Main Groups Of Causes Research Articles

Retrospective analysis of the development of the energy crisis in the European Union

The purpose of the article is to analyze the current economic state of the European Union in the context of the progressive energy crisis. The article characterizes the importance of energy as the most important area of human economic activity for the world economy, identifies the causes and scale of the current energy crisis, examines the directions of countering the energy crisis in the European Union on the example of Germany and France. Within the framework of the conducted research, both general scientific methods (abstraction, analysis, synthesis, analogy, comparison) and methods of comparative legal and content analysis are used. The analysis showed that the crisis phenomena in the energy industry are predetermined by three main groups of causes - natural, geopolitical and economic. The article substantiates the characteristics of the European Union as the center of the modern energy crisis, indicating the conditions for the emergence of a crisis situation in Europe in recent years, which are not related to the special military operation conducted by the Russian Federation in Ukraine. In conclusion, the article substantiates the lack of a strategic nature of the anti-crisis policy of the European Union in the energy sector. The results of the conducted research can be useful for economists involved in the world economy and international economic relations, as well as for undergraduates, undergraduates and postgraduates.

Aggregate causes of adverse events and possible methods to mitigate them within healthcare: Results and lessons learned based on the reports sent to the Hungarian NEVES reporting and learning system

In 2007, the NEVES system started its operation in Hungary. Ever since, more than 26.5 thousand adverse events reports arrived. By analysing these reports, causal research was conducted and recommendations were made to prevent these causes. Based on the results of the causal research, the identification of the most important causes of adverse events within the Hungarian healthcare settings, and the creation of recommendations on how to tackle these causes. To identify possible causes and actions that can be made, a literature survey was conducted for each area. Descriptive statistics was conducted to identify possible associations, after which Ishikawa chart was used to search for possible root-causes. Possible solutions were gathered via focus groups discussions. Summary tables were created based on the results of these focus groups. Nine main groups of causes were identified: regulation; following regulations; shortcomings of activities that should be carried out; not learning from previous events; education; human resources; communication and documentation; the usage of devices; problems with the infrastructure. The recommended solutions can be grouped into six areas: actions regarding the creation and everyday usage of regulations; organising and conducting educations; procurement based on needs; improving communications; learning from mistakes and adverse events; using motivation tools. The analysis made at the national level can be the basis to identify local circumstances and areas of improvement. This requires dedicated leadership, adequate patient safety knowledge and perspective to achieve changes and willingness to make changes. Orv Hetil. 2022; 163(6): 236-245.

Personality and impulsivity as antecedents of occupational health in the construction industry

Objectives. In health and safety at work, two main groups of causes of occupational accidents have been identified: unsafe conditions or technical factors; and the causes related to safe behavior or the human factor. The objective of this study is to analyze the predictive variables (emotional intelligence, personality, impulsivity and safety of the work environment) for three factors of the CONS-32 scale (criterion variables: use of protections, personal risk behavior and personal physical workload) in the construction sector. Methods. Using a sample of 256 Spanish workers from this sector, we analyzed the significant correlations between the three criterion variables and a set of variables extracted from various instruments, as well as the regression models that explain most of the variance. Results. The results show that the main predictive variables that explain the three factors are those related to responsibility as a personality trait, impulsivity and safety of the work environment. Conclusions. Based on the empirical evidence found, the most explanatory factor in all cases is safety climate in the work environment.

ANALYSIS OF CAUSES AND EFFECTS OF ACCIDENTS AT OIL AND GAS PRODUCTION FACILITIES FOR 2003-2019

Background The oil and gas industry of the Russian Federation is one of the strategic spheres of the economy, on the sustainable development and functioning of which the welfare of the country as a whole depends. In turn, the harmonious development of oil and gas production is impossible without ensuring trouble-free and safe operation of facilities. The solution to the problem of ensuring industrial safety begins with the collection of reliable initial data on the state of facilities, accidents, injuries, their prerequisites and consequences. Without in-depth analysis, identification of patterns, reliance on scientific knowledge, it is impossible to offer high-quality solutions to improve safety. Aims and Objectives The purpose of the article is to analyze statistical data on accidents at oil and gas production facilities in the Russian Federation and study patterns. Research Objectives: formation of an array of data on accidents and identification of the presence or absence of dependencies between various factors and accidents; determination of the presence of a causal relationship between the results of the work of the production control service of enterprises, Rostekhnadzor and the causes of accidents. Methods To achieve the aim and solve the set tasks, research methods were used: generalization, classification, search for patterns. Methods of mathematical analysis were used to process and evaluate statistical data. Results The general positive dynamics of reduction of accidents and fatal injuries was revealed. The presence of links between accidents and incidents, fatal injuries, damage, the level of oil production, the number of oil and gas producing organizations, administrative fines of Rostekhnadzor, measures proposed by the production control services has been established. The main groups of causes of accidents identified by Rostekhnadzor and production control services for violations have been identified. A connection has been established between them. Conclusions To reduce accidents and fatal injuries, it is necessary to manage violations at the level of production control of enterprises and Rostekhnadzor, not allowing to move into the area of incidents and accidents. In this case the results obtained should be applied with certain assumptions, due to the small amount of data in the samples. Full analysis requires the availability of publicly available expanded information on accidents, their causes, consequences and results of Rostechnadzor's control and supervisory work, as well as time to update statistics.

Cause-specific mortality rates: Common trends and differences

In contrast to the traditional approach that uses total mortality rates, we want to gain additional insight into the past development of mortality by concentrating on a more detailed breakdown of mortality data, namely by causes of death. We work with the data from five developed countries (USA, Japan, France, England and Wales, and Australia), two sexes, and split the mortality rates into five main groups of causes of death (Infectious&Parasitic, Cancer, Circulatory diseases, Respiratory diseases, and External causes). As it was shown in Arnold and Sherris (2016), these time series of cause-specific mortality rates are cointegrated and so, there exist long-run equilibrium relationships between them. While the previous research focused on the stationary part of the system of cause-specific mortality rates, in the present paper we study its non-stationary part. For this we explicitly extract common stochastic trends from the original variables and compare them across the different datasets. By testing cointegration assumptions about these trends, we are able to get a better representation and understanding of how cause-specific death rates are evolving. We believe that common patterns emerging from such analysis could indicate a link to more fundamental biological processes such as aging.

Endometrial biopsy is an important diagnostic tool for the evaluation of abnormal uterine bleeding

In this study 100 biopsies were taken from the endometrium of childbearing women (18-50 yrs. of age) suffering from abnormal vaginal bleeding from Jan 2019-Dec 2019. Endometrial Biopsy (EB) is safe, an outpatient procedure, low cost, carries out without general anesthesia & the incidence of hemorrhage, infection & uterine perforation are less common than with D&C. EB is an alternative to dilatation & curette (D&C) for the evaluation of infertile & abnormal vaginal bleeding or dysmenorrheic patients. There are two main groups of causes to irregular vaginal bleeding. 1. Organic disease (74% of the cases), in this group there are obvious lesion such as, endometrial polyp, endometrial hyperplasia & chronic endometritis. The most common cause was endometrial hyperplasia 48%, it is commonly seen during the perimenopausal period (40-50yr). Less common causes include chronic endometritis 8%, hydatidiform mole 7%, and endometrial polyp 7%. 2. non-organic disease comprises 19% of all cases, anovulatory period 13% or Luteal phase insufficiency 6%. They are commonly seen from age of 18-40yrs. 6% of the cases found to have normal endometrium. 5 endometrial biopsies were inadequate & unsatisfactory for histopathological interpretation. The aim of this study is to evaluate the usefulness & disadvantages of EB & to compare it with the traditional method of endometrial curette.

Incidence of sudden cardiac death after heart transplantation

Sudden cardiac death (SCD) is a major contributor to the rate of mortality after heart transplantation. However, little is known about the incidence of SCD in heart recipients. To assess the incidence of SCD after heart transplantation. We enrolled consecutive patients transplanted between 2004 and 2017 in two French referral centers. We defined 7 main groups of causes of deaths: SCD, cardiovascular (including Cardiac allograft vasculopathy), infection, primary graft dysfunction, graft failure (including late graft dysfunction, rejection), malignancy and others. Causes of deaths were independently adjudicated by two senior cardiologists based on the analysis of death certificates and medical records. Discrepancies were resolved by discussion until a consensus was made. SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms. A total of 1,363 patients were included. The median follow-up post-transplant was 3.99 years (IQR = 0.49–7.49). A total of 450 patients (33%) deceased during the first year. The leading cumulative causes of death in the first year after transplantation were infection, primary graft failure, multiple organ failure during the period in intensive car unit. Beyond the post-operative high-risk period of the first year, the leading cumulative cause of death was SCD: among the 213 deaths that occurred beyond the first year, 44 patients (21%) died from SCD. In this period, the incidence rate of SCD reached 0,82 per 100 person-year (95% CI: 0.51–2.05) ( Fig. 1 ). In a large multicentric and highly phenotyped cohort of heart transplant recipients, the leading cumulative cause of death beyond the first-year post transplant was sudden cardiac death. Our results open discussion on management of heart recipient, such as the implementation of cardioverter-defibrillators.

ПРИЧИНЫ ВОЗНИКНОВЕНИЯ КОНФЛИКТОВ В СТОМАТОЛОГИЧЕСКОЙ ПРАКТИКЕ, ПУТИ ИХ ПРЕДОТВРАЩЕНИЯ И РАЗРЕШЕНИЯ

Significance: the number of conflicts related to realization of the right to health and medical care especially in such specific branch of medicine as dentistry has recently been on the rise in Russia. Furthermore, among the main fields of social interaction, a large number of interpersonal conflicts does relate to professional activity. Subject of research: conflicts and conflict situations in dental practice. Purpose of work: to identify main groups of causes of conflict situations and conflicts in dental practice and suggest ways to prevent and resolve them. Material and methods: questionnaire survey of dentists with additional interview of the respondents, mathematical and statistical data analysis using the SPSS Statistics software (Pearson chi-square tests, Kruskal-Wallis tests). Results: The majority of the respondents (59.0%) say that they have never had any conflicts with the administration. The leading cause of disagreement is dissatisfaction with the material base and supplies (35%). The prevailing share of the dentists (61.5%) indicate that conflicts between them and a colleague / nurse have never occurred. The main cause of the conflict communication is insubordination or lack of subordination, especially in rural areas and public facilities. Doctors of public healthcare facilities and dentists working in rural areas were more often in conflict with a colleague or manager. Almost all health workers (98%) note that they have encountered conflict patients. The main cause of the conflict communication is long waiting for a dental appointment (33.3%). Out of all factors influencing the relationship, about half of the respondents (53.0%) mentioned the emotional state of the patient. Out of all behavior strategies in conflicts, the majority of dentists (44%) prefer cooperation. Conclusion: Almost all (98%) dentists came into conflict with the patient. The main causes of these conflicts included: long waiting times for admission (33.3%), irrational work of the registry, the administrator (23.1%) and complaints about the quality of services (22.2%). Medical workers with average work experience (10-29 years) were more likely to conflict with the patient about claims to the quality of treatment (31.3%).

Динамика смертности российского населения от основных классов болезней экзогенной этиологии

The paper investigates the dynamics of mortality of the Russian population from infectious and parasitic diseases, dis-eases of the respiratory and digestive organs. The relevance of the research is determined by a global pandemic, record-ed for the first time after the completion of the first stage of the epidemiological transition in developed countries. The main provisions of the concept of epidemiological transition and the specifics of the transition in Russia are considered. The situation for the thirty-year period 1990–2019, characterized by multidirectional dynamics of life expectancy of the Russian population, for which annual statistics are available, is analyzed in more detail, in order to identify the situation with exogenous mortality in the run-up to the pandemic. Among the six main classes of causes of death, the most significant increase over the period under review was for diseases of the digestive system and infectious and parasitic diseases. In the conditions of the "reverse epidemiological transition", there was a twofold decrease in the ratio of mortality from infectious diseases and diseases of the circulatory system: from 1:51.8 in 1991 to 1:25.6 in 2019. The share of deaths from infections in the structure of deaths from causes increased to 1.8%. Even more significantly, the ratio of deaths from cardiovascular diseases to deaths from diseases of the digestive system decreased by two and a half times: from 1:21.6 in 1990 to 1:8.6 in 2019. The share of these diseases in the structure of mortality increased to 5.5%. Since 2006 diseases of the digestive system occupy the fourth position in the structure of Russian mortality by causes, pushing respiratory diseases to the fifth place. Mortality from respiratory diseases, which trends over the 30 years under review repeat the vector of the total mortality of the Russian population, and which is characterized by the maximum decrease among the maingroups of causes of death, increased the gap with the level of mortality from diseases of the circulatory system from 1:11.1 to 1: 14.2 in 1991–2019. Its share in the structure of mortality decreased to 3.3%.

Incidence of sudden cardiac death after heart transplantation

Abstract Background Sudden cardiac death (SCD) is a major contributor to the rate of mortality after heart transplantation. However, little is known about the incidence of SCD in heart recipients. Objective To assess the incidence of SCD after heart transplantation. Methods We enrolled consecutive patients transplanted between 2004 and 2017 in two French referral centers. We defined 7 main groups of causes of deaths: SCD, cardiovascular (including Cardiac allograft vasculopathy), infection, primary graft dysfunction, graft failure (including late graft dysfunction, rejection), malignancy and others. Causes of deaths were independently adjudicated by two senior cardiologists based on the analysis of death certificates and medical records. Discrepancies were resolved by discussion until a consensus was made. SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms. Results A total of 1,363 patients were included. The median follow-up post-transplant was 3.99 years (IQR=0.49–7.49). 450 patients (33%) deceased during the first year. The leading cumulative causes of death in the first year after transplantation were infection, primary graft failure, multiple organ failure during the period in intensiv car unit. Beyond the post-operativ high-risk period of the first year, the leading cumulative cause of death was SCD: among the 213 deaths that occurred beyond the first year, 44 patients (21%) died from SCD. In this period, the incidence rate of SCD reached 0,82 per 100 person-year (95% CI: 0.51–2.05). Conclusion In a large multicentric and highly phenotyped cohort of heart transplant recipients, the leading cumulative cause of death beyond the first-year post transplant was sudden cardiac death. Our results open discussion on management of heart recipient, such as the implementation of cardioverter-defibrillators. Figure 1. Cumulative incidence of causes of death in heart transplant recipients beyond the first year (n=913). Funding Acknowledgement Type of funding source: None

Хологенная диарея: от диагноза к лечению

Bile acid diarrhoea is a common cause of chronic diarrhoea associated with disturbance of the enterohepatic circulation: either excessive biosynthesis/secretion of bile acids or disordered absorption of bile acids in the ileum. At the same time bile acid diarrhoea is an insufficiently studied, frequently underestimated condition, and the questions remain concerning its diagnosis and management. The work discusses the main groups of causes of this pathology, modern diagnostic methods and the difficulties of a differential search. Also, the article offers information about the diet therapy of bile duct diarrhoea and the main groups of administered medications, in particular, modern enterosorbents.

Mortalidad intraurbana, envejecimiento y marginación en Hermosillo, Sonora, 2013-2016

El objetivo de este estudio es analizar la distribución espacial intraurbana de la mortalidad por área de residencia y su asociación con condiciones de marginación y envejecimiento poblacional en Hermosillo, Sonora, en el periodo 2013-2016. Por medio de información proveniente de certificados de defunción y censal, se realizó un análisis espacial exploratorio de la mortalidad de acuerdo con tres grandes grupos de causas de muerte. El análisis se limitó a la mortalidad y dejó pendiente el componente de morbilidad. Los resultados evidenciaron la fuerte asociación entre la distribución espacial de la mortalidad bruta por enfermedad crónica y el envejecimiento poblacional. Así mismo se evidenció la autosegregación espacial que ejercen los residentes de zonas del nivel más bajo de marginación, quienes tienen mayor capacidad para evitar la muerte por cualquier tipo de causa. Los hallazgos muestran los efectos de la segregación espacial residencial de tipo socioeconómico y demográfico sobre los perfiles de mortalidad en los entornos urbanos.

Оптика медико-демографических процессов в контексте устойчивого развития арктического макрорегиона (на примере Архангельской области)

Сохранение и укрепление здоровья населения обозначены как приоритеты развития в Государственной программе «Социально-экономическое развитие Арктической зоны Российской Федерации на период до 2020 года». В статье анализируются тренды ожидаемой продолжительности жизни, смертности от основных причин смерти и младенческой смертности в одном из наиболее крупных по числу жителей регионов Арктической зоны Российской Федерации – части Арктического макрорегиона Архангельской области. Рассматривается дифференциация смертности от основных групп причин смерти, включая болезни системы кровообращения (БСК), новообразования, внешние причины смерти, болезни органов дыхания и пищеварения, инфекционные заболевания и некоторые другие причины в гг. Архангельске, Северодвинске, других городах области и в сельской местности. Анализ основан на стандартизованных коэффициентах смертности (СКС) по причинам смерти.
 Уровень смертности в Архангельской области выше среднероссийских показателей, особенно у мужчин. Наиболее низкая смертность отмечается в Архангельске и Северодвинске, несколько выше – в средних и малых городах и значительно выше – в сельской местности. 
 Структура причин смерти во всех группах поселений более чем на 80% определяется БСК, новообразованиями и внешними причинами, но при этом везде отмечается небольшое снижение доли БСК и внешних причин и более значительный рост доли новообразований. Архангельск характеризуется более высоким уровнем СКС от новообразований. Смертность от внешних причин отличается значительной дифференциацией по группам поселений. Однако СКС от случайных отравлений алкоголем во всех группах находится на одном уровне.

Italian Atlas of mortality inequalities by education level.

To evaluate the geographical and socioeconomic differences in mortality and in life expectancy in Italy; to evaluate the proportion of mortality in the population attributable to a medium-low education level through the use of maps and indicators. Longitudinal design of the population enrolled in the 2011 Italian Census, following the population over time and registering any exit due to death or emigration. The study used the database of the Italian National Institute of Statistics (Istat) developed by linking the 2011 Census with the Italian National Register of Causes of Death (2012-2014) for 35 groups of causes of death. Age, sex, residence, and education level information were collected from the Census. Life expectancy at birth was calculated by sex, Italian region, and education level. For the population aged 30-89 years, the following items were developed by sex: 1. provincial maps showing, for each cause of death, the distribution in quintiles of smoothed standardized mortality ratio (SMR), adjusted for age and education level and estimated with Bayesian models for small areas (spatial conditional autoregressive model); 2. regional maps of population attributable fraction (PAF) for low and medium education levels, calculated starting from age-standardized mortality ratios; 3. tables illustrating for each region standardized mortality rates and standardized years of life lost rate by age (standardized YLL rate), and mortality rate ratios standardized by age (MMRs). Males with a lower education level throughout Italy show a life expectancy at birth that is 3 years less than those with higher education; residents in Southern Italy lose an additional year in life expectancy, regardless of education level. Social inequalities in mortality are present in all regions, but are more marked in the poorer regions of Southern Italy. Geographical differences, taking into account the different population distributions in terms of age and education level, produce mortality differences for all causes: from -15% to +30% in women and from -13% to +26% in men, compared to the national average. Among the main groups of causes, the geographical differences are greater for cardiovascular diseases, respiratory diseases, and accidents, and lower for many tumour sites. A clear mortality gradient with an excess in Southern Italy can be seen for cardiovascular diseases: there are some areas where mortality for people with higher education level is higher than that for residents in Northern Italy with low education level. The gradient for "All tumours", instead, is from South to North, as it is for most single tumour sites. Population attributable fraction for low education level in Italy, taking into account the population distribution by age, is 13.4% in women and 18.3% in men. The study highlighted important geographical differences in mortality, regardless of age and socioeconomic level, with a more significant impact in the poorer Southern regions, revealing a never-before-seen health advantage in the regions along the Adriatic coast. A lower education level explains a considerable proportion of mortality risk, although with differing effects by geographical area and cause of death. There are still mortality inequalities in Italy, therefore, representing a possible missed gain in health in our Country; these inequalities suggest a reassessment of priorities and definition of health targets. Forty years after the Italian National Health Service was instituted, the goal of health equity has not yet been fully achieved.

Trend forecasting of main groups of causes-of-death in Iran using the Lee-Carter model.

Background: Authoritative information and description of the causes of mortality trends is one of the most basic principles of evaluation of the health sector in all countries. Therefore, this study aims to predict the trend in main groups of causes of death in the Islamic Republic of Iran. Methods: The study population comprised all deaths recorded in the system of registration and classification of causes of death of Ministry of Health and Medical Education during the years 2006 to 2015. The information was collected via death certificate, burial permit, and information forms. In order to forecast the trends of causes-of-death, Lee Carter model was employed in a demographic package 18.1 of R software version 3.3.1. Results: Based on the results, the crude death rate in the total population has reduced from 435.86 in 2006 to 405.01 per 100000 population in 2035. It is anticipated that endocrine, nutritional and metabolic diseases with the rate of 197.71 per 100000 population will be responsible for the highest causes of death in the year 2035 and from 2021 onwards, the mental and behavioral disorders will be responsible for the lowest rate of mortality. Conclusion: Non-communicable diseases have a major role in the deaths of Iranian population; therefore, to reduce the impact of non-communicable diseases on individuals and society, a holistic approach is needed which requires all sectors to cooperate.

Improving reliability in forensic engineering: the Delft approach

Based on established theories from literature and best practices of forensic investigations in aerospace engineering, civil engineering and biomechanical engineering, the Delft University of Technology has developed a Delft approach for forensic investigations. This integrated approach consists of three elements. First, because a product has a life cycle with various phases, it is of importance to consider these phases when a failure is investigated. Second, it is acknowledged that failure is a multifaceted phenomenon. Therefore, the ‘Tree House of Failures’ was developed, a taxonomy or categorisation of failure causes, which addresses main groups of causes of failure related to product, instruction and execution. Third, use of a standard investigative approach with the steps ‘orientation’, ‘data collection’, ‘hypotheses generation’, ‘hypotheses testing’, ‘recommendations’ and ‘findings reporting’ is advised. In the Delft approach, the ‘ring of trustworthiness’ is used to underline the mind-set that a forensic engineering investigator should have to assure the investigation’s reliability and validity. The ring of trustworthiness states that an investigation should be objective, repeatable, verifiable, complete and correct. This paper presents the Delft approach for forensic investigations and explains how to use it to prevent several common pitfalls and biases that occur in various stages of a forensic engineering investigation. This approach aims to increase the reliability of forensic engineering investigations worldwide.

Panorama das internações por condições sensíveis à atenção primária no Espírito Santo, Brasil, 2000 a 2014

Objetivo: Descrever a série temporal das internações por condições sensíveis à atenção primária (ICSAP) no estado do Espírito Santo, no período de 2000 a 2014, segundo sexo, faixa etária, porte municipal, macrorregiões e grupos de causa, e investigar os fatores associados à ocorrência dessas hospitalizações. Métodos: Estudo ecológico de série temporal das ICSAP ocorridas de 2000 a 2014. A análise da série temporal foi realizada pelo método Cochrane-Orcutt, e para a análise de regressão multivariável multinível usou-se o modelo de regressão binomial negativa. Resultados: As ICSAP diminuíram 28,79% no período. As maiores taxas foram observadas entre os idosos e as crianças menores de cinco anos, e reduziram mais entre idosos e adultos. Os principais grupos de causas foram as gastroenterites infecciosas e complicações, a infecção no rim e trato urinário, e a insuficiência cardíaca. Houve redução das taxas de ICSAP na medida em que cresceu a taxa de cobertura da estratégia saúde da família (0,60, IC: 0,56-0,66), a proporção de médicos (0,90, IC: 0,84-0,96), de pretos e pardos (0,88, IC: 0,83-0,93) e de pessoas com ensino médio (0,87, IC: 0,76-0,99), enquanto houve acréscimo dessas hospitalizações a cada aumento do produto interno bruto per capita, do índice de Gini, da taxa de urbanização, dos leitos hospitalares e dos planos de saúde. Conclusão: A expansão e consolidação da estratégia saúde da família são importantes para a redução das ICSAP no estado dentre outros fatores, como recursos de saúde e fatores socioeconômicos.

Zgony niemowląt i noworodków w latach 1995-2015 w Polsce.

AimThe aim of the study was the analysis of trends of infant and neonatal mortality in Poland in 1995-2015, overall and by gestational age, main groups of causes and age at death.Material and methodsData from birth and death certificates from 1995, 2000, 2005, 2010, 2014 and 2015 were used. Infant, neonatal, postneonatal, perinatal and gestational age – specific mortality rates were presented. Main groups of causes of deaths were determined according to the International Classification of Diseases ICD-10.ResultsIn Poland, in 1995-2015 infant mortality decreased more than three-fold, similarly to neonatal and postneonatal mortality. Early neonatal mortality decreased almost four-fold, stillbirths rate - twofold and perinatal mortality - almost three-fold. The progress, to the greatest extend was related to preterm births. Infant mortality in this group decreased from 128.5 per 1000 preterm live births in 1995 to 36.8 in 2015. The main causes of all infant deaths are perinatal conditions and congenital anomalies.ConclusionsThe decrease of infant and neonatal mortality has been continued in the last twenty years and affected mainly preterm births born from the shorter and shorter gestations, what implicates growing demand for long lasting health care and rehabilitation. Deaths of infants and neonates born at term and not related to congenital anomalies are relatively rare and need individual assessment.

Mortality of populations potentially exposed to ionising radiation, 1953-2010, in the closed city of Ozyorsk, Southern Urals: a descriptive study.

BackgroundThe city of Ozyorsk (Southern Urals) was created as a secret city in 1945 and is a closed city until today. It housed workers of the earliest and one of the country’s largest nuclear facilities. Workers of the nuclear reactors, radiochemical or reprocessing plants were exposed to high levels of ionising radiation in the early years of operation and possibly further exposed from inhalation of plutonium aerosols.MethodsThe cause-of-death registry of Ozyorsk received paper copies of original death certificates of all deaths of residents of the city. Data were analysed for recent mortality rates (1998–2010) and time trends in age-standardised mortality rates between 1953 and 2010 of main groups of causes of deaths, in particular cancer.ResultsComparing workers of the three main plant types with the remainder of the Ozyorsk residents, and with national figures, all-cause mortality rates were lowest among workers, with ratios compared to national figures of 0.65 (men) and 0.56 (women), and compared to the other residents of 0.77 (men) and of 0.74 (women). For cancer overall, the differences were smaller in men (ratio between workers and national figures of 0.86) and there were no differences in women (ratio of 1.00), but ratios differed by cancer type. Most cancer deaths were however least common in the workers, including leukaemia. Over the last 60 years, all-cause mortality has gradually increased among men in all three groups but was stable among women, whereas cancer death rates have slightly declined in both sexes.ConclusionsHealthy worker effect, relatively better living conditions in Ozyorsk and healthier lifestyles may explain the lower mortality rates in Ozyorsk. Overall mortality time trends in Ozyorsk were similar to the entire country. No apparent radiation-related effects were seen in this population-level analysis, but the radiation-related risks can be better addressed in individual-level studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0078-8) contains supplementary material, which is available to authorized users.

Hospital morbidity in a medium-sized city: differentials between men and women

Objective characterize the hospital morbidity of adults living in the city of Maringá, PR, Brazil, between 2000 and 2011, focusing on the differential between men and women. Method this descriptive study was developed based on data from the Hospital Information System of the Unified Health System in order to investigate the association between groups of hospitalization causes and the average length of hospitalization per gender, in three-year periods. Results the main groups of hospitalization causes for men were: mental disorders, lesions and circulatory diseases; and, among women: tumors, circulatory and genitourinary diseases. Mental disorders and lesions, tumors, circulatory and genitourinary diseases were significantly associated with the female and male genders across the study period. Although not significant, the mean length of hospitalization dropped across the four three-year periods, and only showed a significant difference between men and women in the second triennium. Conclusion differences in the hospital morbidity profile between men and women underline the need for specific health and nursing actions, especially in primary health care, with a view to reducing hospitalizations due to the main groups of causes in the city.