123 research outputs found

    Association of Exposure to Police Violence With Prevalence of Mental HealthSymptoms Among Urban Residents in the United States

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    Importance Police violence is reportedly widespread in the United States and may pose a significant risk to public mental health. Objective To examine the association between 12-month exposure to police violence and concurrent mental health symptoms independent of trauma history, crime involvement, and other forms of interpersonal violence exposure. Design, Setting, and Participants This cross-sectional, general population survey study of 1221 eligible adults was conducted in Baltimore, Maryland, and New York City, New York, from October through December 2017. Participants were identified through Qualtrics panels, an internet-based survey administration service using quota sampling. Exposures Past 12-month exposure to police violence, assessed using the Police Practices Inventory. Subtypes of violence exposure were coded according to the World Health Organization domains of violence (ie, physical, sexual, psychological, and neglectful). Main Outcomes and Measures Current Kessler Screening Scale for Psychological Distress (K6) score, past 12-month psychotic experiences (World Health Organization Composite International Diagnostic Interview), and past 12-month suicidal ideation and attempts. Results Of 1221 eligible participants, there were 1000 respondents (81.9% participation rate). The sample matched the adult population of included cities on race/ethnicity (non-Hispanic white, 339 [33.9%]; non-Hispanic black/African American, 390 [39.0%]; Hispanic/Latino, 178 [17.8%]; other, 93 [9.3%]), age (mean [SD], 39.8 [15.2] years), and gender (women, 600 [60.0%]; men, 394 [39.4%]; transgender, 6 [0.6%]) within 10% above or beyond 2010 census distributions. Twelve-month prevalence of police violence was 3.2% for sexual violence, 7.5% for physical violence without a weapon, 4.6% for physical violence with a weapon, 13.2% for psychological violence, and 14.9% for neglect. Police violence exposures were higher among men, people of color, and those identified as homosexual or transgender. Respondents reported suicidal ideation (9.1%), suicide attempts (3.1%), and psychotic experiences (20.6%). The mean (SD) K6 score was 5.8 (6.1). All mental health outcomes were associated with police violence exposure in adjusted logistic regression analyses. Physical violence with a weapon and sexual violence were associated with greater odds of psychotic experiences (odds ratio [95% CI]: 4.34 [2.05-9.18] for physical violence with a weapon; 6.61 [2.52-17.36] for sexual violence), suicide attempts (odds ratio [95% CI]: 7.30 [2.94-18.14] for physical violence with a weapon; 6.63 [2.64-16.64] for sexual violence), and suicidal ideation (odds ratio [95% CI]: 2.72 [1.30-5.68] for physical violence with a weapon; 3.76 [1.72-8.20] for sexual violence). Conclusions and Relevance Police violence was commonly reported, especially among racial/ethnic and sexual minorities. Associations between violence and mental health outcomes did not appear to be explained by confounding factors and appeared to be especially pronounced for assaultive forms of violence

    The convergence of the concepts of academic and inclusive excellence at research universities

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    Introduction. In the 21st century, there is an active involvement of universities in inclusive processes; however, against the backdrop of increasing diversity, new types of inequality arise in higher education. The processes of transformation of organisational cultures in universities and their research agenda under the influence of inclusion need to be studied.The aim of the present research was to analyse the convergence of concepts of academic and inclusive excellence in foreign universities of the world level, the impact of convergence on their missions, the values expressed in official strategies, the research agenda and the infrastructure of scientific collaborations.Methodology and research methods. The authors conducted a content analysis of three strategies of world-class University associations (the Association of American Colleges and Universities, the Association of Universities in Canada, the League of European Research Universities), nine strategies for the development of universities in the USA and Canada, the European Union, and Australia. A scientometric analysis of Web of Science metadata was performed using the VOSViewer software.Results and scientific novelty. The current research confirms the convergence of values of academic excellence and inclusion in research universities. It is revealed that the concept of inclusive excellence of the university is an enriched version of its academic excellence and denotes a set of university strategies and practices aimed at achieving the best results in training, research and services through maintaining diversity and inclusive processes. The world's leading universities are actively involved in the process of creating an inclusive friendly environment and services, which are accessible to all members of the educational process, regardless of their social status and development characteristics. When universities reach academic heights, they recognise inclusion as the next level of their development. In turn, inclusion becomes a factor in the movement of the university towards academic excellence. The key characteristics and contradictions of the convergence of the concepts of inclusive and academic excellence of universities are identified. The local models of inclusive excellence of universities and the contexts, which influence these models, are described. The gaps between educational policies and research agendas of leading universities are revealed. The clusters of international studies on inclusive processes in higher education are highlighted.Practical significance. Russian universities, which implement the federal programme for improvement of international competitiveness based on the values of academic excellence, are developing in accordance with global trends. Therefore, the model of inclusive excellence of the university can be used in practical terms to implement inclusive strategies and overcome social inequality both at the university and outside of it within the framework of a new educational initiative of Russia on academic leadership.Введение. В XXI веке, с одной стороны, наблюдается активное включение университетов в инклюзивные процессы, с другой - в системе высшего образования на фоне нарастающего разнообразия возникают новые виды неравенства. Процессы трансформации организационных культур университетов и их исследовательской повестки под влиянием инклюзии нуждаются в изучении.Целью представленного в публикации изыскания является анализ конвергенции концепций академического и инклюзивного совершенства в зарубежных университетах мирового уровня, установление влияния данной конвергенции на их миссии, ценности, выраженные в официальных стратегиях, на исследовательскую повестку и инфраструктуру научных коллабораций.Методология, методы и методики. Проведен контент-анализ трех стратегий ассоциаций университетов мирового уровня (Ассоциация американских колледжей и университетов, Ассоциация университетов Канады, Лига европейских исследовательских университетов), девяти стратегий развития университетов США и Канады, Евросоюза, Австралии. При помощи программного обеспечения VOSViewer осуществлен наукометрический анализ метаданных Web of Science.Результаты и научная новизна. Исследование подтвердило конвергенцию ценностей академического превосходства и инклюзии в исследовательских университетах. Продемонстрировано, что концепция инклюзивного совершенства университета представляет собой обогащенную версию его академического совершенства и обозначает совокупность стратегий и практик вуза, направленных на достижение наилучших результатов в обучении, исследованиях и сервисе через поддержание разнообразия и инклюзивных процессов. Ведущие университеты мира активно включились в процесс формирования инклюзивной дружественной среды и услуг, доступных для всех субъектов образовательного процесса вне зависимости от их социального статуса и особенностей развития. Когда вузы достигают академических вершин, они осознают инклюзию как следующий уровень своего развития. В свою очередь, инклюзия становится фактором движения университета к академическому совершенству. Определены ключевые характеристики и противоречия конвергенции концепций инклюзивного и академического совершенства университетов. Описаны локальные модели инклюзивного совершенства учебных организаций высшей школы и контексты, влияющие на эти модели. Обозначены разрывы между образовательными политиками и исследовательскими повестками ведущих университетов. Выявлены кластеры международных исследований, посвященных инклюзивным процессам в высшем образовании. Практическая значимость. Российские вузы, реализующие федеральную программу повышения международной конкурентоспособности на основе ценностей академического совершенства, развиваются в соответствии с глобальными трендами, поэтому модель инклюзивного совершенства университета может быть использована в практическом плане для внедрения инклюзивных стратегий и преодоления социального неравенства как внутри учебного заведения, так и за его пределами в рамках новой образовательной инициативы России по академическому лидерству.The research was carried out with the financial support of the Russian Foundation for Basic Research (RFBR) in the framework of the research project No. 19-013-00373 А “Academic Mobility of Students with Disabilities in the Conditions of Higher Education Transformation”.Исследование выполнено при финансовой поддержке РФФИ в рамках научного проекта 19-013-00373 А «Академическая мобильность студентов с ограниченными возможностями здоровья и инвалидностью в условиях трансформации высшего образования»

    Effect of ABCB1 Gene Carriage and Drug-Drug Interactions on Apixaban and Rivaroxaban Pharmacokinetics and Clinical Outcomes in Patients with Atrial Fibrillation and Deep Vein Thrombosis

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    Aim. To investigate the effect of ABCB1 gene carriage and interdrug interactions on apixaban pharmacokinetics and clinical outcomes in patients with atrial fibrillation and deep vein thrombosis.Material and methods. Patients hospitalized at Yudin State Clinical Hospital participated in the study. A total of 92 patients (50 patients received apixaban and 42 – rivaroxaban) with non-valvular atrial fibrillation and deep vein thrombosis were included. Genotyping was performed by real-time polymerase chain reaction. Direct oral anticoagulants concentrations were measured using an electrospray ionization mass spectrometer in positive ionization mode.Results. In our study we found that in patients carrying the CT+TT ABCB1 (rs4148738) C>T genotype encoding the carrier protein (P-gp), the plasma concentration of rivaroxaban was statistically significantly higher p= 0.026. In addition, we found that patients taking apixaban together with a CYP3A4/P-gp inhibitor were 3.5 times more likely to have hemorrhagic complications than those without inhibitors p = 0.004.Conclusion. Our study revealed that the plasma concentration of rivaroxaban was higher in patients carrying the ABCB1 (rs4148738) C>T polymorphism T allele. And patients taking apixaban together with CYP3A4/P-gp inhibitor had higher risk of hemorrhagic complications in comparison with patients not taking such drugs. Further studies are needed on the influence of pharmacogenetics and pharmacokinetics on the safety and efficacy profile of apixaban and rivaroxaban, taking into account the trend of systemic approach to optimization of anticoagulant therapy of direct oral anticoagulants based on pharmacokinetic, pharmacogenetic biomarkers

    Development of a model for the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury in hospitalized adult patients

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    Relevance. During and after the COVID-19 pandemic, viruses have become a more common cause of pulmonary infections in adults; therefore, the distinction between viral lung injury and community-acquired bacterial pneumonia is of increasing importance. Aim. Development of a model for differentiating community-acquired bacterial pneumonia and viral lung injury, including COVID-19. Materials and methods. This retrospective case–control study included 300 adult patients with viral lung injury and 100 adult patients with community-acquired bacterial pneumonia. Clinical, laboratory, and instrumental data were analyzed, significant factors were selected by which the samples differed, and a model was developed using logistic regression to distinguish between community-acquired bacterial pneumonia and viral lung damage, including COVID-19. Results. The developed model included the following parameters: total protein level, neutrophil/lymphocyte index, heart rate, unilateral infiltration on CT or chest x-ray, vasopressor prescription in the first 24 h of hospitalization, altered level of consciousness, chills, and fatigue. The model had the following characteristics: AUC = 0.94 (0.92–0.96), AUC_PR = 0.84 (0.76 to 0.92), prediction accuracy — 90%, sensitivity — 76%, specificity — 95%, positive predictive value — 83 %. Conclusion. The use of this model can facilitate the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury, including COVID-19, in adults in general wards and intensive care units

    Analysis of associations between pharmacodynamic genetic factors and antipsychotics’ effectiveness and safety in adolescents with acute psychotic episodes taking antipsychotics during a 28-day follow-up

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    Introduction. Antipsychotics are the main drugs for treatment of schizophrenia spectrum disorders. Pharmacodynamic genetic factors are being actively studied to improve the accuracy of antipsychotic selection based on pharmacogenetic testing. Purpose of this study: to establish associations of genetic polymorphisms of the DRD2, DRD3, DRD4, HTR2A, COMT, ZNF804A, and ANKS1B genes with the efficacy and safety of antipsychotics in adolescents with an acute psychotic episode during a 28-day follow-up. Materials and methods. The study included 68 adolescents with an established diagnosis of acute polymorphic psychotic disorder at the time of admission (F23.0-9 according to ICD-10). All patients received an antipsychotic as their main therapy. Patients were monitored for 28 days. The effectiveness of antipsychotics was assessed using the Children’s Global Assessment Scale (CGAS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I). The safety of pharmacotherapy was assessed using the UKU Side Effects Rating Scale (UKU SERS), Sympson-Angus Scale (SAS), Barnes Akathisia rating scale (BARS). From each patient we obtained a buccal scraped epithelium, extracted DNA from it by sorbent method and detected carriage of genetic polymorphisms DRD2 rs1800497 (C>T), DRD3 rs6280 (C>T), DRD3 rs324026 (C>T), DRD4 rs1800955 (C>T), HTR2A rs6313 (T>C), COMT rs4680 (Val158Met, G>A), ZNF804A rs1344706 (A>C), ANKS1B rs7968606 (C>T) by real-time PCR. Results. DRD2 rs1800497 T allele carriers had a stronger reduction in the PANSS subscore «Productive Symptomatics» on day 14 (Me=-7.0 [-9.0;-5.0] vs Me=-7.0 [-8.0;-2.0]; p=0.018) and day 28 of follow-up (Me=-11.0 [-9.0;-5.5] vs Me=-8.0 [-8.0;-2.0]; p=0.019). Also, greater improvement on the CGAS scale on day 14 of follow-up was seen in TC+CC HTR2A rs6313 carriers (Me=2.0 [1.0;3.0] vs. Me=2.0 [1.0;2.0]; p=0.029). DRD3 rs324026 homozygous carriers (TT) had a significantly lower SAS score (Me=0.5 [0.0; 1.0] vs. Me=1.0 [0.0; 5.0]; p=0.016) and UKU subscore «Neurological Disorders» on 28 days of antipsychotic therapy (Me=0.0 [0.0; 0.0] vs. Me=1.0 [0.0; 3.8]; p=0.005). DRD3 rs324026 TT carriers also had lower severity of akathisia according to the BARS scale. Carriers of the T DRD4 rs1800955 allele had a higher SAS scale score on day 28 of therapy compared with CC homozygotes (Me=1.0 [0.0;4.0] vs Me=0.0 [0.0;1.0]; p=0.036). Conclusion. The DRD2 rs1800497 was a predictor of better reduction of productive symptoms; HTR2A rs6313 demonstrated a similar association. The DRD2 rs1800497 polymorphic variant was a predictor of better reduction of productive symptomatology; HTR2A rs6313 demonstrated a similar association. DRD3 rs324026 and HTR2A rs6313 were associated with a lower frequency of neurological adverse reactions and akathisia. In contrast, carriers of the DRD4 rs1800955 were more prone to adverse reactions on pharmacotherapy

    Sex peptide receptor-regulated polyandry mediates the balance of pre- and post-copulatory sexual selection in Drosophila

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    Polyandry prolongs sexual selection on males by forcing ejaculates to compete for fertilisation. Recent theory predicts that increasing polyandry may weaken pre-copulatory sexual selection on males and increase the relative importance of post-copulatory sexual selection, but experimental tests of this prediction are lacking. Here, we manipulate the polyandry levels in groups of Drosophila melanogaster by deletion of the female sex peptide receptor. We show that groups in which the sex-peptide-receptor is absent in females (SPR-) have higher polyandry, and – as a result – weaker pre-copulatory sexual selection on male mating success, compared to controls. Post-copulatory selection on male paternity share is relatively more important in SPR- groups, where males gain additional paternity by mating repeatedly with the same females. These results provide experimental evidence that elevated polyandry weakens pre-copulatory sexual selection on males, shifts selection to post-copulatory events, and that the sex peptide pathway can play a key role in modulating this process in Drosophil
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