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Migrant mortality advantage is established in various studies, but there is a lack of evidence on migrant mortality trends in old age. Previous studies have primarily concentrated on all-cause mortality, and few include older age groups. Discussions about the migrant mortality advantage continue due to concerns about data availability and accuracy. Additionally, the mechanisms explaining the migrant mortality advantage remain unclear. This study examines all-cause and cause-specific mortality among older migrant and nonmigrant adults aged 70 and above using Finnish Cause of Death register data (2002–20) and the corresponding risk population. We investigate differences in overall and cause-specific mortality between migrant and Finnish-born population and by geographical region of origin. We calculated direct age-standardized mortality rates and age group-specific death rates followed by Poisson regression to study relative mortality differences. Age at death, sex, income, region of residence, and year of death were controlled for in the regression analysis. We found evidence of migrant mortality advantage across various causes of death, but there was variation by regions of origin groups and sex. Notably, women exhibit the strongest advantage in respiratory and digestive system diseases, while men demonstrated pronounced advantages in external causes and respiratory diseases. Our study challenges the notion of a general diminishing healthy migrant effect in old age. Our findings emphasize the need for nuanced investigations into socioeconomic factors and tailored interventions for older migrants. [ABSTRACT FROM AUTHOR]

Introduction Duodenal atresia (DA) is the most common atresia of the small bowel. This study aims to assess the prevalence, mortality, and associated anomalies related to DA in Finland from 2004 to 2017. Material and Methods A nationwide study based on registers maintained by the Finnish Institute for Health and Welfare and Statistics Finland containing data on all live births and stillbirths and terminations of pregnancy. The cases were identified based on the ICD-9 and 10 (International Classification of Diseases revisions 9 and 10) codes. Associated anomalies were classified based on the EUROCAT criteria; minor anomalies were excluded. Results There were 249 DA cases including 222 (89.2%) live births, 16 (6.4%) stillbirths, and 11 (4.4%) terminations. There was no significant change in the prevalence rates between 2004 and 2017. Live birth prevalence was 2.75/10,000 and total prevalence was 3.08/10,000 births. A total of 100 (40.2%) cases were isolated, 67 (26.9%) had other multiple congenital anomalies, and 83 (33.3%) were syndromic. There were no terminations in isolated DA. Most associated anomalies were cardiac (36.1%), followed by other gastrointestinal tract anomalies (23.7%) and limb deformities/defects (7.2%). Trisomy 21 was observed in 63 cases (25.3%). Neonatal mortality was 3.6% (n = 8) and at 1 year 95.0% were alive. Both neonatal and infant mortalities were associated with cardiac anomalies (p < 0.001 and p = 0.001, respectively). All neonatal deaths had associated cardiac defect(s). Conclusions The prevalence of DA in Finland remains stable and among the highest reported. DA is often associated with cardiac anomalies, which portend a high risk for mortality. Despite the burden of associated anomalies, overall survival is high. [ABSTRACT FROM AUTHOR]

Background: The etiology and risk factors of congenital vertebral anomalies are mainly unclear in isolated cases. Also, there are no reports on the risk factors for different subgroups of vertebral anomalies. Therefore, we assessed and identified potential maternal risk factors for these anomalies and hypothesized that diabetes, other chronic diseases, smoking, obesity, and medication in early pregnancy would increase the risk of congenital vertebral anomalies. Methods: All cases with congenital vertebral anomalies were identified in the Finnish Register of Congenital Malformations from 1997 to 2016 for this nationwide register-based case–control study. Five matched controls without vertebral malformations were randomly selected. Analyzed maternal risk factors included maternal age, body mass index, parity, smoking, history of miscarriages, chronic diseases, and prescription drug purchases in early pregnancy. Results: The register search identified 256 cases with congenital vertebral malformations. After excluding 66 syndromic cases, 190 non-syndromic malformations (74 formation defects, 4 segmentation defects, and 112 mixed anomalies) were included in the study. Maternal smoking was a significant risk factor for formation defects (adjusted odds ratio 2.33, 95% confidence interval 1.21–4.47). Also, pregestational diabetes (adjusted odds ratio 8.53, 95% confidence interval 2.33–31.20) and rheumatoid arthritis (adjusted odds ratio 13.19, 95% confidence interval 1.31–132.95) were associated with mixed vertebral anomalies. Conclusion: Maternal pregestational diabetes and rheumatoid arthritis were associated with an increased risk of mixed vertebral anomalies. Maternal smoking increases the risk of formation defects and represents an avoidable risk factor for congenital scoliosis. Level of evidence: III [ABSTRACT FROM AUTHOR]

Several studies show that exposure to neighbourhood disadvantage predicts poorer educational outcomes among adolescents. Selective sorting into neighbourhoods, other unobserved childhood family characteristics, and failing to account for other relevant social contexts such as schools inhibit strong causal inference from the associations reported in previous studies. Based on longitudinal register data on the total population of Finnish children in major cities, we studied the extent to which variation in grade point average (GPA) was attributable to schools, neighbourhoods, and families. We also sought to determine whether exposure to neighbourhood disadvantage predicted GPA after accounting for non-random selection into neighbourhoods by comparing siblings with differential exposure to neighbourhoods. Overall, we observed no effect of neighbourhood disadvantage on GPA after accounting for observed and unobserved family characteristics in the general population. However, we did observe a non-negligible but not statistically significant effect of neighbourhood disadvantage among children of parents with only basic education. Family factors accounted for most of the variation in GPA, and only around 1 per cent of the variance was attributable to the neighbourhood. This weak relevance of the neighbourhood to educational outcomes may reflect the success of educational and other social policies limiting the emergence of neighbourhood effects. [ABSTRACT FROM AUTHOR]

Our understanding of the lived experience of transnationalism is limited by the scarcity of high-quality quantitative evidence. Representative evidence on the emotional and identification aspects of transnationalism is especially missing. To address this gap, we investigated the transnational involvement of three migrant groups – Somali, Kurdish and Russian – in Finland. Using high-quality random sample survey data, the study examined transnational activities – remittance sending, following media, keeping in touch with and visits to the country of origin – as well as transnational identification with significant others living abroad. Multiple correspondence analysis (MCA) demonstrated that transnational involvement can be empirically divided into transnational activities and identifications, as suggested by prior theoretical works. Regression analysis showed that transnational activities and identifications varied strongly between the three groups. Russians were the most active in transnational activities while Somalis showed the highest levels of identification with their country of origin. Activities increased with the longer stay, while identification decreased. Family ties played a role in transnational identification. Our results point towards the complexity in the relationship between transnational involvement and economic integration in the host society. [ABSTRACT FROM AUTHOR]

In this paper, we contribute to recent debates on the geographies of discontent by examining the implications of urbanisation on the state as a territorial‐political community in the European context. Building on an Arendtian conception of politics, we argue that the emergence of the "urban" as a dominant spatio‐political imaginary has led to a narrowing of the conditions of politics and political agency within states. The urban imaginary has provoked selective spatio‐political discourses, geopolitical strategies, and policy practices that have resulted in the exclusion of certain social and spatial fractions of society from a shared sense of community and political agency within the state. To demonstrate this point, we empirically analysed the experience of political efficacy in Europe. The results of our analysis show that perceived external political efficacy is weakest in more rural settings and in regions with low GDP and a declining population. Accordingly, we suggest that policy measures ought to be directed against this sort of political alienation and should be used to create a stronger sense of political belonging and community. In this paper, we argue that the emergence of the "urban" as a dominant spatio‐political imaginary has led to a narrowing of the conditions of politics and political agency within states. The urban imaginary has provoked selective spatio‐political discourses, geopolitical strategies, and policy practices that have resulted in the exclusion of certain social and spatial fractions of society from a shared sense of community and political agency within the state. The results of our analysis show that perceived external political efficacy is weakest in more rural settings and in regions with low GDP and a declining population. [ABSTRACT FROM AUTHOR]

Introduction:  The aim of the study was to investigate the prevalence of esophageal atresia (EA), frequency of associated anomalies, and mortality from 2004 to 2017 in the Finnish population. We hypothesized the Spitz classification and the presence of other congenital malformations would predict mortality in patients with EA as well as assumed the survival to be high among patients with EA., Materials and Methods:  This retrospective, population-based study was based on the registries maintained by THL Finnish Institute for Health and Welfare and Statistics Finland. The cases were identified and classified according to the World Health Organization's International Classification of Diseases and Health Related Problems (ICD) revisions 9 and 10 (ICD-9 and ICD-10) codes and accompanying written diagnoses. Associated anomalies were classified based on the EUROCAT criteria, and minor anomalies were excluded. All statistical tests were performed as a two-sided significance level set at p  < 0.05. The chi-square or Fisher's exact test was utilized for categorical variables. The change in prevalence rates during the study period was evaluated with linear regression., Results:  In total, 337 cases with EA were identified including 295 (87.5%) live births, 17 (5.0%) stillbirths, and 25 (7.4%) terminations of pregnancy. The total prevalence for EA in Finland was 4.17/10,000 births with no significant change during the study period, p  = 0.35. Neonatal mortality was 5% ( n  = 15) and 1-year survival was 91.5%. Mortality was associated with syndromic cases ( p  = 0.002). The Spitz classification predicted neonatal mortality better than cardiac anomalies alone ( p  < 0.001 and p  = 0.6, respectively). Type C was the most common atresia type (65.9%) followed by type A (14.8%) and B (6.8%). The most common group of associated malformations were heart defects (35.0%) followed by other gastrointestinal tract malformations (15.3%) and limb anomalies (12.2%). Syndromic cases (12.2%) were associated with type A and B atresias ( p  = 0.001). VACTERL association was observed in 16.6% of the cases., Conclusion:  The overall prevalence of EA remains stable and relatively high in Finland. Despite the high prevalence of co-occurring malformations, the overall survival rate is high. Spitz classification predicted neonatal survival well., Competing Interests: None declared., (Thieme. All rights reserved.)