Nepagrįstas antibiotikų vartojimas gydant ūmine viršutinių kvėpavimo takų infekcija (ŪVKTI) sergančius pacientus ne tik sąlygoja atsparių antimikrobiniams vaistams bakterijų padermių vystymąsi, bet ir didina nepageidaujamo vaistų poveikio dažnį bei išlaidų sveikatos priežiūrai kaštus. Lietuvoje iki šiol nebuvo analizuotos priežastys, lemiančios gydytojų sprendimą skirti bei pacientų norą sulaukti antibiotikų ŪVKTI gydymui. Darbo tikslas – nustatyti ir įvertinti antibiotikų vartojimo ŪVKTI gydymui dažnį ir priežastis Kauno apskrities PSP įstaigose. Darbo uždaviniai - nustatyti antibiotikų skyrimo ŪVKTI gydymui dažnį ir priklausomybę nuo ŪVKTI išraiškos; įvertinti paciento lūkesčius sulaukti antibiotikų ŪVKTI gydymui bei jų ryšį su gydytojo sprendimu skirti antibiotikų ŪVKTI gydymui; įvertinti ligos eigos, gydytojo amžiaus, specialybės bei darbo aplinkos ir sprendimo skirti antibiotikų ŪVKTI sergantiems pacientams sąsajas. Išvados: Sulaukti recepto antibiotikams tikisi trečdalis į PSP įstaigą atvykusių pacientų. Pacientų lūkestis gauti antibiotikų ŪVKTI gydymui susijęs su gydytojo sprendimu skirti šių vaistų. Kauno apskrities PSP įstaigų gydytojai antibiotikų ŪVKTI gydymui skiria 40,2 proc. atvejų. Nepagrįstai daug (32,8 proc.) antibiotikų skiriama “paprastam peršalimui” gydyti. Persikvalifikavę į šeimos gydytojus terapeutai bei vyresnio amžiaus gydytojai antibiotikų ŪVKTI gydymui skiria dažniau lyginant su stacionarią rezidentūrą baigusiais bei jaunesniais šeimos gydytojais. / Most commonly AURTI are caused by viruses, and since antibiotics are ineffective against viral infections, researchers in a number of countries have concluded that the rates of antibiotic prescription for AURTI are unjustifiably high. The aim of the study was to determine and evaluate the reasons and rate of antibiotic use for the treatment of AURTI in primary healthcare units of Kaunas County. The objectives of the study were to determine the rate of prescribing antibiotics for AURTI; to evaluate the patients’ expectations to receive antibiotics for AURTI and to assess the relationship of these expectations with the physicians’ decision to prescribe antibiotics for this disorder; to evaluate the associations of the phy¬sician’s age, specialty and working environment with the decision to prescribe antibiotics for patients with AURTI. Conclusions: One-third of patients who visited PHC institutions expected to receive prescriptions for antibiotics. The patients’ expectations to receive antibiotics for the treatment of AURTI was related to the physicians’ decision to prescribe antibiotics. Physicians of PHC institutions of Kaunas County prescribe antibiotics for AURTI in 40.2% of cases. With unjustified rate (32.8%) antibiotics are prescribed for “common cold”. Internists who had re-qualified as family physicians and older physi¬cians prescribed antibiotics more frequently, compared to those who had comple¬ted full-time residency in family medicine and younger physicians.

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while breastfeeding has been shown to reduce its occurrence. In the current study, a consecutive sample of all infants less than 5 years of age with otitis media and breastfed for at least 6 months was collected from a busy urban clinic for analysis. A survey tool was administered to those meeting study criteria. Primary analysis examined the odds ratio of developing otitis media among breastfed infants between those whose mothers smoked tobacco and those whose mothers did not. As a result, the association between the protective effects of breastfeeding and the detrimental effects of maternal smoking was evaluated in relation to the development of otitis media. Secondary variables including demographics, family history, past medical and birth history, and secondhand smoke exposure were also assessed. Results failed to demonstrate a significant difference in otitis media between the 2 cohorts in this study, and of the secondary variables, only cranio-facial deformities and/or a family history of these conditions resulted in higher otitis media occurrence. Further study with larger populations with higher tobacco use rates may offer additional insights into this matter.

Text in English / Regular exercise has significant physical and psychological health benefits yet, paradoxically, may also have harmful effects. The purpose of this study was to investigate the physical and psychological health risks of distance running, a popular participation sport in South Africa. Structural equation modelling was employed to examine the personality and motivational antecedents of running addiction and its influence, in turn, on self-reported overuse injuries and upper respiratory tract infections in 220 athletic club members. The predictors and physical health effects of customary training load were also assessed. It was found that perfectionistic concerns, Type A behaviour pattern, and task goal orientation had a direct, positive impact on running addiction, which predicted higher running injury scores. In contrast, training workload (Volume × Intensity) was inversely related to injury risk. Neither running addiction nor any training load variables influenced infectious illness susceptibility. The findings of this study indicate that maladaptive perfectionism, Type A behaviour, and achievement goal orientation may be risk factors for running addiction, which may, in turn, contribute to increased injury incidence in South African distance runners. Conversely, heavier training loads may be protective against injury occurrences in this population. The results of this research may help to enhance current understanding of the possible health hazards of distance running. This knowledge may have practical implications for the health and well-being of runners of diverse levels of ability and experience. / Psychology / D.Litt. et Phil. (Psychology)