Unequal access to healthcare and inadequate financing have highlighted the need for healthcare reform to increase efficiency while ensuring equity in healthcare financing worldwide. Our study evaluates the capacity of Kazakhstan's healthcare system reform, transitioning from a tax-financed system to compulsory social health insurance (CSHI), to address equity in healthcare financing. Using quarterly Household Budget Surveys from 2017-Q1 to 2020-Q4 in a staggered difference-in-difference estimation technique, we analyze the impact of the transition on the incidence and intensity of catastrophic health expenditure (CHE) and impoverishment. Our findings show that while the transition from a tax-financed to a CSHI system in the short run lowers both the incidence and intensity of catastrophic health expenditure, it does not alleviate impoverishment. In particular, the reform predominantly benefits wealthier households, with no effect on the relatively poor population. We speculate that the positive outcomes observed from the reform in the short run are largely attributed to the exceptionally high insurance coverage during the transition period. The success of the transition from a tax-based to an insurance-based system is heavily dependent on the rate of insurance coverage of the population, as well as the quality of healthcare services and available finances.

• Klíčová slova
• Catastrophic health expenditure, Health insurance, Impoverishment, Inequity, Kazakhstan,
• MeSH
• financování zdravotní péče * MeSH
• lidé MeSH
• reforma zdravotní péče * ekonomika   metody   statistika a číselné údaje   MeSH
• vážná nemoc * ekonomika   epidemiologie   MeSH
• výdaje na zdravotnictví * statistika a číselné údaje   trendy   MeSH
• zdravotní pojištění ekonomika   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kazachstán MeSH

Informal food markets, particularly those managed by (elderly) women in post-communist Eastern Europe, represent a biocultural phenomenon of profound significance since globalisation and increasingly strict legal frameworks often threaten these reservoirs of biocultural food heritage. In the fall of 2022 and 2023, a preliminary field study was conducted by visiting the informal markets of six Moldovan centres: Chișinău, Orhei, Bălți, Călărași, Comrat, and Taraclia, and conversing with approximately 40 mid-aged and elderly sellers. We argue that these markets are crucial in sustaining small-scale farming, preserving biodiversity, and maintaining a connection between urban communities and rural communities and, ultimately, between these rural citizens and their nature, keeping small-scale family farming and domestic traditional gastronomic activities alive. By trading fresh, homegrown, and homemade food and goods (including handicrafts), these mid-aged and elderly vendors support local economies, promote environmental sustainability, and safeguard traditional ecological knowledge and cultural heritage. This paper explores how grannies' markets contribute to biocultural diversity and sustainable food practices, especially amid the country's recent turbulent political, socioeconomic, and demographic challenges. The analysis advocates for the survival rights of these ecological, economic, and cultural (2-x-eco-cultural) refugia and invites ethnobiologists, food studies and cultural heritage scholars, rural sociologists, and agricultural economists to defend the biocultural diversity of informal food markets, moving them from an "out of necessity" status to a solid pillar of a possible future, new, family farming and small-scale ecological and gastronomic (conscientious) tourism. Policymakers should protect and enhance these informal spaces, especially the socioecological farming systems behind them, as essential socioeconomic and environmental assets. They should emphasise their importance as hubs for biological diversity, cultural preservation, community cohesion, and ecological sustainability.

• Klíčová slova
• Ethnobiology, Food heritage, Grannies’ markets, Informal markets, Moldova,
• MeSH
• biodiverzita MeSH
• dospělí MeSH
• kultura MeSH
• lidé středního věku MeSH
• lidé MeSH
• obchod * MeSH
• senioři MeSH
• venkovské obyvatelstvo MeSH
• zachování přírodních zdrojů MeSH
• zásobování potravinami * MeSH
• zemědělství MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Moldavsko MeSH

A new zodariid species, Zodariellum martinae sp. nov. (♂♀), is described from southeastern Kazakhstan. Furthermore, type specimens of Z. mongolicum Marusik & Koponen, 2001 (♂) and Z. schmidti Marusik & Koponen, 2001 (♂♀), along with comparative material of Z. nenilini (Eskov, 1995) (♂♀), have been re-examined and photographed.

• MeSH
• anatomické struktury zvířat anatomie a histologie   růst a vývoj   MeSH
• ekosystém MeSH
• pavouci * klasifikace   anatomie a histologie   růst a vývoj   MeSH
• rozšíření zvířat MeSH
• velikost orgánu MeSH
• velikost těla MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kazachstán MeSH

New data on the Palaearctic subgenus Holoclera Schiner of dance flies of the genus Rhamphomyia Meigen (Diptera: Empididae) are reported. Three new species are described: Rhamphomyia (Holoclera) richterae sp. nov. (Russia: Adygea, Krasnodarskiy Territory), R. (H.) stepankubiki sp. nov. (Armenia, Turkey), and R. (H.) vikhrevi sp. nov. (Morocco). New extensive distributional data are provided, especially for the Eastern Palaearctic. The subgenus has been found to have a trans-Palaearctic distribution. However, only five of 23 named species, which this group comprises, occur beyond the Urals. The distribution of R. (H.) culicina (Fallén) and R. (H.) sciarina (Fallén) (both R. (H.) flava group) extends to the east as far as the Russian Far East (Magadanskaya and Amurskaya Provinces, respectively). Amongst the species of the R. (H.) nigripennis group, R. (H.) nigripennis (Fabricius) has the broadest distribution extending to the east as far as Krasnoyarskiy Territory of Russia (Eastern Siberia). In addition, R. (H.) lamellata Collin and R. (H.) caliginosa Collin were recorded from Western Siberia and Kyrgyzstan, respectively. The latter is the first record of R. (Holoclera) from Middle Asia. Only one species (R. (H.) sciarina) occurs in the subarctic regions of Asia (Taymyr Peninsula). The following records are new for the states noted: R. (H.) helvetica Barták & Kubík (France and Germany), R. (H.) lamellata (Estonia, Finland and Ukraine), R. (H.) trigemina Oldenberg (Estonia and Sweden), R. (H.) umbripennis Meigen (Armenia), R. (H.) variabilis (Fallén) (Ukraine). An updated key to species of Holoclera from the Palaearctic Region is provided.

• MeSH
• anatomické struktury zvířat * anatomie a histologie   růst a vývoj   MeSH
• Diptera * anatomie a histologie   klasifikace   MeSH
• ekosystém MeSH
• rozšíření zvířat * MeSH
• velikost orgánu MeSH
• velikost těla * MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Arménie MeSH
• Maroko MeSH
• Rusko MeSH
• Turecko MeSH

OBJECTIVE: The objective of this study was to evaluate the effectiveness of human papillomavirus HPV test with HPV16/18 genotyping and liquid-based cytology (LBC) triage as a primary screening method for cervical cancer compared to conventional Pap test in women undergoing routine cervical cancer screening in Tbilisi. METHODS: Cross-sectional, prospective study was conducted, where 1,000 enrolled women aged 30-60 years during one visit underwent conventional Pap smear and Hr-HPV testing (Roche Cobas system). Women with any positive screening results were referred for further evaluation and remaining cells from the Cell Collection Medium vial were used for LBC. The study calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each screening method and receiver-operating characteristic (ROC) curve to evaluate the accuracy of each diagnostic method in identifying people with CIN2+ diseases. RESULTS: The HPV test with HPV16/18 genotyping and LBC triage demonstrated higher sensitivity (76.9%), specificity (71.6%), and PPV (34.5%) compared to conventional Pap tests (p < 0.05). NPV was also high with the HPV test (94.1%). The HPV test alone had the highest sensitivity (92.3%) and NPV (96.7%), but lower specificity (41.4%) and PPV (22.6%) than the HPV test with HPV16/18 genotyping and LBC triage (p < 0.05). Comparing the areas under the curve (AUCs), only the HPV with HPV16/18 genotyping and LBC triage showed a statistically significant difference when compared to conventional Pap (0.71 vs. 0.55, p = 0.03) and high figures of AUC 0.71 (95% CI: 0.58-0.85) suggesting that HPV test with HPV16/18 genotyping and LBC triage is a more reliable screening method for detecting CIN2+ disease and preventing cervical cancer, than other screening modality. CONCLUSION: The results suggest that the HPV test with HPV16/18 genotyping and LBC triage is a more effective primary screening method compared to conventional Pap tests. This information should be the basis for transition from cytological screening to HPV testing in Georgia.

• Klíčová slova
• HPV test, cervical cancer screening, cytology,
• MeSH
• časná detekce nádoru * metody   MeSH
• dospělí MeSH
• genotyp MeSH
• infekce papilomavirem * diagnóza   virologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lidský papilomavirus 16 genetika   izolace a purifikace   MeSH
• lidský papilomavirus 18 genetika   izolace a purifikace   MeSH
• nádory děložního čípku * virologie   diagnóza   MeSH
• Papanicolaouův test * MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• senzitivita a specificita MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Gruzie epidemiologie   MeSH

This study analyzes the relationship between drought processes and crop yields in Moldova, together with the effects of possible future climate change on crops. The severity of drought is analyzed over time in Moldova using the Standard Precipitation Index, the Standardized Precipitation Evapotranspiration Index, and their relationship with crop yields. In addition, rainfall variability and its relationship with crop yields are examined using spectral analysis and squared wavelet coherence. Observed station data (1950-2020 and 1850-2020), ERA5 reanalysis data (1950-2020), and climate model simulations (period 1970-2100) are used. Crop yield data (maize, sunflower, grape), data from experimental plots (wheat), and the Enhanced Vegetation Index from Moderate Resolution Imaging Spectroradiometer satellites were also used. Results show that although the severity of meteorological droughts has decreased in the last 170 years, the impact of precipitation deficits on different crop yields has increased, concurrent with a sharp increase in temperature, which negatively affected crop yields. Annual crops are now more vulnerable to natural rainfall variability and, in years characterized by rainfall deficits, the possibility of reductions in crop yield increases due to sharp increases in temperature. Projections reveal a pessimistic outlook in the absence of adaptation, highlighting the urgency of developing new agricultural management strategies.

• Klíčová slova
• Republic of Moldova, climate change, crop yields, drought, global warming,
• MeSH
• déšť MeSH
• fyziologická adaptace fyziologie   MeSH
• globální oteplování * MeSH
• klimatické modely MeSH
• klimatické změny MeSH
• kukuřice setá růst a vývoj   fyziologie   MeSH
• období sucha * MeSH
• pšenice růst a vývoj   fyziologie   MeSH
• teplota MeSH
• zemědělské plodiny * růst a vývoj   MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Moldavsko MeSH

The emergence of tick-borne encephalitis (TBE) in Europe marked several significant milestones. The discovery of TBE in Czechoslovakia in 1948, with Gallia and Krejčí simultaneously isolating the TBE virus (TBEV) from human samples for the first time in Europe outside the Soviet Union, was pivotal. Subsequent TBEV isolation from ticks suggested the viral transmission via this vector. In 1951, the outbreak in Rožňava in Slovakia (Czechoslovakia) revealed an unexpected mode of transmission, unpasteurized milk from a local dairy, challenging existing understanding. Investigations exposed illicit practices of mixing cow's milk with goat's milk for economic gains. Laboratory research confirmed the outbreak was caused by TBEV, which was substantiated by serological analyses. This was the first and largest documented alimentary TBE outbreak in history. In this review, we delve into both published sources and unpublished archival data, offering a comprehensive understanding of these historic accomplishments and shedding light on these pivotal moments.

• Klíčová slova
• Alimentary infection, History, Tick-borne encephalitis, Tick-borne encephalitis virus, Virus discovery,
• MeSH
• epidemický výskyt choroby MeSH
• klíšťová encefalitida * MeSH
• lidé MeSH
• skot MeSH
• viry klíšťové encefalitidy * MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• skot MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• SSSR MeSH

In Uzbekistan, the number of reported leishmaniasis cases is rising at the alarming rate. In this work, we studied the phlebotomine sand fly (Diptera: Phlebotominae) diversity in the foci of cutaneous leishmaniasis in the Surxondaryo Region of Uzbekistan and compared it with the data obtained for the same area 50 years ago, when infection prevalence was reportedly low. We found that the implicated vector for zoonotic leishmaniasis, P. papatasi, remained eudominant; the proportion of implicated anthroponotic leishmaniasis vector, P. sergenti, rose significantly from averaged 5.4 to 41.4%; Phlebotomus alexandri, a suspected visceral leishmaniasis vector, was eudominant at two sites, and a second suspected vector for this disease, P. longiductus, was newly recorded in the region. We conclude that the increase in the documented cases of cutaneous leishmaniasis in the Surxondaryo Region of Uzbekistan may be connected to the changes in fauna of sand flies vectoring Leishmania spp.

• Klíčová slova
• Diversity, Leishmania, Phlebotomus,
• MeSH
• hmyz - vektory MeSH
• leishmanióza kožní * epidemiologie   MeSH
• leishmanióza viscerální * epidemiologie   MeSH
• Phlebotomus * MeSH
• Psychodidae * MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Uzbekistán epidemiologie   MeSH

Protein tyrosine phosphatase, nonreceptor type 22 (PTPN22), is an archetypal non-HLA autoimmunity gene. It is one of the most prominent genetic contributors to type 1 diabetes mellitus outside the HLA region, and prevalence of its risk variants is subject to enormous geographic variability. Here, we address the genetic background of patients with type 1 diabetes mellitus of Armenian descent. Armenia has a population that has been genetically isolated for 3000 years. We hypothesized that two PTPN22 polymorphisms, rs2476601 and rs1310182, are associated with type 1 diabetes mellitus in persons of Armenian descent. In this association study, we genotyped the allelic frequencies of two risk-associated PTPN22 variants in 96 patients with type 1 diabetes mellitus and 100 controls of Armenian descent. We subsequently examined the associations of PTPN22 variants with the manifestation of type 1 diabetes mellitus and its clinical characteristics. We found that the rs2476601 minor allele (c.1858T) frequency in the control population was very low (q = 0.015), and the trend toward increased frequency of c.1858CT heterozygotes among patients with type 1 diabetes mellitus was not significant (OR 3.34, 95% CI 0.88-12.75; χ2 test p > 0.05). The control population had a high frequency of the minor allele of rs1310182 (q = 0.375). The frequency of c.2054-852TC heterozygotes was significantly higher among the patients with type 1 diabetes mellitus (OR 2.39, 95% CI 1.35-4.24; χ2 test p < 0.001), as was the frequency of the T allele (OR 4.82, 95% CI 2.38-9.76; χ2 test p < 0.001). The rs2476601 c.1858CT genotype and the T allele correlated negatively with the insulin dose needed three to six months after diagnosis. The rs1310182 c.2054-852CC genotype was positively associated with higher HbA1c at diagnosis and 12 months after diagnosis. We have provided the first information on diabetes-associated polymorphisms in PTPN22 in a genetically isolated Armenian population. We found only a limited contribution of the prototypic gain-of-function PTPN22 polymorphism rs2476601. In contrast, we found an unexpectedly close association of type 1 diabetes mellitus with rs1310182.

• MeSH
• diabetes mellitus 1. typu * genetika   MeSH
• fosfatasy MeSH
• introny MeSH
• lidé MeSH
• polymorfismus genetický MeSH
• tyrosinfosfatasa nereceptorového typu 22 genetika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Arménie epidemiologie   MeSH
• Názvy látek
• fosfatasy MeSH
• PTPN22 protein, human MeSH Prohlížeč
• tyrosinfosfatasa nereceptorového typu 22 MeSH

OBJECTIVES: The Cervical Cancer (CC) Screening Programme in Georgia provides insufficient coverage of the target population. The aim of the study is to identify the barriers to cervical cancer screening for women in Georgia in order to plan and implement adequate measures to increase the screening effectiveness. METHODS: The study is based on the results of a survey of 582 women aged 25-60 years (mean age 42.11 + 12.17). Respondents were selected in out-patient clinics. The questionnaire included questions related to the place of residence, ethnicity, religion, marital status, education, employment, cervical cancer awareness and screening, screening participation practices, and barriers to participation. RESULTS: The following factors reliably increase the chance of participating in the screening: residing in Tbilisi, OR = 1.84 (95% CI: 1.10-3.07); higher education, OR = 1.87 (95% CI: 1.09-3.19); being employed as a nurse, OR = 3.42 (95% CI: 1.49-7.85); receiving screening-related information from medical staff, OR = 2.43 (95% CI: 1.42-4.15); and from television, OR = 2.57 (95% CI: 1.47-4.50). The chance of participating in the screening is reduced due to incomplete secondary education, OR = 0.10 (95% CI: 0.01-0.77); single marital status, OR = 0.49 (95% CI: 0.28-0.87); employment in public service, OR = 0.39 (95% CI: 0.17-0.89); and receiving screening-related information from friends, OR = 0.26 (95% CI: 0.09-0.77). Women with higher education are undoubtedly more informed about screening, screening procedures and free programmes than those without higher education. The common barrier to participation in the screening was "fear of the manipulation-related pain" but the most frequent answer was "I'm afraid that the test will detect cancer (36.3%)." Women with a lower level of education are more likely to believe that "Pap testing is appropriate for the women who have active sexual life", and/or "have multiple sexual partners", and/or "have children," and "it is not necessary if a woman has no complaints". CONCLUSION: Screening participation among women in Georgia depends on screening availability, formal education and awareness of CC, sources of information, and employment type.

• Klíčová slova
• awareness, barriers, cervical cancer screening, education,
• MeSH
• časná detekce nádoru MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory děložního čípku * diagnóza   prevence a kontrola   epidemiologie   MeSH
• Papanicolaouův test MeSH
• plošný screening MeSH
• zdraví - znalosti, postoje, praxe MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Gruzie MeSH