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Funding Acknowledgements Type of funding sources: None. Introduction Pulmonary arterial hypertension (PAH) is a rare disease, with an incidence of 15–50 cases per million annually. The disease is associated with further progress and worsening of symptoms despite pharmacotherapy. The severity of PAH symptoms and their effects reduce the patients" quality of life (QoL). Numerous studies show that the quality of life is related to the therapeutic effect of the treatment. Available studies demonstrate that patients QoL deteriorates as the condition progresses. Consequently, the goals of PAH therapy have expanded from increasing survival to improving health-related quality of life. The aim of the study was to determine the clinical and sociodemographic factors influencing the quality of life in PAH patients. Methods The study involved 55 patients with PAH who were examined using the Polish version of the PAH-SYMPACT quality of life questionnaire. The PAH-SYMPACT questionnaire results were correlated with several  variables. Results It was shown that the quality of life correlates significantly (p˂0,05) with WHO Functional Class, NT-pro BNP (N-terminal prohormone of brain natriuretic peptide) value, elderly age (the higher the value, the worse the QoL). On the other hand, the lower the 6MWT (6 minuts walk test) result, the worse the QoL. Moreover, the intensity of the accompanying PAH symptoms, such as chest pain, dyspnoea, arrhythmias, fatigue and weakness were associated with a lower quality of life in patients (p < 0,05). Conclusion Patients" quality of life correlates with many variables, both clinical and sociodemographic. In addition, there is a correlation between the quality of life of patients with PAH and the severity of several symptoms associated with this condition. Determination of factors affecting the quality of life of patients with PAH enables the selection of a more comprehensive therapy.

The role of medical personnel in promoting vaccination and pro-health attitudes seems to be of key importance for protection against COVID-19. The aim of the study was to assess the attitudes of health care workers and students of medical faculties towards preventive vaccinations against COVID-19. A cross-sectional online self-administered survey was conducted among 497 people. The questions concerned attitudes towards vaccination as well as concerns about the side effects of the vaccine and contracting COVID-19. A positive attitude to vaccination was observed in 82% of the respondents. More than 54% respondents were concerned about side effects after COVID-19 vaccination. Medical students under 26 years had a more positive attitude towards COVID-19 vaccination, twice as high as among health care workers OR (95%Cl): 2.20 (1.03–4.66) vs. 4.06 (2.54–6.48), respectively. Students were more concerned than nurses about adverse effects of COVID-19 vaccine 3.8 (3.2–4.1) vs. 3.0 (2.7–3.5) and contracting the virus (1.7 (1.2–2.5) vs. 1.2 (1.0–2.0). Medical students had a more positive attitude toward vaccination than nursing students 4.2 (3.9–4.3) vs. 3.7 (3.3–4.3). In conclusion, predictors of positive attitudes toward vaccination were medical student status and young age.

Background Rationing of nursing care is a relatively new concept. It refers to an error of omission and has a direct influence on the quality of nursing care and treatment outcomes. Nurses who experience chronic fatigue often fail to perform their duties properly, which may lead, for instance, to medical errors attributed to impaired judgment. Therefore, it is necessary to identify factors which give rise to fatigue, leading to rationing of nursing care, and develop strategies to eliminate them. The primary objective of the study was to assess the impact of fatigue on nursing care rationing in paediatric haematology and oncology departments. The secondary objective of this study was to identify the factors, which may influence the nursing care rationing. Methods The study was conducted among 95 nurses (aged between 23 and 58 years) workinginthe Department of Paediatric Oncology, Haematology and Bone Marrow Transplantation of the University Teaching Hospital in Wroclaw. Participation in the study was voluntary and anonymous. Our own sociodemographic questionnaire, the Basel Extent of Rationing of Nursing Carequestionnaire and the modified fatigue impact scale (MFIS) were used in the study. Results The level of fatigue among the nurses participating in the study, as measured by the MFIS, was high, namely 28.97 ± 16.78. It was found that the fatigue of the nurses influenced most often the psycho-social dimension of QoL (1.78 ± 1.05), and least often - cognitive (1.24 ± 0.78). A correlation analysis showed that all aspects of fatigue had a statistically significant positive impact on care rationing (p < 0.05), i.e. the greater the fatigue, the higher the level of care rationing. A regression analysis showed that a 12-h shift pattern was an independent predictor of the level of care rationing (r = 0.771, p < 0.05). Conclusions Nurses working in paediatric haematology departments report a high level of fatigue. Work pattern is an independent determinant of nursing carerationing. A high level of nursing care rationing was found for nurses working 12-h shifts. Trial registration The study was approved by the Bioethics Committee of the Wroclaw Medical University, Poland (February 8th 2019, No. 205/2019).

Poland is among the European countries currently facing the second wave of the SARS-CoV-2 pandemic. A lot of studies confirm the mortality rate of COVID-19 increases with age. Considering the particularly adverse outcomes of a SARS-CoV-2 infection, preventing infections should be the priority for public health professionals. One method for preventing SARS-CoV-2 infections among eldery people may involve implementing procedures for limiting the spread of the pathogen, and providing education to medical staff, so as to bridge any gaps in knowledge on virus spread and post-infection or post-exposure management. Three residential medical centers in Poland were selected for evaluation of existing medical procedures to identify any errors in the current procedures applied for the prevention of SARS-CoV-2 spread in the facility. The project involved 4 steps: (1) Audit of the existing medical procedures; (2) Knowledge evaluation for the staff (n=185) in the senior- and disabled care facilities, administration of a knowledge test developed by the authors to assess knowledge on SARS-CoV-2 prevention; (3) Training for medical staff; (4) Updates and implementation of procedures. The knowledge test conducted revealed a lack of knowledge of medical personnel about SARS-CoV-2. The deficiencies of the surveyed group varied depending on the place of employment. Almost half of the surveyed medical centers (center No. 1 (52%) vs. center No. 2 (44%) vs. center No. 3(59%)) believed that elderly people usually do not show symptoms of SARS-CoV-2 infection. In the facility No. 1, 70% of respondents did know that SARS-CoV-2 can be transmitted via the alimentary route compared to center No. 2 and No. 3 where knowledge about it showed only 28,9% and 24,8% responders, respectively. Also, in facility No. 1, the least among the studied group (67%) knew that people with comorbidities were at risk of covid-19 compared to respondents from facility No. 2 and 3, where, respectively, 100% and 93% had such knowledge. Only 33.3% of the staff of facility No. 1 knew how to deal with a patient who will present symptoms such as temp >38 degrees with coughing or dyspnea while in institution No. 2 and 3, this knowledge was slightly higher at 44% and 60% respectively. The audit of the existing hygiene procedures used to limit the risk of SARS-CoV-2 spread demonstrated a number of shortcomings. Employees at the residential medical care centers included in the study had gaps in knowledge on the spread of SARS-CoV-2. The training sessions implemented at the next stage improved knowledge on SARS-CoV-2 infections. Additionally, decisions were made to modify certain procedures and introduce new ones to better prevent the spread of SARS-CoV-2.