BackgroundA 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.MethodsSix 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.ResultsThe 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.ConclusionsThe need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself.

The impact of changes in the geomagnetic field on the human body remains the subject of studies across the world, yet there is no consensus. Current studies are observing effects that require further work by researchers in order to find out the mechanisms that would allow a proper assessment of the correlations between the Earth‘s magnetic field variations and changes in human organisms. The main purpose of this study was to investigate possible correlations between the strength of time-varying aspects of the local Earth’s magnetic field and incidence of myocardial infarctions. Study participants included 435 males and 268 females who had diagnosis of myocardial infarction during the period of 1 January 2016 to 31 December 2016 and attended the Department of Cardiology at the Hospital of Lithuanian University of Health Sciences (LUHS), Kauno klinikos. Time varying magnetic field data was collected at the magnetometer site located in Lithuania. After mathematical analysis, the results support the hypothesis that the Earth’s magnetic field has a relationship between the number of acute myocardial infarction with ST segment elevation (STEMI) cases per week and the average weekly geomagnetic field strength in different frequency ranges. Correlations varied in different age groups as well as in males and females, which may indicate diverse organism sensitivity to the Earth’s magnetic field.

Abstract.Objectives: Acute coronary syndrome as an acute oxygenated blood deprivation to the heart muscle due to atherosclerotic plaque rupture in the coronary artery followed by thrombosis is possibly associated with changes in the Earth's local time varying magnetic field as they strongly influence hormonal and other regulatory systems' activity. This study analyses the correlation between prevalence of the acute coronary syndrome and the changes in the local time varying aspects of the magnetic field. Methods: Seven-hundred patients admitted to Cardiology Department of Hospital of Lithuanian University of Health Sciences Kaunas Clinics within 2016 due to acute coronary syndrome were retrospectively included into the study. The number of cases per week was compared with the weekly changes of the local Earth magnetic field. The one-year period was divided into two periods: the first-half of the year (weeks 1 to 26) and the second-half of the year (weeks 27 to 52) and more detailed analyses were performed accordingly to the significance of the left main artery lesion. Mean power of local magnetic field fluctuations in Lithuania, measured in pT2 in five different frequency ranges where overlaps between the Schumann resonance and EEG frequency ranges (named as SDelta (0-3.5 Hz), STheta (3.5-7 Hz), SAlpha (7-15 Hz), SBeta (15-32 Hz) and SGamma (32-66 Hz) to distinguish them from the EEG bands). Results: Statistically significant weak and moderate correlations between weekly prevalence of acute coronary syndrome admissions and the magnetic field intensities changes were found. Higher intensities in the SBeta and SGamma ranges were associated with a higher number of admissions throughout the year in females and the SGamma range was associated with higher number of admission only during the second-half of the year in males. A higher intensity magnetic field in SDelta, STheta, SAlpha and SBeta ranges was associated with a higher admissions number due to left main artery lesions in males, while a higher intensity in the SGamma range was associated with higher number of admissions due to left main artery lesions in females through the year. Conclusion: Significant correlation between acute coronary syndrome and changes in the local Earth time varying magnetic field intensities was found. Some frequency ranges are associated with an episode of an acute coronary syndrome. Left main artery lesions significantly correlated with magnetic field changes in most of the frequency ranges in males while only one of the frequency ranges in females.

BackgroundA large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners’ (GPs) experience in mental healthcare and their perceptions about how to increase their involvement in the field.MethodsIn this cross-sectional study, a 41-item questionnaire was distributed to a random sample of 797 Lithuanian GPs in order to investigate current practices in their provision of mental healthcare as well as their suggestions for the improvement of mental healthcare services in primary care.ResultsThe response rate was 52.2%. Three-quarters of the GPs agreed that they feel responsible for the management of mental health problems, but only 8.8% of them agreed that “My knowledge in mental healthcare is sufficient”. Psychiatrists were identified as the mental healthcare team specialists with whom 32% of the respondents discuss the management of their patients with a mental disorder. Collaboration with psychologists and social workers was almost threefold lower (11.6% and 12.5%). Capacity-building of GPs was found to be among the most promising initiatives to improve mental health services in primary care. Other strategies mentioned were policy level and managerial measures as well as strengthening the teamwork approach in mental healthcare.ConclusionsThis study found a low self-reported competence of GPs in mental healthcare and low collaboration among GPs and other specialists in providing mental healthcare. For the situation to improve in the country, these findings point to a need for strategies to improve GPs’ expertise and teamwork in mental healthcare.