913 resultados para everyday life - Russia
Resumo:
Causing civilian casualties during military operations has become a much politicised topic in international relations since the Second World War. Since the last decade of the 20th century, different scholars and political analysts have claimed that human life is valued more and more among the general international community. This argument has led many researchers to assume that democratic culture and traditions, modern ethical and moral issues have created a desire for a world without war or, at least, a demand that contemporary armed conflicts, if unavoidable, at least have to be far less lethal forcing the military to seek new technologies that can minimise civilian casualties and collateral damage. Non-Lethal Weapons (NLW) – weapons that are intended to minimise civilian casualties and collateral damage – are based on the technology that, during the 1990s, was expected to revolutionise the conduct of warfare making it significantly less deadly. The rapid rise of interest in NLW, ignited by the American military twenty five years ago, sparked off an entirely new military, as well as an academic, discourse concerning their potential contribution to military success on the 21st century battlefields. It seems, however, that except for this debate, very little has been done within the military forces themselves. This research suggests that the roots of this situation are much deeper than the simple professional misconduct of the military establishment, or the poor political behaviour of political leaders, who had sent them to fight. Following the story of NLW in the U.S., Russia and Israel this research focuses on the political and cultural aspects that have been supposed to force the military organisations of these countries to adopt new technologies and operational and organisational concepts regarding NLW in an attempt to minimise enemy civilian casualties during their military operations. This research finds that while American, Russian and Israeli national characters are, undoubtedly, products of the unique historical experience of each one of these nations, all of three pay very little regard to foreigners’ lives. Moreover, while it is generally argued that the international political pressure is a crucial factor that leads to the significant reduction of harmed civilians and destroyed civilian infrastructure, the findings of this research suggest that the American, Russian and Israeli governments are well prepared and politically equipped to fend off international criticism. As the analyses of the American, Russian and Israeli cases reveal, the political-military leaderships of these countries have very little external or domestic reasons to minimise enemy civilian casualties through fundamental-revolutionary change in their conduct of war. In other words, this research finds that employment of NLW have failed because the political leadership asks the militaries to reduce the enemy civilian casualties to a politically acceptable level, rather than to the technologically possible minimum; as in the socio-cultural-political context of each country, support for the former appears to be significantly higher than for the latter.
Resumo:
The American book publishing industry shapes the character of American intellectual life. While the newspaper and television industries have been accused of and investigated for bias and lowering America’s intellectual standards, book publishing has gone largely unexamined by scholars. The existing studies of the publishing industry have focused on finance, procedure and history. “There are few ‘theories’ of publishing – efforts to understand the ‘whys’ as well as the ‘hows.’ Few scholarly scientists have devoted significant scholarly attention to publishing” (Altbach and Hoshino, xiii). There are many possible reasons for this lacuna. First, there is a perception that books have always been around, that they are an “old” technology and therefore they don’t appear to have had as much of an impact on our society as television and other media (which were developed quickly and suddenly) seem to have had (Altbach and Hoshino, xiv). Also, despite books’ present and past popularity, television, radio, and now the internet reach more people more easily, and are therefore more topical points of study and observation. In studying the effects of mass media on everyday American life, television and the internet may be the most logical points of study. Regarding public intellectual life however, books play a much more important role. Public intellectual life has always been associated with independent thinkers publishing their work for the masses. For this reason, this I focus on trade publishing. Trade publishing produces fiction and non-fiction works for the general reading public, as opposed to technical manuals, textbooks, and other fiction and nonfiction books targeted to small and specific audiences. Although, quantitatively speaking, “the largest part of book publishing business is embodied in that great complex of companies and activities producing educational, business, scientific, technical, and reference books and materials,” (Tebbel 1987, 439) the trade industry publishes most of the books that most people read. It is the most public segment of the industry, and the most likely place to find public intellectualism. Trade publishing is not only the most public segment of the industry, but it is also the most susceptible to corruption and lowered intellectual standards. Unlike specialty publishing, which caters to a specific, known segment of society, trade publishers must compete with countless other publications, as well as with other forms of media, for the patronage of the general public. As John Tebbel (author of a widely referenced history of the publishing industry) puts it, “The textbook, scientific, or technical book is subjected to much more rigorous scrutiny by buyers and users, and in an intensively competitive market inferior products are quickly lost" (Tebbel 1987, xiv). Since the standards for trade publishing are not nearly as specific – trade books simply need to catch the attention of a significant number of readers, they don’t have to measure up to a given level of quality – the quality of trade books is much more variable. And yet, a successful trade publication can have a much greater impact on society than the most rigorously researched and edited textbook or scholarly study.
Resumo:
There is growing evidence that the course of Bipolar Affective Disorder (BAD) can be altered by psychotherapeutic approaches, such as Psychoeducation. Therefore, this study was performed with the objective of identifying the implications of a Psychoeducation group on the everyday lives of individuals with BAD. To do this, the authors chose to perform a qualitative case study. Participants included twelve individuals with BAD who had attended at least six meetings of the Psychoeducation Group held at the Sao Jose do Rio Preto Faculty of Medicine (FAMERP). Semi-structured interviews were performed, which were recorded and then transcribed and subjected to Thematic Analysis. The present study showed that the referred group experience promoted the individuals' knowledge acquisition; their awareness regarding the disease and adherence to treatment; their making positive changes in life; the possibility of helping other patients to benefit from the knowledge learned in the group; and their awareness regarding other realities and coping strategies, obtained by exchanging experiences with other participants.
Resumo:
Waste management is becoming, year after year, always more important both for the costs associated with it and for the ever increasing volumes of waste generated. The discussion on the fate of organic fraction of municipal solid waste (OFMSW) leads everyday to new solutions. Many alternatives are proposed, ranging from incineration to composting passing through anaerobic digestion. “For Biogas” is a collaborative effort, between C.I.R.S.A. and R.E.S. cooperative, whose main goal is to generate “green” energy from both biowaste and sludge anaerobic co-digestion. Specifically, the project include a pilot plant receiving dewatered sludge from both urban and agro-industrial sewage (DS) and the organic fraction of MSW (in 2/1 ratio) which is digested in absence of oxygen to produce biogas and digestate. Biogas is piped to a co-generation system producing power and heat reused in the digestion process itself, making it independent from the national grid. Digestate undergoes a process of mechanical separation giving a liquid fraction, introduced in the treatment plant, and a solid fraction disposed in landfill (in future it will be further processed to obtain compost). This work analyzed and estimated the impacts generated by the pilot plant in its operative phase. Once the model was been characterized, on the basis of the CML2001 methodology, a comparison is made with the present scenario assumed for OFMSW and DS. Actual scenario treats separately the two fractions: the organic one is sent to a composting plant, while sludge is sent to landfill. Results show that the most significant difference between the two scenarios is in the GWP category as the project "For Biogas" is able to generate “zero emission” power and heat. It also generates a smaller volume of waste for disposal. In conclusion, the analysis evaluated the performance of two alternative methods of management of OFMSW and DS, highlighting that "For Biogas" project is to be preferred to the actual scenario.
Resumo:
This paper explores the significance of ‘life-worlds’ for better understanding why farmers adopt or reject soil conservation measures and for identifying basic dimensions to be covered by social learning processes in Swiss agricultural soil protection. The study showed that farmers interpret soil erosion and soil conservation measures against the background of their entire life-world. By doing so, farmers consider abstract and symbolic meanings of soil conservation. This is, soil conservation measures have to be feasible and practical in the everyday farming routine, however, they also have to correspond with their aesthetic perception, their value system and their personal and professional identities. Consequently, by switching to soil conservation measures such as no-tillage farmers have to adapt not only the routines of their daily farming life, but also their perception of the aesthetics of cultivated land, underlying values and images of themselves. Major differences between farmers who adopt and farmers who reject no-tillage were found to depend on the degree of coherence they could create between the abstract and symbolic meanings of the soil conservation measure. From this perspective, implementation of soil protection measures faces the challenge of facilitating interactions between farmers, experts and scientists at a ‘deeper’ level, with an awareness of all significant dimensions that characterise the life-world. The paper argues that a certain level of shared symbolic meaning is essential to achieving mutual understanding in social learning processes.
Resumo:
The collapse of the Soviet Union at the beginning of the 1990s also meant the end of the idea of a common soviet identity incarnated in the "soviet man" and the new "historic community of the soviet people". While this idea still lives on in the generations of the 1920s to 1940s, the younger generations tend to prefer identification with family, profession, ethnic group or religion. Ms. Alexakhina set out to investigate different interethnic interaction strategies in the multi-ethnic context of the Russian Federation, with an emphasis on analysing the role of cultural and ethno-demographic characteristics of minority ethnic groups. It aimed to identify those specific patterns of interaction dynamics that have emerged in response to the political and economic transformation at present under way. The basic supposition was that the size and growth of an ethnic population are defined not only by demographic features such as fertility, mortality and net migration, but are also dependent on processes interethnic interaction and ethnic transition. The central hypothesis of the project was that the multi-ethnic and multi-cultural composition of Russia is apparently manifesting itself in the ethnic minority groups in various forms, but particularly in the form of ethnic revival and/or assimilation. The results of these complex phenomena are manifested as changes in ethnic attachments (national re-identification and language behaviour (multi-lingualism, language transition and loss of the mother tongue). The stress of the political and economic crisis has stimulated significant changes in ethnographic, social and cultural characteristics of inter-ethnic dynamics such as the rate of national re-identification, language behaviour, migration activity and the spread of mixed marriages, among both those minorities with a long history of settlement in Russia and those that were annexed during the soviet period. Patterns of language behaviour and the spread of mixed marriages were taken as the main indicators of the directions of interethnic interaction described as assimilation, ethnic revival and cultural pluralism. The first stage of the research involved a statistical analysis of census data from 1959 to 1994 in order to analyse the changing demographic composition of the largest ethnic groups of the Russian Federation. Until 1989 interethnic interaction in soviet society was distinguished by the process of russification but the political and economic transformation has stimulated the process of ethnic revival, leading to an apparent fall in the size of the Russian population due to ethnic re-identification by members of other ethnic groups who had previously identified themselves as Russian. Cross-classification of nationalities by demographic, social and cultural indicators has shown that the most important determinants of the nature of interethnic interaction are cultural factors such as religion and language affiliation. The analysis of the dynamics of language shift through the study of bilingualism and the domains of language usage for different demographic groups revealed a strong correlation between recognition of Russian as a mother tongue among some non-Russian ethnic groups and the declining size of these groups. The main conclusion from this macro-analysis of census data was the hypothesis of the growing importance of social and political factors upon ethnic succession, that ethnic identity is no longer a stable characteristic but has become dynamic in nature. In order to verify this hypothesis Ms. Alexakhina conducted a survey in four regions showing different patterns of interethnic interaction: the Karelian Republic, Buryatiya, the Nenezkii Autonomous Region and Tatarstan. These represented the west, east, north and south of the Russian Federation. Samples for the survey were prepared on the basis of census lists so as to exclude mono-Russian families in favour of mixed and ethnic-minority families. The survey confirmed the significant growth in the importance of ethnic affiliation in the everyday lives of people in the Federation following the de-centralisation of the political and economic spheres. Language was shown to be a key symbol of the consciousness of national distinction, confirmed by the fact that the process of russification has been reversed by the active mastering of the languages of titular nationalities. The results also confirmed that individual ethnic identity has ceased to be a fixed personal characteristic of one's cultural and genetic belonging, and people's social adaptation to the current political, social and economic conditions is also demonstrated in changes in individual ethnic self-identification. In general terms, the dynamic nature of national identity means that ethnic identity is at present acquiring the special features of overall social identity, for which the frequent change of priorities is an inherent feature of a person's life cycle. These are mainly linked with a multi-ethnic environment and high individual social mobility. From her results Ms. Alexakhina concludes that the development of national languages and multi-lingualism, together with the preservation of Russian as a state language, seems to be the most promising path to peaceful coexistence and the development of the national cultures of different ethnic groups within the Russian Federation.
Resumo:
This project set out to investigate the effects of the recent massive social transitions in Eastern Europe on the everyday social lives of the inhabitants of three very different nations: Georgia, Russia and Hungary. It focused in particular on the availability and nature of the support networks available to three different segments of each of the societies (manual workers, students and entrepreneurs) and the impact of network participation on psychological and physical well-being. The group set four specific questions to investigate: the part played by individual psychological beliefs in the formation and maintenance of social networks and the consequent formation of trusting relations; the implication of the size and quality of these networks for mental health; the nature of the social groups inhabited by the respondents and the implication of their work schedule and daily routines on the maintenance of a social and family life; and an analysis of how cultures vary in their social networks and intimacy. Three different methods were used to examine social support and its implications: structured questionnaires, semi-structured short interviews and a media analysis of newspaper materials. The questionnaires were administered to 150 participants in each country, equally divided between students studying full time, manual workers employed in factories, and business people (small kiosk owners, whose work and life style differs considerably from that of the manual workers). The questionnaires investigated various predictors of social support including the locus of control, relationship beliefs, individualism-collectivism and egalitarianism, demographic variables (age, gender and occupation), social support, both in general and in relation to significant events that have occurred since the transition from communism. Those with an internal locus of control were more likely to report a higher level of social support, as were collectivists, while age too was a significant predictor, with younger respondents enjoying higher levels of support, regardless of the measures of support employed. Respondents across the cultures referred to a decline of social support and the group also found a direct correlation between social support and mental health outcomes. All 450 respondents were interviewed on their general responses to changes in their lives since the fall of communism and the effects of their work lives on their social lives and the home environment. The interviews revealed considerable variations in the way in which work-life offered opportunities for a broader social life and also provided a hindrance to the development of fulfilling relationships. Many of the work experiences discussed were culture specific, with work having a particularly negative impact on the social life of Russian entrepreneurs but being seen much more positively in Georgia. This may reflect the nature of support offered in a society as overall support levels were lowest in Russia, meaning that social support may be of particular importance there. The way in cultural values and norms about personal relationships are transmitted in a culture is a critical issue for social psychologists and the group examined newspaper articles in those newspapers read by the respondents in each of the three countries. These revealed a number of different themes. The concept of a divided society and its implications for personal relationships was clearest in Russian and Hungary, where widely-read newspapers dwelt on the contrast between "new Russians/Hungarians" and the older, poorer ones and extended considerable sympathy to those suffering from neglect in institutions. Magyar Nemzet, a paper widely read by Hungarian students reflects the generally more pessimistic tone about personal relationships in Russia and Hungary and gave a particularly detailed analysis of the implications this holds for human relations in a modern society. In Georgia, however, the tone of the newspapers is more positive, stressing greater social cohesion. Part of this cohesion is framed in the context of religion, with the church appealing to a broader egalitarianism, whereas in less egalitarian Hungary appeals by the Church are centred more on the nuclear family and its need for expansion in both size and influence. The division between the sexes was another prominent issue in Hungary and Russia, while the theme of generational conflict also emerged in Hungarian and Georgian papers, although with some understanding of "young people today". The team's original expectation that the different newspapers read by the different groups of respondents would present differing images of personal relationships was not fulfilled, as despite variations in style, they found little clear "ideological targeting" of any particular readership. They conclude that the vast majority of respondents recognised that the social transition from communism has had a significant impact on the well-being of social relationships and that this is a pertinent issue for all segments of society. While the group see the data collected as a source to be worked on for some time in the future, their initial impressions include the following. Social support is clearly an important concern across all three countries. All respondents (including the students) lament the time taken up by their heavy work schedules and value their social networks and family ties in particular. The level of social support differs across the countries investigated, with Georgian apparently enjoying significantly higher levels of social support. The analysis produced an image of a relatively cohesive and egalitarian society in which even the group most often seen as distant from the general population, business people, is supported by a strong social network. In contrast, the support networks available to the Russian respondents seem particularly weak and reflect a general sense of division and alienation within the culture as a whole. The implications of low levels of social support may vary across countries. While Russians reported the lowest level of mental health problems, the link between social support and mental health may be strongest in that country. In contrast, in Hungary it is the link between fatalism and mental health problems which is particularly strong, while in Georgia the strongest correlation was between mental health and marital quality, emphasising the significance of the marital relationship in that country.
Resumo:
The project studied the way the post-communist transition has affected the position of women in society and two post-Soviet states, Armenia and Russia, were chosen for a comparative study. Although in many respects the two countries show rather similar tendencies, there are important differences. The most dramatic of these lie in the field of the women's movement and state support, in family lifestyles and public thinking, and in the perception of female roles in society by both women and men in both countries. Whereas in Russia, at least in large cities, it is possible to speak of a movement concerned with equality and women's rights, in Armenia there are few women's organisations and those that exist are most focused on support for children and poor families. In Russia, many post-Soviet changes can be described as a shift towards 'Western' rather than 'Eastern' values, while in Armenia this tendency is much weaker and exists alongside a relapse into traditional attitudes. Iskandarian suggests possible explanations for this, both intrinsic (tradition. motivation) and external (influences, neighbouring countries, involvement in wars, the economic situation, migrations, political regimes). Nevertheless, for both societies it is possible to speak of a growing awareness of women's needs and of the birth of a new tradition in family and public life brought by the post-Soviet winds of change.
Resumo:
The aim of this project was to evaluate the present state and possible changes of water resources in Lake Ladoga and its drainage basin for the purposes of the sustainable development of North-Western Russia and Finland. The group assessed the state of the water resources in quantitative and qualitative terms, taking the system of sustainable development indicators suggested by the International Commission on Sustainable Development as a basis for assessment. These include pressure indicators (annual withdrawals of ground and surface water, domestic consumption of water per capita), state indicators (ground water reserves, concentration of faecalcoliform in fresh water, biochemical oxygen demand), and response indicators (waste-water treatment coverage, density of hydrological networks). The group proposed the following additional indicators and indices for the complex evaluation of the qualitative and quantitative state of the region's water resources: * Pressure indicators (external load, coefficient of anthropogenic pressure) * State indicators and indices (concentrations of chemicals in water, concentrations of chemicals in sediments, index of water pollution, critical load, critical limit, internal load, load/critical load, concentration/critical limit, internal load/external load, trophic state, biotic indicators and indices) * Response indicators (discharges of pure water, polluted water, partly treated water and the ratio between these, trans-boundary fluxes of pollutants, state expenditure on environmental protection, human life span) The assessment considered both temporal and spatial aspects and produced a regional classification of the area according to the index of water pollution. Mathematical models were developed to describe and forecast the processes under way in the lake and can be used to estimate the influence of climatic changes on the hydrological regime, as well as the influence of anthropogenic load on the trophic state of Lake Ladoga and to assess the consequences of accidental discharges of polluting admixtures of different kinds into the lake. The results of this mathematical modelling may be of use to decision-makers responsible for the management of water resources.
Resumo:
The transition in Central and Eastern Europe since the late 1980s has provided a testing ground for classic propositions. This project looked at the impact of privatisation on private consumption, using the Czech experiment of voucher privatisation to test the permanent income hypothesis. This form of privatisation moved state assets to individuals and represented an unexpected windfall gain for participants in the scheme. Whether the windfall was consumed or saved offers a clear test of the permanent income hypothesis. Of a total population of 10 million, 6 million Czechs, i.e. virtually every household, participated in the scheme,. In a January 1996 survey, 1263 individuals were interviewed , 75% of whom had taken part. The data obtained suggests that only a small quantity of transferred assets were cashed in and spent on consumption, providing support for the permanent income hypothesis. The fraction of the windfall consumed grows with age, as would be predicted from the lower life expectancy of older consumers. The most interesting deviation was for people aged 26 to 35, who apparently consumed more that they would if the windfall were annuitised. As these people are at the stage in their lives when they would otherwise be borrowing to cover consumption related to establishing a family, etc., this is however consistent with the permanent income hypothesis, which predicts that individuals who would otherwise borrow money would use the windfall to avoid doing so.
Resumo:
This project intertwines philosophical and historico-literary themes, taking as its starting point the concept of tragic consciousness inherent in the epoch of classicism. The research work makes use of ontological categories in order to describe the underlying principles of the image of the world which was created in philosophical and scientific theories of the 17th century as well as in contemporary drama. Using these categories brought Mr. Vilk to the conclusion that the classical picture of the world implied a certain dualism; not the Manichaean division between light and darkness but the discrimination between nature and absolute being, i.e. God. Mr. Vilk begins with an examination of the philosophical essence of French classical theatre of the XVII and XVIII centuries. The history of French classical tragedy can be divided into three periods: from the mid 17th to early 19th centuries when it triumphed all over France and exerted a powerful influence over almost all European countries; followed by the period of its rejection by the Romantics, who declared classicism to be "artificial and rational"; and finally our own century which has taken a more moderate line. Nevertheless, French classical tragedy has never fully recovered its status. Instead, it is ancient tragedy and the works of Shakespeare that are regarded to be the most adequate embodiment of the tragic. Consequently they still provoke a great number of new interpretations ranging from specialised literary criticism to more philosophical rumination. An important feature of classical tragedy is a system of rules and unities which reveals a hidden ontological structure of the world. The ontological picture of the dramatic world can be described in categories worked out by medieval philosophy - being, essence and existence. The first category is to be understood as a tendency toward permanency and stability (within eternity) connected with this or that fragment of dramatic reality. The second implies a certain set of permanent elements that make up the reality. And the third - existence - should be understood as "an act of being", as a realisation of permanently renewed processes of life. All of these categories can be found in every artistic reality but the accents put on one or another and their interrelations create different ontological perspectives. Mr. Vilk plots the movement of thought, expressed in both philosophical and scientific discourses, away from Aristotle's essential forms, and towards a prioritising of existence, and shows how new forms of literature and drama structured the world according to these evolving requirements. At the same time the world created in classical tragedy fully preserves another ontological paradigm - being - as a fundamental permanence. As far as the tragic hero's motivations are concerned this paradigm is revealed in the dedication of his whole self to some cause, and his oath of fidelity, attitudes which shape his behaviour. It may be the idea of the State, or personal honour, or something borrowed from the emotional sphere, passionate love. Mr. Vilk views the conflicting ambivalence of existence and being, duty as responsibility and duty as fidelity, as underlying the main conflict of classical tragedy of the 17th century. Having plotted the movement of the being/existence duality through its manifestations in 17th century tragedy, Mr. Vilk moves to the 18th century, when tragedy took a philosophical turn. A dualistic view of the world became supplanted by the Enlightenment idea of a natural law, rooted in nature. The main point of tragedy now was to reveal that such conflicts as might take place had an anti-rational nature, that they arose as the result of a kind of superstition caused by social reasons. These themes Mr. Vilk now pursues through Russian dramatists of the 18th and early 19th centuries. He begins with Sumarakov, whose philosophical thought has a religious bias. According to Sumarakov, the dualism of the divineness and naturalness of man is on the one hand an eternal paradox, and on the other, a moral challenge for humans to try to unite the two opposites. His early tragedies are not concerned with social evils or the triumph of natural feelings and human reason, but rather the tragic disharmony in the nature of man and the world. Mr Vilk turns next to the work of Kniazhnin. He is particularly keen to rescue his reputation from the judgements of critics who accuse him of being imitative, and in order to do so, analyses in detail the tragedy "Dido", in which Kniazhnin makes an attempt to revive the image of great heroes and city-founders. Aeneas represents the idea of the "being" of Troy, his destiny is the re-establishment of the city (the future Rome). The moral aspect behind this idea is faithfulness, he devotes himself to Gods. Dido is also the creator of a city, endowed with "natural powers" and abilities, but her creation is lacking internal stability grounded in "being". The unity of the two motives is only achieved through Dido's sacrifice of herself and her city to Aeneus. Mr Vilk's next subject is Kheraskov, whose peculiarity lies in the influence of free-mason mysticism on his work. This section deals with one of the most important philosophical assumptions contained in contemporary free-mason literature of the time - the idea of the trinitarian hierarchy inherent in man and the world: body - soul - spirit, and nature - law - grace. Finally, Mr. Vilk assess the work of Ozerov, the last major Russian tragedian. The tragedies which earned him fame, "Oedipus in Athens", "Fingal" and "Dmitri Donskoi", present a compromise between the Enlightenment's emphasis on harmony and ontological tragic conflict. But it is in "Polixene" that a real meeting of the Russian tradition with the age-old history of the genre takes place. The male and female characters of "Polixene" distinctly express the elements of "being" and "existence". Each of the participants of the conflict possesses some dominant characteristic personifying a certain indispensable part of the moral world, a certain "virtue". But their independent efforts are unable to overcome the ontological gap separating them. The end of the tragedy - Polixene's sacrificial self-immolation - paradoxically combines the glorification of each party involved in the conflict, and their condemnation. The final part of Mr. Vilk's research deals with the influence of "Polixene" upon subsequent dramatic art. In this respect Katenin's "Andromacha", inspired by "Polixene", is important to mention. In "Andromacha" a decisive divergence from the principles of the philosophical tragedy of Russian classicism and the ontology of classicism occurs: a new character appears as an independent personality, directed by his private interest. It was Katenin who was to become the intermediary between Pushkin and classical tragedy.
Resumo:
Patient self-management (PSM) of oral anticoagulation is under discussion, because evidence from real-life settings is missing. Using data from a nationwide, prospective cohort study in Switzerland, we assessed overall long-term efficacy and safety of PSM and examined subgroups. Data of 1140 patients (5818.9 patient-years) were analysed and no patient were lost to follow-up. Median follow-up was 4.3 years (range 0.2-12.8 years). Median age at the time of training was 54.2 years (range 18.2-85.2) and 34.6% were women. All-cause mortality was 1.4 per 100 patient-years (95% CI 1.1-1.7) with a higher rate in patients with atrial fibrillation (2.5; 1.6-3.7; p<0.001), patients>50 years of age (2.0; 1.6-2.6; p<0.001), and men (1.6; 1.2-2.1; p = 0.036). The rate of thromboembolic events was 0.4 (0.2-0.6) and independent from indications, sex and age. Major bleeding were observed in 1.1 (0.9-1.5) per 100 patient-years. Efficacy was comparable to standard care and new oral anticoagulants in a network meta-analysis. PSM of properly trained patients is effective and safe in a long-term real-life setting and robust across clinical subgroups. Adoption in various clinical settings, including those with limited access to medical care or rural areas is warranted.
Resumo:
Objective: To identify which aspects of socioeconomic change were associated with the steep decline in life expectancy in Russia between 1990 and 1994.