Mockevičienė, Birutė

The aim of the paper is to examine the attitudes among key policy stakeholders regarding technology-based self-directed learning in Lithuania as a learning innovation, with a focus on how tensions between innovation and policy regulation hinder the creation of a common understanding. b) design/methodology/approach Methodology. This study employed a qualitative research design to explore the key factors shaping TSDL in Lithuanian high schools and to inform educational policymaking. Data were collected through 14 semi-structured interviews conducted with representatives of the Ministry of Education, Science and Sport, school leaders, teachers, and parents, ensuring a multistakeholder perspective. The semi-structured interview were organised into six core thematic blocks: 1.) current pedagogical practices; 2.) the use of digital technologies in the learning process; 3.) TBSDL as a pedagogical approach, investigating whether and how TBSDL is encouraged in schools, how it is implemented in practice; 4.) challenges and barriers to implementation; 5.) educational policy and governance; 6.) school autonomy and future development.

Healthcare systems face ongoing challenges that require reforms to enhance innovation, accessibility, and efficiency. Lithuania’s healthcare reform aims to enhance equity, quality, and sustainability by reorganising its service network. However, implementation has revealed unintended effects, including “network compression”, where large hospitals absorb services from smaller regional facilities, deepening regional inequality and limiting accessibil-ity for rural populations. A qualitative research method with 22 informants was employed. Healthcare professionals are reporting growing fatigue, increased administrative burdens, and a decline in empathy in patient care. These outcomes highlight how efficiency-oriented poli-cies can unintentionally depersonalise services and marginalise regional healthcare providers. Based on interviews with healthcare professionals, this study examines how reforms trans-form everyday clinical practices and local service delivery. The findings underscore the need to balance efficiency-driven reforms with empathy, professional autonomy, and equitable access to healthcare.

Background As healthcare increasingly shifts toward the home, the burden of care often falls on informal caregivers—family members, friends, or acquaintances—who frequently lack formal training and systemic support. This transition has intensified the risk of safety incidents in home care settings, including medication errors, falls, and other preventable harms. While patient safety researchers have traditionally focused on clinical environments, far less attention has been given to safety incidents in home care and to their cascading consequences for both care recipients and informal caregivers, who can become double victims (i.e., experiencing both the emotional impact of harm to a loved one and distress associated with their own involvement in the event). Purpose To develop and internationally appraise a safety-oriented, multilevel explanatory framework for safer home care provided by informal caregivers, specifying how conditions across ecological levels shape everyday caregiving processes, safety incidents, and interdependent consequences for care recipients and informal caregivers. Methods In this discursive paper, we have described the development of a conceptual framework and its international expert appraisal using a modified Delphi approach. The framework was co-developed within the BetterCare European Cooperation in Science and Technology Action CA22152 through interdisciplinary expert deliberations and a relationship-oriented narrative synthesis of literature identified in PubMed and CINAHL in September 2024. The modified Delphi process appraised the content relevance and cross-contextual interpretability of the principal framework components. Results Thirty-six experts from 19 countries participated in the Delphi appraisal. Consensus was achieved across all framework components in the first round. The final conceptual synthesis, termed the Double Victim Ecosystem Framework for Home Care Safety (DOVE Model), integrates Donabedian’s structure–process–outcome logic with a social ecological perspective. At the micro-level, care-recipient needs, informal caregiver capacities and vulnerabilities, dyadic-relational conditions, and the home environment form an interdependent structural configuration that shapes everyday caregiving and care-coordination processes. Meso-level system capacity and professional support processes, together with macro-level policy, legal, sociocultural, and socioeconomic structures, may buffer or amplify these pathways. Safety incidents represent proximal safety outcomes that may generate cascading clinical, psychological, physical, and relational consequences, including the Double Victim Phenomenon. Conclusion Safety in informal home care is a dynamic, multilevel capacity to anticipate and reduce avoidable harm, respond effectively when harm emerges, and support recovery and learning. The DOVE Model highlights the need for coordinated multilevel strategies to prevent safety incidents, strengthen caregiver preparedness, and provide structured support following safety incidents.

The aim of this study is to investigate the disruption of learning organization principles within dental service organizations, focusing on the critical commitment to patient care and its impact on long‐term staff retention.

Šiuolaikiniai vartotojai ieško ne tik kokybiškų, bet ir asmeniškai jų poreikiams pritaikytų sprendimų. Individualizuota gamyba, pavyzdžiui – baldų pramonėje, tampa vis svarbesnė. Tuo tarpu gamintojams procesas, orientuotas į vartotoją, kelia nemažai iššūkių. Susidoroti su jais – pagalba ir iš Lietuvos mokslininkų.

In Lithuania, the year 2024 has been identified as a pivotal moment for healthcare reform, which encompasses two primary objectives: implementing a proactive public health policy and enhancing the accessibility, quality, and efficiency of healthcare through the restructuring of the service delivery network. This reform is essential for remote regions, where demographic shifts have modified service requirements. Certain services, such as midwifery, have diminished, while others, including elderly nursing care, require reestablishment. Adapting to these reforms has disrupted competencies, underscoring their importance as a critical area for regional development, particularly in enhancing new resources. By analysing the public health reform in Lithuania through the lens of remote regions, it becomes possible to identify specific strategies and practices that can be applied both nationally and internationally. The study aims to highlight shifts in the emerging needs of healthcare personnel's competencies in remote regional areas, particularly during the national healthcare system's structural transformations, and their capacity to achieve the reform goal of delivering top-quality health services based on transformative competencies. The study uses qualitative interviews to identify the competencies health professionals lack following the establishment of new Primary Health Care Centres. The study revealed that while clinical and professional competencies related to legal and clinical responsibilities are easier to adopt from a technical standpoint, competencies like leadership, collaboration, and patient involvement pose greater challenges, leading to community stress. The acquisition of these competencies requires long-term investment in staff development, emotional support, and clear change management. Moreover, the new structure of health centers and newly introduced work processes may increase employees’ emotional exhaustion, stress, or even the risk of burnout if adequate support or training is not provided.

This study explores how patients drive meaningful changes in healthcare, focusing on accessibility, satisfaction, and service delivery through inclusive and interdisciplinary perspectives. Conducted in 2024, it analyzes healthcare trends from 2021 to 2024, emphasizing patient participation in decision-making. This sociological study highlights the interplay between healthcare accessibility and patient satisfaction within the broader framework of inclusive and interdisciplinary innovation. Findings reveal that while 99% of the population relies on primary care, barriers persist in accessing specialist services and navigating the doctor registration system. Reports of accessibility and quality issues increased from 30% in 2021 to 48% in 2024 due to organizational shifts, leading 29% of patients to seek private care to avoid long wait times. Healthcare utilization rebounded, with service visits rising from 23 million in 2020 to 28 million in 2023, exceeding pre-pandemic levels. Primary care, diagnostics, and specialist consultations dominate service use, while mental health, rehabilitation, and nursing remain underutilized. Emergency services serve nearly half the population, yet only 64% rate secondary care positively, exposing quality gaps. The study advocates for patient-centred reforms, reducing bureaucracy, enhancing accessibility, and fostering institutional collaboration. Structural investments are essential for sustainability, as private healthcare provides only temporary relief. By emphasizing patients’ roles in shaping healthcare policy, this research contributes to social innovation discourse. It challenges traditional paradigms by advocating a model where patient feedback and participation drive reform, aligning with SOCIN’s vision of inclusive, interdisciplinary, and impactful healthcare innovations.