Biomedical journals and databases in Russia and Russian language in the former Soviet Union and beyond

In the 20th century, Russian biomedical science experienced a decline from the blossom of the early years to a drastic state. Through the first decades of the USSR, it was transformed to suit the ideological requirements of a totalitarian state and biased directives of communist leaders. Later, depressing economic conditions and isolation from the international research community further impeded its development. Contemporary Russia has inherited a system of medical education quite different from the west as well as counterproductive regulations for the allocation of research funding. The methodology of medical and epidemiological research in Russia is largely outdated. Epidemiology continues to focus on infectious disease and results of the best studies tend to be published in international periodicals. MEDLINE continues to be the best database to search for Russian biomedical publications, despite only a small proportion being indexed. The database of the Moscow Central Medical Library is the largest national database of medical periodicals, but does not provide abstracts and full subject heading codes, and it does not cover even the entire collection of the Library. New databases and catalogs (e.g. Panteleimon) that have appeared recently are incomplete and do not enable effective searching

Maternal Health in Russia : understanding clinical practices in an information poor setting

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Environmental and social factors as determinants of respiratory dysfunction in junior schoolchildren in Moscow.

BACKGROUND: The process of industrialization of the USSR has left a legacy of widespread and often poorly controlled pollution which is widely believed to have adverse implications for health, in particular for respiratory disease among children. OBJECTIVES: To assess the relationship between area of residence and respiratory function in junior schoolchildren in different districts of Moscow. METHODS: A survey was conducted of 539 children aged 6-12 years who attend school and live in one of three districts of Moscow with varying ambient pollution levels. Spirometry [forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)] was assessed at school by trained school health staff. Parents of the children completed a questionnaire asking about respiratory function and factors potentially associated with it, as well as about social and other factors that could influence respiratory development and the health status of their children. RESULTS: There was appreciable difference in the characteristics of the children from the three districts. Children from the lower pollutant districts were generally younger, had higher parental income, and were less frequently exposed to cigarette smoke at home. They were also less likely to report heavy lorry traffic in the streets outside their homes. After adjustment for age, gender and height the FVC was 7.6 per cent (3.6-11.5 per cent) lower in children from the medium pollution district and 9.9 per cent [95 per cent confidence interval (CI) 5.6-14.0 per cent] lower in children from the high pollution district compared with those in the least polluted district (p < 0.001 for trend). These differences were little affected by further adjustment for household income or exposure to household smoking. In contrast, FEV1 showed comparatively little variation across districts. The odds of a forced expiratory ratio (FER) <75 per cent were substantially lower in the high pollution compared with the low pollution district (odds ratio 0.10, 95per cent CI 0.03-0.32 after adjustment for age, gender and height), and there was clear evidence of a trend across pollution categories (p < 0.001). The frequency of reported allergy was also lower in the high pollution district. FVC increased, and the probability of a low FER decreased, with household income. CONCLUSION: Children from areas of high environmental pollution had lower lung capacity but also smaller risk of a low FER compared with those from cleaner areas. The extent to which these differences can be attributed to environmental pollution is unclear without more detailed study. However, socio-economic deprivation, which was associated with pollution, appears to be an important determinant of respiratory function although it was associated with a lower risk of an obstructive pattern of lung function tests

Delivering babies in a time of transition in Tula, Russia.

OBJECTIVE: To investigate the provision of maternal services in the Tula region of Russia, with an emphasis on variations in practice. METHOD: The study was set in Tula Oblast. Data sources included an obstetric information database detailing all Tula deliveries in 2000 (n = 11,123) and structured interviews with the heads of maternity facilities and hospital maternity departments. RESULTS: Caesarean-section rates varied from 3.3-37%; episiotomy from 9-80%; and amniocentesis from 0-51%. As fertility rates fell since the 1980s, increasing numbers of women were hospitalized for 'pathological pregnancy' in an attempt to preserve infrastructure. CONCLUSION: Over-medicalization arises in a system typified by excess capacity and large numbers of specialists. Some practice variations were correlated with characteristics of mothers, but others derive from systems structures such as equipment availability. Improvements in practice will require addressing these structural elements and steering the clinical culture towards evidence-based medicine, rather than simply writing new decrees

The decision to perform Caesarean section in Russia.

BACKGROUND: Clinical practice in Russia is set out in a series of centralized guidelines. However, many of these guidelines are not supported by evidence and, despite their existence, there is considerable unexplained variation in practice. This study examines the decision to recommend a Caesarean section, an intervention for which there is a solid evidence base, but whose use varies considerably among facilities in Russia. AIM: To identify the factors that Russian obstetricians take into account when recommending a Caesarean section. METHODS: Conjoint analysis. Ninety-two obstetricians from three regions were asked to state whether they would recommend a Caesarean section in each of 30 vignettes (including three for validation) combining 10 medical, social and organizational factors previously identified as contributing to the decision to intervene, including some absolute indications to intervene or not to, on the basis of international evidence. RESULTS: Checks for consistency within ratings by individuals gave no cause for concern. However, there was a wide variation in the probability of intervening among obstetricians, with six recommending intervention in only one scenario and one in 27 scenarios. Some factors were consistent with evidence but others were not, such as myopia or previous abortions. INTERVENTION: was more likely at 11 p.m. than at noon. Male obstetricians were more likely to intervene than females. CONCLUSION: This study highlights the importance of understanding clinical decision-making in Russia as a prelude to changing it

Prison health in Russia: the larger picture.

Russia, despite recent legal reforms, still has one of the highest rates of imprisonment in the world. There are many reports of the adverse conditions in Russian prisons, often highlighting the consequences for health, in particular, risks of HIV, tuberculosis, and other infectious diseases. However, there are no reviews of the broader health issues in the Russian penal system. This paper reviews the available information on the health of the imprisoned population in Russia and the factors underlying it. It was undertaken by means of a search of Russian and international literature, including unpublished sources, supplemented by in-depth interviews with 27 key informants from the Ministry of Justice, prison administration, and non-governmental organizations. Published and unpublished data from the ministries of health and justice were used to describe the demographic characteristics of the imprisoned population and compare it with the general population. Although convicts are drawn disproportionately from disadvantaged groups in society and are detained in adverse physical conditions, the standardized mortality ratio from all causes is slightly over one-third of that in the overall Russian male population. This is mainly explained by an eight-fold lower mortality from external causes and a more than two-fold lower mortality from cardiovascular disease. These far outweigh the increased mortality from infectious diseases. The chances of survival of young men in Russia may actually be improved by being in prison, highlighting the need for policies that reduce the overall level of violence and other external risks, such as dangerous driving habits, in Russian society. Yet while conditions are improving in Russian prisons, with death rates falling, there are still many avoidable deaths and high levels of mental illness and infectious disease. There is also much that is not known about the health of Russian convicts, with what is available reflecting what is measured rather than what is important

Implementing general practice in Russia: getting beyond the first steps

Russia has been trying to establish a model of primary health care based on integrated general practice. Is it managing to shake off the old attitudes and infrastructures of the Soviet era