Background: After political transformation in 1989/1990, Poland experienced a general improvement in living conditions and quality of life, but the benefits did not extend evenly across all segments of the society. We hypothesized that the regional differences in mortality due to diseases of the respiratory system are related to socioeconomic status (SES) and its changes over time. Materials and methods: An ecological study was carried out in 66 sub-regions of Poland using the data from the period of 2010 to 2014. Age-standardized mortality rates (SMRs) were calculated separately for men and women in three age categories: ≥15, 25–64 years, and ≥65 years. An area-based SES index was derived from the characteristics of the sub-regions using the z-score method. Multiple weighted linear regression models were constructed to estimate a real socioeconomic gradient for mortality resulting from lung cancer and respiratory diseases. Results: In the regions studied, the SMRs for respiratory disease varied from 70/100,000 to 215/100,000 in men and from 18/100,000 to 53/100,000 in women. The SMRs for lung cancer varied from 36/100,000 to 110/100,000 among men and from 26/100,000 to 77/100,000 among women. After adjusting for the prevalence of smoking and environmental pollution, the SES index was found to be inversely associated with the SMR for lung cancer in each category of age among men, and in the age group of 25–64 years among women. An increase of the SES index between 2010 and 2014 was associated with a decrease of SMR for respiratory disease both in men and women, but this change was not significantly associated with the SMR for lung cancer. Conclusion: SES appears to be an important correlate of mortality from respiratory diseases and lung cancer at the population level, particularly in men. A lower SES was associated with greater mortality from lung cancer and respiratory diseases. An increase in SES over time was related to a decrease in mortality from respiratory disease, but not from lung cancer.

BackgroundHealth status of infants is related to the general state of health of women of child-bearing age; however, women's occupational environment and socio-economic conditions also seem to play an important role. The aim of the present ecological study was to assess the relationship between occupational environment, industrial pollution, socio-economic status and infant mortality in Poland.MethodsData on infant mortality and environmental and socio-economic characteristics for the 66 sub-regions of Poland for the years 2005–2011 were used in the analysis. Factor analysis was used to extract the most important factors explaining total variance among the 23 studied exposures. Generalized Estimating Equations model was used to evaluate the link between infant mortality and the studied extracted factors.ResultsMarked variation for infant mortality and the characteristics of industrialization was observed among the 66 sub-regions of Poland. Four extracted factors: “poor working environment”, “urbanization and employment in the service sector”, “industrial pollution”, “economic wealth” accounted for 77.3 % of cumulative variance between the studied exposures. In the multivariate regression analysis, an increase in factor “poor working environment” of 1 SD was related to an increase in infant mortality of 40 (95 % CI: 28–53) per 100,000 live births. Additionally, an increase in factor “industrial pollution” of 1 SD was associated with an increase in infant mortality of 16 (95 % CI: 2–30) per 100,000 live births. The factors “urbanization and employment in the service sector” and “economic wealth” were not significantly related to infant mortality.ConclusionThe study findings suggested that, at the population level, infant mortality was associated with an industrial environment. Strategies to improve working conditions and reduce industrial pollution might contribute to a reduction in infant mortality in Poland.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0048-1) contains supplementary material, which is available to authorized users.

Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients’ quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.

Improvement and further development of effective strategies for prevention of complications of pregnancy and chronic diseases in the workplace are necessary. Policies aimed at reduction of sickness absence could potentially increase prosperity and the socioeconomic situation in Poland. Int J Occup Med Environ Health 2017;30(6):917-932.

Nutrition is one of the most important environmental factors affecting the physical development and health of children. Education in this area and the development of proper eating habits are priorities. A prerequisite for the proper nutrition of preschool children is knowledge of proper nutrition of people working there. The aim of this study was an evaluation of the knowledge of kindergarten employees participating in the course “Diet full of life – courses in the field of children’s nutrition”. The study included 90 employees of nurseries and kindergartens, participants of the course in the field of children’s nutrition. The research tool was an original questionnaire. Study I (pre-test) was performed before the beginning of the course, while study II (post-test) was performed after its completion. Generalized Linear Models with a Generalized Estimating Equations extension was used to estimate the impact of the number of covariates on knowledge of course participants, taking into consideration the correlation between before- and after-course results. An increase in the knowledge of the participants of the investigated course on children’s nutritional standards was significant and reached 2.053 points on average. No relationship between age, job position, and knowledge level was determined. In the area of principles of proper nutrition for children, older participants had a lower level of knowledge compared to younger ones, and participants with higher education showed a significantly higher knowledge increase as compared to those with vocational education. A significant knowledge increase in the field of dietary behaviors of children was obtained during the course by all examined women, 1.6 points on average (p < 0.001). Younger participants obtained significantly more knowledge from the course than older ones (p < 0.001). Thus, it can be concluded that realization of the course entitled “Diet full of life” specifically relating to young children’s nutrition affected a significant increase in participant knowledge, particularly among the younger age groups and people with higher education. Kindergarten employees need constant supplemental education in the form of training courses, during which they acquire actual knowledge given in an accessible manner for use in practice. The proper assessment of the supplemental education course presented herein, as well as of the course participants, was performed using General Estimating Equations.