RESUMEN
Lyme borreliosis (Lyme disease) caused by the Borrelia burgdorferi sensu lato spirochete is the most common tick-borne infection manifested by a wide spectrum of clinical symptoms. In Poland, the preventive health care does not comprise individual farmers as it is practiced in foresters. The objective of this study was to evaluate the exposure of Polish farmers to infection with B. burgdorferi, based on serological screening test and epidemiological investigation. A total of 3,597 farmers were examined for the presence of B. burgdorferi antibodies, as well as interviewed regarding exposure to ticks and prophylaxis of tick-borne diseases. The prevalence varied between 18.2 and 50.7 % suggesting a focal occurrence of borreliosis. A significant increase in the frequency of positive reactions in the oldest age ranges was observed, equaling 30.9 % in the range of 60-69 years and 53.6 % in the range of 80-91 years. The prevalence of the anti-B. burgdorferi antibodies of IgG class (14.7 %) was similar to that of IgM class (16.0 %). Seroreactivity to B. burgdorferi antigen was significantly higher in the group of farmers exposed to repeated tick bites. Significant relationships were also found between some other risk factors and occurrence of seropositive reactions to B. burgdorferi. To the best of our knowledge, this is the first study concerning seroprevalence to B. burgdorferi carried out on such a large group of farmers. Results indicate a high risk of B. burgdorferi infection among Polish farmers and associations between some risk factors and the presence of seropositive reactions.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Borrelia burgdorferi/inmunología , Agricultores , Exposición Profesional , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Factores de Riesgo , Estudios Seroepidemiológicos , Encuestas y Cuestionarios , Mordeduras de Garrapatas , Control de Ácaros y Garrapatas/métodos , Enfermedades por Picaduras de Garrapatas/epidemiologíaRESUMEN
PURPOSE: The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. MATERIAL AND METHODS: The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. RESULT: From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. CONCLUSIONS: Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.
Asunto(s)
Instituciones de Atención Ambulatoria/normas , Atención a la Salud/métodos , Atención Primaria de Salud/normas , Calidad de la Atención de Salud/normas , Adulto , Instituciones de Atención Ambulatoria/organización & administración , Atención a la Salud/normas , Femenino , Encuestas de Atención de la Salud/métodos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente/estadística & datos numéricos , Médicos de Familia , Atención Primaria de Salud/organización & administración , Encuestas y CuestionariosRESUMEN
PURPOSE: The quality could be assessed from two perspectives: internal and external. From the internal perspective the quality means being consistent with particular conditions and standards. The external perspective is based on relative assessment of the product made by a client who is also aware of other competitors' offer. Despite the professional assessment which is focused on providing health services according to medical and managerial correctness, patient's assessment is also relevant. Measuring patient's satisfaction is additional method of health services quality assessment. The aim of the study was to estimate patients' opinion on quality of ambulatory obstetric and gynaecological services. MATERIAL AND METHODS: The study was conducted in 11 obstetric and gynaecological out-patient clinics of Lublin in September and October 2003. The study tool was an author's questionnaire. Patients were asked to assess such areas as registration before visit, their relationship with nurses and gynaecologists and other aspects of services provision like intimacy assurance and respecting Patient's Rights. The collected data was statistically analysed. RESULTS: 635 patients took part in the study. The biggest groups in the studied population were women at the age of 20-30 years, married, living in cities and secondary educated. It was found that around half of the population is satisfied and 2.2% of them are unsatisfied with the fact that they have chosen particular out-patient clinic. More than 70% of women had positive opinion of following aspects influencing general opinion about service quality: politness of reception desk staff, opening hours, the length of time before a patient is seen by the specialist, intimacy assurance and respect for Patient's Rights in the practice. 80% of patients were satisfied with the relationship with nurses and 3.3% were unsatisfied with it. Eight patients out of ten were satisfied with gynaecological care, less than 2% were unsatisfied. The studied women had also high opinion of the course of visit. More than 90% of studied patients trust their gynaecologists. CONCLUSIONS: More satisfied with the services provided by the obstetric and gynaecological out-patient clinics were women living in cities than in villages and those visiting nonpublic than public practices.
Asunto(s)
Instituciones de Atención Ambulatoria , Servicio de Ginecología y Obstetricia en Hospital/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Calidad de la Atención de Salud , Adulto , Femenino , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud , Humanos , Servicio de Ginecología y Obstetricia en Hospital/organización & administración , Encuestas y CuestionariosRESUMEN
Kynurenic acid, an antagonist of glutamatergic ionotropic receptors and alpha7 nicotinic cholinergic receptors failed to affect nicotine-induced convulsions in mice which may indicate that alpha7 nicotinic receptor-mediated events play no role in seizure activity produced by nicotine.