Russia's national interests in the Transcaucasus and the U.S. policy implications for Armenian national security

The purpose of this thesis is to evaluate Armenian foreign policy toward the two major regional players-the United States and Russia. What are the United States' and Russia's security, economic, political and human rights interests in the South Caucasus? What are the regional security interdependencies and how are they influenced by these powers? What are the major determinants of Armenia's foreign policy? In its pursuit of national interests, what should be Armenia's foreign policy toward these powers? Answering these questions requires knowing Armenia's geopolitical environment, security concerns and historical experience. This thesis finds that Armenia, despite its limited natural resource base and geopolitical complexities, has managed its foreign relations and has addressed its national security concerns quite well. It has maintained good relations with both Russia and the United States, helping to reduce regional polarization and its own security dependence on either of the powers. The flexibility of its policy has allowed Armenia to adjust easily to global geopolitical and regional trends. Increasing U.S. involvement in the South Caucasus and the U.S.-Russian strategic partnership have opened up new avenues for Armenia to strengthen its security.http://archive.org/details/russiasnationali109452865Approved for public release; distribution is unlimited

Microwave Accelerated Transglycosylation of Rutin by Cyclodextrin Glucanotransferase from Bacillus sp. SK13.002

Rutin was subjected to intermolecular transglycosylation assisted with microwave irradiation using cyclodextrin glucanotransferase (CGTase) produced from Bacillus sp. SK13.002. Compared with the conventional enzymatic method for rutin transglycosylation (without microwave irradiation), microwave-assisted reaction (MAR) was much faster and thus more efficient. While the conventional reaction took dozens of hours to reach the highest conversion rate of rutin and yield of transglycosylated rutin, MAR of rutin transglycosylation completed within only 6 min providing almost the same conversion rate of rutin and yield of products consisting of mono-, di-, tri-, tetra-, penta-glucosylated rutins. The optimum transglycosylation conditions for microwave irradiation were 40 °C and 60 W with the reaction system consisting mainly of the mixture of 0.3 g rutin (0.49 mmol) pre-dissolved in 15 mL methanol, 1.8 g maltodextrin in 15 mL of 0.2 M sodium acetate buffer (pH 5.5) and CGTase (900 U). Results from this study indicated that MAR could be a potentially useful and economical technique for a faster and more efficient transglycosylation of rutin

Hygienic awareness of drinking water consumers among students

The purpose of the study is to assess the level of hygienic awareness of drinking water filter use among students.Цель исследования – оценить уровень гигиенической осведомленности в использовании фильтров питьевой воды среди студентов

Analysis of the structure of health care spending in the Sverdlovsk region

The aim of the study – to analyze the structure and dynamics of forming the health care budget in 2017–2020.Цель исследования – проанализировать структуру и динамику формирования бюджета в сфере здравоохранения за период с 2017 по 2020 год

Mechanistic insights into chemical and photochemical transformations of bismuth vanadate photoanodes

Artificial photosynthesis relies on the availability of semiconductors that are chemically stable and can efficiently capture solar energy. Although metal oxide semiconductors have been investigated for their promise to resist oxidative attack, materials in this class can suffer from chemical and photochemical instability. Here we present a methodology for evaluating corrosion mechanisms and apply it to bismuth vanadate, a state-of-the-art photoanode. Analysis of changing morphology and composition under solar water splitting conditions reveals chemical instabilities that are not predicted from thermodynamic considerations of stable solid oxide phases, as represented by the Pourbaix diagram for the system. Computational modelling indicates that photoexcited charge carriers accumulated at the surface destabilize the lattice, and that self-passivation by formation of a chemically stable surface phase is kinetically hindered. Although chemical stability of metal oxides cannot be assumed, insight into corrosion mechanisms aids development of protection strategies and discovery of semiconductors with improved stability

Prerequisites, components and barriers to the implementation of a smoking cessation training course for medical residents in Armenia

Introduction Studies suggest that trained physicians are about twice as likely to offer help to patients who smoke in contrast to non-trained physicians. Yet, inadequate training on tobacco dependence and its treatment is one of the major obstacles for consistent and effective treatment of tobacco dependence. The study aimed to explore the needed resources, prerequisites, components and barriers for implementing a pilot smoking cessation training course for medical residents in Armenia to provide practical skills and knowledge on smoking cessation counseling. Methods The research team utilized a qualitative research method by conducting four focus group discussions (overall 14 residents participated in the discussions) with medical residents from Yerevan State Medical University and four in-depth interviews with medical faculty members and administrators. The participants were recruited using convenience and snowball sampling techniques. Directed content analysis was utilized for data analysis. Results The main preconditions for teaching a smoking cessation training course were the residents’ exposure to tobacco related topics during the years of study, having some experience in advising smokers to quit and in managing patients, and negative attitude toward patient’s smoking. The duration of the training and use of active learning methods were likely to be the important components in planning and implementing the training course. Finally, the major barriers mentioned by participants included lack of time to attend the training due to clinical duties, underestimation of the physician’s role in patient’s decisions related to smoking cessation, low interest in the topic among residents who were smokers themselves, and shortage of time for counseling patients during hospitalization due to their short in-hospital stay. Conclusions Most of the participants were interested in the smoking cessation training course and helping their patients to quit. The study team will need to account for the identified barriers for the successful implementation of the program. Funding The study was a part of a larger collaborative project funded by the Swiss National Science Foundation and Swiss Agency for Development and Cooperation

In silico study of colchicine resistance molecular mechanisms caused by tubulin structural polymorphism.

Starting from 1972, colchicine is known as the most useful drug for prevention of familial Mediterranean fever attacks. However, some patients do not respond to colchicine treatment, even taken in high doses. Despite the fact, that different hypotheses have been proposed, the molecular mechanisms of colchicine resistance are not completely clear. It is generally known, that colchicine binds β-tubulin and inhibits microtubules polymerization. The β-tubulin gene has SNPs, which lead to amino acid substitutions, and some of them are located in colchicine binding site (CBS). We have assumed, that this SNPs can affect tubulin-colchicine interaction and might be the reason for colchicine resistance. With this in mind, we modeled 7 amino acid substitutions in CBS, performed molecular dynamics simulations of tubulin-colchicine complex and calculated binding energies for every amino acid substitution. Thus, our study shows, that two amino acid substitutions in the β-tubulin, namely A248T and M257V, reduce binding energy for approximately 2-fold. Based on this, we assume, that these amino acid substitutions could be the reason for colchicine resistance. Thus, our study gives a new insight into colchicine resistance mechanism and provides information for designing colchicine alternatives, that could be effective for colchicine resistant patients

Learning to assist smokers through encounters with standardized patients: An innovative training for physicians in an Eastern European country

Objectives: A lack of physician training is a major obstacle for effective tobacco dependence treatment. This study assessed the feasibility of an active learning training program and its effects on smoking cessation counselling skills of medical residents in Armenia, an Eastern European country with high smoking prevalence. Study design: The study used a pre-post assessment of smoking cessation counselling activities and a course evaluation survey to assess the feasibility of the intervention in a different environment. Methods: We adapted an active learning training model developed in Switzerland. Residents were trained in Yerevan, Armenia, using video-taped counselling sessions, role plays, standardized patients (actors), group discussions and immediate feedback. The training evaluation was done using a semi-structured anonymous questionnaire. The study assessed the physicians' self-reported smoking cessation counselling activities before and 6 months after the training. A non-parametric Mann-Whitney test was used to assess pre-post differences in physicians' counselling skills measured on ordinal scale. Results: Of the 37 residents trained, 75% were female, 89% aged 20-29 years and 83% were never-smokers. Twenty-eight trainees (76%) returned the course evaluation survey and 32 (86%) answered a questionnaire on skills self-assessment at 6 months follow-up. The majority agreed the course was successful in achieving its learning objectives (64%-96%) and increased their confidence in assisting their patients to quit (74%). After 6 months, the physicians were more likely than at baseline to adhere to evidence-based counselling strategies, including assessing the smoking status and dependence and matching the advice to the patient motivation. The training did not, however, improve the prescription of tobacco dependence medications. Conclusions: Six months after the training, several self-reported smoking cessation counselling activities had significantly improved compared to baseline. This training model is acceptable for medical residents in Yerevan, Armenia and offers a promising approach in addressing the lack of physician counselling skills in similar settings and populations

Behavior change communication model enhancing parental practices for improved early childhood growth and development outcomes in rural Armenia – A quasi-experimental study

The latest evidence demonstrates the importance of nurturing care from conception to lay a strong foundation for children's cognitive, socio-emotional and physical well-being. The interventions enhancing parental practices in children's health and growth, protection from neglect, abuse, and injury have lifelong impact on health, learning, economic productiveness outcomes. Existing maternal and child health delivery platforms might potentially be utilized to integrate Early Childhood Development interventions. However, there is a dearth of studies demonstrating the feasibility and effectiveness of an integrated MCH and ECD model. ECD component was integrated into MCH program activities, implemented and tested in Armenia. For 14 months, all mothers of children aged 0 to 23 months (1300) living in 43 communities in Gegharkunik province (Armenia) participated in the study. Twenty-three intervention communities (680 children) received added ECD package to MCH intervention, and 20 control communities (630 children) received only MCH intervention. We used a quasi-experimental intervention-control design, with pre-and post-data collected. Variables measured and compared were related to child development, nutrition status, parental child care (stimulation, discipline) and nutrition practices.Intervention sites showed 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites. Child caregivers had better child care, nutrition practices and early learning support than controls. No change was found in discipline practices and stunting rates. MCH-ECD integrated model is an effective delivery platform for improving parenting behavior, child growth, and development. Keywords: Behavior change, Parental practices, Early childhood development, Quasi-experimental stud