Prevalence of SARS-CoV-2-specific antibodies in a sample of the Lithuanian population-based study in Spring 2023.

Objectives: Despite positive trends in SARS-CoV-2 epidemiology, seroprevalence surveys remain an important tool for estimating the magnitude of the COVID-19 pandemic. This study aimed to investigate the prevalence of IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins in a sample of the Lithuanian population (N = 517) and evaluate how the pattern of seropositivity correlates with the levels of SARS-CoV-2 infection and vaccination. Methods: Study participants (aged 18-88 years) filled in the questionnaire self-reporting their demographic-social variables, health status, and SARS-CoV-2-related status. The anti-S and anti-N IgG levels were estimated using a microarray ELISA test. Results: After several pandemic waves and vaccination campaign, the seroprevalence of SARS-CoV-2-specific IgG in the analyzed sample was 97.87 % by March-May 2023. We determined the 96.91 % prevalence of anti-S and 58.03 % prevalence of anti-N IgG. The majority of study participants (71.18 %) had hybrid immunity induced by vaccination and SARS-CoV-2 infection. 20.3 % of study participants were anti-N IgG positive without reporting any previous symptoms or a positive SARS-CoV-2 test. A decline of anti-N IgG positivity within 9 months after infection was observed. Conclusions: This study demonstrates high total seroprevalence in March-May 2023 in all age groups indicating a widely established humoral immunity against SARS-CoV-2 in Lithuania.

SARS-CoV-2 Seroprevalence in Lithuania: Results of National Population Survey.

SUMMARY BACKGROUND: Betacoronavirus SARS-CoV-2 has spread in early 2020 worldwide just in several months. The official statistics are consistently collected, but this is mainly based on symptomatic reports. This study was aimed to estimate the seroprevalence of SARS-CoV-2 infection in Lithuanian population. MATERIALS AND METHODS: Study was conducted during August-September 2020 in 6 municipalities of Lithuania. The sample comprised 3087 adult participants from the general population (mean age 53.7 years, 64% female). SARS-CoV-2 antibodies were assessed using AMP IgM/IgG Rapid Test, other data were based on self-report. Seroprevalence was assessed as a crude estimate and as adjusted by sensitivity-specificity of the test. RESULTS: The crude seroprevalence in the total sample was 1.9%, the adjusted - 1.4%, ranging from 0.8% to 2.4% across municipalities. Among seroprevalent cases, 67.2% had IgG, 29.3% had IgM, and 3.5% had both IgG and IgM. An increased risk for seropositive test was observed among people who reported having had close contacts with SARS-CoV-2 positives (OR=5.49, p<0.001). At the borderline significance were female gender (OR=1.75, p=0.082) and non-smoking status (OR=2.95, p=0.072). Among the seropositive participants, 69.0% reported having had no COVID-19 symptoms since 1 March 2020, while 31.0% reported having had at least one of the symptoms. CONCLUSIONS: The SARS-CoV-2 seroprevalence in Lithuanian sample in August-September 2020 was 1.4%, ranging from 0.8% to 2.4% across municipalities. Given the overall official data, by the end of study (11 September 2020) the total COVID-19 rate in Lithuania was 117.5 per 100,000 population or 0.12%. This suggests more than 10 times higher prevalence of virus across the population than the official estimates.

Spiritual Wellbeing of Cancer Patients: What Health-Related Factors Matter?

This study aimed to determine the predictors of spiritual wellbeing of non-terminal stage cancer patients hospitalized in oncology units in Lithuania. An exploratory cross-sectional study design was employed. During structured face-to-face interviews, 226 cancer patients hospitalized in oncology units responded about their spiritual wellbeing, perception of happiness, satisfaction with life, pain intensity, levels of education and physical functioning, and length of inpatient stay. A set of standardized tools were used: spiritual wellbeing scale SHALOM, brief multidimensional life satisfaction scale, Oxford Happiness Questionnaire, Barthel Index questionnaire, and verbal pain intensity scale. Additionally, social- and health-related factors were included in data analyses. Structural equation modeling was adapted for a comprehensive assessment of the mediating effect of spiritual wellbeing on the relationship between different health- and value-related factors. The overall fit of the structural model was generally good: [Formula: see text] = 66.94 (χ2/df = 2.31), CFI = 0.94, RMSEA = 0.08, and SRMR = 0.06. Data were analyzed using the Statistical Package for Social Sciences (IBM SPSS Statistics) version 24.0 and Mplus version 8.2. Level of happiness, life satisfaction, and spiritual wellbeing scored in the moderate upper range. The communal domain of spiritual wellbeing rated with the highest mean score and transcendental domain with the lowest score. Education (b = 0.208, p = 0.004), physical functioning (b = 0.171, p = 0.025), and hospital duration (b = - 0.240, p = 0.001) were significant predictors of spiritual wellbeing. Happiness and life satisfaction were negatively influenced by pain intensity, which ranged from mild to moderate. Levels of education, physical functioning, and length of hospital stay predict spiritual wellbeing of non-terminally ill cancer patients. Happiness, as well as life satisfaction, was negatively predicted by pain intensity but had no direct influence on spiritual wellbeing of cancer patients. Spiritual wellbeing positively influences emotional wellbeing (happiness and life satisfaction), and its influence is stronger than the negative influence of physical pain has on emotional wellbeing.

Translation, Cultural, and Clinical Validation of the Lithuanian Version of the Spiritual Needs Questionnaire among Hospitalized Cancer Patients.

Background and Objectives: The aim was to translate and validate the spiritual needs questionnaire for its use in the Lithuanian context. Materials and Methods: A descriptive, cross-sectional survey design was applied. Structural individual interview method (face-to-face) was employed to collect data on spiritual needs of cancer patients. Responses were obtained from 247 patients hospitalized in nursing and supportive treatment units at public hospitals. Data were analyzed using the Statistical Package for Social Sciences (IBM SPSS Statistics) version 22.0. To assess the psychometric properties of the scale, Cronbach's alpha, split half test, average inter-item, and item-total correlations were calculated for internal consistency. Exploratory factor analysis was used to confirm the construct validity of the translated version of instrument. Results: Lithuanian version of The Spiritual Needs Questionnaire (27 items) had a good internal consistency (Cronbach's alpha = 0.94). The existential and connectedness with family needs factor had the lowest Cronbach's alpha (0.71) in relation to other factors: Religious needs (0.93), giving/generativity and forgiveness needs (0.88), and inner peace needs (0.74). Split-half test showed strong relationship between the both halves of the test. The item difficulty (1.47 (mean value)/3) was 0.49; while all values were in acceptable range from 0.20 to 0.80. Item-total correlations were inspected for the items in each of the four SpNQ-27 factors. Conclusions: The Lithuanian version of Spiritual needs questionnaire demonstrated adequate psychometric properties of the instrument. This instrument, as a screening tool and conversational model, is recommended for clinicians in health care practice to identify patients with spiritual needs.

Is Capacity Building Training Effective for Changing Attitudes toward Health Inequalities? Experience from a Norway Grants Project in Lithuania.

BACKGROUND AND OBJECTIVES: In 2014⁻2017, the Lithuanian University of Health Sciences and partners implemented the project, 'Development of the Model for the Strengthening of the Capacities to Identify and Reduce Health Inequalities', which was financed by The Norwegian Financial Mechanism 2009⁻2014 Public Health Initiatives Program. One of objectives of this project was to increase the awareness about public health and related specialist knowledge and skills in the field of health inequalities. This paper evaluates the effectiveness of capacity-training sessions on capacity building regarding increasing the awareness and knowledge that is needed for addressing health inequalities. MATERIALS AND METHODS: Participants attending capacity-building seminars were asked to complete the same questionnaires before and after these training sessions. A total of 145 questionnaires were received (response rate 71.8%). The evaluation of changes in the pre-survey and post-survey responses in relation to a nonparametric analysis of two related samples was performed using the Wilcoxon test. RESULTS: Respondents were asked to identify the general importance of health inequalities to the national public health agenda. The pre-training median of the survey was nine (minimum four; maximum 10), and post-training was 10 [minimum five; maximum 10] (p < 0.001). Unemployed, low-paid, and low-educated people were identified as the most vulnerable groups of society in terms of health inequalities. A more effective tobacco and alcohol control was identified as the most important inequality measure needed. An absolute majority of participants emphasized the need for intersectoral collaboration for the effective reduction of health inequalities. CONCLUSION: The findings from our study suggest that capacity-building sessions can be effective measures for increasing awareness of health inequalities. It is expected that the outcomes of these training opportunities will act as facilitators for further engagement and ongoing approaches to addressing health inequalities.

General and professional values of student nurses and nurse educators.

AIM: The aim of this study was to explore and compare the self-reported general and professional values in undergraduate student nurses and nurse educators in Lithuania. BACKGROUND: Contemporary nursing requires strong moral motivation and clear values as nurses confront many ethical dilemas in their practice. Students acquire essential values of the nursing profession through the appropriate role modelling of their educators. Nursing students seek to become capable in providing ethical and professional patient care while their educators attempt to model desired behaviours. DESIGN: A national cross-sectional comparative study was carried out in March 2011. Four-hundred eight respondents participated: 316 undergraduate nursing students and 92 nurse educators. METHODS: A 57-item questionnaire was delivered to nursing programs at three universities and six colleges. Permission to conduct the study was granted by The Center on Bioethics. RESULTS: Student nurses and their educators rated the general value of altruism equally. Educators, in comparison with students, ranked honesty and intellectualism significantly higher and more often admired truth-telling in any circumstance. Students were more likely to avoid intellectual challenges in reading and placed lower importance on academic qualifications for career advancement. The professional nursing values of honesty, intellectualism and authority were ranked significantly higher by nurse educators than student nurses. CONCLUSIONS: The study revealed differences in self-reported general and professional values in undergraduate student nurses and nurse educators. The values of nurse educators were not always stronger than those of students. Positive relationships between particular general and professional values in both students and educators confirmed the link between professional and personal values.

Monitoring Health Inequalities at the Municipal Level: Lithuanian Experience.

This study aimed to assess the attitudes of Lithuanian public health professionals towards health inequality monitoring in municipalities. The survey was conducted in public health bureaus (PHBs) and administrations of municipalities in March 2015. All employees of PHBs, all municipal doctors and all employees of health departments were invited to participate in the study (N=318; response rate, 47.2%). The study participants had positive attitudes towards the importance of health inequality monitoring at the municipal level, meanwhile systematic health inequality monitoring was assessed moderately. The majority of the interviewed professionals working at PHBs and municipalities (91.4% and 88.2%, respectively) declared that health indicators were monitored and analysed in their institutions. The respondents acknowledged the importance of routine monitoring of health indicators for assessment of inequalities, but these indicators were not monitored systematically in every municipality and PHB. Public health professionals identified the following measures for better health inequality monitoring: to strengthen intersectoral collaboration, formulate specific objectives of health programmes, promote actions in reducing health inequalities. CONCLUSIONS: Public health professionals working at the municipal level outlined the importance of monitoring and reducing health inequalities. However, health inequality monitoring at the municipal level was considered as insufficient.

Health profile of the urban community members in Lithuania: do socio-demographic factors matter?

BACKGROUND AND OBJECTIVE: Objective of the study was to explore self-perceived health status, health determinants and its associations with socio-demographic factors among urban community members in Lithuania. MATERIALS AND METHODS: Data were obtained from a European survey on urban health, conducted as part of the EURO-URHIS 2 project. The postal questionnaire survey of 3200 adults from Kaunas and Siauliai (Lithuania) was conducted in 2010. A total of 1407 valid questionnaires were analyzed. Statistical analysis was carried out by using SPSS 17.0 inside Complex Sample module that takes design effects into account. RESULTS: Younger respondents (aged 19-64 years) perceived most of the health status indicators better than the older ones (65+ years), while they were less likely to report healthy lifestyle and less often perceived their neighborhood as being socially cohesive than the older ones. Men less frequently experienced psychological problems, indicated regular contacts with friends and/or family and had a greater tendency to be overweighed and obese, daily smokers and drinkers compared to women. Those having secondary or lower educational level perceived most of the health status indicators worse than those with university educational level. Respondents living with a partner less often experienced psychological problems than those living alone. Respondents who indicated having enough money for daily expenses more often perceived their health and health determinants better. CONCLUSIONS: The results of this study demonstrate associations between socio-demographic factors and self-perceived health status, lifestyle and factors of living environment among urban community members in Lithuania.

Inequalities in mortality from infectious diseases and tuberculosis by the level of education in Lithuania.

UNLABELLED: The aim of this study was to evaluate changes in inequalities in mortality from infectious diseases and tuberculosis by educational level among men and women in Lithuania. MATERIAL AND METHODS: The data on mortality from infectious diseases in the Lithuanian population aged more than 30 years for the years 1989 and 2001 gathered from the Department of Statistics and censuses were used for the analysis. The relative and slope indices of inequality were calculated. RESULTS: Mortality from infectious diseases and tuberculosis among persons with primary education was higher than that among persons with university education, and these inequalities were found to be increased in 2000-2002 as compare with 1988-1990 due to declining mortality among persons with university education and increasing mortality among less educated persons. Similar tendencies were observed while evaluating the inequalities in mortality from tuberculosis. In 1988- 1990, the relative indices of inequality for mortality from all infectious diseases and tuberculosis among men were 9 and 13, respectively. In 2000-2002, the relative indices of inequality increased significantly to 16.5 and 28.8, respectively. Inequalities in mortality from abovementioned causes for women with different educational levels were lower than those for men. The slope indices of inequality for mortality from infectious diseases among men with different educational levels were considerably higher than among their female counterparts, and in 2000-2002, they were greater compared with 1988-1990. CONCLUSIONS: While implementing tuberculosis prevention and control program and planning prevention and control measures, greater attention should be paid to less educated Lithuanian population at highest risk of this disease.

[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.

[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.