Links between accidents and lifestyle factors among Lithuanian schoolchildren.
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The aim of the study was to evaluate associations of some lifestyle factors with injuries among schoolchildren. Analysis was performed using data from the survey conducted in 2002 according to the methods of World Health Organization Cross-National Study on Health Behavior in School-Aged Children (HBSC). Using stratified random sampling, the representative sample of 5645 schoolchildren aged 11, 13, and 15 years from 104 schools of Lithuania was drawn and surveyed. Associations between potential risk factors and injuries among schoolchildren were evaluated calculating odds ratio and its 95% confidence intervals. For the evaluation of the impact of explanatory variables on analyzed event, logistic regression analysis was performed. Behavioral, psychological, and social integration factors were associated with the risk to sustain injuries among school-aged children. The impact of these factors varied within subgroups of schoolchildren by grade and sex. The most significant factors were: risk-taking behavior (smoking, alcohol and drug consumption, premature sexual activity), frequent participation in sport activities, involvement in physical fight, longer time spent away from home with friends, experienced bullying, poor self-assessed health and academic achievement, unhappiness, feeling unsafe at school, and high suicidal risk. Analysis failed to identify an expected association between lower socio-economic status and risk for injury. Integrated approach to injury etiology is essential in planning injury prevention and safety promotion activities among schoolchildren, paying particular attention to lifestyle factors, which can have the potential influence on risk to sustain injuries. (+info)
Determinants of outcome in elderly patients admitted to the intensive care unit.
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BACKGROUND: Age is thought to be strongly associated with intensive care outcomes, but this relationship may be confounded by many clinical variables. OBJECTIVES: To compare clinical characteristics of elderly patients (> or = 65 years) admitted to the intensive care unit (ICU) with those in younger patients and to identify the risk factors which independently could predict mortality in patients aged > or = 75 years. DESIGN: Prospective observational cohort study. SETTING: Medical-surgical ICU in a university hospital. SUBJECTS: 2,067 adult patients admitted to the ICU. METHODS: Comparison of clinical characteristics of patients divided into groups according to their age. RESULTS: Elderly patients comprised 51% of the study population. Compared with younger patients, elderly patients were more severely ill on admission, had shock and renal dysfunction. The presence of infection on admission and the incidence rate of infection acquired during stay in the ICU also significantly increased with age. Hospital mortality increased with age: for patients aged > or = 75 years, it was more than double that of patients aged <65 years (39% versus 19%, P < 0.001). Using multivariate logistic regression analysis we determined the independent risk factors of hospital mortality for the patients aged > or = 75 years: impaired level of consciousness, infection on admission, ICU-acquired infection and severity of illness score. CONCLUSIONS: Morbidity and mortality in elderly patients admitted to the ICU are higher than in younger patients. The most important factors independently associated with the highest risk of death are the severity of illness, impaired level of consciousness and infection. (+info)
Health care reform and job satisfaction of primary health care physicians in Lithuania.
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BACKGROUND: The aim of this research paper is to study job satisfaction of physicians and general practitioners at primary health care institutions during the health care reform in Lithuania. METHODS: Self-administrated anonymous questionnaires were distributed to all physicians and general practitioners (N = 243, response rate - 78.6%), working at Kaunas primary health care level establishments, in October - December 2003. RESULTS: 15 men (7.9%) and 176 women (92.1%) participated in the research, among which 133 (69.6%) were GPs and 58 (30.4%) physicians. Respondents claimed to have chosen to become doctors, as other professions were of no interest to them. Total job satisfaction of the respondents was 4.74 point (on a 7 point scale). Besides 75.5% of the respondents said they would not recommend their children to choose a PHC level doctor's profession. The survey also showed that the respondents were most satisfied with the level of autonomy they get at work - 5.28, relationship with colleagues - 5.06, and management quality - 5.04, while compensation (2.09), social status (3.36), and workload (3.93) turned to be causing the highest dissatisfaction among the respondents. The strongest correlation (Spearmen's ratio) was observed between total job satisfaction and such factors as the level of autonomy - 0.566, workload - 0.452, and GP's social status - 0.458. CONCLUSION: Total job satisfaction of doctors working at primary health care establishments in Lithuania is relatively low, and compensation, social status, and workload are among the key factors that condition PHC doctors' dissatisfaction with their job. (+info)
Assessment of potential effects of the electromagnetic fields of mobile phones on hearing.
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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. (+info)
Onset of breast and pubic hair development in 1231 preadolescent Lithuanian schoolgirls.
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BACKGROUND: Correct staging of puberty is essential in order to differentiate different pathologies, as various components of the endocrine system influence breast, pubic, and axillary hair development. AIMS: To determine the current timing of adrenarche and breast development in Lithuanian preadolescent schoolgirls. METHODS: Cross-sectional study of 1231 schoolgirls aged 7.0-11.6 years. Puberty was staged according to the method of Tanner. Mean age at entry into each pubertal stage was calculated by probit analysis. RESULTS: Of the 255 girls aged 7 years, two had premature adrenarche (0.8%) and one premature thelarche (0.4%). Mean age of onset of pubic/axillary hair development was 11.0 years, and for breast development (Stage 2) 10.2 years. Breast Stage 3 development was attained at 11.3 years and Stage 4 at 13.9 years. Mean BMI, height, weight, and systolic blood pressure SD scores were higher in pubertal than in prepubertal girls. Skinfold thickness was also significantly higher in girls with isolated adrenarche than in prepubertal girls. The increase in BMI and weight resulted from an increase in body fat as evidenced by measures of subscapular and triceps skinfold thickness. Girls with only signs of adrenarche or thelarche did not differ from each other from the anthropometric standpoint. CONCLUSIONS: Premature thelarche and premature adrenarche were relatively uncommon in this population. Pubertal onset was slightly earlier than the UK Tanner standards and tended to occur in girls with a higher BMI. (+info)
Higher than expected prevalence of congenital cryptorchidism in Lithuania: a study of 1204 boys at birth and 1 year follow-up.
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BACKGROUND: Cryptorchidism at birth is one of the symptoms of testicular dysgenesis syndrome (TDS). The aim of the study was to detect prevalence of cryptorchidism in Lithuanian newborn boys. METHODS: A total of 1204 consecutively born boys were examined within the first days after birth in one regional hospital. Boys cryptorchid at birth were reexamined 1 year later. RESULTS: The prevalence of cryptorchidism at birth was 5.7% (69 cases). Cryptorchidism was associated with low birth weight (P < 0.0001), preterm delivery (P < 0.0001), small gestational weight (P = 0.03) and other congenital abnormalities of genitalia (P = 0.0001). No correlation between cryptorchidism at birth and maternal age, birth order or mode of delivery was demonstrated in this study, but paternal body mass index <20 kg/m2 was found to be a significant risk factor (P = 0.001). The prevalence of congenital cryptorchidism at 1 year of age was 1.4%. CONCLUSIONS: We detected lower frequency of cryptorchidism at birth in Lithuanian boys than in Danes (9.0%), but higher than in Finns (2.4%). We had expected the frequencies in Lithuania and Finland to be relatively similar because the other symptoms of TDS (incidence of testicular cancer and semen quality) are close in these countries. (+info)
Clinical presentation of pertussis in fully immunized children in Lithuania.
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BACKGROUND: In Lithuania, the vaccination coverage against pertussis is high. Nevertheless, there is a significant increase in pertussis cases in fully immunized children. The aim of our study was to determine the frequency of classical symptoms of laboratory confirmed pertussis and describe its epidemiology in children fully vaccinated against pertussis. METHODS: From May to December 2001, 70 children aged 1 month to 15 years, suffering from prolonged cough were investigated in the Centre of Paediatrics, Vilnius University Children's Hospital. The collected information included personal data, vaccination history, clinical symptoms of the current illness, and treatment before hospitalization. At the admission to the hospital blood samples were taken from all studied children for Bordetella pertussis IgM and IgA. RESULTS: A total of 53 (75.7%) of the 70 recruited patients with prolonged cough showed laboratory evidence of pertussis. 32 of them were fully vaccinated with whole cell pertussis vaccine (DTP). The age of fully vaccinated patients varied from 4 to 15 years (average 10.9 +/- 3.1; median 11). The time period between the last vaccination dose (fourth) and the clinical manifestation of pertussis was 2.6-13 years (average 8.9 +/- 3.0; median 9). More than half of the children before the beginning of pertussis were in contact with persons suffering from long lasting cough illness in the family, school or day-care center. The mean duration from onset of pertussis symptoms until hospitalization was 61.4 +/- 68.3 days (range, 7 to 270 days; median 30). For 11 patients who had had two episodes (waves) of coughing, the median duration of cough was 90 days, and for 21 with one episode 30 days (p < 0.0002). Most of the children (84.4%) had paroxysmal cough, 31.3% had post-tussive vomiting, 28.1% typical whoop, and 3.1% apnea. Only 15.6% children had atypical symptoms of pertussis. CONCLUSION: Fully vaccinated children fell ill with pertussis at the median of 11 years old, 9 years following pertussis vaccination. More than half of the children could catch pertussis at home, at school or day-care center. Clinical picture of pertussis in previously immunized children is usually characterized by such classical symptoms as prolonged and paroxysmal cough, rarely by whopping and post-tussive vomiting, and very rarely by apnea. (+info)
The factors associated to psychosocial stress among general practitioners in Lithuania. Cross-sectional study.
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BACKGROUND: There are number of studies showing that general practice is one of the most stressful workplace among health care workers. Since Baltic States regained independence in 1990, the reform of the health care system took place in which new role and more responsibilities were allocated to general practitioners' in Lithuania. This study aimed to explore the psychosocial stress level among Lithuanian general practitioner's and examine the relationship between psychosocial stress and work characteristics. METHODS: The cross-sectional study of 300 Lithuanian General practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the R. Karasek scale. The analysis included descriptive statistics; interrelationship analysis between characteristics and multivariate logistic regression to estimate odds ratios for each of the independent variables in the model. RESULTS: Response rate 66% (N = 197). Our study highlighted highest prevalence of psychosocial stress among widowed, single and female general practitioners. Lowest prevalence of psychosocial stress was among males and older age general practitioners. Psychosocial stress occurs when job demands are high and job decision latitude is low (chi2 = 18,9; p < 0,01). The multivariate analysis shows that high job demands (OR 4,128; CI 2,102-8,104; p < 0,001), patient load more than 18 patients per day (OR 5,863; CI 1,549-22,188; p < 0,01) and young age of GP's (OR 6,874; CI 1,292-36,582; p < 0,05) can be assigned as significant predictors for psychosocial stress. CONCLUSION: One half of respondents suffering from work related psychosocial stress. High psychological workload demands combined with low decision latitude has the greatest impact to stress caseness among GP's. High job demands, high patient load and young age of GP's can be assigned as significant predictors of psychosocial stress among GP's. (+info)