The Involvement in Domestic Violence and the Severity of Legal, Moral and Social Consequences for the Perpetrators in the Perceptions of Students in Poland and Belarus

Domestic violence is sequential, developmental and dynamic. The aim of this study was to examine whether, in the perceptions of students in Poland and Belarus, there is a relationship between involvement in violence and the legal and social consequences for the perpetrators. A total of 482 university students took part in the study, including 251 students from Poland and 231 students from Belarus. Statistically, Polish respondents were more frequently involved in domestic violence as witnesses and victims, which was confirmed by χ² test. Based on the 95% confidence interval (CI), it can be concluded that the largest number of respondents from both countries surveyed who have been involved in violence as witnesses (85.2-94.8) indicated that an adequate punishment for perpetrators of violence is imprisonment. Students who have never been involved in domestic violence indicated social consequences as appropriate punishment for the use of violence more often than those who have been involved in violence as witnesses, victims or perpetrators. Witnesses and victims were not found to be in favour of more severe punishment or more serious moral and social consequences than perpetrators. The largest number of respondents indicated that the appropriate consequence of using violence should be imprisonment, followed by a restraining order and eviction from the place of residence.

[History of forensic medical examination service in Belarus in the Soviet period (1918-1991)]

The article presents a part of historical path (1918-1991) of forensic medical examination in the Republic of Belarus, the history of origin, formation and development of forensic medical service and the academical departments of forensic medicine in the BSSR. The creation date of the state forensic medical service on the territory of Belarus can be considered as 3 of July 1918 yr. Since then, the service has passed from the judicial and administrative subdivision of the department of public healthcare of Executive Committee of Vitebsk Council of Workers, Peasant and Red Army Deputies (1918), the department of forensic medicine of the PCH of the BSSR (1919), forensic medical department at the Central Chemical and Biological Station of the PCH of the BSSR (1921) to the Institute of Scientific and Forensic Examination of the BSSR (1929), Central Forensic Medical Laboratory of the PCH of the BSSR (1931) and Republican Bureau of Forensic Medical Examination under the Ministry of Healthcare of the BSSR (1952). The historical stages of the existence of the forensic medical service and its state organizations in the BSSR were following: 1) stage of origin (1918-1922); 2) stage of formation (1921-1941, 1946-1952); 3) stage of development (1952). The main forensic medical experts, who made a significant contribution to the origin, formation and development of forensic medical examination in the territory of Belarus were V.F. Chervakov (1930-1939), S.A. Prilutskiy (1939-1941, 1946-1960), V.K. Steshits (1961-1977) and S.S. Maksimov (from 1977).

Seasonal anomalies in radioactivity of the near-surface atmosphere in the Chernobyl-affected area of Belarus

Increased radioactivity in the near-surface atmosphere is virtually an annual occurrence in the Gomel region, Belarus. However, there is no explicit evidence as to what causes these anomalies and whether their origin has a strong seasonal association. To establish any such relations, we have analysed long-term radiation monitoring data recorded in the region over the past 17 years from 2003 to 2020 to find that abnormal levels of atmospheric radioactivity in summer and in winter have different origins. Summer spikes are most likely caused by occasional wildfires blazing in contaminated afforested areas in extreme heat weather, such as the wildfires of 2015 and 2020 in the Chernobyl Exclusion Zone, which is confirmed by backward and forward trajectories of the air mass transport at the time calculated using the HYSPLIT model. By contrast, in winter, when a wildfire cannot occur, a potential source of atmospheric radioactivity in the Gomel region may be the use of wood fuel from contaminated territories in residential woodstoves. Measurements of wood ash sampled from local households across the contaminated area and close to the woods show excessively high concentrations of ¹³⁷Cs and ⁹⁰Sr. The Holt-Winters and the Facebook's Prophet models used for the purposes of this study prove their applicability for performing a short-term (5 years) prediction of the weekly index dynamics of the atmospheric radioactivity.

Physical Activity and Mental Health of Medical Students from Poland and Belarus-Countries with Different Restrictive Approaches during the COVID-19 Pandemic

BACKGROUND

COVID-19 pandemic has struck all of us suddenly and unexpectedly; it deprived the society of a sense of control over their lives on different levels. In a short period of time, it led to a number of changes in everyday life of people all over the world. In particular, these changes affected medical staff, who, all of a sudden, were burdened with new work-related responsibilities and duties. This situation may have had a detrimental effect on their mental health. Due to the unpredictability of the COVID-19 pandemic, we attempted to assess its consequences in terms of mental health and physical fitness of university students from countries in which different approaches to these issues were adopted.

METHODS

A total of 779 medical students (374 students from John Paul II University of Applied Sciences (ABNS) in Biala Podlaska, Poland, and 405 students from Yanka Kupala State University of Grodno (YKSUG), Belarus) took part in the survey. Three standardised psychometric tools were used in the study: The Satisfaction With Life Scale (SWLS), The General Health Questionnaire (GHQ-28) and Stress Coping Inventory (Mini-COPE). In addition, the International Physical Activity Questionnaire (IPAQ) was applied.

RESULTS

The vast majority of students both from Poland and Belarus demonstrated high levels of physical activity. However, students from ABNS manifested significantly higher levels of physical activity compared to their counterparts from YKSUG. Students from Biala Podlaska had greater satisfaction with life during the COVID-19 pandemic, whereas their peers from Grodno exhibited higher levels of mental distress.

CONCLUSION

The COVID-19 pandemic resulted in a significant exacerbation of mental health issues among medical students. In order to alleviate negative effects of the pandemic, it seems necessary for universities to monitor the physical and mental health state of students and to implement prevention programmes.

Medieval and early modern diets in the Polack region of Belarus: A stable isotope perspective

In western and north-western Europe there has been a growing focus on exploring how major economic, political, and social changes during the Medieval period impacted the lived experience of different populations and sectors of society. Stable isotope analysis has proven particularly powerful in this regard, providing direct insights into the long-term diets of individuals and communities. Despite experiencing similarly dramatic social reconfigurations and changes, eastern Europe has, however, received far less attention in this regard. The territory of Belarus has, especially, so far remained a relative blank spot on the bioarchaeological map of Europe, though cities such as Polack emerged rapidly as key nodes within a growing economic and religious network. To gain direct insight into the diets of inhabitants of the Polack region of Belarus in the 11-18th centuries, we applied stable carbon and nitrogen isotope analysis to bone and dentine collagen from human (n = 143) and animal (n = 105) individuals from the city of Polack and surrounding rural sites. Results indicate a diet based on C3 terrestrial resources, which did not differ between sexes and showed limited variation over time. Contrary to expectations, it appears that animal products were commonly consumed by rural dwellers, but no significant reliance on fish resources or millet consumption is found. In contrast to examples from western Europe, we argue that the diets in the city and the surrounding villages remained broadly similar for the majority of the population, and similar to commoners analysed in Poland and Lithuania, perhaps suggestive of slightly different economic changes operating in this part of the Medieval world.

Evaluation of 131I transfer in the environment based on the available measurements made in Belarus after the Chernobyl accident

This study evaluates the 131I transfer from ground deposition to the human thyroid gland after the Chernobyl accident using measurements of 131I concentrations in 1,252 soil, 124 grass, and 136 cow's milk samples as well as 131I thyroid activity measured in 3,100 individuals included in the Belarusian-American cohort. The following parameters of an 131I environmental transfer model used to calculate thyroid doses were evaluated in this study: (i) the interception factor of 131I by pasture grass, which was described by a purely empirical equation, (ii) the removal rate of 131I from pasture grass due to weathering and growth dilution, estimated to be 0.0676 d-1 (half-life of 10.3 d), (iii) the removal rate of 131I from cow's milk, estimated to be 0.0686 d-1 (half-life of 10.1 d), and (iv) the transfer coefficient of 131I from feed to cow's milk, arithmetic mean ± standard deviation of (6.7 ± 8.7) × 10-3 d L-1 (median = 4.0 × 10-3 d L-1). The individual model-based and measurement-based 131I thyroid activities for the Belarusian-American cohort members were calculated using different starting points of 131I transfer in the chain 'ground deposition' → 'vegetation' → 'cow's milk' → 'human thyroid', i.e., the measured 131I concentrations in soil, grass, and cow's milk. De novo thyroid doses from 131I for the 3,100 cohort members were calculated in this study using measured 131I activity concentrations in soil, grass, and cow's milk and were compared with those estimated previously for the same individuals using model-based 131I activity concentrations. It was shown that the use of measured instead of model-based 131I concentrations, in general, did not improve the measurement-based thyroid dose estimates. This is likely to be because there was already a good generic data base for the parameters used in this assessment. This finding indicates that, although the measurements of environmental samples are essential to estimate the parameter values of the 131I transfer model, the individual measurements of 131I thyroid activity are the most valuable information for estimating individual thyroid doses.

Doses from external irradiation and ingestion of 134Cs, 137Cs and 90Sr of the population of Belarus accumulated over 35 years after the Chernobyl accident

This study considers the exposure of the population of the most contaminated Gomel and Mogilev Oblasts in Belarus to prolonged sources of irradiation resulting from the Chernobyl accident. Dose reconstruction methods were developed and applied in this study to estimate the red bone-marrow doses (RBMs) from (i) external irradiation from gamma-emitting radionuclides deposited on the ground and (ii) ¹³⁴Cs, ¹³⁷Cs and ⁹⁰Sr ingestion with locally produced foodstuffs. The mean population-weighted RBM doses accumulated during 35 years after the Chernobyl accident were 12 and 5.7 mGy for adult residents in Gomel and Mogilev Oblasts, respectively, while doses for youngest age groups were 20-40% lower. The highest mean area-specific RBM doses for adults accumulated in 1986-2021 were 63, 56 and 46 mGy in Narovlya, Vetka and Korma raions in Gomel Oblast, respectively. For most areas, external irradiation was the predominant pathway of exposure (60-70% from the total dose), except for areas with an extremely high aggregated ¹³⁷Cs soil to cow's milk transfer coefficient (≥ 5.0 Bq L^-1 per kBq m^-2), where the contribution of ¹³⁴Cs and ¹³⁷Cs ingestion to the total RBM dose was more than 70%. The contribution of ⁹⁰Sr intake to the total RBM dose did not exceed 4% for adults and 10% for newborns in most raion in Gomel and Mogilev Oblasts. The validity of the doses estimated in this study was assessed by comparison with doses obtained from measurements by thermoluminescence dosimeters and whole-body counters done in 1987-2015. The methodology developed in this study can be used to calculate doses to target organs other than RBM such as thyroid and breast doses. The age-dependent and population-weighted doses estimated in this study are useful for ecological epidemiological studies, for projection of radiation risk, and for justification of analytical epidemiological studies in populations exposed to Chernobyl fallout.

Are Benevolent Attitudes More Closely Related to Attitudes toward Homosexuals than Hostile Ones? Cases of Belarus, Kazakhstan, and Russia

Previous studies have shown that ambivalent gender attitudes are associated with attitudes toward homosexuals. However, most of these studies have primarily considered ambivalent attitudes toward women and attitudes toward gay men, and have been carried out in countries with progressive laws regarding homosexuality. In this study, we examined the connection between ambivalent attitudes toward men and women and attitudes toward gay men and lesbian women in countries with conservative sexual legislation. In the first study, participants were residents of Russia (N = 163) and Kazakhstan (N = 194), while the second study used residents of Russia (N = 496) and Belarus (N = 123). Results indicated that benevolent attitudes predicted attitudes toward gays and lesbians better than the hostile ones. At the same time, attitudes toward men and women similarly predicted attitudes toward gays and lesbians. These patterns were manifested among different components of attitudes toward homosexuals. The results are discussed within the social context of the countries.

Level of physical activity of students in Poland, Portugal and Belarus

INTRODUCTION AND OBJECTIVE

The WHO term 'physical activity' refers to all body movements produced by skeletal muscles which require energy expenditure. The ways to be active include daily activities, exertion in the performance of work, or active recreation. The objective of the study is to compare physical activity of the students of Bialystok University of Technology, Higher School of Physical Education and Tourism in Biaystok (Poland), University of Beira Interior in Covilha (Portugal) and Janka Kupala Grodno State University in Grodno (Belarus).

MATERIAL AND METHODS

A total of 1,136 persons participated in the study (398 men and 738 women). The level of physical activity of the students was assessed on the basis of a short version of the International Physical Activity Questionnaire (IPAQ). The individual value of the body mass index (BMI) was calculated for each respondent.

RESULTS

Among men studying at WSWFiTB, in Portugal and Belarus, the dominant level of activity was high. Both in the group of men and women, people studying in Portugal spent the most time sitting during one working day. Without taking into account the gender of the respondents, a high level was the dominant among students of WSWFiTB, in Portugal and Belarus. With regard to overweight and obese people, the highest average amount of energy expenditure was recorded in the case of intensive activity.

CONCLUSIONS

Men, compared to women, were characterized by a higher average amount of energy consumption related to total activity and intensive exercise. Students in Belarus obtained the highest average amount of energy expenditure related to moderate and intensive activity, compared to students at BUT, WSWFiTB and in Portugal. A high level of activity dominated both in the group of underweight/normal body weight, as well as overweight and obese persons.

THYROID SCREENING AND RELIABILITY OF RADIATION THYROID DOSES FOR THE BELARUSIAN IN UTERO COHORT

OBJECTIVE

To describe the status and results of thyroid disease screening and assessment of reliability of radiationthyroid doses in the Belarusian in utero cohort of 2,965 individuals exposed to Chernobyl (Chornobyl) fallout.

MATERIALS AND METHODS

Thyroid screening examinations are currently underway including thyroid palpation by anendocrinologist, ultrasonographic examination by an ultrasonographer and analysis of blood samples for diagnosisof hypo- and hyperthyroidism, autoimmune thyroiditis, thyroid function tests (thyroid-stimulating hormone [TSH],thyroxine [T4], thyroid peroxidase antibody [anti-TPO], and thyroglobulin antibodies [anti-TG]). Reliability of (i)information from 780 pairs of questionnaires obtained during the first and second interviews of the mothers and (ii)thyroid doses, which were calculated for the cohort members using this information, is evaluated.

RESULTS

As of 15 August 2021, 1,267 in utero exposed study subjects had been screened. A single thyroid nodule wasdiagnosed in 167 persons (13.2 % of the total) and multiple thyroid nodules in 101 persons (8.0 %): 189 (14.9 %)persons had nodules detected for the first time at the screening while 79 (6.2 %) persons had nodules detected pre-viously (pre-screening nodules). Fifty-nine out of 268 subjects (22.0 %) with a suspicious thyroid nodule werereferred to fine needle aspiration biopsy, and among them 33 (55.9 %) were biopsied. Reasonable agreement wasobserved for modelqbased doses calculated for the Belarusian in utero cohort members using data from the two inter-views (Spearman's rank-correlation coefficient rs = 0.74, p < 0.001), while measurementqbased doses yielded almost per-fect agreement (rs = 0.99, p < 0.001).

CONCLUSIONS

During the thyroid screening, at least one thyroid nodule was identified in 268 of 1,267 (21.2 %) inutero exposed cohort members. Seven thyroid cancer cases were identified in the cohort, including 5 pre-screeningcases and 2 cases detected during the screening. Ongoing research on this unique cohort will provide importantinformation on adverse health effects following prenatal and postnatal exposure to radioiodine and radiocesium iso-topes, for which available epidemiological data are scant.

Combining Longitudinal Data From Different Cohorts to Examine the Life-Course Trajectory

Longitudinal data are necessary to reveal changes within an individual as he or she ages. However, rarely will a single cohort study capture data throughout a person's entire life span. Here we describe in detail the steps needed to develop life-course trajectories from cohort studies that cover different and overlapping periods of life. Such independent studies are probably from heterogenous populations, which raises several challenges, including: 1) data harmonization (deriving new harmonized variables from differently measured variables by identifying common elements across all studies); 2) systematically missing data (variables not measured are missing for all participants in a cohort); and 3) model selection with differing age ranges and measurement schedules. We illustrate how to overcome these challenges using an example which examines the associations of parental education, sex, and race/ethnicity with children's weight trajectories. Data were obtained from 5 prospective cohort studies (carried out in Belarus and 4 regions of the United Kingdom) spanning data collected from birth to early adulthood during differing calendar periods (1936-1964, 1972-1979, 1990-2012, 1996-2016, and 2007-2015). Key strengths of our approach include modeling of trajectories over wide age ranges, sharing of information across studies, and direct comparison of the same parts of the life course in different geographical regions and time periods. We also introduce a novel approach of imputing individual-level covariates of a multilevel model with a nonlinear growth trajectory and interactions.

Regional diversification of the use of agricultural production potential in the EU candidate and the Eastern partnership countries

Diversification of the agricultural production potential often implies the differentiation of the achieved farming productivity due to its effect on the agricultural resources and structural processes. The article aims to examine the diversity of the production potential in the agricultural sectors of the EU candidate countries (CC) and the Eastern Partnership countries (EPC) and its impact on the variety of the achieved productivity, as well as to present changes in the analyzed indicators in the years 2006–2017. A synthetic measure of agricultural development and a linear regression analysis were applied in the article. The research revealed that Belarus may be distinguished with regard to its production potential, as well as the achieved productivity. In most countries (with the exception of Montenegro and Macedonia), an increase in the value of the synthetic measure of the possessed potential has been recorded in the studied period. However, the synthetic measure of the agricultural productivity level displayed an insignificant raise only in half of the countries surveyed.

Analysis of Maternal Prenatal Weight and Offspring Cognition and Behavior: Results From the Promotion of Breastfeeding Intervention Trial (PROBIT) Cohort

IMPORTANCE

Prenatal experiences can influence fetal brain development.

OBJECTIVE

To examine associations of maternal prenatal body mass index (BMI) with cognition and behavior of offspring born full-term.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study examined follow-up data from a breastfeeding promotion intervention at 31 hospitals and affiliated polyclinics in the Republic of Belarus. Participants included 11 276 children who were evaluated from birth (1996-1997) to adolescence (2017-2019), with maternal BMI information available in prenatal medical records.

EXPOSURES

Maternal BMI, calculated as weight in kilograms divided by height in meters squared, after 35 weeks gestation; secondary analyses examined maternal BMI at other time points and paternal BMI.

MAIN OUTCOMES AND MEASURES

Trained pediatricians assessed child cognition with the Wechsler Abbreviated Scales of Intelligence (WASI) at 6.5 years and the computerized self-administered NeuroTrax battery at 16 years, both with an approximate mean (SD) of 100 (15). Parents and teachers rated behaviors at 6.5 years using the Strengths and Difficulties Questionnaire (SDQ, range 0-40). Mixed-effects linear regression analyses corrected for clustering, adjusted for the randomized intervention group and baseline parental sociodemographic characteristics, and were considered mediation by child BMI.

RESULTS

Among 11 276 participants, 9355 women (83%) were aged 20 to 34 years, 10 128 (89.8%) were married, and 11 050 (98.0%) did not smoke during pregnancy. Each 5-unit increase in of maternal late-pregnancy BMI (mean [SD], 27.2 [3.8]) was associated with lower offspring WASI performance intelligence quotient (IQ) (-0.52 points; 95% CI, -0.87 to -0.17 points) at 6.5 years and lower scores on 5 of 7 NeuroTrax subscales and the global cognitive score at 16 years (-0.67 points; 95% CI, -1.06 to -0.29 points). Results were similar after adjustment for sociodemographic characteristics, pregnancy complications, and paternal BMI and were not mediated by child weight. Higher late pregnancy maternal BMI was also associated with more behavioral problems reported on the SDQ by teachers but not associated with parent-reported behaviors (externalizing behaviors: 0.13 points; 95% CI, 0.02 to 0.24 points; and total difficulties: 0.14 points, 95% CI, -0.02 to 0.30 points). Results were similar for maternal BMI measured in the first trimester or postpartum. In contrast, higher 6.5-year paternal BMI was associated with slightly better child cognition (WASI verbal IQ: 0.42 points; 95% CI, 0.02 to 0.82 points; NeuroTrax executive function score: 0.68 points; 95% CI, 0.24 to 1.12 points) and fewer teacher-reported behavioral problems (total difficulties: -0.29 points; 95% CI, -0.46 to -0.11 points).

CONCLUSIONS AND RELEVANCE

This cohort study supports findings from animal experiments and human observational studies in settings with higher maternal BMI and obesity rates. Higher maternal prenatal BMI may be associated with poorer offspring brain development, although residual confounding cannot be excluded.

In situ determination of 137Cs inventory in soil using a field-portable scintillation gamma spectrometer-dosimeter

A new empirical method for in situ determination of the inventory of ¹³⁷Cs in soil (A_Cs, kBq m^-2) at grasslands and forests using a field-portable NaI(Tl) scintillation spectrometer-dosimeter was developed. The method is based on evaluation of the ambient dose equivalent build-up factor. The practical implementation of the new method with the spectrometer-dosimeter does not require a priori knowledge of the vertical distribution of ¹³⁷Cs in soil. Moreover, the method allows assessing a value of the mean migration depth of ¹³⁷Cs in soil (Z) in terms of g cm^-2. The 95% confidence interval for the mean value of the conversion coefficients from the ambient dose equivalent build-up factor to A_Cs and to Z is less than 10%. The new method has been developed and verified using published data that where obtained at territories in Russia and Belarus heavily contaminated with ¹³⁷Cs (A_Cs > 37 kBq m^-2) due to the Chernobyl accident. Therefore, the survey of less contaminated areas requires additional validation of this method.

Snow as a contributor to spring flooding in Belarus

There are some peculiarities in instrumental observation over snow cover characteristics in Belarus and those of neighboring countries. Maximum snow water equivalent varies around Belarus from 107 mm in Brest to 207 mm in Novogrudok. It differs significantly in terms of years, which is proved by high values of variation coefficients (C_v). Maximums are observed in the south and south-west of Belarus. Minimum values are typical for central and north-eastern parts of Belarus with a stable snow cover. There is a distinct correlation between snow water equivalent and the stations' altitude. We observe a space-time variability of SWE in Belarus' river catchments. Changes in SWE are of cyclic nature. They correlate with current climate fluctuations. In certain parts of Belarus, there is a trend in reduction of SWE up to 8-10 mm in 10 years. This research determines the amount of water that forms spring flood runoff in the catchments of Belarus' big rivers. Possible daily snow melting is calculated in the research as well. It reaches 26 mm in its maximum and 5-6 mm on average. The amount of river runoff water, which is formed within Belarus, is 58 km³. The amount of melt water is 11 km³, which accounts for 19%. In particularly extreme years, melt water reaches 29 km³, which is over a half of all annual river runoff.

Vitamin D Status, Bone Mineral Density, and VDR Gene Polymorphism in a Cohort of Belarusian Postmenopausal Women

Vitamin D plays an important role in bone metabolism and is important for the prevention of multifactorial pathologies, including osteoporosis (OP). The biological action of vitamin is realized through its receptor, which is coded by the VDR gene. VDR gene polymorphism can influence individual predisposition to OP and response to vitamin D supplementation. The aim of this work was to reveal the effects of VDR gene ApaI rs7975232, BsmI rs1544410, TaqI rs731236, FokI rs2228570, and Cdx2 rs11568820 variants on bone mineral density (BMD), 25-hydroxyvitamin D level, and OP risk in Belarusian women. Methods. The case group included 355 women with postmenopausal OP, and the control group comprised 247 women who met the inclusion criteria. TaqMan genotyping assay was used to determine VDR gene variants. Results. Rs7975232 A/A, rs1544410 T/T, and rs731236 G/G single variants and their A-T-G haplotype showed a significant association with increased OP risk (for A-T-G, OR = 1.8, p = 0.0001) and decreased BMD (A-T-G, −0.09 g/cm², p = 0.0001). The rs11568820 A-allele showed a protective effect on BMD (+0.22 g/cm², p = 0.027). A significant dose effect with 25(OH)D was found for rs1544410, rs731236, and rs11568820 genotypes. Rs731236 A/A was associated with the 25(OH)D deficiency state. Conclusion. Our novel data on the relationship between VDR gene variants and BMD, 25(OH)D level, and OP risk highlights the importance of genetic markers for personalized medicine strategy.

Reliability of thyroid doses due to 131I intake exceeding 5 Gy in a cohort of Belarusian children exposed to Chernobyl fallout

High thyroid doses due to Iodine-131 (¹³¹I) intake among individuals exposed in childhood and adolescence to Chernobyl fallout raise questions about their reliability and their impact on the analysis of the radiation-related risk of thyroid cancer and other thyroid diseases in the exposed population. In the present study, an in-depth examination was conducted of thyroid doses from ¹³¹I intake over 5 Gy calculated for 131 subjects of the Belarusian-American cohort of individuals exposed after the Chernobyl accident. Thyroid doses in this cohort study were estimated based on individual radiation measurements of ¹³¹I thyroidal activity and detailed questionnaire data on individual behavior and consumptions of locally produced foodstuffs. Therefore, these doses provide the best basis for assessing reliability. The analysis showed that the result of direct thyroid measurement was mistakenly assigned to three out of 131 study subjects (2.3% of the total), and, therefore, the instrumental thyroid dose for these individuals cannot be correctly estimated. This study confirmed with a high degree of confidence the reliability of thyroid doses due to ¹³¹I intake exceeding 5 Gy that were calculated for the Belarusian-American cohort members.

Post-fire redistribution of 137Cs and algal communities in contaminated forest soils in Belarus

This study was carried out in the forest area of the Gomel region of Belarus contaminated by ¹³⁷Cs following the Chernobyl accident of 1986. The aim of the study was to explore the effects of different types of wildfires on the biological availability of radionuclides and the distribution of algal communities in fire-affected soils. Soil samples were collected in 2017 and 2018 from sites burnt by surface and crown fires, and from two unburnt reference locations. The soil samples were analyzed for radioactivity, agrochemical characteristics and the abundance of photoautotrophs. The proportions of various ¹³⁷Cs fractions, according to our findings, differ between fire-affected and unburnt forest soils, and also between the different types of wildfire. The forest soil affected by surface fire is characterized by an increased amount of easily exchangeable and mobile fractions. In the forest burnt by the crown fire, where the above ground vegetation was almost completely destroyed, the mobile fractions of ¹³⁷Cs are easily washed out from the topsoil, allowing them to penetrate into deeper soil layers. Soil algae play an important ecological role in sustaining terrestrial ecosystems and are sensitive to various physicochemical properties of soil, such as pH level, nutrient content and moisture. Most of these physicochemical properties are known to stimulate the growth of algal cells, however no evidence has been found in this study regarding the relationship between ¹³⁷Cs activities in soil and the algal species richness.

SURGICAL METHODS OF TREATMENT OF END-STAGE HEART FAILURE

The aim of the study is to establish the effectiveness of mechanical support of blood circulation of patients with end-stage heart failure depending on the method of surgical correction. The results of the study are based on the data of examination and dynamic observation of 73 patients (median age 44 (16-69) years, men 68 patients, women 5 patients) who were treated from 2008-2019 іn the following medical institutions: Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of Cardiac Surgery on the Basis of KL «Feofania» DUS. Patients were examined during the initial examination, after 3 months and after a year. The results of surgical treatment of patients with critical heart disease insufficiency: after direct UTS: 24 (92%) patients were treated with positive result, 2 (8%) patients died. There were 18 (46%) patients performed secondary UTS, patients who were on LVAD therapy. 18 (46%) patients who continue LVAD therapy. On LVAD-therapy 3 (8%) patients died. The cause of death is purulent-septic lesions. Which patients were on BiVAD - therapy: secondary UTS performed 4 patients (50%). 4 (50%) patients died on BIVAD therapy. The cause of death in 2 (50%)cases of purulent-septic lesions, and in 2 (50%) cases it is an organ field insufficiency. Analysis of the results of the differential approach to surgical treatment patients with heart failure III-IV FC according to NYHA: patients with critical heart failure in the presence of contraindications to direct transplantation heart rate, it is advisable to consider the use of long-term mechanical circulatory support based on LVAD therapy (p<0001) and BiVAD - therapy (p<0001) as a mechanical bridge to heart transplantation. Applied long-term mechanical support of blood circulation in patients with high indicators of pulmonary hypertension (p<0001), allows to normalize the pressure in the pulmonary artery and consider performing a secondary heart transplant.

[THE MAIN CRITERIA FOR SELECTING PATIENTS WHEN FORMING A WAITING LIST FOR HEART TRANSPLANTATION]

The aim of the study was to optimize the methods of selecting patients for inclusion in the «WAITING LIST» for heart transplantation on the basis of available international data and the introduction of selection criteria. The results of the study are based on survey data and dynamic monitoring of 49 patients (median age 38 (16; 65) years, men 44 patients, women 5 patients) who were treated from 2008-2018 in the centers: Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of cardiac surgery on the basis of KL «Feofania» DUS, Kyiv, Ukraine. Patients were examined during the initial examination, after 3 months, 6 months and after 1 year. The first group consisted of 24 patients with CHF who were on the waiting list for orthotopic heart transplantation, for circulatory support, median age 40.95 (18.0; 65.0) years, men - 23, women - 1; the second group consisted of 25 patients with CHF who were on the waiting list for orthotopic heart transplantation without circulatory support, median age 38.56 (17.0; 64.0) years, men -21, women-4; Scientific novelty of the obtained results. Scientific novelty of the obtained results. For the first time in Ukraine, a road map has been developed and implemented and the dynamics of the movement of recipients who are in the "waiting list" for heart transplantation has been analyzed. Identified risk factors that affect the long-term outcomes and quality of life of patients with heart failure III-IV functional class according to the NYHA classification. Criteria for selection of patients for primary heart transplantation have been developed and implemented. For the first time in Ukraine, a "Waiting List" for a heart transplant has been formed.

Environmental implications of the quality of charcoal briquettes and lump charcoal used for grilling

Numerous studies have been conducted to assess air pollution and human health risks arising from exposure to outdoor cooking, but limited standards have been implemented around the world to assure fuel quality. While charcoal briquettes and lumps are a popular fuel choice for grilling, almost no data specifying their properties are available to consumers. Because the properties of fuels affect the flue gases, it is critical to understand how the quality of grilling briquettes and lumps translates not only into the quality of the grilled food, but, even more importantly, how their emissions impact human safety and the environment. The main purpose of this study is to investigate the impacts of the quality of charcoal briquettes and lumps on potentially harmful emissions during grilling. To analyze their quality, we used reflected light microscopy to identify a range of contaminants, including biomass, mineral matter, coal, coke, metal, rust, plastics, glues, and synthetic resins, in 74 commercially available products made in Poland, the United States of America, Ukraine, Germany, Belarus, the Czech Republic, and the Republic of South Africa. Our data show that majority of the products analyzed do not meet the existing quality standard EN 1860-2:2005 (E) of less than 1% contaminants, some of these products contain up to 26.6% of impurities. The amount of contaminants correlates with particulate matter, as well as CO and CO₂. The contribution of biomass is especially significant because it can be used to predict harmful particulate matter emissions during grilling. The relationship between the composition of charcoal briquettes and lump charcoal and their emissions is particularly strong during the first 15 to 20 min after ignition (when emissions are the highest), therefore, this initial stage is especially unsafe to consumers, and staying away from the grill during this time is recommended.

PHOTODYNAMIC THERAPY IN TREATMENT OF PATIENTS WITH PREMALIGNANT VULVAR DISEASES. FIRST EXPERIENCE OF THE METHOD APPLICATION IN UKRAINE

The aim of the study is to evaluate the tolerability and effectiveness of photodynamic therapy (PDT) of patients with premalignant diseases of the vulva. The study was performed on 10 patients on the basis of the National Cancer Institute of Ukraine (Kyiv). The age of patients ranged from 31 to 67 years old (mean age: 53.3±3.6 years old). The diagnosis was made on the basis of medical history, complaints and clinical examination of patients, vulvoscopy and the results of morphological examination of pathologically altered vulvar tissues. A drug of the chlorine series "Photolon" (RUE "Belmedpreparaty", Republic of Belarus) in doses from 1 to 2.5 mg/kg was used as a photosensitizer (FS). Photoirradiation of pathologically altered foci was performed 3-4 hours after the end of the infusion of FS using a laser coagulator universal "Lika-surgeon" ("Photonics Plus", Ukraine, λ = 660 nm) with a radiation power of 0.4 W in exposure doses of 100 up to 150 J/cm2. PDT tolerability was assessed basing on the frequency and severity of adverse reactions (CTCAE, version 3.0). The effectiveness of PDT was assessed basing on the presence / absence of complaints, data from visual observation of changes in the area of treated lesions and morphological examination data at 3 and 6 months after treatment (WHO criteria). No serious adverse reactions associated with the introduction of FS and PDT session were observed: no allergic reactions (Quincke's edema, urticaria, drop in blood pressure, bronchospasm), no symptoms of skin phototoxicity. In the specified control patients' observation terms, the remission of disease clinical symptoms (an itch in the area of vulva) in the treated pathological centers as well as high frequency of clinical and morphological regressions were noted. The obtained results indicate the relevance and prospects of further research in the field of laser technology and PDT as options for organ-preserving treatment of premalignant diseases of vulva.

A Microwave Digestion Technique for the Analysis of Rare Earth Elements, Thorium and Uranium in Geochemical Certified Reference Materials and Soils by Inductively Coupled Plasma Mass Spectrometry

Two different digestion methods—microwave digestion (Mw) and Savillex digestion (Sx)—were used to evaluate the best quality control for analysis of the rare earth elements, Th and U in the geochemical certified reference material JSd-2, supplied by the Geological Survey of Japan (GSJ). The analysis of trace elements was carried out using inductively coupled plasma mass spectrometry (ICP-MS). The digestion recovery was > 90% for almost all elements by both methods. Mw-4 (four repeats of the microwave digestion) was found to be more effective and faster than Sx. In order to evaluate the efficiency of Mw-4, three other GSJ certified reference materials, JLk-1, JB-1 and JB-3, as well as five different soil samples from Belarus, Japan, Serbia and Ukraine were also analyzed. The Mw-4 method was seen to be promising for complete digestion and recovery of most of the elements. The U/Th ratio showed some heterogeneity for Ukraine and Serbia soils affected by Chernobyl nuclear power plant accident and depleted uranium contamination, respectively. This method can be successfully applied to any type of soils for elemental analyses.

Cost-effectiveness of new MDR-TB regimens: study protocol for the TB-PRACTECAL economic evaluation substudy

INTRODUCTION

Current treatment regimens for multidrug-resistant tuberculosis (MDR-TB) are long, poorly tolerated and have poor outcomes. Furthermore, the costs of treating MDR-TB are much greater than those for treating drug-susceptible TB, both for health service and patient-incurred costs. Urgent action is needed to identify short, effective, tolerable and cheaper treatments for people with both quinolone-susceptible and quinolone-resistant MDR-TB. We present the protocol for an economic evaluation (PRACTECAL-EE substudy) alongside an ongoing clinical trial (TB-PRACTECAL) aiming to assess the costs to patients and providers of new regimens, as well as their cost-effectiveness and impact on participant poverty levels. This substudy is based on data from the three countries participating in the main trial.

METHODS AND ANALYSIS

Primary cost data will be collected from the provider and patient perspectives, following economic best practice. We will estimate the probability that new MDR-TB regimens containing bedaquiline, pretomanid and linezolid are cost-effective from a societal perspective as compared with the standard of care for MDR-TB patients in Uzbekistan, South Africa and Belarus. Analysis uses a Markov model populated with primary cost and outcome data collected at each study site. We will also estimate the impact of new regimens on prevalence of catastrophic patient costs due to TB.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from the London School of Hygiene & Tropical Medicine and Médecins Sans Frontières. Local ethical approval will be sought in each study site. The results of the economic evaluation will be shared with the country health authorities and published in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Registry (NCT04207112); Pre-results.

Polybrominated diphenyl ethers in plastic waste of electrical and electronic equipment: a case study in Belarus

Plastic waste of electrical and electronic equipment (WEEE) can contain polybrominated diphenyl ethers (PBDEs) that have been used as fire retardants for a long time. PBDEs were listed in the Stockholm Convention as persistent organic pollutants, so PBDE-containing plastic waste should be separated and disposed of in an ecologically sound manner. In the article, the results of bromine and PBDE content in plastic samples of WEEE collected in Belarus are presented. The screening method for bromine identification and HRGC/HRMS for PBDE identification were applied. It is shown that bromine is present in 43% of the 111 studied samples. Most often, Br-containing plastic was found in CRT monitor, CRT TVs and LCD monitor (about 50%), printers (35%), and LCD TVs (25%). PBDEs were revealed in 12 Br-containing samples, representing TVs, monitors, and printers. The sum of ∑10PBDEs varied from 6.6 to 21,000 μg/kg. BDE-209 dominated in 9 samples (75% of cases); BDE-183, in two; and BDE-47 and BDE-99, in one sample. Based on the low content of PBDEs in the plastic, year of equipment production, and year of restriction of PBDEs applied in the countries-manufacturers, it was concluded that the presence of PBDEs in plastic is a consequence of contaminated waste recycling. Despite the relatively low concentrations of PBDEs (below the limit values established by the Stockholm and Basel conventions for POP wastes), further research is necessary with an extension of the list of analyzed types of equipment and identification of other brominated flame retardants.

Activity concentrations of 131I and other radionuclides in cow's milk in Belarus during the first month following the Chernobyl accident

The accident at the Chernobyl nuclear power plant (NPP) in Ukraine on April 26, 1986 led to a considerable release of radioactive material resulting in environmental contamination over vast areas of Belarus, Ukraine and western Russian Federation. The major health effect of the Chernobyl accident was an increase in thyroid cancer incidence in people exposed as children and adolescents, so much attention was paid to the thyroid doses resulting from intakes of ¹³¹I. Because cow's milk consumption was the main source of ¹³¹I intake by people, it was important to measure the ¹³¹I activity concentrations in cow's milk to calculate, or to validate, the thyroid doses to the exposed population. Almost 11,000 measurements of total beta-activity in cow's milk were performed using a DP-100 device during the first month after the Chernobyl accident in the most contaminated regions of Belarus. Using an ecological model and calibration coefficients for the DP-100 device the activity concentration of ¹³¹I in cow's milk was derived as well as the activity concentrations of the other radiologically important radionuclides, namely ¹³⁴Cs, ¹³⁷Cs, ⁸⁹Sr and ⁹⁰Sr. The activity concentrations of other radionuclides, such as ⁹⁰Y, ¹³²Te, ¹³²I, ¹³³I, ¹³⁶Cs, ¹⁴⁰Ba, ¹⁴⁰La, ¹⁴¹Ce and ¹⁴⁴Ce, in cow's milk were also estimated and were shown to be of minor importance. The concentrations of ⁹⁵Zr, ⁹⁵Nb, ¹⁰³Ru and ¹⁰⁶Ru in cow's milk were negligible. The data obtained in this study were validated by comparing derived ¹³¹I and ¹³⁷Cs concentrations in cow's milk with gamma-spectrometry measurements performed in milk produced in the same location close to the same date. The results of this study were essential to assess and validate the radiation doses received by the subjects of epidemiological studies related to the health consequences of the Chernobyl accident.

Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows

OBJECTIVE

To illustrate that a mediation framework can help integrate inferences from three growth models to enable a comprehensive view of the associations between growth during specific developmental windows and mid-childhood IQ.

DESIGN

We analysed direct and indirect associations between mid-childhood IQ and length/height growth in five early-life age intervals bounded by conception, birth, early, mid and late infancy, and mid-childhood using estimates from three growth models (lifecourse, conditional change and change score) applied to three historical birth cohorts.

PARTICIPANTS AND SETTING

12 088 term-born children from the Collaborative Perinatal Project (CPP) in the USA (n=2170), the Promotion of Breastfeeding Intervention Trial (PROBIT) in Belarus (n=8275) and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines (n=1643).

PRIMARY OUTCOME MEASURE

Mid-childhood IQ.

RESULTS

Our analyses revealed cross-cohort and cross-interval variations in the direct and indirect effects of foetal and early childhood physical growth on mid-childhood IQ. For example, in CPP, there was a direct association of prenatal growth with IQ that was not evident in the other cohorts, whereas in PROBIT and CLHNS, we observed that foetal and early growth-IQ associations were mediated through size in later periods.

CONCLUSION

Lifecourse, conditional change and change score growth models yield complementary inferences when appropriately interpreted. Future longitudinal studies of associations of early-life growth with later outcomes would benefit from adopting a causal mediation framework to integrate inferences from multiple complementary growth models.

Uncertainties in Radiation Doses for a Case-control Study of Thyroid Cancer among Persons Exposed in Childhood to 131 I from Chernobyl Fallout

Uncertainties in thyroid doses due to I intake were evaluated for 2,239 subjects in a case-control study of thyroid cancer following exposure to Chernobyl fallout during childhood and adolescence carried out in contaminated regions of Belarus and Russia. Using new methodological developments that became available recently, a Monte Carlo simulation procedure was applied to calculate 1,000 alternative vectors of thyroid doses due to I intake for the study population of 2,239 subjects accounting for sources of shared and unshared errors. An overall arithmetic mean of the stochastic thyroid doses in the study was estimated to be 0.43 Gy and median dose of 0.16 Gy. The arithmetic mean and median of deterministic doses estimated previously for 1,615 of 2,239 study subjects were 0.48 Gy and 0.20 Gy, respectively. The geometric standard deviation of individual stochastic doses varied from 1.59 to 3.61 with an arithmetic mean of 1.94 and a geometric mean of 1.89 over all subjects of the study. These multiple sets of thyroid doses were used to update radiation-related thyroid cancer risks in the study population exposed to I after the Chernobyl accident.

"Living in Contaminated Areas"-Consideration of Different Perspectives

Following large-scale nuclear power plant accidents such as those that occurred at Chernobyl (Ukraine) in 1986 and Fukushima Daiichi (Japan) in 2011, large populations are living in areas containing residual amounts of radioactivity. As a key session of the ConRad conference, experts were invited from different disciplines to provide state-of-the-art information on the topic of "living in contaminated areas." These experts provided their different perspectives on a range of topics including radiation protection principles and dose criteria, environmental measurements and dose estimation, maintaining decent living and working conditions, evidence of health risks, and social impact and risk communication. A short summary of these different perspectives is provided in this paper.

Rapid in situ assessment of radiocesium wood contamination using field gamma-ray spectroscopy to optimise felling

The Chernobyl nuclear power meltdown that took place in 1986 has left a radioactive contamination legacy that currently severely limits the economic potential of impacted regions including the Polessie State Radioecology Reserve in Southern Belarus. Extensive areas of forested land could potentially become economically viable for firewood and building materials if radioactive contamination, notably ¹³⁷Cs, could be characterised faster, whilst closely adhering to regulatory limits. Currently, laboursome tree coring and unreliable transfer factors derived from limited soil sampling data are routinely employed in felling decision making, which has financial repercussions owed to the large amounts of waste produced and unnecessary transportation costs. In this study, it is demonstrated that a combination of targeted mobile gamma-ray spectrometry and a newly developed, lead shielded, in situ gamma-ray spectrometry method can significantly speed up the process of characterisation of ¹³⁷Cs wood activity in the field. For the in situ method, Monte Carlo calibration routines were developed alongside spectral processing procedures to unfold spectra collected in the field allowing for separation of ground and tree spectral components. Isolated contributions from the tree could then be converted to activity. The method was validated at a test facility and then demonstrated at three separate sites with differing contamination levels. This technique showed that single trees could be measured within approximately 20% of the activity compared to conventional tree core data. However, some discrepancies were found which were attributed to under sampling using the tree corer and low count rates at the lowest activity site, prompting the need for further data collection to optimise the method. It was concluded that this real-time approach could be a valuable tool for management of contaminated forested areas, releasing valuable timber and ultimately reducing the risk associated with living and working in these areas.

TRIPS 2.0: Toward more comprehensive modeling of radiocaesium cycling in forest

Because internal transfers can play a key role in radiocaesium persistence in trees, a reliable representation of radiocaesium recycling between tree organs in forest models is important for long-term simulations after radioactive fallout in Chernobyl and Fukushima. We developed an upgraded 2.0 version of the initial TRIPS ("Transfer of Radionuclides In Perennial vegetation System") model involving explicit differentiation between tree organs (i.e., foliage, branches, stemwood and bark). The quality of TRIPS 2.0 was evaluated by testing model outputs against independent datasets for pine stands in Belarus and Ukraine. Scenarios involving "hot particle" deposits in forest remained challenging, but in all other scenarios generally positive verification results for soil and tree compartments indicated that the TRIPS 2.0 model adequately combines the major relevant processes. Interestingly, the response of stemwood contamination to changes in radiocaesium availability in soil, as determined by soil conditions, was shown to be more sensitive than for other tree compartments. We recommend the conceptual tree discretization of TRIPS 2.0 for generic forest modeling for two reasons: 1) regardless of different soil conditions, there was concurrent good agreement between simulations and data for individual tree compartments (foliage, branches, stemwood and bark), and 2) the measurements necessary to estimate internal tree transfers are easily accessible to usual field monitoring in forest biogeochemistry (for details, see Goor, F. & Thiry, Y., 2004. Science of the total environment, 325(1-3), 163-180).

Calculation of the effective external dose rate to a person staying in the resettlement zone of the Vetka district of the Gomel region of Belarus based on in situ and ex situ assessments in 2016-2018

The aim of this study was to perform a preliminary assessment of the expected effective dose rate from external exposure to an adult individual staying at that part of the radioactively contaminated territory of the Vetka district of the Gomel region of the Republic of Belarus, from where residents had been resettled after the Chernobyl accident. For this assessment, in summer 2016 and 2018 soil samples were taken from 19 sites located in forests (7 plots), virgin meadows (4 plots), cultivated meadows (6 plots) and vegetable gardens (2 plots), with the subsequent estimation of the inventory and vertical distribution of ¹³⁷Cs in the soil. The values of ¹³⁷Cs inventory in the soil ranged from 452 to 1620 kBq m^-2 (mean = 904 kBq m^-2, median = 964 kBq m^-2). The results of the measurement of soil samples were used to calculate values of the air kerma rate, normalized to the inventory of radioactive caesium in the soil. On average, the normalized indicator of the air kerma rate from the man-made source was higher in forests (1.13 nGy h^-1 per kBq m^-2) compared to virgin meadows (0.95 nGy h^-1 per kBq m^-2). Normalized air kerma rate in cultivated meadows and vegetable gardens was approximately two times lower than the corresponding indicator for virgin meadows. Using a field gamma spectrometer-dosemeter, ambient dose equivalent rate of gamma radiation in the air was measured at the surveyed sites and the contributions of the technogenic and natural components to the dose rate were estimated. Additionally, such measurements were performed on asphalted surfaces (5 sites) and inside two wooden houses. The measured values of the total ambient dose equivalent rate at a height of 1 m above the ground, asphalted surface or house floor varied from 160 to 2260 nSv h^-1. The lowest levels were recorded over asphalted surfaces and inside houses, and the highest ones at forest and virgin meadow sites. The contribution of the technogenic component to the total dose rate varied from 61.9% to 98.8% (mean = 88.9%; n = 26). The effective dose of anthropogenic radiation calculated from the results of in situ measurements in a forest, virgin meadow, cultivated meadow, kitchen garden, asphalted area and house was 0.59, 0.80, 0.34, 0.29, 0.06 and 0.06 μSv h^-1, respectively. Similar values for land plots were calculated based on ex situ analysis of soil samples. It can be expected that, starting from 2020, the average effective external dose of a person staying in the resettlement zone of the Vetka district will not exceed 1 mSv year^-1.

[Current state of antibiotic resistance of pathogens causing community-acquired urinary tract infections in Russia, Belarus and Kazakhstan: results of the international multicenter study Darmis-2018]

OBJECTIVE

To study in vitro activity of antimicrobials against clinical isolates from patients with community-acquired urinary tract infections (UTIs) in different regions of Russia, Belarus and Kazakhstan in 2017-2018.

MATERIALS AND METHODS

A total of 1260 isolates collectedin the Russian Federation, Belarus and Kazakhstanas a part of the international multicenter prospective epidemiological study of the dynamics of antimicrobial resistance of uropathogens causing community-acquired urinary tract infections in different subsets of patients ("DARMIS-2018") were included in the analysis. 1124 strains represented the Enterobacterales order. Uropathogenswere isolated from children and adults of both sexes of all age groups with acute (and recurrences of chronic) community-acquired UTIs including pregnant women with asymptomatic bacteriuriain 34 centers of 26 cities of Russia, Kazakhstan and Belarus in 2017-2018.

RESULTS

Enterobacterales jointly comprised a total of 89,2% of all isolated bacterial pathogens (88,9% in the adult subset; 89,3% in the subset of pregnant women and 91,4% in the subset of children and adolescents under 18). The most prevalent species were Escherichia coli (69,4% in the adult subset; 73,6% in the subset of pregnant women and 77,1% in the subset of children and adolescents under 18) and Klebsiella pneumoniae (11,5% in the subset of adults; 10,4% in the subset of pregnant women and 7,1% in the subset of children and adolescents under 18 years of age). The maximum activity against E. coli among oral drugs demonstrated fosfomycin (97,9% in the adult subset; 95,9% in the subset of pregnant women and 99,1% in the subset of children and adolescents under 18) and nitrofurantoin (97,9% in adult subset; 100% in the subset of pregnant women and 96,3% in the subset of children and adolescents under 18). Out of the parenteral drugs meropenem (out of carbapenems) and amikacin showed the highest activity (99,5% and 97,7% in the adult subset; 99,5% and 99,1% in the subset of pregnant women; 100% and 97,2% in the subset of children and adolescents under 18 years of age, respectively). Ampicillin, amoxicillin/clavulanic acid and trimethoprim/sulfamethoxazole demonstrated the lowest in vitro activity against Escherichia coli (less than 80% for everypatient subset). The susceptibility of E. colito ciprofloxacin was 60,4% in the adult subset; 80,0% in the subset of pregnant women and 80,6% in the subset of children and adolescents under 18. The rate of production of extended spectrum beta-lactamases among E. coli isolates based on the results of phenotypic tests was 21,9%.

CONCLUSIONS

Results of this study indicate the increase of resistance of community-acquired isolates of Enterobacterales and in particular E. coli to the most of antimicrobials in Russia, Belarus and Kazakhstan.

PROFESSIONAL ACTIVITY OF MEDICAL LAWYER

The main aim of the article is a comprehensive study of the theoretical and legal aspects in the context of defining ways of interaction between the professions of lawyer and doctor, to justify the need to assist a medical lawyer and to reveal the main features of his professional activity. To achieve this goal, a comprehensive study of the civil, criminal and administrative legislation of Ukraine regulating the professional activity of a medical lawyer was conducted, the activity of which is aimed at ensuring the proper realization of a person's right to health care, medical care and medical insurance. The results of scientific researches on this subject are analyzed by both Ukrainian scientists and many foreign scientists (USA, Canada, Great Britain, Russia, Belarus, etc.). Different methods of scientific cognition were used during the research. The comparative-legal method made it possible to compare the peculiarities of the legal regulation of the activity of the medical lawyer to Ukraine and other countries. Using the system-complex method, both common and distinct features between the profession of lawyer and doctor were investigated. Based on the dialectical method, it is concluded that there are significant differences in the professional activity of the lawyer and the doctor, and many cases their fields of activity, which leads to the existence of certain ways of interaction between them. Other methods were used in the work, in particular: formal-logical, dogmatic, analysis and synthesis. Based on the conducted research the relation between the professions of the lawyer and the doctor is revealed, which indicates the presence of both several common features and significant differences between them. The main ways of interaction between a lawyer and a doctor are described, in particular, the essence of the most common way of their interaction in the field of jurisprudence is revealed, which is to involve a specialist doctor (usually a forensic expert) to provide an expert opinion. The role and peculiarities of the need for the professional assistance of a medical lawyer are described not only for patients but also for doctors and the medical institution as a whole.

REQUIREMENTS FOR FORMULATING EMULSIONS IN PHARMACY SETTING

The purpose of the study was to substantiate and develop a project of monograph on the liquid dosage form «Emulsions made in pharmacies» for introduction to State Pharmacopoeia of Ukraine. Studies were conducted using analysis of pharmacopoeia rules and technological approaches in different countries for pharmaceutical emulsions. It has used retrospective, logical, systematic and analytical methods. The characteristics of emulsions were generalized and issues of their stabilization were considered. Basic technological approaches to the selection of emulsifiers are determined. The main pharmacopoeia aspects of the regulation of emulsions preparing in pharmacy conditions are examined using the examples of EP, USP, Japanese and the republic of Belarus Pharmacopoeia. A project of monograph "Emulsions made in pharmacies" was proposed to the SPhU for introduction in pharmaceutical practice.

Application of agronomical approaches to rehabilitating territories of the Republic of Belarus affected by the Chernobyl disaster

The environmental radiation pollution resulting from the Chernobyl nuclear disaster in 1986 is one of the main factors limiting agriculture in the eastern regions of Belarus. In the first decade after the accident, the need to mitigate the effects of radiation had a key role in the implementation of countermeasures. As a result, there are widespread areas of high soil fertility potential in the contaminated zone. Today there is a possibility to include new crops (e.g. sugar beet [Beta vulgaris L.]) into regular crop rotation to increase the effectiveness of agriculture and to use the accumulated soil fertility potential. The article discusses a possible agronomic approach to estimating specific fields (working plots) at the scale of agricultural enterprises for placement of sugar beet. The territory of the Mahilyow region of the Republic of Belarus was examined from the perspective of soil suitability to the cultivation of sugar beet. Along with estimating radionuclide accumulation by sugar beet roots, the areas of soils suitable for sugar beet within agricultural enterprises were calculated for selected districts. It was revealed that sugar beet has low ability to absorb radiocaesium and radiostrontium from soils. The contamination density does not restrict the possibility for placement of sugar beet. Instead, soil fertility, specifically content of plant-available phosphorus and boron, was the limiting factor in that. Based on data from field experiments and soil fertility data, a number of enterprises were selected where sugar beet could be included into crop rotations to high economic effect.

Chronicles of nature calendar, a long-term and large-scale multitaxon database on phenology

We present an extensive, large-scale, long-term and multitaxon database on phenological and climatic variation, involving 506,186 observation dates acquired in 471 localities in Russian Federation, Ukraine, Uzbekistan, Belarus and Kyrgyzstan. The data cover the period 1890-2018, with 96% of the data being from 1960 onwards. The database is rich in plants, birds and climatic events, but also includes insects, amphibians, reptiles and fungi. The database includes multiple events per species, such as the onset days of leaf unfolding and leaf fall for plants, and the days for first spring and last autumn occurrences for birds. The data were acquired using standardized methods by permanent staff of national parks and nature reserves (87% of the data) and members of a phenological observation network (13% of the data). The database is valuable for exploring how species respond in their phenology to climate change. Large-scale analyses of spatial variation in phenological response can help to better predict the consequences of species and community responses to climate change.

Knowledge, dentist confidence and management of periodontal patients among general dentists from Belarus, Lithuania, Macedonia, Moldova and Romania

BACKGROUND

Evidence concerning periodontal practice in Eastern European countries is scarce. The aim of the present study was to investigate periodontal risk knowledge, patient management and self-perceived confidence among General Dentists (GDs) from five Eastern European regarding their provision of periodontal care.

METHODS

GDs from Belarus, Lithuania, Macedonia, Moldova and Romania participated in a questionnaire survey. Power calculations were used to identify the sample size for each country. The structured questionnaire included several domains of inquiry. The socio-demographic domain inquired about dentist's age, gender and years of clinical experience. The dental practice domain inquired about practice location, practising or not practising in a group practice and having or not having a periodontist or a dental hygienist in the practice. The distributions of answers across-countries were compared employing one way ANOVA (comparison of means) or Chi square test (comparison of proportions). For each country, the predictors of the study outcomes: a summative knowledge score for periodontal risks and dentist's confidence level were identified employing either linear or logistic multiple regression models.

RESULTS

The sample comprised 390 Belarussian, 488 Lithuanian, 349 Macedonian, 316 Moldovan, and 401 Romanian GDs. The majority of GDs (~ 80%) practiced in urban areas. Age and gender distributions differed significantly among countries. Significant across-country differences were found regarding working/not working in a group practice, having/not having access to a periodontist/dental hygienist and in proportions of patients receiving periodontal treatments or being referred to specialists. None of Macedonian patients nor the majority of Moldovan patients (78%) were referred to periodontists. There were also significant across-country differences in diagnosis, patient management and periodontal knowledge. Only in the Lithuanian cohort were dentists' confidence levels associated significantly with their knowledge. In all countries, taking a medical history was a consistent and significant predictor of having higher periodontal knowledge score. Except in Belarus, periodontal risk assessment was a significantly consistent predictor of certainty levels associated with the provision of periodontal treatments.

CONCLUSIONS

There were substantial differences among GDs in the five countries regarding diagnosis, dentist's confidence and management of periodontal patients.

Seasonal influenza vaccination in middle-income countries: Assessment of immunization practices in Belarus, Morocco, and Thailand

BACKGROUND

Vaccines for the control of seasonal influenza are recommended by the World Health Organization (WHO) for use in specific risk groups, but their use requires operational considerations that may challenge immunization programs. Several middle-income countries have recently implemented seasonal influenza vaccination. Early program evaluation following vaccine introduction can help ascertain positive lessons learned and areas for improvement.

METHODS

An influenza vaccine post-introduction evaluation (IPIE) tool was developed jointly by WHO and the U.S. Centers for Disease Control and Prevention to provide a systematic approach to assess influenza vaccine implementation processes. The tool was used in 2017 in three middle-income countries: Belarus, Morocco and Thailand.

RESULTS

Data from the three countries highlighted a number of critical factors: Health workers (HWs) are a key target group, given their roles as key influencers of acceptance by other groups, and for ensuring vaccine delivery and improved coverage. Despite WHO recommendations, pregnant women were not always prioritized and may present unique challenges for acceptance. Target group denominators need to be better defined, and vaccine coverage should be validated with vaccine distribution data, including from the private sector. There is a need for strengthening adverse events reporting and for addressing potential vaccine hesitancy through the establishment of risk communication plans. The assessments led to improvements in the countries' influenza vaccination programs, including a revision of policies, changes in vaccine management and coverage estimation, enhanced strategies for educating HWs and intensified collaboration between departments involved in implementing seasonal influenza vaccination.

CONCLUSION

The IPIE tool was found useful for delineating operational strengths and weaknesses of seasonal influenza vaccination programs. HWs emerged as a critical target group to be addressed in follow-up action. Findings from this study can help direct influenza vaccination programs in other countries, as well as contribute to pandemic preparedness efforts. The updated IPIE tool is available on the WHO website http://www.who.int/immunization/research/development/influenza/en/index1.html.

EAST SLAVIC SURROGATE MOTHERHOOD: STATE OF LEGAL REGULATION AND RISK OF HUMAN RIGHTS VIOLATION

OBJECTIVE

The aim: The aim of the study is to determine the state of legal regulation of surrogacy in Ukraine, Russian Federation and Belarus, to identify risks of human rights violations, to identify legal and medical mechanisms to combat the exploitation of women, and to outline a portrait of a surrogate mother.

PATIENTS AND METHODS

Materials and methods: The empirical basis is the legislation of Ukraine, Russian Federation and Belarus, which regulates the service of surrogacy, information from the websites of agencies and clinics in this area, as well as personal stories of 41 surrogate mothers, set out in open sources. The following methods were used: dialectical, comparative, statistical, induction and deduction, questionnaire, analysis and synthesis, content analysis.

CONCLUSION

Conclusions: The results of the study clarify both the common features of the legal regulation of surrogacy in the East Slavic countries, and the specifics of each of them; the main problems in the field of its application are outlined; the risks of violation of the rights of genetic parents, children and surrogate mothers are characterized. Legal and medical mechanisms for counteracting the exploitation of surrogate mothers have been identified.

CHALLENGES OF HEALTH CARE PROFESSIONALS' DISCIPLINARY AND CRIMINAL PROSECUTION

OBJECTIVE

The aim of the research is to study the peculiarities of the legislative consolidation of criminal and disciplinary liability for offenses of health care professionals in Ukraine and other states.

PATIENTS AND METHODS

Materials and methods: Criminal legislation of Ukraine, international acts, decisions of the European Court of Human Rights (hereinafter - ECHR), data of the Integrated State Register of Judgments, as well as criminal legislation of Germany, the French Republic, the Kingdom of Denmark, the Republic of Belarus, Kazakhstan and many other countries. A set of general and special scientific methods of scientific knowledge was the methodological basis. The use of the comparative law method has become useful in the analysis of Ukrainian legislation and the legislation of other states.

CONCLUSION

Conclusions: the article examined the features of the legislative consolidation of criminal and disciplinary liability for offenses of health care professionals in Ukraine and other countries. A comparative legal analysis of the legal enshrinement of the corpus delicti in the form of non-performance or misconduct of professional duties by a health care or pharmaceutical worker was carried out on the example of Ukraine and many other countries; types of penalties for medical crimes, which are established for this type of offense, were identified; sanctions for committing a disciplinary misconduct by a health care professional were determined on the example of the legislation of different countries.

LEGAL REGULATION OF EPIDEMIC SECURITY UNDER THE COVID-19 PANDEMIC CONDITIONS IN SOME POST-SOVIET COUNTRIES AND POLAND

OBJECTIVE

The aim: To reveal the features of the epidemic safety and security legal regulation in Belarus, Kazakhstan, Moldova, Poland, Russia and Ukraine during the COVID-19 pandemic.

PATIENTS AND METHODS

Materials and methods: This study is based on Belarusian, Kazakh, Moldavian, Polish, Russian and Ukrainian regulatory acts as well as national court judgments. Such methods as dialectical, comparative, analytic, synthetic, comprehensive, statistical and generalization approaches have been used in the article.

CONCLUSION

Conclusions: the study confirmed that the direct impact on the spread and dynamics of morbidity during the COVID-19 pandemic in the countries to be analyzed is determined by: the presence of government agencies and special institutions involved in combating, preventing and monitoring the spread of infectious diseases and their readiness for effective measures in emergency situations caused, in particular, by epidemics; timeliness and duration of quarantine restrictions, their severity and scope; observance of these restrictions by the population; effectiveness of law enforcement responses to violations. The strengthening of administrative and/or criminal liability had no significant impact on the morbidity situation in the country.

[Longitudinal study of the primary prevention effect on dental caries]

AIM

Assessment of the dental caries prevalence among 12-year-old children in Belarus and Russia and evaluation a possible effect of the primary prevention programs on oral health in adult population.

METHODS

Meta-analysis of the world dental literature and study of the descriptive epidemiology data on the prevalence of dental caries among key age groups of children, adolescents and adults using earlier study data carried in Minsk and Moscow and within the intercountry scientific project using the EGOHID system in 2013-2017 yrs.

RESULTS

Analysis of the epidemiology data on the DMFT of 12-year-old children in the last 40-50 years suggested a trend of the reduction of dental caries prevalence in Belarus and Russia by 10-15%. An effect of the long-term preventive programs on dental caries in adults and elderlies was dubious.

CONCLUSION

The evident success in primary prevention of dental caries in children might improve oral health in adolescents and adult people, however, it had no, or minimal effects on the oral health of elderlies.

Population preferences for breast cancer screening policies: Discrete choice experiment in Belarus

BACKGROUND

Reaching an acceptable participation rate in screening programs is challenging. With the objective of supporting the Belarus government to implement mammography screening as a single intervention, we analyse the main determinants of breast cancer screening participation.

METHODS

We developed a discrete choice experiment using a mixed research approach, comprising a literature review, in-depth interviews with key informants (n = 23), "think aloud" pilots (n = 10) and quantitative measurement of stated preferences for a representative sample of Belarus women (n = 428, 89% response rate). The choice data were analysed using a latent class logit model with four classes selected based on statistical (consistent Akaike information criterion) and interpretational considerations.

RESULTS

Women in the sample were representative of all six geographic regions, mainly urban (81%), and high-education (31%) characteristics. Preferences of women in all four classes were primarily influenced by the perceived reliability of the test (sensitivity and screening method) and costs. Travel and waiting time were important components in the decision for 34% of women. Most women in Belarus preferred mammography screening to the existing clinical breast examination (90%). However, if the national screening program is restricted in capacity, this proportion of women will drop to 55%. Women in all four classes preferred combined screening (mammography with clinical breast examination) to single mammography. While this preference was stronger if lower test sensitivity was assumed, 28% of women consistently gave more importance to combined screening than to test sensitivity.

CONCLUSION

Women in Belarus were favourable to mammography screening. Population should be informed that there are no benefits of combined screening compared to single mammography. The results of this study are directly relevant to policy makers and help them targeting the screening population.

Agency of internal transnationalism in social memory

The article examines the limitations of methodological nationalism in the studies of social memory through a case study of memory of Stalinist repression in Belarus. It analyses how various social agencies - national and local activists, religious organisations, and international foundations - use the memory of repression for constructing post-Soviet Belarusian identity by embedding their national representations in larger transnational frameworks. Drawing on the concept of 'internal globalisation', this article develops the idea of 'internal transnationalism' that suggests the importance of wider transnational configurations for the definition of nation. Internalized transnationalism does not make a national memory concept less nation-centred, but it affects the choice of its cultural, political and civilizational framing. In contrast to methodological cosmopolitanism that implies rediscovering of the national as an internalized global, methodological transnationalism emphasizes the multiplicity of co-existing transnational networks that can be invoked by social actors in their national mnemonic agenda. Using the case of the Kurapaty memorial site the article analyses how multiple framings of memory representations - the Belarusian national memory, liberal anti-communist memory, contesting memories, such as Polish, Baltic and Jewish - compete and juxtapose in the space of social memory of political repression.

Medical error and liability for it in some post-soviet countries (Belarus, Kazakhstan, Moldova, Ukraine)

OBJECTIVE

Introduction: Infliction of harm to life and health due to medical errors is common for the whole world and post-Soviet countries, in particular. The problem of these errors is one of the most important in medical law, although there is no unified concept of it. A small number of sentences in cases of criminal negligence of medical professionals indicates a high latency and often unprovability of this crime in a number of post-Soviet countries. The aim: To disclose the objective and subjective prerequisites of a medical error, reasons for its occurrence, to establish the grounds for criminal liability of medical professionals in case they commit an error and to examine the judicial practice in this regard. Also, to define the concept and types of circumstances exempting criminal liability and their impact on criminal liability issues concerning medical professionals.

PATIENTS AND METHODS

Materials and methods: The study is based on the Belarusian, Kazakh, Moldavian and Ukrainian statutory acts as well as international acts, the European Convention for the Protection of Human Rights and Fundamental Freedoms, case law of the European Court of Human Rights (ECHR), national court judgments. Such methods as dialectical, comparative, analytic, synthetic and comprehensive have been used in the paper.

RESULTS

Review: On the basis of the study, it has been established that there is no unified concept of a medical error, medical personnel are fairly brought to criminal liability only if they commit an unjustifiable error in the presence of all the mandatory elements of a crime provided for in the relevant article of the Criminal Code. At the same time, it is extremely difficult to prove existence of such an error. Besides, at the state levels, causes and mechanisms of occurring errors have not been revealed, they are not even discussed, which makes it impossible to outline measures to prevent them or reduce their frequency and degree of danger.

CONCLUSION

Conclusions: The struggle against medical errors should encompass a number of such activities as standardization of clinical treatment protocols, further education of medical professionals and lawyers in regard to patient safety, thorough investigation of each incident in order to exclude a justifiable error or circumstances exempting criminal liability. Equitable, severe and uncompromising punishments for perpetrators should be an effective means preventing commission of crimes in medicine.

Occupational exposure to metals and other elements in the tractor production

Background

Exposure to metals via air sampling in workplace has been extensively studied; however, the magnitude of individual exposure in various occupational groups may vary dramatically. The aim of this cross-sectional study was to ascertain exposure to selected metals from metal fumes in a series of typical workplaces of contemporary tractor production.

Methods

Ninety-eight (median age 41 (interquartile range (IQR) 23) years, all men) workers from Minsk Tractor Plant were categorized into four groups, including assembly shop workers (group 1); thermal shop staff (group 2); steelmakers (group 3) and welders (group 4). Hair samples (0.25 g) of each worker were tested for Ca, Mg, P, Cu, Fe, Zn, Al, Mn, Cr, Ni, Pb and Cd using atomic emission spectrophotometry. We then tested between-group differences of log-transformed element concentrations using analysis of variance, followed by logistic regression to determine the odds ratio (OR) with its 95% confidence interval (CI) of high exposure for four selected groups.

Results

The median work duration in workers was 6 (IQR 15) years, more in group 1 (10 (IQR 23)). Eight out of 12 included elements yielded significant between-group differences, including Mg, P, Fe, Zn, Mn, Cr, Ni and Cd. Steelmakers had higher Mn hair concentrations (F-ratio 10.41, p<0.001); whereas Fe (F-ratio 12.48, p<0.001), P (F-ratio 12.68, p<0.001), Zn (F-ratio 6.07, p<0.001) and Cr (F-ratio 20.54, p<0.001) were higher in welders. OR of high exposure to Mg in group 3 was 10.00 (95% CI 1.14–87.52), whereas the OR of high exposure to P in group 4 was 18.64 (95% CI 2.22–156.85) compared to group 1.

Conclusions

In the modern full-cycle tractor production, welders may have higher exposure to Fe, P, Zn and Cr, as opposed to steelmakers with higher Mn hair concentrations.