SCIENCES “HEALTH IN OUR HANDS”

ORGANISING COMMITTEE

Anna-Liisa Tamm Jaanika Niinepuu Eisi Tamm Merlis Karja-Kännaste

SCIENTIFIC COMMITTEE

Anna Stecka, MSc College of Rehabilitation in Warsaw, Poland Andrej Ovca, PhD University of Ljubljana, Slovenia Andrew Mathienson, PhD The Australian National University, Australia Evanthia Sakellari, PhD Technological Educational Institute of Athens, Greece Joseph Grannum, PhD Student University of Technology, Jamaica / University of Tartu, Estonia Katrin Lang, PhD University of Tartu, Estonia Tiina Freimann, PhD Tartu Health Care College, Estonia Ülle Parm, PhD Tartu Health Care College, Estonia

CONFERENCE MODERATORS

Ivi Vaher, PhD student Tartu Health Care College, Estonia Kristi Vahur, PhD student Tartu Health Care College, Estonia

Authors: Eerik Jõgi1,2, Ingrid Väling1 Scientific research supervisor: Toonika Rinken1

1 Institute of Chemistry, University of Tartu, Estonia 2 Department of Radiography and Laboratory Science,

Tartu Health Care College, Estonia

Background: Escherichia coli (E. coli) is a common mammalian intestinal bacteria, which is used as an indicator organism for the determination of faecal pollution in fresh water. Currently the microbiological quality of bathing water is assessed using microbiological cultivation, serving as the “gold standard” for the evaluation of water quality, but the acquisition of results is slow and takes several days. Modern alternatives like qPCR allow enumeration of bacteria in a more time-efficient mode, but still require sophisticated lab equipment and sample transportation. In regards of on-site automated monitoring, immunobiosensors possess high potential to replace the abovementioned lab - based methods. However, a biosensor response can be generated by antigens of both live and decayed bacteria, and it is potentially affected by similar species present on the environment. This makes the interpretation and direct comparison of biosensor results with microbiological coli - index problematic, and requires further studies to understand which particular factors are affecting the biosensor signal.

Aim: Immunobiosensor based, automated biosensor E. coli indication in bathing water.

Methods: E. coli specific immunobiosensor results with the enumeration of E. coli cells with microbiological cultivation and qPCR.

Results: The median biosensor results were about 4 times higher than the qPCR results and 40 times higher than the results of microbiological cultivation. We also identified which specific bacteria and on which cell decomposition level could generate a measurable signal of an E. coli immunobiosensor in real bathing waters. As an average, the signal of cultivable E. coli formed only ~ 9 % of the “pure” biosensor signal.

Conclusion(s): It was found that the live cultivable E. coli bacteria caused only 9 % of the measured immunosensor output, while most of the signal was generated by non-cultivable E. coli and its fragments along with different coliforms

Keywords: E. coli, immunobiosensor

Author: Gina Maria Gräfe Scientific research supervisor: Thomas Schrader

Department of Computer Science and Media, Bradenburg University of Applied Sciences, Germany

Background: Over the last few years, improving patient safety has become an increasing focus for healthcare researchers around the world. To facilitate international reporting, data sharing and research collaboration, the WHO published the International Classification for Patient Safety (ICPS). The ICPS provides an internationally agreed conceptual framework, but is still not used as widely as would be desirable.

Aim: A machine-readable patient safety ontology (PSO) will be developed based on the ICPS. The PSO shall enable an exchange of information about medical processes, errors occurring there and preventive measures against these errors. In this way, the importance of the topic patient safety and the essential practices for it become more tangible, especially for healthcare professionals such as nurses, physiotherapists or midwives.

Methods: The development of the PSO was guided by the methodology of Uschold and King. This methodology breaks down the tasks involved in development into (1) identifying the purpose, (2) building the ontology, (3) evaluation, and (4) documentation. The informal ontology development is focused as a special feature. Fluent Editor was used to create the formal ontology. Afterwards, a machine-based consistency check using the ontology reasoner HermiT was performed.

Results: A patient safety ontology based on the ICPS was developed. The PSO comprises 328 classes and enables the assignment of properties, error patterns and safety-promoting measures to medical processes. In addition, the graphical visualization supports the exchange of important patient safety concepts and their complex relationships to each other. The machine-based verification with HermiT was successful and confirms the consistency of the developed PSO.

Conclusion(s): Using the methodology of Uschold and King, a patient safety ontology was successfully developed from the ICPS. The Fluent Editor was suitable for the formal creation of the PSO.

It proved to be a good alternative to OWL-based editors such as Protege because of the OCNL ontology language. In the future, the developed PSO can be an important element to improve the exchange about medical incidents across institution and country boundaries and thereby increase patient safety in medical care.

Keywords: ICPS, patient safety, ontology.

Author: Celine Elsholz Scientific research supervisors: Thomas Schrader, Laura Tetzlaff

Department of Computer Science and Media, Bradenburg University of Applied Sciences, Germany

Background: In the field of patient safety, there are a multitude of concepts with inconsistent definitions. International terminologies such as SNOMED CT hardly contain any terms from this field. To extend the present PSO which is based on the International Classification for Patient Safety (ICPS), an interface to SNOMED CT and the integration of the Open Process Task (OPT) Model shall be created from the point of view of establishing best interoperability.

Aim: The development of a Patient Safety Ontology (PSO) should help to organize terms hierarchically, to create proper definitions and to establish relationships between them. For example, this system will help to analyze reports from Critical Incident Reporting Systems (CIRS) or clinical processes.

Methods: The integration of the OPT model as well as the interface creation to SNOMED CT was done iteratively. The Ontorion Fluent Editor 2015 and the OPT manual were used to model the ontology during the OPT integration. The interface creation to SNOMED CT was done using Python 3.8 and libraries like owlready2.

Results: First, the integration of the OPT model was performed. Classes were created iteratively to map the concepts of the OPT model and relationships were established. The existing processes were divided into patient and resource processes, among others, and the process lists were

expanded. The interface to SNOMED CT was created using three Python scripts. In the first, the processes of the PSO were extracted, in the second, the processes were queried using an automatically created URL to the SNOMED CT browser, and in the third script, and the IDs found from the first script were linked to the respective terms in the ontology using an attribute. If no ID was available, the term gets an ID determined via hash values.

Conclusion(s): The integration of the OPT model could be carried out successfully. First steps towards interoperability between failure analysis models, international terminologies and the PSO have been created. By linking the PSO and SNOMED CT, a standardization of terms in patient safety can take place, simplifying the exchange of information.

Keywords: critical incident reporting systems, ontology, OPT-Model, patient safety, Snomed CT.

Authors: Egne Kürsa, Erik Landõr Scientific research supervisor: Kalle Kepler

Department of Radiography and Laboratory Science, Tartu Health Care College, Estonia

Background: In conventional paediatric radiography, it is recommended to use small focal spot for thoracic imaging, which limits the use of larger X-ray tube currents. A longer exposure time is necessary to obtain images at lower currents, which can cause motion artefacts.

Aim: The aim of the study was to find out the relationship between the focal spot size, focus to receptor distance and image resolution in paediatric chest imaging.

Methods: The experiments were carried out using Siemens Ysio radiograph. A pinhole diaphragm was used to image the focal spot and the resulting image was used to measure its size. Geometric resolution limits were calculated for both small and large focal spots at different focus to receptor distances. Maximum effective resolution was determined using a bar pattern at various focus receptor distances (FRD). Doses of the performed exposures were recorded.

Results: The focal spot sizes (both 0.6 mm and 1.0 mm) corresponded to the dimensions declared by the manufacturer. For the small focal spot, the determined image resolution was 3.4 line pairs per mm (lp/mm) at FRD of 100, 150, 180 and 250 cm, limited by the maximum resolution of the image receptor, 3.47 lp/mm. As for the large focal spot, the image

resolution increased from 2.8 lp/mm at 100 cm FRD to 3.4 lp/mm at 180 cm FRD. While additional filtration of 0.1 mm Cu did not significantly affect the resolution of the images, the entry skin dose decreased by 41% for the small focal spot and 44% for the large focal spot at FRD 100 cm.

Conclusion(s): The recommendation to use the small focal spot for paediatric chest imaging at distances exceeding 105 cm for patients with 15 cm chest diameter is not relevant for common digital image receptors and large focal spot may be used instead, as the image receptor resolution of a digital radiograph is the main limiting factor for image resolution.

Keywords: chest imaging, focal spot, paediatric radiography, radiation dose, resolution.

Author: Emilija Zeltina1 Scientific research supervisors: Astra Zviedre2,3 , Zanda Pucuka4,5, Janis Kolbergs6

1 Faculty of Medicine, Riga Stradinš University, Riga, Latvia 2 Department of Pediatric Surgery,

Riga Stradinš University, Riga, Latvia 3 Department of Pediatric Surgery,

Children’s Clinical University Hospital, Riga, Latvia 4 Department of Pediatrics, Riga Stradinš University, Riga, Latvia 5 Department of Pediatrics,

Children’s Clinical University Hospital, Riga, Latvia 6 Department of Anesthesiology and Intensive Care,

Children’s Clinical University Hospital, Riga, Latvia

Background: Ileocolic intussusception (ICI) is one of the most common surgical emergencies in children. Over 90% of all cases involve abdominal pain.

Aim: The aim of the study is to determine a provision of analgesia before the reduction of ileocolic intussusception.

Methods: A retrospective study was made including 93 patients admitted to Emergency Department with ICI (January 2017 – December 2019). Patients were divided into two groups – 80 patients with FLACC pain score (FLACC) in the range of 0-5 and 13 patients with FLACC in the range of 6–10. Clinical presentation, diagnostic, FLACC and analgesia before the treatment were obtained and compared between groups. Statistical analysis was made by SPSS 26.0 (p<0.05). The study was approved by the Institutional Ethics Review Board.

Results: 93 patients with the median age of 29.2 (11±36) months, 66 (71.0%) were boys and 27 (29.0%) were girls. ICI was confirmed by ultrasound in 96.8% of the cases. 77 (83%) of all patients had pneumatic reduction of ICI and 16 (17%) – surgical treatment of ICI. Statistically significant differences between study groups were found among diagnostic and analgesia. Patients with FLACC ≥ 6 had significantly more usage of X-ray compared to other group before ICI reduction (ꭓ2 = 7.5, df = 1; p = 0.006). Coprostasis were found more often patients with FLACC ≥ 6. (ꭓ2 = 6.88, df = 1; p = 0.015). Necessity of ketorolac tromethamine and fentanyl were significantly increased for patients with FLACC ≥ 6 (ꭓ2 = 32.5, df = 1; p = 0.000 vs. ꭓ2 = 17.1, df = 1; p = 0.001) compared to patients with FLACC < 6. Statistically significant differences in study groups were not found between clinical symptoms, method of treatment and usage of acetaminophen, morphine, metamizole and ibuprofen.

Conclusions: Patients admitted to Emergency Department ileocolic intussuseption require opioids to release pain of FLACC ≥6. The most sensitive of diagnostic metods for suspected ICI is the abdominal USG.

Keywords: analgesia, FLACC pain score, Ileocolic intussusception.

Authors: Triin Põder, Liis Lozano Scientific research supervisor: Siret Läänelaid

Department of Nursing and Midwifery, Tartu Health Care College, Estonia

Background: Estonians experiences with bariatric surgery has not been studied before. Health-care workers could consider patients’ needs and provide appropriate measures of support.

Aim: To describe the experiences of adult patients both before and after the operation. We focused on their preparations before surgery and how they were able to cope with changes in everyday life after surgery.

Methods: We analyze qualitative and descriptive data collected from 12 subjects (10 females and 2 males) from directed open-ended interviews. The data was collected until there was no new information. All the interviews were audio-recorded, transcribed and analyzed by the method of inductive content analysis.

Results: People chose bariatric surgery because they were overweight, had health problems and difficulties moving. They obtained information about bariatric surgery from doctors and internet, including bariatric groups in social media. Participants expressed the need of better information from their doctors. After surgery, many chronic health problems disappeared or eased significantly.

Subjects experienced difficulties adjusting with changed food tastes and small portions.

Furthermore, subjects expressed a desire for further nutritional and psychological counselling before and after surgery. Subjects experienced both support and condemnation from relatives, friends and society. After bariatric surgery, mostly positive changes occurred in self- esteem but the worry of gaining weight remained. Relationships and quality of sex improved in most cases but there was also cases of increased relationship problems and breakups. Single people became more active in romantic relations.

Conclusion(s): Patients of bariatric surgery expressed a desire for further nutritional and psychological counselling before and after the surgery.

Keywords: bariatric operation, coping with everyday life, experiences.

Author: Diana Druse Scientific research supervisor: Ieva Ziedina

Faculty of Medicine, Riga Stradins University, Latvia Pauls Stradins Clinical University Hospital, Riga, Latvia

Background: Autosomal dominant polycystic kidney disease (AD PKD) is a multisystemic and progressive hereditary disorder. AD PKD clinical manifestations are highly varied and age-related, including renal and extra-renal features.

Aim: The aim of the study is to analyze the most common extrarenal manifestations of the disease and compare extra-renal features between the two age-groups: younger than 65 years old and subjects aged 65 and older (elderly group).

Methods: A retrospective study was made including 90 patients with AD PKD from Pauls Stradins Clinical University Hospital outpatient clinic. Data were collected from ambulatory cards and were analyzed by IBM SPSS Statistics version 26.0 (p<0.05). The study was approved by the Institutional Ethics Review Board.

Results: 90 patients with the mean age of 62±10.2SD years, 65 (72.2%) were females and 25 (27.8%) were males. The patients’ mean age of the AD PKD diagnosis was 35±9.36 years in men and 33±9.82 in women. Most common extra-renal manifestations were liver cysts (91.1%), hernias (15.6%) and diverticulosis (13.3%). The most common extra-renal manifestations in elderly patients were liver cysts, which were presented in 97.4%. Liver cysts 86.3% in patients younger than age 65 years. Statistically significant differences between study groups were found in the

frequency of diverticulosis, hernias and common bile duct dilatation (chi square test, p < 0.05).

Conclusion(s): The most common extra-renal manifestation of autosomal dominant polycystic kidney disease in both groups is liver cysts, but not statistically significant difference was found between study groups.

Keywords: liver cysts, polycystic kidney disease.

Author: Age Toomjõe Scientific research supervisor: Anne Vahtramäe

Department of Nursing and Midwifery, Tartu Health Care College, Estonia

Background: Due to the constantly increasing incidence of malignancies and the need to find new effective drugs to treat them, cancer immunotherapy and autoimmune reactions caused by immunotherapeutics have become relevant in recent years. Immunotherapeutics are effective in treating various types of cancer, but due to the fact that their administration imbalances the immune system, they can cause life-threatening adverse events without early detection and proper treatment.

Aim: To describe cancer immunotherapy essence, adverse events caused by immunotherapeutics and nursing activities of treating these adverse events by the example of the three most effective immunomodulatory antibodies.

Methods: Theoretical review of the literature, which contains systematic search of literature, analysis and interpretation of results.

Results: Before starting immunotherapy, nurses need to interview patients thoroughly about their health condition and carry out necessary tests to prevent and cure adverse events caused by immunotherapeutics. In addition, nurses need to inform patients and their relatives about possible side effects and right ways to behave while they appear, because studies show that thorough patient counseling before the first treatment

significantly reduces patients’ anxiety and increases the chances of successful treatment. Furthermore, most adverse events are completely curable when they are diagnosed at early stages.

Conclusion(s): The most common adverse events affecting the health of patients receiving immunotherapy are diarrhea, colitis, hepatitis, skin reactions, pneumonitis and endocrinopathies such as hypophysitis and thyroid dysfunction. Prevention of adverse events is complicated by the fact that they can occur at any time in about two years from the start of treatment. The challenges of treatment are the novelty of immunotherapeutics, which means that both doctors and nurses often do not have sufficient knowledge of the autoimmune reactions they cause and the appropriate treatments for adverse events. Furthermore, this topic is important because from the point of view of nursing it has not been previously discussed in Estonia and no suitable manual for Estonian nurses has been prepared so far.

Keywords: adverse events, cancer immunotherapy, nursing activities, patient counselling.

Author: Birgita Eva Tamm1 Scientific research supervisors: Eve-Merike Sooväli1, Maarja Vislapuu2

1 Department of Nursing and Midwifery,

Tartu Health Care College, Estonia 2 Department of Global Public Health and Primary Care,

University of Bergen, Norway

Background: Approximately every fourth person with diabetes has high diabetes-related distress. Diabetes-related distress refers to negative emotions related to worries and fears in several diabetes care and management areas. Patient-centered psychosocial care for people with diabetes requires problem identification, psychosocial evaluation, and intervention. To date, the level of diabetes-related distress among people with diabetes living in Estonia has not been investigated, which is concerning as research shows its high prevalence. Therefore, it is important to shed light on the concept of diabetes distress and make it available in Estonian.

Aim: The thesis aimed to describe the causes of diabetes-related distress, screening possibilities and reduction opportunities for people with type I and type II diabetes.

Methods: Theoretical literature study, based on systematic search of research articles in

EBSCO (Academic Search Complete, Medline, CINAHL, Health Source: Nursing/Academic Edition), Pubmed and Google Scholar.

Results: According to literature, the leading causes of diabetes-related distress were fear of hypoglycemia, worry of diabetes complications,

regimen-related distress, and distress related to healthcare system. The two most used screening tools to assess diabetes-related distress were: The Problem Areas in Diabetes Scale (PAID) and The Diabetes Distress Scale (DDS). Patient-centered healthcare, motivational interviewing, patient teaching and informing, and problem-solving therapy with realistic goals have shown a positive effect on reducing diabetes distress. Research has shown that support also from health care providers, family and peers had a key role in managing and reducing diabetes-related distress.

Conclusion: Health care personnel play a crucial role in identifying people with high diabetes-related distress, and there are several tools, such as PAID and DSS, that can be used in two-way conversations in diabetes nurse or doctor consultations.

Based on evidence-based sources, this thesis is the first to describe the concept of “diabetes- related distress” in the nursing field in Estonian.

Keywords: diabetes-related distress, causes, assessment, reduction

Authors: Aikaterini Ntokou, Anna Fokianou, Konstantina Kritsa, Georgia Foteini Koutsimpogeorgou, Artemis Margariti, Eleni Ploumi, Charikleia Rizou, Christina Samarika, Mirsini Stasinou, Sotiris Tsavos, Alexandra Eumorfia Tsentidou Scientific research supervisors: Eleni Konstantinou, Dimitra Perifanou, Evanthia Sakellari

Department of Public and Community Health, University of West Attica, Greece

Background: Vaccination is very important and is worldwide one of the most cost-effective preventive health innovations. It requires special education, and vaccination professionals should be competent in order to provide high quality care. Educating Vaccination Competence (EDUVAC) is a 3-year Erasmus+ project, in which five academic institutions from different countries participated: University of West Attica (Greece): coordinating institution, Metropolia University of Applied Sciences (Finland), Trnava University (Slovakia), University of Vic (Spain) and University of Modena and Reggio Emilia (Italy). This program aims at enhancing the knowledge, skills and attitudes of students on vaccination competence using different pedagogical methods.

Aim: The aim of this presentation is to share students’ experiences taking part in the EDUVAC project learning activities.

Methods: During the project cycle students participated in two intensive courses, one held face to face and one held online (including lectures, multicultural group work, etc.); a web-based course, which was based on

asynchronous learning (including self-study, videos, self-tests, etc.); and simulations (including several real-life clinical cases).

Results: As participants of the EDUVAC project, we were able to gain knowledge evidence-based practice on vaccination and develop our competence in order to promote vaccinations among different population groups. Additionally, we got familiar with different cultures and strengthened our collaboration skills in a multinational and multicultural environment. Moreover, we enhanced our digital skills as well as English language skills.

Conclusion(s): Vaccination is a core part of prevention and health promotion, and all future health professionals should contribute to this from their role. Various learning approaches can motivate students to gain knowledge. The different pedagogical methods of EDUVAC showed that learning can be flexible and attractive to students. More information about the EDUVAC project can be found at the website: http://www. eduvac.eu/.

Keywords: academic education, ERASMUS+, students’ experiences, vaccination.

Authors: Gabija Zasytyte, Ineta Matonyte Supervisor: Lina Levickiene

Department of Physiotherapy and Beauty Therapy, Klaipeda State University of Applied Sciences, Lithuania

COVID-19 viral infection is a strain of coronavirus that causes severe functional changes not only in respiratory system, but also due a prolonged period of immobile isolation decreasing physical capacity, muscle endurance, resulting in poor quality of life. These functional changes can be improved by various methods of physiotherapy. Therefore, problematic question how physioteraphy affects respiratory function and physical capacity in COVID-19 patients was raised.

The Aim: To study effect of physiotherapy on respiratory system functional indicators in patients with COVID-19 virus.

Methods: The systematic literature review method was applied in the analysis of scientific articles according to the selected inclusion criteria. (Table 1).

Table 1. Criteria for inclusion of scientific articles

Search language English

EBSCO, PubMed, ELSEVIER Year of publication From 2020 year

Full scientific articles

Patients with COVID-19, subacute period

Over 45 years

Breathing exercises to improve secretion, expectoration, diaphragm strengthening, muscle strengthening, balance training and physical capacity building exercises Applicable tests Spirometry, 6 minute walk test

Spirometry was used to assess respiratory function, during which forced vital lung capacity (FVC) and forced expiratory tourism in the first second (FEV1) were assessed. The 6 minute walk test was used to assess physical capacity.

Results: 5 scientific articles were selected and analyzed according to the inclusion criteria. A total of 278 subjects participated, 96 women and 182 men (age 47–81 years). All studies showed a positive improvement in FVC and FEV1 indicators. Assessing the results of the 6 minute walk test, in all studies, the distance walked in meters increased after the interventions applied, indicating improved physical performance.

Conclusion(s): Research results showed that physiotherapy improved the respiratory functional indicators and physical capacity in patients with COVID-19 virus. Although, in some studies the improvement in FVC and FEV1 did not reach the norm. Furthermore, physical capacity improved from low to moderate or from moderate to good physical performance. It has been observed that the application of methodologies that increase a physical capacity achieves the greater improvement of this indicator.

Keywords: COVID-19, physical capacity, physiotherapy, respiratory functional indicators.

Authors: Carola Globig, Lea-Luise Koerber, Katharina Willert, Darren Williams, Scientific research supervisors: Jacqueline Semper-Jost, Kerstin Schrader

Spektrum Akademie für Ergotherapie und Physiotherapie, Germany

Background: As part of physical therapy and occupational therapy education, students develop and conduct independent studies. The present study deals with leg axis training, which is very common in therapy. It is known from motor learning that working with an external focus of attention is more effective than working with an internal focus of attention.

Aim: The question answered by means of the experiment is “Is there a difference in activation of the leg axis stabilizing muscles between instruction with an internal focus and instruction with an external focus.”

Methods: Bipolar surface electromyography is used to derive the electrical activity at the leg axis stabilizing muscles (biceps femoris muscle, vastus medialis muscle, vastus lateralis muscle, and peroneus longus muscle).

The examination will take place on the dominant leg. To rule out any influences of a training effect on the data, the order of trial 1 (instruction with internal focus) and trial 2 (instruction with external focus) is switched every second subject. To achieve an external focus of attention, a laser pointer fixed to the knee will be used to aim at a target at 3 meters away at the level of the kneecap.

Results: 28 physical therapy students without pre-existing conditions participated in the study. Currently, the data is being analyzed. The interim status suggests that there is no significant difference between the trials (V1: internal focus instruction and V2: external focus instruction) for the biceps femoris muscle, vastus medialis muscle, and vastus lateralis muscle. The results for the peroneus longus muscle give reason to hope that a difference between external and internal attentional focus in favor of the external focus can be demonstrated in a larger study group.

Conclusion(s): In order to obtain a comprehensive statement on the difference between the activation of the leg axis stabilizing muscles by using an external and internal focus of attention, it is recommended to conduct the study with a larger number of subjects.

Keywords: external focus of attention, internal focus of attention, leg axis training.

Author: Liina Press Scientific research supervisor: Jaanika Niinepuu

Department of Nursing and Midwifery, Tartu Health Care College, Estonia

Background: Data was collected from Estonian news outlet web portals by searching for a category/section of the page called “Health” or if it was missing then by search term “Health”. Only articles from 1st of September 2020 to 8th of September 2020 were used. Analysis was conducted by grading the evidence basis of factual claims from the articles. The Criteria for selecting the literature: published in 2010–2021 scientific; the content of the source is in compliance with the topic of the thesis; free access to the full text of the source; source is written in Estonian, Swedish or English. The study is based on 38 topical sources, 23 out of these are scientific articles and 15 websites.

Aim: The aim of this thesis is to describe whether the health articles from Estonian newspapers published in the first week of September are evidence based or not.

Methods: The thesis is theoretical and qualitative article analyses is being used and the method is content analysis.

Results: The basis and practices of picking and presenting sources vary in different news outlets. One needs skills to differentiate articles with valid sources.

Conclusion(s): The thesis serves as a tool to nurses in identifying evidence-based information as well as determining the level of evidence

provided by the newspaper articles. Having evidence-based information for a guide in the field of nursing is of vital importance, since it is the basis for uniform quality nursing care service. The main aim is to raise the awareness of nurses by which they would be able to critically assess information gathered from social media or printed press and increase their ability to filter articles based on the sources evidence basis. Current thesis provides a nurse the much-needed skill set to identify the source and evaluate if that source is evidence based or not.

Keywords: health articles, evidence based, level of evidence base, source.

Author: Birgit Hüneva Scientific research supervisor: Ave Kutman

Department of Physiotherapy and Environmental Health, Tartu Health Care College, Estonia

Background: Pediculosis is a health concern in Estonia and among other countries around the world. The prevalence of the disease varies by country, but most of them acknowledge that the problem is actual and getting rid of the parasite is more difficult as it seems firstly. Estonian Health Board refers to the annual growing prevalence of lice in Estonian kindergartens. Therefore parents’ knowledge about head lice is not known and this could be the key to fight the disease.

Aim: The aim of the research was to find out the occurrence of head lice infestation in pre-school children and their parents awareness about the disease.

Methods: To find out the prevalence of head lice, web-based questionnaire was distributed in various Internet environments. Parents’ awareness was explained by 20 statements. Research started beginning of 2020. The most important groupings were made between those whose children had pediculosis and those who did not, as well as whether those children who had pediculosis went a childcare institution regularly.

Results: There was 1141 respondent, median age was 32.7 years. The survey included participants from all Estonian counties, most respondents were from Tartu and Tartu County.

Pediculosis occurred in 30.9% of children studied. Parents’ awareness was explained by 20 statements, to which the answer could be chosen between three options – whether the statement is right, wrong or can’t say. The average score for the correct respondents was 13.9. Of the statements that explained parents’ awareness of head lice and pediculosis, 11 people were able to give all correct answers, which is 1% of all respondents, and 0.4% of the whole respondent did not get the correct answer to any of the statements. Parents whose child had pediculosis had better knowledge than those whose child had not had. Parents’ awareness of head lice did not differ between parents with one or more children. However, there was a difference in the knowledge of those parents whose child had had pediculosis more than once, their awareness was higher. In the present study, few parents answered that if they had discovered head lice in a child, they had not treated it. It is very important to know that the head lice do not disappear on their own, if pediculosis is left untreated, the problem only gets worse. Ignoring treatment can cause infections.

Conclusion(s): The occurance of pediculosis in pre-school children is about 30% of the children. The parents’ awereness of pediculosis is good. Most of the parents had correct answers to at least half of the statements. The knowledge was better among parents who had had experinece with pediculosis. People with medical education and people whose children have had pediculosis had the highest awareness of head lice and pediculosis.

Keywords: head lice, head lice awareness, head lice occurrence, head lice treatment, pediculosis, Pediculus humanus capitis, preschool children, spread of head lice.

Author: Anete Mootse Scientific research supervisors: Anna-Liisa Tamm, Ülle Parm

Department of Physiotherapy and Environmental Health, Tartu Health Care College, Estonia

Background: Fitness is a rapidly increasing competitive sport beside bodybuilding. Athletes have basically two periods, (1) during the offseason the muscle mass is increased on calorie surplus and (2) competition period when the body fat is reduced by calorie deficiency. Different dietary for fitness athletes are recommended, and although information about sweeteners safety is conflicting, the use of them amongst fitness athletes’ is common.

Aim: The aim was to clarify the consumption habits of sweeteners (products enriched with sweeteners; consumption frequency; the seasonality of the consumption) among Estonian fitness female athletes.

Methods: The electronic questionnaire was used. Data was processed with the program Sigma Plot for Windows 11.0 (GmbH Formation, Germany). Continuous data was compared with t-test and categorical data with the χ2 test (p < 0.05).

Results: Altogether 35 (26% of all athletes; n = 135; median age 33.3 ±6.8y) filled the questionnaire, and 74.3% of them were sweeteners users. Bars, BCAAs, protein puddings, protein powders, calorie-free taste drops and calorie-free soft drinks are the most consumed products, containing mostly steviol glycosides (73.1%); sucralose (69.2%), and aspartame (50%). Sweeteners are consumed on a daily basis (65.4%) on average 2-3 times per day and the consumption is higher (not statistically) in

competition than in off-season period (46.2% vs 19.2%; p = 0.076). The main reasons for the consumption of sweeteners are sugar craving satisfaction and better food flavoring (65.4%), low caloric content (50%) and psychologically easier dieting (30.8%). Sweetener-users compared to non-users (p = 0.015) find sweeteners healthier than sugar. Sweetener users believe that they are safe in reasonable amounts.

Conclusion(s): Estonian female fitness athletes consume sweeteners mostly during the competition period on a daily basis due to their low caloric content to satisfy their sugar craving.

Keywords: female, fitness, nutrition, sweeteners.

Authors: Ieva Ivanauskaitė, Greta Bačiūnaitė Scientific research supervisor: Milda Gintilienė

Kaunas University of Applied Sciences, Lithuania

Background: According to Khizar et al. (2013), tea is the most widely consumed beverage in the world besides water. Different types of tea have antioxidant, anti-inflammatory, antimicrobial, anti-carcinogenic, cholesterol-lowering, antihypertensive, nervous system improving, and thermogenic properties. Since ancient times, tea has been used as a health product or medicine for the prevention and treatment of various diseases. According to historical records, the Chinese have been growing and using tea trees for more than 3,000 years. In China, as well as in many other countries, tea is widely recognized as an everyday beverage (Zhaoming Yan et al., 2020). In 2012, the best-selling teas in Lithuania were: “Chamomile flowers”, “Calendula flowers”, “Thyme grass” (Runkevičiūtė, 2014). According to Khan and Mukhtar (2014), the evidence supporting the health benefits of drinking tea is getting stronger with each new study published in the scientific literature.

Aim: To reveal the consumption habits of the population and knowledge ot tea and its effects on the digestive system.

Methods: Analysis of scientific literature and other sources of information. An instantaneous questionnaire survey was conducted in April 2021. There were 4 age groups of subjects: up to 18 years, 18–25, 25–40, 40–60, 60+ years. The survey of respondents was conducted remotely. A total of 74 questionnaires were collected. The analysis was used to assess consumer knowledge about tea selection, effects, and consumption.

Results: After reviewing the results of this study, it was found that the 18–25 age group (52.7%), mostly women, dominated among the respondents. 93.2% of respondents agreed that medicinal teas have a healing effect. The best knowledge about the effects of teas on the digestive system was revealed by describing ginger, chamomile, and fennel; the least known was dandelion - there was a lack of knowledge. Of the 74 respondents to the survey, a third (26) said they used chamomile most often to improve their digestive system. Peppermint and wormwood have become a rarer but also common answer. When evaluating the choice to buy tea, the recommendations of acquaintances and doctors have the greatest influence (61.1%), but the recommendations of the following advertisements were only five respondents. A large proportion believes that tea has a healing effect, although 60.8% of respondents consume tea for digestion less than once a month or not at all. When faced with digestive problems, respondents first adjust their diet, so 46.6% answered they are in no hurry to see a family doctor (8%). More than half of the respondents buy digestive tea in pharmacies, some grow them in the home environment (15.8%). After consuming these teas, 44.6% of respondents only occasionally feel their effects, and 31.1% of all respondents feel an improvement after consuming teas. The most common gastrointestinal complaints are bloating, heartburn, and ‘indigestion’, and the least common are nausea and constipation.

1. Respondents have limited knowledge about the effects of the most common teas on the digestive system. 2. Respondents usually buy herbs in pharmacies, and the choice is mainly determined by the recommendations of acquaintances and doctors. 3. Flatulence, heartburn, and ‘indigestion’ are the most common gastrointestinal complaints reported by respondents, for which the effect of tea is often effective.

Keywords: indigestion, tea, use of tea.

Author: Sander Reigo1 Scientific research supervisors: Inga Ploomipuu1, Irja Saar2

1 Department of Physiotherapy and Environmental Health,

Tartu Health Care College, Estonia 2 Department of Botany, University of Tartu, Estonia

Background: According to the data of the Poison Information Center, there are several dozen cases of poisoning in Estonia every year in connection with the consumption of edible mushrooms. Poisonings often occur because people do not differentiate between edible and poisonous mushrooms due to their ignorance.

Aim: The aim of the research was to find out the awareness of Estonian people about edible mushrooms.

Methods: Empirical research was conducted using a web-based questionnaire. The questionnaire had both open and closed questions. Respondents represented a cross-section of the age distribution of the Estonian population aged 14–80, who use the channels where the links were shared. In total, 865 responses were collected.

Results: Based on the pictures in the questionnaire, the respondents recognized the Cantharellus cibarius, Lactarius deterrimus and Macrolepiota procera. On the other hand, Galerina marginata, Tricholoma saponaceum and Tricholoma portentosum were poorly known. Mushrooms were best recognized in the pictures by respondents who rated their knowledge of mushrooms as good, followed by respondents with average knowledge and, lastly, respondents with poor knowledge.

Among the respondents, there had been 81 cases of fungal poisoning, out of which 22 respondents had needed medical care, 57 respondents had managed on their own and 2 respondents had managed with the help of Poison Infoline. Main causes of poisoning were Amanita virosa, Gyromitra esculenta and Paxillus involutus. The main symptoms of poisoning were vomiting, abdominal pain, nausea and diarrhea.

Conclusion(s): The respondents have in general good knowledge of edible and poisonous mushrooms and their evaluation of their knowledge was adequate.

The respondents know which mushrooms need to be scalded before taking into consumption. The respondents recognised Lactarius turpis, Lactarius torminosus and Lactarius trivialis as needing processing before consumption.

As for the frequency of picking mushrooms, 64% of the respondents do it more than 4 times a year. Most active group was aged 35-59 years old which also was the most knowledgeable group.

Keywords: awareness of the mushrooms to be harvested, edible mushroom, mushrooming habits, poisoning, poisonous mushroom.

Authors: Kamil Tokarczyk, Ewelina Tokarczyk Scientific research supervisor: Bożena Kowalczyk

Faculty of Health Sciences, Podhale State School of Hogher Vocational Education in Nowy Targ, Poland

Introduction: The continuous progress of civilization affects the limitation of physical activity and a sedentary lifestyle, which translates into pain in the lower spine. Most Poles before the age of 40 experience these ailments, and this problem reduces the quality of life. The accompanying pain limits the functions of the musculoskeletal system.

The aim: The aim of the study was to assess the quality of life in people with pain in the lumbar spine after physiotherapeutic treatment.

Material and methods: The study was conducted with the use of standardized tools and a self-authored questionnaire on 56 people who were diagnosed with pain in the lumbar spine and were referred for rehabilitation. The WHOQOL-BREFF questionnaire was used to measure the quality of life level, while the Laitinen pain index questionnaire was used for the purposes of the pain test. For research purposes, the test was performed before and after the therapy. Results: The therapy had a significant impact on reducing the level of pain in people with lumbar spine ailments. The median of perceived pain decreased after the performed therapy. There was also an improvement in the level of quality of life the somatic, psychological, social and environmental domains. There was no correlation between gender, age, BMI and the assessment of pain levels before and after the therapy. There was also no correlation between the

duration of pain ailments and the level of quality of life, while in the case of the level of perceived pain, it was found that the higher the level of pain, the lower the level of quality of life. Age and BMI had an average impact on the quality of life of the studied group, which means that a person has a higher body weight and is older, the lower the quality of life, except in the social field. There was no relationship between gender and quality of life.

Conclusions: Physiotherapy effectively reduced the level of perceived pain and improved the quality of life of people with pain in the lumbar spine. Age, sex and BMI had no effect on the effectiveness of physiotherapeutic treatment in relation to pain. There was no correlation between the duration of ailments and the quality of life.

Key words: quality of life, lumbar spine, pain

Author: Mari-Mall Puksa Scientific research supervisors: Kristi Vahur, Helen Udras

Department of Physiotherapy and Environmental Health, Tartu Health Care College, Estonia

Background: Due to ease of use, drinking water dispensers are extensively used in workplaces, indoor public spaces and homes. In Estonia the microbiological and chemical quality features and indicators of drinking water have been established by Regulation No. 61 of the Minister of Social Affairs. However, limited research has been done regarding the microbiological quality of the water dispensers after prolonged use.

Aim: The aim of this study was to find out the attitude of Estonian residents towards drinking water dispensers and to evaluate the microbiological quality of Tartu Health Care College s water dispensers.

Methods: The data were collected by web-based questionnaire (n = 135) and microbiological analysis of the water from dispensers.

Results: The survey revealed that more than three-quarters of the respondents considered the water from water dispensers to be of good quality. Primary reasons for that were: absence of unpleasant experience, pleasant taste, and good reputation of water dispensers, poor drinking water quality at home and the existence of local government legislation. The study also found that the majority of the respondents considered regular cleaning of the water dispensers necessary. Half of the respondents considered important cleaning the external details of the water dispenser more often than once a month. Over a quarter of the respondents considered important cleaning the water reservoir of the water dispenser

more often than once a month. As a result of microbiological analysis it was found that heterotrophic plate count exceeded the maximum permitted level in the water of the both water dispensers of Tartu Health Care College. In addition, the presence of coliforms was detected in one of the dispensers.

Conclusion(s): More than three-quarters of the respondents considered the water from water dispensers to be of good quality. The majority of the respondents considered regular cleaning of the water dispensers necessary, while women considered cleaning more important than men. Heterotrophic plate count exceedances occurred in the water of the both water dispensers of Tartu Health Care College. However, the water met the quality requirements for E. coli, Enterococci and P. aeruginosa.

Keywords: attitude, drinking water dispensers, microbiological quality of drinking water.

Authors: Kirkke Reisberg1,2, Eva-Maria Riso1, Jaak Jürimäe1 Scientific research supervisors: Eva-Maria Riso1, Jaak Jürimäe1

1 Institute of Sports Sciences and Physiotherapy,

University of Tartu, Estonia 2 Physiotherapy and Environmental Health Department,

Tartu Health Care College, Estonia

Background: The wide range of health benefits related to engagement in physical activity (PA) in childhood are well known. On the other hand, high sedentary behavior (SB) has been related to a number of health problems. Yet, little is known about the longitudinal associations regarding PA, SB and cognitive skills in childhood, no matter that early years are regarded as the most formative period of cognitive development, and the importance of cognitive health for academic success is well-recognized.

Aim: This study aimed to explore the longitudinal relationships between objectively measured PA, SB and cognitive performance in the transition from kindergarten to school.

Methods: Accelerometer-based PA, SB and cognitive skills were measured in Estonian children (n = 147) in kindergarten (6.6 years) and again at school (7.6 years). Modified Boehm-3 was applied to measure cognitive abilities. Linear regression analysis was used to explore the associations between PA, SB at 6.6 years and cognitive abilities one year later, after performing analysis of whole sample and of children subgrouped as into lower and upper quartiles by their moderate-to-vigorous PA (MVPA) at kindergarten-age.

Results: Analysis of whole sample revealed that in regression model that was adjusted for child ‘s sex, age, awake wear time, sports participation and maternal education, PA of different intensity levels at 6.6 years associated positively and SB negatively with conceptual skills one year later. Subgroup analysis showed that in upper quartile greater light, moderate or MVPA at 6.6 years predicted lower verbal and/or perceptual skills a year later after adjusting for confounders; greater SB at preschool age predicted better verbal skills at first class. At the same time, vigorous PA (VPA) at 6.6 years predicted better perceptual (upper quartile) or verbal (lower quartile) skills at 7.6 years, after controlling for confounders.

Conclusion(s): Higher levels of VPA at kindergarten predicted either better perceptual or verbal skills in first grade after controlling for confounders; the opposite associations were found for other PA levels and cognitive skills in the higher quartile, substantiating the importance of vigorous PA in the cognitive development during the period of kindergarten-to-school transition.

Keywords: children, cognitive skills; physical activity;