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1.
BMC Prim Care ; 25(1): 131, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38658818

RESUMO

BACKGROUND: The COVID-19 pandemic has presented significant global healthcare challenges, particularly impacting the continuity of essential health services in low- and middle-income countries. This study investigates the impact of the COVID-19 pandemic on the utilization and provision of essential health services in Armenia. METHODS: We employed a conventional qualitative study design, conducting semi-structured in-depth interviews (n = 17) within public and private primary healthcare (PHC) facilities in Armenia in 2021. Our study participants encompassed physicians providing specialty services in PHC facilities (e.g. endocrinologists, gynecologists/obstetricians, and pediatricians), regular visitors to PHC facilities (e.g. adults with chronic diseases, parents of children), and policymakers. Thematic analysis was conducted, yielding five emergent categories: mobilization and organization of PHC services during COVID-19; PHC visits during COVID-19; worsening of chronic conditions due to the decline in PHC visits; problems with routine childhood vaccinations; and patient-provider communication challenges. RESULTS: The number of in-person visits to PHC facilities declined due to adaptations in service delivery, imposed lockdown measures, and the public's fear of visiting healthcare facilities. Maternal and child health services continued with no major disruptions. PHC providers deliberately limited the number of maternal and child visits to essential antenatal care, newborn screenings, and routine childhood immunizations. Still, children experienced some delays in vaccination administration. The pandemic resulted in a notable reduction in follow-up visits and monitoring of patients with chronic conditions, thereby exacerbating their chronic conditions. Phone calls were the primary method of patient-provider communication during the pandemic. CONCLUSIONS: The COVID-19 pandemic has had a profound impact on the delivery and utilization of essential healthcare services at PHC facilities, especially for those with chronic conditions who needed continuous care. Unified national-level guidance and technical capacity are needed to direct the provision of essential services at the PHC level, promote effective health communication, and implement digital platforms for the uninterrupted provision of essential care during public health emergencies.


Assuntos
COVID-19 , Atenção Primária à Saúde , Pesquisa Qualitativa , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Armênia/epidemiologia , Feminino , Adulto , Masculino , SARS-CoV-2 , Pandemias , Entrevistas como Assunto
2.
Georgian Med News ; (346): 38-44, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38501619

RESUMO

The purpose of this article is to investigate the manifestation of creativity levels and criteria, conditioned by the ratio of personal qualities, motivational orientation, and contributing and hindering factors. These elements are regarded as pivotal factors in ensuring mental health and socio-psychological maturity. The study involved 300 managers from the private and public sectors of the Republic of Armenia. The research contributes to the academic discourse by introducing novel correlations between scientific concepts of creativity, enriching the theoretical foundations of creativity and motivation, creativity and personal qualities, and creativity and its contributing and hindering factors. Findings suggest a high level of creativity among managers, characterized by fluency, flexibility, and originality. Notably, power and altruism emerge as significant motivational orientations within the manager's psychological profile. Moreover, modern managers do not perceive reward or competition as hindrances to creativity. Essential factors conducive to creativity include dominance, competition, reward, freedom of thought, and a willingness to take risks in decision-making. The proposed creativity research and development model holds promise for informing a scientific approach to the psychological selection and training of managers.


Assuntos
Criatividade , Saúde Mental , Motivação , Armênia
3.
Curr Oncol ; 31(3): 1323-1334, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38534933

RESUMO

BACKGROUND: Annually, approximately 200 new ovarian cancer cases are diagnosed in Armenia, which is considered an upper-middle-income country. This study aimed to summarize the survival outcomes of patients with relapsed ovarian cancer in Armenia based on the type of recurrence, risk factors, and choice of systemic treatment. METHODS: This retrospective case-control study included 228 patients with relapsed ovarian cancer from three different institutions. RESULTS: The median age of the patients was 55. The median follow-up times from relapse and primary diagnosis were 21 and 48 months, respectively. The incidence of platinum-sensitive relapse was 81.6% (186), while platinum-resistant relapse was observed in only 18.4% (42) of patients. The median post-progression survival of the platinum-sensitive group compared to the platinum-resistant group was 54 vs. 25 months (p < 0.001), respectively, while the median survival after relapse was 25 vs. 13 months, respectively; three- and five-year post-progression survival rates in these groups were 31.2% vs. 23.8%, and 15.1% vs. 9.5%, respectively (p = 0.113). CONCLUSIONS: Overall, despite new therapeutic approaches, ovarian cancer continues to be one of the deadly malignant diseases affecting women, especially in developing countries with a lack of resources, where chemotherapy remains the primary available systemic treatment for the majority of patients. Low survival rates demonstrate the urgent need for more research focused on this group of patients with poor outcomes.


Assuntos
Recidiva Local de Neoplasia , Neoplasias Ovarianas , Humanos , Feminino , Carcinoma Epitelial do Ovário , Estudos Retrospectivos , Estudos de Casos e Controles , Armênia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Análise de Sobrevida , Recidiva
5.
BMJ Glob Health ; 9(2)2024 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-38325896

RESUMO

INTRODUCTION: Local coalitions can advance public health initiatives such as smoke-free air but have not been widely used or well-studied in low-income and middle-income countries. METHODS: We conducted a matched-pairs community-randomised controlled trial in 28 communities in Armenia and Georgia (N=14/country) in which we helped establish local coalitions in 2019 and provided training and technical assistance for coalition activity promoting smoke-free policy development and enforcement (2019-2021). Surveys of ~1450 households (Fall 2018, May-June 2022) were conducted to evaluate coalition impact on smoke-free policy support, smoke-free home adoption, secondhand smoke exposure (SHSe), and coalition awareness and activity exposure, using multivariable mixed modelling. RESULTS: Bivariate analyses indicated that, at follow-up versus baseline, both conditions reported greater smoke-free home rates (53.6% vs 38.5%) and fewer days of SHSe on average (~11 vs ~12 days), and that intervention versus control condition communities reported greater coalition awareness (24.3% vs 12.2%) and activity exposure (71.2% vs 64.5%). Multivariable modelling indicated that intervention (vs control) communities reported greater rates of complete smoke-free homes (adjusted Odds Ratio [aOR] 1.55, 95% confiedence interval [CI] 1.11 to 2.18, p=0.011) and coalition awareness (aOR 2.89, 95% CI 1.44 to 8.05, p=0.043) at follow-up. However, there were no intervention effects on policy support, SHSe or community-based activity exposure. CONCLUSIONS: Findings must be considered alongside several sociopolitical factors during the study, including national smoke-free policies implementation (Georgia, 2018; Armenia, 2022), these countries' participation in an international tobacco legislation initiative, the COVID-19 pandemic and regional/local war). The intervention effect on smoke-free homes is critical, as smoke-free policy implementation provides opportunities to accelerate smoke-free home adoption via local coalitions. TRIAL REGISTRATION NUMBER: NCT03447912.


Assuntos
Poluição por Fumaça de Tabaco , Humanos , Armênia , Georgia , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/prevenção & controle
6.
BMJ Open ; 14(2): e080281, 2024 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326250

RESUMO

OBJECTIVES: This study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia. DESIGN: A population-based cross-sectional seroprevalence study combined with a phone survey of tested individuals. SETTING: All administrative units of Armenia including 10 provinces and capital city Yerevan. PARTICIPANTS: The study frame was the general adult population of Armenia aged ≥18 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The participants were tested for anti-HBV core antibodies (anti-HBc) and HBV surface antigen (HBsAg) using third-generation enzyme immunoassays. In case of HBsAg positivity, HBV DNA and hepatitis D virus (HDV) RNA PCR tests were performed. Risk factors of HBV infection ever in life (anti-HBc positivity) and chronic HBV infection (HBsAg positivity) were identified through fitting logistic regression models. RESULTS: The seroprevalence study included 3838 individuals 18 years and older. Of them, 90.7% (3476 individuals) responded to the phone survey. The prevalence of anti-HBc positivity was 14.1% (95% CI 13.1% to 15.2%) and HBsAg positivity 0.8% (95% CI 0.5% to 1.1%). The viral load was over 10 000 IU/mL for 7.9% of HBsAg-positive individuals. None of the participants was positive for HDV. Risk factors for HBsAg positivity included less than secondary education (aOR=6.44; 95% CI 2.2 to 19.1), current smoking (aOR=2.56; 95% CI 1.2 to 5.6), and chronic liver disease (aOR=8.44; 95% CI 3.0 to 23.7). In addition to these, risk factors for anti-HBc positivity included age (aOR=1.04; 95% CI 1.04 to 1.05), imprisonment ever in life (aOR=2.53; 95% CI 1.41 to 4.56), and poor knowledge on infectious diseases (aOR=1.32; 95% CI 1.05 to 1.67), while living in Yerevan (vs provinces) was protective (aOR=0.74; 95% CI 0.59 to 0.93). CONCLUSION: This study provided robust estimates of HBV markers among general population of Armenia. Its findings delineated the need to revise HBV testing and treatment strategies considering higher risk population groups, and improve population knowledge on HBV prevention.


Assuntos
Hepatite B Crônica , Hepatite B , Adulto , Humanos , Adolescente , Vírus da Hepatite B , Estudos Transversais , Antígenos de Superfície da Hepatite B , Prevalência , Grupos Populacionais , Estudos Soroepidemiológicos , Armênia/epidemiologia , Hepatite B/complicações , Anticorpos Anti-Hepatite B , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/complicações , DNA Viral
7.
Parasit Vectors ; 17(1): 54, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38321481

RESUMO

BACKGROUND: Armenia is considered particularly vulnerable to life-threatening vector-borne diseases (VBDs) including malaria, West Nile virus disease and leishmaniasis. However, information relevant for the control of the vectors of these diseases, such as their insecticide resistance profile, is scarce. The present study was conducted to provide the first evidence on insecticide resistance mechanisms circulating in major mosquito and sand fly populations in Armenia. METHODS: Sampling sites were targeted based mainly on previous historical records of VBD occurrences in humans and vertebrate hosts. Initially, molecular species identification on the collected vector samples was performed. Subsequently, molecular diagnostic assays [polymerase chain reaction (PCR), Sanger sequencing, PCR-restriction fragment length polymorphism (RFLP), quantitative PCR (qPCR)] were performed to profile for major insecticide resistance mechanisms, i.e. target site insensitivity in voltage-gated sodium channel (vgsc) associated with pyrethroid resistance, acetylcholinesterase (ace-1) target site mutations linked to organophosphate (OP) and carbamate (CRB) resistance, chitin synthase (chs-1) target site mutations associated with diflubenzuron (DFB) resistance and gene amplification of carboxylesterases (CCEs) associated with resistance to the OP temephos. RESULTS: Anopheles mosquitoes were principally represented by Anopheles sacharovi, a well-known malaria vector in Armenia, which showed no signs of resistance mechanisms. Contrarily, the knockdown resistance (kdr) mutations V1016G and L1014F/C in the vgsc gene were detected in the arboviral mosquito vectors Aedes albopictus and Culex pipiens, respectively. The kdr mutation L1014S was also detected in the sand fly, vectors of leishmaniasis, Phlebotomus papatasi and P. tobbi, whereas no mutations were found in the remaining collected sand fly species, P. sergenti, P. perfiliewi and P. caucasicus. CONCLUSIONS: This is the first study to report on molecular mechanisms of insecticide resistance circulating in major mosquito and sand fly disease vectors in Armenia and highlights the need for the establishment of systematic resistance monitoring practices for the implementation of evidence-based control applications.


Assuntos
Aedes , Anopheles , Culex , Inseticidas , Leishmaniose , Malária , Phlebotomus , Psychodidae , Piretrinas , Animais , Humanos , Resistência a Inseticidas/genética , Inseticidas/farmacologia , Mosquitos Vetores/genética , Acetilcolinesterase/genética , Anopheles/genética , Armênia , Phlebotomus/genética , Mutação
8.
PLoS One ; 19(2): e0292790, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38315645

RESUMO

Cyprus was conquered from several populations because of its special geographical location. In this study, 406 unrelated Cypriot samples were tested based on their mitochondrial DNA. In more detail, 185 were Greek Cypriots, 114 Armenian Cypriots and 107 Maronite Cypriots. This is the first time where the mitochondrial DNA of Greek Cypriots, Armenian Cypriots and Maronite Cypriots is compared with the aim of characterizing the maternal ancestry of Cypriots. The control region of the mtDNA is the most informative in terms of studying maternal ancestry and consists of three hypervariable regions (HVS-I, HVS-II, HVS-III). The hypervariable regions can provide important information regarding the maternal ancestor of the tested samples. The entire control region of the mtDNA was used to determine the mitotypes and subsequently the haplogroups of all the Cypriot DNA samples. Based on the aforementioned analyses, Greek Cypriots were found to be genetically closer to Armenian Cypriots, while Greek Cypriots and Armenian Cypriots showed moderate genetic differentiation with Maronite Cypriots. The most prevalent haplogroups among Cypriots were haplogroups H and U, while R0 is common but in different frequencies for Greek Cypriots, Armenian Cypriots and Maronite Cypriots. It is proposed that the maternal ancestor may have originated during the Neolithic period and/or the Bronze age.


Assuntos
DNA Mitocondrial , Humanos , Grécia , Armênia , DNA Mitocondrial/genética , Chipre , Haplótipos
9.
BMC Health Serv Res ; 24(1): 10, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172981

RESUMO

BACKGROUND: The primary objectives of this study were the evaluation of consumer self-medication practices, the assessment of pharmaceutical care provided by pharmacy employees, and the analysis of consumer satisfaction with such care. The research was also aimed at examining the main criteria that consumers consider important when selecting a pharmacy in Armenia. METHODS: The survey was based on an anonymous questionnaire and carried out between March 2020 and November 2021. It was aimed at providing a comprehensive assessment of pharmaceutical care services and consumer pharmacy choice by investigating two distinct groups: pharmacy consumers and pharmacy employees. RESULTS: The research reveals that many residents in Armenia engage in self-medication without consulting professional sources, which can lead to potential risks and result in dangerous consequences. This is partly due to a lack of trust in pharmacy employees, which is primarily due to their inability to provide adequate information and advice. This study highlights a significant need for improvement in the quality of service provided by pharmacy employees. Despite these challenges, the majority of consumers reported having a preferred pharmacy, and that employee knowledge is the most important criterion when choosing a pharmacy. CONCLUSIONS: Consumer distrust, in this context, is based on the incomplete knowledge or incompetency of pharmacy employees. Collective actions should be taken to improve the role of pharmacy employees and consequently improve the public trust in them, which can ensure better control of self-medication and reduce the instances of mistreatment.


Assuntos
Assistência Farmacêutica , Farmácias , Farmácia , Humanos , Inquéritos e Questionários , Armênia , Comportamento do Consumidor
10.
BMC Health Serv Res ; 24(1): 20, 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38178214

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems throughout the world. Many patients faced delays and cancellation of care due to scaled back services, mobility restrictions, and concerns related to the risk of infection. The present study aimed to assess the prevalence of and risk factors associated with the avoidance or delay of medical care due to COVID-19 in Armenia. METHODS: We conducted a cross-sectional telephone survey of 3,483 adults across Armenia. We used stratified two-stage cluster sampling to select the participants from different age groups proportionate to their size in the population. Logistic regression analysis assessed the association of risk factors with avoidance/delay of routine, urgent/emergency, and any medical care. RESULTS: The mean age of the sample was 49.5 (SD = 14.8), ranging from 18 to 90. About 9.9% of the respondents avoided/delayed any type of medical care; whereas 5.5% avoided/delayed urgent/emergency care and 6.6% routine care. In the adjusted analysis, female gender and higher monthly expenditures were associated with avoidance/delay of routine medical care. Factors associated with delay/avoidance of urgent/emergency care included female gender and higher perceived threat of COVID-19. Younger age, female gender, higher perceived threat and not being vaccinated against COVID-19 were associated with avoidance/delay of any medical care in the adjusted analysis. CONCLUSION: Since avoiding or delaying care might increase morbidity and mortality associated with conditions not related to COVID-19, identifying population groups that are more likely to avoid care is important. Targeting such groups with educational interventions focusing on the risks of using versus not using medical care in times of pandemic might be crucial. Ensuring the provision of in-home healthcare services for high-risk groups might help to address important medical care needs during the pandemic.


Assuntos
COVID-19 , Adulto , Humanos , Feminino , COVID-19/epidemiologia , Pandemias , Estudos Transversais , Armênia/epidemiologia , Inquéritos e Questionários , Assistência Ambulatorial
12.
Ophthalmic Epidemiol ; 31(1): 62-69, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36872562

RESUMO

PURPOSE: This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. METHODS: The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants' demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. RESULTS: Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0-2.1), 1.6% (95% CI: 1.0-2.2) and 6.6% (95% CI: 5.5-7.7), respectively.The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. CONCLUSION: The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.


Assuntos
Catarata , Presbiopia , Erros de Refração , Idoso , Humanos , Pessoa de Meia-Idade , Armênia/epidemiologia , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/prevenção & controle , Catarata/complicações , Catarata/epidemiologia , Presbiopia/complicações , Prevalência , Erros de Refração/complicações , Erros de Refração/epidemiologia , Inquéritos e Questionários , Transtornos da Visão/complicações , Masculino , Feminino
13.
Childs Nerv Syst ; 40(2): 435-444, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37837453

RESUMO

PURPOSE: Central nervous system (CNS) tumors are the most common solid malignancies in children worldwide, including in Armenia. The current study aims to analyze epidemiological data, treatment, and outcomes of children and young adults (≤25 years) with CNS tumors in Armenia during the last 26 years. METHODS: We collected data from pediatric and young adult patients treated in selected sites in Armenia from 1st January 1995 to 31st December 2020. Incidence by sex, age at diagnosis, time from first complaints to diagnosis, histopathology results, treatment strategies, complications, and overall survival (OS) rates were calculated. RESULTS: The multicenter data analysis revealed 149 patients with diagnosed primary CNS tumors over 26 years. Among them, 84 (56.4%) were male. The median age at diagnosis was 7 years (range, 3 months to 25 years), and the median time from the first complaints to diagnosis was 2 months (range, 1 week to 70 months). Medulloblastomas and other embryonal tumors (47), low-grade gliomas (32), and high-grade gliomas (22) were the most commonly diagnosed malignancies. Ependymomas, craniopharyngiomas, germ cell tumors, and other malignancies were observed in 22 patients. For 26 patients, no histopathological or radiological diagnosis was available. Follow-up information was available for 98 (65.8%) patients. The 5-year OS rate for the whole study group was 67.7%. CONCLUSION: Consistent with international data, embryonal tumors, and gliomas were the most commonly diagnosed CNS malignancies in Armenia. Multimodal treatment was often not available in Armenia during the study period, especially for early cases.


Assuntos
Neoplasias do Sistema Nervoso Central , Neoplasias Cerebelares , Glioma , Neoplasias Hipofisárias , Adulto Jovem , Criança , Humanos , Masculino , Lactente , Feminino , Estudos Retrospectivos , Armênia/epidemiologia , Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias do Sistema Nervoso Central/terapia
14.
Georgian Med News ; (343): 6-13, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38096507

RESUMO

Medical aspects of the organization of replenishment of the Armed Forces with healthy and physically strong personnel are of great importance, and the deficit in the number of conscripts and their low-quality condition have become one of the main and important problems for the Armed Forces. The aim of the study was to improve the medical care of male conscripts aged 18-27 years by revealing the regularities and peculiarities of the expert assessment of surgical diseases among this category of young men on the basis of mathematical modeling. The object of the research was the study of the names of surgical profile articles, according to which these people were recognized as unfit or restricted fit for service, and the results of military medical expertise. Descriptive, social, and statistical methods were applied in the course of the study. The final stage was to conduct a systemic multifactor analysis in order to obtain a mathematical model of the process under study. The values of the influence coefficients of the mentioned indicators for 2013-2019 on the obtained mathematical models from the point of view of military-medical expertise of young men with surgical diseases both in the Republic of Armenia as a whole and in its separate regions are presented. Summarizing, it can be stated that from the point of view of military-medical expertise of young men with surgical diseases it is impossible to consider Yerevan city and the regions of RA as separate parts of the Republic of Armenia. Yerevan and the regions of the Republic of Armenia as separate parts, as they appear as a single whole according to the results of systemic multifactor analysis with mathematical modeling.


Assuntos
Nível de Saúde , Militares , Humanos , Masculino , Armênia/epidemiologia , Modelos Teóricos
15.
Sci Rep ; 13(1): 22709, 2023 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-38123608

RESUMO

Poorer mental health is linked to a lower likelihood of voting in elections. However, little is known about this association in non-Western settings. This study examined the association between psychological distress and voting in nine countries of the former Soviet Union (FSU). Data were analysed from 18,000 respondents aged ≥ 18 in Armenia, Azerbaijan, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine collected during the Health in Times of Transition (HITT) survey in 2010/11. Information was collected on previous voting behaviour and future voting intentions. Psychological distress was assessed with a 12-item scale. In pooled multivariable logistic regression analyses psychological distress was significantly associated with 'never voting' (not having voted previously or intending to vote in future) and 'past voting only' (having voted previously but not intending to vote in future). In stratified analyses psychological distress was linked to never voting in women and working-age adults. The significant association between psychological distress and voting was observed only in hybrid political regimes. Psychological distress is associated with a reduced likelihood of voting in FSU countries especially among women, working-age adults and those in hybrid political regimes.


Assuntos
60478 , Adulto , Humanos , Feminino , U.R.S.S. , Armênia , República da Geórgia/epidemiologia , Ucrânia/epidemiologia
16.
BMJ Open ; 13(12): e076171, 2023 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-38159954

RESUMO

INTRODUCTION: Armed conflict worldwide and across history has harmed the health of populations directly and indirectly, including generations beyond those immediately exposed to violence. The 2020 war between Armenia and Azerbaijan over Nagorno-Karabakh, inhabited by an ethnically Armenian population, provides an example of how conflict harmed health during COVID-19. We hypothesised that crises exposure would correspond to decreased healthcare utilisation rates and worse health outcomes for the maternal and infant population in Armenia, compounded during the pandemic. METHODS: Following a mixed-methods approach, we used ecological data from 1980 to 2020 to evaluate health trends in conflict, measured as battle-related deaths (BRDs), COVID-19 cases, and maternal and infant health indicators during periods of conflict and peace in Armenia. We also interviewed 10 key informants about unmet needs, maternal health-seeking behaviours and priorities during the war, collecting recommendations to mitigate the effects of future crisis on maternal and infant health. We followed a deductive coding approach to analyse transcripts and harvest themes. RESULTS: BRDs totalled more in the 2020 war compared with the previous Nagorno-Karabakh conflicts. Periods of active conflict between 1988-2020 were associated with increased rates of sick newborn mortality, neonatal mortality and pre-eclampsia or eclampsia. Weekly average COVID-19 cases increased sevenfold during the 2020 Nagorno-Karabakh war. Key informants expressed concerns about the effects of stress and grief on maternal health and pregnancy outcomes and recommended investing in healthcare system reform. Participants also stressed the synergistic effects of the war and COVID-19, noting healthcare capacity concerns and the importance of a strong primary care system. CONCLUSIONS: Maternal and infant health measures showed adverse trends during the 2020 Nagorno-Karabakh war, potentially amplified by the concurrent COVID-19 pandemic. To mitigate effects of future crises on population health in Armenia, informants recommended investments in healthcare system reform focused on primary care and health promotion.


Assuntos
COVID-19 , Saúde do Lactente , Lactente , Recém-Nascido , Feminino , Gravidez , Humanos , Armênia/epidemiologia , Pandemias , Conflitos Armados , COVID-19/epidemiologia
17.
PLoS One ; 18(10): e0292361, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37831696

RESUMO

Mudbrick constructions are extremely common in ancient western Asia, including the 1st millennium structures of the southern Caucasus and Armenian highlands. However, in the Caucasus the geoarchaeological study of these materials to provide insight into building practices and social structure is a topic little researched, especially when focusing on the longue durée. Artashat/Artaxata (Ararat region, Armenia) was the capital of the Armenian Kingdom of the Artaxiads, founded in the eighties of the 2nd century BC, but even before this the site was occupied in the Chalcolithic period, (ca. 5200-3500 BC), Early Iron Age (ca. 1200-900 BC) and in the Urartian period (ca. 800-600 BC) as well. All the previous occupation phases showed communities that made extensive use of earthen constructions as determined during past and recent archaeological excavations. This multidisciplinary study seeks to examine mudbrick architecture as a proxy for environmental and social interactions during the 1st millennium BC combining geoarchaeology, archaeobotany and building archaeology. We analyzed changes and continuities in architectural form and practices, alongside reconstruction of technological and social processes, to identify issues of raw material procurement, attestation of re-use, and consistency of building practices. The results of the geoarchaeological analysis of the earthen building materials used in different parts of the ancient city point to a re-use of materials over time.


Assuntos
Arqueologia , Tecnologia , Armênia , Materiais de Construção , Ásia Ocidental
18.
Sci Rep ; 13(1): 16591, 2023 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-37789089

RESUMO

Disruptions of key food and fertilizer exports from Russia and Ukraine have exposed many countries to challenges accessing some commodities since these countries' war began. We evaluated the short-term, external, and direct impacts of disruptions of six food commodities and three types of fertilizer supplies from Russia and Ukraine on food access for all trading partners of the two countries by applying a set of trade and socioeconomic indicators. We found that the external food supplies of 279 countries and territories were affected to varying degrees; 24 countries-especially Georgia, Armenia, Kazakhstan, Azerbaijan, and Mongolia-are extremely vulnerable because they depend almost entirely on a variety of food imports from Russia and Ukraine. Access to fertilizers was affected in 136 countries and territories, particularly Estonia (potassic fertilizer), Mongolia (nitrogenous fertilizers), Kazakhstan (mixed fertilizers), and Brazil, the United States, China, and India (all types of fertilizers). An integrated assessment of countries' import types, purchasing power parity per capita, and populations indicated that the Democratic Republic of the Congo, Ethiopia, Egypt, and Pakistan are most vulnerable to such supply disruptions. Development of research into diversification and decentralization strategies for food access is needed to guide stable food supply policies.


Assuntos
Fertilizantes , Abastecimento de Alimentos , Ucrânia , Federação Russa , República da Geórgia , Armênia
19.
Georgian Med News ; (340-341): 30-36, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37805870

RESUMO

The purpose of this study was to investigate the psychological and physiological factors affecting performance levels in adolescent judokas. The research was performed in the "Sport EMI" scientific-research center of Armenian State Institute of Physical Culture and Sport. Participants' performance levels were assessed based on their kyu rankings, a hierarchical ranking system in judo. The psychological assessment involved the completion of the Well-being, Activity, and Mood (WAM) test. The physiological assessment focused on heart rate variability (HRV) measurements, which were obtained using the Varikard 2.51 complex equipment. A total of 23 male teenage judokas, aged between 10 and 16 years, were randomly selected from a judo club to participate in this study. Participants demonstrated high levels of well-being, activity, and positive mood, indicating positive psychosocial outcomes associated with judo practice. Analysis of heart rate variability (HRV) revealed deviations in certain variables, suggesting potential irregularities in autonomic nervous system regulation. Specifically, the Index of Activity of Regulatory Systems (IRSA), low-frequency power (LF), and total power (TP) exceeded normal ranges, indicating increased tension and overall activity in the regulatory systems. In addition, one-way analysis showed significant main effects of age, training duration, and high-frequency power (HF) on the participants' performance level (Kyu). The findings suggest that psychological and physiological factors play significant roles in the performance levels of adolescent judokas. Coaches and practitioners should consider both aspects in optimizing training strategies for young athletes.


Assuntos
Artes Marciais , Humanos , Masculino , Adolescente , Criança , Artes Marciais/fisiologia , Atletas , Frequência Cardíaca/fisiologia , Armênia
20.
Environ Monit Assess ; 195(11): 1278, 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37801148

RESUMO

The narrow-clawed crayfish is a crayfish species that was accidentally introduced into the ecosystem of Lake Sevan in the 1980s. Soon it became one of the most preferred fisheries in the lake and an important link in the food chain by successfully replacing the endemic fish subspecies Sevan khramicarp (Capoeta sevangi, De Filippi, 1865) in the chain of detritivores. However, recently, the stock declines dramatically, associated with two main threats: the impact of burn-spot disease and an increase in fishing pressure on its population. To estimate the state of population under multiple stress conditions, we investigated the dynamics of stock, the size/age and sex structure, the fecundity, and the health status of the population. A comparative analysis of oxidative stress biomarkers (superoxide dismutase, catalase, glutathione-S-transferase activities and reduced glutathione, thiobarbituric acid reactive substance contents) showed significant differences between healthy and infected individuals. Another indirect effect of the disease, which probably leads to a decrease in the stock, was an increase in the proportion of immature females. Also, we observed some decrease in the infection rate along with the decline in the density of crayfish. However, stock reduction and some changes in the population may also be caused by a strong bloom of cyanobacteria.


Assuntos
Ecossistema , Lagos , Humanos , Animais , Feminino , Astacoidea , Armênia , Monitoramento Ambiental
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