Vol 28, No 8 (2021)

Aim: To verify reference values of the heart rate variability (HRV) parameters among healthy 18-27-year olds in the Khanty-Mansi autonomous okrug - Ugra, Eastern Siberia. Methods: Data were collected in series of observational analytical cross-sectional studies between 2006 and 2020. The sample consisted of 13269 subjects - 7442 women and 5827 men aged 18 to 27 years permanently living in Khanty-Mansi autonomous okrug. We studied parameters of background HRV on short-term recordings in the time and frequency domains, Poincare graph and cardiointervalography by R. M. Baevsky. For all HRV parameterswe assessed minimal and maximal values as well as the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile. Gender differences in all studied variables were studied using Mann-Whitney tests after normality testing using Kolmogorov-Smirnov tests with Lilliefors correction. Results: We observed significant differences between central tendencies of all studied HRV parameters between women and men (p < 0.01) with the exception of the relative power of the spectrum in the very low frequency range - an indicator of the adequacy of the regulation processes and the vegetative rhythm indicator. Conclusions: The reference values of the HRV parameters for young adults living in the Khanty-Mansi Autonomous Okrug-Ugrawere verified. Significant gender differences in all the studied HRV parameters were observed except one, which is considered to be an indicator of the adequacy of the regulation processes and the vegetative rhythm indicator. We also discuss applying centile values of the relative spectral power of HRV to identify categories of heart rate modulation.

Aim: To perform expert assessment of monitoring data on air pollution and surface water in the Ryazan region, Central Russia. Methods: A descriptive study. The information of state standards and regulations in the field of sanitation and hygiene, local acts in the field of environmental monitoring, a number of federal and regional statistical books were studied, analyzed and systematized. Screening evaluation of the analytical information, identification and generalization of problems in the existing system of chemical monitoring and identification of hazards and risks were done. We used a method for analyzing and synthesizing statistical information and a method of converting absolute values to relative values. The system analysis allowed us to draw conclusions and recommendations and to suggest the directions for further research. Results: The analysis of atmospheric air and surface water pollution information in the Ryazan region is presented. The urgent need to change the existing system for monitoring atmospheric air and surface water is shown. The ways of the environment chemical monitoring effectiveness increasing and increasing the level of objectivity of environmental quality assessment procedures in the Ryazan region are outlined. The necessity of working and organizing a system of continuous operational monitoring of environmental components, monitoring of toxicants and implementation of independent expert monitoring of environment components with the further going aim to develop "Medical and ecological Atlas of Ryazan region". Conclusions: The situation with chemical pollution of the atmosphere and surface water objects in the Ryazan region has been stagnating since the 1990s. Periodic ultra-high pollution parameters were detected, in some cases exceeding the maximum permissible standards by tens and hundreds of times. The solution of the effectiveness and environmental quality assessment reliability problem lies in the improvement of the state monitoring system and the support of independent expert monitoring.

Aim: To study the signs of destruction of mental ecology of the Russian society after the terrorist attack on 17 October 2018 in Kerch by the assessment of the changes in values, perceptions, and attitudes of the population after the terrorist act, as well as the influence of the mass media and Internet resources. Methods: We performed a population-based cross-sectional survey of residents of the Irkutsk region (n = 1 200) as well as content analysis of the media and Internet resources (n = 61) shortly after the attack. Data were analyzed using exploratory factor analysis. Unpaired t-test was used to study differences between the means of continuous variables. Results: We revealed a significant impact of the college shooting incident in Kerch on personal and social attitudes, perceptions and expectations being mostly negative in their nature, reinforce fears, alienation and anxiety contributing to the destruction of the mental ecology of the society. It was revealed that fear (P = 0.06), depression (P = 0.004) and activity (P = 0.002) were more important factors for the males, although not always reaching the level of statistical significance while anxiety (P = 0.05), indifference (P = 0.007) and empathy (P = 0.002) were more important for the females. The dominant state during an act of mass violence was fear for both the younger- (P = 0.05) and the older- (P=0.04) generations. At the same time, the younger generation was better characterized by activity (P = 0.006), indifference (P = 0.004) and empathy (P = 0.005) while depression (P = 0.003) and anxiety (P = 0.004) were more typical for the older generation. Conclusions: Our study demonstrate that mass violence, constantly discussed in the media and on the Internet, increases the level of anxiety and depression among the people and destroys mental ecology of the society. Significant differences in the reaction on the information across genders and generations were observed.

Background: Cardiovascular diseases (CVD) are the main causes of death worldwide. The incidence of and mortality from CVD in Kazakhstan is greater than in most neighboring countries warranting urgent public health measures related to both primary, secondary and tertiary prevention. Aims: To assess whether a newly developed 6-months public health rehabilitation program for patients with acute myocardial infarction (AMI) with home visits performed by physician assistants is superior to the standard rehabilitation of these patients in Western Kazakhstan. Methods: A randomized controlled study. A total of 75 AMI patients were enrolled after discharge form the hospital and 72 completed the trial. The control group (n = 34) participated in the standard rehabilitation program while the intervention group (n = 38) underwent and experimental rehabilitation program with home visits in addition to the standard program. Body mass index, waist circumference, blood pressure, heart rate, blood lipids, smoking and compliance to the treatment were assessed at the enrollment and after 6 months of the follow-up. Differences between the changes in the intervention and in the control group were compared using Mann-Whitney tests. Results: The experimental program was superior to the standard program in reducing systolic- (-22.5 vs. -2.9 mm Hg, p < 0.004) and diastolic (-6.3 vs. -0.6 mm Hg, p = 0.032) blood pressure, body mass index (-0.99 vs. 0.53 kg/m2, p < 0.001), waist circumference (-3.0 vs. 1.7 cm, p < 0.001) and the number of smoked cigarettes (-12 vs. -3, p = 0.002). Blood lipid profiles improved in both groups. Although slightly more pronounced changes were observed in the intervention group, the differences did not reach the level of statistical significance. Conclusions: The program was more effective on blood pressure, smoking and obesity-related indicators than the standard rehabilitation. Larger studies are warranted to corroborate our findings prior to implementation of the program in practice.