Background: Maintaining physical performance during Ramadan Diurnal Fasting (RDF) is a challenge for professional athletes. The literature shows that sleep disturbances experienced by athletes during RDF are associated with reduced physical performance. The effect of sleep quality on physical performance, and the effect of work status on physical performance during RDF among athletes, besides engaging in trainings, have been little investigated. This study aims to evaluate the effect of RDF on the physical performance of professional athletes taking into consideration their sleep quality and work status. Methods: Professional medium-distance male runners (n = 32) participated in our study in the summer of 2019. Data about socio-demographics, training characteristics, sleep quality (Pittsburg Sleep Quality Index: PSQI), physical performance (Cooper Test; Harvard step test) were collected before and during Ramadan. Student’s-test and Welch and Wilcoxon tests were used for data analysis. Results: Both quality of sleep and physical performance of athletes deteriorated during Ramadan. People with better quality of sleep had better physical fitness/performance both before and during RDF. Athletes who worked beside trainings achieved worse physical fitness test results and had worse quality of sleep. Conclusions: Policies aimed to improve physical performance in RDF should consider the quality of sleep and the work status of athletes.

W związku z wybuchem pandemii COVID-19 cele systemu ochrony zdrowia musiały zostać dostosowane do zmieniającego się otoczenia, aby zrealizować potrzeby zdrowotne pacjentów i wypełnić oczekiwania personelu medycznego dotyczące zapewnienia bezpiecznych warunków pracy w zaistniałej sytuacji kryzysowej. Zmiany działalności personelu medycznego, które wynikają przede wszystkim ze zmian organizacyjno-finansowych, dotyczą systemów ochrony zdrowia na całym świecie i wpływają na funkcjonowanie wszystkich form opieki zdrowotnej. Celem tego artykułu jest wskazanie zmian organizacyjnych i finansowych wynikających z wprowadzonych od ogłoszenia przez WHO pandemii do 8 maja 2021 r. aktów prawnych i zaleceń wpływających na warunki pracy personelu medycznego podstawowej opieki zdrowotnej (POZ) w Polsce. Przegląd wprowadzonych działań w zakresie zapewnienia stabilności funkcjonowania POZ w warunkach pandemii pozwala stwierdzić, że sytuacja zagrożenia zdrowia publicznego ujawniła znaczną potrzebę wprowadzenia zmian organizacyjno-finansowych. Skutkiem zmian wynikających z legislacji oraz dobrych praktyk o istocie medycznej, organizacyjnej i finansowej są modyfikacje systemu ochrony zdrowia w Polsce, które mogą w nim pozostać. Warto jednak podkreślić, że jednym z istotnych wyzwań w zakresie przyszłych reakcji systemu ochrony zdrowia, w tym POZ, na stany zagrożenia zdrowia publicznego jest zachowanie spójności zmian organizacyjnych i finansowych wpływających na płynność oraz skuteczność działań podejmowanych przez personel POZ, a więc również na warunki jego pracy. Punktem wyjścia projektowania takich zmian powinna być analiza rozwiązań wprowadzonych od początku pandemii w Polsce. Można do nich zaliczyć nowe wymagania o charakterze organizacyjnym (warunki lokalowe, organizacja i stanowiska pracy, przepływ informacji czy sposób zaopatrzenia pacjenta) i zmiany finansowe (mobilizację dodatkowych zasobów finansowych w różnych formach). W artykule przedstawiono wiele pytań badawczych, które są warte rozważenia przy ustalaniu problemów i priorytetów w przyszłości, ponieważ zaistniałe zmiany i wnioski sformułowane na podstawie ich analizy mogą przyczynić się do wprowadzenia stałych modyfikacji funkcjonowania POZ w Polsce i ułatwić jej ewentualne dostosowanie do stanów ryzyka zdrowotnego. Med. Pr. 2021;72(6)

Introduction: The State Emergency Medical System (PRM) exists to provide assistance to every person in state of sudden threat to their health or life, operates 24 hours a day, 7 days a week, all year round. The units of the system are hospital emergency departments (SOR) and emergency medical teams, including aviation emergency medical teams. The obvious purpose of the PRM System, which is to save life of human, as any complex activity, is sometimes put to the proof. Appearing and publicised by media cases of late medical attention, calls ignored by a dispatcher or sending emergency medical teams from hospital to hospital seriously undermine the reputation of healthcare service in Poland. The aim: Evaluation of organization of the PRM System in Poland by practitioners – medical staff of Hospital Emergency Departments, ambulance personnel and medical students. Material and methods: The material included a group of 138 interviewees from 768 participants of the 11th Emergency Medicine Conference Kopernik 2018. The research tool was the author’s survey consisting of 12 thematic questions, including one open question, and the part collecting sociodemographic data. The collected empirical material was given descriptive and statistical analysis using Microsoft Excel. The results were presented by calculating the arithmetic mean, median, dominant, standard deviation, coefficient of variation and% of responses respectively. Results: In the majority of respondents’ opinion the organization of the PRM system in Poland is average. The vast majority of respondents (64%) consider the two-people “P” teams to be insufficient. Problems the most often reported by the respondents were lack/or insufficient number of trainings, underfunding of the system, large salaries disparities, shortages of staff, hampered cooperation with other services. Conclusions: The analysis of selected items of the organization of the State Emergency Medical Service in Poland in opinion of practitioners points out the need to implement organizational changes which could improve the system.

Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. Materials and Methods: A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July–December 2019 (pre-pandemic period) versus July–December 2020 (pandemic period) was performed. Results: During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/−13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5–30 h) during the pandemic period vs. 5 h (3–24 h) during the non-pandemic period (p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital (p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. Conclusions: 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode.

Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center.