Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus.

PURPOSE: Mental health-related stigma affects people with mental disorders and their families. We aimed to investigate the experience of stigma among relatives of patients with schizophrenia in Belarus and formulate recommendations for anti-stigma interventions. METHODS: We conducted and thematically analysed 20 interviews with relatives of people diagnosed with schizophrenia. Experience of discrimination, strategies to cope with it, and requests for interventions were examined. RESULTS: A number of themes related to the experience of stigma in the public life of relatives of people with schizophrenia were elicited in relation to: (1) mental health care (difficulties in contacting mental health professionals; in getting appropriate information; lack of alternatives to hospital treatment; absence of appropriate long-term care services); (2) employment of people living with schizophrenia and (3) contact with the police. Analysis of the strategies used to overcome difficulties revealed resignation and passive acceptance, self-reliance, and emotional containment during crises. Despite the passivity and scepticism in expressing needs, participants suggested a number of interventions that could reduce the burden of stigma. CONCLUSIONS: With respect to the public domain of life, substantial stigma and discrimination perceived by families of people living with schizophrenia in Belarus is associated with structural issues of the country's mental health care system. To reduce the stigma-related burden, action must be taken to: (1) educate and support families and (2) deal with structural issues, by reorganising mental health services to better meet the needs of the families of people diagnosed with schizophrenia, and by including them in decision making at all levels.

[Genetic demography of populations of three megalopolises in relation to the problem of creating genetic databases].

Based on data collected from urban residents by questionnaire, the basic parameters of the genetic-demographic structure of populations of the three megalopolises, i.e., Moscow, Kharkov, and Minsk, have been calculated, including the migration coefficients and their dynamics in generations, the radius of the cities migration attraction, the parameters of marriage structure (the proportion ofinterethnic marriages, the level of intraethnic assortative mating, the marital distances), and the gene flow between the ethnic groups. It is shown that the representatives of the most numerous ethnic groups in each megalopolis have considerable amount of admixture. For Russians of Moscow, Ukrainians of Kharkov, and Belarusians of Minsk, the proportion of individuals whose ancestors were all born in the given city for at least three generations and belonged to the same nationality turned out to be very low (4.75% in Moscow, 1.83% in Kharkov, and 3.13% in Minsk). This finding questions the formation of a reference population in the megalopolis as a sampling of aboriginals of certain ethnic origins. In the paper, we justify principles of creating genetic databases for the population of the megalopolis taking into account the complexity and dynamism of its population structure.

Is tuberculosis crossing borders at the Eastern boundary of the European Union?

BACKGROUND: The Eastern border of the European Union (EU) consists of 10 countries after the expansion of the EU in 2004 and 2007. These 10 countries border to the East to countries with high tuberculosis (TB) notification rates. We analyzed the notification data of Europe to quantify the impact of cross-border TB at the Eastern border of the EU. METHODS: We used TB surveillance data of 2010 submitted by 53 European Region countries to the European Centre for Disease Prevention and Control and the World Health Organization Regional Office for Europe. Notified TB cases were stratified by origin of the case (national/foreign). We calculated the contribution of foreign to overall TB notification. RESULTS: In the 10 EU countries located at the EU Eastern border, 618 notified TB cases (1.7% of all notified TB cases) were of foreign origin. Of those 618 TB cases, 173 (28.0%) were from countries bordering the EU to the East. More specifically, 90 (52.0%) were from Russia, 33 (19.1%) from Belarus, 33 (19.1%) from Ukraine, 13 (7.5%) from Moldova and 4 (2.3%) from Turkey. CONCLUSIONS: Currently, migrants contribute little to TB notifications in the 10 EU countries at the Eastern border of the EU, but changes in migration patterns may result in an increasing contribution. Therefore, EU countries at the Eastern border of the EU should strive to provide prompt diagnostic services and adequate treatment of migrants.

[The microbiological structure of chronic suppurative otitis media in the Gomel region].

The objective of the present work was to study the spectrum of microbiota maintaining the inflammatory process in the cavities of the middle ear of the patients presenting with chronic suppurative otitis media (CSOM) and to estimate its susceptibility to antibiotic agents. The discharge from the ears was subjected to microbiological analysis in 138 patients with CSOM. Some of the microorganisms proved highly sensitive to antibiotic agents. The following etiologically important pathogens involved in the maintenance of the chronic pyoinflamatory process in the cavities of the middle ear were identified: bacteria, fungi, and bacterial-fungal associations that accounted for 66.3%, 6.7%, and 26.9% of all CSOM cases respectively. The former group was dominated by S.aureus (34.6%) whereas the group of non-fermentative Gram-negative species and enterobacteria comprised 16.3% and 15.4% of their total number respectively. The microbiota was shown to be highly susceptible to cephalosporins of the 1st and 2nd generations and fluoroquinolones of the 2nd generation. C. albicans proved highly sensitive to fluconazole while mycelial micromycetes responded fairly well to itracnazole and voriconazole.

Comparing alcohol mortality in Tsarist and contemporary Russia: is the current situation historically unique?

AIMS: This study compared the level of alcohol mortality in tsarist and contemporary Russia. METHODS: Cross-sectional and annual time-series data from 1870 to 1894, 2008 and 2009 on the mortality rate from deaths due to 'drunkenness' were compared for men in the 50 provinces of tsarist 'European Russia': an area that today corresponds with the territory occupied by the Baltic countries, Belarus, Moldova, Ukraine and the Russian provinces to the west of the Ural Mountains. RESULTS: In 1870-1894, the male death rate from 'drunkenness' in the Russian provinces (15.9 per 100,000) was much higher than in the non-Russian provinces. However, the rate recorded in Russia in the contemporary period was even higher--23.3. CONCLUSIONS: Russia has had high levels of alcohol mortality from at least the late 19th century onwards. While a dangerous drinking pattern and spirits consumption may underpin high alcohol mortality across time, the seemingly much higher levels in the contemporary period seem to be also driven by an unprecedented level of consumption, and also possibly, surrogate alcohol use. This study highlights the urgent need to reduce the level of alcohol consumption among the population in order to reduce high levels of alcohol mortality in contemporary Russia.

Population drinking and fatal injuries in Eastern Europe: a time-series analysis of six countries.

AIMS: To estimate to what extent injury mortality rates in 6 Eastern European countries are affected by changes in population drinking during the post-war period. DATA AND METHODS: The analysis included injury mortality rates and per capita alcohol consumption in Russia, Belarus, Poland, Hungary, Bulgaria and the former Czechoslovakia. Total population and gender-specific models were estimated using auto regressive integrated moving average time-series modelling. RESULTS: The estimates for the total population were generally positive and significant. For Russia and Belarus, a 1-litre increase in per capita consumption was associated with an increase in injury mortality of 7.5 and 5.5 per 100,000 inhabitants, respectively. The estimates for the remaining countries ranged between 1.4 and 2.0. The gender-specific estimates displayed national variations similar to the total population estimates although the estimates for males were higher than for females in all countries. CONCLUSIONS: The results suggest that changes in per capita consumption have a significant impact on injury mortality in these countries, but the strength of the association tends to be stronger in countries where intoxication-oriented drinking is more common.

Variability of the 3'APOB minisatellite locus in Eastern Slavonic populations.

OBJECTIVE: To describe and compare the 3' apolipoprotein (Apo) B minisatellite allele frequency distributions of Eastern Slavonic populations and their Uralic, Altaic, and Caucasian speaking neighbors. METHODS: Healthy individuals of 10 populations among Russians, Byelorussians, Komis and Bashkirs were studied for variable number tandem repeats (VNTRs) in the 3'ApoB minisatellite region. Data were analyzed with other results reported for this polymorphism in eastern Europeans and Siberians. RESULTS: Allele frequency spectra in Eastern Slavonic, Northern Caucasian and Finno-Ugric speaking populations are bimodal with the main peak in alleles 34-36 and a secondary mode around allele 48, whereas Altaic speaking populations have a unimodal allele frequency distribution with a peak of around 34-36 VNTRs. Population relationships were revealed using both multidimensional scaling analysis (based on Nei's genetic distance estimate) and testing for genetic heterogeneity. Eastern Slavonic populations (Russians, Ukrainians, Byelorussians) were most closely related to each other and formed a separate tight clusterwhen plotted. Testing for genetic heterogeneity among the Eastern Slavonic ethnic groups revealed maximum diversity among Byelorussians, followed by Russians, then Ukrainians. The 3'ApoB minisatellite variability reveals little heterogeneityamong the Eastern Slavonic ethnic groups, whereas there wassignificant heterogeneity for Northern Caucasian and Altaic speakers. CONCLUSION: For this 3'ApoB polymorphism the Eastern Slavonic populations, despite their wide geographical distribution, appear to be much more homogenous than other ethnic groups of the region. Multidimensional scaling analysis of these data allowed for differentiation between individual populations from an ethnic group even if there is little heterogeneity.

Ethnic intermarriage in times of social change: the case of Latvia.

We gain insight into the dynamics of ethnic intermarriage in times of social change by studying marriages between Latvians and Russians (including Belarussians and Ukrainians) that occurred in Latvia before and after independence from the Soviet Union. Before independence, ethnic intermarriage was already rather common, involving about 17% of the marriages annually. Since independence, intermarriage between Russians and Latvians has increased substantially. Part of this increase can be explained by selective emigration, but at least half of it may be due to integrative processes. Although there were more marriages between Russian men and Latvian women before independence, the gender pattern reversed after independence. Intermarriage levels were the highest among the less educated, children of mixed couples, partners with similar educational levels, and people in the countryside.

Y-chromosome STR haplotypes in a population sample of the Byelorussian minority living in the northeastern Poland.

Haplotype and allele frequencies for the eight Y-STRs were determined in a population sample of 156 unrelated Byelorussian males. The most common haplotype was shared by 3.85% of the sample, while 121 haplotypes were unique. The gene diversity was 0.98.

Culture and Munchausen-by-proxy syndrome: the case of an 11-year-old boy presenting with hyperactivity.

OBJECTIVES: To discuss some of the challenges presented to the clinician who deals with a possible Munchausen-by-proxy (MBP) syndrome. METHOD: The case of an 11-year-old boy presenting with hyperactivity is discussed. Information from the initial assessment and the 9-month follow-up period is presented. We highlight some cultural considerations as they apply to this immigrant family. A commentary by Dr H Schrier follows the presentation. RESULTS: The positive outcome is discussed in relation to the validation of the diagnosis as well as to cultural issues. CONCLUSION: Cultural issues and dynamic factors may be important when we consider the diagnosis of MBP syndrome in an immigrant family with different expectations from our health care system.

Lessons learned from the study of immigrants to Israel from areas of Russia, Belarus, and Ukraine contaminated by the Chernobyl accident.

During the past 6 years, immigration to Israel of 700,000 persons from the former Soviet Union (FSU) included about 140,000 from radiocontaminated regions of Belarus, Ukraine, and Russia near Chernobyl. In Beer Sheva, a major center for immigrant absorption in Israel, a primary objective was to evaluate their health status and to refer them for care. 137Cs levels in 1228 men, women, and children were measured with a portable whole-body counter. Whole-body counts showed clear correlation with the degree of 137Cs ground contamination in previous regions of residence. The population could thus be sub-divided according to degree of exposure, based on previous regions of residence. The thyroid status of 300 local immigrant children was evaluated because of the increased risk of childhood thyroid cancer in the regions from which they came. This group was subdivided into comparative groups of children who came from less and more contaminated areas according to the International Atomic Energy Agency soil 137Cs contamination maps. Enlarged thyroids were found in about 40% of both groups. One 12-year-old girl from Gomel had a malignant papillary carcinoma. Thyroid-stimulating hormone levels, though within normal limits, were significantly greater (p < 0.02) for girls from high exposure regions. Liquidators showed significant increases in serum clastogenic factor and in the number of circulating glycophorin A-mutated red cells. In studies of over 700 people from both radiocontaminated and unaffected regions of the FSU, evidence for posttraumatic stress disorder was found more frequently in persons coming from the more contaminated areas.

Insulin-dependent diabetes mellitus in native Estonians and immigrants to Estonia.

The authors compared the epidemiology of childhood insulin-dependent diabetes mellitus in Estonia during 1980-1989 between native Estonians and an immigrant group that consisted mainly of Russians. The average annual incidence of diabetes mellitus was significantly higher in Estonians (11.8 per 100,000 children aged less than 15 years; 95% confidence interval (CI) 10.4-13.3) than in non-Estonians (7.6 per 100,000 children aged less than 15; 95% CI 6.2-9.4). This difference appeared in both sexes. The highest incidence in both Estonians and non-Estonians was recorded in 1982, when the incidence in the immigrant population was twice as high as the baseline level. These data indicate that immigrant populations need not acquire the same risk of insulin-dependent diabetes as the native population.

[Immunogenetic characteristics of the population of the Transcarpathian region of the UkrSSR ABO system erythrocyte antigen findings]. / Immunogeneticheskie osobennosti naseleniia Zakarpatskoi oblasti USSR po dannym éritrotsitarnykh antigenov sistemy ABO.

The phenotypes with their respective alleles frequencies of the ABO system were studied in 33 230 individuals of 9 ethnic groups of the Transcarpathian Region population. Statistically significant differences in allele frequencies were found in Gypsies, Germans and Slovaks as compared to those in the main Ukrainian population. There are significant differences between Hungarians and Gypsies of the Transcarpathian Region and analogous populations beyond the region. Absence of a reliable difference between gene pools of the Slav groups of the population and of Hungarians may point to the local origin of the later.