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The COVID-19 pandemic changed the life of many. The study aimed to identify fragile groups of the population regarding nutrition during the COVID-19 restriction period. An online survey was conducted from 26 July to 3 September 2020. A total of 1173 answers were received from persons aged 18–68 years living in Latvia. The results showed that food availability mainly was not limited, although for 15.3% responders restrictions caused increased worries about not having enough food, and 12.2% noted a decrease in the ability to eat preferred food. Responders aged 40–54 noted that they ate less, and that their food stocks were scarce in comparison with other age groups. Almost 50% of responders increased food consumption. One-fifth of responders increased consumption of foods of low nutritional value, especially among 25–39 year old persons and in households where the economic situation became worse. Fragile groups regarding nutrition in times of COVID-19 restrictions included households whose economic situation became worse during the COVID-19 restrictions, younger people who increased food consumption together with consumption of food of low nutritional value, and persons aged 40–54 years. The data from the study serve as an indicator that more detailed research is needed to determine whether crises such as the COVID-19 pandemic are changing dietary habits and food availability in the population.

Caesarean section is associated with an increased risk of abnormal placental implantation and adverse pregnancy outcomes in subsequent pregnancies. Besides the placenta accrete spectrum, only a few of the previous studies focused on other placental development alterations in the scarred uterus. We assessed placental development deviations in the uterus with a Caesarean section scar by evaluating placental volume (PV) and vascular flow indexes. From 1 January 2021 until 31 March 2022, placental volumes and vascularization indexes (VI, FI, VFI) were prospectively measured by 3D power Doppler and VOCAL techniques in 221 patients attending the first trimester screening program. We also calculated the placental quotient to standardize PV to the gestational age. No statistically significant differences in the values of placental volume, placental quotient and placental vascularization indexes were detected between women with previous Caesarean section delivery or women with vaginal delivery. FI was significantly lower in nulliparous in the first trimester. The results of our study suggest that 3D placental evaluation was not able to detect placental development alteration in the uterus with a Caesarean section scar. Future research needs to verify whether 3D power Doppler and Vocal techniques can provide more information if used in an earlier gestational age. ispartof: DIAGNOSTICS vol:12 issue:11 ispartof: location:Switzerland status: published

OBJECTIVE: To compile existing knowledge on the level of cervical regeneration (detected by ultrasound) after loop electrosurgical excision procedure (LEEP) and to suggest research protocol for further studies. METHODS: We conducted a literature search of Medline, Web of Science, Scopus, and Cochrane databases using the keywords "cervix" and "regeneration" without year restrictions. Our eligibility criteria included studies that analysed cervical volume and length regeneration using ultrasound. A literature review was conducted following PRISMA guidelines and registered in PROSPERO (reg. no. CRD42021264062). Information about the studies was extracted from each analysed study on an Excel datasheet and the average regeneration with standard deviation was calculated. All included studies' possible biases were assessed by the National Institutes of Health's (NIH) quality assessment tool. RESULTS: The literature search identified 802 papers and four trials (n = 309) that met our criteria. They investigated cervical length and volume regeneration after LEEP using ultrasound, concluding that there is a profound regeneration deficit. Average cervical length regeneration after 6 months was 83.4% (±10.8%) and volume regeneration was 87.4% (±6.1%). All analysed studies had their biases; therefore, based on the conducted studies' protocols, we present a CeVaLEP research protocol to guide high-quality studies. CONCLUSION: After LEEP, there is a cervical regeneration deficit. There is a lack of high-quality studies that assess cervical volume regeneration and its relation to obstetrical outcomes. There is a gap in the field and more research is needed to define the prenatal risks related to cervical regeneration. ispartof: JOURNAL OF CLINICAL MEDICINE vol:11 issue:8 ispartof: location:Switzerland status: published

Background The COVID-19 pandemic has challenged the ability of healthcare systems to ensure the continuity of health services for patients with non-communicable diseases (NCDs). The issue of remote consultations has emerged. Before the COVID-19 pandemic, remote consultations were not routinely provided or covered by public health funding in Latvia. This study aimed to describe the dynamics of consultations and the volume of remote consultations provided for patients with particular NCD and explore clinicians’ experiences of providing remote consultations during the first wave of the COVID-19 pandemic in Latvia. Methods A mixed-method study focusing on the first wave of the COVID-19 pandemic in Latvia in Spring 2020 was conducted. Quantitative data from the National Health Services were analysed to assess the dynamics of consultations for patients with selected NCDs. Qualitative data were collected through 34 semi-structured interviews with general practitioners (GPs) and specialists and were analysed using an inductive thematic analysis. Purposive maximum variation sampling was used for participant selection. Results During the period with the strongest restrictions of scheduled on-site consultations, a decrease in the total number of consultations was observed for a variety of NCDs. A significant proportion of consultations in this period were provided remotely. GPs provided approximately one-third of cancer-related consultations and almost half of consultations for the other selected conditions remotely. Among specialists, endocrinologists had the highest proportion of remote consultations (up to 72.0%), while urologists had the lowest (16.4%). Thematic analysis of the semi-structured interviews revealed five themes: 1) Adjusting in a time of confusion and fear, 2) Remote consultations: safety versus availability, 3) Sacrifice and loss of privacy, 4) Advantages and disadvantages of communication technologies, and 5) Different form of communication and a health literacy challenge. Conclusions During the first wave of the COVID-19 pandemic in Latvia, disruptions to health care services decreased the total number of consultations for patients with NCDs provided by both GPs and specialists. In this period, remote consultations proved to be an important instrument for ensuring the continuity of health care for patients with NCDs, and the necessity to develop a well-designed system for telemedicine in Latvia was highlighted.

Objective: Although the World Health Organization (WHO) recommends the presence of a support person, several hospitals in Latvia have restricted the presence of supporting persons due to COVID-19. This study was conducted to understand the importance of partnership and the role of the accompanying person in childbirth in the context of COVID-19 in Latvia.Methods: A mixed method study with sequential explanatory design was conducted from 26 July to 30 October 2020. The quantitative study consisted of a behavioral cross-sectional online survey with convenience sampling. The survey items, methods, and implementation were performed as part of the I-SHARE study carried out in 33 countries, with standardized survey instruments that were focused on sexual and reproductive health issues. In Latvia it was supported by the National Research Program to lessen the effects of COVID-19. Our study analyses only one part of all data. To answer the research question besides quantitative data the qualitative study that consisted of 7 semi-structured in-depth interviews and 11 focus group discussions was integrated.Results: 1,173 people of Latvia have participated in the I-SHARE online survey. The answers of 662 women of reproductive age and 70 pregnant women have been analyzed. Pregnant women had less tension with their partners and received higher partner emotional support before the COVID-19 pandemic than other women of reproductive age, and pregnant women were less frustrated during COVID-19 than non-pregnant women of reproductive age (p < .05). More than half (61.4%) of the pregnant women felt anxiety and depression due to COVID-19 restrictions. The qualitative part of the study revealed that having a partner during childbirth was an important aspect when choosing a facility to give birth in, as the lack of an accompanying person caused anxiety and additional stress.Conclusions: COVID-19 has increased anxiety and depression among pregnant women. Birth companions should not be considered third parties, and establishing a delivery unit visitor policy is necessary to balance the benefits and risks in an evidence-based and compassionate manner.

The field of psychological help in Latvia is undergoing significant changes that require reviewing past practices and professional activities. The term “psychological help” is used quite widely in Latvian regulation, not revealing the semantic difference from other terms as psychological treatment, psychological care, psychological support or psychological aid. The purpose of this article is to find out how the term "psychological help" is used in the regulatory documents of Latvia. The method of qualitative thematic analysis was used to analyse terminology use in selected documents (n115). As a result five topics describing psychological help were identified and defined in the regulatory documents of Latvia: “Professional diversity of psychological help providers”, “Indicators for professional help”, “Targets of professional help”, “Beneficiaries of psychological help”, “Methods of professional help”. The term psychological help in Latvian regulatory documents is revealed in a fragmentary and non-systematic way, which contributes to the confusion of terminological diffusion and boundaries of professional competences.

Sabiedrības veselība Veselības aprūpe Public Health Health Care Darba tēma: “Cilvēka papilomas vīrusa izplatības raksturojums Latvijas sieviešu vidū.” Darba mērķis: Izpētīt cilvēka papilomas vīrusa izplatību Latvijas sieviešu vidū saistībā ar seksuālo uzvedību, hormonālās kontracepcijas izmantošanas un atkarību izraisošo vielu lietošanas paradumiem. Aktualitāte: Cilvēka papilomas vīruss (CPV) ir vīruss, kas var izraisīt patoloģiskas pārmaiņas cilvēka audos un šūnās. Ir atklāts, ka CPV ir visizplatītākā seksuāli transmisīvā infekcija, turklāt pastāv vairāk nekā 100 dažādi vīrusa tipi. Augsta riska tipi var izraisīt dzimumorgānu kārpas un vairākus vēža veidus, piemēram, dzemdes kakla, maksts un rīkles vēzi. Tiek uzskatīts, ka pastāv 80% risks, ka indivīds dzīves laikā inficēsies ar CPV. Pētījuma dizains: šķērsgriezuma pētījums. Pētījuma metodes: Bakalaura darbā tiek izmantota kvantitatīva šķērsgriezuma pētījuma “Dzemdes kakla vēža ierobežošana: inteliģenti un personalizēti risinājumi vēža skrīningam” datu bāze. Pētījuma mērķa grupa ir Latvijas sievietes no 25 līdz 70 gadiem. Kopumā piedalījās 1313 respondentes. Lauka darbs norisinājās no 2020. gada septembra līdz 2022.gada martam. Pētījuma norises laikā sievietēm tika izsniegta pašaizpildes anketa (tika sniegta informēta piekrišana) un maksts uztriepes pašpaņemšanas komplekts CPV izmeklējuma veikšanai. Bakalaura darbā tiek izmantotas aprakstošās statistikas metodes – biežumu sadalījums, šķērstabulas 2x2 un Hī kvadrāta (χ2) (angl.– chi-square) tests. Lai noteiktu 95% ticamības intervālu, tika izmantota datorprogramma “Epitools - Epidemiological Calculators”. Ja rezultāta būtiskuma līmenis (p vērtība) bija mazāks par 0,05 (p

Sabiedrības veselība Veselības aprūpe Public Health Health Care Tēma: Sieviešu dalības dzemdes kakla vēža skrīninga programmā raksturojums Latvijā. Mērķis: Noskaidrot ar dalību dzemdes kakla vēža skrīningā saistītos faktorus skrīninga vecuma sieviešu populācijā Latvijā. Aktualitāte: Eiropā dzemdes kakla vēzis ieņem otro vadošo vietu pēc izplatības rādītāja. Ik gadu Eiropas Savienībā ir reģistrēti 33 000 jaunatklātie dzemdes kakla vēža gadījumi un 15 000 dzemdes kakla vēža izraisītie nāves gadījumi. Latvijā dzemdes kakla vēzis sieviešu vidū vecumā līdz 45 gadiem ir otrais biežāk sastopamais vēža veids un trešais izplatītākais vēža izraisītas nāves cēlonis sievietēm. Ir pieejama savlaicīga dzemdes kakla vēža pirmsvēža stāvokļa noteikšana, kā arī agrīna vēža diagnosticēšana, ko sevī ietver dzemdes kakla vēža skrīnings. Taču, neskatoties uz pieejamo profilaksi, Latvijā ir nepietiekama sieviešu dalība skrīningā. 2022. gadā pirmajā pusgadā sasniegta 58,9% liela atsaucība, kas ir lielākā visa skrīninga programmas pastāvēšanas laikā. Sieviešu dalība skrīningā var variēt atkarībā no dažādiem faktoriem, tajā skaitā sociāli demogrāfiskajiem faktoriem, dzīvesveida paradumiem un esošā informētības līmeņa par dzemdes kakla vēža skrīningu. Pētījuma dizains: Šķērsgriezuma pētījums. Materiāls un metodes: Bakalaura darba izstrādei tika izmantota kvantitatīvā šķērsgriezuma pētījuma ‘‘Dzemdes kakla vēža ierobežošana: inteliģenti un personalizēti risinājumi vēža skrīningam’’ datu bāzes dati. Bakalaura darba ietvaros pētītā mērķa grupa ir Latvijas iedzīvotājas sievietes vecumā no 25 līdz 70 gadiem. Bakalaura darba pētījuma izlase ietvēra 1313 sievietes. Dati ievākti ar pašaizpildāmu aptaujas anketu palīdzību Rīgas Austrumu klīniskās universitātes slimnīcas ambulatorajā daļā, apmeklējot kolposkopijas speciālistu, un 10 Latvijas ģimenes ārstu praksēs. Bakalaura darba datu analīzē pielietotas aprakstošās statistikas metodes - frekvenču biežuma analīze, šķērstabulas, Hī kvadrāta (χ 2 ) tests, Fišera precīzais tests. Aprēķināto rezultātu statistiskā ticamība tika pamatota ar p vērtībām (rezultāti atzīti par statistiski nozīmīgiem, ja p

As the worldwide pandemic of Covid-19 continues, health-care professionals (HCP) have been exposed to different hazards, and there is a need to explore psychological resilience in crisis situations, and to give recommendations for its strengthening. The aim of this study was to examine relationship between psychological resilience and self-care strategies in HCP of Latvia, controlling for gender and age during Covid-19 pandemic, and to determine whether the psychological resilience and self-care strategies differ between HCP and professionals in other fields (POF) unrelated to healthcare. Method. The sample consisted of 1723 employees, who during the state of emergency continued to work in their profession; they were divided in two groups - 77 HCP (18 men, 59 women, age M = 46.23 (SD = 14.43)) and 1646 POF (720 men, 926 women, age M = 44.98 (SD = 11.93)) as comparison group. Specific data of national representative cross-sectional online survey (N = 2608), performed in July, 2020, were selected – demographic items, 7 items forming Psychological Resilience Scale and 17 item forming Self–care Strategies Questionnaire (consist of 4 scales: “Spiritual resources”, “Social support”, “Free time activities”, “Time management”). Results . “Time management” was only predictive for Self-care strategy for psychological resilience in both HCP and POF group. Neither age nor gender predicted psychological resilience in HCP group. No statistically significant differences for major variables between HCP and POF were found. Conclusions. The results suggest that performing such Self-care activity as time management can help to promote psychological resilience of the employees regardless of profession. Given the workload of HCP in pandemic, this is an important result. HCP psychological resilience and used self-care strategies during COVID-19 are not different from POF.

Veselības komunikācija Informācijas un komunikācijas zinātnes Health Communication Information and Communication Sciences Ievads. Jaunu cilvēku labklājība ir īpaši svarīga visās sabiedrībās, un pastāvīgi tiek mēģināts samazināt visa veida veselībai kaitīgu uzvedību šajā populācijā. Ir zināms, ka daudzas nopietnas pieaugušo veselības problēmas ir saistītas ar uzvedību, kas radusies pusaudža gados. Negadījumi ir biežākais pusaudžu nāves cēlonis Eiropā un tie nereti notikuši vielu lietošanas dēļ. Efektīva audzināšana ir apgriezti saistīta ar vielu lietošanu pusaudžu populācijā. Pareiza vecāku komunikācija un audzināšana var būtiski novērst pārmērīgu vielu lietošanu un atkarību veidošanos pusaudžiem. Darba mērķi bija secināt, cik lielā mērā vecāki Latvijā iesaistās pusaudža veselības izglītības, kas vērsta uz dažādu vielu lietošanu, uzlabošanā un attīstīšanā un secināt, kādi būtu pareizie vecāku rīcības modeļi un komunikācijas veidi, lai pusaudzi ietekmētu labvēlīgi attiecībā pret dažādu vielu nemēģināšanu un nelietošanu atkārtoti. Kā arī noskaidrot, kādas problēmas vecāki paši saskata, kas dažreiz liedz vecākiem iesaistīties pusaudžu veselības izglītībā un sasniegt pozitīvu rezultātu attiecībā pret pusaudža vielu nelietošanu. Materiāls un metodes. Darbam izvēlēta kvalitatīvās pētniecības metode. Lai iegūtu informāciju par vecāku pieredzi un priekšstatu par attiecībām, audzināšanu un komunikāciju ar pusaudžiem, veiktas padziļinātas, daļēji strukturētas intervijas ar vecākiem, kuru bērniem šobrīd ir 17-22 gadu. Kopumā intervēti 10 vecāki. Interviju datu apstrādē izmantota tematiskās analīzes metode. Rezultāti. Pēc interviju kodēšanas iezīmējās daži svarīgi audzināšanas un komunikācijas paņēmieni, ko vecāki izmanto attiecībās ar pusaudžiem un ko uzskata par nozīmīgiem, lai panāktu pēc iespējas mazāku vielu lietošanu pusaudžu vidū- nepārspīlēta kontrole, cēloņu-seku likumsakarību skaidrošana, pozitīva piemēra rādīšana, sarunas ikdienas rutīnā, pusaudža nodarbināšana brīvajā laikā, kategorisku aizliegumu neizmantošana, pusaudža autonomijas akceptēšana, uzklausīšana un neuzbāzība. Problēmas, ko vecāki saskatīja, kas varētu traucēt vecāku audzināšanai un komunikācijai sasniegt vielu nelietošanu pusaudžu vidū, bija vecāku laika trūkums, vecāku personiskā pieredze, bailes. Secinājumi. Vecāku komunikācija ar pusaudžiem par vielu lietošanu kopumā atbilst literatūrā ieteiktajai, lai sasniegtu pēc iespējas labāku rezultātu attiecībā uz vielu nelietošanu pusaudzim. Vecāki uzskata, ka vielu lietošana pusaudžu populācijā ir aktuāla problēma un apzinās savu lomu pusaudžu audzināšanā. Tomēr, iespējams, ne visi vecāki apzinās savas ietekmes stiprumu. Galvenie faktori, kas, vecākuprāt, ietekmē vielu lietošanu pusaudžu populācijā, ir saistīti ar pusaudža spriestspējas un interešu attīstīšanu. Savukārt galvenās problēmas, ko vecāki saskata, kas varētu traucēt vecāku un bērnu komunikācijai, bija laika trūkums un vecāka personiskā pieredze un raksturs. Introduction. The well-being of young people is a important in all societies, and constant efforts are being made to reduce all forms of unhealthy behavior. It includes tobacco, alcohol, illicit drug use. Many severe adult health problems are known to be related to behaviors initiated during adolescence. Accidents are the leading cause of death among adolescents in Europe and are often caused by substance use. Effective parenting is inversely related to substance use in the adolescent population. Proper parental communication and upbringing can significantly prevent substance abuse and the development of addiction in adolescents. The aim of the study was to conclude to what extent parents in Latvia are involved in the improvement and development of adolescent health education focused on the use of various substances and to conclude what would be the right parental behavior and communication methods to influence adolescents positively in relation to not trying and not using repeatedly different substances. Material and methods. The method of qualitative research has been chosen for the study. In-depth, semi-structured interviews were conducted with parents whose children are currently 17-22 years old in order to obtain information about parents' experiences and ideas about relationships, upbringing and communication with adolescents. Overall, 10 parents were interviewed. The method used for the interview data processing was thematic analysis. Results. The coding of the interviews highlighted some important parenting and communication techniques used by parents in their relationships with adolescents and what they consider important to achieve the lowest possible use of substances among adolescents – exaggerated control, explanation of cause-and-consequences regularities, setting a positive example, conversations in the daily routine, filling the teenager's free time with activities, non-use of categorical prohibitions, acceptance of adolescent autonomy, hearing and non-intrusion, listening. The problems that parents saw that could hinder parents' upbringing and communication in achieving non-use of substances among adolescents were parents' lack of time, parents' personal experience, and fear. Conclusions. Parental communication with adolescents about substance use to achieve the best possible result regarding the non-use of substances for teenager is generally in line with the literature. Parents consider the use of substances in the adolescent population to be a topical problem and are aware of their role in the upbringing of adolescents. However, not all parents may be aware of the strength of their influence. The main factors that parents believe influence the use of substances in the adolescent population are related to the development of adolescents' judgment and interests. Main problems that parents see that could interfere communication between parents and children were lack of time and the parent's personal experience and personality.