Usage of Agricultural Products in the Implementation of the European Union Social Programs: the Lithuanian Model

Magistrantūros studijų baigiamasis darbas, 61 puslapis, 30 paveikslų, 12 lentelių, 52 literatūros šaltiniai, 8 priedai, lietuvių kalba. PRASMINIAI ŽODŽIAI: socialinė programa, socialinių programų vykdymas, Lietuvoje pagamintų žemės ūkio produktų vartojimo skatinimas. Tyrimo objektas - Europos Sąjungos socialinių programų, naudojant žemės ūkio produktus, administravimo sistema Tyrimo tikslas - numatyti ir pagrįsti Lietuvoje pagamintų žemės ūkio produktų panaudojimo galimybes, vykdant Europos Sąjungos socialines programas. Uždaviniai: 1. apžvelgti ir apibendrinti Europos Sąjungos vykdomų socialinių programų tikslus ir vykdymo patirtį; 2. atlikti žemės ūkio produktų naudojimo, vykdant ES socialines programas, patirties ir administravimo sistemos analizę Lietuvoje; 3. įvertinti žemės ūkio produktų naudojimo, vykdant ES socialines programas Lietuvoje, naudą gamintojams, vartotojams ir valstybei; 4. parengti žemės ūkio produktų naudojimo, vykdant ES socialines programas Lietuvoje, strategiją ir tobulinimo priemonių planą vietos ir nacionaliniu lygmeniu jai įgyvendinti. Tyrimo metodai: lyginamoji, loginė ir sisteminė mokslinės ir metodinės literatūros analizė ir sintezė, indukcijos ir dedukcijos, palyginimo, dokumentų analizės, statistinės informacijos duomenų rinkimo, SSGG analizės, matematinės statistikos, anketinės apklausos ir grafinio vaizdavimo metodai. Tyrimo rezultatai: • pirmojoje darbo dalyje pateikti socialinės programos tikslai, išnagrinėti Europos Sąjungos socialinių programų, naudojant žemės ūkio produktus, reikšmė ir vykdymas; • antrojoje darbo dalyje išanalizuota Lietuvoje vykdomų socialinių programų „Pienas vaikams“ ir „Vaisiai mokykloms“ būklė, įgyvendinimo rodikliai, atlikta programų įgyvendinimo ir administravimo sistemos analizė; • trečiojoje darbo dalyje pateikta Lietuvoje pagamintų žemės ūkio produktų panaudojimo vykdant Europos Sąjungos socialines programas „Pienas vaikams“ ir „Vaisiai mokykloms“ SSGG analizė, programų sukuriama nauda gamintojui, vartotojui ir valstybei vietos ir nacionaliniu lygmeniu bei pasiūlytas tobulinimo priemonių planas sukurtai strategijai įgyvendinti; • detaliai išanalizavimus Europos Sąjungos vykdomų socialinių programų „Pienas vaikams“ ir „Vaisiai mokykloms“ teisinę bazę, administravimo sistemą, programų įgyvendinimo rodiklius ir atlikus anketinę skirtingų respondentų grupių apklausą, nustatyta, jog pagrindinės sritys, kuriose turi būti tobulinamos programos, yra administravimas supaprastinant pareiškėjų dalyvavimo jose tvarką ir programų populiarinimas, o prie Lietuvoje pagamintų pieno produktų, vaisių ir daržovių skatinimo turi prisidėti Lietuvos Respublikos žemės ūkio ministerija, produktų gamintojai, švietimo įstaigos didinant tarpusavio bendradarbiavimą, skleidžiant informaciją apie programų ir programose vartojamų produktų naudą.Final work of University Master studies, 61 pages, 30 figures, 12 tables, 52 references, 8 appendixes, the Lithuanian language. KEY WORDS: social programme, implementation of social programmes, usage of agricultural products produced in Lithuania. Research object – the administration system of the European Union social programmes using agricultural products. Research aim – to forecast and prove the usage possibilities of the Lithuanian agricultural products in pursuing the EU social programmes. Objectives: 1. to review and summarize purposes and experience in pursuing the EU social programmes; 2. to analyse the experience and administration of using agricultural products in pursuing the EU social programmes in Lithuania; 3. to evaluate the benefit for producers, consumers and the state of using agricultural products in pursuing the EU social programmes; 4. to prepare the strategy and plan of developmental measures for using agricultural products in pursuing the EU social programmes at local and national level. Research methods: comparative, logical analysis and systematization of scientific and methodical literature, induction and deduction, comparison, analysis of documents, statistical data collection, SWOT analysis, mathematical statistics, questionnaire, graphical representation. Research results: • The first part gives purposes of social programme and analyses the importance and implementation of the European Union social programmes using agricultural products; • The second part analyses conditions, implementation rates of “School Milk” and “School Fruit” schemes, implemented in Lithuania, programs' implementation and administration system; • The third part represents SWOT analysis of usage of Lithuanian agricultural products in pursuing the European Union social programmes “School Milk” and “School Fruit”, the benefit of the programmes for producers, consumers and the state at local and national level and offers the strategy and plan of developmental measures to implement the strategy; • Analysis of legal basis, administration system, implementation rates and results of questionnaire of the European Union social programmes “School Milk” and “School Fruit”, ascertains that the main areas, where the programs can be improved, are administration and popularization of the programs. Besides, Ministry of Agriculture of the Republic of Lithuania, producers, educational institutions have to contribute to usage of Lithuanian agricultural products and collaborate in dissemination of useful information about the benefit of the programs and the products, used in these programs.  Žemės ūkio akademijaVytauto Didžiojo universiteta

Changes of left and right ventricle mechanics and function in patients with end-stage renal disease undergoing haemodialysis

Background and objectives: Chronic kidney disease (CKD) increases the risk of cardiovascular diseases even in its early stages and is associated with structural and functional cardiac abnormalities. The aim of this study was to use speckle-tracking echocardiography (STE) to evaluate left and right ventricle mechanics and function, markers of subclinical dysfunction in patients with end-stage renal disease (ESRD) undergoing haemodialysis. Methods: Patients with ESRD undergoing regular haemodialysis and with preserved left ventricle (LV) ejection fraction (EF) (n=38) were enrolled in this retrospective study. The control group consisted of 32 age-matched persons with normal kidney function (glomerular filtration rate (GFR) >90 mL/min/1.73 m2 according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)). Conventional 2D echocardiography and STE were performed in all patients. Results: 70 individuals, 31 (44.29%) males and 39 (55.71%) females, were included in the study. There were no significant differences in age, sex and body surface area between the groups. LV end diastolic diameter did not differ between the groups, while LV myocardial mass index was higher in the group of patients on haemodialysis (111.64±27.99 versus 84.21±16.99, p<0.001) and LV diastolic dysfunction (LVDD) was found in 31 (81.6%) patients of this group. LV global longitudinal strain (GLS) (-22.43±2.71 versus -24.73±2.03, p<0.001) and LV global circumferential strain (GCS) at the mitral valve and papillary muscles levels (-18.73±3.49 versus -21.67±2.22, p<0.001; -18.64±2.75 versus -20.42±2.38, p=0.005, respectively) were significantly lower in haemodialysis group patients. The parameters of the right ventricle (RV) free wall longitudinal function including RV GLS (-22.63±3.04 versus -25.45±2.48, p<0.001), were reduced in haemodialysis patients compared with the controls. [...]

Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction

Cardiovascular abnormalities are well-known manifestations of a late form of syphilis – tertiary syphilis. Since the era of antibiotics, the incidence of late manifestations of syphilis has declined almost to a rare entity. The injury of aorta (the aortitis with a dilatation of aortic root and its associated complications) is the most common between all the cardiovascular lesions. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We present the case of a 37-year-old male who was treated for an acute myocardial infarction due to bilateral coronary artery ostial stenosis secondary to syphilitic aortitis. According to the multidisciplinary decision, surgical revascularization (coronary artery bypass grafting, CABG) was performed. According to dermatologist recom- mendation, patient postoperative cardiovascular treatment was supplemented with intra- muscular doses of benzathine penicillin recommended for tertiary syphilis. Further follow-up visits were also planned to detect possible changes of the aortic wall, dynamics of aortic regurgitation or potential anastomotic restenosis due to progression of aortitis

Right Ventricle Mechanics and Function during Stress in Patients with Asymptomatic Primary Moderate to Severe Mitral Regurgitation and Preserved Left Ventricular Ejection Fraction

Background and objectives. Mitral regurgitation (MR) is usually dynamic and increasing with exertion. Stress may provoke symptoms, cause the progression of pulmonary hypertension (PH) and unmask subclinical changes of the left and right ventricle function. The aim of this study was to evaluate changes of right ventricle (RV) functional parameters during stress and to find out determinants of RV function in patients with MR. Materials and methods. We performed a prospective study that included patients with asymptomatic primary moderate to severe MR and preserved left ventricular (LV) ejection fraction (EF) at rest (&ge;60%). Conventional 2D echocardiography at rest and during stress (bicycle ergometry) and offline speckle tracking analysis were performed. Results. 80 patients were included as MR (50) and control (30) groups. Conventional functional and myocardial deformation parameters of RV were similar in both groups at all stages of exercise (p &gt; 0.05). The grade of MR (p = 0.004) and higher LV global longitudinal strain (p = 0.037) contributed significantly to the changes of tricuspid annular plane systolic excursion (TAPSE) from rest to peak stress. Changes of MR ERA from the rest to peak stress were related to RV free wall longitudinal strain (FWLS) and four chambers longitudinal stain (4CLS) at rest (p = 0.011; r = &minus;0.459 and p = 0.001; r = &minus;0.572, respectively). Significant correlations between LV EF, stroke volume, cardiac output and RV fractional area change, S&prime;, TAPSE, FWLS, 4CLS were obtained. However, systolic pulmonary artery pressure and RV functional, deformation parameters were not related (p &gt; 0.05). Conclusions. Functional parameters of LV during exercise and severity of MR were significant determinants of RV function while PH has no correlation with it in patients with primary asymptomatic moderate to severe MR

Dobutamine-stress echocardiography speckle-tracking imaging in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high probability of coronary artery disease

Background and objective: Myocardial deformation indices are considered as sensitive markers of ischemia and may be useful in the quantification of hemodynamic significance of coronary artery disease (CAD). We sought to determine the diagnostic value of speckletracking echocardiography derived myocardial deformation parameters at rest and during stress to determine hemodynamically significance coronary artery stenosis in patients with moderate and high probability of CAD. Materials and methods: In 81 patients (mean age, 64 ± 8.6 years) with stable CAD inducible myocardial ischemia was evaluated by dobutamine stress echocardiography (DSE) and adenosine magnetic resonance imaging (AMRI). Based on AMRI patients were divided into two groups: nonpathologic (n = 41) and pathologic (n = 40). Strain and strain rate (SR) parameters and their changes from the rest (BASE) to low stress (MIN), peak stress (MAX), and recovery (REC) were analyzed using 2D speckle-tracking imaging (STI). Results: In the nonpathologic group, systolic longitudinal and circumferential strain increased significantly from BASE to MIN, as well as systolic SR from BASE to MIN and from MIN to MAX in longitudinal plane. In contrast, in the pathologic group, insignificant longitudinal systolic SR increase and radial and circumferential systolic SR decrease from MIN to MAX was observed. Discriminant function analysis revealed that select STI derived parameters best classify patients into predefined AMRI groups (pathologic and nonpathologic) with the accuracy respectively 90.9% and 83.3%. According to ROC analysis these myocardial deformation parameters had the greatest predictive value of significant coronary artery stenoses: longitudinal strain at high dose (AUC 0.811, sensitivity 89.4%, specificity 64.7%), longitudinal strain rate at high dose (AUC 0.855, sensitivity 88.1%, specificity 71.0% at high doses). The sensitivity and specificity of inducible wall motion abnormalities were 74.0% and 85.0% (AUC 0.798) and was lower compared with the diagnostic value of longitudinal myocardial deformation parameters. Conclusions: Left ventricular strain and strain rate analyses during DSE can be used in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high risk for CAD