Experimental study on stabilometric complex for terrainkur in overweight people.

Overweight and obesity is a multifactorial, multisystem disease declared a global epidemic by the World Health Organization (WHO) as early as in 1997. At least 30% of the working-age population in Russia is overweight. Only the use of physical activity as an integral (basic) part of obesity treatment and maintenance of the body weight achieved in the course of treatment can achieve durable and long-lasting treatment results as well as significant changes in the body structure (fat/non-fat body weight ratio). Terrainkur (therapeutic walking) is a method of spa treatment that combines climatotherapy and physical therapy. One of the problems in physical activity in obese people is the difficulty they experience in exercising due to the impaired walking pattern caused by imbalances in the muscle chains, including pelvic region, cervical region, which reduces endurance and commitment to physical activity. The study found that the exposure group (Terrainkur) showed lower values of "total fat", "metabolic age", "basic caloric value" compared to initial results and the control group; the exposure group (Terrainkur) showed a decrease in the deviation of the centre of body axis projection from the proper axis, the percentage of non-compliance with the proper fluctuations of the foot underextension. These changes contributed to the elimination of terrainkur restrictions and, as a result, improved the patient compliance during the terrainkur exercises.

Mineral water inhalations for bronchial asthma: a meta-analysis.

Bronchial asthma (BA) is a common disease that contributes significantly to the incidence rate and death rate worldwide. A widespread treatment method is the use of inhalations of mineral waters, with conflicting information about their effectiveness. Purpose of the study was to assess the generalized effect power of the course of inhalations of mineral waters on the disease progress in patients with BA. A search of randomized clinical studies in data bases Pubmed, EMBASE, ELibrary, MedPilot amd CyberLeninka, according to PRISMA strategy, published between 1986 and July 2021. Standardized difference of mean values and their 95% of CI were employed for calculation using the random effects model. The meta-analysis drawing on 1266 sources included 14 studies, with 2 of them being randomized controlled clinical studies, including the results of the treatment of 525 patients. All 14 articles contain a conclusion that the inhalation of mineral water has a positive effect on the course of the disease in patients with BA. The analysis demonstrated that the group of patients after mineral water inhalations, compared with the control group, showed improvement of forced expiratory volume (FEV1), expressed both in % of the norm and in liters. The standardized difference of mean values FEV1 (%) (Hedge's g) was 8.2 (95% CI: 5.87 - 10.59; 100%), FEV1 values (liter.) (Hedge's g) was 0.69 (95% CI: -0.33-1.05). A significant heterogeneity of the results of individual studies was found (Q=124.96; tau2 = 14.55, I2 = 69.13%, p<0.0001 and Q=2.35; tau2 = 0, I2 = 0%, p<0.0001). Patients with mild, moderate, and hormone-dependent BA with a controlled and partially controlled disease course, after mineral water inhalations, compared with the control group, demonstrated a statistically significant decrease in the frequency and intensity of the cardinal symptoms of BA and improvement of FEV1.

Long-term outcomes of different rehabilitation programs in patients with long COVID syndrome: a cohort prospective study.

After the resolution of the acute SARS-COV-2 infection, an important percentage of patients do not fully recover and continue to present several symptoms. Nevertheless, there is a lack of data in the literature on the effects of rehabilitation programs on medium- and long-term long COVID symptoms. Therefore, the aim of this study was to evaluate the long-term outcomes after rehabilitation programs in long COVID syndrome patients. A prospective cohort study was conducted from August 2021 to March 2022, involving 113 patients with long COVID syndrome. The patients in the experimental group (EG, n=25) received a tailored and multidisciplinary rehabilitative program, involving aquatic exercises, respiratory and motor exercises, social integration training and neuropsychologic sessions, LASER therapy and magnetotherapy. Patients in the other three comparison groups received eastern medicine techniques (CG1), balneotherapy and physiotherapy (group CG2), self-training and home-based physical exercise (CG3). Once the several rehabilitation protocols had been performed, a structured telephone contact was made with the patients after 6 months ± 7 days from the end of the rehabilitation treatment, in order to record the frequency of hospital ad-missions due to exacerbation of post-exacerbation syndrome, death or disability, and the need for other types of care or drugs. The patients in the comparison groups were more likely to request therapeutic care for emerging long COVID symptoms (χ2=6.635, p=0.001; χ2=13.463, p=0.001; χ2=10.949, p=0.001, respectively), as well as more likely to be hospitalized (χ2=5.357, p=0.021; χ2=0.125, p=0.724; χ2=0.856, p=0.355, respectively) when compared to the patients of the EG. The relative risk (RR) of hospital admissions in the observed cohort was 0.143 ±1,031 (СI: 0.019; 1.078); 0.580±1,194 (CI: 0.056; 6.022); 0,340±1,087 (CI: 0.040; 2.860). The RR of hospital admissions for patients with long COVID syndrome was reduced by 85.7%; 42.0% and 66.0%, respectively, when the experimental rehabilitation technique was employed. In conclusion, a tailored and multidisciplinary rehabilitative program seems to have a better preventive effect not only in the short term, but also over the next 6 months, avoiding the new onset of disabilities and the use of medicines and specialist advice, than other rehabilitative programs. Future studies will need to further investigate these aspects to identify the best rehabilitation therapy, also in terms of cost-effectiveness, for these patients.

Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes?

A variety of rehabilitation programmes can be offered to Long COVID patients, specifically physical training. Indeed 90% of these patients reports impairments of verticalization, stability and spatial orientation, making difficult exercise in the gym. The aim of our study was to assess the effectiveness and safety of aquatic exercise techniques as part of a comprehensive rehabilitation program for patients with Long COVID. The first of a two-stage program involved development of aquatic exercises technique, which was evaluated in 12 patients with impaired upright posture control before and after exercising by "Habilect" video gait analysis system. During the second phase, effectiveness and safety of aqua exercises were tested in water pool as part of a comprehensive rehabilitation programme conducted in 23 patients with Long COVID outcomes. Physical examination, 6-minute step test, Euro-QL-5D questionnaire, Borg scale, laser Doppler flowmetry, cardiointervalography, and spirometry were performed before and after the aquatic exercises program. After the training with aquatic exercises, indices of deviations of the main body axes of the head and the body mass centre ameliorated, as well as direction of body movement vector decreased (p<0.05). This study demonstrated a statistically significant improvement in exercise tolerance in both groups, as measured by the 6-minute step test after rehabilitation. The comparison group averaged 236.7 metres [126; 380] (T=8, p=0.047) after the rehabilitation course and the intervention group averaged 233.71 metres [150; 320] (T=8.0, p=0.047). When tested with the Euro-QL-5D questionnaire, a post-treatment improvement was noted in the comparison group on the anxiety/depression subscale (3 [3;3] (T=0, p=0.043)). In the intervention group, laser Doppler flowmetry revealed a statistically significant increase in microcirculation (6.36 standard units after rehabilitation) [5.54; 8.17] (T=7.0, p=0.004), and a decrease of oxidative metabolism index of 6.89 standard units. [4.76; 6.96] (T=4.0, p=0.03). No serious adverse events were reported. In conclusion, the developed aquatic exercises technique seems to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern.

Changing diets and traditional lifestyle of Siberian Arctic Indigenous Peoples and effects on health and well-being.

The diet of Indigenous Peoples of North-Western Siberia is characterized by a significant proportion of traditional foods. Eating local products provides a ready-made set of macro- and microelements necessary for life in the challenging conditions of the Arctic. Currently, high consumption of traditional foods is typical in the season of fishing or reindeer slaughter, while out of season the consumption of easily digestible carbohydrates increases. Due to climate change, seasonal fishing and traditional migration routes are disrupted and, therefore, the consumption of traditional foods is decreasing. During 5 years of expeditions, we performed a cross-sectional screening of 985 Indigenous People from three districts of the Yamal-Nenets Autonomous Okrug. We analyzed the seasonality of acquisition and consumption of local reindeer and fish products and studied the traditional food storage among 90 Indigenous fishermen and hunters, who exploit cryostorage. As diet affects health, we studied the benefits of local food. The duration of the consumption season is decreasing and therefore the amount of consumption of local food is decreasing as well. This has adverse effects on health with increasing hypertension dissemination. The creation of stocks of fish and reindeer meat in villages and their year-round sale to the population is a necessary step for ensuring the food security and health of the inhabitants in the region.

Indigenous women's reproductive health in the Arctic zone of Western Siberia: challenges and solutions.

In the Russian Arctic, alarming trends (shortage of nomadic Indigenous women, high reproductive loss, child mortality rates) indicate long-term changes towards demographic decline. This study aimed at comparing some indicators of the reproductive health (childbirth rates, number of pregnancies, pregnancy loss) of Indigenous and non-Indigenous women in the exploration of cultural and social factors influencing reproductive behaviour. A multidisciplinary approach draws on methods of medicine, sociology and health economics. It includes data of the women's reproductive health collected from surveys of 879 women (of whom 627 were Indigenous) during expeditions to the settlements and the tundra of the Yamal-Nenets Autonomous Okrug in 2013-2019. In the tundra, 66.7% of registered Indigenous women's pregnancies resulted in childbirth, 7.8% in induced abortions, 25.5% in spontaneous miscarriage. More than three children were delivered by 59.1% of Indigenous women. Most Indigenous families suffered from high pregnancy loss. Marriage between close relatives was 27.0%. Child mortality equalled 24.4%, three times higher than in the population of the settlements and eight times higher than in families immigrating from other regions. The survival of Indigenous peoples significantly depends on women's reproductive health and sufficient medical service that requires targeted policy.

Food Sovereignty of the Indigenous Peoples in the Arctic Zone of Western Siberia: Response to COVID-19 Pandemic.

This article presents the challenges facing reindeer herding as being both a profitable business and part of the traditional culture of the nomadic Indigenous peoples in the Arctic zone of Western Siberia which addresses substantial needs of the local population. Reindeer herding products are used as traditional nutrition, and as effective preventive means and remedies for adapting to the cold and geomagnetic activity in the High North. Export trends of traditional reindeer products have decreased local Indigenous peoples' access to venison and had a negative impact on their health. Due to the COVID-19 pandemic, it is especially urgent for the Indigenous peoples to have sufficient access to traditional food and be involved in policy decision-making to maintain this traditional business. We aim to analyze the dependencies of Indigenous peoples on the reindeer produce-exporting "food value chain" and explore how (1) the independence of reindeer herders could be increased in these export chains and (2) how provision of their products to local communities could be secured. The study takes a multidisciplinary approach based on policy and socioeconomic analyses with input from medical research. Primary sources include data collected from interviews and surveys of Indigenous peoples during expeditions to the Nyda settlement, the Nydinskaya tundra, the Tazovsky settlement, the Tazovskaya tundra, the Nakhodka tundra, the Gyda and Gydansky settlements, the Yavai-Salinskaya tundra, the Seyakha settlement, the Seyakhinskaya and Tambeyskaya tundras located along the southern coast of the Ob Bay, the northeast coast of the Yamal Peninsula, the Tazovsky and Gydansky Peninsulas, and the Shuryshkarsky district. Data were collected during the summers and winters of 2014-2020.

Improving dialogue among researchers, local and indigenous peoples and decision-makers to address issues of climate change in the North.

The Circumpolar North has been changing rapidly within the last decades, and the socioeconomic systems of the Eurasian Arctic and Siberia in particular have displayed the most dramatic changes. Here, anthropogenic drivers of environmental change such as migration and industrialization are added to climate-induced changes in the natural environment such as permafrost thawing and increased frequency of extreme events. Understanding and adapting to both types of changes are important to local and indigenous peoples in the Arctic and for the wider global community due to transboundary connectivity. As local and indigenous peoples, decision-makers and scientists perceive changes and impacts differently and often fail to communicate efficiently to respond to changes adequately, we convened a meeting of the three groups in Salekhard in 2017. The outcomes of the meeting include perceptions of how the three groups each perceive the main issues affecting health and well-being and recommendations for working together better.

Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study.

BACKGROUND: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. METHODS: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated. FINDINGS: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations. INTERPRETATION: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems. FUNDING: The Lowitja Institute.

Slow Progress In Finalizing Measles And Rubella Elimination In The European Region.

All countries in the World Health Organization European Region committed to eliminating endemic transmission of measles and rubella by 2015, and disease incidence has decreased dramatically. However, there was little progress between 2012 and 2013, and the goal will likely not be achieved on time. Genuine political commitment, increased technical capacity, and greater public awareness are urgently needed, especially in Western Europe.