Analysis of undiagnosed tuberculosis-related deaths identified at post-mortem among HIV-infected patients in Russia: a descriptive study

<p>Abstract</p> <p>Background</p> <p>Tuberculosis remains a serious public health threat and economic burden in Russia with escalating rates of drug resistance against a background of growing HIV-epidemic. Samara Oblast is one of the regions of the Russian Federation where more than 1% of the population is affected by the HIV-epidemic; almost half of the cases are concentrated in the largely-industrial city of Togliatti with a population of 800 000.</p> <p>Methods</p> <p>We conducted a retrospective analysis of errors leading to death of HIV-positive patients in general health care hospitals in Togliatti, Russia, in 2008. All (n = 29) cases when tuberculosis was established at autopsy as a cause of death were included.</p> <p>Results</p> <p>Median length of hospital stay was 20 days; in 11 cases the death occurred within the first 24 hours of admission. All cases were known to be HIV-positive prior to admission, however HAART was not initiated for any case, and no relevant tests to assess severity of immunosupression were performed despite their availability. No appropriate diagnostic algorithms were applied to confirm tuberculosis. Major gaps were identified in the work of hospital and consulting physicians including insufficient records keeping. In almost all patients earlier regular HIV-relevant tests were not performed due to poor compliance of patients, many of whom abused alcohol and drugs.</p> <p>Conclusions</p> <p>We conclude that introduction of prompt and accurate diagnostics tests, adequate treatment protocols and intensive training of physicians in management of AIDS and TB is vital. This should include reviewing standards of care for HIV-positive individuals with accompanying social problems.</p

Using Newly available Homicide Data to Debunk Two Myths about Violence in an International Context: A Research Note

This article employs newly available crime and vital statistics data from Russia to debunk two myths about violence in an international context. The first myth is that the United States is the most violent industrialized nation in the world. The second myth is that in spite of other problems associated with Soviet society, at least the totalitarian regime was able to maintain low rates of crime and violence. The newly available data reveal the inaccuracies in each of these statements. Not only is the current Russian homicide victimization rate more than 3 times higher than in the United States, but it has been comparable to or higher than the U.S. rate for at least the past 35 years. Furthermore, preliminary analyses of these data also question the generalizability of other commonly held notions about the production of high rates of violence in the United States.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Mental health reform in the Russian Federation: an integrated approach to achieve social inclusion and recovery

Objective: To facilitate mental health reform in one Russian oblast (region) using systematic approaches to policy design and implementation. Methods The authors undertook a three-year action-research programme across three pilot sites, comprising a multifaceted set of interventions combining situation appraisal to inform planning, sustained policy dialogue at federal and regional levels to catalyse change, introduction of multidisciplinary and intersectoral-working at all levels, skills-based training for professionals, and support for nongovernmental organizations (NGOs) to develop new care models. Findings Training programmes developed in this process have been adopted into routine curricula with measurable changes in staff skills. Approaches to care improved through multidisciplinary and multisectoral service delivery, with an increase in NGO activities, user involvement in care planning and delivery in all pilot sites. Hospital admissions at start and end of the study fell in two pilot sites, while the rate of readmissions in all three pilot sites by 2006 was below that for the region as a whole. Lessons learned have informed the development of regional and federal mental health policies. Conclusion A multifaceted and comprehensive programme can be effective in overcoming organizational barriers to the introduction of evidence-based multisectoral interventions in one Russian region. This can help facilitate significant and sustainable changes in policy and reduce institutionalization

3. mezhdunarodnij seminar po usovershenstvovaniyu apparatov i metodov vneshnej fiksatsii &quot;Apparaty i metody vneshnej fiksatsii v travmatologii i ortopedii&quot; Materialy

Summaries in EnglishAvailable from Latvian Academic Library / LAL - Latvian Academic LibrarySIGLELVLatvi