zwłaszcza w kontekście nowych wyzwań badawczych, związanych z rozwojem socjologii diagnozy lekarskiej, socjologii choroby niepewnej, socjologii leku etc., co umożliwiłoby budowanie zrównoważonego scenariusza rozwoju badań socjomedycznych
EN
The paper seeks to discuss the origin and cognitive identity of the non-medicocentric research orientation in medical sociology as well as the consequences of the emergence of this trend for medical sociology’s field of research and terminology. The subject of analysis is the development of this research orientation in a historical perspective taking into account the role of inter alia Ch. McIntire’s, R. Straus’s and D. Mechanic’s concept of sociomedical research, and the contribution of scholars who refer to humanist sociology in the area of American (F. Davis, E. Freidson, E. Goffman, A. Strauss) and British medical sociology (M. Bury). The subject of analysis are detailed research trends that constitute the non-medicocentric research orientation in medical sociology taking into account the sociology of illness experience and sociology of health. The author advances a proposition that a strong orientation in medical sociology towards lay interpretations and measures undertaken in health and in illness should not lead to the exclusion of institutional medicine outside its research interests, in particular in the context of new research challenges connected with the development of ‘sociology of medical diagnosis’, ‘sociology of uncertain illness’, ‘sociology of pharmaceuticals’, etc., which would make it possible to build a balanced scenario for the development of socio-medical research.
EN
Background: The aim of the study is to present the methods for visualization of epidemiological data using digital contour maps that take into account administrative division of Poland. Materials and Methods: The possibility of epidemiological data visualization in a geographical order, limited to the administrative level of the country, voivodeships and poviats (counties), are presented. They are crucial for the process of identifying and undertaking adequate prophylactic activities directed towards decreasing the risk and improving the population's health. This paper presents tools and techniques available in Geographic Information System ArcGIS and statistical software package R. Results: The work includes our own data reflecting: 1) the values of specific mortality rates due to respiratory diseases, Poland, 2010, based on the Central Statistical Office data, using the R statistical software package; 2) the averaged registered incidence rates of sarcoidosis in 2006-2010 for the population aged 19+ in the Silesian voivodeship, using Geographic Information System ArcGIS; and 3) the number of children with diagnosed respiratory diseases in the city of Legnica in 2009, taking into account their place of residence, using layered maps in Geographic Information System ArcGIS. Conclusions: The tools presented and described in this paper make it possible to visualize the results of research, to increase attractiveness of courses for students, as well as to enhance the skills and competence of students and participants of courses. Med Pr 2013;64(4):533–539
PL
Wstęp: Celem pracy jest przedstawienie metod wizualizacji danych epidemiologicznych z użyciem map konturowych, które uwzględniają podział administracyjny Polski. Materiał i metody: W artykule przedstawiono możliwość prezentowania danych, które dotyczą obserwacji epidemiologicznych, w układzie geograficznym, ograniczonym do poziomu administracyjnego kraju, województwa i powiatu. Wydają się one istotne w procesie rozpoznania i podjęcia właściwych działań profilaktycznych ukierunkowanych na zmniejszenie ryzyka występowania chorób i poprawę stanu zdrowia populacji. Zaprezentowano narzędzia i techniki dostępne w systemie informacji geograficznej ArcGIS i pakiecie statystycznym R. Wyniki: W pracy zamieszczono własne następujące dane: 1) współczynnik umieralności specyficznej z powodu chorób układu oddechowego ogółem w Polsce w 2010 r. w oparciu o dane Głównego Urzędu Statystycznego w Warszawie (z wykorzystaniem aplikacji statystycznej R); 2) uśrednione za okres 2006-2010 współczynniki rejestrowanej zapadalności na sarkoidozę w populacji osób po 19. roku życia w województwie śląskim (z wykorzystaniem systemu informacji geograficznej ArcGIS); 3) liczbę stwierdzonych przez lekarza zachorowań na choroby układu oddechowego u dzieci zamieszkałych w Legnicy w 2009 r. z uwzględnieniem miejsca zamieszkania dziecka (przy wykorzystaniu map wielowarstwowych systemu informacji geograficznej ArcGIS). Wnioski: Wymienione i opisane w pracy narzędzia dają możliwości wizualizacji wyników badań, znacznie podwyższają atrakcyjność odbywanych szkoleń, podnoszą umiejętności, a także kompetencje studentów i słuchaczy szkoleń. Med. Pr. 2013;64(4):533–539
EN
Objective: A number of studies show an association between traffi c-related air pollution and adverse respiratory health effects in children. However, most evidence relates to the regions with low or moderate levels of ambient air pollution. The study was undertaken to assess the impact of traffi c-related air pollution on respiratory health status in children living in the area of high levels of industrial and municipal ambient air pollution. Materials and Methods: Analyses involved data obtained from cross-sectional study on respiratory health in children (N = 5733), conducted between 2003–2004 in Bytom, one of the largest cities of Silesian Metropolis (Poland). Exposure to traffic-related air pollution was assessed by means of geographic information system and expressed as several measures of potential exposure to traffic-related air pollution, involving residential distance to major road and traffic density in the residential area. Logistic regression was used to examin association between reported respiratory health and traffic measures. Results: Statistically signifi cant association was found between doctor-diagnosed asthma and residential proximity to traffic. Results of multivariate logistic regression (logOR; 95%CI) confi rmed the effect of living in an area of a city with high-traffic-density on childhood asthma: 1.60 (1.07–2.39). Similar effects were found in case of allergic rhinitis and rhinitis symptoms, but the observed associations were not statistically signifi cant. Conclusion: The study fi ndings suggest that even in an area with poor regional ambient air quality, adverse respiratory health outcomes are more frequent in children living in a proximity to the high vehicle traffic flow
EN
After the reform of health care system the patient was granted a right to choose where and by whom he wants to be treated, especially as far as a General Practitioner (GP) is concerned. All of the above mentioned factors caused that subjects providing medical services started using marketing tools in order to promote these institutions on the market and to create their positive image. Special concern was attached to the way patients were served, which directly influences satisfaction of the patients with the institution they are treated in. The purpose of this dissertation was to indicate the elements crucial for patients which influence which institution they choose, especially a behavior of a doctor of primary health care. The research took place in 2010 and it included a group of 140 patients in Silesia voivodeship. The stage concerned evaluation of the factors which influenced a decision to be treated by a particular General Practitioner (GP).
EN
Underweight, overweight and obesity among children and adolescents is an important epidemiological problem, mostly because of consequences of health perturbations. This paper is intended to present the analysis of characteristics of children and adolescent physical growth in the context of social and economical situation of families inhabiting the city of Bytom. The Box-Cox transformation according to WHO standards for body weight, body height and BMI (Body Mass Index) is applied in the analysis. The transformation is a base for statistical analysis of measurable data using e.g. t-test, or Mann-Whitney test. Frequencies of underweight, overweight and obesity among children and adolescents are determined by centile ranks and growth charts by the Institute of Mother and Child in Warsaw, Poland, and analysed using differences significance test and the post-hoc test by Benferroni for percentages. The influence of social and economical factors are evaluated with #2-test and log-linear analysis. The main conclusion of the analysis confirms that the percentage of children and adolescents with overweight or obesity is growing. Moreover, the influence of social and economical factors (e.g. education of parents, or the average income per person) is significant. These are premises for further investigations and research in this field.
EN
Objectives Published reports suggest that some adverse health impact may be related to noise exposure, and motor vehicle traffic is considered to be the main source of environmental hazard of noise. The aim of this study has been to assess an association between occurrence of sleep and attention disorders with exposure to the noise generated by motor vehicle traffic in the case of a large group of children living in an urban environment. Material and Methods The data was obtained using a cross sectional study design in Bytom (Silesia, Poland) from 2003–2007 for a selected group of 7–14 year olds (N = 5136). The geographic information system was used for assessing the exposure to noise generated by the motor vehicle traffic. The association between occurrences of sleep disturbances or attention disorders and exposure to the traffic noise was examined by means of multivariable logistic regression. Results Sleep disturbances and attention disorders were found to be statistically significantly associated with exposure to the traffic noise. The multivariable logistic regression results suggest that sleep disturbances and attention disorders were more likely to occur in the case of children living in the area with higher traffic density, the odds ratio (OR) = 1.44 (95% confidence interval (CI): 1.05–1.97) and 1.38 (95% CI: 1.03–1.86), respectively. Conclusions The results of the study have confirmed that the exposure to the traffic noise could be a significant risk factor for sleep disturbances and attention disorders among children. Int J Occup Med Environ Health 2017;30(3):511–520
EN
Objectives This study explores the association between self-reported exposure to traffic-related air pollution and respiratory health symptoms, as well as lung functions and skin prick tests in adolescents living in the vicinity of main roads. Material and Methods The data in the study were acquired using a cross-sectional study conducted between 2004–2005 in Chorzów (Silesia, Poland) among adolescents (N = 936) aged 13–15 years, attending junior high schools. Adverse respiratory health symptoms and exposure to traffic-related air pollution were determined on the basis of a questionnaire. Moreover, all children underwent spirometry and skin prick tests. Multivariable logistic regression with multiple imputation for missing data was used to assess the prevalence of adverse respiratory symptoms in relation to self-reported exposure to traffic-related air pollution, adjusted for socioeconomic and environmental factors. Results Among respiratory tract diseases, asthma and allergic rhinitis associations were statistically significant (OR = 2.16, 95% CI: 1.12–4.15 and OR = 1.69, 95% CI: 1.08–2.64, respectively). Likewise, among respiratory disorders, statistically significant associations were found in the case of wheezes and dyspnea attack (OR = 1.58, 95% CI: 1.10–2.26 and OR = 2.39, 95% CI: 1.56–3.66, respectively), with respect to the vicinity of the main road. Living in the area with high traffic intensity was statistically significantly associated with a higher prevalence of asthma and wheezes (OR = 2.31, 95% CI: 1.22–4.39 and 1.48, 95% CI: 1.09–2.01, respectively). The results obtained did not confirm the relationship between the adopted way of exposure to traffic-related air pollution and lung function indices or skin prick tests. Conclusions Results of the study suggest that children living in the area with intense traffic are more likely to develop respiratory disorders. Moreover, the vicinity of a main road as well as traffic intensity could be suitable in assessing the relationship between road transport and potential health problems among exposed inhabitants. Int J Occup Med Environ Health. 2019;32(4):553–67
EN
Objectives The primary endpoints of the study were to assess the effectiveness of hip joint arthroscopy in the treatment of femoroacetabular impingement (FAI) in patients with joint gap stenosis and to determine if and how quickly patients were able to return to work and physical activity. Material and Methods The prospective study of patients undergoing hip joint arthroscopy due to pain in FAI has been conducted. They were divided into 2 groups depending on the degree of the radiological examination. The criterion was the width of the joint gap. The study group involved 47 patients with hip joint gap of 2–3 mm, identified by means of the standardized X-ray examination. The control group consisted of 45 patients with hip joint gap > 3 mm. The post-operative follow-up period of the patients lasted at least 2 years. In addition, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire together with Harris Hip Score (HHS) were applied. The patients were also evaluated for the post-operative time period enabling return to work. Results All the patients after hip joint arthroscopy returned to normal physical activity within 12 weeks after operation, enabling their return to work. However, it should be noted that during the post-operative follow-up, pain sensations either recurred or did not regress in 37 patients in the study group and 12 patients in the control group after treatment. The nearly equal results of the WOMAC questionnaire and HHS before operation significantly vary between both groups in the last follow up. In the study group they did not change expressively. Conclusions Despite the little invasiveness, hip joint arthroscopy in patients with joint gap stenosis brings about the far from satisfactory results. This procedure is not worth considering. Despite unsatisfactory pain relief, patients decided to returned to work, due to their occupational position and for fear of losing the job due to long absenteeism. Int J Occup Med Environ Health. 2019;32(1):115–20
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