Įvadas. Pertvarkant pirminės sveikatos priežiūros (PSP) įstaigų tinklą, siekiama gerinti sveikatos priežiūros paslaugų prieinamumą, priimtinumą ir kokybę. Todėl, aktualu periodiskai tirti pacientų požiūrį į sveikatos priežiūros paslaugų prieinamumą bei priimtinumą įvairioms socialinėms grupėms. Darbo tikslas: nustatyti ir įvertinti pacientų požiurį į sveikatos paslaugų prieinamumą bei priimtinumą Varėnos pirminės sveikatos priežiūros įstaigoje ir jų ryšius su socialiniais demografiniais veiksniais. Tyrimo metodika. 2006.03.01 – 2006.03.10 laikotarpiu VšĮ Varėnos PSP centre buvo atliekama anoniminė anketinė pacientų apklausa. Apklausoje dalyvavo VšĮ Varėnos PSP centre(miesto gyventojai) ir jo filialuose (kaimo gyventojai) besilankantys pacientai. Buvo išdalinta 280 anketų, atsakė – 208 respondentai (atsakas – 74 proc.). Statistinė duomenų analizė atlikta SPSS 9 versijos programiniu paketu. Rezultatai. Pagrindinis šeimos gydytojo pasirinkimo motyvas yra gydytojo profesionalumas, žinios ir patirtis (72,6 proc.).Centre sveikatos priežiūros paslaugų teritorinis, finansinis, organizacinis ir informacinis prieinamumas buvo geresnis negu jo filialuose.Visi centro pacientai per vieną valandą pasiekdavo PSP įstaigą, tuo tarpu filialų – tik 54,1 proc. respondentų (p<0,05). 32,3 proc. centro respondentų buvo finansiškai pajėgūs įsigyti vaistus, o filialų – tik 15,6 proc. (p<0,05). Prie registratūros langelio ilgiau negu 15 min. laukė 11,1 proc. centro respondentų, o filialų – 26... [toliau žr. visą tekstą] / Introduction. The reorganization of the network of primary healthcare (PHC) institutions is aimed at the improvement of the accessibility, acceptability, and quality of healthcare services. For this reason, periodical investigations of the patients’ attitude towards the accessibility and acceptability of healthcare services to various social groups are relevant. The aim of the study was to determine and evaluate patients’ attitudes towards the accessibility and acceptability of healthcare services in Varėna district primary healthcare unit, and to evaluate the relationships of these attitudes with socio-demographic factors. The methods of the study. During the period of March 1, 2003 to March 10, 2006, we performed an anonymous questionnaire-based inquiry of patients at Public institution Varėna PHC center. The participants of the inquiry were patients who visited Public institution Varėna PHC center (patients living in the city) and its branch offices (patients living in the countryside). In total, 280 questionnaires were distributed, 208 of which were returned (the response rate was 74%). Statistical analysis of the obtained data was performed using the SPSS v. 9 software package. Results. The main motive for the choice of the family physician was the physician’s professionalism, knowledge, and experience (72.6% of answers). The territorial, financial, organizational, and informational accessibility of services at the PHC center was better than in its branch offices... [to full text]

HIV in Karnataka, south India disproportionately burdens female sex workers (FSWs) and men who have sex with men (MSM). The best long-term strategy for managing the global HIV epidemic might involve a preventive vaccine; however, vaccine availability cannot guarantee its acceptability. An exploratory, cross-sectional study was conducted among frontline health service providers (HSPs) working with MSM/FSWs in relation to HIV-related health services in Karnataka. Face-to-face structured interviews were performed to better understand potential barriers/facilitators to acceptability/uptake of a future HIV vaccine among MSM/FSW communities. Descriptive analyses explored HSPs’ perceptions of vaccine acceptability/uptake and likelihood to recommend an HIV vaccine. Although HSPs mentioned numerous potential barriers to future HIV vaccine acceptability/uptake, most believed that MSM/FSWs would be willing to receive the vaccine to protect their health and avoid HIV. HSPs reported being very likely to recommend the vaccine, however young age of potential vaccine recipients negatively affected likelihood to recommend.

The effect of micronization (at 130 and 150 °C) as a potential heat treatment to reduce ‘beany’ aroma and flavor of cooked chickpea (Cicer arietinum) and green lentil (Lens culinaris) flours was investigated. A simultaneous distillation solvent extraction method was developed to extract key volatile compounds with potential contribution to ‘beany’ aroma and flavor notes in micronized pulse flours and analyzed by gas chromatography-mass spectrometry. Concentrations of volatile compounds such as pentanol, hexanal, 2-hexenal, hexanol, heptanal, furan-2-pentyl, 2-octenal, nonanal, 2,4 decadienal, and 2,4- undecadienal were significantly (P<0.05) decreased with micronization. Low fat burgers fortified with 6% micronized chickpea and green lentil flours showed significantly higher acceptability for aroma, flavor, texture, color and overall acceptability (p<0.05) compared to non-micronized samples in a consumer acceptability test with 101 consumers. In addition, fatty acid analysis of burgers showed burgers containing micronized pulses had higher level of linoleic and linolenic acid content.

Bakalauro baigiamajame darbe nagrinėjamos einamosios sąskaitos nesubalansuotumą nagrinėjančios teorijos ir išskiriami einamajai sąskaitai įtakos turintys veiksniai. Darbe identifikuojamos einamosios sąskaitos saldo pasekmės šaliai bei apibrėžiami einamosios sąskaitos saldo priimtinumo vertinimo metodai teoriniu aspektu. Praktinėje dalyje vertinami Baltijos šalių einamosios sąskaitos saldo priimtinumo pokyčiai išskirtais santykiniais rodikliais bei kriterijais. Šių rodiklių ir kriterijų pagalba išskiriamos pagrindinės Baltijos šalių einamosios sąskaitos saldo priimtinumo problemos. Siekiant įvertinti einamosios sąskaitos saldo priimtinumą vertinant jo poveikio ekonominiams rodikliams mastais atliekama koreliacinė regresinė poveikio ekonominiams rodikliams analizė. Darbe pateikiama einamosios sąskaitos ir BVP rodiklių prognozavimas 2010 ir 2011 metams pasitelkiant kokybinį prognozavimo metodą. / The theories, which explore current account imbalance, are analyzed and excluded the factors of main current account imbalance in bachelor work. In this work is identified sequence of country of current account imbalance and described current account imbalance evaluation in theoretical aspects. In the practice part with relative criteria and indicators is evaluating Baltic countries current account imbalance changes. These criteria and indicators help to distinguish main problems of Baltic countries, of current account imbalance acceptability. To assess the acceptability of the current account balance with respect to its impact on economic performance and scale correlation is carried out regression analysis of the impact of economic indicators. In the work there are giving the current account and GDP indicators forecasting years 2010 and 2011 using a qualitative forecasting method.

HIV in Karnataka, south India disproportionately burdens female sex workers (FSWs) and men who have sex with men (MSM). The best long-term strategy for managing the global HIV epidemic might involve a preventive vaccine; however, vaccine availability cannot guarantee its acceptability. An exploratory, cross-sectional study was conducted among frontline health service providers (HSPs) working with MSM/FSWs in relation to HIV-related health services in Karnataka. Face-to-face structured interviews were performed to better understand potential barriers/facilitators to acceptability/uptake of a future HIV vaccine among MSM/FSW communities. Descriptive analyses explored HSPs’ perceptions of vaccine acceptability/uptake and likelihood to recommend an HIV vaccine. Although HSPs mentioned numerous potential barriers to future HIV vaccine acceptability/uptake, most believed that MSM/FSWs would be willing to receive the vaccine to protect their health and avoid HIV. HSPs reported being very likely to recommend the vaccine, however young age of potential vaccine recipients negatively affected likelihood to recommend.

The effect of micronization (at 130 and 150 °C) as a potential heat treatment to reduce ‘beany’ aroma and flavor of cooked chickpea (Cicer arietinum) and green lentil (Lens culinaris) flours was investigated. A simultaneous distillation solvent extraction method was developed to extract key volatile compounds with potential contribution to ‘beany’ aroma and flavor notes in micronized pulse flours and analyzed by gas chromatography-mass spectrometry. Concentrations of volatile compounds such as pentanol, hexanal, 2-hexenal, hexanol, heptanal, furan-2-pentyl, 2-octenal, nonanal, 2,4 decadienal, and 2,4- undecadienal were significantly (P<0.05) decreased with micronization. Low fat burgers fortified with 6% micronized chickpea and green lentil flours showed significantly higher acceptability for aroma, flavor, texture, color and overall acceptability (p<0.05) compared to non-micronized samples in a consumer acceptability test with 101 consumers. In addition, fatty acid analysis of burgers showed burgers containing micronized pulses had higher level of linoleic and linolenic acid content.

De nombreux problèmes ont été identifiés lors des tentatives d’incorporation de protéines végétales dans nos aliments. En particulier, les faux goûts, le goût et la texture ont été mis en évidence comme de véritables obstacles à l’acceptabilité des produits végétaux par les consommateurs. Le consommateur lui-même est aussi un déterminant important en ce qui concerne le terme « acceptabilité ». Donc, dans le but de développer un nouveau produit fermenté à base de protéines de pois deux volets ont été étudié : le produit et le consommateur. Afin de comprendre la physico-chimie et l’acceptabilité de produits fermentés à base de protéines de pois, plusieurs facteurs ont été étudiés dans des étapes successives tels que la culture, les allégations positives sur la santé et l’environnement, les cocktails de souches lactiques et les procédés de préparation. Dès les premiers tests sensoriels, il était clair qu’il ne serait pas facile de convaincre les consommateurs de consommer des produits fermentés à base de pois : les consommateurs français n’acceptent pas les produits même à une faible concentration de pois (10 %). Ni la familiarité pour un produit proche de nos produits étudiés, ni l’encouragement des consommateurs à accepter ce type d’aliment en passant des messages positifs sur les protéines végétales n’étaient assez efficaces. Ainsi, une deuxième série d’études a été réalisée afin d’optimiser les propriétés rhéologiques et organoleptiques de ces produits. La meilleure combinaison, 1- cocktail bactérien (S. thermophilus + Lb. bulgaricus) 2- matière première (globuline de pois isolée dans notre laboratoire) 3- paramètres de préparation (mélange des deux laits avant le traitement thermique à 90 °C) a été sélectionnée afin d’optimiser les produits fermentés en ce qui concerne l’acidité, la fermeté, les profils volatils et peptidiques. Enfin, du point de vue sensoriel, une légère amélioration de l’acceptabilité a été remarquée. 20 % de protéines de pois a donné un produit accepté par la plupart des consommateurs, et 40 % de protéines de pois a été évaluée positivement par certains consommateurs et négativement par d'autres. / Many problems have been identified following the attempts to incorporate vegetal proteins in our food. In particular, off-flavor, taste or texture have been highlighted as real barriers to the acceptability of plant products by consumers. The consumer himself is also an important determinant regarding the term "acceptability." So, in order to develop a new fermented product based on pea, two issues were studied: the product and the consumer. To understand the physico-chemical properties and the acceptability of pea protein-based fermented products, several factors have been investigated in successive stages such as culture, positive health and environmental claims, lactic acid bacteria strains and preparation processes. From the first sensory tests, it was clear that it will not be easy to convince consumers to buy the pea-based fermented product: French consumers did not accept products even in a lower concentration of pea (10%). Neither the familiarity to close products nor encouraging consumers to accept this type of food by transmitting positive messages about vegetal protein were efficient enough. Thus, a second series of studies was carried out in order to optimize the rheologic and organoleptic properties of these products. Best combination of 1- starter culture (S. thermophilus + Lb. bulgaricus) 2- raw material (pea globulin isolated in our laboratory) 3- preparation parameters (mixing both milk before heat treatment at 90 ° C) were selected to optimize the fermented products in terms of volatile compounds and peptide profiles, acidity and firmness. Finally, from the sensory point of view, a slight improvement in the acceptability was noticed. 20% of pea protein gave a product accepted by most of the consumers, and 40% of pea protein was assessed positively by some consumers and negatively by others

Bakgrund: Magtarmkanalen är en viktig del för att en individ ska uppleva fysisk och psykisk hälsa. Inflammatoriska tarmsjukdomar och cancer i tarmen är faktorer som kan leda till att en tarmstomi blir aktuellt. En tarmstomi kan vara permanent och temporär samt involvera olika delar av tarmen. Med en tarmstomi tillkommer ett ansvar hos patienten där egenvård och skötsel blir centralt. Tarmstomin medför kroppsliga förändringar där stöd och undervisning ökar förståelsen för den nya kroppen. Syfte: Syftet med studien var att beskriva patienters upplevelser av att leva med tarmstomi. Metod: Metoden som använts var litteraturöversikt som inkluderat kvantitativa och kvalitativa artiklar. Resultat: Studiens resultat presenteras i fyra områden: Social samvaro- på gott och ont, Begränsningar i vardagslivet, Acceptans av tarmstomi och Mötet med vården. Slutsats: Patienters upplevelser av att leva med tarmstomi kan både vara positiva och negativa. För att patienten ska acceptera sin nya livssituation har sjuksköterskan, vänner och familj en betydande roll. Patientens acceptans till tarmstomin är avgörande för hur kroppen uppfattas och påverkar därmed den psykiska hälsan. / Background: The gastrointestinal tract is an important part for an individual to experience physical and psychological health. Inflammatory bowel diseases and cancer in the intestine are factors that can lead to an intestinal stoma. An intestinal stoma can be permanent or temporary and involve different parts of the intestinal. With an intestinal stoma comes a responsibility which includes self-care and care of the intestinal stoma for the patient. The intestinal stoma entails bodily changes where support and teaching increase the understanding of the new body. Aim: The aim of this study was to describe patients experience of living with an intestinal stoma. Method: This study is a literature review which is based on qualitative and quantitative articles. Results: The results of this study are presented in four areas: Social cohabitation- for better or worse, Limitations in everyday life, Acceptance of the intestinal stoma and The meeting with medical care. Conclusion: Patients experience to live with an intestinal stoma can both be positive and negative. The acceptance of the new life situation includes the patient’s relationship to the nurse, friends and family. Patients acceptance to the intestinal stoma is crucial for how the body perceives and effects the psychological health.

Introduction Cervical cancer is the fourth most common cancer in women worldwide. An estimated 62,000 cases of cervical cancer occur annually in China, accounting for 12% of global incidence. Virtually all cervical cancers are related to infection by Human Papilloma Virus (HPV): effective HPV vaccines have been developed and vaccination programmes introduced in many countries over the last decade. Given the burden of cervical cancer in China, it is imperative that effective primary and secondary prevention strategies are introduced. Effective introduction of HPV vaccination programmes will require education and information strategies that are informed by a comprehensive understanding of the knowledge, attitudes and beliefs about HPV infection and its relationship to cervical cancer in the Chinese population. Aims and objectives The aims of my thesis are: 1) to systematically review the evidence from the Chineselanguage literature in relation to knowledge of and attitude towards HPV infection and HPV vaccination, and 2) to explore knowledge and attitudes about HPV infection, HPV vaccination and cervical screening amongst teenagers in Heilongjiang province in China. Methods I undertook a systematic literature review using two electronic Chinese databases – the ‘Chinese National Knowledge Infrastructure’ (CNKI) database and the ‘Wanfang’ database. These were searched from inception through November 30th 2012: MeSH terms were applied to both Chinese databases. Manual searching of relevant online journals was also undertaken. Following selection of papers based on pre-determined inclusion and exclusion criteria, quality assessment was carried out using a modified quality assessment checklist, and included studies were classified as good, fair or poor quality. Due to heterogeneity of populations and survey instruments a narrative approach was adopted for data synthesis. I also undertook a questionnaire survey of high-school students in China. Questions were designed based on the Health Belief Model, informed by findings from my systematic review, and refined through cognitive interviews prior to field work in early 2014. The survey targeted students in five public high schools in one middle-income city (Mudanjiang city) and two small counties (Ning’an and Hailin) of Heilongjiang province; 3788 young people aged 14-22 years participated. Descriptive statistical analysis was used to summarise demographic characteristics; initially differences were identified using the chi-square test. Factor analysis was applied to identify attitude patterns and logistic regression analysis models were applied to determine the association between attitude (potential predictors) and acceptability, attitude and levels of knowledge. Results Forty seven articles met my inclusion criteria and were included in the systematic review. All included studies were published between 2006 and 2011; all were cross-sectional questionnaire surveys with sample sizes ranging from 100 – 9,865. The quality of included studies varied considerably. Included populations ranged from the general public, to young people, and health professionals. Awareness of HPV and knowledge of the relationship between HPV and cervical cancer, and of the sexually transmitted nature of HPV, were the main issues examined. Awareness of HPV was low among all non-health professionals groups. Similarly, understanding of the relationship between HPV infection and cervical cancer and of the sexually transmitted nature of HPV was low. However, significant differences in awareness and knowledge were found, based on urban/rural status, ethnicity and age. Uighur women had the lowest awareness and knowledge levels, followed by rural women adults, and teenagers. Acceptability of HPV vaccination varied in terms of the vaccine target recipients (whether adult women, or for their daughters), and between health professionals and the general public). Reported levels of HPV vaccine acceptability (for women adults themselves and for their daughters) were higher in North China compared to South China. Health professionals were less willing to accept the vaccine for their daughters than they were to receiving it themselves. The cost, source and appropriate age for HPV vaccination were also frequently examined issues. Importantly, a high proportion of the health professionals believed that the appropriate age for vaccine was over 18 years old for girls. 3788 participants aged 14-22 years were included in the questionnaire survey, with 54% females and 20% urban students. Overall awareness of HPV was 13.2% and acceptability of the HPV vaccine was 68%. Knowledge levels varied in different content areas; for example 74% of respondents knew that HPV vaccination is not 100% effective against cervical cancer while only 6% knew that poor personal hygiene did not increase the risk of contracting HPV infection. Attitudes towards HPV infection and vaccination were also interesting and novel; the greatest concern about HPV vaccination was minor side effects (72%). The highest-rated source of recommendations about HPV vaccination was parents (66%), while there were concerns expressed about ‘gossip’ in relation to HPV vaccination (51%). No urban/rural differences were found in knowledge and attitudes - gender differences existed, but depended on specific circumstances. Participants who were willing to accept HPV vaccination were more likely to be influenced by others, to report high perceived severity of HPV and cervical cancer, to perceive benefits of HPV vaccination and to score well on knowledge questions. Participants with high knowledge scores for HPV infection and vaccination were more likely to consider HPV infection and cervical cancer to be serious, and were less likely to associate HPV infection with stigma. Participants who had high levels of awareness of HPV infection were more likely to be influenced by others in relation to accepting HPV vaccination. Discussion My thesis has produced new and novel findings in relation to HPV vaccination knowledge, attitudes and beliefs in China. Low levels of awareness and knowledge amongst Chinese people may be influenced by traditional Chinese culture, which perhaps makes people more reluctant to consider issues related to sexual practices. Another possible explanation is that people tended to under-report knowledge of HPV when answering the questions in the survey in order to conform to social norms in China - these topics are highly sensitive in China. High levels of acceptability of HPV vaccines may have also been influenced by ‘ways of thinking’ among Chinese people; their natural inclination is to accept all recommendations for vaccination from government agencies – so they may not have thought hard about this choice. There is optimism in the Chinese population that cancer can be prevented by vaccination – indeed, they are inclined to believe it will prevent disease that can generate serious health impacts in the future. Nevertheless, some Chinese people have conservative attitudes towards the effectiveness of HPV vaccination and some suspicion of the drug companies which produce these vaccines. There were significant methodological issues in my comparisons of Western and Chinese literature. Western literature is more likely to comprise good quality studies – typically there are better-defined sampling frames, more valid and reliable instruments and robust theoretical frameworks. The difference in quality between Chinese and Western literature arises from the stricter rules for reporting and evaluation in western publications and the relatively low publishing standards in Chinese literature. / My thesis also details a number of methodological issues which arose in conducting my questionnaire survey – ideally, I would like to follow up the work I have done with a multi-centre population-based study among teenagers in China (an idea which I will pursue once I return to China). This would hopefully provide better quality information on the influences of factors such as socio-economic status and family background in determining acceptability of HPV vaccination. Nevertheless, my relatively modest, school-based study has, I believe, produced results which add to the information available to health care planners and policy makers in the field of HPV vaccination in China. Conclusion My systematic review is, to my knowledge, the first to identify and synthesise findings about knowledge of and attitude towards HPV infection and vaccination in the Chinese literature – as such, it addresses a gap in currently available evidence. Although there are methodological limitations in Chinese literature (with more poor quality studies), the results still have implications for further health education intervention programmes and health policy. My questionnaire survey was also a ‘first’ in many ways – it explored attitudes towards HPV vaccines based on Health Belief Model among Chinese teenagers and examined HPV related stigma among mainland Chinese teenagers. Low levels of awareness and knowledge and conservative attitudes towards sexually related infections suggest the impact of Chinese traditional culture and a range of other social and financial constraints in China. Hence, there is a great deal to be done before HPV vaccination can be implemented in China – there are educational needs, and in many areas societal and cultural attitudes need to be challenged. Significant changes are also need in government policy and investment – these are major challenges for health care in China, and I sincerely hope my thesis will contribute to these important debates.

The recipient in communication is influenced by many complex phenomena through which he or she subconsciously evaluates some personality traits of the speaker. In the current study we are dealing with the question of whether phonetic features also enter into this personal evaluation and how much they can influence perception. As research material we used recordings of 20 speakers 11-15 years old, from which 80 audio items were selected. The items varied by their length (two-syllables vs. four-syllables), existence in the lexicon of the Czech language (real words vs. non-words) and also in the number of speech problems that occurred in them (reduction, assimilation, non-continuous speech etc.). These problematic moments were identified before the creation of the perceptual test and scored by the author of the study and by another student of phonetics. These score points served as the basis for an objective phonetic evaluation, which was later related to the assessment from the respondents. The perceptual test (with versions A and B) was made up of 40 items and was divided into 5 parts according to questions which were concerned with different angles such as the personality traits of diligence and acceptability. These features are part of the Five-Factor Model of Personality and can be included under...