Medicinal plants from the 14th edition of the Russian Pharmacopoeia, recent updates

ETHNOPHARMACOLOGICAL RELEVANCE

Herbal medicine in Russia has a long history starting with handwritten herbalist manuscripts from the Middle Ages to the officinal Pharmacopoeia of the 21st century. The "herbophilious" Russian population has accumulated a lot of knowledge about the beneficial effects of local medicinal plants. Yet, for a long time, Russian traditional and officinal herbal medicine was not well known to the international audience. In our previous comprehensive review, we discussed the pharmacological effects of specific plants included in the 11^th edition of the Pharmacopoeia of the USSR, which was also for a while used in Russia. The 14^th edition of the Russian Federation's State Pharmacopoeia was implemented in 2018.

AIM OF THE REVIEW

The aims of the present review are: (i) to trace the evolution of medicinal plant handling from handwritten herbalist manuscripts to Pharmacopoeias; (ii) to describe the modern situation with regulatory documents for herbal medicinal products and their updated classification; (iii) to summarize and discuss the pharmacology, safety, and clinical data for new plants, which are included in the new edition of the Pharmacopoeia.

METHODS

New medicinal plants included in the 14th edition of the Russian Federation's State Pharmacopoeia were selected. We carefully searched the scientific literature for data related to traditional use, pharmacological, clinical application, and safety. The information was collected from local libraries in Saint-Petersburg, the online databases E-library.ru, Scopus, Web of Science, and the search engine Google scholar.

RESULTS

Investigating the evolution of all medicinal plants referred to in the Russian Pharmacopoeias led us to the identification of ten medicinal plants that were present in all editions of civilian Russian Pharmacopoeias starting from 1778. In the 14^th edition of the modern Russian Pharmacopoeia, medicinal plants are described in 107 monographs. Altogether, 25 new monographs were included in the 14^th edition, and one monograph was excluded in comparison to the 11^th edition. Some of the included plants are not endemic to Russia and do not have a history of traditional use, or on the other hand, are widely used in Western medicine. For 15 plants, we described the specificity of their application in Russian traditional medicine along with the claimed dosages and indications in officinal medicine. The pharmacology, safety, and clinical data are summarized and assessed for nine plants, underlining their therapeutic potential and significance for global phytopharmacotherapy.

CONCLUSIONS

In this review, we highlight the therapeutical potential of new plants included in the modern edition of the Russian Pharmacopoeia. We hope that these plants will play an imperative role in drug development and will have a priority for future detailed research.

Cervical Cancer Screening Participation among Women of Russian, Somali, and Kurdish Origin Compared with the General Finnish Population: A Register-Based Study

Migrant-origin women are less prone to cervical screening uptake compared with host populations. This study examined cervical cancer screening participation and factors associated with it in the Finnish mass screening program during 2008–2012 in women of Russian, Somali and Kurdish origin compared with the general Finnish population (Finns) in Finland. The study population consists of samples from the Finnish Migrant Health and Well-being Study 2010–2012 and Health 2011 Survey; aged 30–64 (n = 2579). Data from the Finnish screening register linked with other population-based registry data were utilized. For statistical analysis we employed logistic regression. Age-adjusted screening participation rates were Russians 63% (95% CI: 59.9–66.6), Somalis 19% (16.4–21.6), Kurds 69% (66.6–71.1), and Finns 67% (63.3–69.8). In the multiple-adjusted model with Finns as the reference; odds ratios for screening were among Russians 0.92 (0.74–1.16), Somalis 0.16 (0.11–0.22), and Kurds 1.37 (1.02–1.83). Among all women, the substantial factor for increased screening likelihood was hospital care related to pregnancy/birth 1.73 (1.27–2.35), gynecological 2.47 (1.65–3.68), or other reasons 1.53 (1.12–2.08). Screening participation was lower among students and retirees. In conclusion, screening among the migrant-origin women varies, being significantly lowest among Somalis compared with Finns. Efforts using culturally tailored/population-specific approaches may be beneficial in increasing screening participation among women of migrant-origin.

Disparities in treatment of diabetes and hypertension among groups of foreign origin and the general Finnish population

BACKGROUND

Migrants from low-income countries are more predisposed to diabetes and cardiovascular risks than host European natives, but how treatment targets are met in migrant patients is unclear. We examined health service use and treatment of diabetes and hypertension among selected migrant groups and the general Finnish population and compared prevalence of cardiovascular risk factors between patients and non-patients.

METHODS

Cross-sectional data from randomly sampled 30- to 64-year-old participants (387 Russian, 198 Somali and 343 Kurdish origin migrants) of the Migrant Health and Wellbeing Survey (2010-2012) were used. Health 2011 survey data (n = 1086) were used as a comparison group.

RESULTS

Compared with the general population, diabetes-related doctor/nurse visits were more frequent among Russian and Somali, but not the Kurdish group. Use of prescribed antidiabetic and antihypertensive drugs were significantly lower among Russians (78%/56%) and Kurdish (68%/58%), but not in Somalis (85%/62%) compared with the general population (96%/78%). Obesity, elevated blood pressure and elevated glucose levels were more prevalent in patients than non-patients, and over 60% of patients and over 70% of non-patients had elevated plasma low density lipoprotein cholesterol. Differences in cardiovascular disease (CVD) risk profiles between patients and non-patients were not associated with socio-economic factors.

CONCLUSIONS

This study indicates disparities in prevalence and management of diabetes and hypertension and their associated risk factors among ethnic groups. Diabetes, CVD risks and treatment outcomes in patients were sub-optimal, especially among foreign origin groups. Comprehensive health promotion strategies are needed to improve cardiometabolic health in vulnerable populations.

Epidemiology of dialysis-treated end-stage renal disease patients in Kazakhstan: data from nationwide large-scale registry 2014-2018

BACKGROUND

The epidemiology of dialysis patients has been little studied in developing countries and economies in transition. We examined the prevalence, incidence and mortality rate of dialysis patients in Kazakhstan, via aggregation and utilization of large-scale administrative healthcare data.

METHODS

The registry data of 8898 patients receiving dialysis therapy between 2014 and 2018 years were extracted from the Unified National Electronic Health System (UNEHS) and linked with the national population registry of Kazakhstan. We provide descriptive statistics of demographic, comorbidity and dialysis-related characteristics.

RESULTS

Among all patients undergoing maintenance dialysis for end-stage renal disease (ESRD), there were 3941 (44%) females and 4957 (56%) males. 98.7% of patients received hemodialysis and 1.3% peritoneal dialysis. The majority of the patients (63%) were ethnic Kazakhs, 18% were Russians and 19% were of other ethnicities. The prevalence and incidence rate in 2014 were 135.2 and 68.9 per million population (PMP), respectively, which were different in 2018 [350.2 and 94.9 PMP, respectively]. Overall mortality rate among dialysis patients reduced from 1667/1000 patient-years [95%Confidence Interval (CI): 1473-1886] (PY) in 2014 to 710/1000PY [95%CI: 658-767] in 2018. We observed 13% lower crude survival probability in females compared to males and in older patients compared to younger ones. Russian ethnicity had 58% higher risk of death, while other ethnicities had 34% higher risk of death compared to in those of Kazakh ethnicity.

CONCLUSION

We describe for the first time in Kazakhstan an increase in the prevalence and incidence of ESRD on dialysis, while mortality rate decreased over time, during 2014-2018. We observed statistically significant lower survival probability in female dialysis patients compared to males, in older patients compared to younger ones, and in patients of Russian ethnicity compared to Kazakh.

Migrants Are Underrepresented in Mental Health and Rehabilitation Services-Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland

Mounting evidence suggests that migration background increases the risk of mental ill health, but that problems exist in accessing healthcare services in people of migrant origin. The present study uses a combination of register- and survey-based data to examine mental health-related health service use in three migrant origin populations as well as the correspondence between the need and use of services. The data are from the Finnish Migrant Health and Wellbeing Study (Maamu), a comprehensive cross-sectional interview and a health examination survey. A random sample consisted of 5909 working-aged adults of Russian, Somali, and Kurdish origin of which 3000 were invited to participate in the survey and the rest were drawn for a register-based approach. Some of the mental health services, based on registers, were more prevalent in the Kurdish origin group in comparison with the general population and less prevalent in the Russian and Somali origin groups. All the migrant origin groups were underrepresented in rehabilitation services. When affective symptoms were taken into account, all the migrant origin groups were underrepresented in all of the services. This calls for actions to promote mental health, diminish the barriers to access services, and improve the service paths for migrants.

Pre-migration traumatic experiences, post-migration perceived discrimination and substance use among Russian and Kurdish migrants-a population-based study

BACKGROUND AND AIMS

The associations between traumatic events, substance use and perceived discrimination have been rarely studied among migrants in host countries. We examined whether pre-migration potentially traumatic experiences (PTEs) or perceived discrimination (PD) are associated with substance use among migrants with voluntary (Russians) and forced (Kurds) migration backgrounds.

DESIGN

Cross-sectional interview and health examination data from the Finnish Migrant Health and Wellbeing Study were used. The target sample (n = 1000 for each group) was drawn from the national population register using stratified random sampling by participants' country of birth and native language.

SETTING

Population-based data were collected from six cities in Finland during 2010-12.

PARTICIPANTS

The participation rates were 68% (Russians) and 59% (Kurds). The analytical sample size varied (Russians n = 442-687, Kurds n = 459-613), as some participants completed only interview, health examination or short interview. The majority of Kurds had a refugee background (75%) while Russians had mainly migrated for other reasons (99%).

MEASUREMENTS

The three main outcomes were self-reported binge drinking, daily smoking and life-time cannabis use. PTEs and PD were self-reported in the interview. Socio-demographic background, migration-related factors and current affective symptoms were adjusted for.

FINDINGS

Among Kurds, PTEs were associated with binge drinking [adjusted odds ratio (aOR) = 2.65, 95% confidence interval (CI) = 1.30-5.42] and PD was associated with life-time cannabis use (aOR = 3.89, 95% CI = 1.38-10.97) after adjusting for contextual factors. Among Russians, PTEs were associated with life-time cannabis use adjusting for contextual factors (aOR = 2.17, 95% CI = 1.12-4.18).

CONCLUSIONS

In Finland, pre-migration traumatic experiences appear to be associated with life-time cannabis use among the Russian migrant population (voluntary migration) and binge drinking among the Kurdish migrant population (forced migration). Perceived discrimination in Finland appears to be associated with life-time cannabis use among Kurdish migrants.

An international cross-cultural study of nursing students' perceptions of caring

BACKGROUND

Single studies suggest that nursing students perceive caring as more an instrumental than expressive behaviour and indicate some differences between caring perceptions in junior and senior nursing students. However, there are limited studies investigating caring perceptions in nursing students across multiple cultures.

OBJECTIVE

To determine perceptions of caring in Slovene, Croatian, Chinese and Russian nursing students and explore whether there are statistically significant differences in perceptions of caring between countries and between first and third-year nursing students.

DESIGN

A cross-sectional descriptive study design was used.

SETTINGS AND PARTICIPANTS

The study included 604 nursing students enrolled in first and third year in seven different nursing faculties in four countries: Slovenia; China; Croatia; and the Russian Federation.

METHODS

The 25-item Caring Dimension Inventory (CDI-25) was used to measure caring perceptions. We also included demographic questions regarding age, gender, country, year of study and type of study. Demographic data were analysed using descriptive analysis while a two-way analysis of variance (ANOVA) adjusted for unequal sample sizes was performed together with a post hoc analysis of the results.

RESULTS

The results of two-way ANOVA showed that both main effects (country and year of study) were statistically significant, as well as their interaction at the 0.05 significance level. The main effect for country was F(3, 596) = 3.591, p < 0.0136 indicating a significant difference in CDI-25 between Slovenia (M = 108.9, SD = 9.2), Russian Federation (M = 107.1, SD = 8.2), China (M = 102.8, SD = 9.7) and Croatia (M = 110.0, SD = 8.6).

CONCLUSIONS

Perceptions of caring in nursing students differ across countries, probably due to different educational systems, curricula, cultural differences and societal values. Implementing caring theories in nursing curricula could help students to cultivate caring during their education.

The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

BACKGROUND

There are limited data on the epidemiology of very late-onset schizophrenia-like psychosis (VLOSLP) and how this relates to potential risk factors including migration, sensory impairment, traumatic life events, and social isolation.

METHODS

We followed up a cohort of 3 007 378 people living in Sweden, born 1920-1949, from their 60th birthday (earliest: January 15, 1980) until December 30 2011, emigration, death, or first recorded diagnosis of nonaffective psychosis. We examined VLOSLP incidence by age, sex, region of origin, income, partner or child death, birth period, and sensory impairments.

RESULTS

We identified 14 977 cases and an overall incidence of 37.7 per 100 000 person-years at-risk (95% CI = 37.1-38.3), with evidence that rates increased more sharply with age for women (likelihood ratio test: χ2(6) = 31.56, P < .001). After adjustment for confounders, rates of VLOSLP were higher among migrants from Africa (hazard ratio [HR] = 2.0, 95% CI = 1.4-2.7), North America (HR = 1.4, 95% CI = 1.0-1.9, P = .04), Europe (HR = 1.3, 95% CI = 1.2-1.4), Russian-Baltic regions (HR = 1.6, 95% CI = 1.4-1.9), and Finland (HR = 1.6, 95% CI = 1.5-1.7). VLOSLP risk was highest for those in the lowest income quartile (HR = 3.1, 95% CI = 2.9-3.3). Rates were raised in those whose partner died 2 years before cohort exit (HR = 1.1, 95% CI = 1.0-1.3, P = .02) or whose child died in infancy (HR = 1.2, 95% CI = 1.0-1.4, P = .05), those without a partner (HR = 1.9, 95% CI = 1.8-1.9) or children (HR = 2.4, 95% CI = 2.3-2.5), and those whose child had a psychotic disorder (HR = 2.4, 95% CI = 2.2-2.6).

INTERPRETATION

We identified a substantial burden of psychosis incidence in old age, with a higher preponderance in women and most migrant groups. Life course exposure to environmental factors including markers of deprivation, isolation, and adversity were associated with VLOSLP risk.

Which anthropometric measures best indicate type 2 diabetes among Russian, Somali and Kurdish origin migrants in Finland? A cross-sectional study

OBJECTIVES

To compare the performance of body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC) and waist-to-hip ratio (WHR) in detecting type 2 diabetes among Russian, Somali and Kurdish (born in Iraq/Iran) origin migrants and Finns.

DESIGN AND PARTICIPANTS

Cross-sectional study comparing health examination survey data of Russian, Somali and Kurdish origin migrants (n=917) aged 30-64 years who took part in the Migrant Health and Wellbeing Survey with the general Finnish population in the Health 2011 Survey (n=887). Participants were randomly selected from the National Population Register.

SETTING

Six cities in Finland, where a substantial majority of migrants live.

OUTCOME MEASURES

Anthropometric measures included objectively measured BMI, WHtR, WC and WHR. Type 2 diabetes was defined based on self-report, laboratory measures of glycated haemoglobin and register data. Test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy.

RESULTS

Among Finns, test performance was highest for WC (AUC=0.81, 95% CI 0.74 to 0.87) and WHtR (AUC=0.81, 95% CI 0.75 to 0.87). Test performance was similar for BMI (AUC=0.80, 95% CI 0.67 to 0.92), WC (AUC=0.79, 95% CI 0.67 to 0.91) and WHtR (AUC=0.70, 95% CI 0.66 to 0.93) among Russians. WC and WHtR had highest test performance also among Somali (AUC=0.74, 95% CI 0.64 to 0.84 for WC and AUC=0.75, 95% CI 0.65 to 0.85 for WHtR) and Kurds (AUC=0.71, 95% CI 0.61 to 0.81 for WC and AUC=0.70, 95% CI 0.59 to 0.80 for WHtR).Among migrants, WHR had the poorest test performance.

CONCLUSION

WC and WHtR performed overall the best across all study groups, however, accuracy of detection was lower particularly among Somali and Kurds. Currently used diabetes risk assessment tools assume a strong association between anthropometrics and diabetes. These tools need to be validated among non-Western populations.

Health indicators and social gradient in adolescent immigrants' health risk and healthcare experiences

Few studies have assessed healthcare experiences in apparently healthy adolescents, or whether healthcare attitudes are linked to the two leading adolescent health indicators, smoking and obesity. Even fewer have examined these relationships in adolescent immigrant groups or made comparisons to adolescent non-immigrants. Using a cross-sectional study, healthcare experiences were compared among three groups of adolescents (n = 589) including Russian immigrants (n = 154), Ethiopian immigrants (n = 54), and non-immigrants (n = 381). Bootstrap estimates indicated positive healthcare experiences were less common among Russian adolescent immigrants (OR = 0.38, CI = 0.17, 0.86) compared to non-immigrants, unless the Russian adolescent immigrants reported above average socioeconomic status, in which case they were more likely than non-immigrant adolescents to report positive healthcare experiences (OR = 3.22, CI = 1.05, 9.85). Positive healthcare experiences were less likely among adolescents who were smokers (OR = 0.50, CI = 0.27, 0.91), and more likely for adolescents with a normal or low BMI (OR = 3.16, CI = 1.56, 6.40) and for those relying on parents for health information (OR = 1.97, CI = 1.05, 3.70).

CONCLUSION

Findings suggest a social gradient in which positive healthcare experiences were more common among adolescence with higher socioeconomic status for some immigrants (Russian adolescents) but not for others. The two leading health indicators were related to healthcare experiences, but as adolescent smokers were less likely to have positive healthcare experiences, proactive efforts are needed to engage this group. What is Known: • Health indicators (such as obesity) and healthcare attitudes are linked to healthcare service use among adolescents sampled from outpatient and inpatient populations. What is New: • A social gradient involving socioeconomic status and being an adolescent immigrant was found regarding risky health indicators (i.e., smoking, use of internet as the primary source of health information). • Problematic health indicators, such as smoking, is linked to less positive healthcare attitudes in apparently healthy adolescents (both immigrants and non-immigrants).

Roadside survey on alcohol and drug use among drivers in the Arctic county of Finnmark (Norway)

OBJECTIVE

The objective of this study was to determine the prevalence of alcohol and potentially impairing drugs among the general driving population in Finnmark and to compare the prevalence among Norwegian, Russian, and other foreign drivers by analyzing samples of oral fluid.

METHODS

In collaboration with local police, drivers were selected for a voluntary and anonymous study using a multistage cluster sampling procedure (selection of roads, time intervals, and drivers within each interval) from September 2014 to October 2015. Age, gender, citizenship, time, and geographical site were recorded. Samples of oral fluid were collected using the Quantisal device. The samples were analyzed for alcohol with an enzymatic method and for 12 illicit drugs and 16 medicinal drugs and some metabolites using ultra-high-performance liquid chromatography with tandem mass spectrometry detection.

RESULTS

A total of 3,228 drivers were asked to participate in the study. The refusal rate was 6.2%. Of the 3,027 participants in the study, 111 (3.7%) were Russian and 204 (6.7%) had citizenship other than Norwegian or Russian. The total prevalence of psychoactive substances was 4.3%. Alcohol was detected in 0.3%, psychoactive medicinal drugs in 2.5%, and illicit drugs in 1.6% of the samples. The most commonly found substances were the sleeping agent zopiclone (1.1%), tetrahydrocannabinol (THC; 1.1%), and the analgesic agent codeine (0.6%). Illicit drugs were detected significantly more often in samples from drivers of citizenship other than Norwegian or Russian. The prevalence of alcohol was somewhat higher among Russian drivers but not statistically significant. There were large differences between age groups and genders concerning illicit drugs and psychoactive medicinal drugs; illicit drugs were more frequently in samples from young male drivers, whereas psychoactive medicinal drugs were more frequently in samples from elderly female drivers.

CONCLUSION

The total prevalence of alcohol and drugs among the general driving population in Finnmark was low and similar to previous Norwegian roadside surveys. Illicit drugs were detected significantly more often in samples from drivers with citizenship other than Russian and Norwegian and among young male drivers.

Diabetes mellitus in two genetically distinct populations in Jordan. A Comparison between Arabs and Circassians/Chechens Living with Diabetes

OBJECTIVES

To compare clinical, anthropometric, and laboratory characteristics in diabetes type 2 patients of 2 genetically-distinct ethnicities living in Jordan, Arabs and Circassians/Chechens.  Methods: This cross sectional ethnic comparison study was conducted in King Abdullah University Hospital, Irbid and The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan between June 2013 and February 2014. A sample of 347 (237 Arab and 110 Circassian/Chechen) people living with diabetes were included in the study. Data were collected through direct interviews with the participants. Clinical data were collected using a questionnaire and anthropometric measurements. Laboratory data were extracted from the patients' medical records. Results: More Arabs with diabetes had hypertension as a comorbidity than Circassians/Chechens with diabetes. Arabs living with diabetes were generally more obese, whereas Circassians/Chechens living with diabetes had worse lipid control. Arabs with diabetes had higher means of glycated haemoglobin (HbA1c) and fasting blood sugar, and more Arabs with diabetes had unsatisfactory glycemic control (60.6%) than Circassians/Chechens with diabetes (38.2%) (HbA1c ≥7.0%). Most participants (88.8%) had at least one lipid abnormality (dyslipidemia).  Conclusion: Multiple discrepancies among the 2 ethnic diabetic populations were found. New diabetes management recommendations and policies should be used when treating people living with diabetes of those ethnicities, particularly in areas of glycemic control, lipid control, and obesity.

Story grammar elements and causal relations in the narratives of Russian-Hebrew bilingual children with SLI and typical language development

BACKGROUND

While there is general agreement regarding poor performance of children with Specific Language Impairment (SLI) on microstructure measures of narrative production, findings on macrostructure are inconsistent.

PURPOSE

The present study analyzed narrative abilities of Russian-Hebrew bilingual preschool children with and without SLI, with a particular focus on story grammar (SG) elements and causal relations, in order to identify macrostructure features which distinguish bilingual children with SLI from those with typical development.

METHOD

Narratives were collected from 35 typically developing bilinguals (BiTD) and 14 bilinguals with SLI (BiSLI) in both Russian/L1 and Hebrew/L2 using a retelling procedure (LITMUS-Multilingual Assessment Instrument for Narratives) (Gagarina, Klop, Kunnari, Tantele, Välimaa, Balčiūnienė, Bohnacker, & Walters, 2012). Each story contained three episodes, and each episode introduced a different protagonist with explicitly stated Goals (G), Attempts (A) and Outcomes (O). Causal relations assessed included Enabling, Physical, Motivational, and Psychological relations, following Trabasso & Nickels (1992). Each Goal-Attempt-Outcome (GAO) episode was examined for the use of SG elements and causal relations.

RESULTS

Group differences emerged for both aspects of macrostructure. For causal relations, narratives of BiSLI children contained fewer Enabling and Physical relations, and differed qualitatively from those of BiTD children. For SG elements, BiSLI children referred to fewer SG elements than BiTD children in the first episode, but performed like BiTD children in the second and the third episodes.

CONCLUSIONS

Story grammar elements in specific episodes along with Enabling and Physical causal relations distinguish the narratives of children with BiSLI from those with BiTD, which stresses the importance of examining wider array of macrostructure features in narratives.

End-of-life care for immigrants in Germany. An epidemiological appraisal of Berlin

BACKGROUND

Since the late 1950's, a steadily increasing immigrant population in Germany is resulting in a subpopulation of aging immigrants. The German health care system needs to adjust its services-linguistically, culturally, and medically-for this subpopulation of patients. Immigrants make up over 20% of the population in Germany, yet the majority receive inadequate medical care. As many of the labor immigrants of the 1960s and 1970s are in need of hospice and palliative care (HPC), little is known about this specialized care for immigrants. This epidemiological study presents utilization of HPC facilities in Berlin with a focus on different immigrant groups.

METHODS

A validated questionnaire was used to collect data from patients at 34 HPC institutions in Berlin over 20 months. All newly admitted patients were recruited. Anonymized data were coded and analyzed by using SPSS and compared with the population statistics of Berlin.

RESULTS

4118 questionnaires were completed and included in the analysis. At 11.4% the proportion of immigrants accessing HPC was significantly (p<0,001) below their proportion in the general Berlin population. This difference was especially seen in the age groups of 51-60 (21.46% immigrants in Berlin population, 17.7% immigrants in HPC population) and 61-70 years (16,9% vs. 13,1%). The largest ethnic groups are Turks, Russians, and Poles, with a different weighting than in the general population: Turkish immigrants were 24% of all Berlin immigrants, but only 13.6% of the study immigrant population (OR: 0.23, 95%CI: 0.18-0.29, p<0.001). Russian and Polish immigrants account for 5.6% and 9.2% in the population, but 11.5% and 24.8% in the study population respectively (Russian: OR 0.88, 95%CI: 0.66-1.16; Polish: OR 1.17, 95%CI: 0.97-1.42). Palliative care wards (PC) were used most often (16.7% immigrants of all PC patients); outpatient hospice services were used least often by immigrants (11.4%). Median age at first admission to HPC was younger in immigrants than non-immigrants: 61-70 vs. 71-80, p = 0.03.

CONCLUSIONS

Immigrants are underrepresented in Berlin´s HPC and immigrants on average make use of care at a younger age than non-immigrants. In this regard, Turkish immigrants in particular have the poorest utilization of HPC. These results should prompt research on Turkish immigrants, regarding access barriers, since they represent the largest immigrant group. This may be due to a lack of cultural sensitivity of the care-providers and a lack of knowledge about HPC among immigrants. In the comparison of the kinds of institutions, immigrants are less likely to access outpatient hospice services compared to PC. Apparently, PC appear to be a smaller hurdle for utilization. These results show a non-existent, but oft-cited "healthy immigrant effect" of the first generation of work immigrants, now entering old age. These findings correspond with studies suggesting increased health concerns in immigrants. Focused research is needed to promote efforts in providing adequate and fair access to HPC for all people in Berlin.

[Russians in Bjelovar hospitals during and after World war I]

The Great War was the beginning of the settlement of the Russian population in the town of Bjelovar in war conditions, most often as prisoners of war directed to the treatment of the military or civilian hospital. Thus, in Bjelovar during the Great War died 71 members of the Russian people, principally the soldiers, prisoners. Some were later permanently inhabited, founded by his family and worked in Bjelovar longer or shorter time.

Spectrum and Frequency of the GJB2 Gene Pathogenic Variants in a Large Cohort of Patients with Hearing Impairment Living in a Subarctic Region of Russia (the Sakha Republic)

Pathogenic variants in the GJB2 gene, encoding connexin 26, are known to be a major cause of hearing impairment (HI). More than 300 allelic variants have been identified in the GJB2 gene. Spectrum and allelic frequencies of the GJB2 gene vary significantly among different ethnic groups worldwide. Until now, the spectrum and frequency of the pathogenic variants in exon 1, exon 2 and the flanking intronic regions of the GJB2 gene have not been described thoroughly in the Sakha Republic (Yakutia), which is located in a subarctic region in Russia. The complete sequencing of the non-coding and coding regions of the GJB2 gene was performed in 393 patients with HI (Yakuts—296, Russians—51, mixed and other ethnicities—46) and in 187 normal hearing individuals of Yakut (n = 107) and Russian (n = 80) populations. In the total sample (n = 580), we revealed 12 allelic variants of the GJB2 gene, 8 of which were recessive pathogenic variants. Ten genotypes with biallelic recessive pathogenic variants in the GJB2 gene (in a homozygous or a compound heterozygous state) were found in 192 out of 393 patients (48.85%). We found that the most frequent GJB2 pathogenic variant in the Yakut patients was c.-23+1G>A (51.82%) and that the second most frequent was c.109G>A (2.37%), followed by c.35delG (1.64%). Pathogenic variants с.35delG (22.34%), c.-23+1G>A (5.31%), and c.313_326del14 (2.12%) were found to be the most frequent among the Russian patients. The carrier frequencies of the c.-23+1G>A and с.109G>A pathogenic variants in the Yakut control group were 10.20% and 2.80%, respectively. The carrier frequencies of с.35delG and c.101T>C were identical (2.5%) in the Russian control group. We found that the contribution of the GJB2 gene pathogenic variants in HI in the population of the Sakha Republic (48.85%) was the highest among all of the previously studied regions of Asia. We suggest that extensive accumulation of the c.-23+1G>A pathogenic variant in the indigenous Yakut population (92.20% of all mutant chromosomes in patients) and an extremely high (10.20%) carrier frequency in the control group may indicate a possible selective advantage for the c.-23+1G>A carriers living in subarctic climate.

[The haplomatch program for comparing Y-chromosome STR-haplotypes and its application to the analysis of the origin of Don Cossacks]

STR haplotypes of the Y chromosome are widely used as effective genetic markers in studies of human populations and in forensic DNA analysis. The task often arises to compare the spectrum of haplotypes in individuals or entire populations. Performing this task manually is too laborious and thus unrealistic. We propose an algorithm for counting similarity between STR haplotypes. This algorithm is suitable for massive analyses of samples. It is implemented in the computer program Haplomatch, which makes it possible to find haplotypes that differ from the target haplotype by 0, 1, 2, 3, or more mutational steps. The program may operate in two modes: comparison of individuals and comparison of populations. Flexibility of the program (the possibility of using any external database), its usability (MS Excel spreadsheets are used), and the capability of being applied to other chromosomes and other species could make this software a new useful tool in population genetics and forensic and genealogical studies. The Haplomatch software is freely available on our website www.genofond.ru. The program is applied to studying the gene pool of Cossacks. Experimental analysis of Y-chromosomal diversity in a representative set (N = 131) of Upper Don Cossacks is performed. Analysis of the STR haplotypes detects genetic proximity of Cossacks to East Slavic populations (in particular, to Southern and Central Russians, as well as to Ukrainians), which confirms the hypothesis of the origin of the Cossacks mainly due to immigration from Russia and Ukraine. Also, a small genetic influence of Turkicspeaking Nogais is found, probably caused by their occurrence in the Don Voisko as part of the Tatar layer. No similarities between haplotype spectra of Cossacks and Caucasus populations are found. This case study demonstrates the effectiveness of the Haplomatch software in analyzing large sets of STR haplotypes.

Culture shapes whether the pursuit of happiness predicts higher or lower well-being

Pursuing happiness can paradoxically impair well-being. Here, the authors propose the potential downsides to pursuing happiness may be specific to individualistic cultures. In collectivistic (vs. individualistic) cultures, pursuing happiness may be more successful because happiness is viewed--and thus pursued--in relatively socially engaged ways. In 4 geographical regions that vary in level of collectivism (United States, Germany, Russia, East Asia), we assessed participants' well-being, motivation to pursue happiness, and to what extent they pursued happiness in socially engaged ways. Motivation to pursue happiness predicted lower well-being in the United States, did not predict well-being in Germany, and predicted higher well-being in Russia and in East Asia. These cultural differences in the link between motivation to pursue happiness and well-being were explained by cultural differences in the socially engaged pursuit of happiness. These findings suggest that culture shapes whether the pursuit of happiness is linked with better or worse well-being, perhaps via how people pursue happiness.

[Association of Polymorphic Variants of Gene MUC19 with Asthma in Russians According to the Results of a Genome-Wide Study]

Asthma is a heterogeneous multifactorial disease that is characterized in most cases by chronic respiratory tract inflammation. We carried out a GWAS in order to identify susceptibility genes for asthma in individuals of different ethnic backgrounds. The study sample consisted of 358 unrelated patients with asthma (160 Russians, 125 Tatars, and 73 Bashkirs) and 369 individuals of a control group (152 Russians, 117 Tatars, and 100 Bashkirs). DNA samples were genotyped with an Illumina human610 quad array (Illumina) as part of the project GABRIEL. Replication of the results of genome-wide analysis was carried out on an additional independent sample of 310 asthma patients (132 Russians, 105 Tatars, and 73 Bashkirs) and 310 individuals in a control group (131 Russians, 106 Tatars, and Bashkirs 77). Genome-wide analysis showed an association of asthma in Russians with the polymorphic loci of gene MUC19 (12q12) encoding gel-forming mucin 19. The highest level of association with asthma was found in rs2933346, which is located in intron 52 of this gene (p = 2.59 x 10(-6)). Seven polymorphic loci of gene MUC19 (rs1492313, rs2588401, rs2588402, rs2638863, rs2638864, rs1352940, and rs2933373), which are in close linkage disequilibrium among themselves and rs2933346, are associated with asthma with the same p-value (p = 4.96 x 10(-6)). The replicative study of rs1492313 in the independent sample of individuals confirmed the presence of the association of the polymorphic loci of this gene with the development of asthma in Russians. According to our data, the association of polymorphic variants of gene MUC19 with asthma has not been previously identified in any study. Our results indicate the important role of polymorphic variants of gene MUC19 in the formation of a predisposition to the development of asthma in individuals of Russian ethnicity.

Association of polymorphisms near the FOXC2 gene with the risk of varicose veins in ethnic Russians

OBJECTIVE

To investigate the association of polymorphisms located near the FOXC2 gene with the risk of varicose veins in ethnic Russians.

METHODS

Allele, genotype, and haplotype frequencies were determined in the sample of 474 patients with primary varicose veins and in the control group of 478 individuals without a history of chronic venous disease.

RESULTS

Polymorphisms rs7189489, rs4633732, and rs1035550 showed the association with the increased risk of varicose veins, but none of the observed associations remained significant after correction for multiple testing. Haplotype analysis revealed the association of haplotype rs7189489 C-rs4633732 T-rs34221221 C-rs1035550 C-rs34152738 T-rs12711457 G with the increased risk of varicose veins (OR = 2.67, P = 0.01).

CONCLUSIONS

Our results provide evidence that the studied polymorphisms do not play a major role in susceptibility to varicose veins development in the Russian population.

[Genetic Association of ADRA2A and ADRB3 Genes with Metabolic Syndrome among the Tatars]

An association study was performed for genetic polymorphisms in ADRB3 (rs4994) and ADRA2A (rs1800544, rs553668) genes to estimate their effect on quantitative parameters, including glucose, insulin, and HOMA-IR index in women from the Tatar population of Russia. It has been shown that CT and CC are associated with metabolic syndrome and increased insulin. It was shown that ADRA2A (rs1800544) gene polymorphism was associated with high levels of insulin and an increased HOMA-IR index in GG- and GC-genotype carriers.

[DISTRIBUTION OF TWO-LOCUS HAPLOTYPES OF MICROBIAL COMPONENT SENSOR GENES TLR1 AND TLR6 IN MAJOR POPULATIONS OF SOUTH URALS]

AIM

Evaluate the fraction of various TLR1-TLR6 haplotypes in populations of Russians Bashkir and Nagaybak of Chelyabinsk Region.

MATERIALS AND METHODS

Potential donors of stem cells from Chelyabinsk Region Station of Blood Transfusion registry were included into the study and split into 3 populations: Russians (81), Bashkir (78) and Nagaybak (84). Genotyping by 2 polymorphisms of TLR1 and TLR6 genes was carried out in all the 3 groups. Point polymorphism of TLR1 gene 1805T>G was determined by polymorphism analysis of length of restriction fragments, and polymorphism of TLR6 gene 745C>T by PCR using sequence-specific primers.

RESULTS

TLR1 1805*G-TLR6 745*T haplotype occurs in population of Russians (42%) and relatively rare--among Bashkir (17%). An inverse picture is observed for TLR1 1805*T-TLR6 745*C haplotype: a more frequent spread among Bashkir (65%) and relatively rare occurrence in Russians (23%). Frequencies of the mentioned haplotypes, that occupy intermediate position compared with corresponding parameters for populations of Russians and Bashkir, were detected for Nagaybak, that, probably, reflects complex pathways of settling of their ancestors and effects of other non-adaptation factors.

CONCLUSION

Frequencies of TLR1-TLR6 two-locus haplotypes in major populations of South Urals were determined for the first time. Further studies in this field will allow better understanding of features of immune response and sensitivity to infections in various populations.

[First case of extensively drug-resistant tuberculosis in Denmark]

In 2013 the first case of extensively drug-resistant tuberculosis was observed in Denmark. A 40-year-old male immigrant had previously been treated with several different antibiotics in his native country Russia. Because of earlier imprisonment in Russia and the fear of reincarceration he did not fully inform the Danish authorities about his disease and treatment. Therefore, he was initially treated with first-line drugs. Once the whole truth emerged and the result of the resistance test was available he was admitted to a highly specialized unit for further treatment.