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Advances in Experimental Medicine and Biology 1211
Clinical and Experimental Biomedicine

Mieczyslaw Pokorski Editor

Advancements
and Innovations
in Health Sciences
Advances in Experimental Medicine
and Biology
Clinical and Experimental Biomedicine

Volume 1211

Series Editor
Mieczyslaw Pokorski
Opole Medical School
Opole, Poland
More information about this subseries at http://www.springer.com/series/16003
Mieczyslaw Pokorski
Editor

Advancements and
Innovations in Health
Sciences
Editor
Mieczyslaw Pokorski
Opole Medical School
Opole, Poland

ISSN 0065-2598 ISSN 2214-8019 (electronic)

Advances in Experimental Medicine and Biology
ISSN 2523-3769 ISSN 2523-3777 (electronic)
Clinical and Experimental Biomedicine
ISBN 978-3-030-32787-3 ISBN 978-3-030-32788-0 (eBook)
https://doi.org/10.1007/978-3-030-32788-0

# Springer Nature Switzerland AG 2019

This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way,
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this
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This Springer imprint is published by the registered company Springer Nature Switzerland AG.
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Contents

The Internet as a Source of Health Information and Services . . . . 1

Maria M. Bujnowska-Fedak, Joanna Waligóra,
and Agnieszka Mastalerz-Migas
Genetic Predisposition for Osteoporosis and Fractures in
Postmenopausal Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Tomasz Mitek, Łukasz Nagraba, Jarosław Deszczyński,
Magda Stolarczyk, Ernest Kuchar, and Artur Stolarczyk
The “Optimum Volume” of Acrylic Cement Filling for Treating
Vertebral Compression Fractures: A Morphometric Study of
Thoracolumbar Vertebrae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Jarosław Dzierżanowski, Paweł J. Winklewski, Monika Skotarczak,
Zuzanna Baczkowska-Waliszewska, Tomasz Szmuda,
Szymon Zdanowski, Marek Radkowski, Piotr Łuczkiewicz,
Piotr Czapiewski, Paweł Słoniewski, Edyta Szurowska,
Urszula Demkow, and Arkadiusz Szarmach
Integrated Rehabilitation Approach with Manual and Mechanic-
Acoustic Vibration Therapies for Urinary Incontinence . . . . . . . . 41
Giovanni Barassi, Rosa G. Bellomo, Franco Frondaroli,
Serena Frondaroli, Alessandro Santarelli, Piera A. Di Felice,
Marco Supplizi, Tommaso Palermo, and Raoul Saggini
Sulfurous Balneotherapy in Poland: A Vignette on History
and Contemporary Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Bożena Kosińska and Marek L. Grabowski
Body Composition and Endocrine Adaptations to High-Altitude
Trekking in the Himalayas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Gerardo Bosco, Antonio Paoli, Alex Rizzato, Giuseppe Marcolin,
Maria Teresa Guagnano, Christian Doria, Suwas Bhandari,
Tiziana Pietrangelo, and Vittore Verratti
Prevalence of Sleep Apnea in Patients with Carotid
Artery Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
A. Nahorecki, K. Postrzech-Adamczyk, A. Święcicka–Klama,
R. Skomro, and A. Szuba

v
vi Contents

Excessive Body Weight and Immunological Response in Children

with Allergic Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Bolesław Kalicki, Agnieszka Lipińska-Opałka,
Katarzyna Kowalczyk, Katarzyna Mycroft, Joanna Królikowska,
Agnieszka Rustecka, and Agata Wawrzyniak
Activity of Lysosomal Enzymes During Protein Malnutrition
and Progesterone Supplementation in the Mouse . . . . . . . . . . . . . 89
Iwona Stanisławska, Bożena Witek, Małgorzata Czarny-Działak,
Ewa Pałka-Łebek, and Marek Łyp
Infections Caused by Influenza Viruses Among Children
in Poland During the 2017/18 Epidemic Season . . . . . . . . . . . . . . . 97
K. Łuniewska, K. Szymański, E. Hallmann-Szelińska,
D. Kowalczyk, R. Sałamatin, A. Masny, and L. B. Brydak
The Influence of National Guidelines on the Management
of Community-Acquired Pneumonia in Children.
Do Pediatricians Follow the Recommendations? . . . . . . . . . . . . . . 103
Grażyna Kraj, Joanna Peradzyńska, Julita Chądzyńska,
Marek Kulus, Krystian Wołoszyn, Teresa Jackowska,
Maria Krajewska, Anna Mołdoch-Łukasik,
Agnieszka Czubik-Przybyła, Aneta Górska-Kot,
and Katarzyna Krenke
Antibiotic Treatment in Patients with Bronchiolitis . . . . . . . . . . . . 111
August Wrotek, Małgorzata Czajkowska, and Teresa Jackowska
Adv Exp Med Biol - Clinical and Experimental Biomedicine (2019) 7: 1–16
https://doi.org/10.1007/5584_2019_396
# Springer Nature Switzerland AG 2019
Published online: 5 July 2019

The Internet as a Source of Health

Information and Services

Maria M. Bujnowska-Fedak, Joanna Waligóra,

and Agnieszka Mastalerz-Migas

Abstract direction in which e-health should be devel-

The Internet is increasingly used for health- oped in the future.
related purposes and evolves with the ever-
changing needs of patients. The aim of this Keywords
study was to assess the level of reliance on E-health services · E-patient · Health
the Internet as a health information source, to information · Health professionals · Internet
examine which online communication user · Needs of patients · Online
activities are the most common for health communication · Sociodemographic factors ·
purposes, and to determine the attitudes and Telecare
needs of patients in this area and the factors
affecting its use. A total of 1000 adults were
selected from the Polish population by random 1 Introduction
sampling. The survey was administered by the
Computer-Assisted Telephone Interview The future of health care services is increasingly
(CATI). The study concluded that 76.9% of associated with the rapid development of infor-
the participants used the Internet for health mation and communication technologies (ICT).
purposes, among whom 72.6% of active and New forms of telecare bring considerable benefits
27.4% of passive users were distinguished. in the field of using health systems, patient–doc-
The role of the Internet as a source of health tor relations, and individuals’ health (Santana
information has increased, which corresponds et al. 2011). A significant increase in the number
to a growing interest in online health services. of chronically ill people, due to population aging
The majority of individuals searching for and severe constraints imposed on health budgets
health information in the Internet lived in in response to the shortage of health care staff,
urban areas, had a high level of education, requires a fundamental change in the care process
and was professionally active. We conclude (Peeters et al. 2013). Online health communica-
that the increased interest in the use of the tion results in lower management costs as, instead
Internet related to health determines the of being referred to hospitals, more and more
patients receive support in their homes. Telecare
works well for both acute and chronic illnesses as
M. M. Bujnowska-Fedak (*), J. Waligóra, it allows health professionals to make diagnoses,
and A. Mastalerz-Migas
treat, and provide specialist consultation to distant
Department of Family Medicine, Wroclaw Medical
University, Wrocław, Poland communities (Burke and Hall 2015). It increases
e-mail: [email protected] the level of convenience, and thus the quality of

1
2 M. M. Bujnowska-Fedak et al.

healthcare, and it ensures the independence of 2007. In the Polish population, the use of such
patients who wish to stay at home. On the one services also is on the rise. It was 15.5% of the
hand, the Internet reduces barriers and facilitates population in 2005, 22.9% in 2007, and 38.2% in
the availability of medical services, but on the 2012 (Bujnowska–Fedak 2015).
other hand, it affects the doctor–patient relation- Even though the ways and methods in which
ship and may influence treatment. Nowadays, people obtain health information from the Internet
patients are well-informed about a wide range of have already been studied in the past, there are
health-related topics and more and more willing still few data on the current use of the Internet for
to take advantage of the opportunities created by health communication and on the factors affect-
the ICT development. ing it. Therefore, the aim of this study was to
Many studies confirm that the Internet is an assess the level of trust with regard to the Internet
increasingly popular source of health information as a health information source, to examine which
for health care providers and consumers alike. online communication activities are the most
The Pew Internet and American Life Project Sur- common for health purposes, and to determine
vey, conducted in 2012, has shown that 72% of the attitudes and needs of patients in this area
US adults use the Internet for health purposes and and the factors affecting its use.
one-third believes it is a good diagnostic tool
(Fox and Duggan 2013). In the Polish population,
the use of the Internet for health-related purposes 2 Methods
significantly increased from 41.7% in 2005 to
66.7% in 2012 (Bujnowska–Fedak 2015). For 2.1 Study Design
many years, it has been mainly used to seek
information. However, in the last two decades, This survey-type study expands on the previous
there was a shift in the role of the patient from a one that has presented the needs and expectations
passive recipient of health information to an of the lay public in Poland, potential recipients of
active Internet user (Lustria et al. 2011). Data health services, concerning the role of mobile
generated from the US Health Information communication devices in medical care
National Trends Surveys (HINTS) of (Waligóra and Bujnowska–Fedak 2019). The
2003–2013 have shown a growing trend in source of research material for both studies was
using online health services, including ordering the same and consisted of a nationwide random
medications, sending emails to doctors, and sample of 1000 Polish adults (F/M: 558/442). The
accessing personal medical information through median age was 53 years (min-max: 18–88). The
online patient portals. According to the HINTS, study was conducted in December 2017 and
7% of Internet users reported communicating January 2018. The use of the Internet for health
online with a health care provider in the past information and services, and the determination
12 months as of 2003. Then, the proportion of of patients’ attitudes and activities in this area
the American population that used the Internet for were considered an independent research ramifi-
communication was gradually growing. There cation of the e-health services. Therefore, it was
were 10% of Internet users in 2005, 14% in herein described as a separate entity.
2008, 19% in 2011, and 30% in 2013 (Tarver The questionnaire was carried out through the
et al. 2018; Beckjord et al. 2007). Two surveys Computer-Assisted Telephone Interviews
conducted in seven European countries in 2005 (CATI). Geographical distribution of participants
and 2007 have shown a higher interest in using was controlled on the basis of voivodeship and
the Internet to communicate with health town size, to ensure the representativeness of the
professionals. Kummervold et al. (2008) have study group. The selection of participants was
reported a growth in the use of interactive Internet planned in such a way as to reach people with
health services from 15.3% in 2005 to 22.7% in the required sociodemographic characteristics.
The Internet as a Source of Health Information and Services 3

Both landline and mobile telephones were communication was assessed by asking the
included in the survey, with a ratio of 37–63%, participants how often they used the Internet to
respectively. An average response rate was 5.2%. communicate with doctors, participate in forums
A “nonresponse” group included people who or self-help groups, and buy medications or med-
failed to answer the phone, did not want to partic- ical components. The response categories were:
ipate in the interview, or were too sick to partici- “everyday” (1), “at least once a week” (2), “once
pate. The vast majority of “nonresponses” were or several times a month” (3), “less than once a
people who refused to participate in the survey month”(4), and “I never use the Internet” (5). The
without giving any reason. In such a case, the frequency of the following activities was
household was replaced by another one with the measured among the Internet users who contacted
same characteristics (region, town size, etc.). their family doctors online: obtaining a prescrip-
Sampling continued until at least 1000 complete tion, making an appointment, asking a particular
interviews were carried out. health question, and getting to know the content
of health professionals’ websites. The question-
naire also contained questions related to the
2.2 Questionnaire sociodemographic characteristics and health
conditions (e.g., respondent’s age, gender, educa-
The questionnaire was developed based on the tion, or place of residence).
currently available literature and our earlier stud-
ies (Bujnowska–Fedak and Mastalerz–Migas
2015; Bujnowska–Fedak and Pirogowicz 2014; 2.3 Data Analysis
Andreassen et al. 2007). It included 23 questions
covering demographic and health status The entire group of participants was divided into
characteristics and also questions related to online four different groups: the total sample, which
information-seeking behavior and interactive use represented the general population, and
of e-health services. Firstly, participants were subsamples of the participants who reported that
asked how often they used the Internet and how they used the Internet for health-related purposes
often they used it for health-related purposes. The (HI-users), further divided into active (HI-active
response categories were the following: “every- users) and passive users (HI-passive users). A
day” (1), “at least once a week” (2), “once or descriptive analysis, followed by a statistical
several times a month” (3), and “less than once analysis, was carried out to identify significant
a month” (4), “I never use the Internet” (5), and “I associations between the participant independent
never use the Internet but I ask others to do it for variables and their opinion on the use of the Internet
me” (6). The importance attributed to the Internet for health-related communication purposes. The cor-
(1) as a source of medical information compared rectness of the distribution of quantitative variables
with other sources such as TV/radio (2), books/ was checked using the Shapiro-Wilk test. None of
health and encyclopedias/booklets (3), courses/ the variables had a normal distribution. For this
lectures/seminars (4), newspaper/magazines (5), reason, only the following nonparametric ones
family/friends/colleagues (6), pharmacy (7), and were used for further analysis: Fisher’s exact test of
direct personal contact with medical professionals independence, Chi-squared test for equal
(8) was also assessed. The responses to this ques- proportions (homogeneity test), and Wilcoxon mul-
tion were given according to the five-point Likert tiple comparison test for unrelated samples. The
scale from “not important” to “very important” significance level of 0.05 was assumed in all the
with the neutral response in the middle. The fre- tests. The statistical package R software v3.5.1 was
quency of various activities related to online used in the calculations.
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