Jagiellonian University Research Articles

Implementation of the course “good chemistry: methodological, ethical and social implications” – a case study

Abstract The article describes the practical implementation of the course titled “Good Chemistry: Methodological, Ethical, and Social Implications” available on the EuChemS e-learning platform. This MOOC course has been used in various ways at several European universities and through blended learning at Jagiellonian University in Krakow (Poland), which is discussed in this article. Since the groups of students participating in the course were not large and it is worth taking a closer look/insight at this issue, the case study method was used. Sample materials and activities for this course are presented. The survey responses of lecturers and students, as well as the activities and posts of Jagiellonian University in Krakow students on the remote learning platform, were analyzed. The strengths and weaknesses of the course were identified, and the need for continuous efforts by lecturers to develop ethical attitudes, critical thinking, and communication skills in students, especially in the field of socioscientific issues, was emphasized.

2.L. Round table: Monitoring health reforms to inform policy innovation: the Health Systems and Policies Monitor

Abstract Background The European Observatory on Health Systems and Policies’ (Observatory) Health Systems and Policy Monitor (HSPM) network convenes an international group of around 50 national health systems researchers from over 40 institutions across 31 high-income countries, including all EU countries, Canada, Israel, the UK and the US. In advance of the HSPM annual meeting, experts share the current year’s “top-three” health reforms in their countries via a standardized survey, soliciting details on content and general implementation processes. Reforms are iteratively organized into to 2 of 11 clusters, derived from the WHO health system building blocks. Experts then discuss background, status and content of national reforms in the year’s main clusters and initiate cross-country collaborations. A repository of over 650 reforms since 2018 has been created and is available online, showcasing reform patterns in HSPM countries. The collected data have informed studies on reform trends in HSPM countries from 2018-2019 and between 2020-2022, with work ongoing. Data are also consulted by researchers and policymakers wishing to learn about and from reforms in other countries. This workshop specifically aims to: • Inform participants about the methodologies used by the HSPM network to track reforms • Highlight common trends in major health reforms across countries since 2018 • Discuss national health reforms and the value of understanding and tracking these across countries • Identify research gaps in reform monitoring relevant to policy makers • Discuss how the health system research community can generate more relevant and actionable evidence Added-value The comparative analysis of reform trends provides insights into how systems operate and the types of reforms more likely to be implemented. The sharing of these insights also serves as a source of inspiration, allowing countries to learn from each other’s successes and failures and adopt proven best practices. This is relevant for policymakers and researchers striving to support health systems strengthening. Therefore, the workshop will support knowledge exchange between researchers and policymakers by (1) informing researchers and policymakers about similar ongoing reforms in other countries and (2) identifying areas where researchers can contribute to country reform agendas, and (3) stimulating interest in cross-country collaborative research on similar and topical reforms in different countries. Format This is a roundtable workshop chaired and moderated by the Observatory. An overview of reform trends and patterns since 2018 will set the scene, followed by an interactive discussion with policymakers and HSPM network members to (1) delve into trend dynamics and implications for health policy and research and (2) identify major (missing) research areas relevant to policymakers. In addition, we will leverage the geographic scope and expertise of the audience to reflect on the value of monitoring reforms. Key messages • Cross-country exchange of information on reform trends and implementation patterns can inspire future reforms and help policymakers identify promising policy approaches abroad. • Knowledge exchange between researchers and policymakers helps to determine evidence gaps and to generate relevant and actionable evidence that can drive policy innovation. Speakers/Panelists Reinhard Busse Berlin University of Technology, Berlin, Germany Ines Fronteira National School of Public Health - NOVA University of Lisbon, Lisbon, Portugal Iwona Kowalska-Bobko Jagiellonian University Medical College, Institute of Public Health, Cracow, Poland Isabel de La Mata DG SANTE, European Commission, Luxembourg, Luxembourg Vesna-Kestrin Petric Ministry of Health, Ljubljana, Slovenia

The Effect of Isometric Exercise Position on the Effectiveness of Isolated Work of the Thigh Flexor Muscles Based on the Results of the sEMG Study.

The main function of the hamstring muscles is to bend the knee joint and support the function of the hip extensors. Their frequent injuries are the result of overload related to, among others, dynamic running or jumping, and inadequate preparation for athletics activities. The asymmetry of the work of individual flexor muscle groups is clearly marked in the case of valgus or varus of the knee joint, i.e., in different positions of the lower limb. The aim of the study was to determine the position and form of a rehabilitation exercise in which an isolated group of muscles flexing the knee joint will show the greatest bioelectrical activity. The study involved 25 students of the Jagiellonian University Medical College. The students were aged 20-26. The average age was 22.9 (±1.4). The study participants included 17 women with an average age of 23.0 (±1.1) and 8 men with an average age of 22.6 (±1.9). Women constituted 68% and men 32% of all respondents. All participants agreed to participate in the study. Surface electromyography measurements in both lower limbs provided an initial number of 50 cases. The activity of the knee flexor muscles during isometric contraction with resistance was measured in correlation with three foot and lower leg settings: internal rotation, neutral position, and external rotation. The bioelectrical activity of the semitendinosus muscle is significantly higher (p < 0.01) in the internal rotation position than in the neutral position of the lower leg, while the bioelectrical activity of the biceps femoris muscle is inversely higher (p < 0.01) in the external rotation position than in the neutral position. The results are significant for both average and maximum values of muscle stimulation. During isometric contraction with resistance, the semitendinosus muscle shows the greatest bioelectrical activity in the internal rotation position of the lower leg and foot, and the biceps femoris muscle in the external rotation position of the lower leg and foot. The above information has important implicational applications when improving isolated groups of hamstrings. In the future, this may contribute to more effective rehabilitation of patients with injuries of the muscles described in the article.

Implementation and development of hospital-based health technology assessment in Poland from the perspective of hospital representatives: qualitative research.

The analysis of health technologies in Poland has so far mainly concerned drugs assessed by the Agency for Health Technology Assessment and Tariffication, which was established for this purpose. Due to the implementation of various forms of investment (hardware, diagnostic, and organizational) in hospitals, and the growing need to properly assess the costs of implemented solutions, Hospital-Based Health Technology Assessment (HB-HTA) began to develop. In order to implement HB-HTA in the Polish healthcare system, in 2019-2022 a project was carried out, the consortium members of which were: the National Health Fund (NHF), the National Institute of Cardiology in Warsaw (NIKARD), and Lazarski University (UŁ). Analyzing the possibilities of developing HB-HTA in Polish hospitals based on the experiences of the study participants. Presenting benefits and barriers for HB-HTA units implementation to Polish hospitals. Qualitative analysis of in-depth interviews with the representatives of hospitals that participated in the HB-HTA project using the Nvivo12 program. A specially prepared questionnaire with questions regarding the pre-project, design, and post-project phases was presented to respondents from five of the seven hospitals participating in the pilot phase of the project, during which HB-HTA reports were prepared for selected medical technologies. The remaining two facilities that were invited refused to participate in the study. The Ethics Committee of the Jagiellonian University Medical College gave consent to conduct the study. Hospital representatives indicate that the HB-HTA methodology allows for the assessment of investments in facilities based on appropriate data. Thanks to the project, employees of hospital units gained new skills, such as becoming familiar with literature reviews in medical bibliographic databases. However, HB-HTA in Poland has not been fully implemented because facilities do not obtain adequate benefits from the implementation of HB-HTA at the organizational and financial level. According to the study participants, the methodology itself should be modified to take into account the needs of the facility. The hospitals participating in the HB-HTA project are developing the field of analyzing how innovative solutions are implemented in their facilities, but not to the extent that was intended in the project design.

Female-age-dependent changes in the lipid fingerprint of the mammalian oocytes.

Can oocyte functionality be assessed by observing changes in their intracytoplasmic lipid droplets (LDs) profiles? Lipid profile changes can reliably be detected in human oocytes; lipid changes are linked with maternal age and impaired developmental competence in a mouse model. In all cellular components, lipid damage is the earliest manifestation of oxidative stress (OS), which leads to a cascade of negative consequences for organelles and DNA. Lipid damage is marked by the accumulation of LDs. We hypothesized that impaired oocyte functionality resulting from aging and associated OS could be assessed by changes in LDs profile, hereafter called lipid fingerprint (LF). To investigate if it is possible to detect differences in oocyte LF, we subjected human GV-stage oocytes to spectroscopic examinations. For this, a total of 48 oocytes derived from 26 young healthy women (under 33 years of age) with no history of infertility, enrolled in an oocyte donation program, were analyzed. Furthermore, 30 GV human oocytes from 12 women were analyzed by transmission electron microscopy (TEM). To evaluate the effect of oocytes' lipid profile changes on embryo development, a total of 52 C57BL/6 wild-type mice and 125 Gnpat+/- mice were also used. Human oocytes were assessed by label-free cell imaging via coherent anti-Stokes Raman spectroscopy (CARS). Further confirmation of LF changes was conducted using spontaneous Raman followed by Fourier transform infrared (FTIR) spectroscopies and TEM. Additionally, to evaluate whether LF changes are associated with developmental competence, mouse oocytes and blastocysts were evaluated using TEM and the lipid dyes BODIPY and Nile Red. Mouse embryonic exosomes were evaluated using flow cytometry, FTIR and FT-Raman spectroscopies. Here we demonstrated progressive changes in the LF of oocytes associated with the woman's age consisting of increased LDs size, area, and number. LF variations in oocytes were detectable also within individual donors. This finding makes LF assessment a promising tool to grade oocytes of the same patient, based on their quality. We next demonstrated age-associated changes in oocytes reflected by lipid peroxidation and composition changes; the accumulation of carotenoids; and alterations of structural properties of lipid bilayers. Finally, using a mouse model, we showed that LF changes in oocytes are negatively associated with the secretion of embryonic exosomes prior to implantation. Deficient exosome secretion disrupts communication between the embryo and the uterus and thus may explain recurrent implantation failures in advanced-age patients. Due to differences in lipid content between different species' oocytes, the developmental impact of lipid oxidation and consequent LF changes may differ across mammalian oocytes. Our findings open the possibility to develop an innovative tool for oocyte assessment and highlight likely functional connections between oocyte LDs and embryonic exosome secretion. By recognizing the role of oocyte LF in shaping the embryo's ability to implant, our original work points to future directions of research relevant to developmental biology and reproductive medicine. This research was funded by National Science Centre of Poland, Grants: 2021/41/B/NZ3/03507 and 2019/35/B/NZ4/03547 (to G.E.P.); 2022/44/C/NZ4/00076 (to M.F.H.) and 2019/35/N/NZ3/03213 (to Ł.G.). M.F.H. is a National Agency for Academic Exchange (NAWA) fellow (GA ULM/2019/1/00097/U/00001). K.F. is a Diamond Grant fellow (Ministry of Education and Science GA 0175/DIA/2019/28). The open-access publication of this article was funded by the Priority Research Area BioS under the program "Excellence Initiative - Research University" at the Jagiellonian University in Krakow. The authors declare no competing interest. N/A.

Validation of the Polish version of an Ageism Scale for Dental Students (ASDS-PL).

Ageism is one of the common forms of discrimination and prejudice. It has also been shown to be present in health professionals, including doctors, nurses, and medical students. The aim of this study was to translate the Ageism Scale For Dental Students (ASDS) into Polish, perform a culture adaptation, and conduct a preliminary validation analysis. The survey was administered to 202 third-, fourth-, and fifth-year students at the Jagiellonian University (No. 1072.6120.283.2020). Data were analyzed using principal components analysis (PCA) with an oblique, Promax rotation, and confirmatory factor analysis (CFA). Cronbach's alpha (α) was calculated to check the internal consistency reliability. Discriminant validity was analyzed using the Mann-Whitney and Kruskal-Wallis test. PCA produced a 10-item scale distributed into three factors, which explains 59.52% of the total variance. Factor 1 ("preconceived notions about dental treatment") contained four items (α=0.703), Factor 2 ("cost-benefit of providing care for older patients")-four items (α=0.660) and Factor 3 ("dentist-older patient interaction")-two items (α=0.662). CFA confirmed that the model is a good fit (RMSE=0.058, 90% CI from 0.014 to 0.092, CFI=0.950, and TLI=0.926). The discriminant validity showed statistically significant differences in factors or individual items related to the year of the study, gender, and having a history of living with an older person(s) or an older patient(s) treated. The validation of the ASDS conducted in Poland identified 10 items with sufficient validity and reliability.

Kompetencja leksykalna nastoletnich użytkowników języka polskiego jako odziedziczonego i ojczystego w ujęciu komparatywnym

Lexical competence of teenage heritage and native users of Polish has never been the subject of a comprehensive comparison. The first extensive empirical data were gathered by the Jagiellonian University research team in the project Heritage and native language – a comparison of language competences of teenage Polish and heritage learners. In the first stage of the present study, vocabulary tests of the two groups were analyzed. The results showed few differences in receptive knowledge, but in productive knowledge heritage users lagged behind. Therefore, in the second stage, selected essays were compared in terms of their vocabulary profiles. It was found that native and heritage language users’ lexical profiles differ markedly, to the considerable disadvantage of heritage users. Polish educators responsible for the schooling of migrant children must be aware of this, as too often heritage speakers who enter home schools after (re)immigration are treated as if there were native users. This however, as this research has clearly shown, is by no means the case.

Badanie potrzeb językowych studentów zza wschodniej granicy. Implikacje dydaktyczne dla praktycznej nauki języka na kierunku Studia polskie dla cudzoziemców

In the academic year 2022/2023, the Faculty of Polish Studies of the Jagiellonian University opened Polish studies for foreigners, which enables learning the Polish language as part of university education. Due to the growing number of students from Ukraine, the goals, effects and content of teaching in this field should be transformed to meet the specific linguistic needs of students from beyond the eastern border. The aim of the article is to present the teaching goals and priorities of students from Ukraine. The results of the study will be compared with the teaching rules of the contemporary methodology of teaching Polish as a foreign language to Eastern Slavs.

Impact of body mass index and gestational weight gain on cesarean delivery rates: a comparative study of dinoprostone-induced vs spontaneous labor.

This study investigates the relationship between pre-pregnancy body mass index (BMI), BMI before labor, and weight gain during pregnancy with the incidence of cesarean delivery (CD) in dinoprostone-induced labor versus spontaneous labor. This retrospective analysis was carried out at the Jagiellonian University Hospital's Obstetrics and Perinatology Department, encompassing term singleton pregnancies from May 2019 to February 2021. BMI was categorized following WHO guidelines. Gestational weight gain was assessed against the Institute of Medicine's 2009 recommendations. Of the 366 cases reviewed, 183 were in the dinoprostone-induced labor group, and 183 were in the spontaneous labor group. The study identified a significant association between higher pre-pregnancy BMI and increased weight gain during pregnancy with elevated CD rates, especially in dinoprostone-induced labor compared to spontaneous labor. Specifically, the dinoprostone-induced labor group showed a 33.9% CD rate compared to 16.9% in the spontaneous labor group. Logistic regression analysis further established that for each 1 kg/m² increase in pre-pregnancy BMI, the odds of undergoing a CD increased by 10%. Elevated pre-pregnancy BMI and excessive gestational weight gain significantly heighten the risk of cesarean delivery, particularly in induced labor. The findings underline the need for individualized labor management strategies for women with higher BMI to optimize maternal and neonatal outcomes.

Muzeum Narodowe w Krakowie – Uniwersytetowi Jagiellońskiemu w 600. rocznicę założenia uczelni

On the occasion of the 660th foundation anniversary of the Academy of Krakow, which fell in 2023, the article takes a closer look at a theme that has not been explored in the academic literature, namely the contribution of the staff of Poland’s oldest national museum in Krakow to the celebrations marking the 600th anniversary of the academy in 1964 with an exhibition entitled Art in Krakow, 1350–1550. It was a monumental exhibition, which is worth recalling so as not to erase the traces of this initiative. The curator of the exhibition for the 600th foundation anniversary of the Jagiellonian University was Maria Kopff. In organising it, she worked with great dedication and devotion, and it was thanks to this exhibition that she gained great professional and moral authority in the museum community, and on many occasions her opinions influenced the most important museum issues in Poland. It was the exhibition that synchronised monuments of sacred art with monuments of a secular nature in a manner unprecedented in the Polish People’s Republic, all in an attempt to show the luxuriant development of Polish art from the 14th to the 16th century. Although the content of the exhibition was close to the so-called ‘historical policy’, exposing, among other things, the secular character of Cracovian art, it undoubtedly presented the enormous achievements of Polish national heritage.

The notion and practice of psychotherapy in Polish psychiatry of the interwar period. Part 1.

The paper explores the development of psychotherapy in Polish psychiatry in the interwar period from the perspective of Kurt Danziger's historical psychology. Firstly, the organizational and social context of the development of Polish psychiatric care in the interwar period and its impact on the development of psychotherapy is outlined. Then, the most influential in Poland, European psychotherapeutic developments in the interwar period are reconstructed. Finally, the views of psychiatric personnel of three psychiatric facilities proposing psychotherapy as one of the main means of treatment of mentally ill patients are introduced: Dziekanka Psychiatric Hospital, the Jewish Hospital in Warsaw and Psychiatry and Neuropathology Clinic of the Jagiellonian University in Krakow. Psychiatric personnel from Dziekanka Psychiatric Hospital, directed by Aleksander Piotrowski, understood psychotherapy broadly, as the influence of the environment on the patient's psyche. Psychiatrists of the Jewish Hospital in Warsaw, Adam Wizel, Gustaw Bychowski, Władysław Matecki, and Maurycy Bornsztajn developed psychoanalytically influenced psychotherapy of schizophrenia. Bychowski also advocated for the application of psychotherapy in such neglected groups of patients as children and the intellectually disabled. Jan Piltz and Eugeniusz Artwiński pursued psychotherapy in the treatment of war neuroses at the Psychiatry and Neuropathology Clinic of the Jagiellonian University.

CALL TO ECLS-Acronym for Reporting Patients for Extracorporeal Cardiopulmonary Resuscitation Procedure from Prehospital Setting to Destination Centers.

The acronym CALL TO ECLS has been proposed as a potential tool to support decision-making in critical communication moments when qualifying a patient for the ECPR procedure. The aim of this study is to assess the accuracy of the acronym and validate its content. Validation is crucial to ensure that the acronym is theoretically correct and includes the necessary information that must be conveyed by EMS during the qualification of a patient with out-of-hospital cardiac arrest for ECMO. A survey was conducted using the LimeSurvey platform through the Survey Research System of the Jagiellonian University Medical College over a 6-month period (from December 2022 to May 2023). Usefulness, importance, clarity, and unambiguity were rated on a 4-point Likert scale, from 1 (not useful, not important, unclear, ambiguous) to 4 (useful, important, clear, unambiguous). On the 4-point scale, the Content Validity Index (I-CVI) was calculated as the percentage of subject matter experts who rated the criterion as having a level of importance/clarity/validity/uniqueness of 3 or 4. The Scale-level Content Validity Index (S-CVI) based on the average method was computed as the average of I-CVI scores (S-CVI-AVE) for all considered criteria (protocol). The number of fully completed surveys by experts was 35, and partial completion was obtained in 63 cases. All criteria were deemed significant/useful, with I-CVI coefficients ranging from 0.87 to 0.97. Similarly, the importance of all criteria was confirmed, as all I-CVI coefficients were greater than 0.78 (ranging from 0.83 to 0.97). The average I-CVI score for the ten considered criteria in terms of usefulness/significance and importance exceeded 0.9, indicating high validity of the tool/protocol/acronym. Based on the survey results and analysis of responses provided by experts, a second version was created, incorporating additional explanations. In Criterion 10, an explanation was added-"Signs of life"-during conventional cardiopulmonary resuscitation (ROSC, motor response during CPR). It has been shown that the acronym CALL TO ECLS, according to experts, is accurate and contains the necessary content, and can serve as a system to facilitate communication between the pre-hospital environment and specialized units responsible for qualifying patients for the ECPR.

Diagnostic utility of translabial ultrasound in pelvic organ prolapse: a prospective observational study

Background The increasing awareness of women’s health issues, specifically pelvic organ prolapse (POP) and urinary incontinence (UI), has spurred a surge in patients seeking specialised advice for these conditions, necessitating modern diagnostic approaches for such issues. This study explored the diagnostic utility of translabial ultrasound for POP, emphasising its correlation with clinical assessments based on International Continence Society (ICS) criteria. Methods Seventy-one patients with POP Quantification System (POP-Q) stage 0-IV with or without UI were prospectively enrolled at Jagiellonian University Medical College between 2014 and 2016. The study objectives included evaluating diagnostic accuracy and concordance across pelvic compartments, correlating the diagnoses with patient-reported symptoms, and identifying variables contributing to diagnostic discrepancies. Results Translabial ultrasound identified POP in 74.5% of the patients, aligning closely with clinical evaluations. Concordance was the highest in assessments performed in the medial compartment (85.8%), while assessments performed in the anterior (29.6%) and posterior (29.6%) compartments showed higher rates of discrepancies. Correlation analyses showed varying associations, with the posterior compartment exhibiting the least pronounced correlation (R = 0.72, p < 0.0001). Self-perceive POP showed no discernible differences in relation to ultrasonographic and clinical assessments. Among the respondents, 55.9% reported experiencing the sensation of POP. Mean POP levels determined using the two approaches precisely matched in 46.5% of these cases. Discrepancies involved variables such as self-perceived POP, number of deliveries, child weight at birth, UI, and sexual activity. Conclusions Translabial ultrasound showed robust correlation with clinical assessments for evaluating POP, especially for defining defects and facilitating treatment-related decision-making. Our findings highlight the reliability of this method, particularly for assessments in the medial compartment. The evidence did not indicate the superiority of either method in detecting POP disorders for symptomatic versus asymptomatic patients. Significantly, a higher POP-Q measurement in clinical examination was correlated with greater sexual activity.

ICTP concentration in cervical-vaginal fluid as a potential marker of membrane collagen degradation before labor.

Numerous physical and chemical processes lead to rupture of membranes. Within the fetal membranes there are numerous types of metalloproteinases, which cause collagen type I degradation. The C-terminal telopeptide of colagen type I (ICTP) is the breakdown product of type I collagen. The aim of the study was to determine whether ICTP is secreted into the vaginal-cervical fluid (VCF) in the case of physiological rupture of the membranes of the fetus before delivery. The study was conducted in March 2021 at the Department of Obstetrics and Perinatology of the Jagiellonian University in Cracow, Poland. Twenty-three cases were included in the study. During routine gynecological examination with the use of specula, VCF was collected twice in a volume of 50 µL. The obtained material was then subjected to enzyme immunoassay using the Human C-telopeptide of type I collagen (ICTP) ELISA Kit (Catalog Number. CSB-E10363h). The concentration of ICTP in the sample was calibrated. The concentration range that the device can detect was 25 ng /mL-800 ng/mL. The presence of ICTP in the VCF was confirmed. The minimum concentration was 43.72 ng/mL, the maximum was 762.59, in five cases the concentration was outside the maximum scale of the device. ICTP was confirmed in the VCF of pregnant women before physiological delivery. Further studies are required to accurately evaluate ICTP as a marker of the processes of collagen degradation in fetal membranes in the mechanism of physiological labor and premature rupture of the membranes.

„Sternicy mediów”. Opis projektu, kwestie metodologiczne

This article describes the “Media Helmsmen” research project, which primary goal was the analysis of the influence of leaders of media organizations on shaping the media market in Poland after 1989. The project began in 2013 during the “Humanistic Management” conference at Jagiellonian University, and was inspired by the idea presented by the late professor Barbara Czarniawska. Even though professor Czarniawska did not conduct her study in Sweden as it was planned, in Poland extensive research material was collected. It allowed the identification of key dilemmas in organizational management media organizations. The article presents the basic research assumptions of the project, including the main research questions: how is the leadership viewed in relation to media organizations? Who exactly is the media helmsman? What are its features? The authors point to the multi-paradigmatic nature of management sciences and emphasize the importance of both theoretical and practical aspects of research. The article includes a brief description of the research process, which is presented in detail in the monograph titled “Media Helmsmen”.

The “University and War” Project – Perspectives of Polish-Ukrainian Studies at the Jagiellonian University (University and War in Ukraine, edited by Alicja Z. Nowak and Kinga Anna Gajda. Berlin: Peter Lang GmbH, 2023)

The “University and War” Project – Perspectives of Polish-Ukrainian Studies at the Jagiellonian University (University and War in Ukraine, edited by Alicja Z. Nowak and Kinga Anna Gajda. Berlin: Peter Lang GmbH, 2023)

Fellowship at Jagiellonian university medical college

Fellowship at Jagiellonian university medical college

Book review: Tomasz Leś, Concepts of wisdom in the philosophy of Socrates, Plato and Aristotle, Jagiellonian University Publishing House, Kraków 2016, 168 pp.

Artykuł stanowi recenzję książki Tomasza Lesia - "Koncepcje mądrości w filozofii Sokratesa".

Living with axial spondyloarthritis: a cross-sectional survey of patient knowledge and perceptions

Diagnosis and effective treatment of axial spondyloarthritis (AxSpA) are often delayed due to inadequate awareness and poor patient-physician communication. Some AxSpA patients fail to maintain an active lifestyle by exercising regularly, further worsening their disease management. The evolving concept of patient-centred care necessitates better understanding of patient awareness and their needs. We aimed to survey AxSpA patients to reflect on healthcare planning and management perspectives. Our self-administered questionnaire focused on perceptions of AxSpA diagnosis and management, particularly exploring issues of physical activity and active lifestyle. Satisfaction with AxSpA medical care and its accessibility, diagnostic delays, patient-physician communication, and support for disease management were also explored. This offline survey was arranged at the Department of Rheumatology, Immunology, and Internal Medicine of Jagiellonian University Medical College and Krakow University Hospital. We surveyed patients with AxSpA attending outpatient clinics between December 1st, 2023 and April 22nd, 2024. The questionnaire included questions on types of physical activities, barriers to exercising, satisfaction with medical care, patient-physician interactions, diagnostic delays, and use of teleconsultations. A total of 117 patients with AxSpA were enrolled (mean age 41.62 years). The majority (n = 93, 79.5%) were employed. There was a male predominance (69, 59%). The average diagnostic delay was 5.5 years. Notably, 104 (88.9%) responders perceived physical activity as a factor influencing their disease course. However, only 32 (27.35%) managed to exercise regularly (≥ 30 min, 2–3 times a week). The majority (70, 59.83%) were irregularly engaged in some form of physical activity, with 15 (12.8%) not exercising at all, and nearly half (48%) reported at least one barrier to maintaining a physically active lifestyle. Pain (32, 27.35%), fatigue (27, 23.08%), lack of motivation (17, 14.53%), and lack of time (12, 10.26%) were noted as barriers to exercising. The respondents preferred to exercise at home. The survey identified critical areas where patient dissatisfaction or uncertainty were notably prevalent: 38 (32.5%) were uncertain and 35 (30%) were dissatisfied with rehabilitation access. For spa therapy, 63 (53.85%) reported uncertainty and 23 (19.7%) expressed dissatisfaction. Only 48 (41%) were treated by a rehabilitation specialist last year. Only 23% of AxSpA patients took part in teleconsultations last year, and 65% preferred in-person visits. While AxSpA patients recognize the importance of physical activity, significant barriers exist to engaging them regularly in exercising. Addressing these barriers through personalized, motivational, and educational strategies could improve patient outcomes. Improving patient satisfaction with healthcare services, particularly in areas of rehabilitation and physician-patient communication, is crucial for improving the overall care of AxSpA patients.

Geographical-Historical Analysis of the Herbarium Specimens Representing the Economically Important Family Amaranthaceae (Chenopodiaceae-Amaranthaceae Clade) Collected in 1821-2022 and Preserved in the Herbarium of the Jagiellonian University in Krakow.

Herbaria constitute a form of documentation, store and secure comparative material, as well as constitute an extra original gene bank. They are an invaluable database among others for the biological, ethnobotanical and agricultural sciences. The digitization of herbarium collections significantly facilitates access to archival materials; however, searching them is still time-consuming. Therefore, our work aims to analyze the herbarium collection of 8801 sheets for specimens representing the economically important family Amaranthaceae (Chenopodiaceae-Amaranthaceae clade) deposited the oldest herbarium in Poland, the herbarium of the Jagiellonian University (KRA). These specimens have been collected from almost all the continents in dozens of countries for over 200 years. The analyses conducted, including the taxonomic coverage, geographical characteristics and origin, temporal coverage and utility importance of representative species, present the discussed resources in a more accessible way and may become a more attractive form for scientists potentially interested in more advanced research work.