Paediatric Type1 Diabetes Management and Mothers' Emotional Intelligence Interactions.

The functioning of the parents' emotional sphere is very important to a child's mental and physical health. This study focused on investigating the association between mothers' emotional intelligence (EI) and paediatric type I diabetes (T1DM) disease management in their children. We hypothesized that mothers' EI is associated with T1DM outcomes. Mothers of children with T1DM aged 6-12 years were surveyed. One hundred and thirty-four mothers, the main caregivers of their diabetic children, provided measures of EI and completed a demographic questionnaire. The primary indicator of diabetes management was haemoglobin A1c (HbA1c; the main form of glycosylated haemoglobin). EI scales and subscales were associated with glycaemic management indices. Logistic regression analysis was applied for the assessment of the association between parents' EI and their paediatric with T1DM disease management. The analysis demonstrated a statistically significant correlation between T1DM management and mothers' ability to understand and control own emotions, to transform their own negative emotions into positive and to control own negative emotions. Mothers' EI scales and subscales of understanding and regulating their own emotions, subscales of transforming their own negative emotions into positive ones and controlling their own negative emotions were statistically reliable predictors of glycaemic control in children with T1DM.

Body size perception, knowledge about obesity and factors associated with lifestyle change among patients, health care professionals and public health experts.

BACKGROUND: The attitudes towards obesity may have an important role on healthier behavior. The goal of the present study was to explore the attitudes towards obesity and to investigate how these attitudes were associated with lifestyle-changing behavior among the patients attending primary care centers, health care professionals and public health experts. METHODS: This cross-sectional survey study was performed in 10 primary care offices in different regions in Lithuania and in 2 public health institutions. Nine hundred thirty-four patients, 97 nurses, 65 physicians and 30 public health experts have filled the questionnaire about attitudes towards obesity and presented data about lifestyle-changing activities during last 12 months. The attitudes were compared between different respondent groups and factors associated with healthier behaviors were analyzed among overweight/obese individuals in our study population. RESULTS: Participants failed to visually recognize correct figure corresponding to male and female with obesity. Majority of respondents' perceived obesity as a risk factor for heart diseases and diabetes but had less knowledge about other diseases associated with weight. About one third of respondents changed their lifestyle during last 12 months. Overweight individuals with age < 45 years (OR 1.64, 1.06-2.55; p = 0.025) were more likely and those who overestimated current weight (OR 0.44, 0.20-0.96; p = 0.036) less likely to change their lifestyle. Disappointment with their current weight (OR 2.57, 1.36-4.84; p = 0.003) was associated with healthier behavior among participants with obesity. CONCLUSION: Participants had similar body size perception and knowledge about obesity. Younger age had significant association with lifestyle changing behavior among overweight individuals and disappointment with current weight among obese participants.

Is blended learning and problem-based learning course design suited to develop future public health leaders? An explorative European study.

BACKGROUND: Public health leaders are confronted with complex problems, and developing effective leadership competencies is essential. The teaching of leadership is still not common in public health training programs around the world. A reconceptualization of professional training is needed and can benefit from innovative educational approaches. Our aim was to explore learners' perceptions of the effectiveness and appeal of a public health leadership course using problem-based, blended learning methods that used virtual learning environment technologies. CASE PRESENTATION: In this cross-sectional evaluative study, the Self-Assessment Instrument of Competencies for Public Health Leaders was administered before and after an online, blended-learning, problem-based (PBL) leadership course. An evaluation questionnaire was also used to measure perceptions of blended learning, problem-based learning, and tutor functioning among 19 public health professionals from The Netherlands (n = 8), Lithuania (n = 5), and Austria (n = 6).Participants showed overall satisfaction and knowledge gains related to public health leadership competencies in six of eight measured areas, especially Political Leadership and Systems Thinking. Some perceptions of blended learning and PBL varied between the institutions. This might have been caused by lack of experience of the educational approaches, differing professional backgrounds, inexperience of communicating in the online setting, and different expectations towards the course. CONCLUSIONS: Blended, problem-based learning might be an effective way to develop leadership competencies among public health professionals in international and interdisciplinary context.

Family Social Environment and Parenting Predictors of Alcohol Use among Adolescents in Lithuania.

The role of the family as the social environment in shaping adolescent lifestyle has recently received substantial attention. This study was focused on investigating the association between familial and parenting predictors and alcohol use in school-aged children. Adolescents aged 13- and 15-year from a representative sample (N = 3715) of schools in Lithuania were surveyed during the spring of 2014. The methodology of the cross-national Health Behaviour in School-aged Children (HBSC) study was applied. HBSC international questionnaires were completed in the classroom anonymously for obtaining information about drinking of alcoholic beverages and family characteristics-family's affluence and structure, style of communication in the family, parenting style, parental monitoring, family time together, etc. Univariate and multivariate logistic regression analysis was applied for assessment of the association between familial variables and weekly alcohol use. Analysis has demonstrated that adolescents from non-intact families tended to show significantly higher risk of being weekly drinkers (OR = 1.69; 95% CI: 1.30-2.19). The following parenting factors were associated with weekly use of alcohol: father's and mother's low monitoring, father's authoritarian-repressive and mother's permissive-neglectful parenting style. Frequent family time together and frequent electronic media communication with parents showed an inverse negative effect than was predicted. The study suggests that alcohol misuse among adolescents could be associated with a non-intact family structure as well as with complex family and parenting determinants which should be investigated more thoroughly by further studies.

Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey.

Background: Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research.

Health-related quality of life measurement in chronic liver disease patients.

BACKGROUND AND OBJECTIVE: Health-related quality of life (HRQOL) is an important health indicator in medical outcome research and clinical practice. This issue tends to attract even more attention with the recent improvements of patient survival after liver transplantation. This review article aims at providing a deeper insight into practices used for evaluating HRQOL in chronic liver diseases (CLDs) and especially cirrhosis patients during different stages of the disease including liver transplantation. MATERIALS AND METHODS: A systematic review of the MEDLINE database and Cochrane library was conducted. A search using the Medical Subject Headings (MeSH) major terms "liver disease" AND "quality of life" was applied for the period from 1966 to 2012. RESULTS: Our review identified 1483 publications. The searched showed that significant increase of publications (from 362 to 1018) was observed during last decade (period 2003-2012) in comparison with previous. The majority of publications were in English (n=1179). The literature search and analysis provided information on the most common generic and disease-specific HRQOL instruments, which are used in CLD patients: Medical Outcomes Study Short Form-36, the National Institute of Diabetes and Digestive and Kidney Diseases Quality of Life questionnaire, the Chronic Liver Disease questionnaire, the Liver Disease Quality of Life questionnaire, and other. CONCLUSIONS: Quality of life instruments are potentially powerful tools for evaluating the functional status, presenting gains of treatment and reflecting patients' ability to return to a normal lifestyle in CLD patients. More attention should be paid by clinicians for integrated use of clinical tests together with HRQOL instruments in liver transplantation for establishing the reference levels of mental, physical, and role-social functioning.

In search for a public health leadership competency framework to support leadership curriculum-a consensus study.

BACKGROUND: Competency-based education is increasingly popular, especially in the area of continuing professional development. Many competency frameworks have been developed; however, few address leadership competencies for European public health professionals. The aim of this study was to develop a public health leadership competency framework to inform a leadership curriculum for public health professionals. The framework was developed as part of the Leaders for European Public Health project-supported by the EU Lifelong Learning Programme. METHODS: The study was carried out in three phases: a literature review, consensus development panel and Delphi survey. The public health leadership competency framework was initially developed from a literature review. A preliminary list of competencies was submitted to a panel of experts. Two consensus development panels were held to evaluate and make changes to the initial draft competency framework. Then two rounds of a Delphi survey were carried out in an effort to reach consensus. Both surveys were presented through Survey Monkey to members of the Association of the Schools of Public Health in the European Region Working Group on Innovation in Public Health Teaching and Education. RESULTS: The framework was developed consisting of 52 competencies organized into eight domains: Systems Thinking; Political Leadership; Collaborative Leadership: Building and Leading Interdisciplinary Teams; Leadership and Communication; Leading Change; Emotional Intelligence and Leadership in Team-based Organizations; Leadership, Organizational Learning and Development and Ethics and Professionalism. CONCLUSION: The framework can serve as a useful tool in identifying gaps in knowledge and skills, and shaping competency-based continuing professional development leadership curricula for public health professionals in Europe.

Health-behaviour inequalities among Russian and ethnic majority school-aged children in the Baltic countries.

AIMS: The main aim of this paper was to investigate whether ethnic heath inequalities exist in self-rated health and risk-taking behaviours (smoking, drunkenness, use of cannabis) between ethnic majority (Estonian, Latvian, Lithuanian) and minority (Russian) population groups of school-aged children in three Baltic countries. METHODS: Investigation was carried out in the framework of Health Behaviour in School-aged Children (HBSC) study. Randomly selected students aged 11, 13, and 15 years answered questionnaires in the classroom in 2006. In total, 14,354 questionnaire forms were selected for analysis. RESULTS: Russian boys were more likely (p<0.05) to evaluate their self-rated health positively in schools with Russian teaching language. Odd ratios for current smoking and drunkenness were significantly lower among Russian boys in the schools with Russian language of instruction (p<0.05) in comparison with the reference group. Russian girls did not differ significantly (the exceptions were smoking in Estonia and cannabis use in Latvia) from the majority population girls by self-rated health as well as by the risk of smoking, drunkenness, and use of cannabis. CONCLUSIONS: The study found some differences in self-rated health and in risk-taking behaviours between Russian minority and ethnic majority students as well as between students of schools with different language of instruction (majority language vs. Russian) in Estonia, Latvia, and Lithuania. Being a member of minority group was not related with poor self-rated health or involvement in risk-taking behaviours in school-aged children in the Baltic countries.

Evaluation of leadership competencies of executives in Lithuanian public health institutions.

BACKGROUND AND OBJECTIVE. Lithuanian and international public health experts emphasize the importance of leadership in public health. The aim of this study was to explore the self-assessed level of leadership competencies of executives in Lithuanian public health institutions. MATERIAL AND METHODS. Data were collected in a cross-sectional survey of executives of Lithuanian public health institutions in 2010. The total number of returned questionnaires was 55 (response rate, 58.5%). Respondents were asked about their competencies in leadership, teamwork, communication, and conflict management. The evaluation was carried out by analyzing the answers provided in the survey, which used a 5-point rating scale. In addition, the Belbin Team-Role Self-Perception Inventory and the Thomas-Kilmann Conflict Mode Instrument were used. RESULTS. The results showed that respondents were reserved or limited in their individual capacities through this evaluation of their leadership competencies. The mean score was 3.47 (SD, 0.71). Skills in competency areas of communication, teamwork, and conflict management were scored higher (3.73 [SD, 0.67], 3.73 [SD, 0.62], and 3.53 [SD, 0.63], respectively). Most of executives preferred to choose action-oriented roles (76.2%). The most common role was "implementer" (69.1%). "Avoiding" (52.7%) was the most common conflict solving strategy. The results showed that 89.1% of executives wanted to improve teamwork; 83.6%, leadership competencies; 81.8%, communication; and 80.0%, conflict management. CONCLUSIONS. The study results suggest that the executives of Lithuanian public health institutions evaluate their leadership competencies moderately. These results indicate the value of leadership training for public health executives.

Social determinants of smoking, alcohol and drug use among Lithuanian School-aged children: results from 5 consecutive HBSC surveys, 1994-2010.

The aim of this study was to analyze the changes in the prevalence of smoking, alcohol and drug use among Lithuanian school-aged children in relation to the place of residence, family affluence, and family structure. MATERIAL AND METHODS. National surveys (26 556 anonymous questionnaires analyzed) of schoolchildren aged 11, 13, and 15 years were conducted in 1994, 1998, 2002, 2006, and 2010 in the framework of the international Health Behaviour in School-aged Children (HBSC) study. RESULTS. In 1994-2010, a significant increase in smoking prevalence was observed both among boys (11.3% to 21.5%, P<0.05) and girls (3.6% to 14.8%, P<0.05). Weekly alcohol consumption increased from 9.6% to 12.9% (P<0.05) among boys and from 4.3% to 7.9% (P<0.05) among girls. The prevalence of "ever use" of any psychoactive substance (data for 15-year-old group only) increased both in boys (14.6% to 33.5%) and girls (6.7% to 18.4%). Urban girls smoked more often than their rural peers. For both genders, such a residential gradient was observed in the use of alcohol and drugs. The respondents from intact families used drugs less frequently than the adolescents from not intact families. The adolescents from affluent families smoked less often, while the prevalence of alcohol and drug use was higher (except weekly alcohol use in girls). CONCLUSIONS. The study has demonstrated a significant increase in the prevalence of smoking, drinking, and drug use among Lithuanian school-aged children during the period of transition to market economy. This study provides some insight that should be addressed in equity-oriented control policies of substance use.

An evaluation of family physicians' educational needs and experiences in health promotion and disease prevention in Poland and Lithuania--a qualitative study.

BACKGROUND: The aim of this study is to explore the views of family physicians/general practitioners about the most important competences in health promotion and diseases prevention and areas where these competences might be below the desired level. METHODS: A qualitative, descriptive study, combining two data collection techniques, was conducted in two Eastern European countries in June and July 2009. Focus groups numbering 10 and 9 physicians, respectively, practising in various clinical settings, were held in Poland and Lithuania. Seven well-informed health care experts were recruited in both countries to provide information during the in-depth interviews. In both formats, questions were devoted to three main areas of health promotion and disease prevention competences: (1) educational, (2) clinical, (3) organisational. A qualitative content analysis was performed. RESULTS: Lithuanian and Polish family physicians/general practitioners view preventive care as one of their main responsibilities. Among 3 areas of competences, participants identified clinical competences as the most important in everyday practice. They also acknowledged that organisational and educational competences might be below the level required for effective preventive care. Only clinical competences were indicated as sufficiently developed during under- and post-graduate medical education. CONCLUSIONS: In addressing current health promotion and disease prevention challenges, teachers of family medicine need to critically consider the training that currently exists for physicians. Development of a high-quality preventive service is not only a matter of proper education in the clinical field but also requires training in practice organisation and patient education.

Specialist English as a foreign language for European public health: evaluation of competencies and needs among Polish and Lithuanian students.

Foreign languages are becoming an essential prerequisite for a successful carrier among all professions including public health professionals in many countries. The expanding role of English as a mode of communication allows for university graduates to project and to seek their career in English-speaking countries. The present study was carried out in the framework of EU Leonardo da Vinci project "Specialist English as a foreign language for European public health." The study aimed to get a deeper insight how the English language is perceived as a foreign language, by Polish and Lithuanian public health students, what is level of their language competence, which level of English proficiency they expect to use in future. MATERIAL AND METHODS. A total of 246 respondents completed the special questionnaires in autumn semester in 2005. A questionnaire form was developed by the international project team. For evaluation of English competences, the Language Passport (Common European Framework of Reference for Languages of Council of Europe) was applied. RESULTS. Current self-rated proficiency of the English language was at the same level for Lithuanian (3.47+/-1.14) and Polish (3.31+/-0.83) respondents (P>0.05). Majority of respondents (88.6% of Lithuanian and 87.8% of Polish) reported using the English language for their current studies. Respondents reported a significant increase in necessity for higher level of English proficiency in future: mean scores provided by respondents changed from B1 level to B2 level. Respondents gave priority to less formal and practice-based interactive English teaching methods (going abroad, contacts with native speakers) in comparison with theory-oriented methods of learning (self-studying, Internet courses). CONCLUSIONS. Similar levels of English language in all five areas of language skills were established in Polish and Lithuanian university students. Respondents gave more priorities to less formal and practice-based interactive English teaching methods (going abroad, contacts with native speakers) in comparison with theory-oriented or classroom-based methods of learning (self-studying, Internet courses). Survey showed a growing interest of students in improving English language in the future in Poland and Lithuania.

Trends of smoking prevalence among Lithuanian school-aged children in 1994-2006.

BACKGROUND. Despite much effort spent on antismoking programs in schools in different countries, limited effects have been observed in many cases. Evidence from European countries shows that active tobacco control actions such as ban on tobacco advertising, increase of tobacco taxes could lead to successful results. Our study was aimed to analyze time trends on smoking in Lithuanian school-aged children during the period of 1994-2006 in the context of antismoking policies, which were implemented in Lithuania. MATERIAL AND METHODS. This study was a part of WHO Cross-National Health Behavior in School-Aged Children (HBSC) study carried out in Lithuania. The standardized methods of international HBSC study protocol were applied. Stratified random representative samples of 5428, 4513, 5645, and 5632 students aged 11, 13, and 15 years were included into school-based anonymous questionnaire surveys in 1994, 1998, 2002, and 2006, respectively (spring semester). Questions on frequency of smoking, age of initiation and other questions were included. Response rates of each of these four questionnaire surveys were higher than 90%. RESULTS. Smoking behavior was more common among boys. The prevalence gap in smoking between boys and girls diminished during period of observation. Prevalence of smoking increased significantly among boys during the period of 1994-2002 (11.3%, 19.8%, and 23.6% in 1994, 1998, and 2002, respectively), but started to decline after (17.3% in 2006, P<0.05). Similar trends were observed among girls: 3.6%, 8.5%, 14.6%, and 12.5% of girls reported smoking in cross-sectional surveys of 1994, 1998, 2002, and 2006, respectively. Boys living in rural areas were more frequent smokers than those living in urban areas in 1994-1998 (9.5% vs 13.9%, P<0.05). However, the surveys of 2002-2006 showed opposite changes (25.6% vs 22.1%, P<0.05 and 17.8% vs 16.9%, P>0.05). Urban girls have reported smoking more frequently in comparison with rural girls. CONCLUSIONS. An increase in tobacco smoking among school-aged children was observed in Lithuania during 1994-2002. A decrease in prevalence of smoking was seen during the period of 2002-2006. These trends could be related to the implementation of tobacco control measures in Lithuania.

[Prevalence of drug use among students of vocational schools in Klaipeda city, Lithuania, in 2004-2006]. / Narkotiku vartojimo paplitimas tarp Klaipedos profesiniu mokyklu moksleiviu 2004-2006 m.

UNLABELLED: The aim was to evaluate the prevalence and trends of drug use among students of vocational schools in Klaipeda city and to establish the relationships between psychosocial factors and drug abuse. PARTICIPANTS AND METHODS: Two cross-sectional questionnaire surveys were carried out among first-year students of vocational schools in Klaipeda. Random samples of 912 and 342 students aged 16-19 years (representatives of Western part of Lithuania) were questioned in 2004 and 2006, respectively. Questionnaires were filled out anonymously in the classroom. Questions have covered information on drugs such as marihuana, club drugs, injectable drugs, and other drugs. Logistic regression was used for evaluation of relationship between drug use and different psychosocial and behavioral determinants of drug use. RESULTS: In 2004, 56.0% of male respondents and 42.0% of female respondents have reported any drug use during their life. The analysis of standardized data (by the place of residence) showed an increase in the prevalence of drug use during 2004-2006: up to 65.5% in boys (P<0.05) and up to 44.0% in girls (P>0.05). Percentage of club drug users increased significantly in girls (from 21.5% to 29.8%; P=0.040) and exceeded the level of boys. The average number of drugs of different types used by boys changed slightly from 1.57 to 1.63 (P>0.05), but increased significantly in girls (from 1.49 to 1.88, P<0.001). The use of drugs was related to school location (graduates of Klaipeda schools used drugs more frequently), communication with friends who use drugs, participation in the parties where drugs are used, alcohol use, and smoking. In 2006 survey, more significant relationship between drug use and social and behavioral factors was observed. CONCLUSION: Several indicators of drug use showed a significant increase in drug abuse among students of vocational schools in Klaipeda during the period of 2004-2006. Multisectorial efforts and integrated preventive measures should be applied for the prevention of epidemics of drug use in Klaipeda city.

Trends in alcohol consumption among Lithuanian school-aged children in 1994-2006 and new challenges.

UNLABELLED: Alcohol abuse is considered one of the most important risk-taking behaviors among young people in the world. This paper presents the results of the WHO collaborative cross-national study on Health Behavior in School-aged Children (HBSC) carried out in Lithuania and other European countries also in USA, Canada, and Israel in 1994, 1998, 2002, and 2006. OBJECTIVE: The aim of this study was to analyze features and trends in alcohol consumption among the samples of 11-, 13-, and 15-year-old adolescents (school-aged children) in Lithuania during 1994-2006. MATERIAL AND METHODS: Representative samples of 5428, 4513, 5645, and 5632 respondents aged 11, 13, and 15 years were included into school-based questionnaire surveys in 1994, 1998, 2002, and 2006, respectively. The standardized research methods were applied. The students have filled in the questionnaires anonymously in the classroom according to the methodology of international HBSC study. The students were asked about lifestyle habits, alcohol consumption, and episodes of drunkenness. RESULTS: The number of students who had been drunk two or more times has increased by 2.5 times (from 9.8%. to 25.6%) during 1994-2006. A significant increase in alcohol consumption was observed among 15-year-old girls - the percentage of girls who have reported alcohol consumption almost approached the percentage of boys (50.3% and 56.8%, respectively; P=0.006). The reported mean age of the onset of first drinking had shifted by 2 years towards younger age during the period of 1994-2006. The comparison of data from 37 countries, participating in this cross-national study, revealed that the prevalence of alcohol consumption among Lithuanian school children is one of the highest (29.0% of boys and 22.1% of girls) and was in the second worst position on a rating scale when comparing with other 36 countries involved in HBSC study. The results suggest that increased use of light alcoholic beverages can cause an increase in the number of drinking teenagers. Ready-to-drink beverages ("alcopops") at least once per week were used by 15.3% of boys and 17.5% of girls (P=0.216); beer - 16.9% of boys and 5.6% of girls (P<0.001). CONCLUSIONS: A significant shift of the onset of drinking alcohol towards younger age was observed in Lithuania during 1994-2006. In recent years, Lithuanian students as compared to peers from other countries are among those who consume alcohol most frequently.

Body image and weight control among adolescents in Lithuania, Croatia, and the United States in the context of global obesity.

AIM: To compare body image and weight control behavior among adolescents in Lithuania, Croatia, and the United States (US), the countries with striking contrasts in the prevalence of overweight among adolescents. METHOD: The study was carried out according to the methodology of the Health Behavior in School-aged Children collaborative survey. Nationally-representative samples of students, aged 13 and 15, were surveyed in Lithuania (3778 respondents), Croatia (2946 respondents), and the US (3546 respondents) in the 2001/2002 school year. RESULTS: In all three countries, girls perceived themselves as being "too fat" more frequently than boys (37.0% vs 19.7%, P<0.001, z test). The prevalence of this perception increased with age among girls (32.7% vs 41.1%, P<0.001, z test) and decreased among boys (21.4% vs 17.9%, P=0.005, z test). Lithuanian adolescents were least likely to perceive themselves as "too fat;" this perception was significantly more frequent in Croatia and the US (24.2%, 27.5%, and 34.3%, respectively; P<0.001, chi(2) test). With the exception of 15-year-old Lithuanian boys, in all respondents the proportion of adolescents with body mass index (BMI) > or =85th percentile who perceived themselves as "too fat" was significantly higher (up to 3.13 times among 15-year-old US girls) than the proportion of adolescents with BMI < or =15th percentile who perceived themselves as "too thin." The highest proportion of overweight boys and girls on a diet or doing something else to lose weight was found in the US. Boys in Lithuania were most likely to be satisfied with their weight regardless of their weight status. CONCLUSION: Perceived body image and weight control behavior differ among adolescents in Lithuania, Croatia, and the US. Cross-cultural, age, and sex influences moderate body image and weight control behavior in underweight and overweight adolescents.

Trends in drinking habits among adolescents in the Baltic countries over the period of transition: HBSC survey results, 1993-2002.

BACKGROUND: The Baltic countries--Estonia, Latvia, and Lithuania--are considered to be an example of regional homogeneity over the period of transition. The World Health Organization cross-national study on Health Behavior in School-aged Children (HBSC) allows a comparison and time trends analysis of behavioral patterns among adolescents in this region. The aim of this study was to estimate the prevalence and trends of alcohol consumption and drunkenness among adolescents of Estonia, Latvia, and Lithuania in 1993/94, 1997/98, and 2001/02. METHODS: Representative samples of 5286 boys and 6485 girls aged 15 from Estonia, Latvia, and Lithuania were surveyed in 1993/94, 1997/98, and 2001/02 school-year within the framework of HBSC study. The standardized survey methods were applied. The research focused on the following outcome variables: i) frequency of drinking beer, wine, and spirits; and ii) frequency of drunkenness. The same wording of questions on the consumption of alcohol was retained in each survey. RESULTS: Beer was the most frequently used alcoholic beverage across the Baltic countries among adolescents. The rate of weekly drinking of any alcoholic beverage increased considerably during the eight years of observation, especially among Estonian and Lithuanian students. In 2001/02, 25% of boys and 12.5% of girls have reported drinking alcohol at least weekly. The rate of regular alcohol drinking was two times higher in boys, while irregular drinking was more prevalent in girls. Two or more episodes of drunkenness in the lifespan were reported by 30% of boys and 15% of girls in 1993/94 and by 52% of boys and 36% of girls in 2001/02. The use of alcoholic beverages was related to the perceived family wealth: the students from the families perceived by them as wealthy were more likely to drink weekly as compared to the students from the families perceived by them as not wealthy. CONCLUSION: Over the period between 1993 and 2002 the prevalence of alcohol consumption among adolescents increased considerably across the Baltic countries. The efforts of dealing with this problem should employ a combination of measures, including the strategies relevant for the period of transition.

Disease-specific health-related quality of life and its determinants in liver cirrhosis patients in Lithuania.

AIM: To evaluate disease-specific quality of life (QOL) in liver cirrhosis patients and to compare it with those of a healthy population. Also an important objective was to assess whether QOL in liver cirrhosis patients differs by age and gender, by type and severity of disease. METHODS: The case group of 131 liver cirrhosis patients was selected. The control group of 262 was enrolled from a healthy population according to the scheme of case-control study. Clinical, demographic, laboratory data were collected. QOL was measured with a specific chronic liver disease questionnaire (CLDQ), which was translated and validated in Lithuanian. QOL scores were compared between groups by age, gender, type and severity of disease. Cronbach's alpha statistics calculation was used for evaluation of internal consistency reliability. Student's t test or ANOVA were used for evaluation hypothesis about probability equation. RESULTS: QOL was significantly lower in liver cirrhosis patients than in healthy population (59.5 +/- 18.3 vs 85.3 +/- 12.3, P < 0.001). The significant QOL differences between case and control groups were observed in domains of worry and abdominal symptoms, the smaller differences-in emotional functions and systematic symptom domains. Significantly worse QOL was in observed patients with increased clinical severity of the disease measured by Child-Pugh class. Age, gender and etiology of disease had an insignificant effect on QOL in cirrhotic patients. CONCLUSION: QOL was significantly impaired in all CLDQ domains in liver cirrhosis patients. Increase in severity of disease was the major factor associated with poorer QOL.

Prognostic factors for short and long-term survival in patients selected for liver transplantation.

UNLABELLED: Indices for predicting of survival are essential tools for assessing prognosis and establishing priority for liver transplantation. Our aim was to investigate the survival and prognostic significance of Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) scale for short and long-term survival prognosis in waitlist of patients selected for liver transplantation. MATERIAL AND METHODS: The group of 236 patients with diagnosis of different chronic liver disease was investigated in period of 4.5 years. Persons with CTP scoring > or =10 were included into the waitlist for liver transplantation. Other inclusion criteria were based on CTP scoring > or =7 plus one or more liver cirrhosis complications. The cumulative and mean survivals were evaluated according to the Kaplan-Meier statistical analysis. The distribution and the survival data for the patients were based on biochemical variables. The clinical status of waitlist patients was evaluated by applying the CTP and MELD scales. The short and long-term survival prognosis was assessed. The odds ratios with 95% confidence interval univariate analysis were evaluated. RESULTS: During the period of 4.5 years 45 persons were selected for waitlist group. Mortality rate was 51.1%, average survival--17.9 months. The significant trends towards higher cumulative proportion of survival were observed for the patients with low serum bilirubin, creatinine and low blood urea. The highest mortality rate was in the group with CTP scores > or =12. The highest mortality and the shortest average of survival were in the group of cases with the highest scores. It was established the significant difference for short-term survival (less than 3 months) prognosis in MELD scale. CTP scores had no predictive influence for survival during 3 months. Also both scoring had high prognostic value for prediction of the long-term survival (more than 3 months). Deterioration of cumulative survival and overall survival were affected by increase of serum bilirubin, blood urea and creatinine. Increase of scores in CTP and MELD scale had the direct positive correlation with increased mortality. MELD scale has higher capability to predict short-term mortality risk in patients with end-stage liver disease. CTP and MELD scales have proven good prognostic capabilities both for short and long-term survival in patients with chronic liver disease.

Alcohol consumption in Lithuanian school-aged children during 1994-2002.

UNLABELLED: Alcohol consumption becomes an important social and health problem among youth in many countries. Analysis of data on alcohol consumption behavior from World Health Organization Cross-National Study on Health Behavior in School-aged Children (HBSC) is presented in the article. This survey is carried out in majority of European countries including Lithuania. Aim of this study was to analyze features and trends of alcohol consumption among representative sample of 11, 13 and 15-year-old school children and to compare results with international data. METHODS: Patterns and trends of alcohol consumption were analyzed in three cross sectional questionnaire surveys of the representative sample of Lithuanian secondary school student's aged 11, 13 and 15 years in 1994, 1998 and 2002. Respectively, 5428, 4513 and 5645 respondents have filled in the questionnaires anonymously in the classroom according the methodology of international HBSC study. RESULTS: Boys were using alcohol on the regular basis (once a week or more often) more frequently than girls. Prevalence of regular alcohol consumption has increased from 9.4 to 13.6% in boys and from 4.2% to 6.5% in girls (p<0.05). Beer was the most popular alcohol drink among the students and was consumed respectively by 8.9%, 10.2% and 12.7% boys, and by 3.4%, 4.6%, 5.4% girls at least once per week. Prevalence of respondents who have reported the drunkenness (two or more times) has increased in boys from 13.3% to 30.1%, and in girls from 27.1% to 19.6% during period 1994-2002 (p<0.05). CONCLUSIONS: Trend of increase of alcohol consumption among school-aged children was observed in Lithuania during 1994-2002. Boys tend to be more frequent regular users of alcohol than girls. Alcohol consumption was significantly increasing with age. Alcohol use behaviors of Lithuanian school-aged children tend to be closer to countries of the Western Europe and the Nordic countries during the period of observation.