The proportion of older people in Poland is higher in rural areas than in urban areas. Thus, we aimed to evaluate treatment rate and factors associated with outcome and safety of intravenous thrombolysis (IVT) in rural residents aged ≥80 years admitted to primary stroke centers. Patients and Methods: This study was a retrospective, observational cohort study of 873 patients treated with recombinant tissue plasminogen activator (rt-PA) in primary stroke centers between February 1, 2009 and December 31, 2017. Among them were 527 rural residents and 231 (26.5%) were ≥80 years of age. The analyses between rural and urban patients aged ≥80 and between rural patients aged <80 and aged ≥80 were performed. Results: The proportion of patients aged ≥80 treated with rt-PA was comparable in rural and urban residents (27.9% vs 24.3% p = 0.24). Rural patients aged ≥80 were also characterized by lower incidence of cardiovascular risk factors and better patients' conditions on admission to hospital. Symptomatic intracerebral hemorrhage rate among ≥80-year-old stroke patients was lower in those living in rural areas than in those living in urban areas (5.4% vs 14.3%, p = 0.02); there were no differences regarding mortality and 3-month functional outcome between both populations. The older group of rural patients was characterized by a higher 3-month mortality (28.5% vs 12.6%, p < 0.001) and lower functional independence rate (34.0% vs 50.5%, p < 0.001) than rural younger patients. Antiplatelet (OR 2.43, 95% CI 1.04-5.66, p = 0.04) and anticoagulant therapy before stroke (OR 3.64, 95% CI 1.21-10.99, p = 0.022), early ischemic changes in baseline computerized tomograprpahy (OR 2.65, 95% CI 1.03-6.82, p = 0.043) were associated with unfavorable outcome; and higher National Institute of Health Stroke Scale score on admission (OR 1.01, 95% CI 1.01-1.20, p = 0.039), higher baseline count of white blood cells (OR 1.33, 95% CI 1.10-0.62, p = 0.003) were associated with mortality in rural patients over 80. Conclusion: We suggest that rural patients aged ≥80 may be safely treated with IVT in routine practice. However, lower efficacy and a higher mortality must be considered in former use of Vitamin K antagonist and antiplatelet or high white blood cells count.

Introduction. The aim of the surveillance over infections is to define the critical points, lacks in knowledge of staff skills, as well as lack of equipment. It is aimed at preventing the same mistakes from being conducted all over again, instead of making those guilty suffer from consequences of their mistakes. Aim. The authors aimed at assessing the quality of nursing care procedures in terms of preventing post-operative wound infections. Materials and methods. The research was conducted in medical treatment, surgical and intensive care ward. A self-constructed questionnaire “Nursing care quality and prophylaxis of hospital-acquired infections” was used for the study. It was validated using the peer judges method. Results and conclusions. The highest nursing care coefficient was noted in county hospitals ( x̅ = 94.5%), while the lowest was noted in clinical hospitals ( x̅ = 91.3%). It was concluded that there is a deficit in adherence to procedures related to post-operative wound treatment.

Introduction. The youth is a group particularly prone to follow trends concerning nutrition and lifestyle. When studying the habits of this age group, it is possible to evaluate its members’ knowledge concerning health behaviours, determine possible deficiencies and suggest appropriate educational programmes resulting in improvement of eating habits and physical activity, and consequently, in longer life in good health. Aim. Lifestyle and eating habits of the high school students identification and analysis of those results in terms of future health condition and health education of the youth. Material and methods. Anonymous survey study was conducted in electronic form among the students attending high schools and technical high schools all over Poland. The study was conducted with an authors’ survey questionnaire (Google form) filled in via the Internet. The questionnaire mainly included closed questions verifying habits connected with eating, physical activity, using stimulants, and metrics (age, sex, voivodeship, size of the place of living, type of school). Statistical analysis was made with the use of Statistica software. Conclusions. The majority of youth has good habits concerning physical activity and beverages consumption, moreover, smoking is not a frequent habit in this group. What needs to be done, is to raise the youth’s awareness about appropriate carbohydrates consumption as well as about regularity and diversity of meals.

Introduction. The quality of medical services can be regarded as an indication of the changes being implemented at a given moment. At the same time, improving the care quality remains essential, regardless of the current situation. This makes upgrading employees’ skills a necessity, for instance by preventing undesired events, like hospital acquired infections which are quite common. Aim. The aim of this study was to measure the quality of nursing care delivered to patients who contracted a hospital-acquired disease, with special attention paid to the adherence by aseptic procedures. Material and methods. The authors of this research study want to assess the quality of nursing care, looking through the lens of adherence by aseptic techniques. Results. The study was conducted in hospitals of three different referral levels. Both the highest (=95.7%) and the lowest (=84.7%) rates in the field of quality of nursing care were reported in provincial hospitals. Conclusion. 1. There is a 10% deficit in terms of adherence to aseptic procedures. 2. Constant supervision and upgrading nursing staff skills is essential.

Introduction. Cerebrovascular diseases in Poland constitute a bigger threat to life in men than in women, especially after the age of 60. Death rates indicate higher stroke over-mortality in the rural population rather than the urban. At the same time, stroke is the main cause of long-term disability, since half of the patients are unable to independently perform daily activities, which makes them dependent on other people. Materials and method. The study was conducted in the Independent Public Healthcare Institution in Kraśnik, eastern Poland. It covered the medical records of 1,500 patients, 780 women (52%) and 720 men (48%), aged 20-100, diagnosed with cerebral infarction. The patients were hospitalised between 2011-2016 in the Neurology Ward with a Stroke Unit, the Internal Medicine Ward, and the Anaesthetics and Intensive Care Ward. Results. The stroke patients hospitalised in the Independent Public Healthcare Institution in Kraśnik were residents of urban communes (59.1% of subjects) and rural communes (40.9%). The most often diagnosed type of stroke was due to embolism of the cerebral arteries (I63.4) in women (63.48%). In men, the most most often diagnosed type was cerebral infarction due to thrombosis of the cerebral arteries (I63.3; 51.33%). Stroke in 36.15% of the female subjects resulted in death. In male subjects, death occurred in 26.11% of the cases. Conclusions. Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population.