Tiltai

The World Health Organization acknowledges that the health of people in the European region has improved significantly, but not everywhere and not equally for all. It has set a strategic goal to improve the health of all, and reduce health inequalities. In meeting this goal, Lithuania purposefully strives to reduce inequalities in the health condition of individuals attributed to different social groups, and differences in accessibility to health care. The primary focus is on people with disabilities. In compliance with the UN Convention on the Rights of Persons with Disabilities, Lithuania seeks to provide people with disabilities with health-care services and programmes of the same availability, quality and level which are provided or applied to other individuals, free of charge or at a reasonable price. However, research has revealed a great deal of problems in fulfilling this obligation. The present article focuses on physicians’ experience, and aims to understand, from a physician’s perspective, the financial opportunities and barriers that they encounter in rendering health-care services to people with disabilities. A survey involving 107 physicians was carried out in 2019 and 2020. The research results showed that Lithuania is making progress in increasing funding to the health-care system in a targeted way covering a wide range of its domains. Therefore, physicians have plenty of opportunities to refer patients with disabilities to other professionals for consultation without any financial constraints, to prescribe reimbursable medication, to carry out laboratory and radiological tests, to give instructions to caregivers on patient care, and to hospitalise a patient or transfer him/her to another hospital. The situation is somewhat worse with prescribing the most appropriate reimbursable measures and reimbursable rehabilitation treatment, and the worst situation has emerged in the sphere of reimbursable psychological and social assistance, because these services are usually granted a minimum level of funding. The trends established verify that there is a strong need to develop a more effective public health policy in Lithuania, to reform the health-care system, and to invest in improving its quality, so that the country can take more measures to ensure the health of the population and the inclusive equality of people with disabilities in the health-care system.

Scientific journal Tiltai / Bridges / Brücken published by Klaipėda University (established in 1991) is devoted to the issues of social sciences, and seeking academic dialogue, also to other human and society functioning-related humanities and biomedical sciences, with expand and interpret different social phenomena and current issues from an interdisciplinary perspective. The publications attempts at analysing and solving actual problems of economy, management, demography, social geography, geopolitics, political sciences, history, education, religious, regional planning and land use, other social problems. Science has no borders. Therefore scientific cooperation is one of the most important elements in the progress of world’s community. Scientists from different countries of the world are kindly invited to write for and contribute to the journal.

The scientific article analyses the subjectively perceived quality of life of adult patients with mental and behavioural disorders, and its relationship to the certification of day care institutions according to the EQUASS quality implementation system and the links with health services provided to adults with disabilities. The aim of the research is to investigate the correlations between the subjectively perceived quality of life of patients with mental and behavioural disorders and the health services provided. The article presents a research study involving 13 respondents (seven men and six women) with mental and behavioural disorders. Qualitative research with the in-depth interview method was applied. The respondents ranged in age from 20 to 48 years (the mean age was 32), all of them had attended the day care centre for from one to 20 years (the average attendance was 7.5 years). The research data were processed using narrative analysis. The research results revealed that adults with mental and behavioural disorders perceive the health system integratively. The essential triangulation that influences the assessment of their subjectively good quality of life was identified: the characteristics of the person himself/herself, the efficiency of services provided, and the professionalism of the employee. It was also found that for respondents receiving inpatient services for ten years or more, the subjectively perceived quality of life is related to social participation in the community. It was also identified that adults with mental disabilities still face stigmatisation; therefore, it is necessary to legally ensure the context of their social participation and valorisation. The research revealed that medical and social services for patients with mental and behavioural disorders require closeness: a person after in-patient treatment and receiving additional psychosocial rehabilitation services focuses on the valorisation of his/her role in society and social participation.

The book Hegel’s Century: Alienation and Recognition in a Time of Revolution (Cambridge University Press, 2021) by Jon Stewart is a profound philosophical book. Reading Hegel is a challenge that requires close attention and a philosophical background; nevertheless, reading Hegel together with Jon Stewart is fully rewarded. The great value of the book is that it is mainly very easy to read, and that makes it different from traditional philosophy books, which people find too difficult. The book has an elegant text and a highly individual way of writing. It has already received recognition in the 2021 Prose Awards by the Association of American Publishers (AAP) for excellence in prose in the category Winner in Philosophy.

Radiation therapy is an important part of breast cancer treatment, reducing local recurrence and improving overall survival. About 1,500 cases of breast cancer are diagnosed in Lithuania every year. About 30% of all newly diagnosed cancers in women are breast cancer, and about 80% of early-stage breast cancers are treated with radiotherapy. New modern radiation techniques have been evaluated with a better understanding of the effects of radiation on the heart. The article reviews the implementation of the deep inhalation breath hold technique in the clinical practice of Klaipėda University Hospital. The purpose of this article is to analyse the results of the first two years after the implementation of the new methods. Assessing the importance of radiotherapy, the author reveals the importance of the innovative deep breathing method in the article, and shares the experience she has gathered. At the same time, scientific and practical assumptions are made that, after the introduction of innovative radiotherapy technologies into practice, new opportunities for optimising the treatment of patients by individualising it open up. The results of the study reveal the need for a prospective cohort study in order to optimise patient education, clarify selection criteria, and increase the availability of modern radiotherapy services. The presentation of this method in an interdisciplinary environment of social and health care specialists allows specialists to familiarise themselves with the achievements of oncological radiotherapy in west Lithuania.

The article shows the expression of social innovation in the Lithuanian military. By presenting different innovation models and processes, the authors argue that social innovation could be an effective tool for increasing the efficiency, resilience and intelligence of the armed forces. While the general public perception of the military is very technocratic, social practices (leadership, collaboration, communication) can broaden that perception through social innovation. The empirical study reveals that the expression of social innovation enriches social practices, and introduces new perspectives, ranging from advanced mental health support measures to operational collaborative strategies. Social innovation can contribute to the management of contemporary challenges both in the military and in society. By presenting the current expression of social innovation, the paper reveals the opportunities for improving social innovation in the Lithuanian military.

The article examines the expression and dynamics of the phenomenon of murder in the city of Klaipėda between 2004 and 2014. This period, which began with the accession of Lithuania to the European Union, has a very important context of societal changes, which provided the authors of the article with theoretical and practical access to an analysis of the causality and expression of the phenomenon of murder. The sociological approach reveals a socio-demographic portrait of the victim and the person who committed a murder, in the context of segments of the structural expression of the phenomenon of murder (age, gender, social status). The article presents statistical data from murders registered in the Official Register of Criminal Acts (ORCA). For the analysis of these data, the authors purposefully chose the positivist theories of external restraint and subculture of violence, which have practical access to reveal segments of the structural expression of the phenomenon of murder in a changing society. This presupposes access to the continuity of research on the resolution of the phenomenon of murder in the next decade (2015 to 2023). The research results presented in the article focus on the development of murder prevention strategies for all structural platforms of society, especially in the fields of education, law and social policy.

Change in the paradigm of the documentary heritage also leads to a change in the concept of memory institutions, whereby the most important function of a memory institution becomes active participation in the process of creating the collective memory. Audience engagement is important in this process. Evaluating the reception of documentary heritage communication allows us to assess the involvement of cultural users in cultural communication. Data from a study of the reception of visitors to an exhibition of one of the most important documents to the country’s statehood, the Act of 16 February, conducted using quantitative methods, showed that visitors to the museum where the Act of 16 February was on show rate the exhibition very highly and contribute to its communication in social networks and by oral communication.

The debate on gastronomic culture and identity, the national heritage, national products and gastronomic nationalism, is one of the most active and popular in the contemporary public discourse. The increased importance of different identities in contemporary networked society drives the popularity of these topics. As a form of the intangible heritage, gastronomic culture is an evolving system that easily links past and present societies. In this way, the gastronomic heritage and the history of gastronomy are easily transferred to contemporary culture, and become the basis for various identities. Given that the intangible heritage operates in society through tangible representations, and that in gastronomic culture one of the most visible representations is dishes, this study analyses the communication of one of them, šaltibarščiai (cold soup), on the social network Facebook. The study aims to determine how the representation of a specific intangible element of the heritage is used to construct the Lithuanian national identity. The research has identified the most important topics of discussion, the discourses involved, and elements of the reality that are important for constructing the national identity and their interrelationships.

The problem of quality of governance is one of the most important issues raised nowadays by international and local organisations. In order to adapt to the rapid processes of globalisation and glocalisation, various methods are being sought to optimise forms of democratic governance in Western countries or among countries which are leaning towards the West. The aim of the article is to increase government accountability and responsibility, promote citizen involvement, and strengthen government-societal relations and trust. In order to achieve this goal, the European Union proposes to give more powers to local government institutions, because they are closest to the citizens, can more effectively assess their needs, and attain them more effectively. To achieve this goal, the 12 principles of Good Governance, recommended by the Council of Europe, are used, and ELoGE (European Label of Governance Excellence) is used as a tool to assess the existence of these principles in local government. The purpose of this article is to identify factors that determine the implementation of the principles in local government, and to ascertain the most important characteristics that would influence the implementation of Good Governance in local government, taking into account the ELoGE evaluation methodology.