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Transition from paediatric to adult health care services is a crucial process for young adults with long-term medical conditions and well organized and coordinated transition process has been strongly highlighted. The aims of this research were to assess the young adults with cerebral palsy overall readiness for adult life, the independency in health care management and independency impacting factors. Eighty young adults (age range 16–21 years) with CP and normal or slightly decreased mental function participated. There were done “face-to-face” structured interviews using the Rotterdam Transition Profile and the Transition Readiness Assessment Questionnaire also the characteristics of participants were obtained. It was revealed that young adults with cerebral palsy show low levels of participation in almost all domains of transition to adult life, the level of attendance of rehabilitation services is not sufficient, and the level of independency for young adults with CP in health care management is between phases of preparation and action. The most impacting factor for independency in health care management was found to be the cognitive status.

Breast cancer treatment may cause unfavourable side effects that directly or indirectly influence the cardio-respiratory capacity among breast cancer survivors, thus affecting physical functioning and the quality of life. Mounting evidence supports that Maximal oxygen uptake (VO2max) is a strong predictor of all-cause mortality and cardiovascular disease, and low VO2max is associated with increased mortality from breast cancer. The aim of the study was to measure cardio-respiratory fitness in breast cancer survivors and determine to what extent VO2max levels are lower compared with healthy counterparts from population. The study included 11 women with a history of breast cancer, the average time after breast surgery being 2–3 years. Aerobic capacity was determined by the Cardiopulmonary exercise test. HUNT3 study was used to define aerobic capacity for healthy women in population. Mean Age for participatns 50 ± 4 years (M ± SD). The comparison of the results from Cardiopulmonary exercise test indicated that breast cancer survivors display VO2max values significantly lower 27.1 ml/kg/min (27%) than healthy counterparts from population, i.e., 34.4 ml/kg/min (P = 0.001). Recognizing the increasing number of breast cancer patients worldwide and the physical reconditioning among the survivors, aerobic exercise training is suitable for improving cardio-respiratory health, functionality, and quality of life.

The article The Role of the Occupational Court of Latvian Medical Association in the System of Legal Liability of Medical Practitioners describes the system of professional liability of medical practitioners, analyzing in details one of the institutions, which ensures professional liability of doctors and dentists – the Occupational Court of Latvian Medical Association. The article characterizes the position and role of the Occupational Court in the system of legal liability of medical practitioners, researches legal regulation for operations of the Occupational Court, the essence of the Occupational Court proceedings and the legal nature of decisions made in the Occupational Court. The article identifies potential problems in operations of the Occupational Court, making proposals how to eliminate the problems found out. The authors offer to expand the competence of the Occupational Court in the future. The article also touches upon such problematic issues relating to legal liability of medical practitioners as doctor's errors and medical errors, causality, etc.

The objective is to examine and compare the usability of two physiotherapy programmes, analyzing respiratory function in patients before and after cardiac surgery in hospital during seven postoperative days (POD). Quantitative randomized prospective study of 157 patients before and after the valve replacement surgery, coronary artery bypass graft and combined surgeries, who moved independently. Participants were randomized into two groups (1 and 2) with different physiotherapy programmes. The routine physiotherapy of breath-enhancing techniques, micro-circulation improvement were used for the first group, for the second group - modified physiotherapy – the improvement of inspiration muscles, mm. quadriceps. gluteus max strength. Anthropometric measurements were defined for both groups on the day before surgery and during spirography - dynamic indicators - forced vital capacity (FVC), forced expiratory volume in the 2nd second (FEV1), Tiffeneau index (FEV1 / VC (%)), peak expiratory flow (PEF), operation parameters. By comparing the postoperative respiratory parameters between the two groups and using independent samples t test, it was found out that the difference in FVC between groups is 1.71 [95% CI: −8.25 to 4.8] and it is not statistically significant (t (155) = −0.52; p = 0.60). Based on the Leuven test results FVC the distribution variance is not statistically notably different for group 1 and group 2 (F = 0.27, p=0.60). Using routine and modified physiotherapy and comparing postoperative dynamic respiratory performance of the two groups, there was no statistically significant difference, proving that the two models are equally effective.

The aim of the study was to perform treatment of juniper wood to obtain wood material with a density and mechanical properties comparable to bone, thus producing a potential material for use in osteosynthesis bone implants. In the first step, partial delignification of wood sample was obtained by Kraft cooking. The second step was extraction with ethanol, ethanol–water mixture, saline, and water to prevent the release of soluble compounds and increase biocompatibility. In the last step, the thermal densification at 100 °C for 24 h was implemented. The results obtained in the dry state are equivalent to the properties of bone. The swelling of chemically pre-treated densified wood was reduced compared to chemically untreated densified wood. Samples showed no cytotoxicity by in vitro cell assays. The results of the study showed that it is possible to obtain noncytotoxic wood samples with mechanical properties equivalent to bones by partial delignification, extraction, and densification. However, further research is needed to ensure the material’s shape stability, water resistance, and reduced swelling.

Craniofacial development is a critical aspect of pediatric growth, influencing fields such as physical anthropology, pediatrics, forensic sciences, and clinical practice. Objectives: This study aimed to assess the trends in craniofacial measurements and indices in Latvian children aged 1–15. Methods: The anthropometrical measurements (head circumference, length, width, facial length, and width) were conducted on 375 children according to the guidelines by R. Martin, K. Saller, and J. Prīmanis at the Anthropology laboratory at the Institute of Anatomy and Anthropology, Rīga Stradiņš University. The cephalic index (CI) and the facial or prosopic index (PI) were calculated, allowing for a detailed examination of cranial and facial proportions. The data were analyzed using descriptive and inferential statistics, including the Pearson Chi-square test and the Spearman correlation coefficient. Results: The findings revealed a consistent increase in head circumference with age, with boys generally having slightly larger heads than girls. The boys and girls exhibited growth in head length and width, particularly noticeable between 1 and 2 years of age. Facial length and width increased with age, with boys typically having longer facial lengths and broader faces than girls. The most common cephalic index category is mesocephaly, which accounts for 52.85% of the population, followed by dolichocephaly at 32.94%. Brachycephaly and hyperbrachycephaly are less prevalent, representing 11.36% and 2.86% of the population. Regarding the facial index categories, hypereuryprosopic is the most prevalent, representing 45.54% of the population, closely followed by euryprosopic at 43.74%. Mesoprosopic is significantly less common, representing only 9.95%. The least common categories are leptoprosopic and hyperleptoprosopic, with prevalences of 0.64% and 0.12%, respectively. The indices analysis showed variations across age groups, with dolichocephaly being more common at younger ages and decreasing over time. Brachycephaly and hyperbrachycephaly remained relatively stable or decreased slightly with age, while mesocephaly displayed less variation. The relationship between the FI and CI in younger age groups was typically weak to moderate and inverse, with a significance level of p < 0.001 or p < 0.01. However, no meaningful correlation was observed in older children aged 14–15. Conclusions: This study provides valuable insights into the craniofacial development of Latvian children, highlighting the measurements, cranial and facial types, and their variations across age groups.

In the world's developed countries, demographic changes, such as aging societies and increased numbers of diabetes patients, have led to an increase in amputations (11), and it is believed that as society ages, the number of people who are older than 65 will face as much as two times more amputations [3]. Of great importance after the amputation of a lower limb is the selection and adaptation of prostheses that allow patients to move around, thus achieving rehabilitation goals much more quickly [5]. A 20090-study of the rehabilitation of people with lower limb amputations in Latvia found that among 183 patients, 50% use their prostheses actively for more than 6 hours a day, 30% did not use them at all or used them for less than 3 hours a day, and 20% used them for 3-6 hours a day. The study included 173 patients with lower limb amputations who were evaluated in 2012 in relation with whether primary prosthesis should be provided. Of 173 patients who were evaluated, only 109 received a decision on primary prostheses, while in 51 cases the process was delayed for 1–3 months, in 12 cases, it was decided that prostheses would not be purposeful. More than 25% of those who followed the recommended treatment and rehabilitation programme to prepare the amputation stump, reduced contracture and enhanced physical working abilities were declared to be appropriate for further prostheses. This indicates serious shortcomings in medical treatments during the early post-amputation period.

An understanding of predictors of family needs for the families of preschool children with cerebral palsy (CP) is important for provision of efficient and cost-effective services. The aim of this study was to identify the characteristics of children, families and services that are risk factors to meeting family needs for community and financial resources. 234 parents of pre-school children with CP completed a modified version of the Family Needs Survey (FNS), the Measure of Processes of Care (MPOC-20), and a demographic questionnaire. The gross motor function level and communication function level of children were classified on the basis of the Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System (CFCS) respectively. Two hierarchical multiple regression models were generated to determine the predictors of unmet family needs. The socialisation and communication skills of children, as well as caregiver employment and family income levels were significant predictors of family needs for community resources (adjusted R2=0.44). Significant risk factors in terms of family needs for financial resources included the child's gross motor limitations, caregiver employment, low levels of family income and no ability to receive services on the basis of enabling and partnership principles (adjusted R2=0.51). A child's limitations in terms of communication, gross motor functions and socialisation, as well as the socioeconomic status of the child's family, must be taken into account when planning services for families with preschool children with CP.

There are many clinical and objectively defined parameters that are used to evaluate a person's disability. Since the World Health Organisation has presented the WHODAS II as a means of objectively measuring subjectively defined functions, greater attention has been focused on self-rated health. Only a few studies, however, have been conducted about differences between self-rated health and objectively defined parameters. The survey for this study was conducted on the basis of WHODAS II and the population in Latvia with spinal cord injury. Respondents were between 18 and 65, and 98 questionnaires were analysed. The results show that people with spinal cord injury on average rate their functioning as limited (33–40 points of 100). Most respondents have been declared to be disabled, which is defined as very serious or severe functional disorders. More than 40% have paid jobs, while one-third do not work for reasons of health. The research shows that there is a close coherence (p< 0.05) between individual, objectively and clinically defined indicators on the one hand and the aspects of the questionnaire in which physical functioning was an important factor on the other hand. In order to understand the real functional abilities of patients and the individual factors that influence those abilities, it is necessary to define functional self-rated health in addition to objectively defined indicators.

Background/Objective: Shoulder overuse due weight-bearing loads – wheelchair propulsion and transfers – are supposed to cause shoulder pain in active wheelchair users. Consequently, shoulder pain has been found to have a high prevalence in the spinal cord-injured population. Severity of pain levels in individuals with spinal cord injury has been shown to impact quality of life. Aim of this study was to describe the consequences of shoulder pain intensity on quality of life, physical activity, and community activities in spinal cord-injured paraplegic wheelchair users. Materials and Methods: It was a qualitative, analytical one moment study where was involved persons after spinal cord injury below Th1 with lower paraplegia, who used manually operated wheelchairs for mobility at least 50% of the time. Main outcomes measure: SF-36textregistered Health Survey, Physical Activity Scale for Individuals With Physical Disabilities, Community Activities Checklist, Wheelchair User’s Shoulder Pain Index, Functional Independence Measure, Goniometry for shoulder joint. Results and analysis: 40 participants (9 female, 31 male) after spinal cord injury (SCI), mean age – 30,8 years, one to twenty years after spinal cord injury. 20 participants had pain in shoulder, 20 participants without pain in shoulder. The intensity of shoulder pain was not related to duration of SCI or the duration of shoulder pain. Shoulder pain intensity scores were inversely related to quality of life. There was a moderate, inverse relationship between shoulder pain intensity and physical activity. There was no relationship, however, between shoulder pain intensity and community activities. The level of community activity was positively related to quality of life. Conclusions: Persons with spinal cord injury who reported lower subjective quality of life and physical activity scores experienced significantly higher levels of shoulder pain. Shoulder pain intensity did not relate to their participation in community activities.

Long-term quality of life of children with special needs has not been studied in Latvia, and information on changes of quality of life (QoL) rates during child’s development period is insufficient. The aim of the study was to analyze and compare the QoL related self-reports of school age children with special needs, which were repeatedly carried out once a year (2009–2010), with the proxy reports of their parents, as well as to compare the obtained results with Europe normative data on QoL developed by KIDSCREEN research group; to investigate the provision of social rehabilitation services for such families. The study was carried out in Riga municipality 2009–2010. Altogether 34 families with 8–11 years of age children with developmental disabilities participated in the study. Both parents and children filled KIDSCREEN-52 questionnaire, but a survey developed by a group of researchers “Social services” was used to gather information from the parents about the received children and family centered social services in the period between the both quality of life assessments. Results showed statistically significant changes in the latest quality of life self-assessment rates of school-age boys and girls with special needs in time period 2009–2010. Participants of the study – children with developmental disabilities – in both cases reported a lower QoL in comparison with Europe normative data on QoL developed by KIDSCREEN research group.

Urinary incontinence is one of the medical problems, which may develop as a result of a stroke, and, according to several authors, its occurrence frequency may reach up to 80%. Clinical symptoms of urinary incontinence are considered to be one of the symptoms, which, along with the severity of the stroke and the level of functional limitations, allows to develop reliable predictions and to make targeted use of resources. Aim of the study, materials and methods. The aim of the study is to explore whether post-stroke urinary incontinence correlates with localization of lesion and clinical symptoms. The study includes 180 patients after a stroke, who have received treatment at Riga Eastern Clinic University Hospital Stroke Unit. All had a comprehensive clinical and functional assessment and cerebral computed tomography (CT). The examination took place at the hospital a few days after the stroke had occurred. Results. There are 180 participants to the study. Symptoms of urinary incontinence were reported for 70.6% of study participants. In 64% of cases new incontinence problems had developed, while in 6.5% of cases the previous symptoms of urinary incontinence (prior to the stroke) had worsened. The most common types of urinary incontinence in the acute period were urge and mixed incontinence (functional and urge incontinence). Patients with low Barthel Index showed higher frequency of urinary incontinence. A comparison of patient groups with and without symptoms of urinary incontinence showed that patients older than 75 years showed more symptoms of urinary incontinence (p = 0.013), and the same can be said about patients with low indicators of Barthel (p = 0.001) and patients with cognitive disorders (p = 0.001). Severity of paresis, aphasia and sensory disorders show a reliable correlation with the type of urinary incontinence. Conclusion. Symptoms of post-stroke urinary incontinence are linked both to a person's age, and functional and cognitive disorders. Urinary incontinence develops more frequently among patients with anterior circulation of the brain and subcortical brain lesion. There is a reliable correlation between severity of neurological lesion and urinary incontinence.

This study provides a comprehensive analysis of the physical development patterns from birth to adolescence, utilizing a longitudinal dataset of 70 children monitored from birth until 17 years of age. The research focuses on the variability of growth trajectories, emphasizing the role of genetic and environmental factors in influencing these patterns. Key findings indicate that most children undergo one or two periods of accelerated growth, with significant variability in the timing and magnitude of these growth spurts. The study also highlights the adaptive nature of growth changes over generations, influenced by ecological, nutritional, and socio-economic conditions. The longitudinal approach reveals critical insights into the timing of peak growth velocities, demonstrating that girls reach their growth peak approximately one year earlier than boys. The analysis of intergenerational growth patterns suggests a significant increase in average height over the century, attributed to genetic diversity and changes in lifestyle and nutrition. This study’s findings emphasize the importance of updating physical development standards regularly to reflect the changing genetic and environmental landscape. The variability in growth patterns and their correlation with health outcomes in later life highlights the need for targeted public health strategies that address the underlying socio-economic and environmental determinants of health. This research contributes to the understanding of physical development trajectories and provides a foundation for future studies aimed at optimizing health outcomes from early childhood through adolescence. The primary objective of this article is to meticulously analyze the dynamics of height growth and accurately identify the periods of accelerated bodily development within the context of longitudinal research.

The article looks into psychological characteristics of self-attitude in juvenile suspects, ac-cused and convicts of violent crimes held in detention facilities. Using the “Self-portrait” projective methodology, observation and psychodiagnostic structured counselling made it possible to reveal the psychological characteristics of self-attitude in such minors. It has been found that the structure of self-attitude components in juvenile suspects, accused and convicts is closely interrelated and organized and is characterised with inadequacy of their self-rating (upward or downward bias), difficulties in controlling one's drives of the body, aggressivity, egotism, proneness to depression, dependency, emotional immaturity, demon-strative behavior, proneness to internal conflict, “criminal contamination”, difficulties in communication.

The aim of the study was to perform treatment of juniper wood to obtain wood material with a density and mechanical properties comparable to bone, thus producing a potential material for use in osteosynthesis bone implants. In the first step, partial delignification of wood sample was obtained by Kraft cooking. The second step was extraction with ethanol, ethanol–water mixture, saline, and water to prevent the release of soluble compounds and increase biocompatibility. In the last step, the thermal densification at 100 °C for 24 h was implemented. The results obtained in the dry state are equivalent to the properties of bone. The swelling of chemically pre-treated densified wood was reduced compared to chemically untreated densified wood. Samples showed no cytotoxicity by in vitro cell assays. The results of the study showed that it is possible to obtain noncytotoxic wood samples with mechanical properties equivalent to bones by partial delignification, extraction, and densification. However, further research is needed to ensure the material's shape stability, water resistance, and reduced swelling. [ABSTRACT FROM AUTHOR]

Craniofacial development is a critical aspect of pediatric growth, influencing fields such as physical anthropology, pediatrics, forensic sciences, and clinical practice. Objectives: This study aimed to assess the trends in craniofacial measurements and indices in Latvian children aged 1–15. Methods: The anthropometrical measurements (head circumference, length, width, facial length, and width) were conducted on 375 children according to the guidelines by R. Martin, K. Saller, and J. Prīmanis at the Anthropology laboratory at the Institute of Anatomy and Anthropology, Rīga Stradiņš University. The cephalic index (CI) and the facial or prosopic index (PI) were calculated, allowing for a detailed examination of cranial and facial proportions. The data were analyzed using descriptive and inferential statistics, including the Pearson Chi-square test and the Spearman correlation coefficient. Results: The findings revealed a consistent increase in head circumference with age, with boys generally having slightly larger heads than girls. The boys and girls exhibited growth in head length and width, particularly noticeable between 1 and 2 years of age. Facial length and width increased with age, with boys typically having longer facial lengths and broader faces than girls. The most common cephalic index category is mesocephaly, which accounts for 52.85% of the population, followed by dolichocephaly at 32.94%. Brachycephaly and hyperbrachycephaly are less prevalent, representing 11.36% and 2.86% of the population. Regarding the facial index categories, hypereuryprosopic is the most prevalent, representing 45.54% of the population, closely followed by euryprosopic at 43.74%. Mesoprosopic is significantly less common, representing only 9.95%. The least common categories are leptoprosopic and hyperleptoprosopic, with prevalences of 0.64% and 0.12%, respectively. The indices analysis showed variations across age groups, with dolichocephaly being more common at younger ages and decreasing over time. Brachycephaly and hyperbrachycephaly remained relatively stable or decreased slightly with age, while mesocephaly displayed less variation. The relationship between the FI and CI in younger age groups was typically weak to moderate and inverse, with a significance level of p < 0.001 or p < 0.01. However, no meaningful correlation was observed in older children aged 14–15. Conclusions: This study provides valuable insights into the craniofacial development of Latvian children, highlighting the measurements, cranial and facial types, and their variations across age groups. [ABSTRACT FROM AUTHOR]

Pertrochanteric fractures (TF) due to osteoporosis constitute nearly half of all proximal femur fractures. TFs are treated with a surgical approach and fracture fixation is achieved using metallic fixation devices. Poor quality cancellous bone in osteoporotic patients makes anchorage of a fixation device challenging, which can lead to failure of the fracture fixation. Methods to reinforce the bone-implant interface using bone cement (PMMA) and other calcium phosphate cements in TFs have been described earlier but a clear evidence on the advantage of using such biomaterials for augmentation is weak. Furthermore, there is no standardized technique for delivering these biomaterials at the bone-implant interface. In this study, we firstly describe a method to deliver a calcium sulphate/hydroxyapatite (CaS/HA) based biomaterial for the augmentation of a lag-screw commonly used for TF fixation. We then used an osteoporotic Sawbones model to study the consequence of CaS/HA augmentation on the immediate mechanical anchorage of the lag-screw to osteoporotic bone. Finally, as a proof-of-concept, the method of delivering the CaS/HA biomaterial at the bone-implant interface as well as spreading of the CaS/HA material at this interface was tested in patients undergoing treatment for TF as well as in donated femoral heads. The mechanical testing results indicated that the CaS/HA based biomaterial increased the peak extraction force of the lag-screw by 4 times compared with un-augmented lag-screws and the results were at par with PMMA. The X-ray images from the patient series showed that it was possible to inject the CaS/HA material at the bone-implant interface without applying additional pressure and the CaS/HA material spreading was observed at the interface of the lag-screw threads and the bone. Finally, the spreading of the CaS/HA material was also verified on donated femoral heads and micro-CT imaging indicated that the entire length of the lag-screw threads was covered with the CaS/HA biomaterial. In conclusion, we present a novel method for augmenting a lag-screw in TFs, which could potentially reduce the risk of fracture fixation failure and reoperation in fragile osteoporotic patients.

This paper compares several commonly used state-of-the-art ensemble-based data assimilation methods in a coherent mathematical notation. The study encompasses different methods that are applicable to high-dimensional geophysical systems, like ocean and atmosphere and provide an uncertainty estimate. Most variants of Ensemble Kalman Filters, Particle Filters and second-order exact methods are discussed, including Gaussian Mixture Filters, while methods that require an adjoint model or a tangent linear formulation of the model are excluded. The detailed description of all the methods in a mathematically coherent way provides both novices and experienced researchers with a unique overview and new insight in the workings and relative advantages of each method, theoretically and algorithmically, even leading to new filters. Furthermore, the practical implementation details of all ensemble and particle filter methods are discussed to show similarities and differences in the filters aiding the users in what to use when. Finally, pseudo-codes are provided for all of the methods presented in this paper.

Radio occultation (RO) provides a cost-effective component of the overall sensor mix required to characterise the ionosphere over wide areas and in areas where it is not possible to deploy ground sensors. The paper describes the RO constellation that has been developed and deployed by Spire Global. This constellation and its associated ground infrastructure are now producing data that can be used to characterise the bulk ionosphere, lower ionosphere perturbations, and ionospheric scintillation.