Vilija Malinauskiene

Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study

BackgroundThe aims of this study were to explore associations of the distance and use of urban green spaces with the prevalence of cardiovascular diseases (CVD) and its risk factors, and to evaluate the impact of the accessibility and use of green spaces on the incidence of CVD among the population of Kaunas city (Lithuania).MethodsWe present the results from a Kaunas cohort study on the access to and use of green spaces, the association with cardiovascular risk factors and other health-related variables, and the risk of cardiovascular mortality and morbidity. A random sample of 5,112 individuals aged 45-72 years was screened in 2006-2008. During the mean 4.41 years follow-up, there were 83 deaths from CVD and 364 non-fatal cases of CVD among persons free from CHD and stroke at the baseline survey. Multivariate Cox proportional hazards regression models were used for data analysis.ResultsWe found that the distance from people’s residence to green spaces was not related to the prevalence of health-related variables. However, the prevalence of cardiovascular risk factors and the prevalence of diabetes mellitus were significantly lower among park users than among non-users. During the follow up, an increased risk of non-fatal and fatal CVD combined was observed for those who lived ≥629.61 m from green spaces (3rd tertile of distance to green space) (hazard ratio (HR) = 1.36), and the risk for non-fatal CVD–for those who lived ≥347.81 m (2nd and 3rd tertile) and were not park users (HR = 1.66) as compared to men and women who lived 347.8 m or less (1st tertile) from green space. Men living further away from parks (3rd tertile) had a higher risk of non-fatal and fatal CVD combined, compared to those living nearby (1st tertile) (HR = 1.51). Compared to park users living nearby (1st tertile), a statistically significantly increased risk of non-fatal CVD was observed for women who were not park users and living farther away from parks (2nd and 3rd tertile) (HR = 2.78).ConclusionOur analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.

Burnout and Perceived Stress among University Coaches in Lithuania

Burnout and Perceived Stress among University Coaches in Lithuania: Romualdas Malinauskas, et al. Lithuanian Academy of Physical Education, Lithuania

Health factors and risk of all-cause, cardiovascular, and coronary heart disease mortality: findings from the MONICA and HAPIEE studies in Lithuania.

Aims This study investigated the trends and levels of the prevalence of health factors, and the association of all-cause and cardiovascular (CVD) mortality with healthy levels of combined risk factors among Lithuanian urban population. Methods Data from five general population surveys in Kaunas, Lithuania, conducted between 1983 and 2008 were used. Healthy factors measured at baseline include non-smoking, normal weight, normal arterial blood pressure, normal level of total serum cholesterol, normal physical activity and normal level of fasting glucose. Among 9,209 men and women aged 45–64 (7,648 were free from coronary heart disease (CHD) and stroke at baseline), 1,219 death cases from any cause, 589 deaths from CVD, and 342 deaths from CHD occurred during follow up. Cox proportional hazards regression was used to estimate the association between health factors and mortality from all causes, CVD and CHD. Results Between 1983 and 2008, the proportion of subjects with 6 healthy levels of risk factors was higher in 2006–2008 than in 1983–1984 (0.6% vs. 0.2%; p = 0.09), although there was a significant increase in fasting glucose and a decline in intermediate physical activity. Men and women with normal or intermediate levels of risk factors had significantly lower all-cause, CVD and CHD mortality risk than persons with high levels of risk factors. Subjects with 5–6 healthy factors had hazard ratio (HR) of CVD mortality 0.35 (95% confidence interval (CI) 0.15–0.83) compared to average risk in the whole population. The hazard ratio for CVD mortality risk was significant in men (HR 0.34, 95% CI 0.12–0.97) but not in women (HR 0.38, 95% CI 0.09–1.67). Conclusions An inverse association of most healthy levels of cardiovascular risk factors with risk of all-cause and CVD mortality was observed in this urban population-based cohort. A greater number of cardiovascular health factors were related with significantly lower risk of CVD mortality, particularly among men.

Myocardial infarction risk and occupational categories in Kaunas 25–64 year old men

Aims: To investigate the risk of a first time myocardial infarction (MI) among different occupational categories in 25–64 year old men in Kaunas, Lithuania, a country in a transition market economy. Methods: Case-control study among men aged 25–64 who were residents in Kaunas between 1997 and 2000. First time, non-fatal MI cases (n = 448) were identified from the MI hospital register (International Classification of Diseases, 10th revision, code I21). Controls (n = 1777) were selected and matched on age, gender, and city district of residence. Information was obtained on occupation, smoking, hypertension, psychosocial, and behavioural factors. The International Standard Classification of Occupations (ISCO) was used to code for occupational categories. The relation between MI and occupational categories was evaluated by logistic regression analysis, adjusting for a number of selected risk factors. Results: Legislators, senior officials, and managers (1st ISCO category) had a twofold increased risk for MI compared to craft and related trades workers (7th ISCO category) after adjustment for age, district, smoking, hypertension, obesity, stress, education, and employment duration. An increased risk for professionals (2nd ISCO category) and plant and machine operators and assemblers (8th ISCO category) was also observed. Employment duration in the last occupation for 20 years and more almost doubled the risk of MI in the whole population. We also found an increased risk for other traditional IHD risk factors such as smoking and arterial hypertension. Conclusions: Differences in first time MI risk among occupational categories were found. Legislators, senior officials, and managers (1st ISCO category), professionals (2nd ISCO category), and plant and machine operators and assemblers (8th ISCO category) were at an increased risk. Differences in psychosocial factors in transition market economy countries may contribute to observed results.

Workplace bullying and post-traumatic stress symptoms among family physicians in Lithuania: An occupation and region specific approach

ObjectivesThe study investigated associations between workplace bullying and post-traumatic stress symptoms as compared to and controlled for associations between the latter and other psychosocial stress factors at work and in everyday life. The study employed a representative sample of Lithuanian family physicians, hence investigated a particularly resourceful occupational group in a geographical region earlier found to have a high risk context for exposure to bullying at work.Material and MethodsWith a response rate of 89.2%, a total of 323 family physicians filled in an anonymous questionnaire on workplace bullying, post-traumatic symptomatology (IES-R), other psychosocial stressors at work and in everyday life, personal health resources (sense of coherence), behavioral characteristics and demographic variables. The statistical software SPSS 14.0, Windows was used in the analysis. Associations were tested using a multivariate logistic regression analysis.ResultsA high prevalence of bullying was found among family physicians in Lithuania, with 13% of them experiencing severe workplace bullying and 17.3% experiencing more occasional incidents of bullying. The prevalence of post-traumatic stress symptoms was also high with 15.8% scoring above the standardized cut-off thresholds for post-traumatic stress disorder. The odds ratio (OR) of severe bullying for post-traumatic stress after adjustment for age and gender was 8.05 (95% confidence intervals (CI): 3.80–17.04). In the fully adjusted model it increased to 13.88 (95% CI: 4.68–41.13) indicating cumulative effects of all the investigated stressors.ConclusionsWorkplace bullying is particularly prevalent among Lithuanian family physicians, as are the symptoms of post-traumatic distress. Strong associations between post-traumatic stress and exposure to severe bullying indicate that bullying is a significant source of mental health.

Cardiovascular risk factors and cognitive function in middle aged and elderly Lithuanian urban population: results from the HAPIEE study

BackgroundThe purpose of this study was to examine associations between cardiovascular risk factors and cognitive ability in middle aged and elderly Lithuanian urban population.MethodsData from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial Factors in Eastern Europe) study were presented. A random sample of 7,087 individuals aged 45–72 years was screened in 2006–2008.ResultsThe scores of immediate recall and delayed verbal recall, cognitive speed and attention were significantly lower in men than in women; yet numerical ability scores were higher in men. Significant associations between lowered cognitive functions and previous stroke (in male OR = 2.52; 95% CI = 1.75-3.64; in female OR = 2.45; 95% CI = 1.75, 3.64) as well as ischemic heart disease history (among male OR = 1.28; 95% CI = 1.03-1.60) have been determined. Higher level of physical activity in leisure time (among female OR = 1.32; 95% CI = 1.03-1.69), poor self-rated health (among male OR = 1.57; 95% CI = 1.15-2.14) and poor quality of life (in male OR = 1.67; 95% CI = 1.07-2.61; in female OR = 2.81; 95% CI = 1.92-4.11) were related to lowered cognitive function.ConclusionsThe findings of the study suggest that associations between cardiovascular risk factors and lowered cognitive function among healthy middle-aged and elderly adults strongly depend on gender.

Menopause and myocardial infarction risk among employed women in relation to work and family psychosocial factors in Lithuania

OBJECTIVES To assess the relationship between menopause and age at menopause and the risk of the first non-fatal myocardial infarction taking into account the possible influence of psychosocial job characteristics, marital stress, level of social support, educational level, occupation, age and traditional ischemic heart disease risk factors. METHODS Population-based case-control study among 35-61 years old employed women in Kaunas, Lithuania. Totally 122 myocardial infarction cases and 371 controls were interviewed in 2001-2004. The logistic regression analysis was performed. RESULTS Younger age at menopause (<or=40 years) showed a tendency for increased myocardial infarction risk (OR=1.78; 95% CI 0.39-8.07) after adjustments for age, smoking, arterial blood pressure and body mass index. However further adjustment for job demands, job control, social support, marital stress, education level, occupation decreased the risk (OR=1.16; 95% CI 0.27-5.01). In the fully adjusted model OR for postmenopausal women was 1.15; 95% CI 0.48-2.75. The association between low job control and myocardial infarction showed step increase, women in the lowest quartile of job control had the highest myocardial infarction risk (OR=4.51; 95% CI 1.90-10.75), while those in the second and third quartiles showed modest risk. Marital stress was an independent myocardial infarction risk factor for employed women (adjusted OR=2.36; 95% CI 1.07-5.19). CONCLUSIONS Menopausal status and younger age at menopause showed only a tendency for increase in myocardial infarction risk among the employed women in Kaunas, Lithuania. Adverse psychosocial job characteristics as low job control, as well as marital stress play more important role in the development of the first myocardial infarction.

Trends in Prevalence of Dyslipidaemias and the Risk of Mortality in Lithuanian Urban Population Aged 45–64 in Relation to the Presence of the Dyslipidaemias and the Other Cardiovascular Risk Factors

The aim of this study was to provide reliable information on dyslipidaemias, to estimate the trend of the prevalence of dyslipidaemias and other selected cardiovascular disease (CVD) risk factors at population level, and to evaluate the risk of all-cause and CVD mortality in relation to presence of mixed dyslipidaemias and other CVD risk factors. Methods Data from the five surveys (1983–2008) are presented. A random sample of 9,209 subjects aged 45–64 was selected for statistical analysis. During follow-up there were 1653 death cases from any cause, 864 deaths from CVD. Estimates of hazard ratios (HR) and 95% confidence intervals (CI) were based on the multivariate Cox proportional hazards regression for all-cause mortality and CVD mortality. Results During 25 year period the prevalence of normal total cholesterol level (<5.2 mmol/L) significantly increased only in women; triglycerides and high density lipoprotein (HDL) cholesterol did not change in men and women. Findings in our longitudinal study showed that in men and women mixed dyslipidaemias (HDL cholesterol <1.03 mmol/L plus triglycerides ≥1.70 mmol/L) significantly increased the risk for all-cause and CVD mortality (respectively in men HR = 1.30; HR = 1.15, in women HR = 1.83; HR = 2.13). These mixed dyslipidaemia combinations combination with the other risk factors such as arterial hypertension, high fasting glucose level increased all-cause and CVD mortality risk in men and women; while, these mixed dyslipidaemias plus smoking increased all-cause and CVD mortality risk only in men compared to never smokers without these dyslipidaemias (respectively HR = 1.89; HR = 1.92); and these dyslipidaemias plus obesity increased all-cause and CVD mortality risk in women (respectively HR = 2.25; HR = 2.39) and CVD mortality risk in men (HR = 1.72), as compared to responders without obesity and these dyslipidaemias. Conclusion Mixed dyslipidaemias (reduced HDL cholesterol plus elevated triglycerides) significantly increased the risk for all-cause and CVD mortality in this Lithuanian population aged 45–64 years.

Workplace bullying and mental health among teachers in relation to psychosocial job characteristics and burnout

OBJECTIVES The objective of the study has been to assess the associations between psychological distress and exposure to workplace bullying, taking into account possible influence of adverse psychosocial job characteristics and occupational burnout in a sample of Kaunas (Lithuania) teachers. MATERIAL AND METHODS The study sample included 517 teachers from 13 secondary schools and was conducted in 2014. The participants filled in the anonymous questionnaire (response rate 71.3%). Twenty-two-item Negative Acts Questionnaire (H. Hoel and S. Einarsen) was used for measuring the exposure to workplace bullying, Goldberg 12-item General Health Questionnaire (GHQ-12) - psychological distress, Maslach Burnout Inventory (MBI) - occupational burnout, Karasek Demand-Control questionnaire - psychosocial job stressors. The IBM SPSS Statistics version 20.0 was used for performing the statistical analysis. Associations between psychological distress, exposure to workplace bullying, psychosocial job characteristics and occupational burnout were analyzed in the logistic regression and expressed in terms of odds ratios (OR). Statistical significance was determined using the 95% confidence interval (CI) level. RESULTS Workplace bullying was prevalent among Kaunas teachers (occasional - 8.3%, severe - 2.9%). Twenty-five percent of teachers suffered from psychological distress. High emotional exhaustion was found in 25.6% of them, high depersonalization in 10.6% and low personal achievement in 33.7% of cases. Almost a half of respondents (47.4%) reported job strain and 59.6% - low social support at work. Occasional and severe bullying was associated with psychological distress after adjusting to job strain, social support and emotional exhaustion, depersonalization, personal accomplishment (adjusted OR was 3.27, 95% CI: 1.56-6.84 for occasional and 4.98, 95% CI: 1.27-19.62 for severe bullying). CONCLUSIONS Occasional and severe bullying were strong predictors for psychological distress. Burnout did not mediate those associations. The effect of job strain and low social support decreased to the insignificant level in the final model. Preventive measures are necessary to improve psychosocial working conditions in secondary education institutions. Int J Occup Med Environ Health 2017;30(4):629-640.

0270 Mental distress in relation to psychosocial factors at work among family physicians

Objectives The study investigated the associations between mental health and job demands, control and social support at work and controlled for physical inactivity, sense of coherence and psychosocial factors in everyday life in a representative sample of Lithuanian family physicians. Method With a response rate 89.2%, a total of 323 family physicians filled in anonymous questionnaire on mental distress (GHQ-12) and psychosocial stressors at work and in everyday life, personal health resources (sense of coherence) and demographic variables. The statistical software SPSS 14.0 for Windows was used in the analysis. Associations were tested by way of multivariate logistic regression analysis. Results The prevalence of mental distress was 40.2% among family physicians and was positively associated with high job demands (p < 0.001), low job control (p = 0.009) and low social support at work (p = 0.009). In a fully adjusted model controlling for age, gender, physical inactivity, sense of coherence, self-rated health, social relations and work-family interface, the adjusted OR for high job demands remained statistically significant with the OR=2.40; 1.40–4.12, but for low job control it was 1.27; 95% CI 0.74–2.19, and for low social support at work - insignificant. Conclusions Nearly half of the family physicians were mentally distressed. Psychosocial job characteristics, especially high job demands play an important role in poor mental health, as well as social relations, self-rated health and low sense of coherence. Health promotion strategies should be applied for this important occupation to diminish mental distress.