"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.     

“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.     

Older Russian emigrés and medical care.

Although emigration from the former Soviet Union is dramatically increasing nationwide, little information has been reported on the medical problems of these emigrés. For older emigrés in particular, the medical realities of aging, in combination with cultural expectations, make the United States'' medical system an arena where the stresses of emigration are expressed and help is sought. We describe the influences of culture and aging on older emigrés'' health and interaction with the American medical system. A qualitative, exploratory study was done of problems and issues in health care use by older Russian emigrés at the ambulatory medical clinic of Mount Zion Medical Center, San Francisco. Cultural expectations and beliefs about health, adaptive health behaviors learned in the former Soviet Union, the stresses of emigration, and the medical realities of aging can result in serious problems in the care and treatment of older Russian emigrés. Recommended solutions include educating emigrés and health care professionals, integrating mental health services into the primary care setting, and expanding supportive services in the community such as adult day health care.     

Health situation in former communist bloc is dire, says Unicef

The UN International Children's Emergency Fund (UNICEF) disclosed the dreadful health situation in the former Soviet Bloc. According to the report, "After the Fall: The Human Impact of Ten Years Transition," women and children in the former communist republic have suffered hard from both economic and social problems. Findings on health are particularly upsetting, especially with the re-emergence of the virtually eliminated "poverty diseases" such as diphtheria, poliomyelitis, tuberculosis, and sexually transmitted diseases (STDs) including HIV infection. Cases of diphtheria in Russia and Ukraine increased to 43,000 in 1998 from 1900 in 1990. Western parts of the former Soviet Union are now suffering from the reappearance of tuberculosis (10% affecting children), syphilis (221 cases per 100,000 population), and STDs, while HIV infection rates were as high as 270,000 by the end of 1998. On the other hand, economic depression has given rise to increasing drug misuse, alcoholism, injury, and suicide among the young population. Patrick McCormick, a spokesperson of the UNICEF Research Center in Florence, which published the report, said "there is freedom now, but the children are paying high for that freedom and they are not in the position to benefit from it".     

XVIIITH International Congress of Psychology,Moscow, USSR,August 4-11, 1966. Information and Program

The XVIIIth International Congress of Psychology has been organized by the Society of Psychologists of the USSR, under the auspices of the International Union of Scientific Psychology and the Soviet Steering Committee, under the chairmanship of P. N. Fedosseyev. The Steering Committee was established by the USSR Ministry of Higher Education, the USSR Academy of Sciences, and the RSFSR Ministry of Education. The President of the Congress is A. N. Leont'yev. The Organizing Committee of the Congress is chaired by A. A. Smirnov; and the Program Committee is chaired by A. R. Luriya, with the assistance of P. Fraisse (Paris), acting on behalf of the International Union of Scientific Psychology.     

Loneliness: Its Correlates and Association with Health Behaviours and Outcomes in Nine Countries of the Former Soviet Union

Background

Research suggests that the prevalence of loneliness varies between countries and that feeling lonely may be associated with poorer health behaviours and outcomes. The aim of the current study was to examine the factors associated with loneliness, and the relationship between feeling lonely and health behaviours and outcomes in the countries of the former Soviet Union (FSU) – a region where loneliness has been little studied to date.

Methods

Using data from 18,000 respondents collected during a cross-sectional survey undertaken in nine FSU countries – Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine – in 2010/11, country-wise logistic regression analysis was conducted to determine: the factors associated with feeling lonely; the association between feeling lonely and alcohol consumption, hazardous drinking and smoking; and whether feeling lonely was linked to poorer health (i.e. poor self-rated health and psychological distress).

Results

The prevalence of loneliness varied widely among the countries. Being divorced/widowed and low social support were associated with loneliness in all of the countries, while other factors (e.g. living alone, low locus of control) were linked to loneliness in some of the countries. Feeling lonely was connected with hazardous drinking in Armenia, Kyrgyzstan and Russia but with smoking only in Kyrgyzstan. Loneliness was associated with psychological distress in all of the countries and poor self-rated health in every country except Kazakhstan and Moldova.

Conclusions

Loneliness is associated with worse health behaviours and poorer health in the countries of the FSU. More individual country-level research is now needed to formulate effective interventions to mitigate the negative effects of loneliness on population well-being in the FSU.     

Lessons from Lithuania: rethinking public health training.

Lithuania faces stark problems that are familiar to most countries in the former Soviet Union: high morbidity and mortality rates, pollution, an unstable economy, and rapid changes in the financing and organisation of health care. In this environment Moore and Dixon visited Kaunas Medical Academy to help identify how training in public health medicine could contribute towards improving the health of the population. Although over 200 hours are devoted to public health training for medical undergraduates, teaching is unfocused, fragmented, and includes little epidemiology--the core subject for public health physicians. Teaching is mainly through long lectures with few group discussions. Student participation and motivation are low. As well as recommending redesign of the curriculum, Moore and Dixon suggested training in teaching methods for teachers. They also suggested that postgraduate training in public health should begin and should be targeted at hospital managers, teaching staff, and existing public health physicians.     

‘Through a Glass Darkly’: The Rockefeller Foundation's International Health Board and Soviet Public Health

In the early 1920s, the Rockefeller Foundation's International Health Board was presenting itself as the watchtower of public health for the world at large. Yet Soviet Russia was never included in any of the International Health Board's programs, despite the efforts of the Russians to reach out to the Board. This paper examines the exclusion of Russia as a function of the conceptual and structural lenses through which the International Health Board ‘saw’ post-revolutionary Soviet public health. It also speculates about the ways in which those who spoke on behalf of Soviet public health contributed to the perceptions of the Board.     

The World Health Organisation. WHO in Europe: does it have a role?

WHO is under pressure from all sides to justify its existence. Donors want to know what they are getting for their money, and health professionals question the relevance of the organisation''s work. The pressure to justify itself is perhaps strongest of all in Europe, where most member countries have fully fledged health infrastructures and high overall levels of health. Now there is the additional threat of encroachment into the field of public health by the European Union. The disintegration of the Soviet bloc has given WHO''s regional office in Europe a new sense of purpose and led to a major shift in resources towards the countries of central and eastern Europe. But WHO''s critics are calling for a different shift in the way its European office works: from its current concentration on broad based policy issues to the nitty-gritty of health care management and delivery.     

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.     

State-sponsored research on creatine supplements and blood doping in elite Soviet sport

The former Soviet Union began participating in international sport after World War II and soon achieved a dominant position in the Olympic Games and other competitions. The success of Soviet athletic programs led to charges of unfair practices but, because of secrecy surrounding Soviet research in exercise biochemistry, it has been difficult to substantiate these charges. This article presents previously restricted information regarding the development and use of creatine supplements and blood doping in the USSR. Early work by Olexander Palladin established the role of creatine in muscle function. In the 1970s, Soviet scientists showed that oral creatine supplements improved athletic performance in short, intense activities such as sprints. Subsequent studies in the West substantiated these investigations and have led to the widespread acceptance and use of creatine supplements to enhance muscle function and athletic performance. In addition, however, the Soviet government supported the development of blood doping, which is banned by the International Olympic Committee. Blood doping was pervasive in the USSR in the 1970s and 1980s, and was used by many Soviet athletes in the 1976 and 1980 Olympic Games. Open publication and discussion may help to prevent the abuses that can come from secret scientific research.     

Primate research resources in the Soviet Union

The authors visited Soviet medical institutions as part of a USA-USSR Professional Exchange Program sponsored by the Fogarty International Center. The primary purpose of this visit was to obtain a general view of the Soviet use and care of laboratory animals in biomedical research and to lay a foundation for a continuing exchange of information and models.     

The 24Th Congress of the Communist Party of the Soviet Union and the Tasks of Soviet Psychology

Congresses of the Communist Party of the Soviet Union are central events for Soviet society, for they adopt general lines of attack on the problems Soviet leaders view as centrally important. This brief statement concerning psychology makes very clear the role that psychology is asked to play in such areas as increasing labor productivity and improving the techniques of upbringing for the nation's youth.     

Innocent,transit, and archipelagic sea lanes passage

Abstract

Norway is involved in two maritime boundary disputes with the Soviet Union. In relation to Svalbard, the Soviet Union argues that the archipelago has a continental shelf and an exclusive economic zone (EEZ) of its own to which all parties to the Svalbard Treaty have equal access. This is disputed by Norway, which maintains that such a view of the matter implies an expansive interpretation of the Svalbard Treaty for which there is no support in international legal practice. In the Barents Sea there is a continuing dispute between Norway and the Soviet Union over the proper location of the continental shelf and EEZ boundaries. This article sets out some of the reasons behind the different arguments on which the two base their respective cases, and the reasons why Norway in the absence of a delineated boundary has refused to accept Soviet proposals for economic cooperation in the disputed ocean area. Major emphasis is placed on the confluence of several circumstances inter alia, geopolitical and historical factors, a strongly asymmetrical power relationship, and legal ambiguity.     

Psychiatry in the Soviet Union

The services for chronically handicapped people with psychiatric disorders in the Soviet Union are described. The system is based upon a network of community units, each of which includes a day centre, a follow-up clinic, and a sheltered workshop. British services could profitably learn from the experience of these units. The diagnostic system used by many Soviet psychiatrists is different from that incorporated in the International Classification of Diseases. In particular, the term “schizophrenia” is used to describe conditions which British psychiatrists would label in other ways.This clinical difference partly explains the different concept of “criminal responsibility,” but another large component of the difference is political rather than medical. There are also variations from British practice in certain juridical procedures. These differences together make Soviet psychiatric practice in the case of political dissenters unacceptable to most British psychiatrists. It is too soon to say that frank discussions of these matters could not lead to improvement. British and Soviet psychiatrists still have something to learn from each other.     

Nutrition transition and dietary energy availability in Eastern Europe after the collapse of communism.

After the economic transition of the late 1980s and early 1990s there was a rapid increase in overweight and obesity in many countries of Eastern Europe. This article describes changing availability of dietary energy from major dietary components since the transition to free-market economic systems among Eastern European nations, using food balance data obtained at national level for the years 1990-92 and 2005 from the FAOSTAT-Nutrition database. Dietary energy available to the East European nations satellite to the former Soviet Union (henceforth, Eastern Europe) was greater than in the nations of the former Soviet Union. Among the latter, the Western nations of the former Soviet Union had greater dietary energy availability than the Eastern and Southern nations of the former Soviet Union. The higher energy availability in Eastern Europe relative to the nations of the former Soviet Union consists mostly of high-protein foods. There has been no significant change in overall dietary energy availability to any category of East European nation between 1990-1992 and 2005, indicating that, at the macro-level, increasing rates of obesity in Eastern European countries cannot be attributed to increased dietary energy availability. The most plausible macro-level explanations for the obesity patterns observed in East European nations are declines in physical activity, increased real income, and increased consumption of goods that contribute to physical activity decline: cars, televisions and computers.     

Focus: Rare Disease: mEDUrare: Supporting Integrated Care for Rare Diseases by Better Connecting Health and Education Through Policy

Rare diseases affect an estimated 6-10% of the Australian population, a prevalence similar to that seen in other regions worldwide. These multi-system conditions are often severely debilitating and affect multiple domains of a person’s life. A salient necessity for effective care provision thus, is holistic care, achieved by appropriate and continual multi-disciplinary and cross-sectoral collaboration. Synonymous with this priority for collaborative care, is the need for increased partnerships between the health and education sectors. This partnership has the potential to benefit people with rare disease of all educational ages, but in particular, school-aged children and young adults. More than 70% of rare diseases affect children, and this population often experiences difficulties with overall well-being and functioning, including impaired school performance and confounding mental and social comorbidities. Ensuring adequate schooling needs and experiences along with provision of adequate medical care, is crucial in ensuring overall well-being for this population. For this, effective partnerships between the health and education sectors are paramount. This article highlights fundamental elements of health and education priorities, ingrained in current strategic documents, to build a policy foundation that informs and supports increased inter-sectoral partnerships between health and education services. Shared priorities identified in both sectors’ guidelines, co-developed with those with lived experience of rare diseases, build a strong policy base for future advocative initiatives to mold better integration between the sectors, a partnership which is vital to improving the overall quality of life, experiences and journeys of people living with rare disease.     

The health status of Russian-speaking immigrants in Germany.

INTRODUCTION: Germany developed today into a country of immigration, which creates an additional burden for the social security system and results in a new challenge for the healthcare. In the last 17 years more than two million "Russia Germans" have been repatriated and about two hundred thousand Jewish refugees have resettled in Germany from the former Soviet Union. Nevertheless relevant data concerning migration-related public health care are very scare. METHODS: Search of PubMed and Journals extracts combined with the own researches, analysing the health status indices of the Russian-speaking immigrants in Germany. RESULTS: Both repatriates of German origin and Jewish refugees demonstrated higher prevalence of impaired lipid metabolism in comparison with native population. 42 % of the 503,040 HBsAg (hepatitis B s-Antigen) carriers in Germany were migrants. The Jewish refugees demonstrated the highest rates of depression and anxiety and the highest levels of awakening cortisol. On the other side German resettlers showed lower cardiovascular as well as all-cause death rates compared to the native Germans. CONCLUSION: The development of adequate health care programmes to address migratory aspects as well as the establishment of quality standards will realistically enhance the capability of responding rapidly to migrant health aspects and help to tackle inequalities in health.