Tomkevičiūtė, Jūratė

Įvadas. Mokomojoje knygoje pateikiamos Medicinos vientisųjų studijų programos baigiamojo magistro darbo (BMD) rengimo rekomendacijos. Dokumentas apibrėžia darbo planavimo, tyrimų etikos, metodologinių reikalavimų ir mokslinės komunikacijos principus, užtikrinančius akademinę kokybę ir tyrimų patikimumą. [...]

Technological advancements have profoundly reshaped healthcare systems, transforming workflows, communication, and education. This paper explores the integration of digital health innovations, including electronic health records (EHRs), artificial intelligence (AI), and virtual reality (VR), within Lithuanian healthcare institutions, educational settings and research initiatives. It emphasizes the pivotal role of health care professionals and nursing informatics in adapting to digital transformation, while also addressing key challenges such as digital competence, system usability, and implementation costs.

At Lithuania’s largest hospital, Kaunas Clinics, digital systems such as Hospital Information Systems (HIS, AREST), and automated monitoring tools are enhancing care coordination and clinical decision-making. A case study from Kėdainiai District Hospital highlights disparities in digital competence between nurses and nursing assistants, underscoring the need for systematic and personalized training programs.

In healthcare education, the Lithuanian University of Health Sciences (LSMU) incorporates simulation technologies, VR, and AI to strengthen students’ clinical reasoning and technical skills in safe, immersive environments. The paper also presents a collaborative initiative with Kaunas University of Technology (KTU) to develop an AI-and XR (extended reality)-based educational model focused on critical clinical scenarios, such as the management of anaphylactic shock. Despite technical and linguistic barriers, innovations like GPU-accelerated speech recognition and AI-driven virtual patients offer promising solutions to enhance health care students’ critical thinking and decision-making in acute care settings.

The authors conclude that the integration of advanced digital technologies and interdisciplinary innovations in both healthcare practice and education not only improves clinical workflows and patient outcomes but also transforms medical training. This ensures future professionals are equipped with the skills and tools essential for delivering high-quality care in modern clinical environments. The paper further highlights the importance of interdisciplinary collaboration in research as a driving force shaping the future of digital health.

Background/Objectives LAS is common in adolescents, yet early management strategies differ. The traditional PRICE + NSAIDs protocol focuses on short-term symptom relief, whereas the PEACE and LOVE framework emphasizes education, early optimal loading, and progressive exercise. This study compared functional recovery between these two approaches.

Leidinyje pateikiamos rekomendacijos, reglamentuojančios baigiamojo magistro darbo (BMD) rengimo procesą Medicinos vientisųjų studijų programoje. Dokumentas apibrėžia darbo planavimo, tyrimų etikos, metodologinių reikalavimų ir mokslinės komunikacijos principus, užtikrinančius akademinę kokybę ir tyrimų patikimumą.

Background and Objectives: A prominent area of research in adolescent ACL reconstruction (ACLR) involves graft selection, with particular interest in the quadriceps tendon (QT) as an alternative to hamstring tendon (HT) autografts, although comparative studies on muscle strength outcomes and patient satisfaction in adolescents remain limited. This study aims to evaluate the influence of QT and HT autografts on muscle strength and satisfaction outcomes post-ACLR in adolescents. Methods: This prospective study was conducted at the Lithuanian University of Health Sciences, enrolling 68 patients aged 12–17. ACLRs were performed using QT or HT autografts. Muscle strength was assessed using an isokinetic dynamometer (Biodex), while patient satisfaction was evaluated through IKDC, Lysholm, and ACL-RSI surveys preoperatively and 12 months postoperatively. Results: 54 patients (24 QT and 30 HT) completed the study. The data are non-parametric and are presented as median (IQR). Isokinetic measurements indicated that QT harvesting led to significantly lower extension strength compared to HT 6 months (p = 0.019) and 12 months post-op (p < 0.001) but showed better H/Q ratios 6 months (p = 0.019) and 12 months post-op (p < 0.001). There was no significant difference between the QT and HT groups in ACL-RSI and Lysholm scores. IKDC scores were significantly higher in the HT group (p = 0.009). Conclusions: QT autografts provide favorable H/Q ratios, yet they exhibit weaker extension strength and lower satisfaction outcomes compared to HT. These results suggest a need for individualized rehabilitation protocols and further research to optimize ACLR graft selection for adolescents.

Temos aktualumas A lateral ankle sprain (LAS) is one of the most common injury, which occurs in children. Despite large number of studies, diversity of treatment strategies persists. Over 20 years acronym PRICE (protection, rest, ice, compression, elevation) and anti-inflammatory drugs (NSAIDs) is first option, despite its lack of high quality evidence. Lately acronym PEACE and LOVE (protection, elevation, avoid anti-inflammatory drugs and icing, compression, education, load, optimism, vascularisation, exercise) was announced, which involves immediate care and rehabilitation of soft tissue damage. It is thought that phases of inflammation help tissue to heal and NSAIDs combined with icing interferes it, so new strategy excludes this combination. Darbo tikslas (-ai) To compare PRICE vs PEACE and LOVE for LAS treatment, to evaluate injury severity outcomes and to verify the need of plaster cast immobilization in adolescents. Tyrimo metodai A prospective randomised study of 65 (37 male, 28 female) patients from 12 to 17 years old who admitted LUHS Paediatric emergency department (ED) in year 2022- 2024 after LAS was executed. Inclusion criteria were first time LAS, acute period of 1 to 4 days after injury, exclusion of chronic pain and any fracture, except avulsion. Depending on symptoms immobilization by plaster cast was applied for 30 patients (46,2%) in the ED. At first visit to the policlinics cast was removed for all of them, lace-up splint was prescribed to all 65 patients and they were randomly allocated to two age and gender homogenous groups: classic (A) PRICE (n = 32, male 62,5%, female 37,5%) or new (B) PEACE and LOVE (n = 33, male 51,5%, female 48,5%) treatment method. Patient diagnose was confirmed by x rays and ultrasound system MyLab 9 eXP 20071, Esaote S.p.A., CE 0123. Ankle function was tested by Biodex isokinetic dynamometer to compare range of motion (ROM) and peak torque to body weight (PEAK TQ/BW) of inversion (IN) and eversion (EV), Y balance test composite scores (YBT CS) were counted to evaluate proprioception between involved (I) and uninvolved (U) legs 1 to 2, 5 to 7 and 12 to 15 weeks after injury comparing two methods. Depending on radiologic findings patients were divided into two groups: I – diagnosed with sprains (grade I) or partial tears (grade II) of lateral ankle ligaments; II – diagnosed with complete tears (grade III) and/or avulsions of lateral malleolus. Data analysis was performed by IBM SPSS 22 software. Two independent samples were compared by Mann-Whitney U test, three measurements in each group were compared by Friedman test. Rezultatai Mean patient age in group was A 14,31 (SD 1,67), in group B 14,64 (SD 1,64). Depending on injury severity 30 patients (46.2%) formed group I and 35 patients (53.8%) group II. There was a significant difference measuring YBT CS deficiencies between U and I legs in group I and II after third testing: YBT-3 CS group I -0,47% vs group II 1,43% (U=353, p=0,02). Only first Biodex testing showed higher deficit of IN for I leg: 1 PEAK TQ/BW IN group I 27,43% vs group II 37,77% (U=358, p=0,028) but later testings showed no significant difference depending on injury severity. Group II showed significantly higher ROM deficit at second and third testing: 2 ROM group I 27,83 ° vs 37,43 ° (U=370, p=0,04), 3 ROM group I 26,53 ° vs 38,54 ° (U=331, p=0,011). Immobilization by plaster cast in the ED was applied to total of 30 (46,15%) patients: 12 (40,0%) group I and 18 (51,4%) group II patients (p=0,357). Application of plaster cast had no better outcomes over 3 testings in IN, EV or ROM: : 3 PEAK TQ/BW IN cast group 31,62% vs no cast group 34,19% (U=483,5, p=0,585); 3 PEAK TQ/BW EV cast group 29,8% vs no cast group 35,74% (U=429, p=0,206); 3 ROM cast group 33,40 ° vs no cast group 32,66 ° (U=513, p=0,875). Two different treatment strategies were compared by Friedman test, pairwise comparisons were performed and B treatment method showed significant better results in YBT CS, PEAK TQ/BW IN and ROM deficit scores: group A YBT CS-1 2,28% and YBT CS-3 1,7% vs group B YBT CS-1 2,42% and YBT CS-3 1,61% (p=0,003); group A 1 PEAK TQ/BW IN 2,09 and 3 PEAK TQ/BW IN 1,84 vs group B 1 PEAK TQ/BW IN 2,27 and 3 PEAK TQ/BW IN 1,68 (p=0,049); group A 1 ROM 2,59 ° and 3 ROM 1,45 ° vs group B 1 ROM 2,64 ° and 3 ROM 1,47 ° (p<0,001). Išvados, rekomendacijos Higher grade of lateral ankle ligaments tear has no significant impact on ankle proprioception outcomes, but has impairement of ROM and early post injury inversion force. Immobilization by plaster cast is used too often even for minor injuries because it has no better outcomes for LAS treatment, it should be used as short as possible and only for pain control. PEACE and LOVE treatment method showed better results than PRICE in YBT CS, ROM and inversion force.

Background: practice-based learning has always been a key element of dental education, and the hours of practical learning during the COVID-19 pandemic has reduced, which may have led to student preparation for the (OSCE) - Objective Structured Clinical Examinations. Aim: to evaluate the impact of the pandemic on the opinion of 5th year students of the Dentistry program, of the Lithuanian University of Health Sciences about the OSCE. Methods: We used a self-administered 15-item questionnaire ((8) - practical and (7) - psychological questions). Each question was scored on a Likert scale (from completely disagree (score 1) to completely agree (score 5)). In May 2019 and May 2022 students were asked an anonymous self-administered written questionnaire after completing assignments of OSCE examination. 111 students in 2019 (response rate 100%) and 107 students in 2022 (response rate 89.17%) participated. Statistical analysis was performed with the SPSS-27. The MannWhitney test was used to calculate the results. The difference in data between two groups are Statistically significant when (p

Background: Pregnancy is a unique moment in a woman's life (Calou et al., 2018) that brings changes in psycho-emotional, spiritual and physical health. The development of antenatal attachment is an important aspect of the transition to motherhood (Ertmann et al., 2021), and perceived pregnancy anxiety can be detrimental to both, mother and foetus. Aims: To determine the relationship among pregnancy anxiety, spiritual well-being, and antenatal attachment in pregnant women. Methods: The cross-sectional survey design was applied from Now. 2019 till Nov. 2021. In total, 292 pregnant women were invited to participate during their 2nd and the 3rd trimesters of pregnancy. The questionnaires from 279 women in the 2ndtrimester and 174 women in the 3rd trimester were analysed. Spiritual well-being (SW)(SHALOM), Pregnancy-related anxiety(PRA) and Maternal antenatal attachment (MAA) scales were used. Findings: The age of respondents ranged from 18 to 45 y with the average of 30.4 (SD=4.6). The majority of women have had their pregnancy planned (84.6%) and most of them (75.3%)considered themselves as religious persons. PRA. Moderate and high levels of anxiety occurred in women during third (52%) and second (48.6%) trimesters of pregnancy, respectively. Anxiety scores were higher in the third trimester than in the second one. Women later in pregnancy were more afraid of being hurt during childbirth and worried about caring for their baby. Pregnancy anxiety had a negative relationship with all dimensions of SW, except Transcendental dimension for the Lived and Ideal domain of SHALOM.SW. Significant difference was found in the Ideal communal, Lived overall and Lived communal domains – the scores in the second trimester of pregnancy were higher compared to the scores in the third trimester. MAA. During the 3rd trimester, the MAA scale was completed by 173 respondents who also participated in the first stage. MAAS Total, Quality and Intensity changed significantly -higher scores were obtained in the third trimester of pregnancy. When comparing the MAAS Quality and Intensity scores, the change in the Intensity score was greater than in Quality score. Conclusion: Pregnant women feel more anxious in the third trimester than in the second. Anxiety in pregnancy is related to the maternal attachment and personal, communal and Ruseckienė, D.,Tomkevičiūtė, J.,Riklikienė, O.29environmental spiritual well-being. This study highlighted the importance of considering multiple aspects of spiritual health and maternal-foetal attachment during pregnancy as they maybe beneficial coping strategies used to adapt to pregnancy anxiety.

Introduction Practice-based learning has always been a key element of dental education, and the change in the concept of the learning process during the COVID-19 pandemic has reduced practical learning hours, which may have led to student preparation for the Objective Structured Clinical Examinations (OSCE) [1]. The Objective Structured Clinical Examination (OSCE) is a practical exam that provides a standardized assessment of clinical competence [2]. Aim To evaluate the impact of the pandemic on the opinion of 5th year students of the Dentistry program, Lithuanian students of the Lithuanian University of Health Sciences about the examination of the Dentistry clinical practice module based on the OSCE methodology. Methods We carried out a cross-sectional survey of Lithuanian students’ opinion and experience towards OSCE examination among dental graduating students in the Lithuanian University of Health Sciences. We used a self-administered 15-item questionnaire. 15 questions were divided into practical questions (8) and psychological questions (7). Each question was scored on a Likert scale (answer options: from completely disagree (score 1) to completely agree (score 5)). In May 2019 and May 2022 students were asked to complete an anonymous self-administered written questionnaire after completing assignments of OSCE examination. 86 students in year 2019 (response rate 100%) and 85 students in year 2022 (response rate 81.4%) participated. Statistical analysis was performed with the SPSS (1.0.0.1406). The Mann-Whitney test was used to calculate and compare the results. The difference in data between two groups are Statistically significant when (p