Coercion, Violation of Privacy and Everyday Difficulties as the Cause of Patient Refusal Treatment in Psychiatric Hospitals in Russia

Treatment in a psychiatric hospital is accompanied by a restriction of independence, violation of privacy, coercion, which causes displeasure of patients. The aim of the study was to verify the scale of everyday problems, violations of privacy and coercion in a psychiatric hospital to develop recommendations for the organization of a therapeutic environment. The study included 191 patients in a psychiatric hospital. Anonymous questionnaire was used. Statistical processing of the database was carried out by nonparametric methods. The majority of patients (67%) estimated the conditions of stay in a psychiatric hospital at 7-10 points (10-point scale), but half of them complained about the need for self-purchase of drugs. A full night's sleep was disturbed by the snoring of others (56.5%), an uncomfortable bed (36.6%), bright light (26.2%). The poor diet was indicated by 45.5% of patients. Patients indicated coercion by medical staff: retention (11.5%), forced administration of drugs (12%), coercion to consent to treatment (22%), refusal to discharge from hospital (35.1%). It was reported that there was a violation of privacy in the toilet (36.6%), difficulties to observe the intimate hygiene (16.8%). These problems caused patients to refuse inpatient treatment if there was the possibility of outpatient treatment (65.2% of men and 52.6% of women). Despite the low level of claims of patients to living conditions, it is important to respect their rights in psychiatric hospitals to privacy, creating a comfortable living space, the organization of differentiated methods of observation by medical staff

«Marshall Plan» for Donbass: prerequisites for investment development

The preconditions for restoration and investment development of Donbass according to the international "Marshall Plan" in case of peaceful settlement of armed conflict are determined. Significant advantages of Donbass as an object of the Marshall Plan implementation are shown, in particular, depending on the stages of the peaceful settlement in the Donbass, as well as the directions of investment of the enterprises of the largest cities of Donbas. The proposed estimation of volumes of annual investments, receipt of additional products, possibilities of its immediate consumption is offered.Визначено передумови відновлення й інвестиційного розвитку Донбасу згідно з міжнародним «Планом Маршалла» у разі мирного врегулювання збройного конфлікту. Показано суттєві переваги Донбасу як об’єкту запровадження «плану Маршалла», зокрема, у залежності від етапів мирного врегулювання в Донбасі, а також напрямки інвестування підприємств найбільших міст Донбасу. Запропоновано укрупнену оцінку обсягів щорічних інвестицій, отримання додаткової продукції, можливості її негайного споживання.Определены предпосылки восстановления и инвестиционного развития Донбасса в соответствии с международным «Планом Маршалла» в случае мирного урегулирования вооруженного конфликта. Показаны существенные преимущества Донбасса как объекта осуществления «плана Маршалла», в частности, в зависимости от этапов мирного урегулирования в Донбассе, а также направления инвестирования предприятий крупнейших городов Донбасса. Предложена укрупненная оценка объемов ежегодных инвестиций, получения дополнительной продукции, возможности ее немедленного потребления

High-resolution NMR structure of the antimicrobial peptide protegrin-2 in the presence of DPC micelles

© 2014 Springer Science+Business Media Dordrecht. PG-1 adopts a dimeric structure in dodecylphosphocholine (DPC) micelles, and a channel is formed by the association of several dimers but the molecular mechanisms of the membrane damage by non-α-helical peptides are still unknown. The formation of the PG-1 dimer is important for pore formation in the lipid bilayer, since the dimer can be regarded as the primary unit for assembly into the ordered aggregates. It was supposed that only 12 residues (RGGRL-CYCRR-RFCVC-V) are needed to endow protegrin molecules with strong antibacterial activity and that at least four additional residues are needed to add potent antifungal properties. Thus, the 16-residue protegrin (PG-2) represents the minimal structure needed for broad-spectrum antimicrobial activity encompassing bacteria and fungi. As the peptide conformation and peptide-to-membrane binding properties are very sensitive to single amino acid substitutions, the solution structure of PG-2 in solution and in a membrane mimicking environment are crucial. In order to find evidence if the oligomerization state of PG-1 in a lipid environment will be the same or not for another protegrins, we investigate in the present work the PG-2 NMR solution structure in the presence of perdeuterated DPC micelles. The NMR study reported in the present work indicates that PG-2 form a well-defined structure (PDB: 2MUH) composed of a two-stranded antiparallel β-sheet when it binds to DPC micelles

Antimicrobial peptide protegrin-3 adopt an antiparallel dimer in the presence of DPC micelles: A high-resolution NMR study

© 2015 Springer Science+Business Media Dordrecht. A tendency to dimerize in the presence of lipids was found for the protegrin. The dimer formation by the protegrin-1 (PG-1) is the first step for further oligomeric membrane pore formation. Generally there are two distinct model of PG-1 dimerization in either a parallel or antiparallel β-sheet. But despite the wealth of data available today, protegrin dimer structure and pore formation is still not completely understood. In order to investigate a more detailed dimerization process of PG-1 and if it will be the same for another type of protegrins, in this work we used a high-resolution NMR spectroscopy for structure determination of protegrin-3 (RGGGL-CYCRR-RFCVC-VGR) in the presence of perdeuterated DPC micelles and demonstrate that PG-3 forms an antiparallel NCCN dimer with a possible association of these dimers. This structural study complements previously published solution, solid state and computational studies of PG-1 in various environments and validate the potential of mean force simulations of PG-1 dimers and association of dimers to form octameric or decameric β-barrels

Coercion, violation of privacy and everyday difficulties as the cause of patient refusal treatment in psychiatric hospitals in Russia

Treatment in a psychiatric hospital is accompanied by a restriction of independence, violation of privacy, coercion, which causes displeasure of patients. The aim of the study was to verify the scale of everyday problems, violations of privacy and coercion in a psychiatric hospital to develop recommendations for the organization of a therapeutic environment. The study included 191 patients in a psychiatric hospital. Anonymous questionnaire was used. Statistical processing of the database was carried out by nonparametric method

Students opinion monitoring by Ural state medical university about score-rating sytem of evaluation achievement

The article analyzes the students’ opinions about the impact of the score-rating system on their academic performance and participation in the research work. The results of the survey of students of the fourth year medical and pediatric departments. The survey results are compared with indicators of achievement and rating of students participate in research work.В статье проведен анализ мнения студентов о влиянии балльно-рейтинговой системы на их успеваемость и участие в научно-исследовательской работе. Рассмотрены результаты анкетирования студентов четвертого курса лечебно-профилактического и педиатрического факультетов. Результаты опроса сопоставлены с показателями успеваемости и рейтингом участия студентов в научно-исследовательской работе

Prevalence and dynamics of depression and anxiety in local and foreign medical students for a 6-year training period

The academic load in medical institutes is 2 times higher than in other universities, and the training itself is emotionally stressful, which affects the students’ health. A continuous sample of 1045 medical students from 1 to 6 year of education was examined: 724 local (Russian) and 321 foreign students (India). Depression was more common among Russian (28.7%) than foreign students (17.8%

Prevalence and dynamics of depression and anxiety in local and foreign medical students for a 6-year training period

The academic load in medical institutes is 2 times higher than in other universities, and the training itself is emotionally stressful, which affects the students' health. A continuous sample of 1045 medical students from 1 to 6 year of education was examine

Initial and severe cases of influenza in 2020-2022 and population immunity prior to epidemic season

The purpose of the present work was to evaluate population immunity to influenza and molecular genetic analysis of influenza viruses detected in the Russian Federation over 2020-2022. In this study, 1344 samples of blood serum collected prior to the 2021-2022 flu season in Siberian, Southern, Far Eastern, Volga and Ural Federal Districts were studied. Seropositivity to the A/Victoria/2570/2019 vaccine strain (H1N1) pdm09 was detected in 25% to 31% of samples from the four federal districts, and in 8% of samples from the Far Eastern Federal District. Seropositivity to the A/Cambodia/e0826360/2020 strain (H3N2) was detected in 24% to 37% of the samples. The lowest population immunity was revealed to the influenza B/Washington/02/2019 vaccine strain (Victoria lineage), with < 10% of serum samples reactive to the studied strain. Since March 2020, the worldwide turnover of all seasonal respiratory viruses has sharply decreased, except of rhinoviruses. From March 2020 to June 2021, we have identified six B/Victoria influenza viruses from sporadic cases of influenza. From June 2021 to the end February 2022, the State Research Center “Vector” received 901 samples positive for influenza A(H3N2) virus RNA, two specimens positive for A(H1N1) pdm09 virus RNA, and 17 samples positive for influenza B. All studied A(H3N2) viruses belonged to the 3C.2a1b.2a2 subclade (Bangladesh group). The two verified A(H1N1) pdm09 influenza viruses belonged to the 6B.1A.5a clade. All studied influenza B viruses were assigned to the B/Victoria genetic lineage, and to 1A.3a2 subclade. The genomes of all identified viruses did not contain mutations of the NA gene responsible for drug resistance to neuraminidase inhibitors, or mutations in РA gene responsible for baloxavir resistance. All viruses tested by fluorescence assay were sensitive to oseltamivir and zanamivir. The worldwide frequency of influenza isolates resistant to antineuraminidase drugs does not exceed 1-2% of cases. Hence, oseltamivir and zanamivir provide effective treatment for seasonal influenza

Cytokine profile in hospitalized patients with COVID-19 of different severity

Analysis of cytokine profile markers in conjunction with the clinical manifestations of coronavirus disease 2019 (COVID-19) can provide valuable information about the pathogenetic manifestations of the disease, and therefore, in the future, determine drugs that affect the cytokine storm and have an anti-inflammatory effect.Aim. To identify correlations between the parameters of the developed cytokine profile and the clinical course in hospitalized patients with COVID-19 of different severity.Material and methods. The study included 70 hospitalized patients with a confirmed diagnosis of COVID-19, with a mean age of 58 [50;69] years, including 40 men (57%) and 30 women (43%). The average lung involvement according to computed tomography (CT) at admission was CT-2 [1;3]. Peripheral venous blood was taken at admission, which averaged 7 [6; 8] days from the symptom onset. Standard biochemical parameters were studied, as well as 47 cytokines and chemokines using the Multiplex system (Merck KGaA, Darmstadt, Germany).Results. Correlations was found between the lung involvement degree and the level of IL-8 (r=0,31, p<0,05), IL-15 (r=0,35, p<0,05), IL-18 (r=0,31, p<0,05), MCP-1 (r=0,36, p<0,05), MIG (r=0,50, p<0,05), TNF-α (r=0,41, p<0,05). An inverse correlation was also found in the level of blood oxygen saturation with the same indicators as follows: IL-8 (r=-0,27, p<0,05), IL-15 (r=-0,34, p<0,05), IL-18 (r=-0,31, p<0,05), MCP-1 (r=-0,40, p<0,05), MIG (r=-0,56, p<0,05), TNF-α (r=-0,45, p<0,05). IL-6 levels were significantly elevated in patients with severe COVID-19 (CT3, CT4), while no increase in IL-6 was observed in patients with moderate disease (CT1, CT2). It is noteworthy that in patients with diabetes, the highest values of IL-12, IL-9 were recorded.Conclusion. Hyperinflammatory syndrome in severe COVID-19 is manifested by high levels of IL-6, MIG, MDC, MCP-1, M-CSF, TNF-α, β, IL-8, IL-18, IL-15. With the CT-1 and CT-2, an increase in only the level of IL-18, IL-8 is noted. The identified patterns prove and make it possible to explain a number of systemic inflammatory changes that occur with COVID-19