Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Thus, the aim of our study was to evaluate the smartphone-based electrocardiogram (ECG) recordings aimed at AF screening at Polish pharmacies. Methods: Prospective AF screening among patients aged ≥65 years was conducted at 10 pharmacies using Kardia Mobile with a dedicated application (Kardia app). Prior AF was a study exclusion criterion. CHA2DS2-VASc score (congestive heart failure, hypertension, age, diabetes mellitus, previous stroke/transient ischemic attack, female sex, and vascular disease) has been collected from every patient. A single-lead ECG has been acquired by the placement of fingers from each hand on the pads. Kardia app diagnosis has been evaluated by the cardiologist. Results: A total of 525 ECGs were performed. Kardia app diagnosis was provided in 490 cases. In 437 (89.18%) cases, it was “normal” rhythm, in 17 (3.47%) recordings “possible AF,” in 23 (4.69%) ECGs “unreadable,” and in 13 (2.65%) “unclassified”. After the cardiologist reevaluation, the new AF was identified in 7 (1.33%) patients. Sensitivity and specificity of Kardia app in detecting AF was 100% (95% confidence interval [CI]: 71.5%-100%) and 98.7% (95% CI: 97.3%-99.5%), respectively. The positive predictive value was 64.7% (95% CI: 38.3%-85.7%) and the negative predictive value was 100% (95% CI: 99.2%-100%). CHA2DS2-VASc score was 2.14 ± 0.69 for those with new AF and 3.33 ± 1.26 in the non-AF group. Conclusion: Kardia app is capable of fast screening and detecting AF with high sensitivity and specificity. The possible diagnosis of AF deserves additional cardiological evaluation. The results obtained in patients with low CHA2DS2-VASc score and “silent” AF confirm the importance of routine AF screening. Cardiovascular screening with the use of mobile health technology is feasible at pharmacies.

Immunization is a very effective health intervention. Moreover, the global vaccines market has been growing rapidly and costs of full children immunization are dramatically higher nowadays than they were 30 years ago. High vaccine prices may limit affordability of vaccination which is why we attempted an evaluation of availability and affordability of 7 and non-reimbursed vaccines mostly used in children in Poland. The study was conducted between October 2016 and October 2017 using a specially designed anonymous questionnaire comprising three closed-ended questions. The study tool was distributed by direct contact or via the Internet. Eventually, answers from 505 pharmacies from the Greater Poland region and 10 primary care clinics were included. 5 out of 7 vaccines were available in all types of facilities. There were some issues, however, with availability of BexseroAE and NimenrixAE. Considering prices, the highest difference (of more than 100%) was found for Infanrix hexaAE and the lowest (38.5%), for Infanrix IPV+HIBAE. In 88.17% of pharmacies included, patients were informed about a thermo-insulating package. 48.39% of respondents indicated that such package is free of charge, while in other pharmacies an average price for the package was EUR 0.48. Although availability and affordability of medicines are crucial objectives of the public health policy, it seems that access to vaccines in Poland might be an area for improvement. Thus, prices of non-reimbursed vaccines could be regulated in Poland nationwide. Moreover, to provide trustworthy information concerning vaccination, healthcare decision makers should consider social education about immunization as an important issue.

Schizophrenia is a serious mental disorder and has a huge economic burden related to direct and indirect costs. Direct costs include such expenditure as hospitalization. Indirect costs, however, result mostly from the loss of productivity. Although patients are frequently interested in job opportunities, unemployment is widespread among them. Thus, we evaluated opinions of medical universities studentsí concerning situation on the labor market among those in the remission stage of schizophrenia. The study was carried out between October 2015 and October 2016 in Poland and other European Union countries using a self designed questionnaire. The study tool consisting of five questions was distributed to students by direct contact and via the Internet. Of a 5200 distributed sheets, we received 1036 questionnaires and 942 were finally analyzed. In the studentsí opinion, patients are generally interested in finding a job but they are afraid coming back to work. Although unemployment is common among patients with schizophrenia, the number of patients capable of working is significantly higher than the number of those actually employed. According to results of the study, getting a job might be effectively supported by non-pharmacological interventions. Considering the noticeably higher number of patients capable of working compared to those employed, development of employment possibilities should be a priority for mental health care decision makers. It should lead to reduction of the patientsí concerns related to looking for a job. Moreover, comprehensive treatment could reduce the economic burden of schizophrenia.