Fortification of food with micronutrients: development of methodological and regulatory framework in the Russian Federation

The available scientific literature, domestic and international regulatory codes of normative documents concerning the fortification of various types of food products have been analyzed. The groups of food products of conventional and regular consumption included into the diets of all categories of consumers, recommended for fortification with essential micronutrients, have been determined: wheat and cereal flour (spelt wheat, buckwheat, oat, corn flour, etc.); pastry; milk and dairy products, including ice cream; non-alcoholic soft drinks; mineralized drinking water; fruit and vegetable juices; fat and oil products (vegetable oils, margarines, spreads, mayonnaise); confectionery and sweets (pastry, sugar, chocolate); cereals (breakfast cereals, muesli, ready-to-eat extruded cereals, instant pasta and cereals, mixtures for bakery, flour for sweet pastry); food concentrates (jelly, instant drinks, concentrates of sweet foods, instant food, instant cereal concentrates); table salt. The groups of food products assigned for certain categories of population are used as part of therapeutic diets for patients with various diseases (metabolic disorder syndrome, cardio-vascular system pathology with atherosclerotic vascular injury, type 2 diabetes mellitus, gastrointestinal tract diseases, non-alcoholic fatty liver disease, diabetic nephropathy, etc.), as well as assigned to reduce the risk of diseases developing, the nutrients are recommended for targeted fortification of certain types of food. Examples of micronutrients fortification of sausages and minced meat semifinished products are given below. Requirements for fortification of mass consumption food products and for fortification of foods for special dietary uses are formulated in this article, the amount of fortifying components in the various groups of food products are justified, ensuring their efficiency for improving the micronutrient status and safety of its consumption. Based on the analysis of the available scientific literature, domestic and international regulatory framework of normative documents on fortification of various types of food products, recommendations have been developed for fortification of food with micronutrients

Склонность к социальному серфингу среди молодежи России: региональная специфика

Introduction. The phenomenon of social surfing, as a specific mobility strategy, largely determines the life of Y and Z generations, and creates an ambiguous context in terms of threats and opportunities for the formation of life trajectories of Russian youth. This actualised the search for theoretical and methodological foundations of understanding and practical tools for assessing the state of this problem, which, in turn, made it possible to scale this phenomenon in the context of the modern youth environment in Russia. The aim of the present research was to identify the degree of loyalty and potential tendency to use the "social surfing" strategy by the representatives of young people in Russian regions, taking into account the assessment of the approval of gender models of this behaviour strategy. Research methodology, methods and techniques. The methodological framework for describing the phenomenon of social surfing is based on the social topology of M. Castells, the heterological concept of the rhizome by J. Deleuze and F. Guattari, the philosophy of mobility by J. Urry, Z. Bauman, U. Beck, the theory of transitivity (E. M. Dubovskaya, T. D. Martsinkovskaya, E. A. Kiselev), the studies of the specifics of youth identity and self-realisation in social space (M. C. Schippers, N. Ziegler, M. Loreto Martínez, P. Cumsille, A. K. Vikulov, T. V. Plotnikova and others) and the modern concepts of happiness (M. Argyll, D. A. Leontiev, A. L. Zhuravlev and others) The study was conducted in different regions of Russia (Novosibirsk, Ekaterinburg, Chelyabinsk, Kazan, Ulyanovsk, Glazov) using psychodiagnostic methodology "Propensity to social surfing of young people" developed by the authors. The study involved young people (N = 510 people aged 18-27 years old, among them female - 68 %, male - 32 %). Results and scientific novelty. It was found that 11.2 % of young men and women approve of social surfing, evaluate its behavioural model as positive and allow similar options for choosing their own life trajectory. Comparative analysis revealed significant differences in loyalty to the social surfing strategy among young people living in different regions of the Russian Federation: the greatest loyalty was manifested by the young residents of Ekaterinburg, Glazov, and Kazan, while the residents of Chelyabinsk predominantly demonstrated a negative attitude to this strategy. The respondents showed an unequal attitude towards male and female social surfing models: with a relatively condescending attitude towards the male model, social surfing of women is frowned upon and is associated with weakness and statement. Meanwhile, the approval of the male model of social surfing creates certain risks of marginalisation and value-semantic anomie among young people. The practical significance of the conducted research is due to the potential possibilities of using the data obtained for choosing approaches to work with young people in the conditions of their high mobility, as well as for creating educational and professional trajectories. © 2021 Russian State Vocational Pedagogical University. All rights reserved.The current research was supported by the grant from the Russian Foundation for Basic Research (RFBR), project No. 16-33-01057 OGN

Multi-Drug Resistance of Mycobacterium Tuberculosis – the Problem of Modern Phthisiology

The 21st century is characterized by the exacerbation of the problem formation and spreading of drug-resistant strains throughout the world. Genetic mutations of Mycobacterium tuberculosis lead to the formation of drug-resistant forms because of long-term use of anti-tuberculosis drugs. The Russian Federation is among the top three countries with a high burden of tuberculosis with multidrug resistance (MDR). The estimated number of cases of tuberculosis with MDR in the Russian Federation was 60,000, which corresponds to half the burden of the European Region in 2015. In the Irkutsk region from 2014 till 2018 the proportion of TB cases with MDR cases increased from 15.2 % to 18.3 %. According to the reference laboratory of the Irkutsk Regional Clinical Tuberculosis Hospital, a significantly higher level of MDR among primary diagnosed was registered in the cities (27.7 %) and the lowest in rural areas of the region (16.5 %). Among the cohorts of patients with tuberculosis, the highest proportion of MDR was in the northern territories of the region (43.1 %), in Irkutsk district (41.2 %) and in large cities, including Irkutsk (38.5 %). Positive correlations were established between cohort of primary diagnosed TB with MDR and among populations in areas with high morbidity along the railway (r = 0.91; p = 0.00001), in the Irkutsk region (r = 0.89; p = 0,00008), and also in the Irkutsk city (r = 0.91; p = 0.00002). This is probably due to the influence of reservoir of tuberculosis infection formed in these localities. The regulatory documents of the Ministry of Health of the Irkutsk Region was developed on the basis of the data obtained, and they include recommendations for improving the diagnosis of tuberculosis in the region using fast and accelerated microbiological diagnostic methods

Project approach to training teachers for secondary vocational education

При проектном подходе к подготовке педагогических кадров для среднего профессионального образования изменяются взаимоотношения между заказчиками – учебными заведениями СПО и профессионально-педагогическим вузом, отвечающим за подготовку квалифицированных педагогов профессионального обученияThe design approach to the preparation of teachers for secondary vocational education changed the relationship between customers – educational institutions of secondary vocational and vocational-pedagogical University responsible for the training of qualified, meeting the requirements of the act, teachers of vocational trainin

Diagnostic analysis of toxic damage due to a dose of zoledronic acid

Zoledronic acid initiates an aseptic chronic inflammatory process in the jaw bones, accompanied by toxic acidosis, which worsens osteoporotic symptom

Viability of causative pathogen in patients with drug-sensitive and drug-resistant forms of respiratory tuberculosis

To predict outcomes of tuberculosis we investigated the viability of Mycobacterium tuberculosis (MTB) in relation to drug resistance of strains and clinical manifestations of tuberculosis. During the study on solid Löwenstein - Jensen medium, we determined the speed, growth rate and drug resistance of MBT in 5945 cultures, isolated from the sputum of patients with pulmonary tuberculosis - residents of the Irkutsk region (2193 -from newly diagnosed patients, 3752 - from previously treated patients). The criterion of high viability of MBT was the growth rate of >100 colonies over 20 days; and low viability corresponded with the growth rate of 30 days. 2171 cultures (36.5 %) had high viability of MBT strains, 3021 (50.8 %) - low, and 753 (12.7 %) cultures had average degree of viability. A high degree of pathogen viability was more often determined in newly diagnosed patients with tuberculosis of intrathoracic lymph nodes (all patients with HIV-infection without antiretroviral therapy), fibrotic-cavernous and infiltrative tuberculosis. Among previously treated patients with tuberculosis the high viability of MBT was often determined in patients with fibrous-cavernous and infiltrative tuberculosis, and caseous pneumonia. Cultures from previously treated patients with tuberculosis of intrathoracic lymph nodes had low degree of viability. The number of drug-sensitive strains was 1992, drug-resistant ones - 3953, including 1430 strains with multidrug resistance. We have found that 37.5 % drug-resistant strains associated with a high degree of viability (multidrug resistance - 38.5 %), it's was more often than the drug-sensitive (35.4 %; p < 0.01)

Применение поликлональных антител у доноров со смертью мозга при пересадке почек

Objective. The objective of this study is to develop a therapeutic strategy for protecting grafts in order to improve the efficiency of kidney transplantation (KT) using polyclonal antibodies (pAbs) through elimination of activated forms of neutrophils, chemo- and cytokines from the donor’s bloodstream, and a decrease in the level of expression of adhesion molecules on the renal vascular endothelium at the pre-transplant stage.Materials and methods. In 2017, we developed and for the first time applied a therapeutic strategy for ischemia-reperfusion injury (IRI) in a brain-dead donor (BDD). Given the limited time interval after brain death has been diagnosed, Timoglobulin (Sanofi Genzyme, France) was administered to the donor at a dose of 8 mg/kg intravenously for 6 hours. Before drug administration and immediately before the start of cold perfusion, a complete blood count and renal transplant biopsy were performed. The study group included 10 BDDs (mean age 39.3 ± 4.4 years) who received anti-thymocyte globulin (ATG). The comparison group included 10 BDDs (mean age 38.5 ± 4.3 years) who did not undergo the new strategy. Donor kidneys were transplanted to 40 recipients (average age 47.5 ± 4.3 years), who were also divided into 2 groups, depending on the graft received (with and without ATG). At the organ donation center, a biobank of specimens from donors of various categories, including those using the IRI therapeutic strategy and recipients for retrospective assessment of the effectiveness of pAbs, was formed.Results. Clinical blood test results show that in the ATG group, there was stable leukopenia (neutropenia and lymphopenia) of 1.46 ± 0.18x109/l. Fifteen (75%) recipients of kidneys obtained from donors with ATG had immediate graft function; in the control group – 10 (50%) recipients.Conclusion. Data obtained testify to the prospects of implementing the proposed strategy in clinical practice, which will improve the quality of the resulting grafts and their suitability for subsequent transplantation, prolong graft functioning due to elimination of leukocytes as a factor of IRI, prevention of early allograft nephropathy, increase in the donor pool by using expanded criteria donors (ECDs).Целью данного исследования явилась разработка протокола медикаментозной защиты трансплантатов для повышения эффективности пересадки почек с помощью применения препарата поликлональных антител (ПКАТ) за счет элиминации из кровотока донора активированных форм нейтрофилов, хемо- и цитокинов, снижения уровня экспрессии молекул адгезии на эндотелии сосудов почек на предтрансплантационном этапе.Материалы и методы. В 2017 году нами был разработан и впервые применен протокол лекарственной коррекции ишемически-реперфузионного повреждения (ИРП) у донора с установленным диагнозом «смерть головного мозга» (ДСМ). Учитывая ограниченный временной интервал после процедуры диагностики смерти мозга, препарат «Тимоглобулин» (Sanofi Genzyme, Франция) вводился в организм донора в дозе 8 мг/кг внутривенно в течение 6 часов. Перед введением препарата и непосредственно перед началом холодовой перфузии выполнялся развернутый клинический анализ крови и биопсии трансплантатов почек. В исследуемую группу были включены 10 ДСМ (ср. возраст – 39,3 ± 4,4 года), которым вводился антитимоцитарный иммуноглобулин (АТГ), группой сравнения были 10 ДСМ (ср. возраст – 38,5 ± 4,3 года) без применения нового протокола. Донорские почки были пересажены 40 реципиентам (ср. возраст – 47,5 ± 4,3 года), которые также были разделены на 2 группы, в зависимости от полученного трансплантата (с АТГ и без АТГ). В центре органного донорства сформирован биобанк образцов от доноров различных категорий, в т. ч. с применением протокола терапевтической коррекции ИРП, и реципиентов для ретроспективной оценки эффективности применения ПКАТ.Результаты. По данным проведенной оценки результатов клинического анализа крови, в группе с введением АТГ наблюдалась устойчивая лейкопения (нейтропения и лимфопения) 1,46 ± 0,18 × 109/л. У 15 (75%) реципиентов почек, полученных от доноров с введением АТГ, наблюдалась немедленная функция трансплантата, в контрольной группе – у 10 (50%) реципиентов.Выводы. Полученные данные свидетельствуют о перспективности внедрения предложенного протокола в клиническую практику, что позволит улучшить качество получаемых трансплантатов, их пригодность к дальнейшей пересадке, увеличить срок функционирования трансплантата за счет элиминации лейкоцитов как фактора возникновения ИРП, предупреждения развития ранней трансплантационной нефропатии, увеличения «донорского пула» за счет использования доноров с расширенными критериями (ДРК)

STRESS FACTORS OF THE URBAN DIGITAL ENVIRONMENT: PERSONAL DETERMINANTS OF SENSITIVITY

The purpose of the study was to assess the role of students’ personal characteristics, which determine a subjectively more acute reaction to the stress factors of the digital urban environment. The study involved 18 people. The most significant stress factors are threats to the safety and confidentiality of respondents, and the most acute reaction to the stress factors of the digital urban environment is provoked by increased anxiety, softness and psychopathy of young residents of the city.Целью проведенного исследования стала оценка роли личностных характеристик студентов, детерминирующих субъективно более острую реакцию на стресс-факторы цифровой городской среды. В исследовании приняло участие 518 человек. Наиболее значимым стрессфакторами являются угрозы для безопасности и конфиденциальности респондентов, а наиболее острую реакцию на стресс-факторы цифровой среды города провоцируют повышенная тревожность, мягкость и психопатия молодых жителей города.Исследование выполнено при финансовой поддержке РФФИ, проект № 20-013-00830 «Реальное и виртуальное пространство мегаполиса: стресс и девиации поведения городской молодежи»

THE STUDY OF THE TENDENCY TO ADDICTIVE BEHAVIOR OF STUDENTS USING THE PSYCHOPHYSIOLOGICAL METHOD

The problem of diagnostics of addictive behavior of students is considered, for the solution of which it is proposed to use the method of oculography, which allows to fix a person’s involuntary attention to stimuli that are significant for him. The results of an experiment conducted to identify the propensity of students to addictive behavior are described.Рассматривается проблема диагностики аддиктивного поведения обучающихся, для решения которой предлагается использовать метод окулографии, позволяющий зафиксировать непроизвольное внимание человека к значимым для него стимулам. Описываются результаты проведенного эксперимента по выявлению склонности студентов к аддиктивному поведению

Удовлетворенность качеством медицинской помощи: «всем не угодишь» или «пациент всегда прав»?

Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation В рамках реализации концепции пациент-ориентированного здравоохранения все большее значение приобретает оценка качества услуг медицинских организации с позиции пациента. С этой целью используется комплексный показатель удовлетворенности пациентов качеством медицинской помощи, который отражает степень соответствия реальных условий оказания медицинской помощи ожиданиям пациента, сформированным под влиянием социокультурных, экономических факторов, а также личного опыта каждого потребителя медицинских услуг. Показатель удовлетворенности является субъективным, при этом степень удовлетворенности не связана непосредственно с качеством медицинской помощи. Кроме того, необходимо всегда учитывать особенности пациента, его социально-культурный и экономический статус, которые могут оказывать влияние на отношение потребителя к полученным услугам.В данной статье был проведен обзор публикаций, посвященных вопросу факторов, оказывающих влияние на уровень удовлетворенности населения медицинской помощью. В ходе работы были проанализированы данные научных коллективов разных стран с участием различных групп населения.На основании обзора был сделан ряд выводов о том, что факторы, определяющие удовлетворенность пациентов, могут быть разделены на две группы. В первую группу входят факторы, являющиеся характеристиками непосредственно пациентов, такие как пол, возраст, этнические и культурные особенности. При этом исследователи в разных странах выявляют различную значимость факторов данной группы для конкретных групп населения и медицинских организаций. Вторую группу составляют факторы, относящиеся к процессу оказания медицинской помощи, ее организации и образуют группу модифицируемых факторов. Кроме того, отмечено, что изменение удовлетворенности пациентов носит волнообразный характер с подъемами и спадами, по этой причине целесообразно проводить политику поддержания определенного уровня удовлетворенности наравне с его увеличением. С этой целью необходимо осуществлять мониторинг уровня удовлетворенности пациентов, для чего требуется разработка нового или адаптация существующего опросника по оценке удовлетворенности, который был бы унифицированным для всех медицинских организаций Российской Федерации.