Ostatni rok życia Polaków w świetle danych SHARE: analiza porównawcza

The paper aims at describing the last year of life of Polish people in comparison with previous years of their life. We include international context as well as gender differences in the analysis. A descriptive part of the paper is based on data from end-of-life interviews of the Survey of Health, Ageing and Retirement in Europe (SHARE). The second part – comparative analysis – in addition to the end-of-life interviews takes into account regular interviews conducted in previous waves. We find differences in the process of health deterioration in the last year of life by cause of death. In particular, individuals who died due to cancer were often relatively healthy in the preceding years of life, but experienced a dramatic decrease in health during the last year of life. Another finding is that time spent in the hospital significantly increases in the last year of life. Moreover, we find that number of daily activities’ limitations is positively associated with care received in the last year of life. The results show that the last year of life is often significantly different than preceding years of life both in Poland and other European countries

A mixed methods study to develop a tool to assess institutional readiness to conduct knowledge translation activities in low-income and middle-income countries

Objective: This paper describes the development of a tool for assessing organisational readiness to conduct knowledge translation (KT) among academic institutions in low-income and middle-income countries (LMICs). // Design: A literature review and stakeholder consultation process were conducted to identify constructs relevant for assessing KT readiness in LMICs. These were face-validated with LMIC stakeholders and organised into a Likert-scale questionnaire. // Participants: The questionnaire was distributed to researchers based at six LMIC academic institutions and members of a global knowledge-to-action thematic working group. // Outcome measures: An exploratory factor analysis was used to identify underlying dimensions for assessing institutional readiness to conduct KT. // Results: 111 respondents with varied KT experiences from 10 LMICs were included in the analysis. We selected 5 factors and 23 items, with factor loadings from 0.40 to 0.77. These factors include (1) institutional climate, (2) organisation change efficacy, (3) prioritisation and cosmopolitanism, (4) self-efficacy, and (5) financial resources. These factors accounted for 69% of the total variance, with Cronbach’s alpha coefficients of 0.78, 0.73, 0.62, 0.68 and 0.52, respectively. // Conclusions: This study identifies a tool for assessing readiness of LMIC academic institutions to conduct KT and unique opportunities for building capacity. The organisational focus of these factors underscores the need for strategies that address organisational systems and structures in addition to individual skills. Future research will be conducted to understand determinants of these factors and develop a comprehensive set of capacity building strategies responsive to academic institutions in LMICs

Analiza stężenia wybranych neuroprzekaźników w surowicy chorych z zespołem Tourette'a

Background and purpose Metabolic disturbances of excitatory and inhibitory neurotransmitters are implicated in pathogenesis of Tourette syndrome (TS). The aim of the study was to measure serum concentrations of glutamic acid, γ-aminobutyric acid (GABA) and glycine in TS patients and evaluate any correlation between neurotransmitter levels and age at onset, actual age, gender, tic severity, duration of the disease and concomitant psychiatric disorders. Material and methods Sixty-seven TS patients, aged 16–59, and 57 healthy controls, aged 19–37, were enrolled in the study. Information regarding medical history and physical investigation was collected using a short questionnaire. Sixty-seven percent of patients were medication-free at the time of examination and the rest had withheld treatment for 24 hours before. Blood samples were taken after a 12-hour fasting period. HPLC technique was used. Results The TS group had higher glutamic acid and lower GABA levels. Glycine concentrations were comparable. No differences regarding neurotransmitter concentrations between treated and non-treated patients were found. Patients with concomitant obsessive-compulsive disorder and severe tics had higher glutamate levels. Glutamate concentrations correlated positively with the number of comorbid psychiatric disorders and GABA concentrations correlated negatively with the number of behavioural problems in patients with comorbidities. There was no correlation between analysed neurochemicals and age, gender, age at onset or disease duration. Conclusions Imbalance between excitatory and inhibitory systems in the brains of TS patients may be reflected by glutamate and GABA serum level changes. Glutamate and GABA may be biomarkers of the disease and high concentration of glutamate may indicate more severe course of TS.Wstęp i cel pracy Zaburzenia metabolizmu neuroprzekaźników pobudzających i hamujących odgrywają rolę w patogenezie zespołu Tourette'a. Celem pracy była analiza stężenia kwasu glutaminowego, γ-aminomasłowego (GABA) i glicyny w surowicy chorych z zespołem Tourette'a oraz ocena zależności pomiędzy stężeniami neurotransmiterów a wiekiem lub płcią, wiekiem w chwili zachorowania, nasileniem tików, czasem trwania choroby i współistniejącymi zaburzeniami psychiatrycznymi. Materiał i metody Zbadano 67 chorych na zespół Tourette'a w wieku 16–59 lat oraz 57 zdrowych osób w wieku 19–37 lat. Wykorzystano ankietę obejmującą informacje z badania podmiotowego i przedmiotowego. Sześćdziesiąt siedem procent chorych nie przyjmowało żadnych leków w momencie badania, u pozostałych wstrzymano podawanie 24 godziny przed pobraniem krwi. Próbki zebrano po 12-godzinnym okresie na czczo. Oznaczeń dokonano metodą HPLC. Wyniki W grupie chorych stężenie kwasu glutaminowego było większe, zaś GABA – mniejsze. Stężenie glicyny było podobne. Nie stwierdzono istotnej różnicy stężeń neuroprzekaźników pomiędzy grupą osób leczonych i nieleczonych. W grupie osób ze współistniejącym zaburzeniem obsesyjno–kompulsywnym oraz ciężkim nasileniem tików stężenie kwasu glutaminowego było większe. Stwierdzono dodatnią korelację pomiędzy stężeniem kwasu glutaminowego a liczbą dodatkowych zaburzeń psychiatrycznych oraz odwrotną kore-lację pomiędzy stężeniem GABA a liczbą zaburzeń behawioralnych w grupie ze współistniejącymi zaburzeniami psychiatrycznymi. Nie stwierdzono korelacji pomiędzy stężeniami analizowanych neuroprzekaźników a wiekiem lub płcią pacjentów, wiekiem zachorowania ani czasem trwania choroby. Wnioski Zaburzenie równowagi pomiędzy układem pobudzającym i hamującym w mózgu chorych z zespołem Tourette'a może się manifestować zmianami stężeń kwasu glutaminowego i GABA w surowicy. Kwas glutaminowy i GABA mogą być markerami choroby, a duże stężenie glutaminianu we krwi chorych może oznaczać cięższy przebieg zespołu Tourette'a

The influence of gender dynamics on polio eradication efforts at the community, workplace, and organizational level

Background: Globally, gender as a barrier or facilitator in achieving health outcomes is increasingly being documented. However, the role of gender in health programming and organization is frequently ignored. The Global Polio Eradication Initiative, one of the largest globally coordinated public health programs in history, has faced and worked to address gender-based challenges as they emerge. This paper seeks to describe the role of gender power relations in the polio program across global, national, subnational, and front-line levels to offer lessons learned for global programs. // Methods: We conducted qualitative key-informant interviews with individuals purposively selected from the polio universe globally and within seven country partners: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, and Nigeria. The interview tool was designed to explore nuances of implementation challenges, strategies, and consequences within polio eradication. All interviews were conducted in the local or official language, audio-recorded, and transcribed. We employed a deductive coding approach and used four gender analysis domains to explore data at the household, community, workplace, and organizational levels. // Results: We completed 196 interviews globally and within each partner country; 74.5% of respondents were male and 25.5% were female. Male polio workers were not allowed to enter many households in conservative communities which created demand for female vaccinators. This changed the dynamics of front-line program teams and workplaces and empowered many women to enter the workplace for the first time. However, some faced challenges with safety and balancing obligations at home. Women were less likely to receive promotions to managerial or supervisory roles; this was also reflected at the global level. Some described how this lack of diverse management and leadership negatively affected the quality of program planning, delivery and limited accountability. // Conclusions: Gender power relations play an important role in determining the success of global health programs from global to local levels. Without consideration of gender, large-scale programs may fail to meet targets and/or reinforce gender inequities. Global disease programs should incorporate a gender lens in planning and implementation by engaging men and boys, supporting women in the workplace, and increasing diversity and representation among leadership

Children’s Proximity and Non-Family Support to Elderly Adults in Europe

Geographical distance between adult children and elderly parents adversely affects the provision of help to the latter. We investigate how neighbours, friends and other non-family individuals compensate for the shortages of help received by elderly persons. On the basis of SHARE data for twelve European countries, we estimate the probability and amount of unpaid support received by persons aged 65 and over living at different distances to their children. Parents living in the proximity rely almost exclusively on family; as the geographical distance between adult children and elderly parents increases, the probability and amount of non-family support increase as well. In eastern and southern Europe, elderly individuals receive more support from both family and non-family than their counterparts in western and northern Europe. Non-family supporters compensate for the absence of children in the proximity, but the engagement of the former depends strongly on cultural and institutional conditions.Odległość między członkami rodziny negatywnie wpływa na pomoc dorosłych dzieci dla ich rodziców będących w podeszłym wieku. Nasze badanie dotyczy tego, jak sąsiedzi, przyjaciele i inne osoby spoza rodziny uzupełniają potencjalne niedobory we wsparciu osób starych. Na podstawie danych SHARE dla dwunastu krajów europejskich szacujemy prawdopodobieństwo i ilość pomocy otrzymanej przez osoby w wieku 65 lat i więcej, które mieszkają w różnej odległości od swoich dzieci. Rodzice mieszkający stosunkowo blisko polegają prawie wyłącznie na wsparciu członków rodziny, natomiast wraz ze wzrostem dystansu rośnie prawdopodobieństwo i ilość pomocy od osób spoza rodziny. W krajach Europy wschodniej i południowej osoby starsze otrzymują więcej pomocy zarówno od członków rodziny, jak i osób spoza niej, niż ich rówieśnicy w krajach Europy zachodniej i północnej. Osoby spoza rodziny kompensują w pewnym stopniu braki we wsparciu osób starszych, ale zaangażowanie tych pierwszych silnie zależy od czynników kulturowych i instytucjonalnych

The decision support facilitating the check-in service at the Chopin airport with the use of computational experiments in SIMIO

Airlines strive to minimize the waiting time for passenger service at the airport. Modification of the passenger service process at check-in stands can be carried out by modelling and then simulating various scenarios in order to obtain time benefits. The organization of service for departing passengers is the most complex system, which includes numerous maintenance activities aimed at preparing them and their luggage for transport by aircraft. Therefore, this article aims to present a few scenarios to improve the passenger service process. Based on the research, assumptions were made for each check-in scenario. Then, the models were implemented in the SIMIO simulation program. In the next step, the passenger distribution for individual desks was modified and a comparison was made with the level of passenger service defined by International Air Transport Association (IATA). The simulation results for individual scenarios are presented and the benefits to be achieved after introducing the proposed changes are indicated. The simulations carried out showed 2 important elements in the current and proposed layout of the ticket and luggage service stations and the introduction of changes to the baggage desks. Article presents the specification of the time spent in the system and waiting in the queue. The conducted analyses have shown that the proposed concept will allow for taking over 40% of passengers using the adjacent Fast Bag Drop (FBD) stands. Research has shown that adding more machines for use will fully cover the demand for FBD. The conclusions presented in the article are valuable when introducing modernization of the passenger and baggage handling process. For future researches, it would be beneficial to test other simulation tools and other scenarios to compare these results with those presented in this article

Translating Implementation Experiences and Lessons Learned From Polio Eradication Into a Global Health Course: Insights From an International Consortium

Lessons learned from one global health program can inform responses to challenges faced by other programs. One way to disseminate these lessons is through courses. However, such courses are often delivered by and taught to people based in high-income countries and thus may not present a truly global perspective. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a consortium of 8 institutions in Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and the United States that seeks to carry out such a transfer of the lessons learned in polio eradication. This short report describes the collaborative process of developing content and curriculum for an international course, the learnings that emerged, the barriers we faced, and recommendations for future similar efforts. Various parts of our course were developed by teams of researchers from countries across South Asia and sub-Saharan Africa. We held a series of regional in-person team meetings hosted in different countries to improve rapport and provide a chance to work together in person. The course content reflects the diversity of team members’ knowledge in a variety of contexts. Challenges to this effort included team coordination (e.g., scheduling across time zones); hierarchies across and between countries; and the coronavirus disease (COVID-19) pandemic. We recommend planning for these hierarchies ahead of time and ensuring significant in-person meeting time to make the most of international collaboration

Developing cadres of gender specialists in global public health to meet increasing demand

Gender is increasingly prioritized in global health and embedded across the Sustainable Development Goals. This shift has created a demand for gender specialists with skills to integrate gender into research and programs. Most global health professionals lack formal training in gender analysis or integration. Gender is often misunderstood—conflated with sex, focused only on women, or limited to maternal health. Training can equip professionals to address these gaps, improve outcomes, and reduce inequities. We developed the Gender and Health Summer Institute at Johns Hopkins Bloomberg School of Public Health to grow this capacity. Using universal design, the Institute enhances accessibility, inclusivity, and engagement. Our goal: build a global cadre of gender specialists driving more gender-responsive and equitable health programs

Evaluation and Support Mechanisms of an Emerging University-wide Global Health Training Program

Background: Global health education is in high demand in the United States, across the continuum of learning, and field experiences are an essential part of this education. However, evaluations of these programs are limited. Objectives: The aim of this study was to evaluate a field placement program at Johns Hopkins University, in Baltimore, Maryland, to understand how to better support student training overseas and faculty mentorship. Methods: We used qualitative and quantitative methods to gather data from program reporting requirements (152 student surveys and 46 experiential narrative essays), followed by 17 semistructured interviews, and 2 focus groups. Data were analyzed through manual coding and a socioecological model served as an analytical and a synthesizing framework. Findings: A series of factors influence the participants' experience in overseas placements spanning across 4 aggregate levels, from individual to societal, including opportunity for professional advancement, independence, loneliness and illness, mentorship quality, funding, institutional partnership building, opportunity for public health contribution, and for development of cultural competency. Faculty and students thought that the program was beneficial to the learning experience, particularly for its contribution to experiential knowledge of a low- and middle-income country setting and for developing cross-cultural relationships. Communication and scope of work were 2 areas in which students and faculty members often had different expectations and many students emerged having cultivated different skills than they or their mentor initially expected. Students found the experience useful for both their academic and professional careers and faculty members saw mentorship, one of their professional responsibilities, emerge. Conclusions: Many socioecological factors influence an overseas field experience, which in turn produces important effects on students' career choices, and faculty members appreciate the opportunity to serve as mentors. The most vital support mechanisms suggested for faculty and students included available funding, clear preparation, and communication facilitation across the experiential continuum

Development, Implementation, and Evaluation of a New Course on Essential Skills for Women's Leadership in Global Health.

While many calls have been made to support the development of women leaders in global health, few resources have been developed and evaluated to meet this goal. We developed and evaluated a one week online short course on the essential skills for women's leadership in global health, offered in June 2021 to 22 students from 4 countries (Australia, Ethiopia, Thailand, and the United States). The course covered the state of women's leadership in global health and influencing factors; leadership theories models and frameworks; self-awareness and self-assessments; organizations and enabling environments; communication; and negotiation, and was designed to promote skills via practice, discussion, and debrief. Students rated the course highly and enjoyed the skills-building components, diversity of voices presented throughout the course, and embedded networking opportunities. Future iterations of the course, particularly those held in low-and middle-income countries, should contextualize materials, co-create with local instructors and amplify local voices, and consider incorporating shadowing, coaching, mentorship, and communities of practice