Alexander Valerievich Kudryavtsev

Road traffic fatalities in Arkhangelsk, Russia in 2005–2010: Reliability of police and healthcare data

PURPOSE To estimate and compare reliability of traffic mortality data of the police and the healthcare sector in Arkhangelsk, Russia. METHODS The study matched traffic mortality data of the police and the regional healthcare statistics centre for the period from 2005 to 2010. Individual investigations of unmatched cases were performed, and the underlying causes of the non-matches were established. The obtained distribution of non-matches by causes served as basis for estimating the true numbers of traffic fatalities in the two sources, in appliance with corresponding fatality definitions and registration rules. A data accuracy index (DAI) was calculated for each source by using an adapted version of the formula for calculating accuracy of a diagnostic test. This was used as a measure for data reliability. Time trends in annual DAIs were estimated for each source by χ(2)-test for linear trend. RESULTS During the 6-year period, the police and the healthcare statistics centre registered 217 and 237 traffic fatalities in Arkhangelsk, respectively. Matching of data from the two sources resulted in 162 matched cases, 55 unmatched cases in the police data, and 75 unmatched cases in the healthcare data. More than a half (56%) of the non-matches were attributed to incompatibility of the definitions in the two data registration systems; 39% were attributed to failures in the healthcare data. Other non-matches were due to scarce identifying information (2%) or were not classifiable (2%). None of the non-matches were clearly attributable to failures in the police data. The 6-year DAI was 98% for the police data and 80% for the healthcare data. The DAI for the police data was stable over 2005-2010 (ranging from 96% to 100%). The DAI for the healthcare data increased from 66% in 2005 to 98% in 2010 (Ptrend<0.001). CONCLUSION The findings suggest that traffic mortality data of the police were more reliable, compared to the healthcare data. However, reliability of the healthcare data was improving during the study period.

Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics

Background To describe suicide rates in the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) in 2002–2012, as well as associated socio-demographic characteristics. Study design Retrospective population-based mortality study. Methods Data from autopsy reports were used to identify 252 cases of suicide in the NAO in 2002–2012. Data on socio-demographic characteristics of these cases were obtained from passports and medical records at local primary health care units, and were then linked to total population data from the Censuses in 2002 and 2010. Suicide rates for the indigenous Nenets population and the non-indigenous population were standardized to the European standard population. The rates were also estimated according to different socio-demographic characteristics and compared by calculating relative risks. Results The crude suicide rates were 79.8 per 100,000 person-years (PYs) in the Nenets population and 49.2 per 100,000 PYs in the non-indigenous population. The corresponding standardized estimates were 72.7 per 100,000 PYs and 50.7 per 100,000 PYs. The highest suicide rates in the Nenets population were observed in the age group 20–29 years (391 per 100,000 PYs), and in females aged 30–39 years (191 per 100,000 PYs). Socio-demographic characteristics associated with high suicide rates in the Nenets population were age 20–39 years, male, urban residence, having secondary school or higher education, being an employee or employer, and being single or divorced. Males aged 20–29 years, and females aged 30–39 and aged 70 years and above had the highest suicide rates in the non-indigenous population (137.5, 21.6 and 29.9 per 100,000 PYs, respectively). The elevated suicide rates observed in the non-indigenous population were associated with male sex, rural residence, secondary school education, being an employee or employer, and being single or divorced. Conclusions Suicide rates in the NAO were substantially higher among the indigenous Nenets population than the non-indigenous population, and were associated with different socio-demographic characteristics.

Road traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005–2010

The study investigated trends in traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005–2010. Data were obtained from the road police. Negative binomial regression with time regressor was used to investigate trends in monthly incidence rates (IRs) of crashes, fatalities, and non-fatal injuries. During the six-year period, the police registered 4955 crashes with fatal and non-fatal injuries, which resulted in 217 fatalities and 5964 non-fatal injury cases. The IR of crashes with fatal and non-fatal injuries per total population showed no evident change, while the IR per increasing total number of motor vehicles decreased on average by 0.6% per month. Pedestrian crashes constituted 51.8% of studied crashes, and pedestrians constituted 54.6% of fatalities and 44.5% of non-fatal injuries. The IRs of pedestrian crashes and non-fatal pedestrian injuries per total population decreased on average by 0.3% per month, and these were the major trends in the data.

Explaining reduction of pedestrian–motor vehicle crashes in Arkhangelsk, Russia, in 2005–2010

Objective . To explain a reduction in pedestrian–motor vehicle crashes in Arkhangelsk, Russia, in 2005–2010. Study design . Retrospective ecological study. Methods . For 2005–2010, police data on pedestrian–motor vehicle crashes, traffic violations, and total motor vehicles (MVs) were combined with data on changes in national road traffic legislation and municipal road infrastructure. Negative binomial regression was used to investigate trends in monthly rates of pedestrian–motor vehicle crashes per total MVs and estimate changes in these rates per unit changes in the safety measures. Results. During the 6 years, the police registered 2,565 pedestrian–motor vehicle crashes: 1,597 (62%) outside crosswalks, 766 (30%) on non-signalized crosswalks, and 202 (8%) on signalized crosswalks. Crash rates outside crosswalks and on signalized crosswalks decreased on average by 1.1% per month, whereas the crash rate on non-signalized crosswalks remained unchanged. Numbers of signalized and non-signalized crosswalks increased by 14 and 19%, respectively. Also, 10% of non-signalized crosswalks were combined with speed humps, and 4% with light-reflecting vertical signs. Pedestrian penalties for traffic violations increased 4-fold. Driver penalties for ignoring prohibiting signal and failure to give way to pedestrian on non-signalized crosswalk increased 7- and 8-fold, respectively. The rate of total registered drivers’ traffic violations per total MVs decreased on average by 0.3% per month. All studied infrastructure and legislative measures had inverse associations with the rate of crashes outside crosswalks. The rate of crashes on signalized crosswalks showed inverse associations with related monetary penalties. Conclusions. The introduction of infrastructure and legislative measures is the most probable explanation of the reduction of pedestrian–motor vehicle crashes in Arkhangelsk. The overall reduction is due to decreases in rates of crashes outside crosswalks and on signalized crosswalks. No change was observed in the rate of crashes on non-signalized crosswalks.

Injury prevention and safety promotion course in a Russian Master of Public Health programme.

The Global Burden of Disease Studies describe and emphasise injury as a major and increasing component in the panorama of global ill health. Russia has the one of the highest injury rates in Europe. When a Master in Public Health programme was planned and started in 2007 in Arkhangelsk, Russia, under the auspices of University of Tromsø, Norway, a course on Injury Prevention and Safety Promotion was included. A take-over programme (training-the-trainers) was implemented within the course. The present paper describes the course content, the students and their background, the training-the-trainers programme, the evaluation procedure and its results. So far, 53 students have passed the course, 77% being female. The majority of students were medical doctors (51%), psychologists (11%), pedagogues (9%), dentists (6%) and nurses (6%). The take-over programme has functioned well by gradually using students of excellence as teachers. In 2012, the take-over programme is completed and only Russians teach. Evaluation by students of the course content, organisation and pedagogic approach was useful for improvements.

Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18

Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.

Risk factors for perinatal mortality in Murmansk County, Russia : a registry-based study

ABSTRACT Background: Factors contributing to perinatal mortality (PM) in Northwest Russia remain unclear. This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Objective: This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Methods: The study population consisted of all live- and stillbirths registered in the Murmansk County Birth Registry during 2006–2011 (n = 52,806). We excluded multiple births, births prior to 22 and after 45 completed weeks of gestation, infants with congenital malformations, and births with missing information regarding gestational age (a total of n = 3,666) and/or the studied characteristics (n = 2,356). Possible associations between maternal socio-demographic and lifestyle characteristics, maternal pre-pregnancy characteristics, pregnancy characteristics, and PM were studied by multivariable logistic regression. Crude and adjusted odds ratios with 95% confidence intervals were calculated. Results: Of the 49,140 births eligible for prevalence analysis, 338 were identified as perinatal deaths (6.9 per 1,000 births). After adjustment for other factors, maternal low education level, prior preterm delivery, spontaneous or induced abortions, antepartum hemorrhage, antenatally detected or suspected fetal growth retardation, and alcohol abuse during pregnancy all significantly increased the risk of PM. We observed a higher risk of PM in unmarried women, as well as overweight or obese mothers. Maternal underweight reduced the risk of PM. Conclusions: Our results suggest that both social and medical factors are important correlates of perinatal mortality in Northwest Russia.

232 Establishment of the first russian injury registry in shenkursk

Background External causes of death are the second main killers in several parts of Russia. However, no systematic collection and analysis of injury data exists hindering development of effective prevention. Our aim was to establish an injury registry in Shenkursk (Arkhangelsk region) and present the structure of injuries in January June 2015. Methods All injuries admitted to Shenkursk district hospital during 1.1.2015 30.6.2015 were registered using standard form. It includes items on type, place, time, preceding circumstances, and mechanism of accident, mechanism of injury and socio-demographic data of the injured. Distributions of injuries across these variables were used to identify typical injury cases and risky circumstances. Results Altogether, 673 non-fatal injury cases were recorded (76%). Injuries to the head (21.6%), injuries to the wrist and hand (18.3%), injuries to the knee and lower leg (10.7%) were the most common. By severity, 64%, 28.7% and 6.2% of injuries were minor, moderate, and serious, respectively, 2 cases were severe, and one was critical. Hospitalisation rate was 9.2%. Males constituted 60.9% of cases. Children and elderly accounted for 32.5% and 13%. A half of injuries occurred during leisure. Most injuries occurred on homestead lands (20.1%), inside of dwellings (16.3%) and on streets (7.1%) during walking (30.2%). The most common accident mechanisms were “have slipped” (16.0%); error or loss of control when dealing with object, person or animal (15.7%); “have stammered/stumbled” (13.9%). The most common injury mechanisms were punch/kick due to fall after having slipped/stammered/stumbled (23.7%), punch/kick due to contact/collision with an object in motion (9.2%) and punch/kick due to due to impacts of human or animal. Most common external injury-related factor was ice-covered surface (11%). More injuries occurred on Sundays (17%) than during other days. Use of alcohol 24 hours prior to trauma was reported by 28.1% of cases. Conclusions Children and men and are most vulnerable groups. Preventive interventions should address leisure, domestic and other routine activities on homestead lands, in dwellings, and on the streets. Removal of slippery surfaces and promotion of anti-slip devices should be considered. Special emphasis should be given to reduction of alcohol use.

Socio-demographic Characteristics of Suicides in the Nenets Autonomous Okrug, Northwestern Russia.

Objective To investigate suicide rates in the indigenous (Nenets) and non-indigenous populations of the Nenets Autonomous Okrug (NAO) in 2002-2012 with associated socio-demographic characteristics. Design Retrospective population-based mortality study. Methods Data from autopsy reports were used to identify 252 cases of suicide in the NAO in 2002-2012. Data on socio-demographic characteristics were obtained from passports and medical records and linked to population data from the Censuses. Suicide rates for the Nenets population and the non-indigenous population were calculated according to different socio-demographic characteristics. Corresponding relative risks for each population group were compared. Results The crude standardized suicide rates were 72.7 per 100 000 person-years in the Nenets and 50.7 per 100 000 person-years in the non-indigenous population. The highest suicide rates in the Nenets population were observed in the age group 20-29 years and in females aged 30-39 years. Socio-demographic characteristics associated with high suicide rates for the Nenets were 20-39 years of age, male gender, urban residence, having secondary school or higher education, being an employee or employer, and being single or divorced. Males aged 20-29 years and females aged 30-39 and aged 70 years or over had the highest suicide rates in the non-indigenous population. The higher suicide rates in the non-indigenous population were associated with male gender, rural residence, secondary school education, being an employee or employer, and being single or divorced. Conclusions Suicide rates in the NAO were higher among the indigenous Nenets population than the non-indigenous population, and were associated with different socio-demographic characteristics.