Evaluating the impact of a partnership for creating change in substance misuse practice in St. Petersburg, Russia

This paper reports on an evaluation of an innovative education and training programme for nurses and narcologists in St. Petersburg, Russia. The aims of the evaluation were: first, to evaluate the effect of the education and training programme on the clinical practice of doctors and nurses who have had direct contact with the programme and, second, to evaluate the influence of the education and training programme on city-wide drug and alcohol policy and practice. Brief contextual information regarding the programme is provided prior to an account of the qualitative methodology. Particular attention was paid to the work of Patton [Utilisation-focused evaluation, second ed., Sage, London, 1986; Qualitative research and evaluation methods, third ed., Sage, London, 2002] for the theoretical framework and to Hantais and Mangen [Cross-national research methods in the social sciences, Pinter, London, 1996] regarding the methodological issues that surround international and cross-cultural research projects. Data collection was carried out in St. Petersburg and in the United Kingdom, which involved key participants in the programme. The data analysis followed Miles and Huberman [Qualitative data analysis. An expanded sourcebook, second ed. Sage, Thousand Oaks, 1994] which yielded six major themes: rehabilitation, the role and continuing professional development of the trained nurse; the status of the nurse training-college and the staff, small scale projects and their significance; sharing experiences/networking/face-to-face meetings; and, lack of resistance. The findings are discussed and recommendations for further involvement are identified.     

Laboratory diagnostics for non-viral sexually transmitted infections in St. Petersburg, Russia: current situation and hallmarks for improvements

Background   The numbers and performance characteristics of laboratories providing sexually transmitted infection (STI) diagnostic services, as well as the rates of morbidity due to STIs in St. Petersburg, Russia, remain largely unknown.
Objective   The aim of the present study was to evaluate the range, quality and availability of diagnostic services for several non-viral STIs ( Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis ) in St. Petersburg during the period September 2005 to June 2006.
Methods   Survey data focusing on organization and performance characteristics of STI diagnostic services were assessed using questionnaires, telephone interviews and site visits.
Results   A total of 118 laboratories providing STI diagnostic services were identified. Of the surveyed laboratories, 54% (64 of 118) diagnosed syphilis, 81% (96 of 118) gonorrhoea, 80% (94 of 118) trichomoniasis and 49% (58 of 118) chlamydial infections. Although most of the laboratories could provide a presumptive diagnosis for syphilis, most of the N. gonorrhoeae and T. vaginalis testing of women did not adhere to international recommendations. Of the laboratories with the capacity to diagnose C. trachomatis infection, 69% still used serological testing (enzyme-linked immunosorbent assay) to detect antibodies to C. trachomatis .
Conclusions   Overall, the diagnostic methods used to establish a laboratory diagnosis, the system of case reporting, the training of laboratory personnel and the level of interlaboratory communication clearly require improvement. This study represents the first step in a process of evaluation of the laboratory support for STI services and the establishment of an interlaboratory network in St. Petersburg.     

Invasive infections caused by Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae among children in St Petersburg, Russia.

This study investigated the causes of invasive bacterial infections in children aged <15 years in St Petersburg, Russia, during 2001-2003, using culture and antigen detection methods (rapid antigen latex agglutination (RAL)) for normally sterile body fluids. A pathogen was detected in 90 cases (culture 50, RAL 40). Neisseria meningitidis was the most common pathogen (66%), followed by Haemophilus influenzae (19%) and Streptococcus pneumoniae (16%). Meningitis was the main clinical diagnosis (68/90, 76%), with N. meningitidis serogroup B, H. influenzae type b (Hib), and S. pneumoniae serogroup 1 being the most common isolates. Hib was less prevalent in St Petersburg than it was in industrialised countries before the introduction of Hib vaccinations.     

Women's reproductive health needs in Russia: what can we learn from an intervention to improve post-abortion care?

It has been well documented that abortion is a common means of controlling fertility in Russia. Women undergo repeat abortions throughout their reproductive lives, but recent studies of abortion trends in the Russian Federation suggest that abortion rates are on the decline, use of modern contraceptives is increasing, and women dislike abortion as a method of fertility control. Using data collected during 1999-2003 in women's health facilities in three Russian cities, this paper reports the results of an evaluation of interventions to improve post-abortion care, which show an impressive increase in post-abortion contraceptive counselling but no reduction in the rate at which women present at clinics for repeat abortions. The findings indicate a discrepancy between women's stated preferences for modern medical contraceptive methods and their abortion-seeking behaviour. Further exploration of these data suggests that certain women resort to abortion with greater frequency than others, and points to the need for a more focused investigation of these women. These results indicate the complexities associated with changing what has been a relatively common and long-standing practice, and have implications for improving reproductive health services. Meeting the reproductive health needs of Russian women requires not only improved provider and client knowledge but may also demand a more focused delivery of client-centred care than may be the case in other settings.     

Activities of daily living among St Petersburg women after mild stroke

The aim of the present study was to determine how women living in St Petersburg, Russia, who have had a mild stroke, describe their performance in activities of daily living (ADL) and to elicit possible causes of their occupational dysfunction. Thirty-six women who had experienced a mild stroke and been referred to a rehabilitation centre participated in the study. Data collection was conducted through interviews, including the 'ADL Staircase' and a modified 'Frenchay Activities Index for Stroke Patients'. Additional data were collected through field notes and information from team members and relatives. The results showed that women who have had a mild stroke and ADL limitations experience occupational dysfunction in ADL that is most often caused by a combination of overprotection from relatives, the women's own feelings of anxiety and insecurity, and an overemphasizing of their disability. The results are limited, based on the small sample and restricted geographic area. There is a need to further investigate how individuals who have had a mild stroke can be physically and socially rehabilitated and reintegrated into the community in countries with developing economies such as Russia.     

Far East Scarlet-Like Fever Caused by a Few Related Genotypes of Yersinia pseudotuberculosis,Russia

We used multivirulence locus sequence typing to analyze 68 Yersinia pseudotuberculosis isolated in Russia during 1973–2014, including 41 isolates from patients with Far East scarlet-like fever. Four genotypes were found responsible, with 1 being especially prevalent. Evolutionary analysis suggests that epidemiologic advantages could cause this genotype’s dominance.     

Sequences of the second internal transcribed spacer of ribosomal DNA for three species of <Emphasis Type="Italic">Trichostrongylus</Emphasis> (Nematoda: Trichostrongylidae) from sheep in Russia

Summary For the first time, DNA sequence data were obtained for three species of Trichostrongylus from Russia. Internal transcribed spacer (ITS-2) of ribosomal DNA was sequenced for T. axei, T. colubriformis and T. probolurus from sheep from the Moscow region. ITS-2 rDNA length was estimated as 238 nucleotides for T. colubriformis and T. probolurus and 237 nucleotides for T. axei. The G+C content of the ITS-2 sequences of T. colubriformis, T. axei and T. probolurus were 31 %, 32 % and 34 % respectively. The level of interspecific differences in ITS-2 of rDNA of T. axei, T. probolurus and T. colubriformis ranged from 3 to 4 %. The ITS-2 sequences from the Russian specimens were compared with those of T. axei, T. probolurus and T. colubriformis from Australia and Germany. Intraspecific variation ranged from 0 % in T. colubriformis to 3.0 % in T. axei.     

Geographic Variation in Suicide Rates: Relationships to Social Factors,Migration, and Ethnic History

Geographic variation in suicide rates is thought to be the result of interactions between two major components: the social organization combined with cultural tradition and biological or genetic factors. The present study examined regional patterns of suicide rates in European Russia. Our study looked at ethnic and national formations with respect to suicide patterns. The results indicated that the suicide rates vary greatly among the regions of the Russian Federation, with suicides more common in the northern regions of European Russia than in the south of the country. The south and north gradient of suicide distributions in Russia resemble that of other European countries. Throughout the Middle ages the north and northwest territory of present-day Russia has been an area of intensive interethnic contacts between the Old Slavs, which have colonized this territory, and native people of Finno-Ugrian and Baltic origin. The results indicated that the historical prevalence of the Finno-Ugrian component in the north of the country has possibly led to its higher suicide rate.     

Behavioral Assessments in Russian Addiction Treatment Inpatients: A Comparison of Audio Computer-Assisted Self-Interviewing and Interviewer-Administered Questionnaires

Abstract

Purpose: Assess agreement between reported sex and drug use behaviors from audio computer-assisted self-interviewing (ACASI) and interviewer-administered questionnaire (IAQ). Method: Participants (N = 180) enrolled in an HIV intervention trial in Russia completed ACASI and IAQ on the same day. Agreement between responses was evaluated. Results: Of the 13 sex behavior questions, 10 items had excellent agreement (kappas/ICC 0.80–0.95) and 3 items had moderate agreement (kappas/ICC 0.59–0.75). The 3 drug behavior questions had excellent agreement (kappas/ICC 0.94–0.97). Among HIV-specific questions asked of HIV-positive participants (n = 21) only, 2 items had excellent agreement (kappas 1.0) and 3 items had moderate agreement (kappas 0.40–0.71). Conclusions: Assessment of drug and sex risk behaviors by ACASI and IAQ had generally strong agreement for the majority of items. The lack of discrepancy may result from these Russian subjects’ perception that computers do not ensure privacy. Another potential explanatory factor is that both interviews were delivered on the same day. These data raise questions as to whether use of ACASI is uniformly beneficial in all settings, and what influence cultural factors have on its utility.