Moderate/heavy alcohol use and HCV infection among injection drug users in two Russian cities

BACKGROUND

In Russia, injection drug use and transmission of blood-borne pathogens such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are inextricably linked, however the burden of alcohol use remains unexplored among injection drug users (IDUs).

METHODS

Individuals who were 18 years of age and older and had injected drugs in the previous 30 days were recruited in the cities of Novosibirsk and Ivanovo by respondent driven sampling. Consenting individuals were administered a quantitative survey instrument and provided blood samples for serological testing.

RESULTS

In Novosibirsk and Ivanovo, 29% and 35% of respondents were categorized as moderate/heavy drinkers, respectively. Individuals reported problems related to alcohol use that affected their physical health (23%), family (55%), and induced financial hardships (43%). In the multivariate analysis, we found that methamphetamine injection in the past 12 months was a strong and significant correlate of moderate/heavy drinking in Novosibirsk (aOR=5.63 95% CI: [1.01-31.47]) and Ivanovo (aOR=3.81 95% CI: [2.20-6.62]). There was poor agreement between self-reported HCV status and HCV test results (κ=-0.05 and 0.26 in Novosibirsk and Ivanovo, respectively). IDUs who correctly knew their HCV seropositive status in Novosibirsk and IDUs who correctly knew their HCV seronegative status in Ivanovo were significantly more likely to be moderate/heavy drinkers.

CONCLUSION

Alcohol use is problematic among IDUs who are at high risk for HCV. Future interventions should target IDUs who are moderate/heavy drinkers in order to prevent liver complications resulting from HCV infection.

Inhibitory control and working memory in post-institutionalized children

Inhibitory control and working memory were examined in post-institutionalized (PI) children adopted into United States families from Russian institutions. The PI sample originated from institutions that were less severely depriving than those represented in previous studies and approximated the level of psychosocial deprivation, which is characterized by adequate physical resources but a lack of consistent and responsive caregiving. PI children (N = 75; 29 male) ranged in age from 8-17 years (M = 12.97; SD = 3.03) and were grouped according to whether they were adopted after 14 months or before 9 months. A non-adopted comparison group (N = 133; 65 male) ranged in age from 8-17 years (M = 12.26; SD = 2.75). PI children adopted after 14 months of age displayed poorer performance on the stop-signal and spatial span tasks relative to PI children adopted before 9 months of age after controlling for age at assessment. The two PI groups did not differ in their performance on a spatial self-ordered search task. Older-adopted PI children also showed poorer spatial span task performance compared to non-adopted children, but younger-adopted PI children did not. Task performance was significantly associated with parent-rated hyperactive-impulsive behavior in everyday contexts. These findings suggest that exposure to prolonged early institutional deprivation may be linked with inhibitory control and working memory difficulties years after adoption.

[Population frequency and age of c.806C > T mutation in CYB5R3 gene as cause of recessive congenital methemoglobinemia in Yakutia]

Type-1recessive congenital methemoglobinemia (RCM) is a rare autosomal disease characterized by a deficiency of the soluble form of nicotineamide adenine dinucleotide (NADH)-cytochrome b5 reductase (b5R) and clinically manifests as cyanosis of skin and mucous membranes. In the Russian Federation, type-I RCM is widely disturbed in Yakutia due to the local founder effect. The molecular genetics cause of type-I RCM in Yakutia is mutation c.806C > T in the CYB5R3 gene. In this work we used 13 polymorphic markers, which flanking the CYB5R3 gene to establish the founder haplotype. The age of the mutation was estimated as about 285 +/- 135 years. In this work, we have evaluated the frequency of the c.806 C > T mutation in Yakutia, which averaged 55 : 1000 Yakuts. The calculated frequency of disease was 1: 1250 Yakuts.

Metabolic syndrome between two ethnic minority groups (Circassians and Chechens) and the original inhabitants of Jordan

The prevalence of metabolic syndrome is increasing worldwide and exhibits variation among ethnic groups. The objective of this study was to estimate and compare the prevalence of metabolic syndrome and its components between two ethnic groups (Circassians and Chechens) in Jordan and the original inhabitants of Jordan. Data were collected from a cross-sectional study of Circassian (n = 436), Chechen (n = 355), and Jordanian (n = 3234) population aged 18 years and older. Metabolic syndrome was defined according to International Diabetes Federation criteria. Age-standardized prevalence rate of metabolic syndrome was Jordanians 38.0 %, Circassians 32.0 %, and Chechens 33.7 %. Compared to Jordanians, both minority groups had lower means of body mass index, total cholesterol, fasting blood glucose, and triglycerides. The means of high-density lipoprotein and low-density lipoprotein were significantly higher among Circassians compared to Jordanians and Chechens. The odds of BMI defined by overweight and obesity and diabetes were less common among Circassians and Chechens compared to Jordanians. The prevalence of the metabolic syndrome and its individual components is relatively high in the three ethnic groups compared to world. Variation in components between groups may relate to ethnicity. Therefore, a community-based integrated approach is needed that would include behavioral, social changes that would lead to the prevention and treatment of the metabolic syndrome.

Initial validation of the Russian version of the World Mental Health Structured Clinical Interview for DSM-IV

BACKGROUND

The Structured Clinical Interview for DSMIV (SCID) is a highly reliable diagnostic instrument used worldwide. However, there is little data as to its reliability and validity outside of the U.S.

OBJECTIVE

To create a Russian version of the World Mental Health (WMH) SCID and to test its validity among Russian Jewish emigres in the U.S.

METHOD

The author, a bilingual Board Certified psychiatrist who has been trained in the application of the original English SCID and WMH SCID, supervised the translation and adaptation of the WMH SCID into Russian. A convenience sample, consisting of 35 subjects, was interviewed by two clinicians trained by the author, yielding 54 diagnoses. All interviews were audio taped and blindly reviewed by the author, who served as the gold standard.

RESULTS

32 subjects met criteria for one or more of 11 DSMIV depressive and anxiety disorder diagnoses. There was very good inter-rater agreement; median kappa was 0.75; seven disorders had kappas ranging from .65 (Depressive Disorder Not Otherwise Specified) to 1.0 (dysthymia and agoraphobia). Sensitivity was 88.9% and specificity was 77.1 %, compared to the "gold standard" diagnosis.

CONCLUSION

Initial data suggest that the Russian version of the WMH SCID is a valid instrument.

[Comparative characteristics of 24-hour blood pressure profile and heart rate variability in indigenous and non-indigenous patients with chronic coronary heart disease and hypertension from the Yamal-Nenets Autonomic District]

AIM

To investigate the specific features of a 24-hour blood pressure (BP) profile and heart rate variability (HRV) in the indigenous peoples (Nenets, Khanty, Selcups, and Komis) and newcomers with chronic coronary heart disease (CHD) and hypertension, who lived in the Yamal-Nenets Autonomic District.

SUBJECTS AND METHODS

Two hundred male and females patients aged 21 to 55 years (mean age 48.2 +/- 0.7 years) with chronic CHD and hypertension, who resided in the Far North, were examined. All the patients were divided into 4 groups: (1) 50 aboriginal patients with hypertension only; (2) 50 newcomers with hypertension only; 3) 50 natives with chronic CHD and hypertension; (4) 50 non-natives with the above conditions. The groups were matched for gender, age, and the duration of hypertension and CHD. To study the nature of changes in the 24-hour BP profile, all the patients underwent 24-hour ambulatory BP monitoring (ABPM) and HRV examination.

RESULTS

The HRV analysis revealed that all the groups had increases in sympathetic autonomic nervous system (ANS) activity (88% in Group 1; 96% in Group 2; 94% in Group 3, and 92% in Group 4) and decreases in parasympathetic ANS activity (76% in Group 1; 74% in Group 2; 78% in Group 3; and 72% in Group 4), which was suggestive of neurocardiopathy. Analyzing the data of 24-hour ABPM showed that among the natives, there were more patients with increased systolic and diastolic BP (SBP and DBP) variability and higher nocturnal SBP time index (TI). These groups also showed a preponderance of patients with abnormal 24-hour BP profiles as compared to the groups of newcomers (p = 0.034). Among the latter, there were more patients with higher SBP and DBP variability and increased daytime DBP TI and also more patients with a normal nocturnal BP reduction (p = 0.012).

CONCLUSION

The group of indigenous populations displayed a predominance of non-dippers and night-pickers and higher nocturnal SBP and DBP whereas the group of non-indigenous ones exhibited a preponderance of dippers and higher daytime SBP and DBP variability.

[Results of duplex scanning of brachiocephalic arteries and estimation of the lipid spectrum in coronary heart disease and arterial hypertension in indigenous and alien population of Yamalo-Nenetsky Autonomous District]

The work aimed at studying atherosclerotic lesions in brachiocephalic arteries and lipid spectrum in coronary heart disease (CHD) and arterial hypertension (AH) in indigenous and alien population of Yamalo-Nenetsky Autonomous District. It included 200 patients with CHD and AH (men and women aged 21-55 years, mean 48.2 +/- 07 yr). They were allocated to indigenous and alien groups (100 persons each). The patients matched for age and sex were examined by duplex scanning based at an outpatient facility (Salekhard). The indigenous population showed more pronounced thickening of the intima-media complex (IMC) of the common carotid artery (p = 0.001) and more frequent lesions of the main head arteries with stenosis of different severity (especially in internal carotid arteries). Total cholesterol, LDLP and atherogenicity index were similar in both groups and higher than normal. Indigenous subjects had less atherogenic structure of the lipid spectrum due to lower TG and VLDLP but higher HDLP levels.

Working with Russian-Jewish immigrants in end-of-life care settings

This article examines Russian-Jewish immigrant clients' attitudes toward death and dying in the context of today's health care system. Aspects of individuals' collective past--such as the traumatic history of their country of origin; cultural prohibitions against discussing pain, suffering, and death; and the lack of familiarity with palliative care that are likely to affect their decisions about end-of-life care--are discussed. Case vignettes are provided, with a discussion on how best to engage these clients in therapeutic work.

[The functional analysis of polymorphic insertions of Alu retroelements at acute lymphoblastic leukemia]

Human genome variability observed within patient cohorts is considered as a goal of functional genomics essential for personalized medicine progress. In the current research we implement functional analysis of 31 polymorphic Alu insertions located within gene introns for individual genomes of patients with acute lymphoblastic leukemia (ALL). As a result we demonstrated a decrease of the primary transcripts content for 21 Alu-containing alleles. The most strong inhibitory effect of 10 Alu insertions was observed in both mononuclear blood cells of healthy donors and B-lymphoblasts of ALL patients. Allele frequencies of three Alu insertions that are located in MEF2C (two of them) and TAX1BP1 genes significantly differ (p-value 0.027. 0.052. 0.014 accordingly) between cohorts of healthy donors and ALL patients. Prolong influence of the Alu insertions on intracellular content of mature mRNA was studied for corresponding allele of TARBP1 gene.

Food label use and food label skills among immigrants from the former Soviet Union

OBJECTIVE

To assess food label use and skills and to identify their correlates among immigrants from the former Soviet Union (FSU).

DESIGN/SETTING/PARTICIPANTS

Cross-sectional survey of a convenience sample of 200 FSU immigrants residing in New York City.

VARIABLES MEASURED

Food label use and skills; acculturation; and socioeconomic and psychosocial factors.

ANALYSIS

Chi-square tests and multivariate logistic regression analysis assessed relationships among the outcomes and socioeconomic and other characteristics.

RESULTS

Fifty-five percent reported using food labels always/often; only 32% had good label skills. FSU immigrants particularly had difficulty understanding servings per package and percent daily value. Food label use was significantly associated with factors such as positive attitude toward food labels, and importance of recommendations such as avoiding too much salt and saturated fat. However, these factors were not related to food label skills, which was positively associated with longer residency in the United States (> 7 y).

CONCLUSIONS AND IMPLICATIONS

There is a need for nutrition education among FSU immigrants to increase their food label use and skills to promote healthful food selection. Developers of new food labels should consider ways to present percent daily value and servings per package in a more consumer-friendly manner. Simplifying the presentation of this information could improve food label skills in FSU immigrants, among others.

[Genetic epidemiological study of monogenic hereditary diseases in the Republic of Tatarstan: population dynamic factors determining the differentiation of the load of hereditary diseases in five districts]

A genetic epidemiological study has been performed in five districts of the Republic of Tatarstan, Russia: Arsky, Atninsky, Kukmorsky, Buinsky and Drozhzhanovsky raions. The total size of the population surveyed is 188 397 people. Tatars accounted for 77.13% of the population analyzed (145466 people) and were represented by two main ethnic groups: Kazan Tatars and Mishars. The medical genetic study encompassed the total population of the districts, irrespective of ethnicity, and was carried out according to the standard protocol developed in the Laboratory of Genetic Epidemiology of the Research Center for Medical Genetics of the Russian Academy of Medical Sciences. After segregation analysis, the prevalence rates of the main types of monogenic hereditary disorders (MHDs), i.e., autosomal dominant (AD), autosomal recessive (AR), and X-linked diseases, have been calculated for the total population of the five districts and for Tatars alone. The prevalence rates ofAD, AR, and X-linked diseases considerably vary in different subpopulations. The largest difference in the MHD prevalence rate has been found between the rural and urban populations. The overall prevalence rate of MHDs was one patient per 293 urban residents and populations and one patient per 134 rural residents, with a wide variation between subpopulations, from 1 : 83 people in the rural population of Atninsky raion to 1: 351 people in the town of Kukmor. Comparison of the MHD prevalence rate in Tatars with those in populations surveyed earlier has shown that the characteristics of the load of MHDs in the Tatar population are similar to those in some districts of the republics of Bashkortostan, Udmurtia, Mari El, and Chuvachia. In Russian populations of European Russia, the MHD prevalence rates are substantially lower. Correlation analysis has shown high (r = 0.5-0.9) significant correlations between the local inbreeding (a), the im index, the random inbreeding (F(ST)), and the AD and AR prevalence rates in the Tatar population. This analysis has demonstrated that genetic drift is the main population dynamic factor determining the MHD load in the Tatar population.

Migrant selection and the health of U.S. immigrants from the former Soviet Union

Few prior studies have investigated the health of U.S. immigrants from the former Soviet Union (FSU). Utilizing data from the 2000 U.S. census and the 2000-2007 National Health Interview Survey (NIHS), we compare levels of disability of FSU immigrants with U.S.-born whites (ages 50-84). Our findings suggest an "epidemiologic paradox" in that FSU immigrants possess higher levels of education compared with U.S.-born whites, but report considerably higher disability with and without adjustment for education. Nonetheless, FSU immigrants report lower levels of smoking and heavy alcohol use compared with U.S.-born whites. We further investigate disability by period of arrival among FSU immigrants. Changes in Soviet emigration policies conceivably altered the level of health selectivity among émigrés. We find evidence that FSU immigrants who emigrated during a period when a permission to emigrate was hard to obtain (1970-1986) displayed less disability compared with those who emigrated when these restrictions were less stringent (1987-2000). Finally, we compare disability among Russian-born U.S. immigrants with that of those residing in Russia as a direct test of health selectivity. We find that Russian immigrants report lower levels of disability compared with Russians in Russia, suggesting that they are positively selected for health despite their poor health relative to U.S.-born whites.

Pharmacy students at the University of Tartu 1802-2010--a historical study

The aim of this article was to give an historical overview of pharmacy education in Estonia and the social profile of pharmacy students of the University of Tartu (previously Dorpat and Jurjew) during the period 1802-2010. In addition, separate data is presented about female students and students of Estonian ethnicity. During the period observed, 6736 students studied pharmacy in the University of Tartu, of whom 4184 graduated in the specialty. The largest proportional representation by place of birth was Tartu and the Tartu region (13.5%). 42% of the students were 21-25 years old. The majority (96.84%) of the students were Estonians. At the end of the 19th century, russification of the university resulted in Russian being made the official language of instruction, with a concomitant decrease of ethnically German and an increase in ethnically Estonian students. Changes in admission policies have led to an increased number of Russian students among graduates since 2004. 2319 of the total 6736 students were female. During the period 1926-1940, women achieved the majority among graduates and they represent the majority up to the present day.

Suicidal behavior among immigrants

INTRODUCTION

This paper explores the association between suicidal behavior and immigrant status among Israeli residents from the former USSR (FSU).

METHOD

The Israeli component of the World Mental Health Survey (INHS) provided information on suicide ideations, plans and attempts. The INHS samples included Israel-born Jews (n = 2,114) and post-1990 immigrants from the FSU (n = 814). Data on completed suicide were extracted from the countrywide report of the Ministry of Health.

RESULTS

The controlled lifetime rates of suicidal behavior among FSU immigrants were significantly higher than among their Israel-born counterparts. A higher risk was found in the first years following immigration among young adults with higher education and without a spouse. Completed suicide rates were higher among the FSU immigrants than in the general Israeli population with the largest risk among young-adult immigrant men.

DISCUSSION

The findings are consistent with previous studies and are discussed in the context of both suicide rates in the country of origin and migratory stressors. Preventive measures are suggested.

Understanding the "Russian mortality paradox" in Central Asia: evidence from Kyrgyzstan

In the former Soviet republics of central Asia, ethnic Russians have exhibited higher adult mortality than native ethnic groups (e.g., Kazakh, Kyrgyz, Uzbek) in spite of the higher socioeconomic status of ethnic Russians. The mortality disadvantage of ethnic Russians at adult ages appears to have even increased since the breakup of the Soviet Union. The most common explanation for this "Russian mortality paradox," is that deaths are better reported among ethnic Russians. In this study, we use detailed mortality data from Kyrgyzstan between 1959 and 1999 to evaluate various explanations for the Russian mortality paradox: data artifacts, migration effects, and cultural effects. We find that the most plausible explanation is the cultural hypothesis because the personal behaviors that appear to generate a large part of the observed mortality differences (alcohol consumption, in particular) seem to be closely tied to cultural practices. We examine the implications of this finding for understanding the health crisis in post-Soviet states.

[Endogamy and isolation by distance in the Tatarstan population]

A total sample of 31 837 marriage records made in 13 raions (districts) of Tatarstan in 1990-2000 have been used to determine the endogamy index and parameters of Malecot's isolation by distance model. The endogamy index varied from 0.45 in Pestrechinsky raion to 0.74 in Aktynashsky raion. The parameters of Malecot's isolation by distance model varied in Tatars as follows: random inbreeding, from 0.00014 to 0.00076; root mean square migration, from 46 to 110 km.

Understanding the relationship between language proficiency, language impairment and rehabilitation: Evidence from a case study

The goal of this study was to address the relationship between language proficiency, language impairment and rehabilitation in bilingual Russian-English individuals with aphasia. As a first step, we examined two Russian-English patients' pre-stroke language proficiency using a detailed and comprehensive language use and history questionnaire and evaluated their impairment using the Bilingual Aphasia Test. We then attempted to replicate and extend Kiran and Roberts' study in 2010, examining results of a primarily semantic treatment for anomia in one Russian-English bilingual patient. The patient's ability to name the trained and untrained items in both the trained (English) and untrained (Russian) languages significantly improved by achieving 100% accuracy. Finally, we examined whether improvements observed in treatment were captured by a broader language test such as the Bilingual Aphasia Test. Results are discussed with respect to factors contributing to the successful treatment and the implications of rehabilitation on assessment of language skills as a function of treatment.

Rhythm measures and dimensions of durational variation in speech

Patterns of durational variation were examined by applying 15 previously published rhythm measures to a large corpus of speech from five languages. In order to achieve consistent segmentation across all languages, an automatic speech recognition system was developed to divide the waveforms into consonantal and vocalic regions. The resulting duration measurements rest strictly on acoustic criteria. Machine classification showed that rhythm measures could separate languages at rates above chance. Within-language variability in rhythm measures, however, was large and comparable to that between languages. Therefore, different languages could not be identified reliably from single paragraphs. In experiments separating pairs of languages, a rhythm measure that was relatively successful at separating one pair often performed very poorly on another pair: there was no broadly successful rhythm measure. Separation of all five languages at once required a combination of three rhythm measures. Many triplets were about equally effective, but the confusion patterns between languages varied with the choice of rhythm measures.

[Population structure of Volga Tatars inferred from the mitochondrial DNA diversity data]

The data on mitochondrial DNA (mtDNA) variation in two populations of Volga Tatars, representing the population of Buinsk and Aznakaevo districts of the Republic of Tatarstan are presented. Comparative analysis of the data on mtDNA variation in the populations of Eastern Europe showed that Volga Tatars were characterized by low interpopulation differentiation (F(ST) = 0.33%), while the level of interethnic differentiation in Eastern Europe is 1.8%. Genetic similarity of Tatars from the eastern regions of Tatarstan to Bashkirs, as well as of Tatars from western regions to Chuvashes, with whom they share territorial borders, was revealed. Positive correlation between population genetic structure in Eastern Europe and linguistic affiliation of the ethnic groups studied was observed.

[The clinical and ethnic characteristics of elderly and senile patients with discirculatory encephalopathy, living in separate regions of the Sakha (Yakutia) Republic]

The clinical and ethnic characteristics of patients with discirculatory encephalopathy in separate regions of The Republic Sakha (Yakutia) were studied. The analysis of risk factors has shown that the leading reasons of vascular defeat of a brain in all surveyed patients were the atherosclerosis and an arterial hypertension. However, in the patients living in Northern areas of The Republic Sakha (Yakutia) where the ecological situation has remained better, these risk factors were present less often. Clinical symptoms of discirculatory encephalopathy, as well as numerous subjective and clinical displays, have been most expressed in the patients living in Viljujsky region of the Republic, adverse ecologically.

Policy experiment in Russia: cash-for-babies and fertility change

Population decline in modern day Russia is alarmingly steep: Russia loses approximately 750 thousand people each year. To combat population decline, the Russian government instituted aggressive pro-natalist policies. The paper evaluates the capacity of new policies to change women's reproductive behavior using a socio-institutionalist theoretical framework, which analyzes the gendered interaction between the states, the labor market, and family. The paper arrives to a disappointing conclusion that while efforts to improve fertility are quite aggressive, new policies do not challenge gendered hierarchies neither in public nor in private spheres, which will further depress fertility rates of Russian women.

"Abortion will deprive you of happiness!": Soviet reproductive politics in the post-Stalin era

This article examines Soviet reproductive politics after the Communist regime legalized abortion in 1955. The regime's new abortion policy did not result in an end to the condemnation of abortion in official discourse. The government instead launched an extensive campaign against abortion. Why did authorities bother legalizing the procedure if they still disapproved of it so strongly? Using archival sources, public health materials, and medical as well as popular journals to investigate the antiabortion campaign, this article argues that the Soviet government sought to regulate gender and sexuality through medical intervention and health "education" rather than prohibition and force in the post-Stalin era. It also explores how the antiabortion public health campaign produced "knowledge" not only about the procedure and its effects, but also about gender and sexuality, subjecting both women and men to new pressures and regulatory norms.