The Arctic Research Group is running a number of population based studies concerning environmental contaminants and human health in all eight Arctic countries, as well as well as the following countries in the southern hemisphere: South Africa, Malawi, Zimbabwe, Ghana, Argentina, Chile, Brazil, Vietnam, Australia. Projects in Central Asia and Northern Africa (e.g., Morocco) are in development.
The basic design is similar and compatible in all studies: Biological samples from delivering women and their newborn children, medical records, pregnancy outcome, child development, and a thorough dietary assessment. Advanced statistical methods are implemented and a number of papers are published or in the planning phase. Normally the group has produced 1-2 PhDs per year. For 2014 the first dissertation will be Kalavati Channa in February, and at least two more are expected during 2014.
Evidence-basis for injury prevention in Northwestern Russia: the Shenkursk population-based injury registry study
PhD student Tatiana Unguryanu
Main supervisor Alexander V Kudryavtsev
Supervisor Andrej M Grjibovski
Supervisor Tordis A Trovik
Background. Injuries are the third leading cause of death in the WHO European region after diseases of circulatory system and neoplasms. External causes of death are the second main killers in several parts of Russia. International evidence shows that the first prerequisite for effective injury prevention is the local injury data of good quality. Harstad Safe Community in Norway has 30-years experience of comprehensive injury surveillance. The Shenkursk injury registry in Russia is built up on the injury registration model that is used in Harstad. It is targeted towards understanding of causes, circumstances and mechanisms of injuries and serves an evidence basis for injury prevention at municipal level.
Overall objective of the project
- To provide evidence-basis for injury prevention in Shenkursk, Northwestern Russia through descriptive and analytic studies of Shenkursk Injury Registry data
Specific objectivesof the project
- To assess completeness and validity of the Shenkursk Injury Registry data
- To present local panorama of injuries and investigate major injury problems in Shenkursk population (fall injuries, alcohol-related injuries) using the injury registry data and provide an evidence basis for development of local interventions
- To estimate the economic burden of injuries in Shenkursk
Methods. The study is being conducted in Shenkursk district of Arkhangelsk region, Northwestern Russia. The district had a population of 13 530 on 1 January 2015. All injuries admitted to Shenkursk district hospital since January 2015 are registered using the standard injury registration form. The collected data include socio-demographic characteristics of the injured, information on type, place, time, preceding circumstances of an injury, mechanism of predisposing accident, mechanism of injury, and prior alcohol use.
Registry data between January, 1st 2015 and December, 31st 2018 will be comprised. The injury panorama will be described for the two-year period from January 2015 to December 2016. The description of fall injures will be carried out for the three-year period from January 2015 to December 2017. The study of economic burden of injuries in Shenkursk will be carried out for a 4-year period from January 2015 to December 2018.
The completeness of the registry data will be assessed through linkage of all the records in the registry in one year period (July 2015 - June 2016) to the records in the routinely used hospital system for accounting of medical services in the same period. The quality control will be performed for the same one-year period through double entry of the raw data from original paper forms and assessments of the agreement in variables entered by two independent raters.
The fall-injuries will be described in three age strata: 0–17 years, 18–59 years and 60+ years on the following variables: age, gender, place, season, time, preceding activities, mechanisms of predisposing accidents and involved factors, injury severity. Estimates of the economic burden of injuries in Shenkursk will be performed using depersonalized data from the hospital system for accounting of medical services.
Descriptive statistics, regression analyses, cluster analysis, non-parametric methods are planned to be used to analyze the injury registry data.
Assessing differences in cardiovascular risk factors in the general populations of Russia and Norway and associations to indices of heart failure with or without preserved ejection fraction
PhD candidate: Michael Stylidis
Overall aim of the project: Improving phenotyping of heart failure, to use lifetime exposure to risk factors to improve detection of treatment options and refine use of genetic transcription profiles as diagnostic markers.
With the decline in ischemic heart disease, there is a concomitant decline in heart failure with reduced ejection fraction but as the population lives longer due to decreased mortality of cardiovascular disease, heart failure with and without ischemic heart disease is a main cause of hospitalization in western countries.
At present, there is no cure for heart failure with preserved ejection fraction and no good secondary preventive treatments. To detect lifestyle changes with an impact on cardiac dysfunction will have both a curative and preventive potential, but due to increasing comorbidity with aging restricting possible life style changes, pharmacological treatment options are warranted as well as better diagnostic tools.
Advances in the understanding of changes in genetic transcription in heart failure have so far not produced new treatment options partly due to insufficient phenotyping of heart failure cases.
Our study will use a population based prospective design to determine predictors of incident heart failure with preserved ejection fraction (HFpEF) in over 7000 subjects from the Tromsø Study over 20 years. The collaborating HUNT study will contribute HFpEF cases from a shorter follow up of more than 100 000 subjects. So far, studies have mainly analyzed predictors of overall heart failure where predictors of myocardial infarction heralding heart failure with reduced ejection fraction (HFrEF) will dominate. Our study will focus on HFpEF analyzing possible predictors such as overweight, hypertension, physical activity, diabetes, lifestyle, diet and alcohol consumption together with recognized and unrecognized myocardial infarction.
Project period: 03.09.2015 – 02.09.2019
Main supervisor: Henrik Schirmer
Co-supervisor: David Leon
The Murmansk County Environmental Contaminant Study
Postdoc: Erik Anda
Surveillance of contaminant levels in tissues of pregnant women in Murmansk County, North West Russia, and predictions on possible adverse health effects in mothers and new-borns.
Murmansk County in North West Russia has differentiated polluting industry in close proximity to housing. Pollution from local sources, long range transport and food products aggregate in the peoples that inhabit the area. Further, the impact of such pollution on human health is at its largest in early human development, e.g. in the womb. Thus, pregnant women that live in Murmansk County are subjected to a certain burden of contaminants specific to that geographical Arctic area transported there from other areas in the world as well as local pollution from for example mining factories specific to areas within the County.
Persons involved: Erik Anda, Anton Kovalenko and Jon Øyvind Odland
Project period: 15.05.10 – 01.09.14
The Murmansk County Birth Registry (MCBR) and the Arkhangelsk County Birth Registry (ACBR)
The MCBR was established in 2005 and have registered all deliveries in Murmansk County from January 1st 2006 until December 31st 2012. There are over 60 000 deliveries entered into the birth registry. The MCBR has been discontinued, but the data is viable and available and there are several students and scientists currently working with data from the registry.
The ACBR is a replica of the MCBR, but for Arkhangelsk Region (excluding Nenets). The ACBR was established in 2011 and is of yet not fully operational. Continuation is pending on funding from the Ministry of Health and Care Services.
Persons involved: Erik Anda, Andrej Grjibovski, Anton Kovalenko, Anna Usynina and Jon Øyvind Odland.
Congenital Malformations in Murmansk County, Russia
PhD-candidate: Anton Kovalenko, MD, Institute of Community Medicine, UiT the Arctic University of Norway
Recognizing that the lack or inadequacy of vital registration systems in Russia, and inaccurate records of the causes of death, are major barriers to estimating the size of public health problems attributable to birth defects, using birth registry data may be a solution. The main objectives of the project are - investigate the incidence of birth defects in Murmansk region from birth to the age of 3, inter- and intra-county variations in incidence and prevalence, investigate associations between birth defects and known causes in the regions, compare incidence and known risk factor distribution between Murmansk region and Northern Norway, improve prenatal diagnostics and identify opportunities for preventing birth defects and improving the health of children.
Main supervisor: Erik Anda
Co-supervisor: Tormod Brenn
Project period: 01.12.12 – 01.12.15
Heart rate decline: Association with other variables and the role in cardiovascular disease
Over the last few decades, resting heart rate (RHR) has shown a remarkable decline in the general population of Tromsø. From 1986 to 2007 RHR means within each ten year age group have dropped by about 10 beats per minute; a little less in men and little more in women.
- To describe the nature and extent of the heart rate decline in a large sample from the general population;
- To explain the heart rate correlation with possible determinants and other relevant risk factors and estimate the effect of the reduction related to increased physical activity, reduced smoking and possible other factors;
- To estimate the role of heart rate values in cardiovascular morbidity and mortality.
The data to be used are from the Tromsø Study. Follow-up information on mortality and heart disease morbidity is available as well. All analytic approaches will be quantitative. Analyses will include cross-sectional approaches with focus on mean values, un-adjusted and adjusted for possible determinants. Longitudinal considerations may reveal how values change from one study to the next for the same attendees. For the follow up, the essential method is Cox regression.
Project period: Nov. 2012 – Oct. 2016
Suicides and suicidal Behavior in the Population of The Nenets Autonomous Okrug, Russia
The overall aim of the study is to identify major risk factors associated with suicides in the different ethnic groups (indigenous and non-indigenous) of the Nenets Autonomous Okrug.
The alarming news 5-6 years ago from the Nenets Autonomous Okrug (NAO), Euro-Arctic Russia, indicate the suicide rates considerably much higher than known from other districts of the country. During the last ten years suicide rates in the NAO raised up to 100 per 100 000 and more (World Health Organization (WHO) defines the level 20 per 100 000 as critical). The local health experts also underline the suicide as one of the main demographic problems. The health authorities in the region took this information serious and started to work out a plan for how to approach this problem. They also connected with professionals outside the Okrug in order to elaborate this threatening health problem.
The problem of suicide in the NAO will be explored from the basic points. Epidemiological factors and associations will be discovered and defined in order to use it for the prevention activities. These activities targeted also by the ethnical approach. The new study is based on the analysis of two groups of NAO population (indigenous and non-indigenous), committed suicides during the last decade. The selected cases were studied in details. Knowledge obtained via the study will describe the main patterns of suicide in two population groups of the Nenets Autonomous Okrug. It will clarify the main causes of suicides in the Russian Arctic and possibly explain the high rates of it. The study will identify the main risk factors and the most vulnerable social groups related to the suicides. The expected results will be used in the development of further suicide prevention program(s) for the NAO and other Russian Arctic regions.
Project period: 01 December 2012 – 30 November 2015
Project Leader/Main supervisor: Odd Nilssen
Co-supervisors: Tormod Brenn, Alexander Kudryavtsev
Perinatal, neonatal, and infant mortality in Arkhangelsk and Murmansk Counties, Russia
PhD-candidate: Anna Usynina, MD, MPH, Institute of Community Medicine, UiT The Arctic University of Norway
The overall aim of the PhD project is to assess the associations between perinatal, neonatal, and infant mortalities and selected characteristics based on the data obtained from the population-based Arkhangelsk and Murmansk Counties Birth Registries. Both regression and survival analyses will be performed to achieve the study objectives.
Main advisor: Erik Anda, MPH, PhD, PostDoc, Institute of Community Medicine, UiT The Arctic University of Norway.
Co-advisors: Andrei Grjibovski, MD, PhD, Senior Advisor, Professor, Norwegian Institute of Public Health, Oslo; Institute of Community Medicine, UiT The Arctic University of Norway. Alexander Kudryavtsev, PhD, PostDoc, Institute of Community Medicine, UiT The Arctic University of Norway.
The epidemiology of congenital birth defects in Monchegorsk in 1973-2012: register-based study
PhD-candidate: Vitaly Postoev
There is no complex population-based information about birth defects' prevalence in North-West Russia, which contains information about all groups of defects. The aetiology of most birth defects is not well defined.
To investigate the prevalence and structure and risk factors of birth defects among newborns in Monchegorsk in 1973-2012 by the data of Kola Birth Register and Murmansk County Birth Registry and to evaluate the efficiency of prenatal screening.
Main supervisor: Prof. Jon Øyvind Odland
Oral health and occupational stress in undergraduate students
PhD student: Sergei Drachev (firstname.lastname@example.org; email@example.com)
Oral diseases such as dental caries and periodontal diseases are significant public health problems because of their high prevalence around the world, their physical and psychological influence on individuals and high treatment costs (Sheiham, 2005). Russia is of specific interest for dental studies, as oral health has been observed to be poor in the country. Prevalence of dental caries among children in North-West Russia is still high and considerable higher than in the neighbouring Nordic countries (Petersen et al., 2003, Koposova et al.,2013).
Young adults aged 18-25 years are a particularly important group in the study of dental health and its determinants. This age range comprises periods of biological, psychological, and social development and is a transition between adolescence and adulthood, when persons take responsibility for their health and develop their own health behaviour.
Aims of the study:
- to investigate dental caries experience and determinants in medical and dental students in North-West Russia;
- to assess the prevalence of dental anxiety (DA) and to explore the association between DA and socio-demographic and socioeconomic factors; oral health behaviour; and oral, general, and psychological health in medical and dental students in North-West Russia;
- to describe Oral Health-Related Quality of Life (OHRQoL) and to investigate the association between OHRQoL and selected factors in medical and dental students in North-West Russia.
Around 800-850 full-time undergraduate students aged 18-25 years from medical and dental faculties of the Northern State Medical University, Arkhangelsk, North-West Russia will be included in this cross-sectional study. Information on socio-demographic and socioeconomic factors; oral health behaviour; oral, general, and psychological health; occupational stress; DA; OHRQoL will be obtained from a structured, self-administered questionnaire. A clinical dental examination will be performed to assess dental caries experience, Simplified Oral Hygiene Index, and Gingival Index.
Project period: Feb 2015 – Jan 2019
Project Manager/Main supervisor: Professor Tordis A. Trovik, DDS, MPH, PhD
Co-supervisor: Associate Professor Tormod Brenn, PhD