Usage of Social Networks to Engage Citizens in the Decision-Making Process in the Municipality

The Master's work examines the usage of social networks to engage citizens in the decision-making process. The work consists of three parts. More efficient engagement of citizens can be achieved through social networks. The support of social networks can be determined by the intensity of political participation and the engagement of citizens on the Internet, while forming and maintaining the accumulated social capital. Social networks provide an opportunity to speed up and facilitate the connection between local self-government institutions and society. The social networks play an important role in public governance, especially in its communication processes, as they change the usual methods of communication and dissemination of information. It becomes easier and quicker to publish political content, to get feedback, to form an opinion. Social networks can be used in the decision-making process at different stages in order to involve citizens, as the target audience is easier accessible. A qualitative study strategy was chosen for the research, but it was used to fill it with both qualitative and quantitative approaches. It is intended to examine the use of social networks for the engagement of citizens in the decision-making process in the case of the Šiauliai City Municipality. The method of analysis of scientific literature helped to provide a theoretical justification for the study. The method of the documents’ content analysis revealed the engagement of social networks in the decision-making process in the municipality of Šiauliai City. The partly structured interview method explains who and how municipal representatives use social networks and how they appreciate the engagement of citizens through them. The content analysis of Facebook posts identifies the use and use of social networks’ accounts and their content in the case of the Šiauliai City Municipality itself and its representatives. The results of the survey have shown that the municipality is actively using the new technologies to publicise information. The main tools to publicise the activities are the municipality’s website, Youtube channel and Facebook account. However, too little attention is given for the municipality’s Facebook account data, functions and their exploitation – this is shown by the very limited data in the municipal activity reports. It can be argued that social networks still play a purely informative role. To sum up the results of the survey of the opinion of the municipal representatives, it is noted that social networks are too little used for the targeted engagement of citizens in the decision-making process. Members of the Council actively use personal social networks to receive citizens’ views and feedback, but they do not notice a direct engagement in decision-making on the current content of the municipality’s Facebook (citizens are attempted to include only by the presentation of the information and believing that citizens will participate actively). The content analysis of the Facebook account records revealed that appointments are used to publicise information and identity. Thus, the results of the study obtained by various methods confirmed that the engagement of citizens in the decision-making process in municipalities is fueled by social networks, i.e., the reason for the engagement is only implied, it is the expected result of the publication of information

The usage of social networks for citizen engagement at the local self-government level: the link between municipal councillors and citizens

Social networks perform a highly important role in public governance, especially in its communication processes, since they are an alternative to usual methods of communication and the dissemination of information, and it is becoming easier and quicker to publicise the political content, to receive feedback, and to form one’s opinion. Citizens can express their viewpoints on issues which are relevant to self-government, whereas representatives of the municipality can inform citizens about activities and ongoing changes, seek the support of citizens, and pursue their political career goals. The purpose of this research is to reveal how social networks can be employed for citizen engagement at the local self-government level, by identifying the characteristics of the link between municipal councillors and citizens. The research employed both quantitative and qualitative research approaches, using methods such as the content analysis of 335 account entries (posts) on the social network Facebook by four municipal councillors and semi-structured interviews with said councillors. The empirical research demonstrates that municipal councillors use their Facebook accounts to disseminate information on important matters of local self-government, raising questions which are relevant to society, and receiving feedback from citizens (assessment of problems, suggested solutions); however, there is a lack of other kinds of engagement of citizens, i.e. institutional (applied by a municipality), via Facebook, even though there are possibilities available for not only the dissemination of information but also for discussions and the submission of suggestions via social networks

Disseminated ovarian, bone, and bone marrow metastases from gastric cancer

The main cause of death in patients with gastric cancer is disease dissemination. It is not clear why gastric cancer metastasizes to different organs. Early detection and destruction of circulating malignant cells before developing metastases may markedly improve survival of these patients. Krukenberg tumors (metastases of non-gynecological origin in the ovaries) usually are circular cell carcinomas of gastric cancer. Bone metastases of gastric cancer are rare, but if they are diagnosed, patients survive only 2–5 months on the average. Disseminated bone marrow metastases from gastric cancer do not always show the sudden course of the disease, but hematological complications are signs of poor prognosis. Hematological paraneoplastic disorders can be miscellaneous: they usually manifest as anemia of various origin, as leucocytosis in half of the patients, as leukemoid reactions in one-third of the patients, and as hemolysis and thrombocytopenia in half of the patients (often with disseminated intravascular coagulation). Currently, chemotherapy is the most effective treatment for outspread gastric cancer. Unfortunately, there is no exclusively effective scheme for treatment. Lymph node metastases are more sensitive to chemotherapy than primary gastric cancer, while in contrary, hepatic metastases are less sensitive than primary gastric cancer. This article includes a literature review and a rare case of gastric cancer

Circulating inflammatory markers in cervical cancer patients and healthy controls

There is increasing evidence that host inflammatory responses play an important role in the development and progression of cancers. There are some data that cancer is associated not only with inflammation at the site of the lesion, but also with dysregulations of the host overall systemic immune response. In the case of cervical cancer, inflammation is an important factor associated with the development, progression, and potential metastasis of the disease. What is unclear still in the potential for modifications of host responses to human papillomaviruses (HPV) – a known causative agent of CC, that could be induced by cigarette smoking. In particular, it remains to be determined how the inflammation induced by HPV infection could impact on CC incidence/severity. In this prospective study, serum levels of 10 cytokines were evaluated using Multiplex and ELISA assays. The samples were the sera of 43 CC patients and 60 healthy (NILM) controls. All outcomes were evaluated in relation to host HPV and to their smoking status. The results in indicated that serum sTREM-1, TNFα, IFNβ, IL-1β, and IL-6 levels were significantly increased in CC (HPV+) patients compared to healthy NILM controls. A similar trend was observed for IL-10 and IL-2 levels. Within the two groups, differences in cytokine levels between smokers and never smokers were not remarkable. The findings here support the hypothesized role of systemic inflammation in the pathophysiology of CC

Experience of community pharmacists in providing advice about vulvo-vaginal complaints

Background: Many over-the counter drugs are available for treatment vulvo-vaginal complaints. Choosing for self-diagnosis and self-medication can contribute to delayed diagnosis and improper treatment. Pharmacists are the gatekeepers for rational self-medication and refering. However, it is not clear which barriers they meet and which advantages they use during consultations. Objective: To analyze the experiences of community pharmacists advising on vulvo-vaginal complaints. Methods: A qualitative study to evaluate pharmacists experience in providing advice about vulvo-vaginal complaints was conducted from January to March 2015. New respondents were included till saturation was achieved. Twenty-one Lithuanian community pharmacists were interviewed, recorded and transcribed verbatim. The qualitative content analysis approach was used for data collection during semi-structured interviews and for data analysis. Interview transcripts and documents were content analyzed independently by 2 researchers. Consensus was reach during negation in cases of disagreement. Thematic coding of narratives was performed, data was categorized into hierarchic tree. Results: Four main areas of special attention emerged: Provision of the service; uncertainty during counseling, collaboration with other health care providers and gatekeeping. Despite wide use of over-the counter drugs for vulvovaginitis, pharmacists recognize their limitations for proper diagnosis and try to implement their gatekeeper role through providing reference to a physician, education of patients about the necessity to establish a diagnosis, and discussing possible complications resulting from irrational treatment. Pharmacists seeks to improve their service through collaboration with other healthcare providers. The main topics of advice are information on use, drug-drug interaction, adverse reactions, the spectrum of choices. While providing the service pharma [...]

Lichen sclerosus et atrophicus in pediatric and adult male patients with congenital and acquired phimosis

Lichen sclerosus et atrophicus is a chronic inflammatory sclerotic and atrophic disease of unknown cause that predominantly affects male and female genital skin. This study was designed to evaluate histological characteristics of congenital and acquired phimoses among pediatric (n=60) and adult (n=60) male patients who were admitted for circumcision to the Clinics of Urology and Pediatric Surgery of Kaunas University of Medicine Hospital between 2000 and 2003 and to determine the rate of lichen sclerosus et atrophicus and other histological diagnoses among them. This study demonstrates that 45.1% of congenital and 62.3% of acquired phimoses show histological signs of lichen sclerosus et atrophicus. The rate of lichen sclerosus et atrophicus was statistically significantly higher among patients with acquired than congenital phimosis. Boys with acquired narrowing of prepuce were statistically significantly 3.9 times more likely to develop lichen sclerosus et atrophicus than those with congenital phimosis. There were no statistically significant differences between rates of lichen sclerosus et atrophicus and other dermatological diagnoses among pediatric and adult male patients if the type of phimosis (acquired or congenital) was considered. Histological features of lichen sclerosus et atrophicus and other histological diagnoses in boys and men with phimosis were detected with equal frequency irrespective the age of the subjects. The rate of lichen sclerosus et atrophicus was similar among all boys (56.7%) and men (53.3%) treated for phimosis. Only the type of phimosis had a statistically significant influence on the rate of lichen sclerosus et atrophicus and other histological diagnoses

Vaikų ir suaugusiųjų įgimtos ir įgytos fimozės sąsaja su sklerozine ir atrofine kerplige

Lichen sclerosus et atrophicus is a chronic inflammatory sclerotic and atrophic disease of unknown cause that predominantly affects male and female genital skin. This study was designed to evaluate histological characteristics of congenital and acquired phimoses among pediatric (n=60) and adult (n=60) male patients who were admitted for circumcision to the Clinics of Urology and Pediatric Surgery of Kaunas University of Medicine Hospital between 2000 and 2003 and to determine the rate of lichen sclerosus et atrophicus and other histological diagnoses among them. This study demonstrates that 45.1% of congenital and 62.3% of acquired phimoses show histological signs of lichen sclerosus et atrophicus. The rate of lichen sclerosus et atrophicus was statistically significantly higher among patients with acquired than congenital phimosis. Boys with acquired narrowing of prepuce were statistically significantly 3.9 times more likely to develop lichen sclerosus et atrophicus than those with congenital phimosis. There were no statistically significant differences between rates of lichen sclerosus et atrophicus and other dermatological diagnoses among pediatric and adult male patients if the type of phimosis (acquired or congenital) was considered. Histological features of lichen sclerosus et atrophicus and other histological diagnoses in boys and men with phimosis were detected with equal frequency irrespective the age of the subjects. The rate of lichen sclerosus et atrophicus was similar among all boys (56.7%) and men (53.3%) treated for phimosis. Only the type of phimosis had a statistically significant influence on the rate of lichen sclerosus et atrophicus and other histological diagnoses

Prevalence of Human Papillomavirus Types 16, 18, and 45 in Women With Cervical Intraepithelial Changes: Associations With Colposcopic and Histological Findings

The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. Material and Methods. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. Results. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/ CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). Conclusions. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions

Associations among Serum Lipocalin-2 Concentration, Human Papilloma Virus, and Clinical Stage of Cervical Cancer

Background and objective: Lipocalin 2 (LCN2) has an oncogenic role in promoting tumorigenesis through enhancing tumor cell proliferation and the metastatic potential. The aim of our study was to determine whether serum LCN2 could serve as a diagnostic marker of cervical cancer (CC) and to evaluate the correlation between its serum concentration, the clinical stage of the cancer and Human Papilloma Virus HPV infections in women. Materials and methods: A total of 33 women with histologically proven cervical cancer (CC), 9 women with high- grade cervical intraepithelial neoplasia (HSIL) and 48 healthy women (NILM) were involved in the study. A concentration of LCN2 was assayed with the Magnetic LuminexR Assay multiplex kit. An HPV genotyping kit was used for the detection and differentiation of 15 high-risk (HR) HPV types in the liquid-based cytology medium (LBCM) and the tissue biopsy. Results: The majority (84.8%) of the women were infected by HPV16 in the CC group, and there was no woman with HPV16 in the control group (P < 0.01). Several types of HR HPV were found more often in the LBCM compared to in the tissue biopsy (P = 0.044). HPV16 was more frequently detected in the tissue biopsy than the LBCM (P < 0.05). The LCN2 level was higher in HPV-positive than in HPV-negative women (P = 0.029). The LCN2 concentration was significantly higher in women with stage IV than those with stage I CC (P = 0.021). Conclusions: Many HR HPV types, together with HPV16/18, can colonize the vagina and cervix, but often HPV16 alone penetrates into the tissue and causes CC. The serum LCN2 concentration was found to be associated not only with HR HPV infection, irrespective of the degree of cervical intraepithelial changes, but also with advanced clinical CC stage. LCN2 could be used to identify patients with advanced disease, who require a more aggressive treatment

Surgical treatment of advanced epithelial ovarian cancer

Primary cytoreductive surgery remains the standard care in advanced ovarian cancer. Optimal cytoreductive surgery is defined as a residual tumor load less than 1 cm. after operation. The randomized clinical trials showed that interval debulking surgery improved survival in patients who did not undergo optimal primary debulking surgery. The retrospective trials have suggested that the outcome for patients treated with neoadjuvant chemotherapy followed by interval debulking surgery is the same as for patients treated with primary debulking surgery followed by adjuvant chemotherapy. The neoadjuvant chemotherapy should not to be used for clinical practice until the randomized clinical trial carried out by Gynecological Cancer Group of the European Organization for Research and Treatment of Cancer and National Cancer Institute of Canada answers this question. There are no data from randomized trials to show the survival advantage in patients who received second-look operation as compared to those who did not