Stress and Fatigue Management Using Balneotherapy in a Short-Time Randomized Controlled Trial.

Objective. To investigate the influence of high-salinity geothermal mineral water on stress and fatigue. Method. 180 seamen were randomized into three groups: geothermal (65), music (50), and control (65). The geothermal group was administered 108 g/L salinity geothermal water bath for 2 weeks five times a week. Primary outcome was effect on stress and fatigue. Secondary outcomes were the effect on cognitive function, mood, and pain. Results. The improvements after balneotherapy were a reduction in the number and intensity of stress-related symptoms, a reduction in pain and general, physical, and mental fatigue, and an improvement in stress-related symptoms management, mood, activation, motivation, and cognitive functions with effect size from 0.8 to 2.3. In the music therapy group, there were significant positive changes in the number of stress symptoms, intensity, mood, pain, and activity with the effect size of 0.4 to 1.1. The researchers did not observe any significant positive changes in the control group. The comparison between the groups showed that balneotherapy was superior to music therapy and no treatment group. Conclusions. Balneotherapy is beneficial for stress and fatigue reduction in comparison with music or no therapy group. Geothermal water baths have a potential as an efficient approach to diminish stress caused by working or living conditions.

Prevalence and determinants of anxiety and depression symptoms in patients with type 2 diabetes in Lithuania.

BACKGROUND: Depression is associated with a variety of diabetes complications, including diabetic retinopathy, nephropathy, neuropathy, and macrovascular complications. The prevalence of the symptoms of anxiety (32%) and depression (22.4%) in patients with diabetes is considerably higher than in general population samples (10%). The aim of this study was to evaluate the prevalence and determinants of anxiety and depression symptoms in patients with type 2 diabetes (T2DM). MATERIAL AND METHODS: This survey was conducted during 2007-2010. In total, 1500 patients were invited to participate in the study. The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety for the evaluation of the depressive state and anxiety. Statistical analysis was carried out using SPSS 17.0. RESULTS: More than 70% of all respondents who participated in the study had diabetes mellitus complications (72.2%). The prevalence of mild to severe depression score was 28.5% (95% CI 25.7-31.4). The prevalence of anxiety was 42.4% (95% CI 39.3-45.5). Anxiety was more frequent among females (46.8%) than among males (34.7%) (p<0.001). A significant negative trend was observed between prevalence of anxiety and depression, and age and education (p for trend <0.001). CONCLUSIONS: A significant association between depression and diabetic complications was identified (p<0.05). Duration of diabetes was a risk factor significantly associated with higher scores of anxiety among the patients with T2DM.

Quality of life in relation to social and disease factors in patients with type 2 diabetes in Lithuania.

BACKGROUND: Diabetic patients are more than twice as costly to manage as non-diabetic patients, due mainly to the high costs associated with management of diabetic complications. As in most nations of the world, the number of patients with DM is increasing every year in Lithuania. The aim of this study was to determine relation between quality of the life and disease and social factors of patients with type 2 diabetes in Lithuania. MATERIAL AND METHODS: Independently prepared questions about the subjects of the survey were: gender; age; weight; education; social and marital status; duration of the disease (in years); treatment method; complications; morbidity with arterial hypertension; change in dietary habits after diagnosis of diabetes (started to eat accordingly to recommendations of the therapist); how often nourishment is taken accordingly to recommendations of the therapist; if beginning to exercise after diagnosis of the diabetes; and if exercising, exercises at least 2-3 times per week. Body mass index was calculated as the relation between body mass in kg and height m square (BMI=kg/m2). The hospital anxiety and depression (HAD) scale was used for the evaluation of depression and anxiety. Quality of life of patients was evaluated with the SF-36 questionnaire. We surveyed 1022 patients with type 2 diabetes (372 men and 650 women). Association between quality of the life and explanatory parameters (disease and social factors) were analyzed using the logistic regression analysis model. RESULTS: We found that women had lower scores than men in all fields of quality of life (p<0.001). Peroral treatment had a positive impact on the quality of life (QL) fields of the role limitations due to emotional problems (ORa 0.16. 95% CI 0.07-0.34; p<0.001). Treatment with insulin had a positive effect on restriction of activity because of emotional problems (ORa - 0.23. 95% CI 0.11-0.49; p<0.001) and mental health (ORa - 0.38. 95% CI 0.19-0.78; p=0.008), but had a negative impact on bodily pain (ORa - 3.95. 95% CI 1.41-11.09; p=0.009) and physical health (ORa - 4.14. 95% CI 2.03-8.47; p<0.001). CONCLUSIONS: Age and BMI are less important factors that can influence quality of life. Peroral treatment positively acted on the role limitations due to emotional problems, bodily pain, and mental health, but had a strong negative effect on emotional state.

Factors influencing psychoemotional strain and fatigue, and relationship of these factors with health complaints at sea among Lithuanian seafarers.

UNLABELLED: The aim of the study was to identify the factors influencing psychoemotional strain and, fatigue among Lithuanian seafarers and relationship of these factors to health complaints at sea. MATERIAL AND METHODS: Two questionnaire surveys were carried out during mandatory health examination at the Maritime Medicine Center of Klaipeda Seamen's Hospital in 2003 and 2007. From November to December 2003, 998 seafarers aged 20-64 years were interviewed (first study). The second study carried out during November-December 2007 involved 932 20-64-year-old seafarers. The questionnaire comprised questions on sociodemographic data, factors of maritime industry, experienced psychoemotional strain and fatigue, and subjective evaluation of health. RESULTS: The first study showed that older seafarers aged from 35 to 54 years were more likely to experience psychoemotional strain (P<0.001). Long working hours (9-10 hours and 11-12 hours) in harmful conditions and increased eyestrain were associated with psychoemotional strain among seafarers in the first study as well (P<0.001). Higher education level and detrimental factors to health (vibration and noise) were significant risk factors for the occurrence of psychoemotional strain among seafarers in the second study (P<0.05). The relationship between many risk factors related to seafarers' work, demographic data, and subjectively evaluated psychoemotional strain and fatigue appear to be accumulative in character. Health complains at sea (insomnia, depression, waist and spinal pain) were related to psychoemotional strain, but sleep disorders were associated with fatigue. CONCLUSIONS: Seafarers employed on a certain ship, under particular conditions, and being exposed to risk factors or their combination may experience health disorders related to increased fatigue and psychoemotional strain.

Self-rated health among physicians.

The aim of the study was to analyze self-rated health among physicians depending on their sex, age, workplace (hospital or polyclinic), and specialty. MATERIAL AND METHODS. The studied group consisted of 377 26-70-year-old physicians randomly selected from various county hospitals and polyclinics of Lithuania. There were 85 men and 292 women. The inquiry was performed using the complemented (by the authors of the study) version of the WHO anonymous questionnaire of the quality of life (1995). Responses were evaluated based on physicians' evaluation of their own health, which was rated as very good, good, satisfactory, poor, and very poor. RESULTS. Only 8.2% of males and 5.8% of females evaluated their health as very good (P>0.05). More men, compared to women, evaluated their health as good (62.3% and 53.1%, respectively; P<0.05), whereas more females evaluated their health as satisfactory, compared to males (36.0% and 25.9%, respectively; P<0.05); 2.4% of males and 5.1% of females (p>0.05) stated that their health was poor. In most cases, physicians of different age groups presented equal evaluations of their health except for physicians in the age groups of 26-37 and 38-43 years - those who evaluated their health as very good comprised a significantly higher percentage (P<0.05), compared to other age groups. As expected, a higher percentage of older physicians evaluated their health as satisfactory. In addition to that, more hospital physicians, compared to those working in polyclinics, evaluated their health as good (12.8% and 1.8%, respectively; P<0.05) and vice versa - significantly more physicians working in polyclinics evaluated their health as satisfactory, compared to those working in hospitals (38.1% and 26.8%, respectively; P<0.05). A significantly higher percentage of surgeons, compared to general practitioners or therapists, evaluated their health as very good (15.8%, 4.5%, and 6.1%, respectively; P<0.05) and a significantly lower percentage - as satisfactory (P<0.05). CONCLUSIONS. Irrespectively of sex, 6.4% of the studied physicians evaluated their health as very good; 55.2%, as good; 33.7%, as satisfactory; 4.7%, as poor; and 0.3%, as very poor. A higher percentage of physicians who evaluated their health as very good or good were 26-37 and 38-43 years of age, whereas more physicians in older age groups evaluated their health as satisfactory. A higher percentage of physicians working in hospital evaluated their health as very good, whereas more physicians who worked in polyclinics evaluated their health as satisfactory. Compared to general practitioners and therapists, surgeons more frequently evaluated their health as very good and significantly less frequently - as satisfactory.

Association between environment and psycho-emotional stress experienced at sea by Lithuanian and Latvian seamen.

This is the first scientific research in Lithuania and Latvia that involves a national cross-sectional study of the seamen of two different countries--Lithuania and Latvia--including the evaluation and comparison of seamen's working environment, lifestyle, health, the prevalence of health-damaging risk factors, as well as the causative relationships between the objective and subjective health evaluation and psycho-emotional stress experienced at sea. The aim of the study was to investigate the frequency and predictors of the psycho-emotional stress experienced at sea by Lithuanian and Latvian seamen. Beside the common statistical methods, the logistic stepwise regression analysis was used in order to find the risk factors of the self-rated stress and to correct the risk estimates for the confounding variables. Seamen of both countries indicated that they experienced psycho-emotional stress after, on the average, 2.7-2.8 months from the beginning of the voyage. More than one-half (57.5%) of Latvian seamen stated that they had experienced psycho-emotional stress, whereas the respective percentage of Lithuanian seamen was smaller (46.1%). The obtained findings showed that, having evaluated the influence of all the analyzed factors (industry-specific, health and lifestyle, medical and demographic), there was no significant difference between the seamen of the two countries concerning the experience of psycho-emotional stress on the ship. The following main prognostic factors related to the occurrence of psycho-emotional stress on the ship were determined: higher or specialized secondary education level (p<0.001), age of 35-44 or 45-54 years (p<0.01), 9-10 or 11-12 hours of work per day when being exposed to detrimental factors (p<0.01), the evaluation of one's health status as "average" (p<0.05), and evaluation of one's physical capacity as "quite good" or "average" (p<0.01). The occurrence of psycho-emotional stress was mostly influenced by work in the environment requiring increased visual strain (p<0.001) and vibration (p<0.05). We found that the following factors were associated with the occurrence of psycho-emotional stress on the ship: depression that occurred more frequently at sea than on shore (p<0.001), disturbed working and resting regimen due to time zone changes (p<0.001), and disturbed regular sexual life (p<0.001). Many of the unique aspects of seafaring are unchangeable. However, it possible to modify, supplement, or develop new strategies to reduce the impact these factors have on the health of individual seafarers.

[Comparative analysis of nourishment of Lithuanian and Latvian seafarers at sea]. / Lietuvos ir Latvijos jurininku mitybos laive lyginamasis tyrimas.

OBJECTIVE: To evaluate and compare the nourishment of Lithuanian and Latvian seafarers at sea. MATERIAL AND METHODS: The present pilot study was comprised of 997 Lithuanian and 993 Latvian seafarers applying for obligatory medical examination. Participants were asked to fill out a questionnaire consisting of 44 questions. The questionnaire helped to obtain information on general data (age, education, position on ship, work record, types of ship, number of crew on ship, months of work on ship per year), medical care and health, smoking habits, usage of alcohol, weight, height, physical activity on ship, harmful factors at sea, nourishment on ship. RESULTS: At sea Latvian seafarers more often than Lithuanian seafarers took boiled and roast potatoes, porridge or flakes, cheese, curd cheese, meat, chicken, sound fruits and vegetables, eggs, coffee and juice. Every fourth seafarer drank coffee without sugar, every third put one teaspoonful, and every third--two teaspoonfuls of sugar into the cup. Twice more Lithuanians than Latvians drank tea without sugar (40.6 and 23.9%, respectively). About one-third of Lithuanian (32%) and less than a half of Latvian (40%) seafarers drank tea and coffee with two teaspoonfuls of sugar; 4-5% of seafarers put three and more teaspoons of sugar into their cup of coffee or tea. Latvian seafarers at the average consumed more white (2.1 slices) and French bread (1.9 slices) per day than Lithuanians (1.6 and 1.2 slices, respectively). Consumption of brown bread was almost the same--approximately 2.3 slices. More than a half (57.2%) of Lithuanians and 11% more of Latvians (68.2%) added salt to the food served on board. Approximately 2% of Latvian and 1.5% of Lithuanian seafarers added salt prior to tasting the food. CONCLUSIONS: At sea Latvian seafarers more often than Lithuanian seafarers took boiled and roast potatoes, porridge or flakes, cheese, curd cheese, meat, chicken, sound fruits and vegetables, eggs, coffee and juice. On the average Lithuanian seafarers took less sugar than Latvian seafarers. Latvian seafarers consumed more white and French bread than Lithuanian seafarers. Latvian seafarers consumed more salt than Lithuanian seafarers.