The health of immigrant women: Queensland women from the former Yugoslavia

A study of the social and health status of women from the former Yugoslavia was conducted in Queensland, Australia. Study participants were predominantly refugee women who had migrated to Australia between 1991 and 1996. A significant number of the women rated their health status as poor or fair. Most women did not perceive any change in health following migration, but more felt that their health had deteriorated than improved. Applying a social model of health, we explored the social contexts of countries of origin and destination that impact on women's health. We analyze how preimmigration trauma, settlement problems, health risk behaviors, and participation in screening programs affect women's health status and health needs. Data analysis indicated that government and nongovernment services can reduce the impact of preimmigration experience on health risk behaviors and poor health outcomes only to a limited degree. Since the low socioeconomic status of immigrants following immigration was identified by women as a main contributing factor to their poor health status, government support in tackling structural barriers in accessing the Australian labor market is essential to achieve positive health outcomes.     

Exploration of factors linked with high cervical cancer rates in women from the former Yugoslavia in Victoria,Australia

Objectives: The aim of the project was to identify the cervical screening rate and other factors that may be associated with high rates of cervical cancer in women from the former Yugoslavia compared to the general population in Victoria, Australia. Design: A cross-sectional survey was conducted by structured personal interviews of 42 Bosnian, 56 Croatian, 49 Macedonian, and 35 Serbian women, and 39 women who identified as Yugoslav or of mixed background. Self-report data were collected on Pap testing behaviour, estimated screening rate of each community, stage-based barriers to cervical screening, and women's theories about causes of cervical cancer within their community. Results: Women in this study had an acceptable screening rate, but barriers to cervical screening were similar to those of other groups. While Macedonian women believed more of their community had Pap tests than the other cultural groups, just under half were under-screened themselves. Smoking rates were very high for women in this study. The most common causes of cervical cancer suggested by women in the study were: a low screening rate, lifestyle stress, and chemicals. Conclusion: It is unlikely that the high cervical cancer rate in women from the former Yugoslavia is a result of under-screening, lifestyle stress, or chemicals. Smoking may well contribute to the cancer rate, however the most likely explanation is that cancers not previously detected in Yugoslavia are now being found, together with cervical abnormalities, within the systematic two yearly screening programme of PapScreen Victoria, in Australia.     

2010年北京市归因于大气PM2.5污染的过早死亡研究

目的 评估大气PM2.5长期暴露导致的过早死亡,为科学制定政策保护人群健康提供科学依据.方法 收集卫星遥感反演的北京市2010年的PM2.5浓度数据、人口数据、基线死亡率等基础数据,利用GIS空间统计工具将网格化的PM2.5污染数据转换为区县尺度数据,基于WHO的经典全球疾病负担评估模型和PM25全暴露范围RR函数表,评估北京市各区县归因于大气PM2.5污染的过早死亡,并探讨其空间分布特征及分疾病种类的特点.结果 2010年北京市各区县的大气PM25年均浓度均超过GB 3095-2012《环境空气质量标准》二级浓度限值(35 μg/m3);北京市归因于大气PM:5污染的过早死亡数为16 527人,归因死亡率为0.843‰,中心城区和东南部郊区的过早死亡风险较高,过早死亡数最多的为朝阳区(5 648人,归因死亡率为1.542‰)和海淀区(4 21 1人,归因死亡率为1.284‰),过早死亡数最少的为西北部郊区.结论北京市2010年归因于大气PM2.5污染的过早死亡人数较多,应引起相关部门的重视;在制定政策减少归因于大气PM2.5污染的过早死亡时,应重点关注人口密集的中心城区和发展较快的东南部郊区,并基于各区县过早死亡的疾病分布特点开展针对性的宣教和防控.     

Monitoring health in the war-affected areas of the former Yugoslavia, 1992-1993

In October 1992 the World Health Organization (WHO) set up ahealth monitoring programme in the former Yugoslavia to obtaininformation on communicable disease upon which to base decisionsabout medical aid requirements. This paper covers the firstyear of the programme (October 1992–October 1993) anddetails the steps taken to set it up. Information was soughtfrom personal contacts, ‘ad hoc’ sources (UnitedNations agencies and non-governmental organizations) and thehealth authorities of the regions of former Yugoslavia. An attemptwas made to establish a sentinel monitoring system to provideroutine data to allow health predictions to be made. A bulletinwas produced to disseminate surveillance results and healthadvice. The system obtained sufficient data (mostly from ‘adhoc’ sources) for WHO to take informed decisions aboutmedical aid but the sentinel system was not established successfully.     

Medical evacuations from the region of former Yugoslavia: The experience of 2 years

In September 1992, the International Organization for Migration(IOM), an intergovernmental humanitarian organization basedin Geneva, Switzerland, implemented the special medical programme(SMP) for the medical evacuation of war victims in former Yugoslavia.For inclusion into the SMP, patients must be victims of war,suffer from a serious medical condition with a favourable prognosis,not treatable locally, be stable enough to survive air traveland withstand delay between medical documentation and actualevacuation. As of August 1994,1,484 patients In need of secondarytreatment not locally available were evacuated to hospitalsin 31 countries. Most patients suffered from fractures, amputationsand nerve injuries. Seventy-two per cent originated from Bosnia-Herzegovina.This paper discusses various problems encountered, such as bureaucraticobstacles, ongoing armed conflict hampering humanitarian activities,lack of funding and the effects of the sustained media attention.     

Occupational Health in Yugoslavia

Abstract

Occupational health in Yugoslavia was once well organized in accordance with WHO declarations and ILO conventions and recommendations. Since the 1990s, the system has been disrupted by destruction of the former Yugoslavia, wars, refugees, changes in the economy, and NATO bombardment. Economic trends, main industries, and employment and unemployment conditions in Yugoslavia are presented. The organization of occupational health services, their tasks, and prevailing problems are discussed. Occupational diseases and relevant research and educational opportunities are described. The authors conclude by suggesting approaches to improving worker's health in the future.     

Evaluation techniques for the Healthy School project in Yugoslavia

In preparation for the implementation of the Healthy Schoolproject in Yugoslavia, great attention was paid to evaluationprocedures and instruments. One of them was the ‘Drawand Write Investigation Technique’ suitable for monitoringchanges in pupils' knowledge during first four grades of elementaryschooL The pupils (n=473) in first four grades were tested inthree cities: Belgrade, Novi Sad and Zajecar. The results werecompared and tested by age, sex, residence, and type of health-promotingmeasures mentioned. The results proved that the technique issensitive enough to reveal expected differences in knowledgeacquired in school. The technique was accepted by teachers,health workers, and pupils as very attractive and interesting.With some adaptations and modifications ‘Draw and WriteInvesti gation Technique’ will be used as a knowledge-changeevaluation instrument in the Healthy School project in Yugoslavia     

天津市1999－2015年慢性非传染性疾病过早死亡趋势分析

目的 分析1999-2015年天津市30~69岁居民心脑血管疾病、肿瘤、糖尿病和慢性呼吸系统疾病过早死亡及其变动趋势,探讨其在不同特征人群中的特点并评价危害程度。方法 采用天津市CDC收集的居民全死因监测数据,户籍人口信息源自天津市公安局。以2000年世界标准人口计算年龄别、性别标化死亡率,根据WHO推荐的早死概率计算方法统计居民过早死亡概率,采用Joinpoint回归和Cochran-Armitage趋势检验分析17年的变化趋势以及在不同年龄、性别以及城乡之间分布差异。结果 1999-2015年天津市慢性非传染性疾病（慢性病）过早死亡标化死亡率为382.38/10万至250.95/10万,呈逐年下降趋势[年度变化百分比（APC）=-2.41%,P<0.001],过早死亡概率为19.67%~12.85%,呈逐年下降趋势（APC=-2.49%,P<0.001）。心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病过早死亡概率均呈下降趋势（APC分别为-2.92%、-1.13%、-9.51%和-3.39%,均P<0.001）。男性慢性病过早死亡呈逐年下降趋势,过早死亡概率为22.27%~16.47%（APC=-1.59%,P<0.001）。女性慢性病过早死亡低于男性,过早死亡概率为17.02%~9.17%,也呈逐年下降趋势（APC=-3.84%,P<0.001）,下降趋势快于男性。城市居民慢性病过早死亡概率为21.04%~12.34%（APC=-3.26%,P<0.001）;农村居民慢性病过早死亡概率为17.80%~13.54%（APC=-1.54%,P<0.001）。农村居民慢性病过早死亡由原先低于城市逐渐高于城市。结论 1999-2015年天津市居民慢性病过早死亡呈下降趋势,男性、农村居民为过早死亡高发人群。     

The combined impact of rural residence and socio-economic status on premature mortality

The health of rural and urban populations differs, with rural areas appearing healthier. However, it is unknown whether the benefit of living in rural areas is felt by individuals in all levels of deprivation, or whether some suffer a disadvantage of rural residence. For England and Wales 2001–2003 premature mortality rates were calculated, subdivided by individual deprivation and gender, for areas with differing rurality characteristics. Premature mortality data (age 50-retirement) and a measure of the individual's deprivation (National Statistics Socio-economic Classification 1–7) was obtained from death certificates. Overall premature mortality was examined as well as premature mortality subdivided by major cause. Male premature mortality rates (age 50–64) fell with increasing rurality for individuals in all socio-economic status classifications. The most deprived individuals benefitted most from residence in increasingly rural areas. Similar trends were observed when premature mortality was subdivided by the major causes of death. Female premature mortality rates (age 50–59) demonstrated similar trends but the differences between urban and rural areas were less marked.     

Health under fire: The WHO in the former Yugoslavia

In July 1992, in former Yugoslavia the World Health Organization(WHO) launched a humanitarian assistance programme. The programmewas aimed at maintaining public health in the war-affected areaswith 4 million refugees and displaced persons, over 200,000dead, at least twice as many wounded, over 60,000 patients inneed of rehabilitation and at least 1 million persons with deeppsychological scars. The programme had 4 objectives: publichealth Interventions (Induding health and nutrition monitoring),physical and psychosodal rehabilitation, distribution of medicalsupplies and health care reform. A key feature was a systematicassessment of the needs of the affected population by meansof health and nutrition monitoring which helped to target theassistance. For some areas the WHO'S medical supplies were theonly source of much needed drugs. With the health authoritiesWHO initiated a health care reform, to enable the qualitativelyreasonably good but top-heavy and expensive health care systemsInherited from the socialist era to recuperate and survive.The WHO programme has helped avert major epidemics, preventedscurvy and rickets and helped people to survive the cold ofthe winter.     

Turning points in time trends of cancer mortality in Japan: Premature mortality is more sensitive in the progress of cancer prevention

The aims of this study were to demonstrate the trend of overall mortality rate and premature mortality rate for select types of cancer in Japan and to assess the utility as a target indicator. The age-adjusted mortality rate for the total population (overall mortality rate) and that for persons under 65 years of age (under 65 mortality rate) for stomach cancer, liver cancer and lung cancer from 1950 to 1997 in Japan were calculated. Moreover, the turning point year of the mortality trend was estimated using a regression model of the rate of annual increase in each mortality rate. As the results show, a decline in the under 65 mortality rate preceding a decline in the overall mortality rate was observed in stomach cancer and male liver cancer. Also, the under 65 mortality rate due to lung cancer seemed to begin to decline in recent years for males, while the overall mortality rate has been increasing. This study suggests that the premature mortality rate is a more sensitive indicator of the effectiveness of cancer prevention. Hence, because of not only the larger burden of premature deaths, but also the sensitivity, premature mortality is considered to be suitable as a target indicator for cancer prevention strategies.     

Infant mortality and economic instability in Yugoslavia

Efforts to manage Yugoslavia's debt crisis beginning in 1979 led to economic policies which resulted in declining real income in subsequent years. This has been associated with a slowing of the rate at which infant mortality has declined. There is no evidence, however, that populations in poor parts of the country experienced a more dramatic impact on infant mortality than did populations in more favored regions. The lack of difference is attributed to redistributive social policies among and within republics.     

Serum Leptin Levels in Patients with Premature Ejaculation

Leptin is a fat cell-derived hormone signaling the hypothalamus about food intake, the regulation of weight, and sexual behavior. The inhibitory effect of serotonin on libido, ejaculation, and orgasm is well documented. There is an interaction between leptinergic and serotonergic systems in the central nervous system. This study was conducted to evaluate serum leptin levels of the patients with premature ejaculation. The study group consisted of 15 patients with premature ejaculation according to Diagnostic and Statistical Manual of Mental Disorders, Third Revised Version ( DSM -III-R) and 15 healthy controls. The fasting serum leptin levels were measured. Significantly high serum leptin levels in the patients were found after body mass index or age adjustment. The intravaginal ejaculation latency time negatively correlated with leptin levels in both patient and control groups. In addition, there was a positive correlation between leptin levels and the duration of illness. It would appear that leptin may be associated with premature ejaculation.     

Years of potential life lost as the indicator of premature mortality in occupational medicine

Measurement of premature mortality is necessary to plan medical programs and to conduct effective medical activities. The purpose of this study was to compare the years of potential life lost (YPLL) with other mortality indices and to understand the usefulness and limitations of quantitative measurement for premature mortality. Data concerning death during employment were surveyed from 1979 to 1984. One thousand seven hundred twenty-five deaths were observed in 1,504,462 person-years in the study population. Proportionate mortality ratios indicated medical problems concerning malignant neoplasms and heart disease, but they could not identify the problems of suicide and traffic accidents occurring in the relatively younger group. YPLL by a constant end point at 60 years of age could rank these causes next below the major leading causes of death. Thus, YPLL might be a useful indicator of the problems concerning premature mortality in occupational medicine.     

早产儿早期微量喂养的临床观察

目的探讨早产儿早期微量喂养的意义。方法将我院收治的116例早产儿随机分为两组,观察组予以早期微量喂养,对照组早期单纯以静脉营养,待出现吸吮反射后再予人工喂养。结果观察组在胎便排出、喂养耐受、向肠道营养过渡及体重恢复增长方面均优于对照组。结论正确开展早期微量喂养有助于患儿康复。     

早产儿早期微量喂养的临床观察

目的探讨早产儿早期微量喂养的意义。方法将我院收治的116例早产儿随机分为两组,观察组予以早期微量喂养,对照组早期单纯以静脉营养,待出现吸吮反射后再予人工喂养。结果观察组在胎便排出、喂养耐受、向肠道营养过渡及体重恢复增长方面均优于对照组。结论正确开展早期微量喂养有助于患儿康复。     

Elevated risk of myocardial infarction in very young immigrants from former Yugoslavia

We performed a hospital based case–control study to assess if the risk of myocardial infarction at a very young age (≤40 years) was elevated in immigrants from the region of former Yugoslavia. Patients were classified as “exposed” if they or both their parents were born in former Yugoslavia. Consecutive myocardial infarction patients were recruited in the immediate post-infarction period from two Viennese hospitals over a 3.5-year period. Control patients free of myocardial infarction were frequency matched on age, gender, centre, and time in an approximate 1:2 ratio. Logistic regression was used for the assessment of an association between Yugoslavian descent and myocardial infarction. Overall, we recruited 102 myocardial infarction patients and 200 controls. The median age of infarction patients was 37.3 years. Yugoslavian descent was strongly associated with myocardial infarction (crude OR 7.3, 95% CI 3–18). This association was attenuated after multivariate adjustment (OR 3.9, 95% CI 1.2–13) but remained statistically significant. Using Miettinen’s formula for population attributable risk, we calculated that between 15.3% (adjusted) and 17.8% (unadjusted) of myocardial infarction cases in very young patients could be attributable to immigrants from the studied region. In conclusion, we found that the risk of developing myocardial infarction at a young age is elevated in immigrants from the region of former Yugoslavia and their offspring. Even though residual confounding cannot be ruled out definitively, this risk seems to be independent of established cardiovascular risk factors.     

北京市2010-2015年慢性非传染性疾病早死概率研究

目的 探索性分析2010-2015年北京市四类慢性非传染性疾病（慢性病）早死概率等相关指标的趋势变化。方法 利用来源于北京市户籍居民死因监测系统中2010-2015年北京市户籍居民死亡登记资料,应用WHO推荐计算方法,分析慢性病年龄标化死亡率、慢性病70岁之前的死亡比例和四类慢性病早死概率。结果 2010-2015年,北京市户籍人口慢性病约占总死亡的90%,慢性病年龄标化死亡率从332.43/10万下降到280.02/10万。四类慢性病早死概率从12.81%下降到11.11%。以2015年为基准计算,男性四类慢性病早死概率为14.63%,距离2025年控制目标（12.23%）尚有16.4%的下降空间;女性四类慢性病早死概率为7.54%,距离2025年控制目标（7.03%）有6.8%的下降空间。2015年北京市城区四类慢性病早死概率为9.72%,郊区为13.67%,郊区高于城区。结论 北京市慢性病死亡率相关指标已达到世界高收入国家水平。四类慢性病早死概率男性远高于女性,建议进一步加强慢性病的预防和控制,关注重点人群,最终实现25×25的目标。     

On the origin of mass casualty incidents in Kosovo, Yugoslavia, in 1990

In March 1990, a mysterious outbreak of illness spread suddenly among thousands of ethnic Albanian high school students in Kosovo (Yugoslavia). It was an unprecedented event on the worldwide scale both in terms of the number of cases and in terms of controversies concerning the aetiology. A retrospective analysis indicated that the epidemic consisted mainly of cases who felt ill in the absence of exposure to any physical agent. It is suggested that in an atmosphere of severe tension between the two ethnic groups living in Kosovo an increased frequency of respiratory infections may have triggered mass sociogenic illness.