“HEALTH IN OUR HANDS”

2ND INTERNATIONAL STUDENT CONFERENCE IN HEALTH SCIENCES

“HEALTH IN OUR HANDS”

CONFERENCE ABSTRACTS

Anna-Liisa Tamm jaanika Niinepuu Lembi Kaasik Stella Tiit Erik Landõr Sander Reigo ORgANISINg cOMMITTEE

Ermo Kruuse Anne Rosenberg Merlis Karja-Kännaste Ave Kutman Inga Ploomipuu Kristi vahur

ScIENTIfIc cOMMITTEE/ ABSTRACT REVIEW COMMITTEE:

Ülle Parm, Phd Tartu Health care college, Estonia Eeva Liikanen, Phd Tampere University of Applied Sciences, finland davide Ticchi, Phd stud. Tallinn University, Estonia Anna Stecka, MSc college of Rehabilitation in Warsaw, Poland Nadine Alice Higgins, MSc RgN Nightingale House / Whiston Hospital, United Kingdom

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JURY COMMITTEE FOR ORAL PRESENTATIONS:

Saima Hinno, Phd Tartu Health care college, Estonia Merle varik, Phd stud. Tartu Health care college, Estonia Eerik jõgi, Phd stud. Tartu Health care college, Estonia jelena Sokk, Phd University of Tartu, Estonia Kerstin Plessl, Phd fH campus Wien, Austria Ellen van Korven fontys University of Applied Science, Netherlands Steven Onkelinx, Phd fontys University of Applied Science, Netherlands françoise Ineichen, MSc High School of Health vaud, Switzerland Robert Neil Higgins, Phd University of Salford, School of Health and Society, UK

jan Homma Netherlands food and consumer products safety authority (NvWA)

JURY COMMITTEE FOR POSTER PRESENTATIONS:

Merle Talvik, Phd Tallinn Health care college, Estonia Katarina Sadovnik, MSc fT campus Wien, Austria Katrin Lang, Phd University of Tartu, Estonia Evanthia Sakellari, Phd Technological Educational Institute of Athens, greece joseph grannum, Phd stud. University of Technology, jamaica/University of Tartu, Estonia

CONSEQUENCES OF SOCIAL NETWORKING ADDICTION IN ADOLESCENTS

Author: Marcos Lacombe guerrero

Scientific research supervisor: Antonia Pades jiménez

department of Nursery and Physiotherapy, balearic Islands University, Palma, Spain

Background: Social networking addiction is defined as physical, social and emotional dependence on the use of social networks. In many cases it implies an abnormal use in the usage frequency. That addiction is as recent as social networking development and massive usage. Most recent data indicates that 11% of people are not able to stop using their social networking for shorts periods of time (some hours). In case of people under 25 years old, this data increases until 18%. And 2% of them have a several/critical addiction. All of this indicates that this phenomena is social relevant and it exists and special interest in its study.

Aim: We can find a main aim and two secondary aims.

Main aim: have knowledge about consequences of social networking addiction.

Secondary aims: • Identify social networking addiction´s tools. • Describe relation between tools and the addiction.

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Methods: We have done a systemic research in different data base (APA, dIALNET, PubMed, EbScOhost & ERIc), using keywords and inclusion criteria of: time (ten years), language (Spanish, English & german) and adolescent fellows.

Results: The results obtained have determined a relationship between addiction to social networks and negative impacts on adolescents, with special emphasis on the correlation between addiction to social networks and other addictions such as: internet use, smoking or alcoholism. We also highlight the role of the personality in the likelihood of developing an addiction to social networks.

Conclusion(s): With all this we can determine that social networks are a remarkable tool in the people´s life and the abuse of this has a negative impact on all areas of the individual highlighting the academic, social, emotional, psychological and physical areas.

Keywords: addiction, adolescent, social networking.

THE HYGIENE AND SAFETY OF ESTONIAN PLAYROOMS AS ASSESSED BY PARENTS

Author: Egle Silluta

Scientific research supervisor: Kristi vahur

Physiotherapy and Environmental Health department, Tartu Health care college, Estonia

Background: Playrooms have been gaining popularity amongst parents in recent years, both as places of leisure for children and for throwing birthday parties. Unlike nursery schools and daycare centers, health protection regulations do not apply to playrooms.

Aim: The aim of this thesis is to determine the hygiene and safety conditions of Estonian playrooms as assessed by parents.

Methods: A questionnaire was used for data collection and distributed via google.doc, childcare-themed facebook groups and other social media networks. The questionnaire was completed by 169 people around Estonia.

Results: The study concluded that parents tend to be satisfied with playrooms (72.2%). 40% of respondents have noted problems with hygiene and safety. The main safety hazards are broken toys and attractions. Hygiene problems include dirty carpet and toys. 80.5% of the respondents claim that they were not made aware of the rules upon entering the playroom, but that these were displayed in a visible place on the wall. 36.1% associated going to playrooms with health problems. The illnesses associated with playrooms are mainly upper respiratory tract infections.

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26% of the respondents’ children have been injured in playrooms. Most were caused by the child falling over or running into another child.

Conclusions: The majority of respondents claim that they were not made aware of the rules upon entering the playroom, but that these were displayed in a visible place on the wall. just under half of the respondents have heard an employee verbally refer to the rules or noticed them helping a child resolve a problem. Less than half of the respondents have noted problems with hygiene and safety and associate health problems with playrooms. One third of the respondents’ children have been injured in playrooms.

Keywords: children’s safety, hygiene conditions, playrooms.

STATE OF KNOWLEDGE AND THE PREVALNECE OF ACNE (ACNE VULGARIS) AMONG YOUNG PEOPLE IN KLAIPEDA (LITHUANIA)

Authors: Aistė gudžiūnaitė, Agnė Červonikovaitė, Samanta Sokolovaitė

Scientific research supervisor: gražina Šniepienė

Klaipeda State University of Applied Sciences, Lithuania

Aim: To analyze young people’s state knowledge about acne, their skin condition and skin care habits.

Methods: A quantitative survey was carried out, a validated questionnaire was used and the data collection method was applied - a written survey. The study was conducted among 264 young people in Klaipeda, aged 18 to 25 years. The data was processed using the SPSS software data package. The results of the statistical analysis are presented in charts using the Microsoft Excel program.

Results: 50.6% of the respondents had mixed facial skin, 11.5 % - oily, 14.9 % - dry, 9.2% - normal, 8.8% - sensitive, and 5% could not determine. for most of the respondents, face skin is prone to excessive sebum secretion, redness and dryness. 42.2% of the respondents are trying to reduce acne symptoms at home. 30.5% – believes that the sun obviously improves skin condition, 23.4% feels that it worsens the condition of the skin, and 25.3% feels that there is no significant effect. Respondents think that fast food, chocolate, saturated fat and spicy food provoke their acne.

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Conclusion: The study showed that acne occurred in 50.2% of young people, mainly in the face, back and decollete areas. Most respondents are solving their acne problems at home. Also, most respondents never used medicinal products for the treatment of acne damaged skin. According to the study, young people learn about acne, skin care and treatment from the internet. They lack professional knowledge of the factors causing acne and skin worsening factors.

Keywords: acne, young people, knowledge

COMMUNITY HEALTH PREVENTION IN THE FIELD BY NURSING STUDENTS

Authors: joycia Piquet, Téa Leresche

Scientific research supervisor: françoise Ineichen

Health High School in canton of vaud (HESAv), Lausanne, Switzerland

Background/Aim: Our area has vineyards classified as World Heritage Sites. Once per generation, since 1797, we celebrate and reward the best winemaker. It is an important traditional event for the area called: fête des vignerons. They welcomed 20 000 people per show in an arena during four weeks. Our Nursing school had been mandated as the “health partner”. Therefore, we had to build and apply a health promotion project to prevent some risks linked with the population.

Methods: We applied the green & Kreuter method to construct our project. The particularity is that we used the method in its full form from needs identification to application and evaluation. We worked with three different populations: elderly and people with reduced mobility in and out the arena, actors- volunteers of the show and young people to carry out drowning prevention. during three months, 60 students worked on the first phase: the project development. by groups of four students, we studied characteristics of our target population: epidemiology facts, physical environment, political, administrative and financial constraints. Among 16 projects, mandataries selected three. Then, we had two weeks before the event to finalize the implementation. finally, we launched and applied the three selected projects. We, 60 students and five teachers,

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worked each day of show so 21 days on four weeks and covered the event from 8:00 am to 2:00 am.

Results: The mandataries as well as the three-target populations of the projects were satisfied with the health promotion projects. Even if our projects seemed to be very well prepared and that we felt confident, when we confronted the project with reality, we realized that the gap between theory and reality was huge and that reality constraints had to be taken into account.

Conclusion: This experience had a dual impact, pedagogical and community. Nursing students have become aware of their roles in the community. They can transfer them to any situation. To go further, it would be interesting to transfer this model to another event to see if it suitable to such cultural events.

Keywords: cultural event, green & Kreuter method, health promotion, nursing bachelor.

STRENCO INTENSIVE PROGRAM: STUDENTS’ EXPERIENCES IN COLLABORATION AND COPRODUCTION IN MENTAL HEALTH

Authors: foteini dimitrakopoulou, Kalliroi dragomanovits, Eleni Petratou

Scientific research supervisor: Evanthia Sakellari

department of Public and community Health, University of West Attica, greece

Background: STRENcO Project is a 3 year Erasmus+ funded project which is based on coproduction and collaboration in mental health among students, academics, service users and practitioners. The project is a partnership between Trinity college dublin (Ireland): coordinating institution, Tampere University of Applied Sciences (finland), jyväskylä University of Applied Sciences (finland), University of Salford (UK), vIvES University of Applied Sciences (belgium) and University of West Attica (greece).

Aim: The aim of this presentation is to share students’ experiences about the first STRENcO Intensive Program (IP).

Methods: STRENcO Project focuses on the development of learning materials and digital resources that will be open source for professionals and the wider community. Part of STRENcO is to organize three Intensive Programs. The first IP took place at University of Salford in Manchester between 16–22 May 2018. The theme was about collaborative work and co-production in mental health. Students and academics from 5 HEIs mentioned above, alongside with service users and practitioners,

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came together in order to strengthen knowledge and working practices in mental health. during the IP methods such as brainstorming exercises, presentations and gamification were used as a way of learning about mental health and developing new ideas around it in a co-productive way.

Results: As participant students of the first STRENcO IP, we were able to understand the significance of co-production and collaboration in mental health between countries through new learning methods. In personal level, we gained theoretical knowledge about how mental health systems work, as well as study the system’s differences between greece and the other European countries leading us to the conclusion that greece has already integrated the collaboration of health service workers in health processes.

Conclusion(s): STRENcO is a program that helps students, academics, service users and practitioners from different countries to develop a coproductive way of working in mental health. More information about STRENcO can be found at www.strenco.eu.

Keywords: collaboration, co-production, Erasmus+, mental health.

THE POSSIBILITIES OF USING METAPHORICAL ASSOCIATIVE CARDS (MAC) AND CARDS FOR FAIRY TALE IN PSYCHOLOGICAL WORK WITH CHILDREN AND TEENAGERS

Author: Lebedev M.A., galkina g.d

Scientific research supervisor: butorin v.v.

Psychology and pedagogics department of Moscow State Academy of Physical Education (MSAPE), Russia

Annotation: the article describes a tool called metaphorical associative cards (MAc), in the context of the use in psychological work with children and teenagers. This tool can be used both in the diagnostic and in the therapeutic field. first, we would like to note a reduction in the time of formation of rapport with a client, as well as reliance on a visual image and a plot that facilitates the process of counseling. MAc and cards for fairy tale-making can be used both in individual and in group work.

Key words: MAc, metaphorical associative cards, cards for fairy tale-making, fairy tale-making, fairy tale therapy, art therapy, visualization, diagnostics of emotional states, rapport, psychology of childhood, adolescents.

Nowadays there is a wide choice of various techniques and the incentive of the materials, which are intended for expansion of an arsenal of the opportunities of the psychologist as standardized and projective. Such methods as pictural tests (“My family”, “The house, a tree, the person”, “A fantasy animal” and so forth), color tests (Lyusher and so forth) are

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received great popularity among projective methods, while is known less about the MAcK method in Russia though its popularity grows. [4]

There are more and more courses in work with MAc. The increasing number of experts in the field of consultation estimate using of this incentive material. Even the conferences are held which are completely devoted to use of MAc. [5]

Metaphorical associative cards are the tool which can be used in work with adults and with children too (the choice of a concrete pack, method and questions is of great importance), both in group, and in individual work. The first pack of MAc is appeared in 1975, and was published in 1985 in germany. [3] despite it, there are bases to see and other roots of MAc, for example, the symbolical systems are developing since Renaissance. [2] firstly, Lyubov Moshinskaya has begun to be engaged in promoting of the MAc method in Russia. She offered application of this method when rendering psychological assistance to people who suffered from the tragedy in beslan in 2004.

MAc can be different types, for example with subject images, with abstract images, with photos, there can be signatures and symbols at them. The psychologist and the head of Institute of practical psychology of Ayr Olga garkavets offered classification of packs of MAc by three types, which are subject, portrait and abstract. [6]

Work can be conducted both in opened (when the client chooses those cards which approach under the task given by the psychologist by himself), and in closed. It is possible to carry out work with one card or several. The MAc is given the chance of an accurate and fast round of resistance of the client, without resorting to rigid, traumatic for mentality methods.

Important observation of authors can be considered subconscious color elections which are often shown by both children and adult clients.

despite the task directed to the choice of certain plots, many clients subconsciously also choose cards in certain color scale that gives to the psychologist additional opportunities for the analysis of current emotional state.

Examples of techniques for working with MAc:

• The client is asked to choose a card that matches his emotional state, self-awareness; • The client is asked to make a picture of his life path (his past), using a sequence of maps and talking about it; • The client is asked to choose a card that resembles the person who has influenced in his current situation (possibly who has caused a traumatic experience, or important to him); • During working with a group, it is possible that everyone takes a card for himself or herself, which is close to mood, and then tells the others about the story he has seen. At the same time, other members of the group can comment on how these plots can be related to each other. An attentive psychologist gets the opportunity to create a picture of intragroup relations, without resorting, for example, to sociometry, which some psychologists consider as an unethical method.

A psychologist who uses an MAc has an advantage in therapeutic work. for example, he may not ask the question “What do you think can be done to change the situation?” but say differently: “choose a card that matches the problem situation”. Now select and draw a card, which depicts what can help you. This technique makes it easier for the client to understand the internal possibilities for action in life and can be used both in work with adults and for children. When working with children, cards can be used for fairy tale-making, when identification with a magic character or object is performed to enhance this state. According to our observations, this approach can also be relevant when working with students, including

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involved in sports, which has been tested when working with the MAc “greek Myths” (author – E. Morozovskaya, a psychologist and the MAcconsultant) and maps for fairy tale-making.

When working with children, one more component of work with the MAc appears. This is a diagnosis of not only emotional states and typological properties of the personality, but also the possibility of diagnosing the type of thinking, the development of imagination and intelligence. for example, at the request of students of lower grades to take a few cards and tell them a made-up story, you can track the peculiarities of thinking and the stage of its development. for example, pupils of the first and second grades of elementary school often describe the plots of each individual map, which does not have a logical connection. However, by the end of the elementary school, children are already creating clear logical sequences of a fictional tale. However, if it does not happen, a psychologist may give additional attention to a particular child. The described technique is not always suitable for MAc, but it is well suited for cards for fairy tale-making (as an example of such cards is the Stash of the good Wizard, released by Rech Publishing House in 2014. Thanks to the colorful illustrations, children create and tell stories with great pleasure. The same technique was successfully tested on university students). The author of maps for fairy tale-making is T. zinkevich-Evstigneeva, the founder of the Integrated fairy Tale Therapy Method and the International Institute for Integrated fairy Tale Therapy.

Another way to work with children is to use MAKs and cards for fairy tale-making in training activities, both with children and adults (teachers or parents). [1] for example, an emerging children’s team is given a task: everyone chooses a card, then they create and tell a story together, and it is necessary to keep within the allotted time. As variations, it may be suggested to choose several cards, choose a storyteller from the group or tell stories in turn, etc. The intervention of the psychologist is minimal. He tells the children the rules, makes sure that they do not fight and do not

create serious conflicts, and listens to the story. It is possible to identify children with leadership qualities, as well as to organize team building with such kind of work. In most cases, children who have a time-limited task, even in an unformed team, learn to negotiate with each other. This method especially interesting when working with sports teams.

Working with cards, the psychologist significantly reduces rapport time, which is especially important in a limited period or in a situation where it is not known how many sessions will be able to hold. visualization of images, visibility, client fantasy, guided by questions of a psychologist, allow you to create a model of the situation. [3]

A huge number of possibilities of using metaphorical associative cards and maps for fairy tale-making makes these tool a worthy choice of a psychologist looking for non-standardized, projective and at the same time effective ways of working in various situations. Some decks and techniques are great for working with children.

Sources:

zanina L.v. Technology support the viability of teachers /L.v. zanin, Mb Ingerleib // Scientific support of the system of staff development. 2017. №3 (32). URL: https://cyberleninka.ru/article/n/tehnologiya-podderzhki-zhiznestoykosti-pedagogov (reference date: 03.12.2018).

Kazantseva, E.v. Metaphorical associative cards as “Magical” psychotherapeutic practice // concept. 2017. №1. URL: https://cyberleninka. ru/article/n/metaforicheskie-assotsiativnye-karty-kak-magicheskayapsihoterapevticheskaya-praktika (appeal date: 03.12.2018).

Rasskazova, E.v. Metaphorical associative cards as a tool in the work of a practical psychologist (article) / URL: https://www.b17.ru/article/15482/

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Education program of Moscow institute of psychoanalises (Non-state private educational foundation of higher education) “Metaphorical associative maps in the work of a psychologist. Author’s classes” URL: http://inpsycho.ru/edu_all/lektorij/mak_v_rabote_psixologa._avtorskie_master-klassyi

The 5th international conference of the publishing house “genesis” “Metaphorical maps in the work of a psychologist. closing the circle “URL: http://www.knigi-psychologia.com/tsentr-obucheniya/konferentsiya-ifestival/konferentsiya-metaforicheskie-karty-v-rabote-psikhologazamykaya-krug/

MAc for professionals: Olga garkavets coaching course // URL: http:// garkavets.com/makprofi date of contact: 13/05/2019

ETHICAL PROBLEMS AND MORAL DISTRESS IN PSYCHIATRIC NURSING

Author: Marit Reier

Scientific research supervisor: Reet Urban

Nursing and Midwifery department, Tartu Health care college, Estonia

Background: Psychiatric nurses encounter unique ethical problems while providing care to mentally ill patients. Unresolved ethical problems can lead to nurses’ moral distress. There is a limited amount of available scientific information about psychiatric nurses’ experiences on moral distress and moral distress inducing ethical problems in psychiatric nursing. A better understanding of the topic would help psychiatric nurses to be aware of ethical problems and the impact of moral distress.

Aim: To describe moral distress experienced by psychiatric nurses and to describe ethical problems leading to moral distress in psychiatric nursing.

Methods: Theoretical literature review based on 15 peer-reviewed articles, two master’s thesis, one doctoral thesis and one diploma paper. Additionally, one web-based dictionary and materials from approved organizations were used.

Results: Psychiatric nurses experience moral distress in different levels and frequencies, depending on their working environments and culture in the wards. Nurses’ personal ideals and moral sensitivity play also an important role in developing moral distress. Psychiatric nurses experience

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moral distress through negative emotions, which may lead to depression and burnout syndrome. Nurses who experience moral distress are less satisfied with their work and may decide to leave their specialty. The main ethical problems that lead to moral distress in psychiatric nurses are related to practices of restricting patient autonomy and usage of restraints as well as concerns about stigmatization and discrimination against patients. Additionally, some ethical problems are related to difficulties in maintaining patients’ safety due to constraints deriving from nurses’ working environments.

Conclusion(s): Psychiatric nurses’ levels of moral distress and the frequency of experiencing moral distress situations vary among nurses. Moral distress inducing ethical problems derive from peculiarities of psychiatric nursing profession as well as from their general working environment. Moral distress experiences have a negative impact on psychiatric nurses’ mental health, job satisfaction and the quality of nursing care.

Keywords: ethical problems, moral distress, psychiatric nurses.

GAIT RECOVERY IN PATIENTS WITH SUBACUTE STROKE APPLYING KINISIFORO SYSTEM

Author: Svetlana Kravcoviene

Scientific research supervisor: vaida Piekuvienė

Klaipeda State University of Applied Sciences, Lithuania Palanga Rehabilitation Hospital, Lithuania

Background: Walking dysfunction occurs in more than 80 percent of stroke survivors. After applying different techniques of physiotherapy most of the patients are able to recover their walking ability, though this recovery is partial and remaining walking dysfunction causes difficulties in performing daily activities. In order to restore gait function robotassisted gait training is being used increasingly. However, according to some authors, the effects of robot-based therapy are comparable to those of regular gait training exercises with no clear advantages.

Aim: To evaluate the effects of different physiotherapy techniques on gait recovery in patients after stroke.

Methods: The subjects of the study were 12 stroke patients who underwent rehabilitation at Palanga Rehabilitation Hospital in 2019. The criteria for participation were: first stroke, subacute period, age 55-70 years, a score of 21 or higher of Mini-Mental State Examination, muscles strength of affected leg, grade ≥ 2–3. Patients were randomly assigned into two groups. first group received gait training with Kinisiforo System; second group – manual therapist-assisted gait training (over ground gait training exercises). duration of research was 3 weeks.

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Measurements: Manual muscle testing, Postural Assessment Scale for Stroke Patients (PASS), 10 meter walk test (walking speed, gait asymmetry, stride length, step width), Timed “Up and go” test, berg balance Scale, Wisconsin gait Scale for assessment of hemiplegic gait.

Results: The results showed that both gait training methods improved gait and balance. There was more change in trunk control and muscle strength in group I than in group II. After applying Kinisiforo System strength of plantar flexor muscles of the impact leg almost reach norm. Walking speed, stride length and gait symmetry in group I improved twofold compared to group II.

Conclusion(s): Results have shown that after gait training with Kinisiforo patients experienced a bigger improvement in gait. End-effector type robot-assisted gait training systems strongly influence changes in propulsion generation during gate cycle. The principle of elliptical motion insures better trunk control and influences change in gait symmetry. The above mentioned factor strongly influences change in walking speed.

Keywords: Kinisiforo System, over ground gait training, PT, stroke.

HIGH INTENSITY AEROBIC EXERCISE AND MOTOR MEMORY

Authors: Aiste Samsonaite, Amanda Rasiulyte

Scientific research supervisors: Rasa baceviciene, Laura Kyguoliene

University of Applied Sciences Panevezys, Lithuania

Background: The benefits of physical activity on brain function, brain health and cognition are well been demonstrated that an acute bout of exercise can positively affect cognition and declarative memory. The relationship between exercise and memory has been summarized in a literature and assertion that acute exercise having positive effects on long-term memory. New studies have reported that an acute bout of high intensity aerobic exercise can also improve motor skill learning. High intensity aerobic exercise amplifies offline gains in procedural memory acquired during motor practice.

Aim: The aim of this was to investigate the role of intensity exercise on motor skill learning.

Methods: fifteen healthy males and females 19,93 ±1,71 (Sd) years old were recruited in the study. We investigated the effects of high intensity exercise (200 squats) effect on the retention of a visuomotor accuracy tracking task. The subjects played a video game “ball sorting” on the gAMMA dynamographic platform. Errors and operating times of the tasks were recorded and monitored.

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Results: based on the results of gAMMA dynamographic platform we found that high-intensity exercise significantly (p<0,05) reduced the number of task errors from 21,7±10,0 to 9,9±7,6 and shortened the task execution time.

Conclusion: High intensity aerobic physical exercise improves motor memory.

Keywords: exercise, motor memory, video games.

COGNITIVE AND PSYCHOMOTOR FUNCTION OF YOUNG PEOPLE AFTER HIGH INTENSITY PHYSICAL EXERCISE

Authors: gedas Sakalauskas, Amanda Rasiulyte

Scientific research supervisors: Rasa baceviciene, Laura Kyguoliene

University of Applied Sciences Panevezys, Lithuania

Background: Studies show that physical activity due to accelerated metabolism, oxygen and blood flow, encourages changes in the human brain. It has been found that after a single physical load, processes in the brain cortex becomes more active and improves motor skills, motion learning, enhance memory, improves cognitive processes. Exercise increases attention and performance on cognitive task.

Aim: to determine the impact of physical activity on cognitive and psychomotor functions of young people.

Methods: The study involved health 15 young males and females aged 19.93 ±1.71 year. Participant’s cognitive and psychomotor functions were measured with Short Time Memory Test and Schedule tables with numbers test. Speed of visual searches was measured before and after high intensity (200 squats) physical exercise.

Results: Independent sample t-test and two – factor repeated measures ANOWA revealed that the high intensity aerobic exercise is impairing visual memory, but the response time is shortened, improves focus stability, change visual scanning and reduces task execution time.

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Conclusion: High intensity aerobic physical exercise decreases visual memory but has no significant effect on cognitive functions.

Keywords: cognitive and psychomotor function, exercise, memory.

PAIN NEUROSCIENCE EDUCATION AS A PART OF PHYSIOTHERAPY

Author: geitrin jansen1, 2

Scientific research supervisor: Eeva-Liisa Sibul3

1 Physiotherapy and Environmental Health department, Tartu Health care college, Estonia 2 The North Estonia Medical centre, Tallinn, Estonia 3 Tartu University Hospital, Estonia

Background: chronic pain is a widespread condition, which affects approximately 20% of the population. Today, physiotherapist is one of the health care specialists who needs to have a good understanding of chronic pain and its management. Pain neuroscience education might offer a new way in approaching chronic pain patients.

Aim: To give an overview about pain neuroscience education, its conduct, its affecting factors and it’s efficiency.

Methods: A theoretical overview of relevant scientific articles.

Results/Conclusion(s):

The modern treatment of chronic pain is based on a biopsychosocial model that takes into account the biological, psychological and social factors affecting the patient. There are three main mechanisms for explaining chronic pain: nociceptive, neuropathic, nociplastic. It is also important to know that one patient may have multiple pain mechanisms at the same time.

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There are still no clear and widely used guidelines for PNE. However, the following three points can be of guidance. first, to identify patients’ misconceptions about pain and redesign them. Second, make a person familiar with the biology of pain. Third, check out what was memorized earlier and how the patient understood it and set goals. The amount of time it takes for PNE may vary for each individual, depending on his previous knowledge of chronic pain and emotional state.

PNE is influenced by a number of placebo and nocebo factors including the beliefs of patients and physiotherapists, and the competence of the physiotherapist in communicating with the patient.

PNE has been found to have a long-lasting effect on catastrophizing and kinesiophobia, PNE has no significant effect on pain and disability.

Keywords: biopsychosocial, chronic pain, nocebo, pain neuroscience education, placebo.

THE INCREASE OF OBESITY IN THE ISLANDS OF PACIFIC OCEAN

Authors: Aurélie chavanne, valentine Portmann

Scientific research supervisor: françoise Ineichen

Health High School in canton of vaud (HESAv), Lausanne, Switzerland

Background: Obesity is a major health worldwide issue. In recent years, the increase in obesity rates among developed countries has been particularly significant, especially in Pacific Islands populations. Many causes have been identified and are helping to understand the rising incidence of obesity. These include the fast changes dues to the development of technology and industry, and the import of processed food. There is a rise of non-communicable diseases and comorbidities related to obesity.

Methods: In order to better understand this phenomenon, we chose to use it as the main issue of our end-ofstudy work (bachelor in Nursing). We learned about it by researching and analyzing various scientific articles. We also had the opportunity to do a nursing traineeship in the Pacific Ocean. We lived in Wallis and futuna for two months, where we worked in the area of prevention and in a dispensary.

Results: This traineeship enabled us to observe a significant lack of knowledge about health and a lack of compliance in a majority of the inhabitants. Nutrition is indeed a major problem, directly related to the rise in obesity rates. Moreover, the sedentary behavior rate has increased considerably since the arrival of new technologies. These observations are

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consistent with the research we have done before. Some articles point the existence of a “thrifty gene” that could explain part of obesity. We have also noted the usefulness of multidisciplinary support. good collaboration and good communication improve care and allow a direct impact on the patient’s health. We particularly noticed that the involvement of each health professional enables interventions to be carried out.

Conclusion: Obesity is a major problem in the Pacific Ocean islands, mainly because of the recent and rapid changes in their lifestyles. Thanks to interdisciplinarity, the various health promotion and prevention interventions are more numerous and demonstrate a growing impact on the health of the people of the Pacific Ocean islands. collaboration is essential when working on a public health issue, such as obesity.

Keywords: collaboration, obesity, comorbidities, health promotion and prevention, Pacific Islands.

FETAL MACROSOMIA'S EFFECT ON DELIVERY COMPLICATIONS

Authors: Ilze dupuža, Kristīne buķe

Scientific research supervisor: Natālija vedmedovska

department of Obstetrics and gynaecology, Riga Stradiņš University, Latvia

Background: fetal macrosomia is defined as birth weight above 4000g. This condition can only be confirmed after delivery, but it has an important relation with delivery complications.

Aim: The purpose of this study is to analyze how fetal macrosomia compared to normal fetal weight affects delivery complications and neonatal health.

Methods: A total of 1051 medical history cases of pregnant women and neonates who were delivered between january 2016 and december 2016 in Maternity Hospital of Riga were included in this study. SPSS version 23.0 was used for statistical analyses. Neonates were divided into 2 groups – with and without macrosomia. Neonates without macrosomia were taken for control group to compare delivery complications.

Results: In the study correlation was found with maternal risk factors associated with macrosomia - mean gestational age at delivery (P < 0.001), prolonged pregnancy (>42weeks) (P = 0.002), mean maternal weight at the beginning of pregnancy (P < 0.001), gestational weight gain (P < 0.001) and maternal gestational diabetes (P = 0.002). Also significant

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correlation compared to the control group was found between fetal macrosomia and polyhydramnion (P < 0.001), cefalopelvic disproportion (P = 0.005), uterine dysfunction (P < 0.001), need for episiotomy (P = 0.057) and intervention after vaginal delivery (P = 0.029). The study revealed that macrosomia affects the method of delivery (P = 0,001). Macrosomia correlated with greater blood loss during vaginal delivery (P < 0.001) and caesarean section (P = 0.022) compared with normal neonate weight group. Also fetal macrosomia correlated with neonatal health - low Apgar score at first minute (P = 0.026).

Conclusion(s): There is statistically significant correlation between fetal macrosomia and delivery complications after comparing with control group. It is important to preclude macrosomia’s risk factors. by carefully following the mother’s weight, controlling gestational diabetes and duration of pregnancy it is possible to avoid major macrosomia’s risk factors and it can improve the outcome of childbirth.

Keywords: delivery complications, fetal macrosomia, neonatal health.

COMPARISON OF TWO TESTING SYSTEMS FOR HPV GENOYTYPING AND EVALUATION OF CYTOLOGICAL CORRELATIONS

Author: fabian König

Scientific research supervisors: Romana Michenthaler, Karin gstinig

fH campus Wien and Wilhelminenspital, general Hospital, Austria

Background: The Human Papillomaviruses (HPv) are responsible for over 99% of cervical cancer cases, one of the most common types of cancer in women. Especially the high-risk (HR) genotypes 16 and 18, which are associated with 70% of these tumor diseases, hold high oncogenic potential. The screening of HPv displays an essential diagnostic tool for prevention of cervical cancer and linked precursor lesions. considering that HPv infections are usually transient and 10% of cervical cancer cases show HPv negative results, co-testing via PAP smears remains just as crucial.

Aim: The aim of the study is to compare the cobas®4800 HPv Test to the AmpliSens® HPv HcR genotype-titre-fRT PcR Test and evaluate their respective results to which degree they yield a similar outcome. furthermore, another objective is to estimate to which degree cytological findings correlate to the respective HPv result.

Methods: both methods are real-time PcR assays that work via hybridization of fluorescent labelled probes. The cobas assay is able to identify HPv 16 and 18 and detect twelve other HR-HPv genotypes (31, 33, 35, 39,

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45, 51, 52, 56, 58, 59, 66 and 68), pooled as OTHER HPv. On the other hand, the AmpliSens test is able to identify all of these HPv genotypes.

Results: In 118 of 127 cases both testing systems showed compliant results; these findings are considered significant with a p-value of 0.3 using a binomial test. HPv 16 and other HR-genotypes displayed clear correlations to precancerous lesions while HPv 18 was underrepresented. HPv 16, 51, 31, 56 and 66 represented the highest prevalence in this order.

Conclusion(s): After statistical analysis, both the cobas and the AmpliSens test showed similar enough results to be considered representative in diagnosing HvP physical status. cytological correlations to common high-risk genotypes emphasize the importance of co-testing and not solely relying on HPv testing. furthermore, a distribution of HPv-HR genotypes in vienna has been rendered with HPv 16, 51, 31, 56 and 66 being the most common types.

Keywords: cervical cancer, genotyping, HPv, precancerous lesions.

POSSIBLE REASONS RELATED TO NON-PARTICIPATION DURING BREAST CANCER SCREENING AMONG ESTONIAN WOMEN

Author: Marilyn Koor1

Scientific research supervisors: Kadi Lubi1, Taisi Kõiv2

1 Health Education center, Tallinn Health care college, Estonia 2 Public Relations and Health Promotion department, Health Insurance fund, Estonia

Background: breast cancer is the most commonly occurring cancer in women and the second most common cancer overall. Mammography is the best way to detect breast cancer in its early stages. In 2014 around 26 million European women were invited to population-based breast cancer screening in Europe and only around 16 million women were screened.

Aim: the aim of the research is to give an overview about the reasons for not participating in breast cancer screening on the example of health insured Estonian women aged 50-69 years.

Methods: This research is empirical research in which five semi-structured interviews were conducted and transcribed verbatim. Interviewees were selected according to the following criteria: women gender, age 50-69 years, Estonian- speaking, health insured, has received an invitation for breast cancer screening and has not participated in breast cancer screening for the past 3 years. The interviewees were found using both the convenience sampling and the snowball sampling methods. The

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interviews were coded and based on the results, a thematic text analysis was performed.

Results: The interviewees’ responses showed that despite their unhealthy habits, their self-assessment to their health status is positive and it has an effect and role for non-participation during breast cancer screening. Their habits to visit a doctor are affected by their childhood experiences and are associated with having certain symptoms. Interviewees’ knowledge about breast cancer risk factors is vague, which, together with practical barriers such as logistical problems and lack of time, has also affected their decision to participate in breast cancer screening.

Conclusion(s): In addition to the information above, it can be concluded that the concept of disease prevention through a regular health check without any specific complaints is still unfamiliar to the interviewees.

Keywords: breast cancer, knowledge, participation, risk factors, screening.

THE SPECIFIC EFFECT OF STAT3 ISOFORMS ON ACUTE MYELOID LEUKEMIA CELLS AND THEIR INTERACTION WITH MURINE ENDOTHELIAL CELLS

Author: carmen Marita Schweicker1, 2

Scientific research supervisors: dagmar Stoiber-Sakaguchi 2,3,4, Petra Aigner3, Martina Stöckl1

1 University of Applied Sciences, fH campus vienna, Austria 2 Institute of Pharmacology, center for Physiology and Pharmacology, Medical University of vienna, Austria 3 Ludwig boltzmann Institute for cancer Research, vienna, Austria 4 department Pharmacology, Physiology and Microbiology, division of Pharmacology, Karl Landsteiner University of Health Sciences, Krems, Austria

Acute myeloid leukemia (AML) is one of the most common and aggressive leukemia in adulthood affecting annually around 3.7 people per 100,000 inhabitants throughout Europe. despite intensive treatment, the survival rate of AML patients over 70 years of age is only around 10% within five years after diagnosis.

Signal transducer and activator of transcription 3 (STAT3) is an essential transcription factor and thus of fundamental importance for the development, survival, proliferation and migration of cells. An increased STAT3 expression has been observed in AML patients and has been associated with both the development and adverse course of the disease. Although STAT3 is mainly known for its oncogenic effect due to continuous activation of the isoform STAT3α, recent research has shown its ability to function as a tumor suppressor in various cancer types. The c-terminal

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shortened version STAT3β acts as tumor suppressor and fulfills various transcriptional mechanisms in a STAT3α-independent manner.

fetal liver stem cells from STAT3 wild type, STAT3β transgenic, homozygous STAT3β knock-out (Δβ/Δβ) and heterozygous STAT3α (Δα/+) c57bL/6j mice were transformed in a previous project with the well-described AML oncoprotein MLL-Af9 and utilized in this study for various in vitro assays. In order for AML cells to enter the bloodstream and the surrounding organs in vivo, cells must migrate through multiple endothelial cell layers. To investigate whether AML cells change their proliferation and receptor expression upon contact with endothelial cells, the AML cells were kept in co-culture with murine endothelial cells.

A significantly reduced proliferative behavior of STAT3 Δα/+ AML cells was confirmed by growth curves via flow cytometry, fluorescence-dye based proliferation assays and cell cycle analysis via 7-AAd viability staining. After co-culture, significantly more AML cells were in active proliferation phase and the expression of L-selectin necessary for cell migration was upregulated in all STAT3 cell lines. The expression of the stem cell receptor cXcR4 was comparable in all cell lines and cXcR4 mRNA expression was significantly down-regulated after co-cultivation. Slightly increased migration, analyzed via transwell assays, and proliferation was detected in STAT3 Δβ/Δβ AML cells, indicating a tumor suppressive effect of STAT3β.

Keywords: acute myeloid leukemia, STAT3, MLL-Af9, tumor suppressor.

IDENTIFICATION OF CAF (CANCER ASSOCIATED FIBROBLASTS) – DERIVED FACTORS LEADING TO MAPK ACTIVATION IN COLON CANCER CELLS

Author: Lena Hohl

Scientific research supervisor: Helmut dolznig

Institute of Medical genetics, Medical University of vienna, Austria

Background: colorectal cancer (cRc) is the third most frequent malignancy in men and women and one of the leading causes of tumor-related deaths. In the past, experimental evidence has shown that progression of cancer does not depend exclusively on individual characteristics of the tumor cells but is also strongly affected by the tumor microenvironment (TME). cancer associated fibroblasts (cAfs) are major contributors to the cellular TME and promote oncogenesis by providing cancer cells with numerous growth factors, which in turn activate several pro-survival and other pro-tumorigenic signaling pathways. MAPK signaling represents a crucial pathway in regard to cancer. However, it has not been established yet how cAfs are activating MAPK in cRc cells.

Aim: conclusively, the aim of this study was to identify signaling pathways induced by cAfs or paracrine factors produced by cAfs that lead to MAPK activation in cRc cells.

Methods: A medium throughput cellular screen via an In-cell Western assay (IcW) was conducted. A kinase inhibitor library targeting 378 kinases was utilized. Phosphorylation of ERK was examined as a representation of the activated signaling cascade.

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Results: Indeed, we were able to show ERK activation in cRc cells induced by cAfs. More interestingly, we detected several kinases and identified potential upstream growth factors, which might be responsible for ERK activation in cRc cells, the most promising being Aurora kinase b, c- Met, vEgfR, PI3K, mTOR and chk 1.

Conclusion(s): Although the IcW was validated as a highly applicable assay for our approach, further investigation of the detected candidates conducting different assays is recommended. Nevertheless, the results presented in this thesis could reveal novel targets for colorectal cancer therapy in the near future.

Keywords: colorectal cancer, In-cell Western assay, kinase inhibitor library, MAPK signaling, tumor-stroma crosstalk.

DETERMINATION OF HIGH SENSITIVE C-REACTIVE PROTEIN IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS AND IT'S SENSITIVITY TO IRON STORAGE PROTEIN – FERRITIN

Author: Heneli Ristisaar1

Scientific research supervisors: chris Pruunsild2, Mai Treial1, 2

1 Radiography and biomedical Laboratory Science department, Tartu Health care college, Estonia 2 Tartu University Hospital children’s clinic, Estonia

Background: In recent years, according to the data of the Tartu University Hospital’s children’s clinic and the Tallinn children’s Hospital, an average of 250‒270 new juvenile idiopathic arthritis (jIA) cases have been diagnosed annually. jIA is the most common chronic rheumatic disease in childhood, which may cause incapacity for work at a later age, which is why diagnosis and treatment should be as fast and accurate as possible. various inflammatory markers are used to monitor jIA activity.

Aim: The aim of the thesis was to examine whether there is a difference between the jIA subtypes in the mean value of the high sensitive c-reactive protein (cRP-hs) and/or ferritin, and their possible predictive role in the progression of the disease.

Methods: A total of 150 jIA patients who visited pediatric rheumatologist at the Tartu University Hospital’s children’s clinic from january 8th to May 31th, 2018, were included in the research and their blood sample was collected. cRP-hs was measured by photometric method and ferritin

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by electrochemiluminescence-immune method. The biomarkers in three different subtypes were statistically analyzed with Welch Anova test and correlation between two markers with Spearman rho test. A p value of < 0.05 was considered statistically significant.

Results: Of the seven jIA subtypes oligoarthritis (persistent, extended) and seronegative polyarthritis were the most frequent ones. In 3‒15-yearold age group statistically different cRP-hs mean values were determined between persistent and extended oligoarthritis (p=0,047). The mean cRP-hs values for extended oligoarthritis and seronegative polyarthritis were higher in 3‒15 and 16‒19-year age groups compared with persistent oligoarthritis. There was no statistically significant difference in the values of ferritin, but higher mean values were observed in patients with seronegative polyarthritis and extended oligoarthritis. These subtypes are considered to be clinically alike and more aggressive at the onset of the disease. No significant correlation was found between the two biomarkers.

Conclusion(s): Persistent and extended oligoarthritis present differently clinically and by mean cRP-hs values as well. determination of ferritin gives more information of disease activity in aggressive jIA subtypes - seronegative polyarthritis and extended oligoarthritis.

Keywords: ferritin, high sensitive c-reactive protein, juvenile idiopathic arthritis.

EXPERIENCE OF PATIENTS LIVING WITH HIV/ AIDS OF NURSING CARE THEY RECEIVE

Author: Rael Helminen

Scientific research supervisor: Marjo Palovaara

jAMK University of Applied Sciences, finland

Human Immunodeficiency virus (HIv) is a global pandemic. In 2017 36.9 million people were living with HIv and 1.8 million people became newly infected globally according to the World Health Organization (WHO). In this thesis an investigation on HIv patient’s experiences was conducted through literature review. The aim of the study was to inform the nurses about their care that possibly influences the experiences of HIv patients. The scope of the study was limited to finland, and guided by research questions from the experiences of HIv patients with nursing care givers. In finland, 4,000 people live with HIv and 200 new infections are reported annually. finland has the lowest number of HIv patients compared to the rest of the world. In general, HIv-related deaths decreased by 38% between 2000-2017 globally, in large part because more people globally have access to antiretroviral therapy (ART). About 20.9 million patients had received ART by mid-2017. It was found out that HIv/AIdS patients faces stigmatization, not only from the society, but also from the nursing care professionals. The study therefore recommends generic guides for treatment and management of patients living with HIv/AIdS. It also reiterates the role of nurses and other care givers to ensure that they not only cover medication, but also assist in providing counseling and other acts of compassion to both infected and affected patients and their families.

Keywords: HIv/AIdS, nursing care, patient experience, stigmazation.

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THE EFFECT OF DIFFERENT PHYSIOTHERAPY METHODS ON PAIN, DAILY PHYSICAL ACTIVITY AND SEDENTARY LIFESTYLE ASSOCIATIONS WITH INFERTILITY TREATMENT AND PREGNANCY OUTCOMES AMONG COUPLES ENTERING ASSISTED REPRODUCTIVE PROCEDURES

Authors: Siret Läänelaid1,2, Theodora Kunovac Kallak3, Salih joelsson, L.3 ., jonatan R. Ruiz4,5, Edward j. davey, E3 ., julus Hreinsson3, Kjell Wånggren3, Anneli Stavreus Evers3, Ruth Kalda1 , Andres Salumets6,7,8 , francisco b. Ortega4,5, Signe Altmäe7,9

Scientific research supervisors: Ruth Kalda1, Andres Salumets 6,7,8, Signe Altmäe 9

1 University of Tartu, Institute of family Medicine and Public Health, Estonia 2 Tartu Health care college, Estonia 3 Uppsala University, department of Women’s and children’s Health, Sweden 4 University of granada, department of Physical Education and Sports, Spain 5 Karolinska Institutet, department of biosciences and Nutrition, Huddinge, Sweden 6 Tartu University Hospital, Women’s clinic, Estonia 7 competence centre on Health Technologies, not applicable, Tartu, Estonia 8 University of Helsinki and Helsinki University Hospital, department of Obstetrics and gynecology, finland 9 University of granada, department of biochemistry and Molecular biology, Spain

Background: Several factors affecting ART success, such as age and individual’s genetic background are non-modifiable, while there is emerging evidence that different modifiable factors including nutrition, PA, sedentary lifestyle can influence ART outcomes. PA has been associated with reproductive outcomes in men and women, however it is not clear to what extent PA could help or harm infertility treatment outcomes. further, previous studies have focused on assessing PA using self-reported questionnaires, which have several limitations and there is a need to assess PA and sedentarism with objective tools in order to clarify the impact of PA on infertility and its treatment.

Aim: To describe who physical activity (PA) and sedentary lifestyle influence infertility treatment and pregnancy outcomes among couples entering assisted reproductive procedures?

Methods: This study was carried out among 128 individuals, 64 women and 64 men, entering for the first-time infertility clinic for ART procedures. The data were collected from the centre for Reproduction at Uppsala University Hospital, Sweden between february 2011 and january 2014.

baseline PA and sedentary time (before entering any treatment) were assessed using an objective method - accelerometry for seven consecutive days and additionally by self- reported questionnaires. for every couple the infertility treatment and pregnancy outcomes were recorded. The sedentary time and PA were compared with the general Swedish population group (n=1172 individuals) data. Pearson’s correlation and logistic regression models were used for data analyses.

Results: In general, the couples, entering infertility treatment were more active (moderate or high intensity PA in women was 47,0 ± 16,8 min/day and men 48,0 ± 16,8 min/day) compared to the general Swedish population (women 36 ± 3 min/day and men 41,0 ± 4 min/day respectively).

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However, they had recorded more sedentary time (women 683,5 ± 80,8 min/day and men 709,1 ± 65,0 min/day) than the general Swedish population (women 486 ± 11 min/day and men 497 ± 13 min/day respectively). Among our couples undergoing infertility treatment, the mean sedentary time of women was lower than that of men, while moderate or high-intensity PA was higher in men.

When comparing the couples, these couples who underwent ART procedures (Ivf, IcSI, or IUI) were physically less active (less high-intensity PA) and were more sedentary (watched more Tv) than these couples who did not need ART (after revisions became spontaneously pregnant or mild ovarian stimulation was performed) (p<0,05). Nevertheless, in the present study we did not detect any significant impact of couple’s PA and sedentary time on infertility treatment and pregnancy outcomes.

Conclusion(s): couples undergoing ART are likely to be less physically active and more sedentary. Nevertheless, our study results do not show any effect of PA and sedentary time on infertility treatment and pregnancy outcomes indicating that there is no need to change couple’s activity habits before entering ART procedures.

Keywords: assisted reproductive technology (ART), infertility, physical activity, pregnancy outcome, sedentary time.

EFFECT OF HIGH-INTENSIVE INTERVAL TRAINING ON CHANGES OF BODY COMPOSITION, CARDIORESPIRATORY FITNESS, ENDOTHELIAL FUNCTION AND BLOOD BIOCHEMICAL MARKERS IN OBESE BOYS

Author: Marit Salus1,2

Scientific research supervisors: jaak jürimäe1 , vallo Tillmann3

1 University of Tartu, faculty of Medicine, Exercise and Sport Sciences, Estonia 2 Physiotherapy and Environmental Health department, Tartu Health care college, Estonia 3 University of Tartu, department of Pediatrics, Estonia

Background: Obesity is a common health problem in childhood and is the risk factor for cardiovascular diseases (cvd) later in life. for example, being overweight and obese is inversely associated with physical activity and fitness. Lower cardiorespiratory fitness (cRf) has been associated with higher levels of inflammation markers and endothelial function is characterized by maximal oxygen consumption in men. The use of time effective high-intensive interval training (HIIT) to reduce the risk factor for cvd and body weight, improve cardiorespiratory fitness, endothelial function and improve health parameters has become popular during last years in overweight and obese adults. However, there are no short-term intervention studies performed in obese boys which have investigated these short-term associations.

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Aim: To investigate the effect of HIIT on body composition, cardiorespiratory fitness, endothelial function and blood biochemical parameters in boys with obesity. As this study is still in the beginning phase, the aim of this abstract is to give a brief overview of the study- methods for estimating causal effects and potential outcomes.

Methods: boys with obesity (12-16 years old) will randomized into a 12-week intervention as follows: (1) HIIT [6 x 30-seconds bouts at ‘all out’ sprints, interspersed with 4 min of active recovery, 3 times/week]; (2) control group. cRv is quantified through a maximal exercise test (vO2peak) while body composition is assessed using dual-energy X-ray absorptiometry (dXA). blood samples will be analyzed for serum fasting lipids, insulin sensitivity and biomarkers of inflammation. Endothelial function of the brachial artery will be measured via vascular function using high-resolution vascular ultrasound.

Results: for the year or 2022 we hope to get results that will show the efficacy of HIIT on increasing cRf, reducing adiposity, having a positive effect on inflammation markers and to endothelial function in boys with obesity.

Conclusion(s): from the results we hope to conclude that short-term intervention leads to improvements in various markers of cardiometabolic health.

Keywords: body composition, high cardiorespiratory fitness, intensive interval training, obese and overweight boys.

RECONSIDERING THE MEANING OF HEALTH LITERACY

Author: Inga Ploomipuu1

Scientific research supervisors: jack Holbrook2, Miia Rannikmäe2

1 Physiotherapy and Environmental Health department, Tartu Health care college, Estonia 2 Science Education centre, University of Tartu, Estonia

Background: Keeping pace with many new health-related challenges and developments nowadays becomes important for everyone. frenk et al. (2010), concerned with the fragmented, outdated and static health care curricula, suggest that a thorough re-examination of health education is needed. They suggest that the current competences of health care professionals do not cope with 21st century challenges. Enhancing health literacy (HL) for all, as the goal for health education, is seen as a potential answer (WHO, 2013), through promoting health education at all educational levels (Hansen et al., 2015).

Aim: To redefine HL with respect to this becoming the goal for health education as scientific literacy is seen as the goal for science education.

Methods: critical review of the literature over last 30 years (>200 papers, 70 journals, 19 books/documents), until concept saturation (33 sources) for developing a model of HL. The literature was chosen on the basis of its contribution to the concept (influence, citations) and originality.

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Results: Literature definitions of HL range from knowledge and skills to more value-orientated components, focusing on the general public rather than professionals. HL and health education are meaningfully interrelated in a similar manner to the way scientific literacy can be seen as encompassing science education. The proposed model shows that HL is the target for health education just as scientific literacy is the target for science education. being largely based on and subsumed within scientific literacy, HL has a meaningful component independent of science education conceptualisation and scientific literacy with respect to attitudes, values, mind-set and specific skills as described in the revised definition.

Conclusion(s): A revised definition of HL is suggested as: Health literacy is a person’s knowledge, motivation and competences to access, comprehend, appraise and apply health information in order to make judgements and socially responsible health decisions, possessing positive attitudes, values, mind-set and skills, plus an overall capability to cope and thrive in contemporary health-related issues in everyday life, as well as professional settings, considering ethical, social, psychological, philosophical and cultural aspects of one’s actions.

Keywords: health education, health literacy, science education, scientific literacy.

PHYSICAL ACTIVITY, BODY COMPOSITION AND SLEEPING DURATION AND ASSOCIATIONS BETWEEN THEM IN 6–8 YEARS OLD CHILDREN FROM TARTU IN TRANSITION FROM KINDERGARTEN TO SCHOOL

Author: Kersti Undrits

Scientific research supervisor: Eva-Maria Riso

Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia

Aim: The aim of the Master’s thesis is to objectively evaluate the activity of children, body composition and sleep time, and to find the connections between them in the 6–8 year-old children of Tartu during the transition from kindergarten to 1st grade.

Methods: This Master’s thesis is part of the study “Objectively measured physical activity and capacity of Tartu´s 6–8 years old children”. data was collected from 147 children, 75 of whom were boys and 72 were girls. children aged 6 to 8 years were enrolled in this study. children were assessed for physical activity with an accelerometer, sleep time and exercise activity was measured on the basis of a movement diary, physical ability with various tests, anthropometric indicators, and four skin fold thicknesses. The analysis of the data focused mainly on sleep patterns and its changes based on different characteristics.

Results: during the transition period from kindergarten to school, the average hours of sleepers and non-sleeper did not change statistically. children who slept normal hours (≥10 hours) were 52 in kindergarten and

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55 children in first grade. There was no statistically significant difference in the average sleep time during the transition from kindergarten to firstclass children, but the average workday sleep time was different. While in the first grade, the children slept more on weekdays than at the kindergarten. In the kindergarten the sleeping time was on average 575±41 minutes on weekdays and 614±58 minutes in the first grade. There was no statistically significant difference in body weight between kindergarten and first grade normal hour sleepers (≥10 hours) and children who slept under normal hours (<10 hours). In the kindergarten, those who did not fulfill the MvPA norms slept on average longer than the ones that fulfilled the norm. No such difference was measured in the first grade.

Conclusion(s): The results of this Master’s thesis show contradictory results in previous studies. for example, there are statistically significant changes in sleep time when children go to school. first graders were having more sleep time than in kindergarten.

Keywords: children, physical activity, sleep duration, transition to school.

TARTU JAAN POSKA GYMNASIUM`S 11TH GRADE STUDENTS`AMBULATORY ACTIVITY LEVELS, SLEEP DURATION AND SCREEN TIME ANS ASSOCIATIONS BETWEEN THEM

Author: Märt Riso1 ,

Scientific research supervisors: Triinu Palo1 and Eva-Maria Riso2

1 Tartu jaan Poska gymnasium, Estonia 2 Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia

Aim: The aim of this study was to assess the physical activity of the 11th grade students of Tartu jaan Poska gymnasium using pedometers and evaluate the sleep duration and screen time using self-reported data and to examine the associations between these parameters.

Methods: Seventy nine students from 11th grade (39 boys and 40girls) agreed to participate in this study. Seventy five students provided valid pedometer data. The average number of steps and active minutes of all measured days, schooldays and weekend days were registered by using pedometers. The participants of study filled the log diary of physical activity (Appendix 1). The mean values of measured variables were found. The group means were compared using Student’s t-test for independent groups. Pearson bivariate correlation analysis was used to examine associations between measured variables. chi-square statistics was used to compare categorical values.

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Results: The average step number during week, on schooldays and on weekend days was accordingly 7955±2351, 8560±2359 and 6420±3537 steps daily. The number of active minutes during week, on schooldays and weekend days was accordingly 39±22, 40±21 and 30±29 minutes daily. The number of steps on schooldays and on weekend days did not differ significantly. Twenty two percent of study participants met the recommendations of 10000 steps daily. Average sleep duration during schooldays was about 7.5 hours and screen time was about 4 hours daily. Positive correlation was found between step number and number of active minutes. Screen time on schooldays and weekend days correlated positively also.

Conclusions: The physical activity of the 11.grade students of jaan Poska gymnasium is rather low. Sleep duration on schooldays was too low for evaluated age group. The pursuits of screen time have to be checked among gymnasium students.

Key words: gymnasium students, number of active minutes, number of steps, physical activity, screen time, sleep duration.

PHYSICAL ACTIVITY IN ESTONIAN SCHOOLCHILDREN OF DIFFERENT AGE

Author: grete Udras

Scientific research supervisor: Eva-Maria Riso

Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia

Aim: The aim of the work was to compare physical activity in Estonian I, II and III school level schoolchildren and investigate whether there a relationship between physical activity and body mass index (bMI) in normal and overweight schoolchildren.

Methods: 500 schoolchildren from I, II and III school level were recruited from 13 randomly selected schools in Estonia: 287 from I school level (1.-3. grade; 142 boys, 136 girls), 211 from II school level (4.-6. grade; 96 boys, 115 girls); 54 from III school level (7.-9. grade; 22 boys, 32 girls). In addition to anthropometrical measures (body height, body mass and bMI) in each student physical activity was determined over 7 continuous days using an accelerometer. Students physical activity was registered as time spent in different intensity zones: sedentary time (SEd), light physical activity (LPA) and moderate to vigorous physical activity (MvPA). furthermore, the percentage of students reaching the MvPA standard of WHO was determined for each school level.

Results: The MvPA standard was reached by 60% of the I school level students, 36% of the II school level students and 32% of the III school level students. The percentage of overweight schoolchildren was 31%

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in the I school level, 26% in the II school level and 25% in the III school level. boys were more active in the MvPA zone than girls irrespective of the school level. girls and boys showed no differences in LPA zone in the I and II school level, whereas in the III school level boys were more active than girls. There were no differences between boys and girls in time spent in the SEd zone, irrespective of the school level. SEd time was negatively associated with MvPA in I and III school level. No significant associations were found between bMI and physical activity indices in any school level.

Conclusions: With an increasing age physical activity decreases and time spent in the SEd zone increases in children and youth, which leads to a higher percentage of overweight students. As obesity may cause various diseases, the current findings suggest that physical activity in Estonian children and youth is not sufficient in order to assure good health and normal body weight. It could be shown that overweight children and youth may not be always less active than their normal weight counterparts.

Keywords: bMI, normal weight children, overweight children, physical activity, schoolchildren.

THE EFFECT OF ALCOHOL TRADE FROM LATVIA TO BUYING HABITS AND CONSUMPTION PATTERN OF ESTONIANS

Author: Tuuli Muistna1

Scientific research supervisor(s): Anna-Liisa Tamm1, Ülle Parm1, Aivar voog2

1 Physiotherapy and Environmental Health department, Tartu Health care college, Estonia 2 Kantar Emor, Estonia

Background: consumption of alcohol in Estonia has decreased probably due to excised taxes during last years. This has lead Estonians to buy more alcohol from the neighboring country Latvia.

Aim: The aim of this study was to examine how the cross border trading impacts Estonians’ buying and drinking habits.

Methods: Study was conducted in collaboration with Kantar Emor Research company. Web-based questionnaire was carried out 5 times in 2016-2017 among Estonian inhabitants (n=33000; 18-74y). The study group involved subjects reflecting Estonian population according to gender, ethnical, age groups and living regions. differences in proportions were compared using chi-square test.

Results: 5519 participants (♀=52%; Estonians=68%) were enrolled (first to the fifth 495, 802, 1715, 1440, 1067, respectively). 16% of the study group did not buy or use any alcohol and this number did not change during study period. In december 2017 compared to december 2016, the

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number of alcohol buyers from Latvia increased more than 100% (from 16% to 41%). South Estonians (92%) were the most frequent buyers in december 2017 and North-East Estonians (26%; p≥0.01) were rare buyers. Purchases were not associated with sex, age or income. Most frequently alcohol buyers were enterprisers (75% of them) in comparing with all other professions (p≥0.01) and retired people (p=0.04). Results of this study showed that buying is not associated with consuming, because for example frequent buyers (people from Tartu) consume less alcohol than others – probably they resell or store it for future events.

Conclusion(s): Excised tax or accessibility of a low-priced alcohol from neighboring country does not affect Estonian’s alcohol purchase. final conclusions about changes in consumption habits cannot be made due to a short study period.

Keywords: alcohol policy, border trade, public health.

WORKAHOLISM IN THE WORK OF A MASSAGE THERAPIST – A PILOT STUDY

Authors: Marta dupkevica, Liene Krauze-Luste

Scientific research supervisors: Sandra Seimane1,2, Evija Levensteina1,2

1 Riga Medical college of Latvian University, Latvia 2 Riga Eastern Hospital clinic gailezers, Latvia

Background: Workaholism was first conceptualized in the early 1970s as a behavioral addiction, featuring compulsive use and inter-personal conflict (Quinones & griffiths, 2015). It is one of the most common forms of modern dependencies in many Western countries, with especially high risk for workers of Health care (Molino, cortese, & ghislieri, 2018). It is determined by possibility to work more hours, intensive communication with clients and by continuous physical effort (gillet, Morin, cougot, gagne, 2017).

Aim: To explore the tendency of workaholism between the massage therapists.

Methods: A prospective study was conducted collecting data from massage therapists working in medical services – health centers, rehabilitation centers, Spa centers and massage salons. They all filled out online The bergen Work Addiction Scale, 2012. It consists of 7 Likert type questions, scored from 1 to 5 (never to always). Score 4 (Often) or 5 (Always) on 4 or more of these 7 statements may suggest about workaholism. There were included demographic data, and questions about employment and work experience as well.

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Results: This quantitative study was based on a self-assessment questionnaire. data were collected from 93 massage therapists – 86% (n= 80) women, 14% (n=13) men. The mean age of participants was 36.7, with youngest 21 and oldest 66. The mean working experience was 6,6 years, with range from 1 to 48 years. 2/3 of total massage therapists (61.3%) choose to select their own working hours. 12% of surveyed massage therapists are with workaholic tendencies, with cut-off scores on at least 4 of 7 symptoms of work addiction. All work addicted are women. Results revealed that 43% of all participants spent more time working as initially intended, workaholics deprioritized hobbies, leisure activities and exercise because of work.

Conclusion(s): due to the shortcomings of the sample the results of the study cannot be generalized yet. Woman should be more attended, as they are more prevalent in this profession in Latvia. Relatively high amount of massage specialists work too much hours.

Keywords: massage therapist, workaholic, work addicted.

BACK PAIN PREVALENCE AND ELATION WITH WORK AT STATE EMERGENCY MEDICAL SERVICE IN LATVIA

Author: Kintija Ivanova1

Scientific research supervisors: Evija Levensteina1,2, Sandra Seimane1,2

1 Riga Medical college of Latvian University, Latvia 2 Riga Eastern Hospital clinic gailezers, Latvia

Background: back pain is a common health problem in the workplace and most workers are expected to experience symptoms during their working life. Pain can lead to limitations in major life domains - work, social and recreational activities. Emergency medical service (EMS) workers are in very high risk in developing back pain as the job includes both – long sitting hours and physically hard work.

Aim: To determine the prevalence of back pain in EMS and its relation to working conditions.

Methods: A prospective study was conducted collecting data from State Emergency Medical Service in Latvia including doctors, paramedics and medical assistants with working experience at least 2 years. They all filled out the questionnaire with 15 questions. SPSS 22 was used for data processing, level of significance < 0.05.

Results: In the study 148 respondents took a part, 68% (n=100) were women and 32% (n=48) men. The mean age of participants was 37.52 (Sd±10,165) with range 21 - 60 years. The mean working experience was 9.91 (Sd±5.8918) years and 76% (n=112) are working as full time

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job. back pain fell 85% (n=125) respondents, 85% (n=106) connecting it with work conditions. Intensity of pain variants from mild in 10% (n=13), medium in 67% (n=84) and moderate in 22% (n=28) respondents. With statistically significant correlations (p=0.00) those who have pain are older (mean age is 39.2 (Sd±10.1)) comparing to those who don`t (mean age 28.2 (Sd±3.06)) and with larger working experience (mean 10.89 (Sd±5.75) years), and 4.65 (Sd±3.35) respectively. 28% (n=72) noted that back pain at work is provoked by wearing heavy bags, other 28% (n=72) by transporting patients with stretchers and 29% (n=74) believing that back pain at work is provoked by prolonged sitting.

Conclusion(s): Study showed that the vast majority of EMS workers suffer from back pain and it is provoked by working conditions. Pain appears early - mostly after the fifth year of work. There is need to find ways to reduce physical strain and preventive measures, otherwise the health of already understaffed EMS workers are damaged.

Keywords: back pain, EMS, pain.

THE IMPACT OF PHYSIOTHERAPY ON MOBILITY AND TRUNK CONTROL IN PATIENTS WITH THORACIC TRAUMA

Author: Aurelija grinevičienė

Scientific research supervisor: jurgita boltutiene

Klaipeda State University of Applied Sciences, Lithuania

Background: In case of thoracic trauma, people often experience paraplegia – diminish lower limb control and complete loss of trunk control. for these reasons people starts using a wheelchair and they need to learn how to use this compensatory technique and become mobile in order to integrate into the community. The tasks of the entire rehabilitation team are to solve these problems, however, the physiotherapist must perform the main task – strengthen the patient‘s muscles, restore trunk control, teach how to use wheelchair to make the person self-sufficient in all situations.

Aim: To determine physiotherapy impact to mobility and trunk control for people who experienced thoracic trauma.

Methods: Scientific literature analysis, testing – experiment, mathematic analysis.

Results: due to trunk control was improved person’s mobility also changed - after physiotherapy patient became independent, self-sufficient, able to self-serve, move and transfer.

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Conclusion(s): 1. Independent mobility is defined as autonomous movement without compensatory measures. 2. Results of the trunk control test show that physiotherapy has a significant impact on the restoration of trunk control. After 6 weeks of physiotherapy patient had developed trunk control. Also, according to the results of Wheelchair Skills Test Questionnaire, it was shown that after physiotherapy person had mastered. 3. The wheelchair (this is result of restoration of trunk control) changes in the condition of the person due to PT are also obvious – improved posture. 4. According to the results of the functional independence test, patient was dependent on the people around them, before physiotherapy and after physiotherapy patient became independent, self-sufficient, able to self-serve, move and transfer.

Keywords: mobility, physiotherapy, thoracic trauma, trunk control.

EFFECTIVENESS OF THERAPEUTIC EXERCISES ON LOWER BACK PAIN AND TO FUNCTIONAL STATUS OF SPINE

Authors: dmitri Kurganov, Triin Kont

Scientific research supervisor: Marit Salus

Physiotherapy and Environmental Health department, Tartu Health care college, Estonia

Background: Lower back pain (LbP) is one of the fastest-spreading musculoskeletal diseases in Europe and all around the world. It is estimated that 80% of people experience it once in their lifetime, and 7-10% cases of them become chronic. It is most common among people of working age and its emergence affects work ability, personal well-being and quality of life. If left untreated, it can worsen spine functional status (fS). Scientific background of LbP treatment suggests mostly therapeutic exercise program for longer time periods: at the mean for 6-8 weeks. The effectiveness of shorter training period than 6 weeks is still in doubt.

Aim: The aim of the intervention was to evaluate the effectiveness of 4-week period therapeutic exercises on relieving pain and improving fS of lower back.

Methods: Empirical study was carried out in which 5 people (4 females, 1 male; mean age 43.7±8.7 years; range 32 to 49 years) received therapeutic exercise program (2 training sessions per week; 60 minutes one training session) focusing on spinal mobility, core strengthening and stabilization exercises. Subjects were assessed using the visual Analog Scale

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(vAS) for LbP severity and SpinalMouse for fS of spine. Assessments were performed one week before and immediately after last therapeutic exercise session.

Results: Results showed improvement in average vAS value (4.6±0.72, 1.4±0.8, respectively) and also better average fS value in flexion (96.6°±12.32; 104.1°±7.52, respectively) and in extension (25.6°±7.36; 27.6°±9.12, respectively ) of spine after exercise program.

Conclusion(s): based on the obtained results, it can be concluded that a 4-week exercise program consisting of targeted therapeutic exercises alleviate LbP, increase mobility and improve fS of spine. The limitations of this study was the minority of subjects and also the lack of follow-up period. Even though, based on individual analyzes, this study shows that short-time period of therapeutic exercises can lead to improvements in LbP and in fS of spine.

Keywords: lower-back pain treatment, non-specific low back pain, therapeutic exercises.

THE IMPACT OF STABILIZATION AND DYNAMIC EXERCISES ON PAIN INTENSITY AND FUNCTIONAL CAPACITY FOR INDIVIDUALS WITH CHRONIC NECK PAIN

Author: Kamile Skruibyte

Scientific research supervisor: jurgita boltutiene

department of Rehabilitation, Klaipeda State University of Applied Sciences, Lithuania

Background: Neck pain episodes are healed by the special treatment, but about 50% of individuals still feel the pain which turns into chronic. In this fast moving world, more and more people are spending their time in sitting position, which means more than 50% of muscles are working in isometric position, which can lead to long lasting musculoskeletal disorder. Special exercises can improve pain intensity and functions of the neck, using active physiotherapy for individuals who suffer from chronic neck pain. It is one of the most leading causes why people lived with disability most of the years and this reason emphasizes the significance of researches, to determine effective treatment strategies based on the mechanisms of neck pain.

Aim: This research was carried out to evaluate stabilization and dynamic exercise programs impact on pain intensity and functional capacity for individuals with chronic neck pain.

Methods: Ten individuals with chronic neck pain participated in this research. They were included or excluded into research following criteria. Individuals, with chronic neck pain, vAS <6, NdI score >14 were included.

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Surgical intervention, pregnancy, history of neck injury, deformations in the neck, high blood pressure and vAS score >6 were exclusion criteria. Participants were randomly assigned into one of two intervention groups: neck stabilization exercise group (n= 5), dynamic exercise group (n= 5). Treatment was administered every other day for two weeks: five times in a hospital and five exercise days at home. variables were assessed at baseline and at the end of second week. Pain intensity rates were assessed using visual Analogue Scale (vAS), disability caused by neck pain was assessed using Neck disability Index (NdI), active range of motion was assessed using goniometer and deep cervical flexors endurance was assessed using Stabilizer Pressure biofeedback. data were analysed using mathematical analysis.

Results: There was no big difference in participants’ scores on pain intensity, Neck disability Index, cervical range of motion and deep cervical flexors endurance at baseline. At the end of the second week, scores for pain intensity were less, neck disability index also showed improvement in neck function. Also research showed that neck active range of motion increased in both groups, but more in stabilization exercise group. deep cervical flexors endurance increased more in stabilization exercise group.

Conclusions: This research demonstrates that both, neck stabilization and dynamic exercise programs are effective in management of chronic neck pain in term of all indicators analyzed. Therefore a neck stabilization exercise is more effective for neck disability, pain intensity, cervical range of motion and deep cervical flexors endurance.

Keywords: chronic neck pain, functional capacity, stabilization and dynamic exercises impact, pain intensity.

ACTIVITY AND STRENGTH ENDURANCE OF THE CORE MUSCLES IN LUMBAR SPINAL STENOSIS

Authors: Rimantė Urbonaitė, Aurelija ciparytė

Scientific research supervisor: daiva Lenčiauskienė

Klaipeda State University of Applied Sciences, Lithuania

Background: Low back pain is the most common medical condition and the cause of disability, which imposes a huge personal, social and economic burden on the Western world. It effects from 80% to 90% of the general population. degenerative lumbar spine lesions are the most common cause of low back pain. They occur due to overload of the spine and joints and are age related. Lumbar spinal stenosis causes pain in lumbar spine, neurogenic claudication, numbness and weakness in the muscles of the lower limbs. The symptoms are provoked by standing and walking, and relieved – by sitting and the position of leaning forward. Problems can be solved by physiotherapy methods to eliminate biomechanical changes.

Aim: To assess the effect of different physiotherapy methods on pain, daily activity and strength endurance of the core muscles in lumbar spinal stenosis.

Methods: Scientific literature analysis, testing-experiment, mathematical analysis.Testing was performed before and after physiotherapy. visual analogue pain scale (vAS) was used to assess pain. Influence of lumbar spine pain on patients functional condition in daily activities was evaluated by modified Oswestry disability Index questionnaire. Trunk flexors, extensors and lateral flexors muscle endurance was assessed by

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Mcgill trunk muscle endurance tests.The study included 12 patients randomized to two groups. One group performed core stability exercise program and the other William‘s flexion exercise program. The exercise programs lasted for 8 weeks with a frequency of 3 times per week.

Results: Low bak pain intensity and Oswestry disability Index assesment results revealed that both physiotherapy methods were similarly effective in reducing low back pain, therefore, they both can be recommended for lumbar spinal stenosis pain relief and functional status improvement. core muscle strength endurance improvement was observed in both exercise groups subjects however, the core stability exercises significantly more effectively increasesd core muscles strength endurance.

Conclusion(s): The core stability exercise program was more effective because it influenced all parameters a little bit more and had a much greater effect on trunk muscle endurance, especially it significantly influenced trunk flexion endurance.

Keywords: core stability exercises, lumbar spinal stenosis, physiotherapy methods, William‘s flexion exercises.

THE EFFECT OF MASSAGE ON REDUCING THE FOREHEAD AND GLABELLAR LINES

Authors: greta gudauskaite, Emilija gečaitė

Scientific research supervisor: Kristina Letkauskaitė

Klaipeda State University of Applied Sciences, Lithuania

Background: The forehead and glabellar lines are formed by the constant contraction of the forehead muscles. As a result, the ability of the muscle to return to its original position is weakened, muscle elasticity decreases and the muscle shortens. The purpose of the massage is to improve the elasticity of the muscles and reduce wrinkles/lines.

Aim: To analyze the effect of massage on reducing the forehead and glabellar lines.

Methods: four women (50-55 years of age) with visible the forehead and glabellar lines were enrolled in the study. Ten minute forehead massage was performed 3 times a week. Two women undertook a course of eight massages and the other two – a course of sixteen massages. comparative photographs were taken to determine change of the forehead and glabellar lines in dynamics and at rest using the Merz Aesthetics scale. The depth of lines is assessed on a scale of 0 to 4. Also, Mimic meter device was used to measure movements of the skin (changes in facial expression, mm/s) due to the contractions of forehead muscles (10 repetitions). Measurements were taken before and after 1st massage, before and after 8th massage and before and after 16th massage.

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Results: All participants showed a reduction of at least one Merz Aesthetics scale point after eight massages. The two participants who continued with additional eight massages did not show any significant changes in the depth of the forehead and glabellar lines. Study data collected with Mimic meter device after eight massages showed improvement in the function of muscle relaxation, increase in contraction and relaxation amplitude. After additional eight massages the results were further improved.

Conclusion(s): Massage is effective in reducing the forehead and glabellar lines and improving the elasticity of the muscles.

Keywords: glabellar lines, forehead lines, massage, wrinkles.

VACUUM EXTRACTION'S EFFECT ON DELIVERY OUTCOMES

Authors: Kristīne buķe, Ilze dupuža

Scientific research supervisor: Natālija vedmedovska

department of Obstetrics and gynecology, Rīga Stradiņš University, Latvia

Background: A vacuum extraction is one of the main types of assisted delivery methods used in a modern medicine. It is an instrument of choice when the shortening of second stage labour is required. However, this method is associated with various complications for the new-born, such as cefalohematoma, scalp bruising, caput succedaneum, retinal hemorrhage, and more severe complications like subgaleal hemorrhage and intracranial hemorrhage. besides that, the mother may be affected by an increased risk of vaginal rupture and likeliness of episiotomy, therefore it is a must to review the indications for each individual case.

Aim: The purpose of this study is to analyse how vacuum-assisted delivery affects delivery outcomes.

Methods: A total number of 931 medical history records of pregnant women and neonates were included in this study. A comprehensive collection of research data was carried out between january 2016 and december 2016 in the Maternity Hospital of Riga. All women listed in this study were split into two groups based on the delivery methods, i.e. normal and vacuum-assisted delivery. The analysis of this research was done by using the SPSS statistical program.

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Results: There were significant delivery outcome differences for vacuum–assisted delivery in comparison to normal deliveries in Apgar score in the first minute (P < 0.001) and after 5 minutes (P < 0.001), acute and progressive fetal distress (P < 0.001), neonatal clavicle fracture during delivery (P = 0.002) and cephalohematoma (P < 0.001). A correlation was found between maternal complications – profound vaginal rupture (P < 0.001) and need for episiotomy (P < 0.001). In addition, this study revealed that labia minora, majora and perineum rupture was less common in vacuum extraction than in normal delivery (P < 0.001).

Conclusion(s): There is a statistically significant correlation between vacuum-assisted delivery and maternal and neonatal complications during childbirth. The vacuum extraction is an operative vaginal delivery and it is necessary to be used only in the case when the indications are present.

Keywords: delivery complications, neonatal complications, vacuumassisted delivery.

PAROXYSMAL ATRIAL FIBRILLATION AND COGNITIVE FUNCTIONS

Author: Liga Katrina Linde1

Scientific research supervisors: Sandra Seimane1,2, Evija Levensteina1,2

1 Riga Medical college of Latvian University, Latvia 2 Riga Eastern Hospital clinic gailezers, Latvia

Background: More than 16 million people in the United States are living with cognitive impairment. It is previously noted that atrial fibrillation (Af) is associated with a high risk of cognitive decline, which is independent of stroke. cognitive impairment can cause problems with a person’s thinking, communication, understanding or memory.

Aim: To investigate the association between paroxysmal atrial fibrillation and cognitive impairment.

Methods: cross-section study was performed in two biggest hospitals of Riga. Patients with paroxysmal atrial fibrillation, 18-80 years were enrolled in the study. They were screened by Montreal cognitive Assessment test (MocA), with cutoff <26 for cognitive impairment. Sociodaemographic data included information about gender, age, level of education, family status. The statistical processing of the data was performed using SPSS Statistics 22 program.

Results: There were included 250 atrial fibrillation patients. data were collected from 53.2% (n= 133) women, 46.8% (n=117) men. The mean age of participants was 65.54 ±10.77, with youngest 18 and oldest 80.

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There were 54% Latvians (n=135), 42% Russians (n=105). 58% were with secondary education. The mean value of MocA scale was 24.86 ± 2.59 points. 59.20% (n=148) of patients had light cognitive impairment, p<0.01. Participants with cognitive impairment were older (M=68.78 years) than those without it (M=60.84 years).

Conclusion(s): There is an association between atrial fibrillation and cognitive impairment, considering that about two thirds of Af patients had light cognitive impairment. Patients with atrial fibrillation, especially older, need more attention in communication and care.

Keywords: atrial fibrillation, cognitive functions, cognitive impairment.

THE RELATIONSHIP BETWEEN SELF-STIGMA AND QUALITY OF LIFE OF ADULTS WITH MENTAL ILLNESS AND THE THERAPEUTIC TECHNIQUES FOCUSING ON REDUCING SELF-STIGMA OF ADULTS WITH MENTAL ILLNESS

Authors: dagmar-christel Mähar, Liina Oherjus

Scientific research supervisor: Margit Lenk-Adusoo

Nursing and Midwifery department, Tartu Health care college, Estonia

Background: Adolescents with mental illness often experience stigma and discrimination which can have severe impact on long-term clinical, social and vocational functioning.

Aim: The aim of research is to describe the relationship between self-stigma and quality of life of adults with mental illness and the therapeutic techniques focusing on reducing self-stigma of adults with mental illness.

Methods: In the present study topic-related literature in English and Estonian from 2004-2018 was used. In total 39 original peer-reviewed articles were selected and used according to the research tasks.

Results: from the sociodemographic indicators expanded upon in the thesis (level of education, employment, marital status, the age when mental illness manifested, the duration of the mental illness, the number of hospitalizations and use of drugs) unemployment is the only indicator that affects self-stigma and thereby quality of life negatively. The higher

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the self-stigma, the poorer the treatment adherence. The higher the self-stigma, the higher the hopelessness and the lower the quality of life. It can be said, that there is a correlation between self-esteem and selfstigma – the lower the self-esteem, the higher the self-stigma. Thereby the quality of life is lower.

The aim of three described therapeutic techniques (Ending Self-stigma (ESS), Narrative Enhancement and cognitive Therapy (NEcT) and coming Out Proud (cOP), is to create a more positive self-image through different methods, for instance psych education, the principles of cognitive-behavioral therapy, creating new narratives of self-image, active listening and discussing the pros and cons of coming out into public with one’s mental illness.

Conclusion(s): Self-stigma has a significant negative effect on quality of life. The higher the self-stigma, the lower the quality of life. Ending Selfstigma (ESS), Narrative Enhancement and cognitive Therapy (NEcT) and coming out Proud (cOP) are the most researched therapeutic techniques that focus on reducing the self-stigma of adults with mental illness. All three above-mentioned therapeutic techniques reduce self-stigma.

Keywords: mental illness, quality of life, self-stigma, therapeutic technique.

COMPARISON OF STRESS FOR MEDICAL STUDENTS IN LATVIA AND LITHUANIA

Author: Eliza Kuzmicka1

Scientific research supervisors: Evija Levensteina1,2, Sandra Seimane

1 Riga Medical college of Latvian University, Latvia 2 Riga Eastern Hospital clinic gailezers, Latvia

Background: Medicine studies are percieved as being stressful. Stress response can help to cope with and manage demanding periods such as exams and coursework deadlines, so a little stress is beneficial, but if experienced frequent and in high levels, it can give negative effect on cognitive functions which affects studies in medical school and life outside it.

Aim: To comparise stress among medical students in Latvia and Lithuania.

Methods: A prospective study was conducted collecting data from medical students (doctors, physician assistants, nurses, masseurs, biomedical laboratories, radiologist assistants, podologists, social carers, social rehabilitators, cosmetologists, oral hygiene specialists, health services managers) in Latvia and Lithuania. They all filled out the medical student stressor questionnaire (MSSQ). Stress levels was measured in six divisions - academic related stressors (ARS), intrapersonal and interpersonal related stressors (IRS), teaching and learning related stressors (TLRS), social relates stressors (SRS), dive and desire related stressors (dRS), group activities related stressors (gARS).

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Results: In a study participated 158 respondents, 84% (n=134) from Latvia and 16% (n=24) from Lithuania, 93% (n=147) were women and 7% (n=11) men. The mean age of participants was 25.5 and the mean study course 2.5. Overall results came out similar for both - Latvians and Lithuanians. for ARS high level showed in 49.3% (n=66) Latvians and 45.8% (n=11) Lithuanians, and moderate in 32.8% (n=44) Latvians, 37.5% (n=9) Lithuanians. for dRS mild in 73.9% (n=99) Latvians and 62.5% (n=15) Lithuanians). TLRS levels were moderate in 50% (n=67) Latvians and 45.8% (n=11) Lithuanians. However, there were some differences too- at IRS Lithuanians have more severe stress 20.8% (n=5), than Latvians 6.8% (n=9).

Conclusion(s): Results are similar for Latvian and Lithuanian students in all categories except TLRS and SRS dominated high and moderate stress. This study should be continued by increasing the number of respondents. It would also be interested in engaging the students from Estonia.

Keywords: MSSQ, medicine students, stress.

PERCEPTIONS OF SIMULATION TRAINING IMPACT AMONGST RADIOGRAPHY STUDENTS

Author: Merili Tilgar

Scientific research supervisor: Tiina Kukkes

Radiography and biomedical Laboratory Science department, Tartu Health care college, Estonia

Background: Simulation training is a method used to expand students’ knowledge, skills and attitudes while avoiding unnecessary health risks to real patients. In recent years, to enhance professional skills among radiography students, the use of simulation training has increased. To ensure optimum use and development of simulation training in radiography education the exploration of student perceptions was required.

Aim: To describe radiography students’ perceptions of the impact of simulation training on learning skills and achieving performance confidence.

Methods: Subjects of the study comprised I, II, III and Iv year radiography students (in total 68 students) in the academic year 2017/2018. data was collected with a questionnaire filled in by students. The questionnaire included 32 statements regarding the impact of simulation training on skills acquisition and confidence development with the help of actors, phantoms and models, and the anatomage table. A 4-point Likert scale, involving options “totally agree”, “agree”, “disagree” and “strongly disagree”, was used for evaluation. comments could be added to all statement categories. Quantitative data was analyzed by descriptive statistics, student comments were analyzed by thematic analysis.

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Results: The questionnaire was responded by 58 students (response rate 85%) as follows: year 1 – 18, year 2 – 11, year 3 – 13, and year 4 – 16, including 17 male and 41 female respondents. Almost all students agreed that using phantoms and models helped them to obtain skills to handle the x-ray machine (92.5%), position the patient (92.5%), take xray images (100%) and analyze image quality (92.5%). 92.5% of students agreed that the use of actors helped them to obtain patient informing skills and ergonomic techniques, but they disagreed that actors increased their confidence in communication (22.5%) or in patient informing (25%).

Conclusion(s): Simulation training is supporting the acquisition of practical radiographic and patient care skills by students, although it is somewhat less effective in the development of student confidence levels. High quality simulation equipment and adequate teacher preparation are essential for effective simulation training.

Keywords: confidence, simulation, simulation education, radiographer, skills.

THE RESULTS OF „VENOUS ULCER KNOWLEDGE TEST“ IN TALLINN HEALTH CARE COLLEGE, ANSWERED BY NURSING STUDENTS FROM SECOND COURSE

Author: Anete Rätto

Scientific research supervisor: Ljudmila Linnik

department of medicine, Tallinn Health care college, Estonia

Aim of this study is to describe students knowledge about venous ulcer. In the research we used descriptive, empirical and quantitative methods. data was collected between 10.10.2018 - 06.12.2018 with questionnaire named “venous ulcer knowledge test”, which was used before at finland Health care college as a test to finish the course.

Method. Of the 100 respondents I got 96 answes. 86.5% of them were female and 13.5% male. data were statistically analyzed using descriptive statistics.

Results. Second course nursing students knowledge about venous ulcer is above average (71.7% correct answers). 37.5% of respondents have had been in contact with a patient who whas venous ulcer, but only 17.7% have had training about venous ulcers. All respondents knew about necrotic, granulation and fibrin tissue. They didn’t know about compression therapy sockings and how to take care of venous ulcer. Our students knowledge was lower than finland students (84%) and higher than Hungary students (51.2)%.

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Conclusion. The results gave a first impression of students knowledge about venous ulcer. The results will be used to develop e-learning and simulation tasks during the ERASMUS + international project. from the rest of the world we can also see that the knowledge is quite low. A study from Rabeh, Soraia Assad Nasbine which was held in Sao Paolo nursing school, showed that students knowledge was 50%. They also made a virtual learing environment, which improved students knowledge.

Keywords: knowledge, nurse, simulation, students, venous ulcer.

TALLINN HEALTH CARE COLLEGE’S SECOND COURSE NURSING STUDENTS KNOWLEDGE ABOUT PRESSURE ULCERS USING “PIEPER’S PRESSURE ULCER KNOWLEDGE TEST” RESULTS

Authors: janika Loog, Kristina Lillemets

Scientific research supervisor: Ljudmila Linnik

department of medicine, Tallinn Health care college, Estonia

Background: Pressure ulcer is a serious health issue and it occurs daily. Hospital acquired pressure ulcers cause patient harm including pain, expensive treatments, prolonged hospital stay and premature death. In USA more than 2.5 million people get pressure ulcers in acute care and 60 000 of them die because of the complications.

Aim: The purpose the study is to assess the nursing students’ knowledge about preventing pressure ulcers, describing different stages of pressure ulcers and taking care of the already existing pressure ulcer.

Methods: descriptive, empirical and quantitative method was used. The data was collected in the time span of two months 10.10.2018-06.12.2018 using “Pieper’s pressure ulcer knowledge test”. The second course students were chosen to fill in the questionnaire. Of the 100 students 88 filled in the questionnaire. 89.8% were women and 10.2% were men. The data was analyzed statistically. The questionnaire had 47 questions that had three main topics: preventing, staging and wound care. The students had to decide whether the statement was correct, incorrect or “I don’t know”.

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Results: based on the result it was found that the second course nursing students’ knowledge about pressure ulcers was average (61.8% correct answers). Students knew the least about “Persons who can be taught should shift their weight every 30 minutes while sitting in a chair” - 85.2% answered incorrectly. They also didn’t know about “A person who cannot move him or herself should be repositioned every 2 hours while sitting in a chair” and ”Persons confined to bed should be repositioned every 3 hours” - 80.7% answered not correctly. The students knew really well that ”All care given to prevent or treat pressure ulcers must be documented” - 97.7% answered correctly.

Conclusion(s): In conclusion it could be said that the students’ knowledge about pressure ulcers could be a lot better. The same knowledge test was used to conduct a study in two nursing colleges in Iran, where the overall percentage of correct answers was 67%. The same test was also used to assess orthopedic nurses’ knowledge about pressure ulcers and they answered 65% correctly. Pressure ulcer incidents are high, but with good knowledge about prevention, staging and wound care there would be less pressure ulcer incidents. Schools need a better learning program for pressure ulcers.

Keywords: Pressure ulcer, students, knowledge, nurse, simulation