Browsing by Author "Berķis, Uldis"
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Item Accessibility problems in home environment for seniors in Latvia : Experience from the research project innovAge (WP2)(EDP Sciences, 2018) Tomsone, S.; Saukuma, L.; Liepina, Z.; Zalkalns, J.; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityItem Aerobic capacity for breast cancer survivors 2 to 3 years after breast surgery(EDP Sciences, 2019-01-01) Ceseiko, Rudolfs; Tomsone, Signe; Majevska, Laura; Vetra, Aivars; Berķis, Uldis; Vilka, Lolita; Department of Rehabilitation; Rehabilitācijas fakultāteBreast cancer treatment may cause unfavourable side effects that directly or indirectly influence the cardio-respiratory capacity among breast cancer survivors, thus affecting physical functioning and the quality of life. Mounting evidence supports that Maximal oxygen uptake (VO2max) is a strong predictor of all-cause mortality and cardiovascular disease, and low VO2max is associated with increased mortality from breast cancer. The aim of the study was to measure cardio-respiratory fitness in breast cancer survivors and determine to what extent VO2max levels are lower compared with healthy counterparts from population. The study included 11 women with a history of breast cancer, the average time after breast surgery being 2–3 years. Aerobic capacity was determined by the Cardiopulmonary exercise test. HUNT3 study was used to define aerobic capacity for healthy women in population. Mean Age for participatns 50 ± 4 years (M ± SD). The comparison of the results from Cardiopulmonary exercise test indicated that breast cancer survivors display VO2max values significantly lower 27.1 ml/kg/min (27%) than healthy counterparts from population, i.e., 34.4 ml/kg/min (P = 0.001). Recognizing the increasing number of breast cancer patients worldwide and the physical reconditioning among the survivors, aerobic exercise training is suitable for improving cardio-respiratory health, functionality, and quality of life.Item Changes in muscular strength based on full cervical flexion(EDP Sciences, 2018) Vetra, Janis; Skļarevičs, Vladimirs; Anoufriev, Gregory; Kalnins, Imants; Vetra, Janis, Jr.; Umbrasko, Silvija; Kotovs, Vladislavs; Beilina, Larisa; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityWe present our study of influence full cervical flexion position on the changes in muscle strength of the upper extremities. This position is typical for a person working on mobile phone or iPad. The purpose of the study was determination of the connection between change of the head flexed position and changes in upper extremity muscles strength. The present study involved 80 healthy volunteers and was performed at the Department of Morphology in Riga Stradins University, Riga, Latvia. For measurements we have used the MicroFET2 Hand Held Digital Muscle Tester to determine the strength of the muscles of the hand and arm (M. abductor pollicis longus, M. biceps brachii, M. triceps brachii, M. deltoideus). The results of measurements were then used to analyze the difference in the strength of the muscles innervated by the spinal cord cervical region (C5–C8 nerves) for the same person sitting in the vertical position and sitting with the head flexed maximally. The results of our study support the hypothesis that the changes in the strength of measured muscles are related to the mechanical distension of the spinal cord, which leads to changes in spinal cord’s blood supply. The kyphotic position of the cervical spine during head flexion shows that in the spinal cord segments C5 and C7 are formed mechanical distension. Using our statistical study, we can conclude that there is strong relationship in the strength change in some of the observed muscles between vertical position and full flexion of headItem Coaching to strengthen critical success factors in integrative care for chronic fatigue patients : the Patient Needs-Resources Model(2023-07-21) Arāja, Diāna; Krūmiņa, Angelika; Nora-Krūkle, Zaiga; Schneider, Marion; Berķis, Uldis; Murovska, Modra; Institute of Microbiology and Virology; Department of Infectology; Development and Project DepartmentTheoretical and empirical studies discover that an integrative approach is particularly important in chronic disorders and multiple long-term conditions, such as chronic fatigue. Chronic fatigue syndrome (CFS) is a classic example of a potentially severe, multisystemic illness with a wide diversity of symptoms and the corresponding diagnostic complexity. The prevalence of CFS-like syndromes expanded in the context of the COVID-19 pandemic, increasing the disorder and treatment burden. Thus, this article aimed to draw attention to the possibilities to strengthen the integrative approach to diagnosing and treating chronic disorders and multiple long-term conditions. The main critical success factors identified for integrative approaches were: a holistic approach, that provides a more comprehensive diagnostic and personalized treatment strategy, a multidisciplinary team, and patient engagement. The strengths and weaknesses of these factors were explored and coaching was identified as a potential unifying and reinforcing element. Coaching has a wide spectrum of manifestations clearly representing a holistic approach, that has been successfully used in multidisciplinary team building. Moreover, coaching exposes support addressing the patient engagement issues identified by the Patient Needs-Resources Model (PN-R Model) such as low levels of self-efficacy, optimism, and subjective well-being. Coaching may assist patients to identify and prioritize their goals, becoming aware of their personal resources, developing strategies for managing symptoms, and building skills to increase their self-efficacy and active engagement in the treatment process. Therefore, the authors emphasize coaching as a perspective element of optimization of patient care, that requires additional theoretical and long-term empirical research.Item Comparison of adolescent's values : Riga and Vidzeme region(EDP Sciences, 2019-01) Mihailova, Sandra; Martinsone, K.; Pipcane, Arta; Berķis, Uldis; Vilka, Lolita; Socioloģijas un psiholoģijas katedra; Department of Health Psychology and PaedagogyThe determination of individual values is the first step in the process of the personal development. Thus, the main purpose of this research is to investigate the difference between value hierarchies of Riga students and rural students and their subjective opinions about factors affecting them and compare the results with the values of previous generations. It is a pilot study with a comparative cross-sectional design. The study was carried out in several schools of Latvia in 2018: 2 schools of Riga and 2 rural schools of Vidzeme region. Participants were 11th and 12th grade students: 50 from Riga, 50 from rural schools. The research of values was based on the M. Rokeach value ranking test. It is found that the individual hierarchies of values in one group context differ more than hierarchies of adolescent groups of various years and different backgrounds. There are no significant differences related to the terminal and instrumental values between adolescents of Riga and rural areas: love, cheerfulness and education are more important for Riga students, but rural students prefer responsibility, obedience, capability. Some values have not been influenced by time or socio-economic and political situation, but some values have increased or decreased their significance with years.Item Digital assistance to support integrated healthcare(2023-12-28) Arāja, Diāna; Berķis, Uldis; Murovska, Modra; Institute of Microbiology and Virology; Development and Project DepartmentItem The dynamics of value system in 1998 and 2015 : Longitudinal research in Latvia(EDP Sciences, 2018) Sokola-Nazarenko, Marina; Martinsone, Kristine; Mihailova, Sandra; Levina, Jelena; Elina, Karsa; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityValues may change during life because a person obtains new life experience and competencies. In the past decade, many Latvian psychologists studied people's values and their connections with different factors like cultural, political, social, economic changes and other factors [1-3 and other]. Since 1994 Latvia has gone through different social-economic changes like crisis, economic growth, assumption to NATO and EU. and acceptation of euro currency. These changes can influence participants' values. The aim was to conduct a comparative longitudinal research in individuals' values in 1998 and 2015, at the beginning of their youth and then in adulthood, in order to answer the following questions: what values were in 1998 and 2015; what differences in values had appeared comparing 1998 and 2015 in same persons. Results showed that the most important values in 1998 and 2015 were "Family", "Love", "Responsibility". "Honesty" and "Cheerfulness". Significant changes appeared in "Health" that became significantly important in 2015 and replaced the importance of "Love". Most achievable values in 1998 and 2015 were "The beauty of nature and art" and "Cognition" but in 2015 also "Active life" which replaced "Self-confidence" that was important in 1998. Significant changes appeared in "Self-confidence", "Wisdom", "Active life", "Freedom", "Interesting job", "Learning" and "Friends" as well, where importance of some values increased and some decreased in 2015.Item Economic burden of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) to patients : comparative study(2019) Arāja, Diāna; Brenna, Elenka; Hunter, Rachael M; Pheby, Derek; Berķis, Uldis; Lunga, Asja; Murovska, Modra; Rīga Stradiņš UniversityItem Exploring the Joint Potential of Inflammation, Immunity, and Receptor-Based Biomarkers for Evaluating ME/CFS Progression(2023-12-20) Berķis, Uldis; Svirskis, Šimons; Krūmiņa, Angelika; Grāvelsiņa, Sabīne; Vilmane, Anda; Arāja, Diāna; Nora-Krūkle, Zaiga; Murovska, Modra; Development and Project Department; Institute of Microbiology and Virology; Department of InfectologyBackground: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic condition with no identified diagnostic biomarkers to date. Its prevalence is as high as 0.89% according to metastudies, with a quarter of patients bed- or home-bound, which presents a serious public health challenge. Investigations into the inflammation-immunity axis is encouraged by links to outbreaks and disease waves. Recently, research of our group revealed that antibodies to beta2-adrenergic (anti-β2AdR) and muscarinic acetylcholine (anti-M4) receptors demonstrate sensitivity to the progression of ME/CFS. The purpose of this study is to investigate the joint potential of inflammatome - characterized by interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-2, IL-21, Il-23, IL-6, IL-17A, Activin-B, immunome (IgG1, IgG2, IgG3, IgG4, IgM, IgA) and receptor-based biomarkers (anti-M3, anti-M4, anti-β2AdR) determined -, for evaluating ME/CFS progression, and to identify an optimal selection for future validation in prospective clinical studies. Methods: A dataset was used originating from 188 persons, including 54 healthy controls, 30 patients classified as "mild" by severity, 73 as "moderate," and 31 as "severe," clinically assessed by Fukuda/CDC 1994 and International consensus criteria. Markers characterizing inflammatome, immunome, and receptor-based biomarkers were determined in blood plasma via ELISA and multiplex methods. Statistical analysis was done via correlation analysis, principal component, and linear discriminant analysis, and random forest classification; inter-group differences tested via nonparametric Kruskal–Wallis H test followed by the two-stage linear step-up procedure of Benjamini, Krieger, and Yekutieli, and via Mann-Whitney U test. Results: The association between inflammatome and immunome markers is broader and stronger (coupling) in severe group. Principal component factoring separate components affiliated with inflammatome, immunome, and receptor biomarkers. Random forest modeling demonstrates an out-of-box accuracy for splitting healthy/with condition groups of over 90%, and of 45% for healthy/severity groups. Classifiers with the highest potential are anti-β2AdR, anti-M4, IgG4, IL-2, and IL-6. Discussion: Association between inflammatome and immunome markers is a candidate for controlled clinical study of ME/CFS progression markers that could be used for treatment individualization. Thus, coupling effects between inflammation and immunity have a potential for the identification of prognostic factors in the context of ME/CFS progression mechanism studies.Item Factors determining competitiveness in healthcare institutions in Latvia - Results of the EKOSOC-LV national research programme(2019) Villeruša, Anita; Behmane, Daiga; Kokarēviča, Anita; Berķis, Uldis; Cauce, Vinita; Rīga Stradiņš University; Department of Public Health and EpidemiologyCompetitiveness as a factor of a company selling its services in the market is becoming more relevant in the healthcare sector. The number of institutions that offer their services to international patients is growing. Research shows that the development of medical tourism is country-specific. The main objective of this publication is to discover positive and negative factors for engagement in the provision of services to non-residents. The data was obtained from a cross-sectional study in which 86 managers of health care institutions in Latvia completed a questionnaire. A total of 80.2% of health care institutions had provided services to non-resident patients in the previous year while 19.8% did so regularly. Institutions mainly used websites to advertise their services. Only a small number of institutions employed a marketing specialist or had a strategy to attract non-resident patients. Heads of institutions pointed to a number of internal and external barriers in this connection, including lack of staff, low motivation, limited language skills, inadequate infrastructure, insufficient state-level support to promote the export of services, the social environment, and problems in the health system itself. The study revealed areas that need to be improved regarding future policies to attract non-resident patients and to increase global competitiveness.Item Gender as a recruitment criterion in the parliamentary political elite of Latvia (1993-2016)(EDP Sciences, 2018) Metla-Rozentale, Lelde; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityThe globalization process has transformed substantially understanding of the issue of border. Revising borders is also seen in political science - in the area of political elite recruitment. Recruitment criteria and their importance are changing, including the importance of gender. In 1981 the United Nations General Assembly adopted the Convention on the Elimination of All Forms of Discrimination Against Women, which provides equal rights of genders in the political elite, the so-called "mirror representation". i.e.. in the political elite men and women should be represented proportionally according to their number in society [4]. It should be particularly stressed that the purpose of "mirror representation" is not only to ensure equal rights of genders, but first of all to improve the quality of politics. As soon as Latvia regained its independence in 1990, the complicated process of formation (recovery) of the democratic governance model started. In 1993 the first parliamentary elections were held, and by 2016 elections for eight parliamentary terms had been held [3]. In view of the complex political history of Latvia. it is interesting and important to clarify the role of gender in the Latvian parliamentary political elite recruitment process - what correlations can be observed with regard to the male and female share in the parliament during the period from 1995 till 2016, and the extent to which it complies with the sex ratio breakdown of the society.Item Health literacy as a challenge for health education(EDP Sciences, 2018) Stars, I.; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš University. Scientific literature demonstrates a well-established correlation between education and health literacy; education and health outcomes; health literacy and health outcomes. Health literacy has a mediating role between education and health. Health literacy is known as a complex concept, it has multiple definitions, underlying meanings and conceptual models. Diversity of health literacy can be a challenging motivator for health education. Indepth study of scientific literature was carried out to highlight the link between health literacy and health education and to emphasize health literacy challenges for health education. Five health literacy challenges for health education were identified: (1) health literacy as an outcome related to health education interventions; (2) multilayered health literacy or different levels of health literacy; (3) the concept of health literacy and its comprehensiveness; (4) shift from a passive to more interactive and empowering health education; (5) cultural context of health literacy and health education. Enhanced health literacy definitions and conceptual models require more complex, comprehensive, socially oriented, culture sensitive, participatory health education.Item How will future health policy impact on regional disparities and healthcare in Latvia(EDP Sciences, 2019) Bikava, Ieva; Kreituse, Ilga; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš University; Politikas zinātnes katedraLatvia is a country with high level of regional disparities and as researches have approved – income, education, and environment significantly affect the status of people's health. The reforms in healthcare have been carried out under the flags of accessibility, efficiency, effectiveness, and quality since 1991. Some groups support the idea that the state should take over almost all services, the others claim that more responsibilities should be transferred to the private sector, and dispute on service provider network and financing system. In accordance with the coalition theory and legislation of Latvia, the initiators and designers of the structural reforms are politicians, elected by the citizens. In theory, every politician represents the political party with its ideology and vision that is expressed in the Programme of the party. Due to Parliament elections in 2018, to understand which way the country will go, and how the chosen strategy will impact on the regional disparities, analysis of the middle-term development strategy was made. Research results showed that political parties in Latvia are not based on the ideology and the strategical development vision of the State, so the development and changes made in legislation are mainly ad-hoc decisions or the result of lobbying activities of influential groups. Due to the lack of middle term vision as the gap between long-term development strategy and short-term decisions, unfortunately, the prognosis of future health politics leads to the conclusion that regional disparities and the problem with Health care accessibility in next decades will only rise. Key words: health policy / regional disparities / political party ideologyItem Impact of different physical activities on executive functioning(EDP Sciences, 2018) Sneidere, K.; Harlamova, J.; Arnis, V.; Ulmane, Z.; Mintale, I.; Kupcs, K.; Stepens, A.; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityItem Influence of high physical load endurance exercises on the anthropometric parameters and health status of military personnel(EDP Sciences, 2018) Plavina, Liana; Vellere, Natalija; Umbrasko, Silvija; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityMilitary personnel are in high-risk group for health disorders, musculoskeletal pathology and psychological overload. We provide evaluation of the anthropometric parameters and health status of military personnel, Cadets, who have participated in ten days duration Combat training course. Combat training course is associated with life-style change – social, environmental, climate and geographical conditions, biorhythms, nutrition etc., with an increase in physical and psych emotional loads. It is characterized with transition from daily routine of military study process in National Defence academy to military exercise in external environment. Cadets faced to feeding limitation, sleeping deprivation intensive and continuous training, strict discipline etc. We provided analysis of anthropometric parameters before, and in time of Combat training course, summarized data of health statement and health problems that were fixed in the medical cards. The proper body mass supports good health capacity and we provided assessment of it. Physical fitness and body composition have adverse effect on military performance. Body composition undergoes changes during higher physical load performance. Military personnel have high risk to health, concerning impact of external and internal factors. According the review of medical cards of cadets group, we indicated main problems, which are fixed after the Combat training course.Item Integrative approach as a dormant element of integrated healthcare(2023-12-28) Arāja, Diāna; Krūmiņa, Angelika; Berķis, Uldis; Nora-Krūkle, Zaiga; Murovska, Modra; Rīga Stradiņš UniversityItem Interest group impact on E-health implementation in Latvia(2018) Bikava, I.; Kreituse, I.; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityDemocratic state governance should provide the society with mechanisms to impact policy development and implementation. Society members are presented by interest groups that can use internal and external ways to have impact on the government and reform implementation processes. This article represents research that was made on E-health implementation in Latvia – identifying main obstacles and reasons of delayed implementation, and analyses active interest groups and their impact on the implementation process. The research results showed that the main reason of delayed implementation was poor governance from the responsible authority and lack of interest group involvement in the reform development and implementation process.Item Legal consequences and problems of the servitudes of right of way established by administrative acts in Latvia(2018) Dinsberga, J.; Bite, K.; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityThe right to own a property is guaranteed by the Article 105 of the Constitution of the Republic of Latvia that in the same time stipulates that the said rights may be restricted only in accordance with law. This legitimate property right restriction is determined in Article 928 of the Civil Law: the ownership may be restricted both by private intent and by law. One of the restrictions of ownership rights is the servitude of right of way which is established by law, a contract, a court judgement, or a will. During the land reform, the State Forest Service, land commissions, and municipalities had the legal basis to establish the servitude of right of way also by an administrative act, taking a corresponding decision. However, many decisions were insufficient and legally incorrect. As a result, today the servitudes of right of way established by the administrative acts during the period of the land reform do not fulfil their purpose and cause a number of legal and practical problems both to owners of immovable property and to state institutions. In order to explore these problems, referring to the Article 7 of the Paragraph 105 of the protocol resolution No.56 of the Cabinet of Ministers from 29 October 2013, the Ministry of Environmental Protection and Regional Development in cooperation with the Ministry of Transport, the Ministry of Justice, and the Ministry of Agriculture issued the Conceptual Report “On the Problems Occurring in Relation with the Servitudes of Right of Way Established during the Land Reform and Their Possible Solutions” (hereinafter – the Conceptual Report). In general there are 2 possible solutions, but for the second solution there are five courses of action, one of which – in cases when there is a road on private property that is needed for public use it is to be determined as an encumbrance of the immovable property “Public road”. The aim of the research is by analysis of the problems of the servitudes of right of way, established by the administrative acts during the period of the land reform, to evaluate whether the solutions offered in the Conceptual Report are practically applicable and will give the desired result, as well as to offer the author’s vision for solution of the existing problems. The author has used the scientific research approaches – descriptive, analytical, inductive and deductive, logical-constructive, formal-dogmatic, graphical and interpretation of legal norms – grammatical, systemic, and teleological.Item Limbs joint position sense in patients with chronic non-specific back pain(EDP Sciences, 2018) Pahomova, Natalija; Smite, Daina; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityTo analyze limbs joint positions’ sense and its relationship with pain intensity and duration in patients with chronic non-specific back pain. Methods: Study design: cross-sectional study. For assessment of patients, the following elements were used: general data collection protocol; evaluation of pain intensity using the Visual Analogue Scale; assessment of limb kinesthesia: determination of reposition precision of a 90-degree flexion angle in shoulder, elbow, hip and knee joints. Subjects. The study included 100 patients (88 women, 12 men) with chronic nonspecific back pain, who met the selection criteria for the study. The average age of patients was 45.9 ± 11.6 years, and it ranged from 19 to 64 years. Results: All participants of the study were found to have diminished upper and lower limbs kinesthesia. The study results showed plausible (p < 0.05) relation between limbs kinesthesia and pain intensity and duration, and these correlations were significantly determined by pain localization. Conclusion: Limb kinesthesia is plausibly related to the manifestation of pain in patients with chronic non-specific back pain.Item Multi-criteria decision analysis as a tool for evaluation of unmet needs in health care(EDP Sciences, 2018) Araja, Diana; Berķis, Uldis; Vilka, Lolita; Rīga Stradiņš UniversityThe United Nations Sustainable Development Goals appointthat all Member States have agreed to try to achieve Universal HealthCoverage by 2030. This includes financial risk protection, access to qualityessential health-care services and access to safe, effective, quality andaffordable essential medicines for all. The World Health Organisation hasdefined the Universal Health Coverage as a priority, which means that allpeople can use the preventive, curative, rehabilitative and palliative healthcare services they need, of sufficient quality to be effective, while alsoensuring that the use of these services does not expose the user to financialhardship. The classic approach of the unmet medical needs is definedas the total self-reported unmet needs for medical care for the followingthree reasons: financial barriers, waiting times, too far to travel. Accordingto the Eurostat data, overall range of unmet medical needs in Latvia isthe highest of the European Union countries, however, the accessibilityof health services depends on a multitude of factors that relate to thehealth system and also to the patients themselves. Therefore the Multi-criteria decision analysis approach could be acceptable for assessment ofthe unmet medical needs. The data on unmet medical needs for Latviashould be additionally evaluated, taking into account the “therapeutic need”,which refers to the need for a better treatment than the treatment currentlyreimbursed, from the perspective of the patient. Apart from therapeutic need,the concept of societal need should be investigated, which refers to theneed for a better treatment than the currently available treatment for societalreasons.