Soviet Union Countries Research Articles

'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan.

BackgroundDespite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs).MethodsSemi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors.ResultsStigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included:criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers.ConclusionsApproaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater accessibility because of multiple, complex, and interrelated barriers to HIV/AIDS service utilisation at the service delivery level. Factors external to, as well as within, the health sector are key to understanding the access deficit in the FSU where low or concentrated HIV/AIDS epidemics are prevalent. Funders of HIV/AIDS programmes need to consider how best to tackle key structural and systemic drivers of access including prohibitionist legislation on drugs use, limited transparency and low staff salaries within the health sector.

State and Secularism: Perspectives from Asia ed. by Michael Heng Siam-Heng and Ten Chin Liew (review)

Reviewed by: State and Secularism: Perspectives from Asia ed. by Michael Heng Siam-Heng and Ten Chin Liew Peter van der Veer (bio) Michael Heng Siam-Heng and Ten Chin Liew, editors. State and Secularism: Perspectives from Asia. Singapore: World Scientific Publishing Company, 2010. 364 pp. Hardcover $106.00, ISBN 978-981-4282-37-6. A book that comes out of Singapore offering perspectives from Asia on the state and secularism naturally raises the expectation that the particular nature of the Singaporean state is under consideration. This happens in one chapter by Kenneth Paul Tan. His emphasis is on the successful manipulation of cultural values in a managerial pragmatism that characterizes Singapore’s multicultural governance. Religion is seen as a potentially disruptive force that needs to be controlled but also as the basis of a civil religion of economic prosperity that is shared by all. He does not pay much attention to the actions and ideas of religious communities and their leadership in Singapore that would complicate his picture of a well-orchestrated society. What the rest of the book offers is a large number (eighteen chapters) of interesting reflections on the European philosophical literature on secularism, discussing the usual suspects, including Locke, Comte, John Stuart Mill, Rawls, Charles Taylor, and others. It is hard to discover any particularly Asian perspectives in these reflections except for the fact that the authors are Asian. Europe is also the subject of a couple of essays that deal with secularism in the European Union and, inescapably, with laïcité in France. These are all very competent accounts, but for the specialist there is hardly anything new here. The same is true for the essays on South Asia, but they do have the special charm that some of the major activists for an Indian brand of secularism, Swami Agnivesh and Asghar Ali Engineer, have contributed. The volume also includes essays on Malaysia, Indonesia, Turkey, and Egypt. The latter about Egypt by Mona Abaza contains an important account of different positions taken by Egyptian intellectuals, including the exiled Nasr Abu Zayd, about religion and secularism. Perspectives from Asia can be best found in the essays on China. Zhao Litao notices the revival of religion in the post-Deng era. The state continues to repress unwanted religious expressions, but tolerates a larger range than before. He rightly points out that popular religion, rooted in local communities, falls largely outside of the contemporary state regulation that is focused on the five major religions. It is in this area that one has to look for interactions between secular politics and communal religious networks. In my view, a useful comparison in this volume could have been made with Communist states such as the Soviet Union or Easter European countries or Vietnam and North Korea in Asia rather than with liberal states like France, England, and the United States. This would have solved Tan Sor Hoon’s problem that the term “secularism” is seldom used to describe China. It is Communism’s atheism that is at issue here. His contribution in this volume raises the old problem of the essential secular nature of Confucianism. In his view, Confucian morality guarantees religious freedom, but this interpretation separates morality from state formation. Prasenjit Duara points out correctly that one might [End Page 333] want to think about the relationship between modern citizenship and old and new models of religious subjectivity. Such questions are not asked systematically in this volume, with the result that it remains a conference proceedings rather than an integrated volume. Peter van der Veer Peter van der Veer is director of the Max Planck Institute for the Study of Ethnic and Religious Diversity in Göttingen and professor-at-large at Utrecht University. He specializes in comparative work on nationalism and religion. Copyright © 2013 University of Hawai‘i Press

Disparities in diabetes care: role of the patient's socio-demographic characteristics

BackgroundThe commitment to promoting equity in health is derived from the notion that all human beings have the right to the best attainable health. However, disparities in health care are well-documented. The objectives were to explore disparities in diabetes prevalence, care and control among diabetic patients. The study was conducted by Maccabi Healthcare Services (MHS), an Israeli HMO (health care plan).MethodsRetrospective study. The dependent variables were diabetes prevalence, uptake of follow-up examinations, and disease control. The independent variables were socio-economic rank (SER), ethnicity (Arab vs non Arab), supplementary voluntary health insurance (SVHI), and immigration from Former Soviet Union (FSU) countries. Chi Square and Logistic Regression Models were estimated.ResultsWe analyzed 74,953 diabetes patients. Diabetes was more prevalent in males, lower SER patients, Arabs, immigrants and owners of SVHI. Optimal follow up was more frequent among females, lower SERs patients, non Arabs, immigrants and SVHI owners. Patients who were female, had higher SERs, non Arabs, immigrants and SVHI owners achieved better control of the disease. The multivariate analysis revealed significant associations between optimal follow up and age, gender (males), SER (Ranks 1-10), Arabs and SVHI (OR 1.02, 0.95, 1.15, 0.85 and 1.31, respectively); poor diabetes control (HbA1C > 9 gr%) was significantly associated with age, gender (males), Arabs, immigrants, SER (Ranks1-10) and SVHI (OR 0.96, 1.26, 1.38, 0.72, 1.37 and 0.57, respectively); significant associations with LDL control (< 100 gr%) were revealed for age, gender (males) and SVHI (OR 1.02, 1.30 and 1.44, respectively).ConclusionDisparities in diabetes prevalence, care and control were revealed according to population sub-group. MHS has recently established a comprehensive strategy and action plan, aimed to reduce disparities among members of low socioeconomic rank and Arab ethnicity, sub-groups identified in our study as being at risk for less favorable health outcomes.

Mycobacterium tuberculosis Beijing Lineage Favors the Spread of Multidrug-Resistant Tuberculosis in the Republic of Georgia

High rates and transmission of multidrug-resistant (MDR) tuberculosis (TB) have been associated with the Mycobacterium tuberculosis complex (MTBC) Beijing lineage, pointing to the importance of pathogen genetic factors for the modulation of infection outcome and epidemiology. We present here an in-depth analysis of the population structure of MTBC strains from the Republic of Georgia, a high-incidence setting at the Black Sea Coast. Phylogenetic lineages were identified based on 24-locus MIRU-VNTR (for mycobacterial interspersed repetitive unit-variable number tandem repeat) and spoligotyping analysis. Clusters of strains with identical genotyping profiles were determined as an indicator for the rate of recent transmission. Among the 183 M. tuberculosis isolates investigated, the most prominent lineage found was Beijing (26%), followed by the LAM (18%), Ural (12%), and Haarlem (5%) strains. A closely related previously undefined phylogenetic group (62 strains) showed a genotyping pattern similar to laboratory strain H37RV and was denominated as "Georgia-H37RV-like." Although isoniazid resistance was found among strains of different lineages, MDR TB was nearly completely restricted to Beijing strains (P < 0.0001). Approximately 50% of the isolates were grouped in clusters, indicating a high rate of recent transmission. Our data indicate that, in addition to the confirmation of the importance of Beijing genotype strains for the TB epidemiology in former Soviet Union countries, a high-population diversity with strains of the LAM, Ural, Haarlem, and a previously undefined lineage represents nearly two-thirds of the strains found in Georgia. Higher rates among previously treated and MDR TB patients point to a higher potential of lineage Beijing to escape therapy and develop MDR TB.

II. Twenty-First Century Socialism

"Why talk of socialism?" we may ask. After all, "socialism" has had such negative connotations since its collapse in the Soviet Union and other Eastern European countries. For many years after Soviet socialism disappeared, intellectuals and progressive forces talked more of what socialism must not be than of the model that we actually wanted to build. Some of the facets of Soviet socialism that were rejected—and rightly so—were: statism, state capitalism, totalitarianism, bureaucratic central planning, the kind of collectivism that seeks to homogenize without respecting differences, productivism (which stresses the growth of productive forces without being concerned about the need to protect nature), dogmatism, atheism, and the need for a single party to lead the transition process.This article can also be found at the Monthly Review website, where most recent articles are published in full.Click here to purchase a PDF version of this article at the Monthly Review website.

Liver Cirrhosis Mortality in Europe, with Special Attention to Central and Eastern Europe

Background and Aims: Over the last decades, Europe has experienced dramatic changes in the geographical variation of liver cirrhosis rates. We attempt to provide a comprehensive analysis of patterns and trends in liver cirrhosis mortality in European countries and regions. Methods: Age-standardized (world standard) liver cirrhosis mortality rates per 100,000 person-years at ages 20–64 for 35 separate countries were computed using the World Health Organization Mortality Database. Results: In the analyzed period (1959–2002), a very strong East-to-West gradient in mortality rates was observed. An increase of the burden of mortality due to liver cirrhosis appeared in Eastern Europe in two specific areas: South-eastern Europe and North-eastern Europe. In the first group of countries, liver cirrhosis mortality was 10–20 times higher than in most other European states, levels never before observed in Europe. In the countries of North-eastern Europe (former Soviet Union countries) liver cirrhosis mortality was characterized by dramatic changes (both positive and negative) in specific periods of time. Conclusions: Despite the fact that the etiology of liver cirrhosis is multifactorial, it seems that alcohol drinking is the factor that best explains the observed patterns in frequency of this disease in Europe. Alcohol control policies in Central and Eastern Europe could lead to an appreciable reduction of premature mortality from liver cirrhosis.

Development of a standardised tool to survey MDR-/XDR-TB case management in Europe: Table 1–

To the Editors: The emergence of multidrug-resistant tuberculosis (MDR-TB, defined as in vitro resistance to isoniazid and rifampicin) 1–5 and extensively drug-resistant TB (XDR-TB, defined as in vitro drug resistance to isoniazid and rifampicin plus any fluoroquinolone and at least one of the injectable drugs: capreomycin, kanamycin or amikacin) represents a major threat to TB control at the global level 1–5. In 2007, the World Health Organization (WHO) estimated a prevalence of 511,000 MDR-TB cases (with 150,000 deaths) and 50,000 XDR-TB cases (and 30,000 deaths) 1; 14 out of 19 high-MDR-TB burden territories are located in Former Soviet Union (FSU) countries 1. XDR-TB is a manmade product, resulting, in essence, from clinical mismanagement of newly diagnosed pan-susceptible TB cases as well as MDR-TB cases 1, 2. There is evidence that suboptimal TB case management in parts of Europe contributes to the development of resistance to the XDR-TB defining drugs 4–7. In spite of the growing amount of public awareness about TB drug resistance, the essential variables necessary to fully understand MDR-TB and XDR-TB are unfortunately not systematically collected, analysed and reported in published studies 2, 8. Although the international community is providing a rapid response to XDR-TB (formulation of an emergency plan 9; development of an instrument to support implementation and scale-up of national strategies and to assess programmatic needs 10), no standardised and comprehensive tool is available to survey the key factor responsible for the emergence of MDR-/XDR-TB: inappropriate TB case management. The aim of this letter is to describe the process undertaken by the Tuberculosis Network European Trialsgroup (TBNET) in collaboration with the European Centre for Disease Prevention and Control (ECDC) to develop a standardised tool to survey MDR-/XDR-TB case management in the …

AroniaPlants: A Review of Traditional Use, Biological Activities, and Perspectives for Modern Medicine

The Aronia genus (Rosaceae family, Maloideae subfamily) includes two species of native North American shrubs: Aronia melanocarpa (Michx.) Ell. (black chokeberry) and Aronia arbutifolia (L.) Pers. (red chokeberry). The fruits of A. melanocarpa have been traditionally used by Potawatomi Native Americans to cure colds. In the first half of the 20(th) century, cultivars of black chokeberry were introduced to the Soviet Union and other European countries, providing fruits used by food industry. At present, it is used mainly for juice, jam, and wine production, as well as an ornamental plant. Among other substances, the berries of A. melanocarpa contain anthocyanins and procyanidins, possessing strong antioxidative potential. Numerous health-promoting activities-namely, antioxidative, antimutagenic, anticancer, cardioprotective, hepatoprotective, gastroprotective, antidiabetic, anti-inflammatory, antibacterial, antiviral, radioprotective, and immunomodulatory-have been demonstrated for black chokeberry extracts by both in vitro and in in vivo studies. The presented review summarizes the information concerning botany, cultivation, chemical composition, and pharmacological activities of Aronia plants.

Political Trust and Historical Legacy: The Effect of Varieties of Socialism

This article, unlike the vast existing literature on political trust, focuses on trust in post-socialist countries and, more specifically, on trust of young people rather than on trust of general populations. Studying young people is important in the context of establishing democracy and the survival of democracy. The authors examine the continuous effect of socialism and stipulate that the legacy of the type of socialist regime is a major determinant of political trust in Central and Eastern European and former Soviet Union countries. Utilizing individual-level data from an institutional survey, the authors find that distinguishing between different types of socialism is instrumental in explaining political trust. Results on the former Yugoslavia, however, suggest that the effects of socialism might be temporarily overshadowed in the short run by drastic post-socialist events such as warfare. The findings have implications for policies aimed at fostering political trust in post-socialist countries and for discerning future patterns of political and social developments.

House Price Determinants in Selected Countries of the Former Soviet Union

This paper analyses the recent boom-bust cycle in the housing markets of selected Former Soviet Union (FSU) countries. The analysis is based on a newly constructed database on house prices in the FSU countries. Our estimations suggest that house price developments can largely be explained by the dynamics of fundamentals, such as GDP, remittances, and external financing. Overall, we find that deviations of house prices from their fundamentals have not been pronounced, suggesting that house price bubbles have not been formed in the FSU countries.

House Price Determinants in Selected Countries of the Former Soviet Union

This paper analyses the recent boom-bust cycle in the housing markets of selected Former Soviet Union (FSU) countries. The analysis is based on a newly constructed database on house prices in the FSU countries. Our estimations suggest that house price developments can largely be explained by the dynamics of fundamentals, such as GDP, remittances, and external financing. Overall, we find that deviations of house prices from their fundamentals have not been pronounced, suggesting that house price bubbles have not been formed in the FSU countries.

Estonian Way to Liberal Economic System

Estonia 1 has adopted the one of the most radical programs of stabilization and transformation amongst not only the former Soviet Union countries but among previously centrally planned economies as well.The commodity and service were balanced mainly through the price liberalization and introduction of the internally convertible national currency. This was supplimented with the austerity in public consumption and surpluss in the state budget. The changes were also associated with a radical shift in the foreign trade rearientation. The economy that previously was oriented to almost costless recources from the former Soviet Union and work mostly for the Soviet markets seems to be very well adjusted to western and broad participation in the world economy.

Construction of Self and the Other in the Accounts of Polish Travellers to Post-Soviet Countries

Travel is one of the important modes of identity construction. It is influenced by individual choices as well as by macro-contexts of institutional practices and changes. Based on the study of the accounts of young middle-class Polish travellers to the former Soviet Union countries, this article attempts to demonstrate the ways in which macro-processes of systemic transformation and European integration affect the identity-building processes. After offering a discussion of the cultural meanings of emphasising the uniqueness of their experience and difference from 'mainstream tourists' by the travellers, the article turns to the interpretation of the role of the encounter with local dwellers as an important identity-formation related experience. The analysis of the acceptance or rejection of food from local dwellers demonstrates the ambiguous attitude of travellers to the local dwellers and attempts to place this ambiguity in the macro-context.

Cyrillic databases of former Soviet Union countries

The article considers different search options using patent databases (DB), which belong to the former Soviet Union (SU) countries and where the Cyrillic alphabet and Russian language are used. The main emphasis is on the databases where there is the possibility of using an English interface. In the cases when it is not possible to receive information in English advice is given on what kind of machine translation is preferable. Advice is given for English- and Russian-speaking users for making the search more efficient.

Religious Reestablishment in Post-Communist Polities

After the collapse of the atheistic Soviet Union and Communist party-dominated countries in Central and Eastern Europe, many analysts predicted that as new governments ushered in laws guaranteeing religious freedom, a new religious pluralism would result. Public opinion surveys conducted during the first years of postsocialism confirmed that throughout Eastern Europe and the Soviet successor states, there was a resurgence in belief in God and life after death, as well as reports of increased levels of church attendance, particularly among the younger generations. Two decades after the collapse, however, post-communist countries have not become bastions of religious diversity or practice, and religious relations mirror those of a century past, when traditional ethnic churches dominated the landscape. How can we explain what appears to be religious reestablishment across the postcommunist countries? What developments have contributed to stalled progress in the realm of religious freedom? When the communist parties that controlled the Eastern bloc countries fell along with the Soviet Union and new “democratic” movements embarked on the mission of writing new constitutions and establishing representative institutions, many countries adopted legislation that significantly liberalized the field of religious freedom. Initially, this liberalization allowed for traditional

Rehabilitation of Dilapidated Water Supply &amp; Integration of New Sanitation Services: Lessons from a Sector Analysis in Azerbaijan

A sector wide analysis was conducted in Azerbaijan, which included a review of the water supply and sanitation provisions in 51 medium sized towns. In the Former Soviet Union (FSU) countries, the standards for provision of water supply & sanitation were set at a very high level. However, the services were provided at two speeds - water supply systems were put in to meet long term future demands, while the sanitation was to be provided later on. Following the collapse of the FSU, after gaining independence, many countries have embarked on updating and renewing these public services. Given that the countries have adopted a market based economy, there arose a need to carry out a comprehensive reassessment of the whole system for its rehabilitation, ie the existing, and very dilapidated water supply systems, the lack or partial provision of sanitation in most cases, the changes required in the institutional set ups and the new expectations of the customers. The paper addresses these issues based on a comprehensive analysis of the 51 towns, which included reconnaissance surveys in sample towns, detailed survey of the infrastructure and socio-economics in three priority towns. The paper discusses ways & means by which countries might meet their MDG's and develop the means to integrate water supply & sanitation with other essential public services such as waste management and community development. The last is an important element for consideration, because in the absence of income earned by the communities, their ability to finance the provision of public services will fail and the cycle of infrastructure degradation will restart.

Die Kontrolle der Tuberkulose in den Nachfolgestaaten der Sowjetunion am Beispiel Russlands

Tuberculosis (TB) remains a serious threat to public health in Russia and other former Soviet Union Countries. The purpose of this paper is to describe the current trends of TB and MDR-TB in Russia and identify the characteristics of the traditional Russian TB control model inherited from the Soviet Union. We discuss current challenges to TB control in the country. WHO tuberculosis notification data were analysed for Russia and 14 other former Soviet Union countries. To investigate the characteristics of TB control in Russia, we performed a systematic literature review using MEDLINE/EMBASE databases. 136 articles were initially identified of which 66 fulfilled the inclusion criteria. Full texts were reviewed. Additionally, we reviewed non-systematically Russian state reports, guidelines and legislations. In 2006, nearly 125 000 TB cases and 28 000 TB deaths were notified in the Russian Federation. The TB notification rate was 13 times higher than in Germany. The characteristics of the traditional Russian TB control model include: a centralised disease-specific inpatient network for diagnosis and treatment of TB, countrywide population screenings using fluorography, a strong focus on X-ray for diagnosis and disease classification, individualised and lengthy inpatient care, high rates of drug resistance, and inefficient financing systems. Current challenges to TB control in Russia are: the implementation of a quality-assured laboratory network for sputum-smear microscopy, culture and drug susceptibility testing, ensuring MDR-TB treatment and control, prevention and management of TB/HIV, and reform of health care financing systems. For TB control to be successful in the Russian Federation, the characteristics of the traditional TB control model need to be taken into account.

Testing Language, Testing Ethnicity? Policies and Practices Surrounding the Ethnic German Aussiedler

Aussiedler are ethnic Germans from the former Soviet Union and other Eastern European countries who are granted the right to resettle in the Federal Republic of Germany (FRG) if they can provide evidence of German ancestry, attachment to the German language and culture, and ongoing assertion of German ethnicity. This article outlines the policies, legislation, and practices the German authorities have adopted to deal with these people. In particular, it describes and analyses the role assigned to the German language and the language testing practices involved in the recognition process. It summarizes the criticisms that this “language test” has attracted and discusses how it reflects or contradicts ideologies of language, ethnicity, and national identity.

FSU Immigrants in Canada: A Case of Positive Triple Selection?

This paper investigates the economic performance of immigrants from the Former Soviet Union (FSU) countries in Canada. The contribution of this paper lies in its use of a natural experiment to detect possible differential labour market performances of Soviet immigrants prior to and after the collapse of the Soviet Union. In short, the collapse of the former Soviet Union allows an exogenous supply change in the number and type of FSU immigrants potentially destined to enter Canada. For this purpose, Census microlevel data from the 1986, 1991, 1996 and 2001 Canadian Census are utilized to estimate earnings and employment outcomes for pre- and post-FSU immigrants.

Partia komunistyczna walcząca z religią i państwo komunistyczne gwarantujące wolność religijną jako teoretyczne podstawy marksizmu-leninizmu w walce z religią i Kościołem katolickim w krajach realnego socjalizmu

Marek Jędraszewski in his article The Communist Party fighting with religion and the communist state guaranteeing religious freedom, as theoretic background for Marxism-Leninism in fight against religion and Catholic Church in the countries o f real socialism, presents philosophical and ideological principles, which direct the course of politic of communists states in the battle against religion and Church, especially Catholic Church. The author shows sources of that in antireligious thoughts of the modem Europe: deism of Enlightenment and philosophy of Feuerbach for whom the sole condition of substantial human freedom was appreciation of radical atheism. Next, author presents the Marxist conception of religion as the “opiate of the masses” and “opiate for the masses”. On the end, is presenting Lenin’s distinction between antireligious program of party and worldview neutrality of state, which was the ground for cutthroat war against religion, both in the Soviet Union and other countries of People’s democratic so-called the Ostblock) in the period 1944-1989. Author resemble the main thesis of the Pius XI encyclical Divini Redemptoris from 1939, which shows antihumanistic, furthermore felon face of “godless communism”. The best example giving by the author, for the rightness of popes words, is abatement of the Catholic Church by the communist party in the Poland in the times of Polish People’s Republic. As a conclusion author is citing words of pope John Paul II from encyclical Centesimus annus: “Marxism had promised to uproot the need for God from the human heart, but the results have shown that it is not possible to succeed in this without throwing the heart into turmoil” (CA, 24).