Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. National Institute for Health and Care Research.

Introduction: Limited information is available on trends in hepatitis C virus (HCV) infection, particularly in Central Europe. To address this knowledge gap, we analyzed HCV epidemiology in Poland, considering socio-demographic characteristics, changing patterns over time, and the impact of the COVID-19 pandemic. Material and Methods: We examined HCV cases (diagnosis and deaths) reported by national registries and used joinpoint analysis to estimate time trajectories. Results: Between 2009 and 2021, there were changes in the trends of HCV, shifting from positive to negative in Poland. Among men, there was a significant increase initially in diagnosis rate of HCV in rural areas (annual percent change, APC_2009–2016 +11.50%) and urban areas (APC_2009–2016 +11.44%) by 2016. In subsequent years until 2019, the trend changed direction, but the reduction was weak (P_trend > 0.05) in rural areas (−8.66%) and urban areas (−13.63%). During the COVID-19 pandemic, the diagnosis rate of HCV dramatically decreased in rural areas (APC_2019–2021 −41.47%) and urban areas (APC_2019–2021 −40.88%). Among women, changes in the diagnosis rate of HCV were less pronounced. In rural areas, there was a significant increase (APC_2009–2015 +20.53%) followed by no significant change, whereas changes occurred later in urban areas (APC_2017–2021 −33.58%). Trend changes in total mortality due to HCV were mainly among men, with a significant decrease in rural (−17.17%) and urban (−21.55%) areas from 2014/2015. Conclusions: The COVID-19 pandemic reduced HCV diagnosis rates in Poland, especially for diagnosed cases. However, further monitoring of HCV trends is necessary, along with national screening programs and improved linkage to care.

Background/Objectives: International studies state that older adults are at an increased risk of mental health symptoms and disorders (depression, anxiety, and stress), especially elderly women aged >65 years. The literature on this topic is scarce, and there is a need for studies that investigate the associations between mental health issues and overall health in elderly women. This study aimed to investigate depression, anxiety, and stress symptoms in elderly women in association with health status. Methods: A community-based cross-sectional study was conducted in Klaipeda, Lithuania, in 2020. The survey included elderly women (n = 306) aged 65 to 80 years studying at the Third Age University in Klaipeda city. The DASS-21 and SHSQ-25 scales were used for the survey. Associations and correlations between both scale indicators were calculated. Results: Sociodemographic factors such as age, marital status, and place of residence were not statistically significant in terms of mental health, except for women living alone, who had slightly lower levels of depressive symptoms (p = 0.015). Mental health issues were quite common; almost half of the participants had higher than normal levels of anxiety (49.0%) and depression (48.4%), and one-third (29.8%) experienced stress. A strong positive correlation was observed between mental health symptoms and physical health, with anxiety having the greatest effect size on fatigue (Cohen’s d = 0.950, p < 0.001), cardiovascular symptoms (Cohen’s d = 0.757, p < 0.001), and mental status (Cohen’s d = 1.036, p < 0.001). Depressive symptoms had a large effect size on fatigue (Cohen’s d = 0.764, p < 0.001) and mental status (Cohen’s d = 0.816, p < 0.001), while stress had a moderate effect size on all health domains. Conclusions: The findings highlight that anxiety symptoms are a major contributor to mental health conditions and overall health in elderly women. This study’s results emphasise the need for targeted interventions to address mental health challenges in elderly women.

Background/Objectives: Seafarers are a particularly isolated workforce, as they are on-site only with their colleagues, both on and off duty. Long-term duties in the sea environment, irregular working hours, changing time zones, and lack of sleep are some of the many factors that negatively affect the physical and mental health of seafarers. This study aimed to explore the occupational stressors faced by seafarers in Lithuania using the HSE Management Standards Indicator Tool (HSE-MSIT). Methods: In 2023, a quantitative study, using a paper survey, of seafarers’ occupational stressors was conducted in Klaipeda city, Lithuania. A total of 385 Lithuanian seafarers participated in the study. Results: The greatest sources of stress at work were identified as changes at work, relationships, peer support, and management support. Role clarity, demands, and work control were not strong stressors for the seafarers. Analysis of perceived stress levels revealed notable differences between groups with different work experience and job positions. Analysis of years of service (0–11 years vs. 12+ years) found that seafarers with shorter service experienced more stress in terms of demands (p = 0.005), role clarity (p = 0.004), work control (p = 0.035), and relationships (p = 0.02). Based on job position (senior vs. junior), junior seafarers experienced significantly higher stress in the demands (p = 0.001) and role clarity (p = 0.009) subscales. The study revealed that job position and years of work had weak negative correlations with stress indicators at work. The Demands subscale was moderately positively correlated with relationships and change at work. The Relationships subscale was moderately positively correlated with peer support and change at work. Role clarity was moderately negatively correlated with change at work and relationships. Conclusions: Overall, changes at work, relationships, peer support, and management support in the working environment emerged as key factors of perceived stress among seafarers. Junior seafarers and seafarers with shorter years of service experienced higher stress at work. These findings may help in the development of targeted stress management and training strategies tailored to different profiles of seafarers.

Background/Objectives: Occupational stress among police officers has been widely studied internationally, yet little is known about how stressors manifest in smaller, post-transition European contexts such as Lithuania. The study aimed to identify key occupational stressors among Lithuanian police officers and to examine how stress patterns differ by gender, job position, and years of service, using a multidimensional framework of organizational and interpersonal factors. Methods: A cross-sectional survey was conducted in 2024–2025 among 381 police officers from five randomly selected Lithuanian police stations. Participants completed the validated Lithuanian version of the Health and Safety Executive Management Standards Indicator Tool (HSE-MSIT). Seven domains of occupational stress were analyzed: job demands, managerial and peer support, relationships, organizational change, work control, and role clarity. Statistical analyses included Mann–Whitney U test, univariate ANOVA, and confirmatory factor analysis (CFA) with multi-group invariance testing. Results: The CFA supported a second-order structure of job stress, although model fit indices showed moderate adequacy (CFI = 0.768, TLI = 0.751). Managerial support, change at work, and peer support were the strongest contributors to the overall stress construct. While gender-related differences were minimal, officers with longer tenure reported lower job demands and greater role clarity. Junior officers expressed a more positive perception of feedback from managers and organizational changes. Measurement invariance tests revealed some item-level non-invariance, suggesting that group comparisons should be interpreted with caution. Conclusions: Occupational stress among Lithuanian police officers is primarily shaped by organizational rather than individual factors. Enhancing managerial competence, communication transparency, and peer-support mechanisms could substantially improve officers’ psychological well-being and resilience within law enforcement institutions.

This study evaluated the immune response to vaccination against COVID-19 in 534 healthcare frontline workers in Vilnius, Lithuania. The incidence of COVID-19 was reduced significantly after vaccination started in the healthcare sector. SARS-CoV-2 antibodies were detected in groups V–VII and this level of antibodies was found to be effective in preventing COVID-19. Sustained immune response was achieved after two vaccination doses, which remained stable for up to 6 months. After the booster dose, antibody levels remained high for an additional 12 months. Although SARS-CoV-2 antibody levels decreased after 6 months, even lower levels of antibodies provided protection against the Delta strain. The booster dose distributed the antibody titer in the high-level antibody groups, offering maximum protection at 12 months. However, even individuals with high antibody titers were observed to contract COVID-19 after vaccination with a booster dose and 6 months in the presence of the Omicron strain. Unfortunately, high levels of antibodies did not provide protection against the new strain of COVID-19 (the Omicron variant), posing a risk of infection. When comparing the antibody titer of vaccinated participants without COVID-19 and those with COVID-19, the change in antibodies after vaccination was significantly lower in infected participants. Individuals with comorbidities and specific conditions had lower antibody levels.