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Introduction: The J Project (JP) physician education and clinical research collaboration program was started in 2004 and includes by now 32 countries mostly in Eastern and Central Europe (ECE). Until the end of 2021, 344 inborn errors of immunity (IEI)-focused meetings were organized by the JP to raise awareness and facilitate the diagnosis and treatment of patients with IEI., Results: In this study, meeting profiles and major diagnostic and treatment parameters were studied. JP center leaders reported patients' data from 30 countries representing a total population of 506 567 565. Two countries reported patients from JP centers (Konya, Turkey and Cairo University, Egypt). Diagnostic criteria were based on the 2020 update of classification by the IUIS Expert Committee on IEI. The number of JP meetings increased from 6 per year in 2004 and 2005 to 44 and 63 in 2020 and 2021, respectively. The cumulative number of meetings per country varied from 1 to 59 in various countries reflecting partly but not entirely the population of the respective countries. Altogether, 24,879 patients were reported giving an average prevalence of 4.9. Most of the patients had predominantly antibody deficiency (46,32%) followed by patients with combined immunodeficiencies (14.3%). The percentages of patients with bone marrow failure and phenocopies of IEI were less than 1 each. The number of patients was remarkably higher that those reported to the ESID Registry in 13 countries. Immunoglobulin (IgG) substitution was provided to 7,572 patients (5,693 intravenously) and 1,480 patients received hematopoietic stem cell therapy (HSCT). Searching for basic diagnostic parameters revealed the availability of immunochemistry and flow cytometry in 27 and 28 countries, respectively, and targeted gene sequencing and new generation sequencing was available in 21 and 18 countries. The number of IEI centers and experts in the field were 260 and 690, respectively. We found high correlation between the number of IEI centers and patients treated with intravenous IgG (IVIG) (correlation coefficient, cc, 0,916) and with those who were treated with HSCT (cc, 0,905). Similar correlation was found when the number of experts was compared with those treated with HSCT. However, the number of patients treated with subcutaneous Ig (SCIG) only slightly correlated with the number of experts (cc, 0,489) and no correlation was found between the number of centers and patients on SCIG (cc, 0,174)., Conclusions: 1) this is the first study describing major diagnostic and treatment parameters of IEI care in countries of the JP; 2) the data suggest that the JP had tremendous impact on the development of IEI care in ECE; 3) our data help to define major future targets of JP activity in various countries; 4) we suggest that the number of IEI centers and IEI experts closely correlate to the most important treatment parameters; 5) we propose that specialist education among medical professionals plays pivotal role in increasing levels of diagnostics and adequate care of this vulnerable and still highly neglected patient population; 6) this study also provides the basis for further analysis of more specific aspects of IEI care including genetic diagnostics, disease specific prevalence, newborn screening and professional collaboration in JP countries., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abolhassani, Avcin, Bahceciler, Balashov, Bata, Bataneant, Belevtsev, Bernatowska, Bidló, Blazsó, Boisson, Bolkov, Bondarenko, Boyarchuk, Bundschu, Casanova, Chernishova, Ciznar, Csürke, Erdős, Farkas, Fomina, Galal, Goda, Guner, Hauser, Ilyina, Iremadze, Iritsyan, Ismaili-Jaha, Jesenak, Kelecic, Keles, Kindle, Kondratenko, Kostyuchenko, Kovzel, Kriván, Kuli-Lito, Kumánovics, Kurjane, Latysheva, Latysheva, Lázár, Markelj, Markovic, Maródi, Mammadova, Medvecz, Miltner, Mironska, Modell, Modell, Mosdósi, Mukhina, Murdjeva, Műzes, Nabieva, Nasrullayeva, Naumova, Nagy, Onozó, Orozbekova, Pac, Pagava, Pampura, Pasic, Petrosyan, Petrovic, Pocek, Prodeus, Reisli, Ress, Rezaei, Rodina, Rumyantsev, Sciuca, Sediva, Serban, Sharapova, Shcherbina, Sitkauskiene, Snimshchikova, Spahiu-Konjusha, Szolnoky, Szűcs, Toplak, Tóth, Tsyvkina, Tuzankina, Vlasova and Volokha.)

Georgia and Armenia are situated at the northern rim of the thalassemia belt and bordering to countries with a known high prevalence of thalassemias. In this study we assessed the carrier frequency and potential spectrum of alpha- and beta-globin mutations among 202 and 190 unselected Georgian and Armenian subjects, respectively. We found four alpha-globin mutations (-3.7del, -4.2del, anti-3.7 triplication, poly-A2) in 9 Armenians (4.74%) and 4 Georgians (1.78%). The heterozygous beta-globin codon 8 [-AA] mutation was detected in one individual from Armenia only. Overall, carrier frequencies seem to be low in both countries, supporting the notion that thalassemias are not a major health problem there.

Objectives: The present study tested the role of low self-control, positive parental and peer relationships, and ethnic minority status (Armenian or Azeri), in explaining variability in depressive symptoms in Georgian youth., Methods: Self-report data were collected from N = 8254 adolescents in Georgia (55.5% female, M age = 15.57, SD 1.03). Hypotheses were tested using structural equation modeling (SEM) with latent constructs., Results: Low self-control significantly and positively predicted depressive symptoms, while perceived parental warmth did so negatively; peer friendship quality was unrelated. Ethnic minority status explained a very small amount of unique variance in depressive symptoms for Azeri youth only, not for Armenian adolescents. Multi-group SEM moderation tests provided evidence that the links between constructs were invariant across ethnic groups. The model explained 15.6% of variance in depressive symptoms., Conclusions: Findings support the salience of the tested depressive symptom correlates among Georgian adolescents, consistent with previous evidence from other countries. Adolescent ethnic minority status did not increase risk of depressive symptoms. Self-control emerged as the strongest correlate.

Background: To reduce antimicrobial resistance (AMR), initiatives such as surveillance activities and activities to increase knowledge about how and why antibiotics (ABs) are (mis)used are needed. More surveillance systems are in place in the WHO Western European region than in the Eastern region, and only sparse knowledge exists about the current culture of AB use in the Eastern European countries., Objective: To investigate AB knowledge, attitudes and behaviors in countries in the WHO Eastern European region in order to identify overall similarities and differences across the region and how AB knowledge, attitudes and behavior patterns may be influenced by the national health care system., Methods: Semi-structured interviews were conducted in Armenia, Georgia, Kazakhstan, Moldova, Russia and Tajikistan with patients, doctors and pharmacists. In total, 80 interviews were carried out. A directed content analysis was applied, followed by a comparative analysis, identifying the similarities and differences in AB attitudes, knowledge and behaviors between the countries and discussing how the national health care systems might influence these patterns., Results: Cross-national patterns were identified regarding patients seeking ABs over-the-counter (OTC), patient variations in their requests for ABs when consulting doctors, and, finally, doctors and pharmacists appearing knowledgeable about ABs and their uses, with doctors displaying careful attitudes towards AMR. Indications of national differences between the countries included the ability of patients to afford ABs, prescribing practices of doctors and pharmacist attitudes towards selling ABs without prescriptions. Multiple aspects involved in patient and pharmacist AB decision making were detected, such as various rationales involved in buying/selling ABs OTC, implying that these processes are more complex than previously reported in the literature., Conclusions: Similarities across the Eastern European region could be seen in patient needs and uses of antibiotics obtained OTC at community pharmacies, whereas doctors appeared more influenced by specific structures of the national healthcare system., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Georgian language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability, and construct validity (convergent and discriminant validity). A total of 100 JIA patients (26% systemic, 57% oligoarticular, 16% RF negative polyarthritis, and 1% RF positive polyarthritis) and 100 healthy children, were enrolled at two paediatric rheumatology centre. Notably, none of the enrolled JIA patients is affected with psoriatic arthritis or with enthesitis-related arthritis or with undifferentiated arthritis. The JAMAR components discriminated healthy subjects from JIA patients, except for the school-related problems variable. All JAMAR components revealed good psychometric performances. In conclusion, the Georgian version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.

Aim - to define the parameters of physical development of children in orphanages. 72 children (45 boys, 27 girls) without chronic debilitating diseases and condition aged from 1 to 6 years from Tbilisi and Makhinjauri orphanages (Georgia) were assessed. Height and weight of all subjects were measured and BMI, height SDS (standard deviation score) and weight SDS were calculated. Data were compared to the normal values (national data). The retardation of the physical development were seen along almost all findings. The significant differences regarding age and gender were not revealed. The most expressed tendency to delay was expressed in the height of boys, particularly aged 3-5 years. Our data confirm that institution upbringing has a negative impact on the growth of children of 1-6 years of age. In children aged from 1 to 6 years who are healthy but live in orphanages there is a marked tendency to lag behind in physical development, mainly in height. The above-mentioned confirms the opinion about negative impact of upbringing in orphanages on the physical development of children.

Previous research has documented the importance of parenting on adolescent health and well-being; however, some of the underlying mechanisms that link the quality of parent-child relationship to health, adjustment, and well-being are not clearly understood. The current study seeks to address this gap by examining the extent to which sleep functioning mediates the effects by parental warmth on different measures of adolescent problem behaviors. Specifically, we test whether sleep functioning, operationalized by sleep quality and sleep quantity, mediates the relationship between the parental warmth and three measures of problem behaviors, namely alcohol use, illegal drug use, and deviance, in two nationally representative samples of Georgian (N = 6,992; M = 15.83, 60% females, and Swiss (N = 5,575; M = 17.17, 50% females) adolescents. Based on tests for parallel mediating effects by sleep functioning of parental warmth on problem behaviors in the MEDIATE macro in SPSS, the findings provided evidence that both sleep quality and sleep quantity independently and cumulatively mediated the effects of parental warmth on each of the three problem behaviors in both samples, with one exception. These results highlight the salience of positive parenting on sleep functioning among teens in two different cultural contexts, and, in turn, on measures of problem behaviors.