Alcohol-related injuries and alcohol control policy in Lithuania: effect of the year of sobriety, 2008.

AIMS: To evaluate the changes in mortality and the years of potential life lost (YPLL) due to alcohol-related injuries, as well as the impact of alcohol-related injuries on life expectancy during the period of the implementation of comprehensive alcohol control policy in Lithuania. METHODS: Data on deaths from injuries (ICD-10 codes V01-Y98) of the able-bodied population (aged 15-64 years) during 2006-2009 were obtained from the Lithuanian Department of Statistics. Age-standardized rates of alcohol-related mortality and YPLL per 100, 000 population due to injuries and the impact of alcohol-related injuries on life expectancy were calculated. The results of forensic autopsies were the basis for the alcohol-attributable fraction. RESULTS: The age-standardized YPLL/100,000 of the able-bodied population due to alcohol-related injuries was 2285.6 (4067.5 for males and 573.6 for females) in 2009. In 2009, YPLL/100,000 due to alcohol-related injuries declined by 16.3%, while due to alcohol-related traffic accidents by 51.2% when compared with 2006. However, YPLL/100, 000 due to alcohol-related suicides increased among males. A 15 to 64-year-old decedent lost an average of 21.2 years of life due to alcohol-related injuries (21.6 years on average per male and 19.1 per female). The impact of alcohol-related injuries on life expectancy decreased from 1.14 years (1.86 for males and 0.34 for females) in 2006 to 0.97 years (1.62 for males and 0.26 for females) in 2009. CONCLUSION: The positive changes in YPLL due to alcohol-related injuries and the impact of alcohol-related injuries on life expectancy indicate successful implementation of evidence-based alcohol control measures.

International migration of Lithuanian oral health professionals: a survey of graduates.

AIM: To assess the intentions of general dentists, dental specialists, dental hygienists, assistants and technicians graduated from Lithuanian educational institutions in 0032010 to engage in practice in foreign countries. MATERIAL AND METHODS: A questionnaire survey was carried out among all graduates (N = 347) general dentists, dental specialists, dental hygienists, assistants and technicians in Lithuania in 2010. The response rate was 82.7%. RESULTS: 32.4% of graduates from all oral health specialties mentioned their intentions to emigrate from Lithuania. The highest rate of emigration intentions was found among dental assistants (35.5%) and general dentistry graduates (26.9%). Factors related to higher reported intentions to emigrate were relatives or friends residing in other states, self-rating of personal unhappiness, or residing in large cities. As many as every fourth (23.1%) dental hygienist, assistant and technician graduates had already planned, arranged and organised for emigration. Major destination countries are the UK, Ireland, Norway and Sweden. Of all oral health professionals, the highest rate of reported intentions to emigrate was among dental hygienists, assistants and technicians, therefore many of them will not join the professional community in Lithuania. CONCLUSION: The survey gives indications about the possible magnitude of emigration of oral health professionals from Lithuania and is the first study of its kind. The results show that Lithuania is a major sending country in the context of international oral health professionals' migration flows.

Occupational effects on the family well-being of dentists in Lithuania: a survey of dentists.

BACKGROUND AND OBJECTIVE: Work-related commitments unavoidably interfere with the dentist's everyday life. Therefore, the objective of our study was to assess the impact that a dentist's occupation might have on the family well-being. MATERIAL AND METHODS: The questionnaire was sent to all (N=2449) licensed dentists registered in the Lithuanian Dental Association (response rate, 68.2%). The data were analyzed by means of multiple logistic regression analysis. RESULTS: Most dentists reported difficulties in reconciliation of their professional activities and family life, i.e., insufficient time to spend with a family, necessity to reduce family leisure activities, neglected duties to the family, limited time for hobbies, and work-related anxiety and nervousness at home. These hazardous occupational effects were mainly related to long working hours, which negatively affected all areas of family life. CONCLUSIONS: Occupational hazards, particularly long working hours of dental practitioners, had negative effects on all areas of the dentist's family life. Although dentists frequently faced difficulties in reconciliation of their professional activities and their family interests, in general, they had quite a harmonious family life. The findings suggest that the focus should be on finding the ways to reduce working hours in order to facilitate the reconciliation of a successful dental practice and family life. Additionally, there might be other effective means, e.g., to cope with stress or to develop better working and leisure time management skills.

[Assessment of disability-free life expectancy in Lithuania]. / Vidutines tiketinos gyvenimo be negalios trukmes Lietuvoje ivertinimas.

UNLABELLED: THE AIM of the study was to evaluate disability-free life expectancy of Lithuanian males and females in 2001. MATERIAL AND METHODS: The data about the Lithuanian population and the deceased were available from the Statistics Lithuania, while information about the prevalence of disability was obtained from the Population and Housing Census performed in 2001, where the question on the registered disability was included. The method, presented first by Sullivan in 1971, was applied for the assessment of disability-free life expectancy. RESULTS: Disability-free life expectancy of Lithuanian males and females was 60.6 and 70.6 years, respectively, accounting for 91.9% of male and 91.0% of female total life expectancy. At the age of 65, disability-free life expectancy was 6.2 years for males and 11.7 for females (45.8% and 64.9% of total life expectancy for males and females, respectively). Disability-free life expectancy declined more intensively with increasing age, comparing to total life expectancy. Disability-free life expectancy of females exceeded that of males by 10 years, while life expectancy with disability did not differ significantly. CONCLUSION: Monitoring of disability-free life expectancy, based on officially registered disability and mortality statistics, should be used for the assessment of economic and social burden of disability for the society and state.

[Inequalities in life expectancy of Lithuanian males and females and contribution of major causes of death]. / Lietuvos vyru ir moteru vidutines tiketinos gyvenimo trukmes netolygumai bei juos lemiancios mirties priezastys.

UNLABELLED: The aim of this study to assess inequalities in life expectancy of Lithuanian males and females throughout the period of 1990-2006 and to estimate the contribution of major causes of death to inequalities in life expectancy. MATERIAL AND METHODS: Information on deaths was obtained from the Lithuanian Department of Statistics. Life table analysis was carried out. Analysis of components was applied in order to assess the contribution of the major causes of death to the differences in life expectancy of males and females. The joint point regression analysis was used to identify the critical points, wherever a statistically significant change in life expectancy occurred. RESULTS: Two cut points, dividing the trends in life expectancy into three periods of decreasing, increasing, and again decreasing life expectancy, were characteristic of both males and females in 1990-2006. Changes in life expectancy were more pronounced for males in all three periods. Overall change in life expectancy was not statistically significant for males and was increasing by 0.2% annually for females throughout the period of investigation. The greatest number of years in life expectancy was lost due to cardiovascular diseases in both males and females. External causes contributed most to the difference in life expectancy of able-bodied (aged 15-64 years) males and females. Differences in life expectancy of males and females decreased from 12.3 to 11.8 years throughout the period of 1994-2006; however, it remained among highest in Europe. Since 1991, external causes of death have become the major, though decreasing, contributors to inequalities in life expectancy between males and females. In 2006, compared to 1994, contribution of cardiovascular diseases and cancer increased. CONCLUSION: Attempts to reduce demographic and social inequalities in health should become a priority in social and health policy formulation. The criteria for evaluation of the national and regional health and social programs should reflect aspects of equal opportunities in health for males and females.

Inequalities in life expectancy by education and socioeconomic transition in Lithuania.

OBJECTIVE: To present changes in life expectancy of males and females by the level of educational achievement and describe different aspects of inequalities in life expectancy over the decade of socioeconomic transition in Lithuania. MATERIAL AND METHODS: This analysis is based on routine mortality statistics and census data for 1989 and 2001 for the entire country. The study included the population more than 25 years of age. RESULTS: Increasing inequalities in life expectancy by education have occurred due to increasing life expectancy amongst persons with higher educational achievements, and conversely, a declining life expectancy in groups with low levels of education. Cardiovascular diseases were responsible for the greatest number of years lost in life expectancy by all educational categories both in males and females. The numbers of years lost due to cardiovascular diseases decreased in majority of educational categories, particularly in lower secondary educational group. The increase in the years of life expectancy lost was observed due to external causes of death, the higher education being associated with the lower numbers of years lost, especially in females. The greatest impact on the difference in life expectancy between males with university and primary education was caused by external causes both in 1989 and 2001, while the major contribution to the educational differences in life expectancy of females was made by cardiovascular diseases. CONCLUSIONS: Favorable forecast of declining health inequalities by education in Lithuania can hardly be expected in the nearest future. Collective efforts and constructive actions should address the health problems of the least privileged groups in terms of education, as well as promotional efforts directed at young people to complete their education and guarantee of equal opportunities for education.

[Private or public dental care? Patients' perception and experience in Lithuania]. / Privati ar valstybine odontologine gydymo istaiga? Lietuvos pacientu nuomone ir patirtis.

SUMMARY OBJECTIVE: To compare demographic and social groups of patients, their satisfaction with services in public and private dental institutions. MATERIAL AND METHODS: A random sample of 3000 Lithuanian residents was selected; 1801 participants answered a postal questionnaire. The response rate was 60.0%. Univariate analysis, chi(2) criterion, z-test, and multiple logistic regression were used to evaluate the association between institution type, demographic and social characteristics of the respondents. RESULTS. Less than half of Lithuanian residents (41.2%) visited public dental institutions, 35.9%--private, 25.9%--both. They preferred private dental sector due to better quality of service, public--due to closeness to residence or being the treatment place of acquaintances. Patients visiting public institutions required cheaper treatment, while patients visiting private institutions--qualitative, though more expensive, using modern technologies. The number of dental visits in the past year was lower in public institutions than in private ones. The majority of patients treated in public, private, and both institutions were satisfied with dental services. The least satisfied were visiting both institutions. More respondents with secondary and lower education used public services as compared to those with higher education. Urban population visited public institutions more often than rural population. Respondents with a monthly income of less than 500 Lt for one family member used public dental services more often than those receiving a higher income. Older patients visited public dental institutions more often than younger ones. CONCLUSIONS. More Lithuanian residents are treated in public dental institutions (up to 67.1%) than in private. Older, receiving lower income patients preferred public institutions. The majority of patients in public clinics as well as in private sector are satisfied with the service. Those who visited both types of institutions were least satisfied with dental services.

Priorities in effective management of primary health care institutions in Lithuania: Perspectives of managers of public and private primary health care institutions.

BACKGROUND: Primary health care institutions are looking for opportunities to create value for patients and to increase the competitiveness of the health care institution. Determination of competitive priorities for creation of value for patients in the management of primary health care institutions allows improving competitiveness and achieving a competitive advantage in the market. THE AIM OF THE STUDY: To determine the priorities in the management of public and private primary health care institutions by using the focus group discussion method with managers. METHODS: The study was exploratory with intention to find a ground for a management theory and to be the root for the development of health care reform in Lithuania. Focus group discussions were held in 10 Lithuanian counties; 10 focus group sessions were carried out. A total of 48 primary health care executives were interviewed. The participants of this qualitative study were given 8 questions related to value creation of the primary health care institution to patients and rise in competitiveness. The main question of the focus group discussion was "What are the main priorities of management of primary health care institution?" The criteria of data collection based on the deep understanding of the phenomenon and the richness of data expressed by participants of the research. RESULTS: Qualitative research showed that the priorities of management of primary health care institutions were work management of an organization; human resources management; patient management; and health policy decision making. The participants of focus groups pointed out that effective work of primary health care institutions is ensured by the model of management, doctor-patient communication, quality and timely delivery of health care services, and financial resources. The major decisions involving the management of patients were as follows: meeting patients' expectations, quality and timely satisfaction of patients' needs, effective solution of patients' problems, patient-centered services, patient satisfaction, and communication with the patient. Accessibility to services, quality, geographical accessibility, disease prevention, strengthening of patients' health and adequate funding were mentioned as the priorities of health policy.

[The activity of the Clinic of Ophthalmology as the subunit of the Faculty of Medicine of the University of Lithuania (Vytautas Magnus University) during 1922-1938]. / Lietuvos universiteto (Vytauto Didziojo universiteto) Medicinos fakulteto Akiu klinikos veikla 1922-1938 metais.

The aim of the study was to evaluate the activity and the validity of the expansion of the Clinic of Ophthalmology of the University of Lithuania (since 1930-Vytautas Magnus University) operating in Kaunas city between 1922 and 1938. The evaluation was based on the analysis of changes in inpatient and outpatient flow, the structure of cases of inpatient treatment, and the usage of beds. In the analysis, we used annual reports of the Clinic of Ophthalmology as well as data presented in statistical publications of the Department of Health for the studied period. The changes in the indices of the activity of the Clinic were evaluated using the logarithmic regression coefficient. A more rapid increase in the number of patients discharged from the Clinic of Ophthalmology was observed during 1922-1930 (on the average, by 9% per year). During 1931-1938, only the number of discharged men was increasing. During the studied period, the majority of the cases of inpatient treatment were lenticular diseases (19%), trachoma (16%), and corneal diseases (16%). During 1922-1930, the sharpest increase was observed in the number of inpatients with eyeball diseases and eye traumas (on the average, by 12.3% per year) and during 1931-1938, in the number of patients with trachoma (on the average, by 6.7% per year). The analysis of the indices of the activity of the inpatient unit confirmed the need for the expansion of the Clinic during 1922-1930, but revealed that the expansion of the material basis of the Clinic up to 50 beds during 1931-1938 was not efficient. In the outpatient unit of the Clinic of Ophthalmology, the number of visits per year and the number of admitted patients per year during the studied period increased by 2.5 and 3.5 times, respectively.

Clinical cosmobiology: distribution of deaths during 180 months and cosmophysical activity. The Lithuanian study, 1990-2004. The role of cosmic rays.

UNLABELLED: The aim of this study is a next step of our previous, initial, publications--to explore the links between monthly death number (total, and for the major death causes and each gender) with levels of monthly cosmophysical activity in a long-term, big cohort observation. METHODS: Death number during 180 consecutive months from the National Registry of Lithuania for years 1990-2004 were studied. A total of 630,205 deaths were analyzed (333,035 males). For comparison, monthly indices of solar activity, geomagnetic activity, and cosmic ray activity and year and month (1-12) of the study were used. The cosmophysical data were obtained from space research centers in the USA, Russia, and Finland. Statistics. Pearson correlation coefficients (r) and their probabilities (P) between compared parameters were calculated. A multivariate model of prediction was designed. RESULTS: It was a significant correlation between total monthly death number and indices of cosmic ray activity and, inverse, of solar activity; in men stronger than in women. Monthly geomagnetic activity was significantly correlated with traffic accidents, ischemic heart disease/stroke ratio, suicide victim number. Deaths from stroke, noncardiovascular causes, suicide, traffic accidents were related with cosmic ray activity and, inverse, with solar activity. Relationship of ischemic heart disease/stroke ratio to year of observation showed additional evidence for the growing role of stroke in cardiovascular mortality. CONCLUSIONS: Monthly death number is linked to cosmic ray activity, and inverse, to solar activity. Central place of stroke-related deaths in cardiovascular mortality is emerging. Geomagnetic activity, in monthly account, plays a relatively minor role. We presume that forces antagonistic to cosmic ray activity, like solar activity and geomagnetic activity, can prevent some negative biologic effects of cosmic ray.

Factors related to job satisfaction among Lithuanian dentists.

UNLABELLED: The objective of this study was to evaluate the level of overall job satisfaction among Lithuanian dentists, to explore the satisfaction with different work environmental factors and relate it to overall job satisfaction. MATERIAL AND METHODS: All (N=2449) Lithuanian Dental Chamber members were sent a questionnaire. It comprised a 5-point Likert scale structured questions that were developed according to the Dentist Satisfaction Survey. RESULTS: The level of overall job satisfaction among Lithuanian dentists was 4.06 (95% CI 4.03-4.10) out of 5 of Lickert scale. The least satisfying work areas was social security (2.64, 95% CI 2.59-2.69) and income (2.79, 95% CI 2.74-2.84); the most satisfying area was patient (3.75, 95% CI 3.71-3.78) and professional relations (3.83, CI 3.79-3.87). Reasonable working hours (OR 6.71; 95% CI 1.19-37.75), satisfaction with professional evaluation and appreciation (OR 2.31; 95% CI 1.62-3.30) and income (OR 1.88; 95% CI 1.22-2.89) had the most significant positive impact on dentists' overall job satisfaction. CONCLUSIONS: In general, Lithuanian dentists experience great job satisfaction. Postgraduate studies, not limited possibility for professional development has most positive impact for dentists' overall job satisfaction and work environmental factors are less important for it. Findings of this study show the issues that need special attention to increase the level of job satisfaction among Lithuanian dentists and thus improve all dental care system.

Occupational hazards of dental profession to psychological wellbeing.

OBJECTIVE: The aim of this study was to examine self perceived psychological wellbeing of Lithuanian dentists and to relate complains of well being to occupational hazards of dental profession. MATERIALS AND METHODS: All dentists (2449) registered in Lithuanian Dental Chamber license registry were approached by post questionnaire which included structured questions regarding occupational hazards and their effects on self perceived psychological wellbeing. RESULTS: Overall majority (95.1%) of Lithuanian dentists reported that dental profession influences their general health and more than a half (52.4%) experienced health complains on either a frequent or very frequent basis. Substantial numbers of Lithuanian dentists reported work related stress, fatigue, nervousness and anxiety. Tension before work and awakenings at night were frequent complains. Of all, 94.2% of respondents indicated that long working hours affect their general health and 41.7% were bothered by this condition on a frequent or very frequent basis. Although less than 10% of dentists indicated overwork, they indicated that long working hours influence their psychological wellbeing. CONCLUSION: Substantial numbers of Lithuanian dentists reported different impairment of their psychological well-being. These complains were related to occupational hazards of dental profession.

Seasonal patterns of suicides over the period of socio-economic transition in Lithuania.

BACKGROUND: In Lithuania, suicides are a grave public health problem, requiring more extensive investigation. The aim of the study was to assess the seasonal variations of suicides in Lithuania throughout the years 1993-2002, describing patterns by gender, age and method of suicide. METHODS: The study material consisted of all registered suicides (n = 16,147) committed throughout 1993-2002 in Lithuania. Smoothed trends were inspected. The seasonal effect was explored using monthly ratio statistics and spectral analysis. RESULTS: Suicides in Lithuania have a distinct annual rhythm with peaks in summer and troughs in December. The December frequencies fell by more than 23% in men and 30% in women, while June peak reached nearly 23% in men and July peak exceeded 29% in women, compare with the average levels, (p < 0.05). Hanging was the most common method of suicide both in men and women comprising up to 90% among all suicides in 1998-2002. Among different methods, only hanging suicides showed significant seasonal variations, especially in men. The seasonal amplitude has decreased over time. CONCLUSION: Substantial seasonal variations in suicides were associated with a high proportion of hanging. Extremely high suicide rates in Lithuania require further extensive studies and urgent preventive programs, taking into account the suggestions of this survey.

Social dimensions of mortality from external causes in Lithuania: do education and place of residence matter?

OBJECTIVES: To assess inequalities in mortality from external causes by the level of education and the place of residence during the period of socio-economic transition in Lithuania. METHODS: Information on deaths, place of residence, and the level of education of persons aged 25 and older was derived from the National Database of Lithuania and censuses for 1989 (n=3537) and 2001 (n=4790). RESULTS: Mortality from external causes of Lithuanian urban and rural populations was strongly associated with the level of education. Educational inequalities increased throughout the period of socio-economic transition. In urban areas, mortality among the least educated population was 3.20 times higher in 1989 and 3.37 times higher in 2001, compared to those with university-level education. In rural areas the educational mortality rate ratios reached 3.47 and 4.33, respectively. The greatest educational inequalities were observed in suicide mortality, especially among males. CONCLUSIONS: The results of this study disclosed increasing inequalities in mortality from external causes. Less educated populations, especially in rural areas, should receive particular attention in the development of strategies for the prevention of mortality from external causes.

Monthly number of newborns and environmental physical activity.

UNLABELLED: In the last decades many studies have demonstrated the cosmophysical influences on human homeostasis. The aim of the study was to explore links between environmental physical activity--solar, geomagnetic, cosmic ray--and monthly number of newborns in general and, separately, for each gender. MATERIAL AND METHODS: The distribution of newborns' number (n=286,963) over 96 months in the Republic of Lithuania from 1995 to 2002 was compared with the monthly cosmophysical indices nine months before the month of delivery. For the comparison of gender ratio, other 52,289 newborns at the same time were studied in a big Israeli hospital. Pearson's correlation coefficients and their probabilities between the newborns' number and cosmophysical indices were established. RESULTS: A strong and significant inverse correlation of monthly newborns' number with monthly solar activity indices (r=-0.72, p<0.0001) and similar, but positive, with cosmic ray activity was shown (r=0.67, p<0.0001). CONCLUSIONS: The monthly number of newborns of both genders is strongly and significantly related to the level of monthly cosmic ray and, inverse, to solar activity indices nine months before the month of delivery. Geomagnetic activity was not significantly related to the monthly number of newborns. The subject and mechanism of these relationships needs further investigation.

[Vegetables and fruits and risk of stomach cancer]. / Darzoviu bei vaisiu vartojimas ir skrandzio vezio rizika.

OBJECTIVE: Stomach cancer is the second common cause of death in Lithuania and most countries of the world. Nevertheless, there were no reports of epidemiological studies on stomach cancer in Lithuania. Therefore, a hospital-based case-control study has been carried out in order to assess the associations between vegetables and fruits and risk of stomach cancer. MATERIAL AND METHODS: Hospital-based case-control study included 379 cases with newly histologically confirmed diagnose of stomach cancer and 1137 controls that were free of cancer and stomach diseases. Cases and controls were matched by gender and age (+/-5 yr). Information on demographic variables, family history on cancer, life-style habits, such as diet, smoking, alcohol consumption, and physical activity was collected by a questionnaire. Conditional logistic regression was used to compute the odds ratio (OR) and their 95% confidence intervals (CI). RESULTS: After adjustment for other food items (vegetables, fruits, different types of meat, processed meat and fish, dairy and starchy products, coffee, green tea), that were related to outcome, smoking, alcohol use, family history on cancer, education level and residence, stomach cancer risk was inversely associated with consumption of raw vegetables such as cabbage (OR=0.24; 95% CI=0.10-0.57; > or =1-3 times/month vs. almost never), carrots (OR=0.42, 95% CI=0.20-0.86; 1-6 times/week vs. almost never) and garlic (OR=0.59, 95% CI=0.37-0.96; 1-6 times/week vs. almost never). Protective effect has been observed for intake of broccoli (OR=0.52, 95% CI=0.28-0.98; 1-4 times/week vs. < or =1-3 times/month). There were no statistically significant associations between stomach cancer risk and consumption of citrus or others fruits. In conclusion, higher consumption of raw vegetables such as cabbage, carrots, garlic as well as broccoli may decrease a risk of stomach cancer, whereas intake of citrus fruits has no relation with a reduced risk of the disease.

Space weather and human deaths distribution: 25 years' observation (Lithuania, 1989-2013).

BACKGROUND: Human health is affected by space weather component [solar (SA), geomagnetic (GMA), cosmic ray (CRA) - neutrons, space proton flux] activity levels. The aim of this study was to check possible links between timing of human (both genders) monthly deaths distribution and space weather activity. METHODS: Human deaths distribution in the Republic of Lithuania from 1989 to 2013 (25 years, i.e., 300 consecutive months) was studied, which included 1,050,503 deaths (549,764 male, 500,739 female). Pearson correlation coefficients (r) and their probabilities (p) were obtained for years: months 1-12, sunspot number, smoothed sunspot number, solar flux (2800 MGH, 10.7 cm), adjusted solar flux for SA; A, C indices of GMA; neutron activity at the earth's surface (imp/min) for CRA. The cosmophysical data were obtained from space science institutions in the USA, Russia and Finland. The mentioned physical parameters were compared with the total number of deaths, deaths from ischemic heart disease (n=376,074), stroke (n=132,020), non-cardiovascular causes (n=542,409), accidents (n=98,805), traffic accidents (n=21,261), oncology (n=193,017), diabetes mellitus (n=6631) and suicide (n=33,072). RESULTS: Space factors were interrelated as follows for the considered period: CRA was inversely related to SA and GMA, CRA/SA (r=-0.86, p>0.0001), CRA/GMA (r=-0.70, p<0.0001); SA and GMA were correlated (r=0.50, p<0.0001). The total deaths distribution was inversely related to SA (r=-0.31, p<0.0001) and correlated with CRA (neutron) activity (r=0.234, p<0.0001). Ischemic heart disease (IHD) deaths (most at home) show a drop yearly (r=-0.2551), more for men. It was correlated with GMA for the total IHD population and men. Stroke deaths were inversely related to SA (r=-0.38, p<0.0001) and correlated with CRA (r=0.41, p<0.0001) and year (r=0.49, p<0.0001), showing a steady rise. The IHD/stroke deaths ratio was negatively correlated with the years of observation (r=-0.754, p=0.0001). Non-cardiovascular deaths were inversely related to SA (r=-039, p<0.0001) and correlated with CRA (r=0.263, p<0.0001). Oncology deaths that now are dominating in many places were inversely related to SA (r=-0.475, p<0.0001) and correlated with CRA (r=0.426, p<0.0001). Suicide showed a drop with years (r=-0.29, p<0.0001), possibly related to excessive immigration of young population (18-34 years) in the last decade and correlated with two of three GMA indices. Traffic accidents were correlated with SA and GMA (r=0.392-0.461, p<0.0001) and inversely related to CRA (r=-0.436). CONCLUSIONS: Most groups of deaths are related to space weather component activity. Extreme levels of activities of both groups (SA, GMA, and opposite CRA - neutron) are related to some health risks. In the considered period, there were relatively few GMA storms and low GMA was dominating, accompanied by higher CRA (neutron) activity. The ways of action of the components of space weather on the human body need additional studies. There is a special need for the prevention of rising cerebral vascular accidents and oncology malignancies as the causes of death.

Inequalities in daily variations of deaths from suicide in Lithuania: identification of possible risk factors.

The aim of this study was to analyze daily variations in mortality from suicides of Lithuanian urban and rural populations in two different periods of economic and political development of the country (1988-1990 and 1998-2000). The highest proportion of suicides occurred on Mondays and during the first days after the major public holidays, especially in men. Suicide mortality in rural areas was significantly higher in comparison to urban; nevertheless, daily variation was more marked in urban areas. Developing market economy and rising unemployment did not increase daily variation in suicides.

Socio-economic transition, inequality, and mortality in Lithuania.

The study assessed inequalities in mortality of Lithuanian urban and rural populations throughout the period of socio-economic transition (1990-2000). Mortality from major causes of death, except cancers in females, was higher among the rural population. Inequality in mortality increased during the period of transition, especially among males, mainly due to more rapidly improving health of the urban population. Cardiovascular diseases and external causes made the largest contribution to the inequality. Differences in mortality of urban and rural populations point to greater social and psychological stress affecting the rural population, unhealthy life styles, inequities in accessibility of health care and lack of preventive programs in rural areas.

Healthy life expectancy--an important indicator for health policy development in Lithuania.

UNLABELLED: The aim of the study was to assess the changes in healthy life expectancy of the Lithuanian population between the years 1997 and 2001 and to explore the differentials of this combined mortality and subjective health measure in males and females. MATERIAL AND METHODS: The data about the Lithuanian population and the deceased were available from the Lithuanian Department of Statistics, life tables for 1997 and 2001 were created and life expectancy estimated. The method presented first by D. F. Sullivan was applied for the assessment of healthy life expectancy. The data on self-perceived health of the Lithuanian population were acquired from the surveys of the health behavior of a randomly selected sample of the adult population of Lithuania, carried out by the Lithuanian Center for Health Education. RESULTS: Healthy life expectancy at birth increased from 52.7 in males and 52.6 in females in 1997 up to 53.7 in males and 55.3 in females in 2001. The proportion of healthy life expectancy in the total life expectancy at birth increased both in males and in females. Though the total life expectancy of males is 10-11 years shorter, females are expected to spend considerably more years in poor health, even though some positive changes were observed. CONCLUSION: Increasing healthy life expectancy reflects improving health of Lithuanian population. This integrated health indicator should be periodically assessed and used for development health strategies to promote health in Lithuania.