High rates of neural tube defects in Ukraine

BACKGROUND: Oral consumption of synthetic folic acid can prevent neural tube defects (NTDs), which are some of the most severe congenital anomalies. The prevalence of NTDs in Ukraine and other countries of the former U.S.S.R. has not been well studied. We determined the prevalence of NTD-affected pregnancies in Northwestern Ukraine as background for policy decisions related to flour fortification in this country. METHODS: The Ukrainian-American Birth Defects Program was established in 1999 and conducts population- based surveillance of birth defects in several oblasts (states) of Ukraine. We determined the prevalence of NTDs in the Volyn and Rivne oblasts of Northwestern Ukraine for three years, 2000-2002. RESULTS: There were 75,928 births in the two oblasts in 2000-2002. There were 159 cases of NTDs among live births, stillbirths, and induced abortions. The prevalence of NTDs in the two oblasts in Northwestern Ukraine is 2.1 per 1000 births. CONCLUSIONS: The prevalence of NTD-affected pregnancies we found in Northwestern Ukraine is almost four times what it should be. This prevalence suggests that population folate deficiency is widespread in Ukraine. Universal folic acid fortification of flour milled in Ukraine is urgently needed to end this epidemic of birth defects. Such fortification would be expected to prevent folate deficiency anemia, heart attacks, and strokes.     

Health and nutrition in Eastern Europe and the former Soviet Union during the decade of transition: A review of the literature

The collapse of the Soviet Union was the most important historical event at the close of the 20th century. The jarring nature of this transition has resulted in large fluctuations in household resources and increased uncertainty in all facets of life for the individuals concerned. Much academic research and popular writing has explored the socioeconomic and political ramifications of bringing these countries into mainstream capitalism. This paper provides a review of the literature examining health outcomes in Eastern Europe and the former Soviet Union during the transition period. The research, which has studied the human face of transition, spans multiple disciplines and it is thus currently difficult for interested researchers to obtain an overview of the basic facts, as well as, the more detailed nuances, concerning developments. This paper highlights what we currently know about health outcomes in transition countries and what we do not know, and suggests future areas of research which may help fill important gaps in our knowledge.     

Indicating Success with Material Symbols after the Collapse of the USSR

The growth in the role of the military sector of certain Soviet states in the overall structure of the national economy, to the detriment of other sectors, along with providing military assistance to other countries, with government subsidies to unprofitable enterprises and long-term unproductive production that never reached a buyer—these were the factors that provided the prime conditions for the collapse of the Soviet Union. The authors survey the stark economic status of the country, and show that in conditions of complete deficit citizens would value highly any chance to get hold of products that reflected the viability and status of their owners, even though the quality of these products declined steadily for a number of reasons. This article seeks to describe in detail the reasons and components of these prerequisites, as a way to review life in Russian society under conditions of shortage and poverty that presaged the collapse of the USSR, and the consequences this all had for post-Soviet Russian culture.     

Rabies and other lyssaviruses

Since rabies has not been reported in Japan for nearly the past 50 years, it has been relegated to the status of a forgotten infectious disease in this country. However,in the neighboring Asian countries, Africa, America, the number fo rabies cases had not decrease but on the contrary, seen an increasing trend. In Russia and the former Soviet Union countries (CIS countries), the number of information. Between 30,000 approximately 20,000 fatal cases of rabies in both humans and animals had been reported yearly butit was thought that the number might run up to hundred of thousands.japan, Taiwan, UK, Australia and New Zealand are rabies-free countries and should be considered the exception rather than the norm. Due to the long Lull in which rabies has not occurred in Japan,people tend to forget that the disease can infect all mammals including humans, with a mortality rate of 100% after manifestation of debilitating nervous symptoms and that is one of the most dangerous zoonotic viral diseases on earth.     

Economic gain,stability of pollination and bee diversity decrease from southern to northern Europe

Bees are in decline potentially leading to reduced pollination and hence production of insect-pollinated crops in many countries. It is however still unclear whether the consequences of pollinator shortages differ among countries with different environmental and societal conditions. Here, we calculated economic gains attributed to insect (particularly bee) pollination (EVIP) as well as their contribution to the total value of crop production (vulnerability), and analyzed their temporal trends and inter-annual variability from 1991 to 2009 for each country of the European Union (EU). To understand which factors drive country-specific differences in pollinator dependency and stability of insect-dependent crop yields, we further asked whether EVIP, vulnerability and stability of yields were influenced by a country's climate, the number of wild bee species and/or managed honeybee hives per country, and (agricultural) gross domestic product (GDP).Across Europe, crop pollination by insects accounted for 14.6 [±3.3] billion EUR annually (EVIP), which equaled 12 (±0.8)% of the total economic value of annual crop production. Gains strongly varied among countries. Both EVIP and vulnerability increased (and the inter-annual variation of vulnerability decreased) significantly from the colder northern to the warmer Mediterranean EU countries, in parallel with increases in the number of wild bee species. Across years, economic importance of pollination increased in all but three EU countries. Apples were the most important insect-pollinated crop in the EU, accounting for 16% of the EU's total EVIP. Our results show that whereas dependency on insect pollination increased from the colder north to the warmer south, variation in economic gain from insect pollination decreased, indicating that Mediterranean countries had more stable yields of pollinator-dependent crops across years and thus more reliable gains from pollination services.     

Interplay between mobility,multi-seeding and lockdowns shapes COVID-19 local impact

Assessing the impact of mobility on epidemic spreading is of crucial importance for understanding the effect of policies like mass quarantines and selective re-openings. While many factors affect disease incidence at a local level, making it more or less homogeneous with respect to other areas, the importance of multi-seeding has often been overlooked. Multi-seeding occurs when several independent (non-clustered) infected individuals arrive at a susceptible population. This can lead to independent outbreaks that spark from distinct areas of the local contact (social) network. Such mechanism has the potential to boost incidence, making control efforts and contact tracing less effective. Here, through a modeling approach we show that the effect produced by the number of initial infections is non-linear on the incidence peak and peak time. When case importations are carried by mobility from an already infected area, this effect is further enhanced by the local demography and underlying mixing patterns: the impact of every seed is larger in smaller populations. Finally, both in the model simulations and the analysis, we show that a multi-seeding effect combined with mobility restrictions can explain the observed spatial heterogeneities in the first wave of COVID-19 incidence and mortality in five European countries. Our results allow us for identifying what we have called epidemic epicenter: an area that shapes incidence and mortality peaks in the entire country. The present work further clarifies the nonlinear effects that mobility can have on the evolution of an epidemic and highlight their relevance for epidemic control.     

HIV/AIDS epidemic in Eastern Europe: Recent developments in the Russian Federation and Ukraine among women

Background: The Russian Federation and the Ukraine are among the Eastern European countries with the fastest growing number of cases of HIV. According to data from the Joint United Nations Program on HIV/AIDS, nearly 90% of newly reported HIV diagnoses in Eastern Europe in 2006 were from the Russian Federation (66%) and the Ukraine (21%). A growing number of women are infected with HIV. The impact of gender on HIV/AIDS is an important factor in understanding the development and evolution of the HIV/AIDS epidemic in Eastern Europe.Objective: The aim of this study was to assess the importance of integrating gender consideration into the creation of HIV programs and to examine the effect of gender on HIV/AIDS.Methods: Reported HIV/AIDS cases from the official epidemiological register of the Ukrainian Centre for AIDS Prevention alongside data from the Russian Federal AIDS Center were analyzed. Joint United Nations Program on HIV/AIDS country fact sheets were reviewed and analyzed, and this information was supplemented with published HIV prevalence and sexually transmitted disease case reporting information, unpublished reports, and expert evaluations.Results: Of the newly registered cases of HIV, the proportion of women rose from 13.0% in 1995 to 44.0% in 2006 in the Russian Federation, and from 37.2% in 1995 to 41.9% in 2006 in the Ukraine. There has also been a considerable increase in mother-to-child transmission of HIV since 1995. Between 1987 and 1994, the proportion of children among the people newly infected with HIV in the Ukraine was 2.2%; in 2006 it was 17.6%. In 2006, 16,078 new HIV cases were registered in the Ukraine and 39,652 new HIV cases in the Russian Federation. Large increases in the number of HIV-infected women were reported from both countries.Conclusions: The data examined in this study suggest subregional differences in the magnitude of the HIV/AIDS epidemic in the Russian Federation and the Ukraine and the importance of the impact of gender on the rapid spread of the HIV/AIDS epidemic among women and women of child-bearing age. To protect women from HIV infection, it is important to find ways to empower them by implementing policies and specific prevention measures that increase their access to knowledge about HIV/AIDS; the empowerment of women is vital to reversing the HIV/AIDS epidemic.     

Long-term effects of job loss on male health: BMI and health behaviors

Employment is one of the most critical determinants of health and health behaviors for adults. This study focuses on Ukraine and measures how an involuntary job loss – defined as job loss due to business closures, reorganizations, bankruptcies, or privatization – affects BMI, being overweight or obese, smoking, alcohol consumption, and physical activity. There are three reasons to study Ukraine in the aftermath of an enormous economic transition that resulted in employment contraction as high as 40 % compared to 1990. First, nearly all published studies on the relationship between job loss and health and health behaviors have been on developed countries, meaning that our study fills the gap in the literature on transition economies. Second, the job losses that we study are plausibly exogenous and affected a significant share of the population. Third, the longitudinal survey follows individuals for up to 10 years starting from 2003, allowing us to capture the long-term effects of past job loss on outcomes at a specific point in time and their trajectories across the life cycle. Applying growth-curve models, we show that past involuntary job loss significantly alters the age trajectories of all considered outcomes at both extensive and intensive margins.     

Radiotherapy in small countries

AimTo examine the availability of radiotherapy in small countries.MethodsA small country was defined as a country with a population less than one million persons. The economic status of each country was defined using the World Bank Classification. The number of cancers in each country was obtained from GLOBOCAN 2012. The number of cancer cases with an indication or radiotherapy was calculated using the CCORE model.ResultsThere were 41 countries with a population of under 1 million; 15 were classified as High Income, 15 Upper Middle Income, 10 Lower Middle Income and one Low Income. 28 countries were islands. Populations ranged from 799 (Holy See) to 886450 (Fiji) and the total number of cancer cases occurring in small countries was 21,043 (range by country from 4 to 2476). Overall the total number of radiotherapy cases in small countries was 10982 (range by country from 2 to 1239). Radiotherapy was available in all HIC islands with 80 or more new cases of cancer in 2012 but was not available in any LMIC island. Fiji was the only LMIC island with a large radiotherapy caseload. Similar caseloads in non-island LMIC all had radiotherapy services. Most non-island HIC did not have radiotherapy services presumably because of the easy access to radiotherapy in neighbouring countries.ConclusionThere are no radiotherapy services in any LMIC islands.     

Assessment of sustainable development in the EU 27 using aggregated SD index

In the European Union the sustainable development is a fundamental and overarchingobjective enshrined in the Treaty and measuring progress towards sustainable development is an integral part of the EU Sustainable Development Strategy. Eurostat produce a monitoring report every two years based on the EU set of sustainable development indicators (SDIs). The main objective of this paper is to create an aggregated index of the sustainable development from EU set of SDIs for each 27 EU country based on the PCA. The headline indicator economic growth was not involved because its increase is not expressly followed by positive change in other SDIs from social, economic and environmental fields. The aggregated SD index enables to get an overall picture about the position of each of the 27 EU countries and its development in terms of the sustainability over time as assumed in the EU Sustainable Development Strategy. Sweden, Denmark, Netherland, and Great Britain have repeatedly reached the highest value of aggregated SD index. The highest positive change in the aggregated SD index has occurred in countries with the lowest value of aggregated SD index. Moreover, we put this new aggregated index in relation with economic growth and found that there is a negative correlation between aggregated SD index and the economic growth for most of the 27 EU countries.     

An empirical assessment of human development through remote sensing: Evidences from Italy

The Human Development Index (HDI) based on life expectancy, education and per-capita income, is one of the most used indicators of human development. However, undeniable problems in data collection limit between-countries comparisons reducing the practical applicability of the HDI in official statistics. Elvidge et al. (2012) proposed an alternative index of human development (the so called Night Light Development Index, NLDI) derived from nighttime satellite imagery and population density, with improved comparability over time and space. The NLDI assesses inequality in the spatial distribution of night light among resident inhabitants and has proven to correlate with the HDI at the country scale. However, the NLDI presents some drawbacks, since similar NLDI values may indicate very different levels of human development. A modified NLDI overcoming such a drawback is proposed and applied to assessment of human development at 3 spatial scales (the entire country, 5 geographical divisions and 20 administrative regions) in Italy, a country with relevant territorial disparities in various socioeconomic dimensions. The original and modified NLDI were correlated with 5 independent indicators of economic growth, sustainable development and environmental quality. The spatial distribution of the original and modified NLDI is not coherent with the level of human development in Italy being indeed associated with various indexes of environmental quality. Further investigation is required to identify in which socioeconomic context (and at which spatial scale) the NDLI approach correctly estimates the level of human development in affluent countries.     

Demographics of the European Apicultural Industry

Over the last few years, many European and North American countries have reported a high rate of disorders (mortality, dwindling and disappearance) affecting honeybee colonies (Apis mellifera). Although beekeeping has become an increasingly professional activity in recent years, the beekeeping industry remains poorly documented in Europe. The European Union Reference Laboratory for Honeybee Health sent a detailed questionnaire to each Member State, in addition to Kosovo and Norway, to determine the demographics and state of their beekeeping industries. Based on data supplied by the National Reference Laboratory for honeybee diseases in each European country, a European database was created to describe the beekeeping industry including the number and types of beekeepers, operation size, industry production, and health (notifiable diseases, mortalities). The total number of beekeepers in Europe was estimated at 620 000. European honey production was evaluated at around 220 000 tons in 2010. The price of honey varied from 1.5 to 40 €/kg depending on the country and on the distribution network. The estimated colony winter mortality varied from 7 to 28% depending on the country and the origin of the data (institutional survey or beekeeping associations). This survey documents the high heterogeneity of the apicultural industry within the European Union. The high proportion of non-professional beekeepers and the small mean number of colonies per beekeeper were the only common characteristics at European level. The tremendous variation in European apicultural industries has implication for any comprehensive epidemiological or economic analysis of the industry. This variability needs to be taken into account for such analysis as well as for future policy development. The industry would be served if beekeeping registration was uniformly implemented across member states. Better information on the package bee and queen production would help in understanding the ability of the industry to replace lost honey bee stocks.     

Hubs and Authorities in the World Trade Network Using a Weighted HITS Algorithm

We investigate the economic hubs and authorities of the world trade network (WTN) from to , an era of rapid economic globalization. Using a well-defined weighted hyperlink-induced topic search (HITS) algorithm, we can calculate the values of the weighted HITS hub and authority for each country in a conjugate way. In the context of the WTN, authority values are large for countries with significant imports from large hub countries, and hub values are large for countries with significant exports to high-authority countries. The United States was the largest economic authority in the WTN from to . The authority value of the United States has declined since , and China has now become the largest hub in the WTN. At the same time, China''s authority value has grown as China is transforming itself from the “factory of the world” to the “market of the world.” European countries show a tendency to trade mostly within the European Union, which has decreased Europe''s hub and authority values. Japan''s authority value has increased slowly, while its hub value has declined. These changes are consistent with Japan''s transition from being an export-driven economy in its high economic growth era in the latter half of the twentieth century to being a more mature, economically balanced nation.     

Bovine viral diarrhoea eradication and control programmes in Europe.

The economic impact of BVDV infections has led a number of countries in Europe to start eradication or control programmes. While in both cases the primary step is identification and elimination of persistently infected (PI) animals, the strategy applied thereafter is dependent on the density and seroprevalence of the regional cattle population.One of the first countries to design and implement an eradication programme was Sweden in 1993, a country with a relatively low cattle density and no vaccination. For screening, an indirect antibody ELISA for serum, milk and bulk milk samples is being used. The basics of the Swedish model are no vaccination, voluntary participation, and financing of the entire scheme by the subscribing farmers. BVDV-free herds are certified and permanently checked. While in 1993 only about 35% of the herds were seronegative, about 87% were BVDV-free in 2001.The aim of control programmes in high density areas with high seroprevalence is to minimize economic losses by reducing the incidence of PI animals and thereby virus circulation (German model). Participation is voluntary, and parts of the costs are carried by the public animal insurance (Tierseuchenkasse). Screening is performed using an antigen capture ELISA with blood or serum. In Lower Saxony, for example, a herd is declared BVDV unsuspicious if all animals up to 36 months are BVDV antigen negative and the female offspring older than six months is vaccinated twice (an inactivated vaccine is used for basic immunization, and an attenuated live virus vaccine for boosting).     

Cross-border Comparison of Post-socialist Farmland Abandonment in the Carpathians

Agricultural areas are declining in many areas of the world, often because socio-economic and political changes make agriculture less profitable. The transition from centralized to market-oriented economies in Eastern Europe and the former Soviet Union after 1989 represented major economic and political changes, yet the resulting rates and spatial pattern of post-socialist farmland abandonment remain largely unknown. Remote sensing offers unique opportunities to map farmland abandonment, but automated assessments are challenging because phenology and crop types often vary substantially. We developed a change detection method based on support vector machines (SVM) to map farmland abandonment in the border triangle of Poland, Slovakia, and Ukraine in the Carpathians from Landsat TM/ETM+ images from 1986, 1988, and 2000. Our SVM-based approach yielded an accurate change map (overall accuracy = 90.9%; kappa = 0.82), underpinning the potential of SVM to map complex land-use change processes such as farmland abandonment. Farmland abandonment was widespread in the study area (16.1% of the farmland used in socialist times), likely due to decreasing profitability of agriculture after 1989. We also found substantial differences in abandonment among the countries (13.9% in Poland, 20.7% in Slovakia, and 13.3% in Ukraine), and between previously collectivized farmland and farmland that remained private during socialism in Poland. These differences are likely due to differences in socialist land ownership patterns, post-socialist land reform strategies, and rural population density.     

Social determinants of health and tobacco use in thirteen low and middle income countries: evidence from Global Adult Tobacco Survey

Background

Tobacco use has been identified as the single biggest cause of inequality in morbidity. The objective of this study is to examine the role of social determinants on current tobacco use in thirteen low-and-middle income countries.

Methodology/Principal Findings

We used nationally representative data from the Global Adult Tobacco Survey (GATS) conducted during 2008–2010 in 13 low-and-middle income countries: Bangladesh, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay, and Viet Nam. These surveys provided information on 209,027 respondent''s aged 15 years and above and the country datasets were analyzed individually for estimating current tobacco use across various socio-demographic factors (gender, age, place of residence, education, wealth index, and knowledge on harmful effects of smoking). Multiple logistic regression analysis was used to predict the impact of these determinants on current tobacco use status. Current tobacco use was defined as current smoking or use of smokeless tobacco, either daily or occasionally. Former smokers were excluded from the analysis. Adjusted odds ratios for current tobacco use after controlling other cofactors, was significantly higher for males across all countries and for urban areas in eight of the 13 countries. For educational level, the trend was significant in Bangladesh, Egypt, India, Philippines and Thailand demonstrating decreasing prevalence of tobacco use with increasing levels of education. For wealth index, the trend of decreasing prevalence of tobacco use with increasing wealth was significant for Bangladesh, India, Philippines, Thailand, Turkey, Ukraine, Uruguay and Viet Nam. The trend of decreasing prevalence with increasing levels of knowledge on harmful effects of smoking was significant in China, India, Philippines, Poland, Russian Federation, Thailand, Ukraine and Viet Nam.

Conclusions/Significance

These findings demonstrate a significant but varied role of social determinants on current tobacco use within and across countries.     

"Infant mortality in Armenia 1992-2003": a comment.

The purpose of this comment is to counsel caution in some of the conclusions drawn in an otherwise fine article recently published in Economics and Human Biology on infant mortality in Armenia by Hakobyan, Mkrtchyan and Yepiskoposyan. These relate first, to the reliability of estimates and trends in infant mortality estimated from DHS data; second, to the interpretation of what the authors consider to be a 'low' infant mortality rate in former communist countries given their level of economic development; and third, to the role of the health care infrastructure in countries of the former Soviet Union in producing these 'low' infant mortality levels. This comment argues that trends in infant mortality in Armenia and other CIS countries, although probably declining, are perhaps less certain than the authors allow, that existing evidence does not suggest that they are uniformly low by global standards, or that the health care systems in CIS countries are uniformly effective in reducing infant deaths.     

45th Discussion forum on LCA—environmentally extended input–output analysis and LCA, September 15, 2011, Berne, Switzerland

The discussion forum on life cycle assessment (LCA) on September 15, 2011, aimed at summarizing recent environmentally extended input?Coutput analysis (EE-IOA) and the combination with LCA for the computation of environmental impact of imports. Input?Coutput tables (IOT) represent the financial flows in a country or economic regions. Extending IOT with information on emissions and resource uses allows for the analysis of environmental impacts due to production and consumption activities in a country. This instrument is called EE-IOA. It enables the analysis of total environmental impacts of countries or economic regions. The combination with trade statistics and LCA was presented as an alternative to multiregional input?Coutput models for determining environmental impacts of imports over the whole life cycle. The 45th LCA forum gathered several international speakers who provided a broad and qualified view on the topic. The theoretical background, results for different countries and regions, uncertainties, and possible improvement options for EE-IOA were discussed. The following main conclusions were drawn at the end of the discussion forum: EE-IOA is a useful instrument for analyzing the total environmental impacts of countries and the main drivers of environmental impacts. As a next important step, the participants would like to see an increase in user friendliness of EE-IOA combined with LCA, e.g., by harmonizing data, data formats, and classifications.     

Rabies in Kazakhstan

BackgroundRabies is a neglected zoonotic disease. There is a sparsity of data on this disease with regard to the incidence of human and animal disease in many low and middle income countries. Furthermore, rabies results in a large economic impact and a high human burden of disease. Kazakhstan is a large landlocked middle income country that gained independence from the Soviet Union in 1991 and is endemic for rabies.Conclusions/SignificanceThis study demonstrates that in Kazakhstan there is a substantial economic cost and health impact of rabies. These costs could be reduced by modifying the vaccination programme that is now practised. The study also fills some data gaps on the epidemiology and economic effects of rabies in respect to Kazakhstan.     

“Infant Mortality in Armenia 1992–2003”: A comment

The purpose of this comment is to counsel caution in some of the conclusions drawn in an otherwise fine article recently published in Economics and Human Biology on infant mortality in Armenia by Hakobyan, Mkrtchyan and Yepiskoposyan. These relate first, to the reliability of estimates and trends in infant mortality estimated from DHS data; second, to the interpretation of what the authors consider to be a ‘low’ infant mortality rate in former communist countries given their level of economic development; and third, to the role of the health care infrastructure in countries of the former Soviet Union in producing these ‘low’ infant mortality levels. This comment argues that trends in infant mortality in Armenia and other CIS countries, although probably declining, are perhaps less certain than the authors allow, that existing evidence does not suggest that they are uniformly low by global standards, or that the health care systems in CIS countries are uniformly effective in reducing infant deaths.