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

ETHNOPHARMACOLOGICAL RELEVANCE

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

AIM OF THE REVIEW

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

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

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

BACKGROUND AND AIMS

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

DESIGN

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

SETTING

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

PARTICIPANTS

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

MEASUREMENTS

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

FINDINGS

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

CONCLUSIONS

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

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

A cross-sectional descriptive study design was used.

SETTINGS AND PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

INTERPRETATION

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

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

OBJECTIVES

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

DESIGN AND PARTICIPANTS

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

SETTING

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

OUTCOME MEASURES

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

RESULTS

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

CONCLUSION

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

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

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

CONCLUSION

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

OBJECTIVES

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

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

BACKGROUND

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

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

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

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

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

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

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

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

AIM

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

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

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

Sources of marital conflict in five cultures

This analysis of previously collected data examined four fitness-relevant issues for their possible role in marital conflict. These were sex, finances, division of labor, and raising children, selected in light of their pertinence to sex differences in reproductive strategies. Over 2,000 couples in five diverse cultures were studied. Marital conflict was assessed by the Problems with Partner scale, which was previously shown to demonstrate measurement invariance across cultures and genders. All four issues were significantly related to perceived marital problems in almost all cases. Thus, conflict tended to arise around issues relevant to reproductive strategies. A few cultural idiosyncrasies emerged and are discussed. In all cultures, wives reported more problems than husbands. Another important issue was kindness. The results suggest that a key factor in marital success or failure may be kindness necessary to sustain this prolonged and intimate relationship of cooperation for raising one's offspring.

DESCRIPTION OF GASTROESOPHAGEAL REFLUX DISEASE IN DIFFERENT ETHNIC GROUPS, LIVING IN THE NORTH

INTRODUCTIOD: Over the past 15 years, the relative frequency of detection of erosive form of GERD has increased from 3,1 to 16%. Manifestations of GERD in different ethnic populations of Yakutia are not well understood.

AIM

Studying kliniko-endoscopic and the morfofunktsionalnykh of features of GERD in various ethnic groups living in conditions of Yakutia.

MATERIALS AND METHODS

The study included 168 patients with GERD of different ethnic origins. Yakuts, Evens and Evenks, were considered as indigenous people and newcomers were all persons of other nationalities, who arrived at different times from other regions of Russia. The average age was 41.75 ± 24.73 years.

RESULTS

Clinical manifestations of GERD in different ethnic groups living in Yakutia. Leukoplakia of the esophagus was detected in the indigenous population are four times more likely than newcomers. With GERD associated with thyroid disorders prevalent low level of contamination of Helicobacter pylori. Helicobacter pylori infection in patients with GERD in Yakutia was higher among immigrants than among the indigenous, with a high degree of contamination of Helicobacter pylori was detected more frequently in immigrants than among the indigenous. Pathological gastroesophageal reflux during the daily pH-metry of the esophagus was detected more frequently in patients visiting than among the indigenous.

CONCLUSIONS

The found features of a current of GERD can be further the basis for the individualized and differentiated approaches to treatment of this disease.

THE ROLE OF VIRAL HEPATITIS IN THE MECHANISM OF LIVER CANCER FORMATION AMONG THE FAR NORTH INDIGENOUS INHABITANTS

INTRODUCTION

Yakutia is a region of high prevalence of viral hepatitis B, C and D. The rating and ranking of risk factors for the formation of cirrhosis and primary liver cancer in patients with chronic viral hepatitis (CVH) B, C and D in the Republic of Sakha (Yakutia) (R S(Y)), it is a serious medical problem.

AIM

Studying of the main reasons for the progression of chronic viral hepatitis B, C and D to cirrhosis and liver cancer in the Far North.

MATERIALS AND METHODS

Materials of official statistics of theTerritorial Rospotrebnadzor and official registration of the Ministry of Health of RS (Y); serological and molecular biological research methods to the studying of HCV genotype B, C, D.

RESULTS

On the basis of long-term morbidity of chronic viral hepatitis B, C and D and their outcomes in Yakutia defined a role in the progression to cirrhosis and primary liver cancer, ethnicity and genotype of HBV and HDV. Established fact of viral replication in cirrhosis and primary liver cancer under adverse social and environmental factors, genetically determined increased concentration of acetaldehyde due to impaired activity of alcohol dehydrogenases (ADH) and aldegiddegirogenases (AIDG) at the indigenous inhabitants of the republic proves the need for targeted therapy of complex events.

CONCLUSIONS

The regions of Yakutia are the most affected by the virus of hepatitis B, C and D with progressive course of the disease to cirrhosis and cirrhosis liver cancer, defined by genotype hepatitis B & D, in which significantly usually occurs primary liver cancer, also noted that the combined mixed-replicating virus hepatitis is a risk factor for primary liver cancer.

CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF THE CHRONIC GASTRITIS WITH FUNCTIONAL DYSPEPSIA IN THE REPUBLIC OF SAKHA (YAKUTIA)

INTRODUCTION

Chronic gastritis with syndrome, functional dyspepsia (SFD) is one of the most pressing problems in medicine. Certain scientific and practical interest is the elucidation of the frequency and clinical manifestations of functional dyspepsia in patients hospitalized in the gastroenterology department YAGKB and frequency combinations of chronic gastritis (including H. pylori) with functional dyspepsia.

AIM

The aim of the study was to investigate the clinical and morphological features of the chronic gastritis with syndrome pattern of functional dyspepsia in native-born and people of the Republic of Sakha (Yakutia), and to assess the effectiveness of treatment, depending on the gastric acid and H. pylori.

MATERIALS AND METHODS

This study examined 105 patients with functional dyspepsia, including 41 patients with epigastric pain syndrome and 64 patients with postprandial distress syndrome. Considered groups of patients were homogeneous for age, gender, by ethnicity. Of the 105 patients included in the study, I group were 57 indigenous people (80% of them--Yakutia), 11 group--48 people visiting (Caucasians).

RESULTS

Clinical presentation and course of chronic gastritis with functional dyspepsia in the Republic of Sakha (Yakutia) have a number of distinctive features: epigastric pain syndrome occurs in 26.8% of patients and 73.2% of the indigenous population of the visitor, the intensity of pain in the root is much lower than that of visitors--12 and 85% respectively. Postprandial distress syndrome was diagnosed in 71.9% of patients and 28.1% of the indigenous newcomers. At endoscopy in all patients with functional dyspepsia diagnosed chronic gastritis. The native inhabitants of the most common mixed gastritis (54.5%), the newcomers--superficial gastritis (66.7%).

CONCLUSIONS

The found features of a current of functional dyspepsia can be further the basis for the individualized and differentiated approaches to treatment of this disease.

GASTROESOPHAGEAL REFLUX DISEASE IN ASSOCIATION WITH LIPID-METABOLIC INDICATORS AT THE YAKUTSK

AIM

To estimate interrelations of gastroesophageal reflux disease with lipid-metabolic indicators at the Yakutsk.

MATERIALS AND METHODS

A one-stage investigation of 100 patients of the Yakut nationality with gastroesophageal reflux disease (GERD) is carried out. For estimating the association of GERD clinical symptoms with lipid-metabolic indicators a method of binary logistical regress with compulsory inclusion of predictors has been used.

RESULTS

According to results of the comparison most statistically significant distinctions of metabolic indicators are revealed at GERD esophageal (eructation) and extra-esophageal symptoms (night cough), dyspepsia (distention, epigastric heaviness), as well as snoring. Logistical regression analysis has confirmed interrelation of clinical symptoms with lipid-metabolic indicators, as waist circumference, a level of arterial pressure and blood lipid (triglycerides, lipoprotein cholesterol of low and high density).

CONCLUSIONS

Thus, the estimation of interrelation of GERD clinical symptoms with MS criteria at the Yakutsk has revealed the influence of MS components, especially abdominal adiposity, arterial hypertension and triglycerides on the development of dyspepsic symptoms (distention, epigastric heaviness), GERD esophageal (eructation) and extra-esophageal manifestations (night cough).

CHARACTERISTIC OF ACTUAL FOOD AT ELDERLY AND SENILE AGED POPULATION OF YAKUTIA

AIM

To conduct estimation of actual food among in digenous and arrived population of Yakutia of elderly and senile ages.

MATERIALS AND METHODS

In the work results of epidemiological research with analysis of actual food of the population of Yakutia at the age of 60 years and over are presented. On the basis of a list of candidates with use of random selection a representative sample of men and women of Yakutsk at the age of 60 years and more has been generated. In total 775 foreheads were surveyed, the middle age has made 75.7 ± 9.4 years. For the analysis of actual food 575 people (244 men and 331 women) have been included. Among the surveyed there were 244 respondents of the in digenous population (the Yakuts) and 331 arrived respondents (the Russians, the Ukrainians, the Byelorussians, the Poles, the Germans, the Jews). The estimation of actual food is conducted by means of a frequency questionnaire.

RESULTS

High content of general fat, sated fat acids, polyunsaturated fat acids and refined sugar due to low consumption of general carbohydrates is revealed. At the analysis of food package of the indigenous population in comparison with the newly arrived some distinctions in consumption of following products are revealed: fresh, tinned and frozen vegetables, potatoes, eggs, horsemeat, venison, koumiss, fresh fruit and berries, oil and fats, bean, juice and drinks, sugar, chocolate and confectionery products.

CONCLUSIONS

daily food intake of the indigenous population of elderly and senile ages is notable for lower daily caloric content, greater general fat, SFA, less consumption of refined sugar on the background of significantly lower content of general carbohydrates, starch and food proteins. In diets at theYakuts there is considerably lower consumption of fresh and tinned vegetables, potatoes, eggs, fresh fruit and berries, bean, nuts, sugar, chocolate and confectionery products and higher consumption of meat products (horsemeat, venison), oil and fats.

CONTRIBUTION OF CEREBRAL VASCULAR ANOMALIES IN HEMORRHAGIC STROKE STRUCTURE IN DIFFERENT RACIAL GROUPS OF YAKUTIA

INTRODUCTION

Hemorrhagic stroke (HS) has higher incidence in Asian population compared to Caucasian. The reason for this phenomenon is not clearly understood.

AIM

To investigate the contribution of cerebral vascular anomalies in hemorrhagic stroke structurein different racial groups of Yakutia.

MATERIALS AND METHODS

The study group included 1078 consecutively hospitalized patients with acute HS. A comparative analysis of demographic data and frequency of CVA, which were identified as a cause of HS, was carried out between the group of indigenous patients of Asian race and the group of Caucasian patients.

RESULTS

The proportion of hemorrhage due to rupture of cerebralarterial aneurysms (CAA) in the hospital HS structure was higher in Asians, compared to Caucasians (p = 0.001; OR = 1.7; 95% CL: 1.2-2.4). No difference in the arteriovenous malformations' (AVM) frequency was found between groups (p = 0.345), as well as in age and gender distribution (p = 0.052 and p = 0.759, respectively). The CAA frequency was higher among female patients compared to male in both racial groups (p < 0.0001; OR = 1.71; CI 95% 1.3-2.3).

CONCLUSIONS

In Yakutia, the proportion of hemorrhage due to rupture of cerebral arterial aneurysmsin hemorrhagic stroke structure is higher among indigenous ethnic group of Asian race, compared to Caucasians. No difference in the arteriovenous malformations' frequency was found between racial groups, as well as in age and gender distribution. The cerebral aneurisms' frequency was higher among female patients compared to male in both racial groups. Further studies of cerebral vascular anomalies and stroke risk factors using a population-based data in different racial groups are needed.

FEATURES OF CLINICAL-FUNCTIONAL MANIFESTATIONS OF CHRONIC OBSTRUCTIVE LUNG DISEASE IN COMBINATION WITH METABOLIC SYNDROME IN ETHNIC GROUPS OF THE YAKUTS AND THE RUSSIANS

AIM

Studying features of clinical-functional manifestations of chronic obstructive lung disease in the combination with metabolic syndrome in the Yakut ethnic group.

MATERIALS AND METHODS

The basic group consisted of 39 patients of Yakut nationality with chronic obstructive lung disease (COLD) in the combination with metabolic syndrome (MS), middle age of them being 53.4 ± 1.17 years. The comparison group comprised 40 patients of Russian nationality with COLD and MS with middle age 53.1 ± 1.21 years. Features of clinical manifestations and respiratory functions are studied.

RESULTS

Cough and sputum were noted in dynamics for 3 years by 64.1% of Yakut patients and 85% of the Russians, p = 0.033; the intensity of cough was marked at 30% of patients of Russian nationality and 15.4% of patients of the Yakut nationality, p = 0.01 6. The morning sputum and daily sputum within 3 months a year at the Russians in comparison with the Yakuts was marked in 95 % vs 74,4 %, p = 0.011; 80.0% vs 56.4% p = 0.024, accordingly. According to Medical Research Council (mMRC) Dyspnea Scale (Mahler et al., 1985) dyspnea has been 2.2 ± 0.09 points atthe Yakuts vs 2.7 ± 0.09 points at Russian, p = 0.002. At patients of the Yakut nationality more often exacerbations were registered 2 times a year (53.8%), at patients of Russian nationality noted 3 times a year (55%). Respiratory function manifestations have been at patients of the Yakut nationality with COLD and MS, in comparison with similar Russian patients: forced expiratory volume for a first second (FEV,) - 64,0+2,30 % vs 56,8?2,69 %, p = 0,026; forced vital capacity of lungs (FVC) - 65,0?2,45 vs 65,0?3,70, p = 0.733; FEV1/FVCL ratio being 102.5 ± 2.81 vs 87.3 ± 3.30, p = 0.000, accordingly.

CONCLUSIONS

Regardless of ethnicity the phenotype "D" has higher prevalence rate of clinical phenotype COLD in the combination with metabolic syndrome, thus at the Russians the clinical COLD is characterized by severe clinical manifestations in comparison with theYakuts, and also in both ethnic groups expiratory dysfunctions in the form of decreasing FEV1, decreasing FVC and increases of ratio FEV1/FVC > 70% are marked.

EPIDEMIOLOGICAL FEATURES OF CHRONIC VIRUS HEPATITIS B AND C IN THE REPUBLIC SAKHA (YAKUTIA)

High disease burden of chronic virus hepatitis B and C of population in the Republic Sakha (Yakutia) is subject to referring it to endemic territories due to these infections. For a 15-year-old period the disease has been registered at higher rates in the Russian Federation.

THE ANALYSIS OF MAJOR RISK FACTORS OF CARDIOVASCULAR DISEASES AMONG INHABITANTS OF THE NORTH REGION

Last years the problem of organism's adaptation to severe climate-environmental conditions of the Far North has been intensively developed. The Republic of Sakha (Yakutia) is the most northern republic of the Russian Federation. People have created a unique way of life, language, original culture on this cold part of the earth and have carried centuries later. This unique experience has been saved up throughout many centuries and generated in natural environment of habitation and passed from generation to generation. Last years the changes of living conditions of indigenous population, urbanization and globalisation, deterioration of ecological conditions exhausted reserve possibilities of organism. Among the indigenous population health change has menacing character, especially among the children's population. The analysis of major risk factors of the development of cardiovascular diseases among the indigenous population of the north has been carried out in this research.

[Genetic characterization of populations of the Volga-Ural region according to the variability of the Y-chromosome]

An analysis of genetic diversity in nine ethnic groups of the Volga-Ural region was carried out using 15 biallelic loci in the nonrecombining region of the Y-chromosome. The major Y-chromosome haplogroups in the region are R1a-M198, R1b-M269, and N-M231. It was found that Bashkirs show the greatest difference from other populations of the Volga-Ural region according both to F(st) and to the principal component analysis. In addition, analysis of the frequency distribution of Y-chromosome haplogroups was carried out in the Besermyan population, which was not studied previously from the Y-chromosome perspective. The results of this study revealed the predominance of haplogroup N-M231 (54.7%) in this ethnic group, which may indicate the prevalence of the Finno-Ugric component in the formation of the patrilineal component in the gene pool of the Besermyan ethnic group.

THE ROLE OF MEDICAL AND SOCIAL FACTORS IN PREDICTING DISABILITY TUBERCULOSIS

In persisting study are considered social, epydemiological and clinical features by sick tuberculosis lungs with for the first time installed by disability. On the grounds of got result are revealled main criteria of the forecasting to disability on tuberculosis lungs. Disability of pulmonary tuberculosis is an important medical and social problem and is dependent on the social and clinical factors. The study of disability reveals the main reasons for poor prognosis in tuberculosis, which leads to a more chronic course with frequent exacerbations and relapses. In Russia, the dynamics of disability for tuberculosis does not tend to decrease. Unfavorable epidemiological disability tuberculosis remains high in the structure of the primary disability in Yakutsk and Sakha (Yakutia) (2.8%, 2.5% - respectively).

POLISH STUDIES OF THE MEDICAL TRADITIONS OF THE AINU

Present knowledge of the history of Ainu culture is owed in significant part to Polish Far-East researchers Bronisław Piłsudski (1866-1918) and Wacław Sieroszewski (1858-1945). They were both exiled to Siberia for their patriotic activity at the time where Poles struggled for independence. Bronisław Piłsudski is known for using glass photographic plates and wax recording cylinders for recording the already disappearing culture of the Ainu people. It is thanks to his research that we are able today to trace back the names of over 100 plants that had therapeutic, and as believed by Ainu, also magical power. The plants with the highest therapeutic significance had common characteristics: strong effects, intensive scent and stings. Nowadays, the Ainu people constitute an ethnic minority in Japan (population of over 20 000) and are supported by the Center for Ainu and Indigenous Studies at the Hokkaido University in Sapporo.

GENDER FEATURES OF THE ANTHROPOMETRIC, CEPHALOMETRIC AND BIOIMPEDANCE PARAMETERS IN THE STUDENTS OF YAKUTIA

To establish the anthropo-ecological portrait of the current population of Yakutia, it is necessary to study the regularities of the variability of physical status in different gender groups and develop regional standards of the physical development of different age-sex groups of the population with regard to the peculiarities of the environment. The aim of this study is to do research on the gender features of anthropometric, cephalometric and bioimpedance parameters in the students of Yakut ethnicity. The measures of 228 Yakut girls and 168 Yakut youths born and permanently resident in Yakutia were analyzed. Anthropometric measurements were performed using the method of V.V. Bunak (1941), somatotyping--using the Rees-Eysenck index (1945). Head type was determined by the cephalic index, face type--by the upper facial index. Bioelectrical impedance analysis with the use of ABC--01 Medass analyzer was performed to estimate body composition. Adipose tissue mass (AM), skeletal muscle mass (SMM), lean mass (LM), active cell mass (ACM) and phase angle (PA) were determined. Obtained material was processed by the method of variation statistics with the use of SPSS 17.0 software package. Overall measures of the soma of the examined groups have gender features of body organization that are expressed in the significantly higher values of all measured parameters in the youths of Yakutia. In our study, the sexual dimorphism in the distribution of somatotypes by the Rees-Eysenck index has not been identified. The analysis of cephalometric measures has revealed reliably higher parameters of absolute head sizes in the youths. Gender differences in the distribution of head and face types have not been found in the examined ethno-age group. Significantly larger absolute amount of AM has been established in the girls. The measures of SMM, ACM and LM are reliably higher in the youths. The values of active and reactive tissue resistance are reliably higher in the girls. Gender features of the anthropometric, cephalometric and bioimpedance parameters of the students have been established. The conducted study presents the anthropo-ecological image of this age-sex group of the population of Yakutia.

BREADTH SPREADING OF VIRAL HEPATITIS MARKERS IN THE RISK GROUPS IN THE REPUBLIC OF SAKHA (YAKUTIA)

INTRODUCTION

Republic of Sakha (Yakutia) is a hyperendemic region of Russian Federation for spreading of parenteral viral hepatitis B, C and D. In risk groups of these diseases are firstly medical personnel, who contacting with infection carriers including latent infections family and members of families of chronic viral hepatitis carriers.

AIM

To reveal the breadth of spreading of viral hepatitis markers in the risk groups.

MATERIALS AND METHODS

The level of HBV- and HC- infection were determined in medical staff of large multi specialty hospital and family members of people with viral hepatitis B and C. Epidemiological, clinical, serological and molecular biology methods of viral hepatitis diagnostics were applied in this study.

RESULTS

Results of this study showed that the staff at surgery and hematology departments and all nursing staff belong to the high-risk of HBV-infection groups. Therefore, they are a priority for active immunization. Attention is paid on the fact that infectivity of medical staff is not equally distributed in dependence on type of department and position of medical staff. Rate HBV-marker detecting in "family hearths" was dependent on degree of interrelationship with infection source. According received information, in families of patientwith chronic hepatitis B spreading of infection was higher (77.6%) then in families of patients with acute hepatitis B (39.7%). At primary examination of families an anti-HCV was detected in 9.3 ± 1.8% cases, i.e. the spreading of HCV was at low-activity.

CONCLUSIONS

Results of our study on spreading of hepatitis B and C in Yakutia showed the high rate of appearance of HCV and HBV markers in the risk groups.

REGIONAL TRENDS IN THE WORKING-AGE POPULATION MORTALITY RATE IN THE REPUBLIC OF SAKHA (YAKUTIA) IN 1990-2012

Regions of the Russian Federation differ in climatic-geographic, medical-demographic and social-economic situations. One of the regions with distinct peculiarities is the Republic of Sakha (Yakutia). Ranking first by the territory (3,103.2 thousand sq x km), Yakutia is on the 81th place by the population density among regions of the Russian Federation (0.3 people per 1 km2).Yakutia is one of the most isolated and inaccessible regions of the world: 90% of the territory lacks all-the-year-round transportation. Regions of the republic, as well, differ significantly in the climatic conditions and the levels of social-economic development, which influences the population health indicators, including mortality. This survey aimed to study the trends of mortality in the working-age population in different groups of regions. To do this, basing on the statistical data, we compared the levels, trends and structure of mortality in 1990-2012. It was established that the different groups of regions show a significant variation in the working-age population mortality, depending on the social-economic conditions. Since 2000, the Arctic group of regions has demonstrated higher mortality in working-age men and women, especially of cardiovascular and digestive system diseases, and external causes. Lying beyond the Arctic Circle, these regions have severe conditions and a relatively low level of social-economic development. As for the rural regions, despite the relatively favourabe situation, they also show a high level of mortality of external causes. The industrial regions are characterized by higher social-economic development, better transport infrastructure, a satisfactory material base of medical institutions. They also have sufficient resources of health institutions, including the staff and modern equipment for treatment and diagnostics, as well as, which is critical, the full range of medical specialists. Thus, these regions demonstrate lower population mortality; however, there is still mortality of infectious diseases, neoplasms, and respiratory diseases.

THE PREVALENCE OF CHRONIC VIRAL HEPATITIS IN CHILDREN AND ADOLESCENTS IN YAKUTIA

Chronic hepatitis in children represents a serious health and social problem. Under the conditions of the high prevalence of viral hepatitis in Yakutia epidemiological process has a number of peculiarities. In children chronic hepatitis often occurs with minor clinical manifestations, which complicate diagnosis. The study of the epidemiological, clinical and laboratory data is an important task.The aim of the study was to investigate the epidemiological characteristics of chronic hepatitis in children and adolescents living in hyper-endemic region.

MATERIALS AND METHODS

The study included 1568 patients'data, registered in the dispensary with a diagnosis of chronic hepatitis in the period from 2000 to 2012. Epidemiological history data of 304 patients with chronic hepatitis were analyzed. The data from official statistics were used for epidemiological analysis. Processing of clinical and laboratory studies was performed using the statistical package IBM SPSS STATISTICS 19.

RESULT

CH epidemiological features were identified, including the prevalence of HBV-infection in etiological structure, the high incidence of the disease among the indigenous population, a high risk of intra-familial infection with hepatitis B virus , high frequency of perinatal infection with hepatitis C virus. It was proposed to maximize screening tests for markers of viral hepatitis and to improve quality control of vaccination.

CONCLUSIONS

The epidemic process of viral hepatitis in children and adolescents in Yakutia is characterized by domination of HBV-infection in the structure of chronic hepatitis. The predominance of the indigenous nationalities among patients with chronic hepatitis B and the leading role of family contact in the routes structure of infection transmission indicates the importance of ethnic and social factors in contraction of the disease.

[The basic medical demographic indicators of population health of Russia up to 2013]

The actual medical demographic situation in Russia is characterized by positive trends of natality and mortality. At that, deepening of habitation differences in rate of lethal outcomes at the first year of life and gender differences in level of mortality at able-bodied age is established.

[Features of the Udmurt mitochondrial gene pool in relation to tribal structure]

We present novel data on mitochondrial DNA polymorphism in the Udmurt population, which represents a Finno-Ugric ethnos residing in the Volga-Ural region. Our analysis of the Udmurt mtDNA polymorphisms have shown that neighboring ethnoses had almost no effecton formation of the Udmurtian intraethnic diversity. These results strongly indicate that genetic differences in the Udmurtian population are determined by their tribal structure rather than their geographic location.

[Characteristics of migration in the population of Yevpatoria (Crimea)]

Indicators characterizing population migration were calculated according to the marriage records of Yevpatoria (Crimea) of 1960/1961, 1985, and 1994/1995. The marital migration coefficient m in those years was 0.80, 0.75, and 0.66, the endogamy index was 0.04, 0.08, and 0.15, and the rate of marriage contingency by birthplace was 0.15, 0.16, and 0.19, respectively. The highest values of the positive mating assortative index were recorded for people from the Caucasus, Central, Central Black Earth Oblast, and Northwest regions of Russia in 1960/1961 and for migrants from Moldavia, the republics of Central Asia and Caucasus, Western Siberia, and Ukraine in 1985. In 1994/1995, natives of Yevpatoria were also included in this group. The average distance of migration by year was 909, 1280, and 1314 km, and the marital distance was 960, 1397, and 1171 km. The "radius" of the Yevpatoria population, in accordance with the Maleco model in the years under study, was 98, 134, and 137 km. The distance isolation indicator b was decreasing and amounted to 0.00049, 0.00043, and 0.00038. Inthe migration flow in all of the periods, the majority of immigrants came from different regions of Ukraine outside Crimea (27-31%), followed by natives of various places in Crimea (21-24%.), Central (3.6-8.5%), and Central Black Earth (1.8-6.1%) regions of Russia, and the South Caucasus (4.0-5.7%). The proportion of Russians and Jews decreased in the migration flow, while the proportion of Ukrainians and representatives of non-Slavic nationalities increased.

Developing Culturally Targeted Diabetes Educational Materials for Older Russian-Speaking Immigrants

PURPOSE

Older adults who immigrate late in life face many challenges adapting to a new country. Immigrants bring their cultural beliefs and behaviors with them, which can influence their ability to make dietary changes required when they have type 2 diabetes. Culturally targeted patient education materials are needed to improve immigrants' health literacy and abilities to self-manage diabetes. Currently, there is a scarcity of diabetes patient education materials to meet the educational needs of the Russian-speaking immigrant group. The purpose of this article is to describe a project in which culturally targeted diabetes education materials for older Russian-speaking immigrants were designed and developed.

CONCLUSIONS

Culturally targeted patient education materials are essential if they are to be accepted and used by clients from different ethnic minority populations. The creation of culturally relevant materials requires a team effort and community stakeholder input. The availability of materials on the internet facilitates access and use by health care providers. Culturally targeted education materials are an important component in addressing health literacy in ethnic minority populations. Next steps require that these materials be evaluated to test their impact on diabetes self-management behaviors and clinical outcomes such as adherence, amount of physical activity, and blood glucose levels.

Nativity, language spoken at home, length of time in the United States, and race/ethnicity: associations with self-reported hypertension

BACKGROUND

Characterization of health conditions in recent immigrant subgroups, including foreign-born whites and Asians, is limited but important for identifying emerging health disparities. Hypertension, a major modifiable risk factor for cardiovascular disease, has been shown to be associated with acculturation, but the acculturative experience varies for different racial/ethnic groups. Assessing the impact of race/ethnicity on the relationship between acculturation-related factors and hypertension is therefore of interest.

METHODS

Data from the 2005-2008 waves (n = 36,550) of the NYC Community Health Survey were combined to estimate self-reported hypertension prevalence by nativity, language spoken at home, and time spent in the United States. Multivariable analyses were used to assess (i) the independent associations of acculturation-related factors and hypertension and (ii) potential effect modification by race/ethnicity. Sensitivity analysis recalibrating self-reported hypertension using measured blood pressures from a prior NYC population-based survey was performed. Prevalence was also explored by country of origin.

RESULTS

Being foreign vs. US born was associated with higher self-reported hypertension in whites only. Speaking Russian vs. English at home was associated with a 2-fold adjusted odds of self-reported hypertension. Living in the United States for ≥10 years vs. less time was associated with higher self-reported hypertension prevalence in blacks and Hispanics. Hypertension prevalence in Hispanics was slightly lower when using a recalibrated definition, but other results did not change substantively.

CONCLUSIONS

Race/ethnicity modifies the relationship between acculturation-related factors and hypertension. Consideration of disease prevalence in origin countries is critical to understanding health patterns in immigrant populations. Validation of self-reported hypertension in Hispanic populations is indicated.

[South African tick bite fever in a group of Russian tourists]

The paper describes a clinical case of South African tick bite fever in a group of Russian tourists. The group of 5 people who had been ill with this disease after a tourist trip to the South African Republic (the Kruger National Park in the north-eastern province of Mpumalanga) were followed up. During their trip, all of them were bitten by different insects many times. The disease exhibited different clinical presentations; however, all the patients were noted to have a fever with slight intoxication and a maculopapular rash at different sites of the body; 3 had lymphadenopathy and one had a primary effect at the site of tick sticking. The diagnosis was verified by indirect immunofluorescence for the detection of high titers to Rickettsia conorii. The course of the disease was favorable in all the patients treated with antibiotics (doxycycline or ceftriaxone).

[Analysis of a GSTM1 gene deletion in the context of the GSTM genomic cluster diversity in three Russian populations]

A total of 16 to 60% of individuals in human populations are homozygous with respect to a deletion of the Glutathione-S-transferase M1 gene. In this study, we evaluated the relationship between the GSTM1 gene deletion and genetic diversity of the GSTM cluster, which includes this gene, in three Russian populations. The study was based on the comparison of the haplotype distribution in two groups of individuals subdivided accordingly to the presence of the deletion. The first group included individuals with completely deleted GSTM1 gene, and the second group comprised individuals having at least one functional variant of GSTM1 gene. The analysis of the haplotype frequencies in groups revealed no specificity in their distribution both within the populations and between them.

Orthographic learning and self-teaching in a bilingual and biliterate context

The aim of this study was to examine self-teaching in the context of English as a foreign language literacy acquisition. Three groups comprising 88 sixth-grade children participated. The first group consisted of Russian-Hebrew-speaking bilinguals who had acquired basic reading skills in Russian as their first language (L1) and literacy and who were literate in Hebrew as a second language. The second group consisted of Russian-Hebrew-speaking bilinguals who had not learned to read in their native Russian but had acquired Hebrew as their first literate language. The third group consisted of Hebrew-speaking monolingual children who were literate in Hebrew. This design facilitated examining the effect of biliteracy and bilingualism on basic English reading skills. We hypothesized that due to the proximity between the Russian and English orthographies as opposed to the Hebrew-English "distance," the Russian-Hebrew-speaking biliterate group who acquired basic reading and spelling skills in L1 Russian would have superior self-teaching in English as opposed to the two other groups. The standard two-session self-teaching paradigm was employed with naming (speed and accuracy) and orthographic choice as posttest measures of orthographic learning. Results showed that after 4 years of English instruction, all three groups showed evidence of self-teaching on naming speed and orthographic recognition. The Russian-Hebrew-speaking biliterate group, moreover, showed a partial advantage over the comparison groups for initial decoding of target pseudowords and clear-cut superiority for measures of later orthographic learning, thereby showing self-teaching while supporting the script dependence hypothesis.