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Interaction among general practitioners age and patient load in the prediction of job strain, decision latitude and perception of job demands. A cross-sectional study.

BACKGROUND: It is widely recognized and accepted that job strain adversely impacts the workforce. Individual responses to stressful situations can vary greatly and it has been shown that certain people are more likely to experience high levels of stress in their job than others. Studies highlighted that there can be age differences in job strain perception. METHODS: Cross-sectional postal survey of 300 Lithuanian general practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the Karasek scale. The analysis included descriptive statistics; logistic regression beta coefficients to find out predictors and interactions between characteristics and predictors. RESULTS: Response rate was 66% (N = 197). Logistic regression as significant predictors for job strain assigned - duration of work in primary care; for job demands- age and duration of working in primary care; for decision latitude- age and patient load.The interactions with regard to job strain showed that GP's age and job strain are negatively associated to a low patient load. Lower decision latitude for older GP age is strongly related to higher patient load. Job demands and GP age are slightly positively related at low patient load. CONCLUSIONS: Lithuanian GP's have high patient load and are at risk of stress, they have high job demands and low decision latitude. Older GP's perceive less strain, lower job demands and higher decision latitude in case of low patient load. Young GP's decision latitude has week association to patient load. Regarding to the changes in patient load younger GP's perceive it more sensitively as changes in job demands.

Adult↗

Assessment of potential effects of the electromagnetic fields of mobile phones on hearing.

BACKGROUND: Mobile phones have become indispensable as communication tools; however, to date there is only a limited knowledge about interaction between electromagnetic fields (EMF) emitted by mobile phones and auditory function. The aim of the study was to assess potential changes in hearing function as a consequence of exposure to low-intensity EMF's produced by mobile phones at frequencies of 900 and 1800 MHz. METHODS: The within-subject study was performed on thirty volunteers (age 18-30 years) with normal hearing to assess possible acute effect of EMF. Participants attended two sessions: genuine and sham exposure of EMF. Hearing threshold levels (HTL) on pure tone audiometry (PTA) and transient evoked otoacoustic emissions (TEOAE's) were recorded before and immediately after 10 min of genuine and/or sham exposure of mobile phone EMF. The administration of genuine or sham exposure was double blind and counterbalanced in order. RESULTS: Statistical analysis revealed no significant differences in the mean HTLs of PTA and mean shifts of TEOAE's before and after genuine and/or sham mobile phone EMF 10 min exposure. The data collected showed that average TEOAE levels (averaged across a frequency range) changed less than 2.5 dB between pre- and post-, genuine and sham exposure. The greatest individual change was 10 dB, with a decrease in level from pre- to post- real exposure. CONCLUSION: It could be concluded that a 10-min close exposure of EMFs emitted from a mobile phone had no immediate after-effect on measurements of HTL of PTA and TEOAEs in young human subjects and no measurable hearing deterioration was detected in our study.

Adolescent↗

Advising overweight persons about diet and physical activity in primary health care: Lithuanian health behaviour monitoring study.

BACKGROUND: Obesity is a globally spreading health problem. Behavioural interventions aimed at modifying dietary habits and physical activity patterns are essential in prevention and management of obesity. General practitioners (GP) have a unique opportunity to counsel overweight patients on weight control. The purpose of the study was to assess the level of giving advice on diet and physical activity by GPs using the data of Lithuanian health behaviour monitoring among adult population. METHODS: Data from cross-sectional postal surveys of 2000, 2002 and 2004 were analysed. Nationally representative random samples were drawn from the population register. Each sample consisted of 3000 persons aged 20-64 years. The response rates were 74.4% in 2000, 63.4% in 2002 and 61.7% in 2004. Self-reported body weight and height were used to calculate body mass index (BMI). Information on advising in primary health care was obtained asking whether GP advised overweight patients to change dietary habits and to increase physical activity. The odds of receiving advice on diet and physical activity were calculated using multiple logistic regression analyses according to a range of sociodemographic variables, perceived health, number of visits to GPs and body-weight status. RESULTS: Almost a half of respondents were overweight or obese. Only one fourth of respondents reported that they were advised to change diet. The proportion of persons who received advice on physical activity was even lower. The odds of receiving advice increased with age. A strong association was found between perceived health and receiving advice. The likelihood of receiving advice was related to BMI. GPs were more likely to give advice when BMI was high. More than a half of obese respondents (63.3%) reported that they had tried to lose weight. The association between receiving advice and self-reported attempt to lose weight was found. CONCLUSION: The low rate of dietary and physical activity advice reported by overweight patients implies that more lifestyle counselling should be provided in primary health care. There is an obvious need for improved training and education of GPs in counselling of overweight patients focusing on methods of giving dietary and physical activity advice.

Adult↗

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals.

BACKGROUND: The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. METHODS: A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). RESULTS: Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. CONCLUSION: QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size - the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals.

Attitude of Health Personnel↗

Some Lithuanian ethnobotanical taxa: a linguistic view on thorn apple and related plants.

BACKGROUND: The perception and use of plants correspond with common plant names. The study of plant names may give insight into historical and recent use of plants. METHODS: Plant names in dictionaries and folklore have been evaluated. A etymological analysis of the names is provided. Onomasiological and semasiological aspects have been considered. Therefore, species named with names related to each other have been selected. RESULTS: Plant names containing the stem dag- or deg- may belong to either of two categories: incenses or thorny plants. Plants named in durn- have been in use as psychopharmaca. The name rymo points not to Rome but to the use of plants as anodyne or psychopharmaca.

Atropa belladonna↗

Sudden cardiac death and geomagnetic activity: links to age, gender and agony time.

BACKGROUND: In previous studies, we analyzed sudden cardiac death (SCD) of shorter and longer agony time with geomagnetic activity (GMA) levels, with controversial results. The goals of the present study were (1) to study SCD at ages below 65 and 65 and older for each gender on days of low (Io) and higher (IIo-IVo) GMA; (2) to compare links between SCD and GMA with death at 1 h and from 1 to 24 h. METHODS: We studied 1327 SCD, 392 (29.5%) females and 935 (70.5%) males, from the Kaunas Registry (part of the MONICA Study): 785 deaths during 1826 consecutive days (1994-1998) at ages 25 to 64 years and 524 deaths at ages 65 and older during 732 consecutive days (1996-1997). Of these, 261 SCD occurred at 1 h, 1076 between 1 h and 24 h without prodromes. GMA data were obtained from the National Geophysical Data Center and the National Space Services Center, USA. Student t-test and its probabilities for daily SCD at Io and IIo-IVo GMA were compared. RESULTS: The daily number of SCD was significantly different for most of the compared groups at lowest and higher GMA levels. For all SCD, both at age <65 and at >65, the frequency was significantly higher on days of IIo-IVo GMA than on days of Io GMA (p=0.00067-0.03). A strong trend for more SCD on days of Io GMA was seen in males aged <65 who died within 1 h (p=0.06); females aged <65 who died within >1 h to 24 h (p=0.06), and females >65 who died within 1 h (p=0.0267). Females below the age of 65 who died in less than 1 h showed a trend toward higher SCD frequency at IIo-IVo GMA that did not achieve significance (p=0.057). CONCLUSIONS: The distribution of SCD, with short (< or =1h) and longer (1-24 h) time of death, on days of lowest (Io) GMA differs from that on days of unsettled, active, or stormy (IIo-IVo) GMA. Despite the general trend to higher SCD frequency at IIo-IVo GMA, certain rapidly dying groups (< 65 y males, > 65 y females) showed a strong trend toward higher numbers of SCD at the lowest GMA.

Age Factors↗

Caries prevalence and oral hygiene in Lithuanian children and adolescents.

Contrary to what is observed in many Western societies, the caries prevalence among children and adolescents in the Baltic States remains high. The aims of the present study were to describe the caries prevalence and oral hygiene among 7-, 12-, and 15-year-old Lithuanians and to correlate the caries prevalence with fluoride content in the drinking water, oral hygiene, gender, ethnicity, and pattern of sugar consumption. The investigation was based on cluster samples, and the clinical investigation was performed in accordance with criteria defined by WHO. High DMFT values were registered (mean DMFT = 1.3 among 7-year-olds; DMFT = 4.9 among 12-year-olds and 7.0 among 15-year-olds) and were associated with low fluoride content in the drinking water and poor oral hygiene. Girls showed higher DMFT values than boys. No correlation between pattern of sugar consumption and caries prevalence could be disclosed.

Adolescent↗

Children with Asperger syndrome: specific aspects of their drawings.

Free drawings of children with AS, aged 7-16 years, were analysed in relation to the clinical picture comprising their difficulties in communication, social behaviour and cognition. All children showed good abilities in drawing. Pictures had some common traits and were distinctly original, reflecting peculiarities of the syndrome features. Analysis of free drawings was found to be a helpful tool in understanding the inner world and the dynamic changes during the therapy process of these children.

Adolescent↗

Cancer mortality and morbidity among Lithuanian asbestos-cement producing workers.

OBJECTIVES: This study investigated the incidence of cancer and cause-specific mortality among workers in the two Lithuanian asbestos-cement factories. METHODS: The study included 1887 asbestos-cement workers, 1285 men and 602 women, and 37000 person-years. The two factories were active from 1956 (A) and 1963 (B), and the workers were observed from 1978 to 2000. The analysis was based on a comparison between the observed and expected numbers of cancer and causes of death. The observed numbers of cancer were obtained through linkage with the national cancer registry. The date and causes of death were obtained from two different sources. The expected numbers were calculated on the basis of gender- and age-specific incidence and mortality rates in 5-year periods from the whole country. Standardized incidence ratios (SIR) and standardized mortality ratios (SMR) and 95% confidence intervals (95% CI) were calculated. Duration of employment and time since first exposure were used as indicators of exposure. RESULTS: During the follow-up, 1978-2000. 473 deaths were observed versus 489 expected. There was no excess risk of deaths from nonmalignant respiratory diseases, except for an elevated risk of mortality in relation to the digestive organs other than cancer, 18 observed versus 12.2 expected (95% CI 0.9-2.3). There was no excess risk for any types of cancer, except for colorectal cancer in men, 17 observed cases (SIR 1.6, 95% CI 1.6-2.6) and one case of mesothelioma in a woman. CONCLUSIONS: This study on asbestos-exposed workers did not show any excess risk of respiratory cancer or deaths of pneumoconiosis.

Adult↗

Smoking and other factors influencing the oral health of Lithuanian Army recruits.

The aim of our research was to determine the prevalence of smoking among Lithuanian army recruits and how smoking and other factors affect oral health. The findings of our research showed that 70% of recruits smoke. The analysis of the research findings showed that smoking had a negative effect on oral hygiene. Especially smoking was harmful with respect to periodontal tissues. The periodontal lesions were more prevalent and severe among recruits who smoked. Smokers had a higher Community Periodontal Index of Treatment Needs index than nonsmokers. The analysis of the research findings showed that the state of oral health was related to other factors, such as oral hygiene, age, and education. It was determined that the oral hygiene of males living in the countryside and having poorer education was worse than that of males living in the city. Their status of periodontal tissues was worse, and they had more decayed and untreated teeth. The findings of the logistical regression analysis showed that poor education and living in the country, irregular tooth brushing, poor oral hygiene, and smoking were the most important factors related to a great number of untreated decayed tooth surfaces.

Adolescent↗

Hypercholesterolemia and smoking habits of Lithuanian military personnel.

OBJECTIVE: To investigate the prevalence of risk factors for cardiovascular disease, namely, hypercholesterolemia and current smoking, among 25- to 54-year-old men and women among Lithuanian active duty military personnel. METHODS: Serum cholesterol levels were measured enzymatically for 200 persons (126 men and 74 women). Interviews regarding smoking habits were performed for 82.5% of those persons (98 men and 67 women). RESULTS: Hypercholesterolemia (total cholesterol level of > or = 6.2 mmol/L) was determined for 45.2% of men and 40.5% of women. After distribution of men and women into three age groups (25-34, 35-44, and 45-54 years), it was determined that the rate of hypercholesterolemia increased with age (among groups of men, 29.6%, 46.7%, and 74.0%; among groups of women, 18.8%, 51.5%, and 40.0%, respectively). The proportion of current smokers among men was 2.6 times higher than that among women (45.9% vs. 17.9%; p < 0.001). The highest rate of current smoking was in the 35- to 44-year group of men (64.5%). The coexistence of hypercholesterolemia and current smoking among men was 3.1 times higher than that among women (23.5% vs. 7.5%; p < 0.01). The highest rates of current smoking with hypercholesterolemia were in the 35- to 44-year and 45- to 54-year groups of men (32.2% and 31.8%, respectively). CONCLUSION: The data demonstrated a relatively high rate (32.1%) of coexistence of two independent risk factors for cardiovascular disease (hypercholesterolemia and current smoking) among men 35 to 54 years of age from Lithuanian military personnel.

Adult↗

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women.

BACKGROUND: Genital Chlamydia trachomatis infections in women are traditionally detected by testing cervical and urethral samples. This sampling approach is not acceptable in some, e.g. screening situations. We evaluate an alternative approach, i.e. use of vaginal self-collected specimen for testing by polymerase chain reaction. METHODS: The sensitivity of self-collected vaginal (introital) samples to diagnose genital infections by Chlamydia trachomatis using Roche AMPLICOR CT/NG PCR was compared with the cervical- and first-voided urine samples from women consulting with- (Group 1; n=123) and without (Group 0; n=160) genital symptoms. Women were interviewed regarding genital hygiene. Genital symptoms and signs were noted. RESULTS: C. trachomatis DNA was detected in 13.0% of women from Group 1 and in 5.0% of women from Group 0, i.e. in urine of 6.5% vs. 1.9%, in the cervical swab in 9.8% vs. 5.0% and in vaginal swab in 11.4% vs. 3.8% of women, respectively. The vaginal sample was the most sensitive specimen for detecting C. trachomatis in the Group 1 women. It had sensitivity of 87.5% vs. 75% for cervical- and 50% for urine specimens. In Group 0, the cervical sample was 100% sensitive, while the vaginal introital sample and urine had a sensitivity of 75% and 37.5%, respectively. C. trachomatis was less often detected in urine of women who routinely practised genital washing. CONCLUSIONS: Vaginal sampling performed by the woman herself is a sensitive approach and might serve as an important stimulus for screening for C. trachomatis infections in young women at risk.

Adolescent↗