L. Valius - Academia.edu (original) (raw)
Papers by L. Valius
Global Health Action, 2013
Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicara... more Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology. Results: Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers' awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become 'gate-openers' to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts. Conclusions: To improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level.
OBJECTIVES: The study aimed, firstly, to assess changes in the service profile of primary care ph... more OBJECTIVES: The study aimed, firstly, to assess changes in the service profile of primary care physicians between 1994, when features of the Soviet health system prevailed, and 2004, when retraining of GPs was completed. Secondly, to compare service profiles among current GPs, taking into account their positions before being retrained. METHODS: A cross-sectional repeated measures study was conducted among district
Ten years of primary care reform in Lithuania: comparing the task profiles of primary care doctors in 1994 and GPs in 2004
Background: Since its independence in 1990 Lithuania is transforming health care from the previou... more Background: Since its independence in 1990 Lithuania is transforming health care from the previous Soviet system to a decentralised social insurance based system with a strong emphasis on primary care. Doctors have been re-trained to become GPs with a gatekeeping position. GPs can either work as employees in the public centres or in their own private practice, contracted to the
[Effects of prognostic parameters and radiotherapy on survival of patients with pulmonary cancer]
Terapevticheskiĭ arkhiv, 2004
To analyze factors influencing expected survival of pulmonary cancer (PC) patients given radiothe... more To analyze factors influencing expected survival of pulmonary cancer (PC) patients given radiotherapy, i.e. age of the patient, stage of the disease, size of the tumor, involvement of the lymph nodes, a total focal dose, space distribution of the dose. Among PC patients 87% were males and 73.9% were 60 years of age and older. Local PC (stage IIIa and IIIb) was diagnosed in 65.2%. Non-small-cell PC was in 83.8%. Effects of radiotherapy on the survival was analysed in 115 patients. Total focal doses made up 30 Gy (3.0 Gy/10 fractions) to 70 Gy (2.0 Gy/35 fractions). Longer survival was achieved after irradiation with greater dose and modern three-dimentional planning of conformic radiotherapy. A significant prolongation of the survival was seen in raising the total focal dose to 50 Gy. There is a correlation between the dose and conformity of the dose distribution. During the study 58.2% patients died. Assessment of the survival of PC patients given radiotherapy has shown that negativ...
Reproductive health, 2015
In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Healt... more In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented.This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America.1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants.2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with t...
Global Health Action, 2013
Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicara... more Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology. Results: Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers' awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become 'gate-openers' to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts. Conclusions: To improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level.
Organizational and structural changes in PHC centres during health care reform in Lithuania
Background: The increasing health care inequalities and morbidity, inefficient payment system cha... more Background: The increasing health care inequalities and morbidity, inefficient payment system challenged to a new health care reform with its priority primary health care after Lithuania’s independence in 1990. Former district doctors have been re-trained to become GPs and former policlinics have been modernized and decentralized. The private medicine was introduced. This paper is an evaluation of structural and organizational changes in PHC centres between 1994 and 2004. Research question: Are PHC centres better organized after PHC reform? Are there any differences between private and public PHC centres in 2004? Methods: In 1994 and 2004 identical questionnaires have been completed by random samples of primary care physicians about the: workload, working arrangement, practice equipment. Data entry, processing and analysis were carried out using SPSS software. Results: In 1994 the response among district doctors was 333 (87%) and among primary care pediatricians 262 (87%). In 2004 t...
Lietuvos bendrosios …, 2011
BMC Family Practice, 2013
Background: A team approach in primary care has proven benefits in achieving better outcomes, red... more Background: A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Methods: Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. Results: The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors.
Global Health Action, 2013
Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicara... more Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology. Results: Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers' awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become 'gate-openers' to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts. Conclusions: To improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level.
OBJECTIVES: The study aimed, firstly, to assess changes in the service profile of primary care ph... more OBJECTIVES: The study aimed, firstly, to assess changes in the service profile of primary care physicians between 1994, when features of the Soviet health system prevailed, and 2004, when retraining of GPs was completed. Secondly, to compare service profiles among current GPs, taking into account their positions before being retrained. METHODS: A cross-sectional repeated measures study was conducted among district
Ten years of primary care reform in Lithuania: comparing the task profiles of primary care doctors in 1994 and GPs in 2004
Background: Since its independence in 1990 Lithuania is transforming health care from the previou... more Background: Since its independence in 1990 Lithuania is transforming health care from the previous Soviet system to a decentralised social insurance based system with a strong emphasis on primary care. Doctors have been re-trained to become GPs with a gatekeeping position. GPs can either work as employees in the public centres or in their own private practice, contracted to the
[Effects of prognostic parameters and radiotherapy on survival of patients with pulmonary cancer]
Terapevticheskiĭ arkhiv, 2004
To analyze factors influencing expected survival of pulmonary cancer (PC) patients given radiothe... more To analyze factors influencing expected survival of pulmonary cancer (PC) patients given radiotherapy, i.e. age of the patient, stage of the disease, size of the tumor, involvement of the lymph nodes, a total focal dose, space distribution of the dose. Among PC patients 87% were males and 73.9% were 60 years of age and older. Local PC (stage IIIa and IIIb) was diagnosed in 65.2%. Non-small-cell PC was in 83.8%. Effects of radiotherapy on the survival was analysed in 115 patients. Total focal doses made up 30 Gy (3.0 Gy/10 fractions) to 70 Gy (2.0 Gy/35 fractions). Longer survival was achieved after irradiation with greater dose and modern three-dimentional planning of conformic radiotherapy. A significant prolongation of the survival was seen in raising the total focal dose to 50 Gy. There is a correlation between the dose and conformity of the dose distribution. During the study 58.2% patients died. Assessment of the survival of PC patients given radiotherapy has shown that negativ...
Reproductive health, 2015
In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Healt... more In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented.This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America.1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants.2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with t...
Global Health Action, 2013
Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicara... more Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology. Results: Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers' awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become 'gate-openers' to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts. Conclusions: To improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level.
Organizational and structural changes in PHC centres during health care reform in Lithuania
Background: The increasing health care inequalities and morbidity, inefficient payment system cha... more Background: The increasing health care inequalities and morbidity, inefficient payment system challenged to a new health care reform with its priority primary health care after Lithuania’s independence in 1990. Former district doctors have been re-trained to become GPs and former policlinics have been modernized and decentralized. The private medicine was introduced. This paper is an evaluation of structural and organizational changes in PHC centres between 1994 and 2004. Research question: Are PHC centres better organized after PHC reform? Are there any differences between private and public PHC centres in 2004? Methods: In 1994 and 2004 identical questionnaires have been completed by random samples of primary care physicians about the: workload, working arrangement, practice equipment. Data entry, processing and analysis were carried out using SPSS software. Results: In 1994 the response among district doctors was 333 (87%) and among primary care pediatricians 262 (87%). In 2004 t...
Lietuvos bendrosios …, 2011
BMC Family Practice, 2013
Background: A team approach in primary care has proven benefits in achieving better outcomes, red... more Background: A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Methods: Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. Results: The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors.