Миф о "Братьях Карамазовых". Какой Достоевский нужен современной России?

В статье на основе текста романа «Братья Карамазовы» опровергается позиция И. Евлампиева, который видит в Ф.М. Достоевском по преимуществу гностического мыслителя, а также эксплицируются теоретические предпосылки тенденциозного подхода к творчеству русского писателя. Акцентируется внимание на связи романов Достоевского с православной традицией, а также значимости этой позиции для становления русского самосознания и истории России.У статті на основі тексту роману «Брати Карамазови» спростовується позиція І. Євлампієва, який вбачає у Ф.М. Достоєвському переважно гностичного мислителя, а також експлікуються теоретичні передумови тенденційного підходу до творчості російського письменника. Робиться акцент на зв’язку романів Достоєвського з православною традицією, а також на значимості цієї позиції для становлення російської самосвідомості та історії Росії.In the article the position of I. Evlampiev, who considers F.M. Dostoyevskiy, for the most part, as a gnostic thinker, is being disproved on the basis of the text of the novel “The Karamazov brothers”. Also, theoretical preconditions of tendentious understanding of the creative work of the Russian writer are being explicated. Besides, the relationship between Dostoyevskiy’s novels and orthodox tradition and the importance of this position for establishing Russian self-consciousness and the history of Russia are being indicated

Zorggebruik na schietincident in Alphen aan den Rijn: gezondheid van getroffenen en niet-getroffen omwonenden 1 jaar na dato.

Healthcare utilisation of those affected by the shooting incident in Alphen aan den Rijn, the Netherlands; health of affected and non-affected neighbouring residents 1 year afterwards. Objective: To examine effects of the mass shooting in the city of Alphen aan den Rijn, the Netherlands, on the 9th of April 2011 on the health and healthcare utilisation of those affected. Design: Observational longitudinal study in general practice in which affected persons were compared with a reference group of neighbouring residents. Method: Effects of the mass shooting on the health and healthcare utilisation of those affected was analysed using healthcare data from victim services, mental health care organisations, social work and general practitioners in the neighbourhood in which the mass shooting occurred. First, for all those affected by the mass shooting (n=677) we identified whether they used any services from victim services, mental health care or social work after the incident. Those affected by the mass shooting were identified based on their demand for healthcare related to the incident and based on information of the municipal health service about relatives of injured, witnesses and healthcare workers. Second, health and healthcare utilisation in general practice of 161 affected persons and 115 residents in the year before and after the mass shooting were extracted from the electronic medical records of general practices. Diagnoses and symptoms were coded using the International Classification of Primary Care (ICPC); drug prescriptions coded according to the Anatomic Therapeutic Chemical (ATC) Effects of the mass shooting on health and healthcare utilisation based on data of general practices were analysed with logistic and Poisson multilevel regression analyses for repeated measurements. Results: Three hundred twenty-six of those affected by the mass shooting (48%) were registered with victim services, of which 43% only had an intake interview. Six percent of those affected (n=42) were registered with social care and six percent (n=39) were under treatment of a mental care organisation. Most of those affected under treatment of a mental care organisation (88%) were still under treatment one year after the mass shooting. After the shooting, prevalence of psychological and social problems as presented in general practice increased significantly for affected persons (OR:2.99;95%CI:1.75-5.12), especially the prevalence of anxiety and stress reactions (OR:4.07;95%CI: 1.86-8.92). Problems predominantly were presented in the first quarter after the mass shooting. The trend in prevalence of psychological and social problems was higher for those affected compared with the reference group of neighbouring residents (OR:2.68;95%CI:0.93-7.72), but not for any other health problem examined. After the mass shooting incident, drugs active on the central nervous system were more often prescribed to both those affected by the mass shooting and residents (OR: 2,12; 95%CI:1,35-3,33 and OR: 1,95 95%CI:1,10-3,45). Those affected by the mass shooting were more often prescribed hypnotics and sedatives (OR:2.32; 95%CI:1.08-4.98) and benzodiazepines (OR: 1.87; 95%CI:1.07-3.26) in the year after the incident compared with a year before. The trend in drug prescriptions did not differ between those affected and the reference group of residents. The number of contacts with general practice did not change after the incident for both those affected by the mass shooting and the reference group of residents. Conclusion: The mass shooting had a negative impact on the psychological well-being of those affected, but on group level of relatively limited duration and extent in the first year after the mass shooting. For a small group, this was not the case: 6% of those affected were under treatment of a mental health organisation. Comparing the results of this study with the international literature on effects of mass shooting incidents, effects on health of those affected are much smaller in our study compared with US studies. Such differences are, in addition to the differences in study design (questionnaires vs. electronic medical records), common in research on the effects of traumatic events and found in other epidemiologic studies also. Another important explanation may be that we have a large variation in the degree of exposure to the mass shooting incident: people less exposed to the mass shooting incident report less health problems. Furthermore, not all of those affected will visit a general practice for their health problems. (aut.ref.

Odour annoyance in the neighbourhood of livestock farming: perceived health and health care seeking behaviour.

Introduction and objectives. Odour annoyance forms the main source of environmental stress in residents living in the proximity of animal feeding operations (AFOs) and it has been associated with reduced health. This study aims to gain more insight into the association between AFOs in the neighbourhood, odour annoyance, other environmental stressors, and health, and incorporates health care seeking behaviour for reported symptoms. Materials and methods. Cross-sectional data from 753 people living in an area in the Netherlands with a high density of AFOs was evaluated. Odour and other environmental annoyances in the neighbourhood, general health and symptom reporting were obtained by questionnaire. Health care utilisation was obtained from electronic medical records of general practices. The number of pigs, poultry and cattle within a 500 m radius from homes was computed using Geographic Information System data. Mutually adjusted multiple Poisson and (ordinal) logistic regression analyses were performed. Results. The number of pigs, poultry and cattle was equally associated with odour annoyance. This annoyance was associated with reduced general health and increased reporting of respiratory, gastrointestinal, neurological and stress-related symptoms. Participants rarely consulted their general practitioner for reported symptoms. Environmental stressors were weakly associated. Conclusions. The number of animals around the homes was associated with odour annoyance. Odour annoyance was associated with reduced health, which could be a reason for caution with the construction of new AFOs. (aut. ref.

Doctor-diagnosed health problems in a region with a high density of concentrated animal feeding operations: a cross-sectional study.

Background: There is growing interest in health risks of residents living near concentrated animal feeding operations (CAFOs). Previous research mostly focused on swine CAFOs and self-reported respiratory conditions. The aim was to study the association between the presence of swine, poultry, cattle and goat CAFOs and health of Dutch neighbouring residents using electronic medical records from general practitioners (GPs). Methods: Data for the year 2009 were collected of 119,036 inhabitants of a rural region with a high density of CAFOs using information from GIAB (high exposed population). A comparison was made with GP data from 78,060 inhabitants of rural areas with low densities of CAFOs (low exposed population). Associations between the number of CAFOs near residents’ homes and morbidity were determined by multilevel (cross-classified) logistic regression. Results: n 2009, the prevalence of most respiratory and gastrointestinal conditions was similar in the high and low exposed population. Exceptions were pneumonia, atopic eczema and unspecified infectious diseases with an increased prevalence, and sinusitis with a decreased prevalence in the high exposed population. Within the high CAFO density region, the number of poultry, cattle and swine CAFOs near residents’ homes was not associated with allergic, respiratory or gastrointestinal conditions. Conversely, each additional goat CAFO within the postal code area of residents’ homes significantly increased the odds of unspecified infectious disease and pneumonia by 87 and 41 percent, respectively. Conclusions: Using GP records, pneumonia and unspecified infectious diseases were positively associated with the number of goat CAFOs near residents’ homes, but no association was found between swine, cattle, and poultry CAFOs and respiratory, allergic or gastrointestinal conditions. (aut. ref.

Q Fever and pneumonia in an area with a high livestock density: a large population-based study

Concerns about public health risks of intensive animal production in the Netherlands continue to rise, in particular related to outbreaks of infectious diseases. The aim was to investigate associations between the presence of farm animals around the home address and Q fever and pneumonia.Electronic medical record data for the year 2009 of all patients of 27 general practitioners (GPs) in a region with a high density of animal farms were used. Density of farm animals around the home address was calculated using a Geographic Information System. During the study period, a large Q fever outbreak occurred in this region. Associations between farm exposure variables and pneumonia or 'other infectious disease', the diagnosis code used by GPs for registration of Q fever, were analyzed in 22,406 children (0-17 y) and 70,142 adults (18-70 y), and adjusted for age and sex. In adults, clear exposure-response relationships between the number of goats within 5 km of the home address and pneumonia and 'other infectious disease' were observed. The association with 'other infectious disease' was particularly strong, with an OR [95%CI] of 12.03 [8.79-16.46] for the fourth quartile (>17,190 goats) compared with the first quartile