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1.
Prim Health Care Res Dev ; 22: e81, 2021 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-34911588

RESUMO

AIMS: The aim of this paper is to introduce an operational checklist to serve as a tool for policymakers in the WHO European Region to strengthen primary health care (PHC) services and address the COVID-19 pandemic more effectively and to present the results from piloting the tool in Armenia. BACKGROUNDS: PHC has the potential to play a fundamental role in countries' responses to COVID-19. However, this potential remains unrealized in many countries. To assist countries, the WHO Regional Office for Europe developed a guidance document - Strengthening the Health Systems Response to COVID-19: Adapting Primary Health Care Services to more Effectively Address COVID-19 - that identifies strategic actions countries can take to strengthen their PHC response to the pandemic. Based on this guidance document, an operational checklist was developed to serve as a tool for policymakers to operationalize the recommended actions. METHODS: The operational checklist was developed by transforming key points in the guidance document into questions in order to identify potentially modifiable factors to strengthen PHC in response to COVID-19. The operational checklist was then piloted in Armenia in June 2020 as part of a WHO mission to provide technical advice on strengthening Armenia's PHC response to COVID-19. Two WHO experts performed semi-structured, face-to-face interviews with nine key informants (both facility managers and clinical staff) in three PHC facilities (two in a rural and one in an urban area). The data collected were analyzed to identify underlying challenges limiting PHC providers' ability to effectively and efficiently respond to COVID-19 and maintain essential health services. FINDINGS: The paper finds that making adjustments only to health services delivery will be insufficient to address most of the challenges identified by PHC providers in the context of COVID-19 in Armenia. In particular, strategic responses to the pandemic were missed, due, in part, to the absence of COVID-19 management teams at the facility level. Furthermore, the absence of PHC experts in Armenia's national pandemic response team meant that health system issues identified at the facility level could not easily be communicated to or addressed by policymakers. The checklist therefore helps policymakers identify critical challenges - at both the facility and health system level - that need to be addressed to strengthen the PHC response to the COVID-19 pandemic.


Assuntos
COVID-19 , Armênia , Humanos , Pandemias , Atenção Primária à Saúde , SARS-CoV-2
2.
Georgian Med News ; (319): 118-124, 2021 Oct.
Artigo em Russo | MEDLINE | ID: mdl-34749335

RESUMO

It is not so easy to understand the essence of the definition of physical health, although this phrase consists of two words that have an important semantic meaning, that is, "health" is a generalized characteristic, and "physical" is related to the physical capabilities of a person. The purpose of this study was to study the relationship between some physiological indicators of the physical health of the Armenian population. A cross - sectional study of 2000 residents aged 11 to 79 years (men n=429, average age - 33.7±13.2 and women n=1171, average age-34.6±12.1) of the Republic of Armenia was conducted. Physiological indicators (wellness and its component indicators-body composition, endothelium and stress resistance (stress scores) and) were measured using the Mutiscan BC-OXi PLUS Version 2.9 RU monitoring system to study indicators with acceptable reproducibility and a significant difference in values. Studies of the general sample showed that among the population of Armenia, the indicators of endothelium and wellness are within the normal range, the indicator of body composition is slightly below the norm, and the indicator of stress resistance is on the border between the norm and the violation. The average indicators of stress resistance, endothelium and wellness are significantly higher in women compared to men and a reliable direct proportional relationship of average strength between the indicators of stress resistance-wellness, endothelium-wellness and body composition-wellness in both groups are revealed. It was found that the correlation infrastructure (according to Spearman and Pearson) of the above indicators is subject to significant changes depending on gender, while the level of these indicators (in points) in the studied samples is significantly less susceptible to changes.


Assuntos
Composição Corporal , Adulto , Armênia/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Adulto Jovem
3.
Georgian Med News ; (318): 124-128, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628392

RESUMO

Georgia and Armenia are situated at the northern rim of the thalassemia belt and bordering to countries with a known high prevalence of thalassemias. In this study we assessed the carrier frequency and potential spectrum of alpha- and beta-globin mutations among 202 and 190 unselected Georgian and Armenian subjects, respectively. We found four alpha-globin mutations (-3.7del, -4.2del, anti-3.7 triplication, poly-A2) in 9 Armenians (4.74%) and 4 Georgians (1.78%). The heterozygous beta-globin codon 8 [-AA] mutation was detected in one individual from Armenia only. Overall, carrier frequencies seem to be low in both countries, supporting the notion that thalassemias are not a major health problem there.


Assuntos
Talassemia , Armênia/epidemiologia , República da Geórgia/epidemiologia , Humanos , Mutação , Globinas beta/genética
4.
Artigo em Inglês | MEDLINE | ID: mdl-34639853

RESUMO

The trauma of a genocide can be transmitted to subsequent generations though familial mental health, sociopolitical trauma, and cultural narratives, thereby impacting mental health and well-being. Understanding specific mechanisms that are unique to each ethnic group impacted by genocide illuminates cultural, sociopolitical, and individual factors related to the transmission. For the Armenian community, the unresolved historical loss of the Armenian Genocide of 1915, with the threat of acculturation for such a large diasporic population, a continued denial by the perpetrators, as well as subsequent generations' refugee experiences, may further exasperate the impact of transgenerational trauma from the genocide. This literature review explores the mental health needs of Armenian youth in the current sociopolitical context and provides implications for how schools and communities may use this knowledge to inform supports that center Armenian community healing. Future directions for research are also discussed.


Assuntos
Genocídio , Trauma Histórico , Refugiados , Adolescente , Armênia , Humanos , Saúde Mental
5.
Asian J Psychiatr ; 66: 102862, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34583092

RESUMO

BACKGROUND: Although the World Health Organization has called for mental health services to be integrated into primary care, mental health remains in most countries, and especially in low- and middle-income countries, one of the most neglected topics in the training curriculum of frontline health workers. As a result, primary healthcare professionals leave medical and nursing schools with insufficient knowledge, and often with negative attitudes towards mental disorders. AIM: We investigated the effect of a brief training intervention on schizophrenia and depression conducted among general practitioners and nurses in Armenia. METHODS: Training interventions were one-day, face-to-face, interactive workshops, including didactic presentations and discussions of case studies. We used a quasi-experimental design of the before/after type, to compare data on knowledge, attitudes and practices collected before and after the training sessions. RESULTS: Mean scores for knowledge, attitudes and practices increased significantly (p < 0.001) among both nurses and GPs for both schizophrenia (111 GPs and 167 nurses) and depression (459 GPs and 197 nurses). CONCLUSIONS: Our experience suggests that a brief training intervention can result in significant improvements in knowledge, attitudes and practices among primary healthcare workers and could help improve mental health services.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Esquizofrenia , Armênia , Depressão/terapia , Pessoal de Saúde , Humanos , Atenção Primária à Saúde , Esquizofrenia/terapia
6.
Georgian Med News ; (316-317): 107-113, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34511455

RESUMO

The aim of the study was to validate the Armenian language version of the COMQ-12 quality of life (QL) instrument among teenagers with chronic otitis media (COM). A case-control study was conducted in 350 teenagers aged 16 to 18 years: the case group of patients with COM (120) and the control group of practically healthy teenagers (230). Study participants' quality of life was assessed by specific COMQ-12 (Chronic Otitis Media Questionnaire-12) and not specific SF-36 (The Short Form-36) questionnaires. Hospital Anxiety and Depression Scale (HADS) instrument has been used to assess the effect of COM on the emotional field of the patients. The expressiveness of cognitive function was assessed by the Montreal Cognitive Assessment test (MoCA). According to the research data among risk factors which had statistically significant influence on COM morbidity rate in teenagers were: presence of disabled person in a family (OR=8,8), unfavorable psychological atmosphere in the family (OR=2,9), presence of accompanying chronic disease in teenagers (OR=2,1) and presence of chronic ENT diseases in parents (OR=2,1). Use of the non-specific questionnaire showed that COM mostly influences on psychological component of Mental Healthdomain of QL, as well as Social Functioning. The average score of QL in the group with COM was 28,3, and in the practically healthy group it was 3,4 (Mann-Whitney U=1725,0; р <0,01). COM mostly influences on the following scales of the COMQ-12 questionnaire: Q-3, Q-4, Q-6, Q-8, Q-9 Q-12.There was a statistically significant correlation between the parameters of COMQ-12 and SF 36 questionnaires for the following questions: Q-4, Q-6, Q-8, Q-9, Q-12. Anxiety and depression symptoms were recorded in 52,2% of teenagers in the group of cases and in 13,4% in the control one (p<0.001). The correlation analysis has shown that among the patients with COM there is an association between anxious-depressive disorders and cognitive dysfunction. COMQ-12 questionnaire used for the first time in Armenia population among the teenagers with COM showed high reliability, internal consistency and construct validity.


Assuntos
Otite Média , Qualidade de Vida , Adolescente , Armênia , Estudos de Casos e Controles , Humanos , Idioma , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
7.
Isotopes Environ Health Stud ; 57(5): 535-552, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34519245

RESUMO

Lake Sevan is a meso-eutrophic water body, which was severely impacted by anthropogenic level decrease, pollution and eutrophication during the last century. Starting in the 1970s, these processes resulted in the formation of an oxygen-depleted hypolimnion during summer-autumn stratification of the lake. In this work, we demonstrate for the first time that eutrophication of the lake leads not only to the full depletion of oxygen and nitrate in the hypolimnion but as well to the presence of sulfate-reducing microorganisms and toxic hydrogen sulfide. Concentrations of hydrogen sulfide in the hypolimnion of Major and Minor Sevan in October were as high as 9 and 39 µM, respectively. In October 2019, 66 % of lake's bottom was covered by sulfidic waters, while the fraction of sulfidic water volume reached 19 %. Values of δ34S for hypolimnetic sulfide are lower by only 7-12 ‰ compared to epilimnetic sulfate, while δ33S values of sulfide are similar to the δ33S values of sulfate. These isotopic fingerprints are not consistent with microbial sulfate reduction as the sole source of hydrogen sulfide in the hypolimnion. We attribute the formation of a sulfidic deep-water layer to a combination of microbial sulfate reduction in the water column and diffusion of hydrogen sulfide from the sediments.


Assuntos
Eutrofização , Lagos , Armênia , Sedimentos Geológicos , Sulfetos , Água
8.
Ann Transplant ; 26: e930943, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34545060

RESUMO

BACKGROUND Treatment of end-stage renal disease constitutes a heavy financial burden, especially in developing countries. Maintaining a kidney transplantation program is an extremely complex task in countries with limited resources. It often requires expertise and support from developed countries. Living donor kidney transplantations (LDKT) have been performed regularly in the Republic of Armenia since 2002. The purpose of this article is to review the history and outcomes of kidney transplantation in Armenia. MATERIAL AND METHODS A chart review was performed retrospectively on all patients who had undergone LDKT in Armenia. The key personnel involved in the development and operation of the unique kidney transplant program in the country were interviewed for a comprehensive review of the history and challenges of transplantation. RESULTS There were 172 LDKT (4 re-transplantations) performed between 2002 and 2019. The mean age of recipients was 35.9±13.4 years (range 7.1-65.7): 116 (67.4%) were male and 12 (6.9%) were children (<18 years). Seventy-four patients (43%) had peri- (n=5) and postoperative (n=69), mostly mild, surgical complications. Delayed graft function occurred in 17 (9.9%) patients, requiring hemodialysis in 16, and 6 patients stayed HD-dependant. Sixty-nine patients (40.1%) had at least 1 episode of acute rejection, with 26 (15.1%) having more than 1. Late complications were mostly infectious (n=49) or malignant processes (n=13). Follow-up studies showed that out of 172 patients, 126 had functioning grafts, 17 died with functioning grafts, 3 were lost to follow-up, and 26 lost grafts. Graft survival at 1, 3, 5, and 10 years, non-censored for death, after LDKT was 96.4% (CI 93.6-99.2), 93.7% (CI 89.9-97.5), 90.5% (CI 85.7-95.3), and 75.3% (CI 66.9-83.7), respectively. CONCLUSIONS Findings from this study suggest that a renal transplant program with acceptable outcomes can be successfully introduced in countries with limited resources.


Assuntos
Transplante de Rim , Adolescente , Adulto , Idoso , Armênia , Criança , Países em Desenvolvimento , Feminino , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
9.
Int J Med Mushrooms ; 23(5): 21-31, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347992

RESUMO

Several edible and medicinal Agaricomycetes mushrooms possess biologically active compounds with different therapeutic effects, such as antioxidant, anti-inflammatory, hypocholesterolemic, hypoglycemic, anti-hypertensive, fibrinolytic, and thrombolytic, and have potential use as cardioprotective remedies. Previous studies have shown that mushrooms possessing cardioprotective effects (CPEs) contain a high amount of vitamins and minerals and low fat content, which make them applicable as a supplementary dietary and functional food for the prevention and treatment of cardiovascular diseases. The current review evaluates the resource value of 31 edible and nonedible medicinal Agaricomycetes mushrooms with potential CPEs growing in the territory of Armenia and discusses the future perspectives of their usage in biotechnology and biomedicine.


Assuntos
Agaricales , Antioxidantes , Armênia , Vitaminas
10.
BMC Cancer ; 21(1): 941, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34418986

RESUMO

BACKGROUND: It is known that one of the reasons for the increased incidence of hematological malignancies is caused by the growth of multiple myeloma (MM). Worldwide, approximately 159,985 new cases of MM are diagnosed representing 0.9% of all cancer diagnoses and 106,105 patients will die from MM accounting for 1.1% of all cancer deaths per year. Despite significant advances in the MM treatment the mortality rates are still high. The presented study is the first accurate epidemiological study of ММ in Armenia for the period of 2006-2018. METHODS: The initial data for this retrospective cohort survey were derived from ambulance cards, hospitalization journals, and clinical data from the Registry of Blood Diseases at the Yeolyan Hematology Center. RESULTS: Data analysis showed that during 2006-2018 the average annual incidence for the MM was 1.2 per 100,000 population. A significant increase was observed in 2018 compared to 2006, 1.9 vs. 0.7 per 100,000 population. Interestingly, there were no sex differences in the overall MM incidence during the study period. According to the received data, during the period of the 2006-2009 and 2014-2018 the 1-year survival rate for both sexes decreased dramatically from 83 to 64.1% at age group 60 years and below and from 78.5 to 68.1% in group 60 years and over. The 1-year overall survival (OS) for both sexes decreased by 18.9% for patients (≤60 age group) and 10.4% (> 60 age group) in the period of 2006-2009 to the period of 2014-2018. CONCLUSIONS: The incidence rates for the MM increased during the analyzed period. Our study showed that males and females in the age group 60 years and below had better 5-year overall survival compared to elder ones and females have better survival.


Assuntos
Mieloma Múltiplo/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adulto , Idoso , Armênia/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Grupos Populacionais , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo
11.
BMJ Open ; 11(7): e049257, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34326052

RESUMO

OBJECTIVE: To describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings. SETTING: Primary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available. DESIGN AND PARTICIPANTS: Before (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study. OUTCOME MEASURES: Consultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described. RESULTS: Care for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%). CONCLUSIONS: Despite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic. Insight in the highly variable pandemic responses, as measured in this multicountry audit, can aid in fine-tuning national action and in coordinating a pan-European response during future pandemic threats.


Assuntos
COVID-19 , Infecções Respiratórias , Armênia , Bélgica , Teste para COVID-19 , Europa (Continente)/epidemiologia , Alemanha , Grécia , Humanos , Pandemias , Polônia , Atenção Primária à Saúde , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/epidemiologia , SARS-CoV-2
12.
Clin Exp Rheumatol ; 39 Suppl 132(5): 18-21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34251301

RESUMO

OBJECTIVES: Familial Mediterranean fever (FMF) is an autosomal-recessive, inflammatory disorder characterised by short, recurrent attacks of fever, accompanied by pain in the abdomen, chest, or joints and complications of amyloidosis. Recently, we observed a significant association between the serum amyloid A1 (SAA1) ß/ß genotype and a delayed disease onset in 386 M694V homozygous FMF patients. This follow-up study was conducted to additionally analyse MEFV genotypes other than M694V/M694V for a possible influence of the SAA1 genotype on the age of disease onset. METHODS: A total of 700 Armenian patients diagnosed with FMF based on the Tel-Hashomer criteria and carrying two MEFV mutant alleles were included in this study. Patients were divided into three MEFV genotypic subgroups: M694V homozygotes (M694V/M694V), M694V compound heterozygotes (M694V/Other), and patients with genotypes excluding M694V (Other/Other). MEFV and SAA1 analyses were performed by a commercial reverse-hybridisation assay, and resulting genotypes were matched against the demographic and clinical characteristics of the patients. RESULTS: Within the subgroup of M694/M694 homozygotes, SAA1 genotype ß/ß could be identified in 115 (34.43%) and 32 (61.54%) patients with an age of onset <20 and ≥20 years, respectively(p<0.001). However, no such relationship could be observed for MEFV genotypic subgroups M694V/Other (p=0.465) and Other/Other (p=0.697). CONCLUSIONS: Our data suggest, that the influence of SAA1 genotypic variation on the age of disease onset restricts to FMF patients homozygous for MEFV mutation M694V.


Assuntos
Febre Familiar do Mediterrâneo , Proteína Amiloide A Sérica/genética , Adulto , Idade de Início , Armênia , Febre Familiar do Mediterrâneo/diagnóstico , Febre Familiar do Mediterrâneo/genética , Seguimentos , Genótipo , Homozigoto , Humanos , Mutação , Pirina/genética , Adulto Jovem
13.
Arch Osteoporos ; 16(1): 87, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34089424

RESUMO

Age-specific intervention and assessment thresholds based on FRAX® were developed for eight Eurasian countries participating in the EVA study (Armenia, Belarus, Georgia, Moldova, Kazakhstan, the Kyrgyz Republic, the Russian Federation, and Uzbekistan). The intervention thresholds (major osteoporotic fracture) ranged from 3.6 (Armenia and Georgia) to 12.3% (Uzbekistan) for people at age 50 years, and from 16 (Armenia) to 27% (Belarus) at the age of 90 years. These thresholds enable a substantial advance in the ease of detection of individuals at high fracture risk. INTRODUCTION: The purpose of this study was to derive and compare FRAX-based intervention and BMD assessment thresholds for 8 Eurasian countries in the EVA study. METHODS: The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF), calculated without BMD, equivalent to a woman with a prior fragility fracture but no other clinical risk factors, and a body mass index (BMI) of 25.0 kg/m2. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI of 25.0 kg/m2, without previous fracture or other clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. RESULTS: The age-specific intervention thresholds ranged from 3.6 (Armenia and Georgia) to 12.3% (Uzbekistan) for men and women at the age of 50 years and from 16 (Armenia) to 27% (Belarus) at the age of 90 years. The difference between countries was most evident at younger ages and become progressively less with advancing age. CONCLUSIONS: For the 8 Eurasian countries, the newly established FRAX-based intervention thresholds provide an opportunity to improve the clinical detection of both men and women with a high risk of fracture and improve treatment rates.


Assuntos
Densidade Óssea , Fraturas por Osteoporose , Idoso de 80 Anos ou mais , Armênia , Pré-Escolar , Feminino , Georgia , Humanos , Cazaquistão , Quirguistão , Masculino , Pessoa de Meia-Idade , Moldávia , República de Belarus , Medição de Risco , Fatores de Risco , Federação Russa , Uzbequistão
14.
Malar J ; 20(1): 265, 2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34118950

RESUMO

BACKGROUND: Although avian Plasmodium species are widespread and common across the globe, limited data exist on how genetically variable their populations are. Here, the hypothesis that the avian blood parasite Plasmodium relictum exhibits very low genetic diversity in its Western Palearctic transmission area (from Morocco to Sweden in the north and Transcaucasia in the east) was tested. METHODS: The genetic diversity of Plasmodium relictum was investigated by sequencing a portion (block 14) of the fast-evolving merozoite surface protein 1 (MSP1) gene in 75 different P. relictum infections from 36 host species. Furthermore, the full-length MSP1 sequences representing the common block 14 allele was sequenced in order to investigate if additional variation could be found outside block 14. RESULTS: The majority (72 of 75) of the sequenced infections shared the same MSP1 allele. This common allele has previously been found to be the dominant allele transmitted in Europe. CONCLUSION: The results corroborate earlier findings derived from a limited dataset that the globally transmitted malaria parasite P. relictum exhibits very low genetic diversity in its Western Palearctic transmission area. This is likely the result of a recent introduction event or a selective sweep.


Assuntos
Variação Genética , Haplótipos , Proteína 1 de Superfície de Merozoito/genética , Plasmodium/genética , Aves Canoras/parasitologia , Animais , Armênia , Marrocos , Portugal , Federação Russa
15.
J Affect Disord ; 292: 782-787, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34175591

RESUMO

BACKGROUND: People with disabilities (PWD) are at increased risk of poor mental health. However, this association and the pathways involved remain under-researched in many parts of the world. This study examined the association between disability and psychological distress in nine countries of the former Soviet Union (FSU). METHODS: Data were analysed from 18,000 adults aged ≥18 years collected during the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010 and 2011. Information was obtained on disability status, the severity of the disability and psychological distress. Logistic regression analysis was used to estimate associations. RESULTS: In a fully adjusted combined country analysis, disability was associated with over two times higher odds for psychological distress (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.86-2.58). The strength of the association varied across the individual countries. Among PWD more severe disability was associated with significantly higher odds for psychological distress (OR: 2.12, 95%CI: 1.26-3.55). LIMITATIONS: The data were cross-sectional and disability status was self-reported, possibly resulting in underreporting. CONCLUSIONS: Disability is associated with worse psychological health in FSU countries, especially among those with more severe disabilities. As poor mental health may also increase the risk of negative outcomes in PWD, this finding highlights the importance of the early detection and treatment of mental disorders in PWD in these countries.


Assuntos
Pessoas com Deficiência , Angústia Psicológica , Adolescente , Adulto , Armênia/epidemiologia , Estudos Transversais , Georgia , Humanos , Federação Russa/epidemiologia , U.R.S.S. , Ucrânia
16.
J Virol Methods ; 295: 114199, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34091213

RESUMO

COVID-19 pandemic severely impacted the healthcare and economy on a global scale. It is widely recognized that mass testing is an efficient way to contain the spread of SARS-CoV-2 infection as well as aid in the development of informed policies for disease management. However, the current COVID-19 worldwide infection rates increased the demand for rapid and reliable screening of infection. We compared the performance of qRT-PCR in direct heat-inactivated (H), heat-inactivated and pelleted (HC) samples against RNA in a group of 74 subjects (44 positive and 30 negative). Then we compared the sensitivity of HC in a larger group of 196 COVID-19 positive samples. Our study suggests that HC samples show higher accuracy for SARS-CoV-2 detection PCR assay compared to direct H (89 % vs 83 % of the detection in RNA). The sensitivity of detection using direct samples varied depending on the sample transport and storage media as well as the viral loads (as measured by qRT-PCR Ct levels). Altogether, all the data suggest that purified RNA provides more accurate results, however, direct sample testing with qRT-PCR may help to significantly increase testing capacity. Switching to the direct sample testing is justified if the number of tests is doubled at least.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , Programas de Rastreamento/métodos , SARS-CoV-2/isolamento & purificação , Armênia/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Humanos , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/genética , Sensibilidade e Especificidade , Manejo de Espécimes , Carga Viral , Inativação de Vírus
17.
PLoS One ; 16(5): e0249776, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34038415

RESUMO

Stunting undermines economic growth by perpetuating the vicious cycle of poverty and labour market performance. Studies have captured the trend in stunting and present distributional evidence of policy effects in the country contexts. We identify the determinants of U5 (under 5 years of age) malnutrition for the poor and the Nonpoor and compare the distribution of stunting at four time points (2000, 2005, 2010 and 2015) over a 15-year period between different groups of population. Further, we decompose the gap in malnutrition into causes of differences in stunting between worse-off and better-off socioeconomic groups of the population and estimate the magnitude of distributional differences in stunting between two socioeconomic groups. We also present the inequality trend over time that provides insights into the dynamicity of the effect of different determinants on stunting at different time points. Using 35,490 observations from Armenian Demographic and Health Survey Data [four waves: Year2015,9533; Year2010,8644; Year2005,8919; Year2000,8334], we apply regression-based decomposition method and inequality measures to identify the determinants of malnutrition and distribution of stunting between and within socioeconomic groups. Although the proportional difference in prevalence of stunting between worse-off and better-off children of 13 months and above are reduced by 9.5% in 2015 compared to 2000, the association between socioeconomic position and stunting is statistically significant among children aged 13 months and above in 2000, as well as among children of 36 months and above in 2015. This study demonstrates that the less of socioeconomic distribution of the population, but rather more of the effect from in-country region and settlement of residence are significantly associated with stunting. The approach of our analysis is potentially also a useful tool to generate evidence for decision making towards achieving SDGs 2.2. We conclude that development in childhood is not independent from the distributional effect of region specific development initiatives. Understanding the regional characteristics and resources allocated for the maternal and child health is the necessity to address stunting.


Assuntos
Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Armênia/epidemiologia , Pré-Escolar , Bases de Dados Factuais , Feminino , Transtornos do Crescimento/patologia , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Desnutrição/diagnóstico , Classe Social
18.
Georgian Med News ; (312): 168-172, 2021 Mar.
Artigo em Russo | MEDLINE | ID: mdl-33964847

RESUMO

The medical support of the Police officers is a complex and multifaceted process, which has two components: the health and medical and legal aspects themselves. We covered the health and medical aspects of the medical care of the RA Police officers in different issues of the "Georgian Medical News" for 2019-2020. The problems of its legal aspects are not fully presented. The object of the study: laws, decisions of the RA Government, orders of the Chief of Police and other documents reflecting various aspects of the state of legal normative acts regulating medical provision of RA police officers. The research methods used were historical, social, comparative. The aim of the study was to assess the usefulness of the current legal acts on medical care of the RA Police officers. Studying the current documents regulating the medical care of employees allows us to draw the following conclusions: - the existing system of departmental health care does not allow to resolve the thealth issues of the RA Police officers; - to improve the medical service of the RA Police there is a need in good medical care program.


Assuntos
Polícia , Armênia , Humanos
19.
Ann Chir Plast Esthet ; 66(3): 201-209, 2021 Jun.
Artigo em Francês | MEDLINE | ID: mdl-33966906

RESUMO

INTRODUCTION: This work relates the experience of three French surgical missions in the care of the war wounded during the armed conflict in Nagorno Karabakh which took place from September 27 to November 10, 2020. MATERIALS AND METHODS: Three surgical missions were carried out in Armenia between October 2020 and January 2021. Surgeons intervened in different hospitals, at different times of the conflict and on various war wounds. RESULTS: The presence of a plastic surgeon proved to be essential in the care of war wounded, especially in delayed emergency and secondary care. The ortho-plastic treatment offered during these missions has proven to be effective in the reconstruction of limbs. These missions made it possible to introduce the induced membrane technique of Masquelet AC in Armenia. During our visit to the Yerevan burn center, we mentioned the very probable use of white phosphorus as an etiology in several of the cases analyzed. CONCLUSION: We relate the particular experience of civilian surgeons in the context of a modern armed conflict. The presence of a plastic surgeon proved to be indispensable in the care of war wounded and especially in their secondary reconstructions.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Cirurgiões , Cirurgia Plástica , Armênia , Humanos
20.
BMC Public Health ; 21(1): 951, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016072

RESUMO

BACKGROUND: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce their underlying risk factors, which are often linked to lifestyles. To effectively supplement nationwide policies with targeted interventions, it is important to know how these risk factors are distributed across socioeconomic segments of populations in LMICs. This study quantifies the prevalence and socioeconomic inequalities in lifestyle risk factors in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030. METHODS: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with the different lifestyle risk factors. RESULTS: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is "often or sometimes drunk" compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively - 0.147, - 0.210, - 0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI - 0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off. The associations between the share of GDP spent on health and the socioeconomical distribution of lifestyle factors are multidirectional. CONCLUSIONS: This study emphasizes the importance of lifestyle risk factors in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in lifestyle risk factors - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted to supplement nationwide policies.


Assuntos
Países em Desenvolvimento , Estilo de Vida , Adulto , Armênia , Burundi , Camboja , Chade , Egito , Feminino , Gâmbia , Humanos , Masculino , Nigéria , Prevalência , Fatores de Risco , Ruanda , Fatores Socioeconômicos , Tanzânia , Timor-Leste , Togo , Zimbábue
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