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Sample records for child mortality rates

  1. Trends in child mortality in India.

    Science.gov (United States)

    Behl, A S

    2013-01-08

    To assess Indias recent trends in child mortality rates and disparities and identify ways to reduce child mortality and wealth-related health disparities, we analyzed three years of data from Indias National Family Health Survey related to child mortality. Nationally, declines in average child mortality were statistically significant, but declines in inequality were not. Urban areas had lower child mortality rates than rural areas but higher inequalities. Interstate differences in child mortality rates were significant, with rates in the highest-mortality states four to six times higher than in the lowest-mortality states. However, child mortality in most states declined.

  2. Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries.

    Science.gov (United States)

    Raj, Anita; Boehmer, Ulrike

    2013-04-01

    This study was designed to assess associations between national rates of girl child marriage and national rates of HIV and maternal and child health (MCH) concerns, using national indicator data from 2009 United Nations reports. Current analyses were limited to the N = 97 nations (of 188 nations) for which girl child marriage data were available. Regression analyses adjusted for development and world region demonstrate that nations with higher rates of girl child marriage are significantly more likely to contend with higher rates of maternal and infant mortality and nonutilization of maternal health services, but not HIV.

  3. Parental mortality rates in a western country after the death of a child

    DEFF Research Database (Denmark)

    Werthmann, Jessica; Smits, Luc J.M.; Li, Jiong

    2010-01-01

    within a larger sample and focus on adverse health effects as an objective measure of possible long-term effects of maladaptive grief reactions. Methods: For the time period between 1980 and 1996, all children in Denmark who died before 18 years of age were identified. Parents who had lost a child were...... was not greater for fathers than for mothers. Conclusions: The results of this study revealed no significant effect of sex of the deceased child on mortality in these bereaved parents. The results might differ if this study was replicated in a population with a different grief culture and, more importantly...

  4. Child mortality estimation: consistency of under-five mortality rate estimates using full birth histories and summary birth histories.

    Directory of Open Access Journals (Sweden)

    Romesh Silva

    Full Text Available BACKGROUND: Given the lack of complete vital registration data in most developing countries, for many countries it is not possible to accurately estimate under-five mortality rates from vital registration systems. Heavy reliance is often placed on direct and indirect methods for analyzing data collected from birth histories to estimate under-five mortality rates. Yet few systematic comparisons of these methods have been undertaken. This paper investigates whether analysts should use both direct and indirect estimates from full birth histories, and under what circumstances indirect estimates derived from summary birth histories should be used. METHODS AND FINDINGS: Usings Demographic and Health Surveys data from West Africa, East Africa, Latin America, and South/Southeast Asia, I quantify the differences between direct and indirect estimates of under-five mortality rates, analyze data quality issues, note the relative effects of these issues, and test whether these issues explain the observed differences. I find that indirect estimates are generally consistent with direct estimates, after adjustment for fertility change and birth transference, but don't add substantial additional insight beyond direct estimates. However, choice of direct or indirect method was found to be important in terms of both the adjustment for data errors and the assumptions made about fertility. CONCLUSIONS: Although adjusted indirect estimates are generally consistent with adjusted direct estimates, some notable inconsistencies were observed for countries that had experienced either a political or economic crisis or stalled health transition in their recent past. This result suggests that when a population has experienced a smooth mortality decline or only short periods of excess mortality, both adjusted methods perform equally well. However, the observed inconsistencies identified suggest that the indirect method is particularly prone to bias resulting from violations

  5. Trends and Disparities in Child Mortality in India.

    Science.gov (United States)

    Behl, A S

    2012-06-10

    This secondary analysis of Indias National Family Health Survey data assessed India's recent trends in child mortality rates and disparities. Nationally, declines in average child mortality rates from 1992 to 2005 were statistically significant, but declines in inequality were not. Urban areas had lower child mortality rates than rural areas but higher inequalities. Interstate differences in child mortality rates were significant, with rates in the highest-mortality states four to six times higher than in the lowest-mortality states. Significant child health disparities persist despite declines in child mortality rates. Implementing low-cost, effective interventions in districts with the highest number of child deaths could accelerate reductions in child mortality and decrease inequalities.

  6. Child mortality in rural India

    NARCIS (Netherlands)

    B. van der Klaauw (Bas); L. Wang (Lihong)

    2011-01-01

    textabstractThis paper focuses on infant and child mortality in rural areas of India. We construct a flexible duration model, which allows for frailty at multiple levels and interactions between the child's age and individual, socioeconomic, and environmental characteristics. The model is estimated

  7. Gender difference in child mortality.

    Science.gov (United States)

    Ahmed, F A

    1990-12-01

    1976 census data and data on births to 8788 ever married women from the 1980 Egyptian Fertility Survey were analyzed to determine if son preference was responsible for higher mortality among girls than among boys and what factors were associated with this higher mortality. During 0-3 years, boys were more likely to die than females. For example, the overall male-female sex ratio for the 1st year was 118:100. At ages 5, 10, 15, and 2 0, however, girls were more likely to die. The sex rations for these years were 98, 95, 93, and 91. In fact, the excess mortality among illiterate mothers accounted for most of the overall excess mortality. As mother's educational level rose, the excess mortality of girls fell, so that by university level boys experienced excess mortality (130, 111, 112, 105). Less educated mothers breast fed sons longer and waited more months after birth of a son to have another child indicating son preference, but these factors did not necessarily contribute to excess mortality. The major cause of female excess mortality in Egypt was that boys received favored treatment of digestive and respiratory illnesses as indicated by accessibility to a pharmacy (p.01). Norms/traditions and religion played a significant role in excess mortality. The effect of norms/traditions was greater than religion, however. Mother's current and past employment strongly contributed to reducing girls' mortality levels (p.01). These results indicated that Egypt should strive to increase the educational level of females and work opportunities for women to reduce female child mortality. Further, it should work to improve women's status which in turn will reduce norms/traditions that encourage son preference and higher mortality level for girls.

  8. Estimating spatial inequalities of urban child mortality

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    John R. Weeks

    2013-01-01

    Full Text Available BACKGROUND Recent studies indicate that the traditional rural-urban dichotomy pointing to cities as places of better health in the developing world can be complicated by poverty differentials. Knowledge of spatial patterns is essential to understanding the processes that link individual demographic outcomes to characteristics of a place. A significant limitation, however, is the lack of spatial data and methods that offer flexibility in data inputs. OBJECTIVE This paper tackles some of the issues in calculating intra-urban child mortality by combining multiple data sets in Accra, Ghana and applying a new method developed by Rajaratnam et al. (2010 that efficiently uses summary birth histories for creating local-level measures of under-five child mortality (5q0. Intra-urban 5q0 rates are then compared with characteristics of the environment that may be linked to child mortality. METHODS Rates of child mortality are calculated for 16 urban zones within Accra for birth cohorts from 1987 to 2006. Estimates are compared to calculated 5q0 rates from full birth histories. 5q0 estimates are then related to zone measures of slum characteristics, housing quality, health facilities, and vegetation using a simple trendline R2 analysis. RESULTS Results suggest the potential value of the Rajaratnam et al. method at the micro-spatial scale. Estimated rates indicate that there is variability in child mortality between zones, with a spread of up to 50 deaths per 1,000 births. Furthermore, there is evidence that child mortality is connected to environmental factors such as housing quality, slum-like conditions, and neighborhood levels of vegetation.

  9. Labor migration and child mortality in Mozambique

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    Yabiku, Scott T.; Agadjanian, Victor; Cau, Boaventura

    2013-01-01

    Male labor migration is widespread in many parts of the world, yet its consequences for child outcomes and especially childhood mortality remain unclear. Male labor migration could bring benefits, in the form of remittances, to the families that remain behind and thus help child survival. Alternatively, the absence of a male adult could imperil the household's well-being and its ability to care for its members, increasing child mortality risks. In this analysis, we use longitudinal survey data from Mozambique collected in 2006 and 2009 to examine the association between male labor migration and under-five mortality in families that remain behind. Using a simple migrant/non-migrant dichotomy, we find no difference in mortality rates across migrant and non-migrant men's children. When we separated successful from unsuccessful migration based on the wife's perception, however, stark contrasts emerge: children of successful migrants have the lowest mortality, followed by children of non-migrant men, followed by the children of unsuccessful migrants. Our results illustrate the need to account for the diversity of men's labor migration experience in examining the effects of migration on left-behind households. PMID:23121856

  10. [Political crises in Africa and infant and child mortality].

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    Garenne, M

    1997-01-01

    Many African countries experienced severe political crises after independence, and in a number of cases the crises had significant demographic consequences, especially for child mortality. Data based on maternity histories allowed the reconstruction of child mortality trends over the past 20-30 years in Uganda, Ghana, Rwanda, Madagascar, and Mozambique. The indicator used was the child mortality quotient (number of deaths of under-5 children per 1000 births). Uganda's child mortality declined from 227/1000 in 1960 to 154/1000 in 1970, but the trend was reversed in 1971, when Idi Amin Dada came to power, and the rate reached 204/1000 in 1982 before beginning to decline again. The level of mortality remained high, however, and was still 160/1000 in 1988. Ghana suffered a political and economic crisis during 1979-84. Child mortality rose from 130/1000 in 1978 to 175/1000 in 1983. Mortality rates began a rapid decline after structural adjustment programs were begun, possibly due to improved management of health services. The child mortality rate in Rwanda increased from around 220/1000 in 1960 to 240/1000 in 1975, before beginning a decline in the late 1970s that reached 140/1000 by 1990. The period of political stability and relative prosperity during the 15-year reign of Juvenal Habyarimana was associated with the decline. Political crises marked by student and peasant uprisings were associated with Madagascar's child mortality rate increase from about 145/1000 in 1960 to 185/1000 in 1985. Mozambique was beset by civil war after independence, in which destruction of the health infrastructure was a strategy. The child mortality rate increased from 270/1000 to 470/1000 between 1975 and 1986, a peak war year. The factors by which political crises affect mortality so profoundly remain to be explained, but particular attention should be given to studying the health sector.

  11. Child mortality and economic variation among rural Mexican households.

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    Millard, A V

    1985-01-01

    In two rural Mexican communities, rates of child mortality are significantly related to economic situations of households. Measured over the childbearing years of post-reproductive women, the rate of child mortality (ages 0-5 years) per mother is 163 per 1000 children in one village and 338 in the other. Significant economic correlates, which are defined ethnographically in each community, are housing quality, quality of farm land and marital status. Correlations of child mortality rates with economic variables range from -0.25 to -0.54, showing that poorer mothers lose significantly more children in the first 5 years of life. These results parallel those of urban, regional, national and international studies, but economic correlates of child mortality have not previously been found in rural Latin America. The methodological contributions of this study include a meld of ethnographic and survey techniques of data collection, the development of culturally appropriate variables to measure economic status, the use of child rather than infant mortality rates, and a household-related demographic measure, the rate of child mortality per mother.

  12. Statistical Analysis of Factors Affecting Child Mortality in Pakistan.

    Science.gov (United States)

    Ahmed, Zoya; Kamal, Asifa; Kamal, Asma

    2016-06-01

    Child mortality is a composite indicator reflecting economic, social, environmental, healthcare services, and their delivery situation in a country. Globally, Pakistan has the third highest burden of fetal, maternal, and child mortality. Factors affecting child mortality in Pakistan are investigated by using Binary Logistic Regression Analysis. Region, education of mother, birth order, preceding birth interval (the period between the previous child birth and the index child birth), size of child at birth, and breastfeeding and family size were found to be significantly important with child mortality in Pakistan. Child mortality decreased as level of mother's education, preceding birth interval, size of child at birth, and family size increased. Child mortality was found to be significantly higher in Balochistan as compared to other regions. Child mortality was low for low birth orders. Child survival was significantly higher for children who were breastfed as compared to those who were not.

  13. Mortality rates among wild chimpanzees.

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    Hill, K; Boesch, C; Goodall, J; Pusey, A; Williams, J; Wrangham, R

    2001-05-01

    In order to compare evolved human and chimpanzees' life histories we present a synthetic life table for free-living chimpanzees, derived from data collected in five study populations (Gombe, Taï, Kibale, Mahale, Bossou). The combined data from all populations represent 3711 chimpanzee years at risk and 278 deaths. Males show higher mortality than females and data suggest some inter-site variation in mortality. Despite this variation, however, wild chimpanzees generally have a life expectancy at birth of less than 15 years and mean adult lifespan (after sexual maturity) is only about 15 years. This is considerably lower survival than that reported for chimpanzees in zoos or captive breeding colonies, or that measured among modern human hunter-gatherers. The low mortality rate of human foragers relative to chimpanzees in the early adult years may partially explain why humans have evolved to senesce later than chimpanzees, and have a longer juvenile period.

  14. Child health and mortality in Guinea-Bissau

    DEFF Research Database (Denmark)

    Kovsted, Jens Anders; Pörtner, Claus Christian; Tarp, Finn

    2002-01-01

    This paper studies factors that influence child health in Bissau, the capital of Guinea-Bissau. This environment is characterised by high infant mortality, but not by malnutrition. We show that although maternal education is important in determining child health and mortality this effect diminishes...... or disappears when health knowledge is introduced as an explanatory variable. It emerges that health knowledge has large and positive effects on both child mortality and health when instrumented for to capture endogeneity...

  15. Success in reducing maternal and child mortality in Afghanistan.

    Science.gov (United States)

    Rasooly, Mohammad Hafiz; Govindasamy, Pav; Aqil, Anwer; Rutstein, Shea; Arnold, Fred; Noormal, Bashiruddin; Way, Ann; Brock, Susan; Shadoul, Ahmed

    2014-01-01

    After the collapse of the Taliban regime in 2002, Afghanistan adopted a new development path and billions of dollars were invested in rebuilding the country's economy and health systems with the help of donors. These investments have led to substantial improvements in maternal and child health in recent years and ultimately to a decrease in maternal and child mortality. The 2010 Afghanistan Mortality Survey (AMS) provides important new information on the levels and trends in these indicators. The AMS estimated that there are 327 maternal deaths for every 100,000 live births (95% confidence interval = 260-394) and 97 deaths before the age of five years for every 1000 children born. Decreases in these mortality rates are consistent with changes in key determinants of mortality, including an increasing age at marriage, higher contraceptive use, lower fertility, better immunisation coverage, improvements in the percentage of women delivering in health facilities and receiving antenatal and postnatal care, involvement of community health workers and increasing access to the Basic Package of Health Services. Despite the impressive gains in these areas, many challenges remain. Further improvements in health services in Afghanistan will require sustained efforts on the part of both the Government of Afghanistan and international donors.

  16. Child mortality estimation: estimating sex differences in childhood mortality since the 1970s.

    Directory of Open Access Journals (Sweden)

    Cheryl Chriss Sawyer

    Full Text Available INTRODUCTION: Producing estimates of infant (under age 1 y, child (age 1-4 y, and under-five (under age 5 y mortality rates disaggregated by sex is complicated by problems with data quality and availability. Interpretation of sex differences requires nuanced analysis: girls have a biological advantage against many causes of death that may be eroded if they are disadvantaged in access to resources. Earlier studies found that girls in some regions were not experiencing the survival advantage expected at given levels of mortality. In this paper I generate new estimates of sex differences for the 1970s to the 2000s. METHODS AND FINDINGS: Simple fitting methods were applied to male-to-female ratios of infant and under-five mortality rates from vital registration, surveys, and censuses. The sex ratio estimates were used to disaggregate published series of both-sexes mortality rates that were based on a larger number of sources. In many developing countries, I found that sex ratios of mortality have changed in the same direction as historically occurred in developed countries, but typically had a lower degree of female advantage for a given level of mortality. Regional average sex ratios weighted by numbers of births were found to be highly influenced by China and India, the only countries where both infant mortality and overall under-five mortality were estimated to be higher for girls than for boys in the 2000s. For the less developed regions (comprising Africa, Asia excluding Japan, Latin America/Caribbean, and Oceania excluding Australia and New Zealand, on average, boys' under-five mortality in the 2000s was about 2% higher than girls'. A number of countries were found to still experience higher mortality for girls than boys in the 1-4-y age group, with concentrations in southern Asia, northern Africa/western Asia, and western Africa. In the more developed regions (comprising Europe, northern America, Japan, Australia, and New Zealand, I found

  17. Quantifying child mortality reductions related to measles vaccination.

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    Jeremy D Goldhaber-Fiebert

    Full Text Available BACKGROUND: This study characterizes the historical relationship between coverage of measles containing vaccines (MCV and mortality in children under 5 years, with a view toward ongoing global efforts to reduce child mortality. METHODOLOGY/PRINCIPAL FINDINGS: Using country-level, longitudinal panel data, from 44 countries over the period 1960-2005, we analyzed the relationship between MCV coverage and measles mortality with (1 logistic regressions for no measles deaths in a country-year, and (2 linear regressions for the logarithm of the measles death rate. All regressions allowed a flexible, non-linear relationship between coverage and mortality. Covariates included birth rate, death rates from other causes, percent living in urban areas, population density, per-capita GDP, use of the two-dose MCV, year, and mortality coding system. Regressions used lagged covariates, country fixed effects, and robust standard errors clustered by country. The likelihood of no measles deaths increased nonlinearly with higher MCV coverage (ORs: 13.8 [1.6-122.7] for 80-89% to 40.7 [3.2-517.6] for ≥95%, compared to pre-vaccination risk levels. Measles death rates declined nonlinearly with higher MCV coverage, with benefits accruing more slowly above 90% coverage. Compared to no coverage, predicted average reductions in death rates were -79% at 70% coverage, -93% at 90%, and -95% at 95%. CONCLUSIONS/SIGNIFICANCE: 40 years of experience with MCV vaccination suggests that extremely high levels of vaccination coverage are needed to produce sharp reductions in measles deaths. Achieving sustainable benefits likely requires a combination of extended vaccine programs and supplementary vaccine efforts.

  18. Geography of child mortality clustering within African families.

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    Kuate-Defo, Barthélémy; Diallo, Khassoum

    2002-06-01

    After decades of sustained child mortality reductions, infant and early childhood mortality levels in Africa remain high. This can partly be ascribed to the concentration of child mortality within particular families, communities or geographic localities. Strong mortality clustering is indicative of marked social inequality and of an unequal distribution of health and health-related resources and infrastructures. It also signifies a concentration of nutritional and sanitary behaviors harmful to the good health and longevity of children. Finally, it likely points to the existence of particular genetic problems in certain families, or environmental problems within specific communities. Using nationally representative family level data from all sub-regions of Africa, two important findings emerge from this study. First, levels of mortality have generally declined in all countries over time, and as mortality decreases, mortality clustering tends to follow the same trend. Second, bio-demographic covariates have a more important effect on familial mortality clustering risks than socio-economic ones.

  19. Mortality Rates Among Arab Americans in Michigan

    OpenAIRE

    Dallo, Florence J.; Schwartz, Kendra; Ruterbusch, Julie J.; Booza, Jason; Williams, David R.

    2012-01-01

    The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, ...

  20. Prioritizing child health interventions in Ethiopia: modeling impact on child mortality, life expectancy and inequality in age at death.

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    Kristine Husøy Onarheim

    Full Text Available BACKGROUND: The fourth Millennium Development Goal calls for a two-thirds reduction in under-5 mortality between 1990 and 2015. Under-5 mortality rate is declining, but many countries are still far from achieving the goal. Effective child health interventions that could reduce child mortality exist, but national decision-makers lack contextual information for priority setting in their respective resource-constrained settings. We estimate the potential health impact of increasing coverage of 14 selected health interventions on child mortality in Ethiopia (2011-2015. We also explore the impact on life expectancy and inequality in the age of death (Gini(health. METHODS AND FINDINGS: We used the Lives Saved Tool to estimate potential impact of scaling-up 14 health interventions in Ethiopia (2011-2015. Interventions are scaled-up to 1 government target levels, 2 90% coverage and 3 90% coverage of the five interventions with the highest impact. Under-5 mortality rate, neonatal mortality rate and deaths averted are primary outcome measures. We used modified life tables to estimate impact on life expectancy at birth and inequality in the age of death (Gini(health. Under-5 mortality rate declines from 101.0 in 2011 to 68.8, 42.1 and 56.7 per 1000 live births under these three scenarios. Prioritizing child health would also increase life expectancy at birth from expected 60.5 years in 2015 to 62.5, 64.2 and 63.4 years and reduce inequality in age of death (Gini(health substantially from 0.24 to 0.21, 0.18 and 0.19. CONCLUSIONS: The Millennium Development Goal for child health is reachable in Ethiopia. Prioritizing child health would also increase total life expectancy at birth and reduce inequality in age of death substantially (Gini(health.

  1. The healthy immigrant effect and mortality rates.

    Science.gov (United States)

    Ng, Edward

    2011-12-01

    According to the 2006 Census, almost the Canadian population were foreign-born, a percentage that is projected to reach at least 25% by 2031. Studies based on age-standardized mortality rates (ASMR) have found a healthy immigrant effect, with lower overall rates among immigrants. A duration effect has also been observed-immigrants' mortality advantage lessened as their time in Canada increased. ASMRs based on the 1991 to 2001 census mortality follow-up study indicate a healthy immigrant effect and a duration effect at the national level for all-cause mortality for both sexes. However, at the national level, the mortality rate among women from the United States and from Sub-Saharan Africa was similar to that of Canadian-born women. For the three largest Census Metropolitan Areas (Toronto, Montreal and Vancouver), a healthy immigrant effect was not observed among women or among most men from the United States or Sub-Saharan Africa.

  2. Mortality rates among Arab Americans in Michigan.

    Science.gov (United States)

    Dallo, Florence J; Schwartz, Kendra; Ruterbusch, Julie J; Booza, Jason; Williams, David R

    2012-04-01

    The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, all-cause and cause-specific mortality rates for Arab Americans were in the range of whites and blacks. However, Arab American men had lower mortality rates from cancer and chronic lower respiratory disease compared to both whites and blacks. Among women, Arab Americans had lower mortality rates from heart disease, cancer, stroke, and diabetes than whites and blacks. Arab Americans are growing in number. Future study should focus on designing rigorous separate analyses for this population.

  3. Asthma mortality in the Danish child population

    DEFF Research Database (Denmark)

    Jørgensen, Inger Merete; Jensen, V B; Bülow, S

    2003-01-01

    Child death due to asthma is a rare and potentially preventable event. We investigated possible risk factors for death due to asthma in children and adolescents, as a step towards preventing or minimizing asthma death in this age group, and improving asthma management and care. We reviewed all 10...

  4. Disparities in Under-Five Child Injury Mortality between Developing and Developed Countries: 1990–2013

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    Yun Huang

    2016-07-01

    Full Text Available Objective: Using estimates from the 2013 Global Burden of Disease (GBD study, we update evidence on disparities in under-five child injury mortality between developing and developed countries from 1990 to 2013. Methods: Mortality rates were accessed through the online visualization tool by the GBD study 2013 group. We calculated percent change in child injury mortality rates between 1990 and 2013. Data analysis was conducted separately for <1 year and 1–4 years to specify age differences in rate changes. Results: Between 1990 and 2013, over 3-fold mortality gaps were observed between developing countries and developed countries for both age groups in the study time period. Similar decreases in injury rates were observed for developed and developing countries (<1 year: −50% vs. −50% respectively; 1–4 years: −56% vs. −58%. Differences in injury mortality changes during 1990–2013 between developing and developed nations varied with injury cause. There were greater reductions in mortality from transport injury, falls, poisoning, adverse effects of medical treatment, exposure to forces of nature, and collective violence and legal intervention in developed countries, whereas there were larger decreases in mortality from drowning, exposure to mechanical forces, and animal contact in developing countries. Country-specific analysis showed large variations across countries for both injury mortality and changes in injury mortality between 1990 and 2013. Conclusions: Sustained higher child injury mortality during 1990–2013 for developing countries merits the attention of the global injury prevention community. Countries that have high injury mortality can benefit from the success of other countries.

  5. Entrenched geographical and socioeconomic disparities in child mortality: trends in absolute and relative inequalities in Cambodia.

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    Eliana Jimenez-Soto

    Full Text Available BACKGROUND: Cambodia has made considerable improvements in mortality rates for children under the age of five and neonates. These improvements may, however, mask considerable disparities between subnational populations. In this paper, we examine the extent of the country's child mortality inequalities. METHODS: Mortality rates for children under-five and neonates were directly estimated using the 2000, 2005 and 2010 waves of the Cambodian Demographic Health Survey. Disparities were measured on both absolute and relative scales using rate differences and ratios, and where applicable, slope and relative indices of inequality by levels of rural/urban location, regions and household wealth. FINDINGS: Since 2000, considerable reductions in under-five and to a lesser extent in neonatal mortality rates have been observed. This mortality decline has, however, been accompanied by an increase in relative inequality in both rates of child mortality for geography-related stratifying markers. For absolute inequality amongst regions, most trends are increasing, particularly for neonatal mortality, but are not statistically significant. The only exception to this general pattern is the statistically significant positive trend in absolute inequality for under-five mortality in the Coastal region. For wealth, some evidence for increases in both relative and absolute inequality for neonates is observed. CONCLUSION: Despite considerable gains in reducing under-five and neonatal mortality at a national level, entrenched and increased geographical and wealth-based inequality in mortality, at least on a relative scale, remain. As expected, national progress seems to be associated with the period of political and macroeconomic stability that started in the early 2000s. However, issues of quality of care and potential non-inclusive economic growth might explain remaining disparities, particularly across wealth and geography markers. A focus on further addressing key

  6. Infant and child mortality: the implications for fertility behaviour.

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    Ruzicka, L T; Kane, P

    1988-01-01

    In developing countries, infant and child mortality affect fertility through biological or involuntary mechanisms operating through shortened breastfeeding, and more rapid return of ovulation following upon an infant death. Fertility is also affected through volitional responses of couples to perceived mortality levels in the community (insurance effect) or experience of earlier child loss (replacement effect) as well as through societal responses to high probability of child loss. In return, fertility affects infant and child mortality through birth to very young mothers, due to physiological immaturity of teenaged mothers and low birth-weight, as well as through birth to old mothers in high birth orders, due to maternal depletion syndrome. Trussel and Pebley estimated that the elimination of 4th and higher order births, along with the limitation of reproduction within the age of 20 to 34 years old, would reduce infant mortality by about 12%. A large number of studies show strong evidence that the timing and spacing of birth have a significant impact on both maternal and child health. According to Maine and McNamara (1985), who analysed data from 25 developing countries, if all children were born 2 years apart, 1/5 of infant deaths could be avoided. Mother's ill-health, maternal mortality, mother's malnutrition and its consequences in low quality breast milk and short breastfeeding, reduce sharply the new child's chances of survival. Many of these adverse biological and physiological conditions for childbearing can be compensated for by the provision of health care of high quality, including family planning, as well as education and good nutritional status of the mother and her children. Unfortunately, in many societies and for large segments of the population, such conditions are still a dream.

  7. Biplot models applied to cancer mortality rates.

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    Osmond, C

    1985-01-01

    "A graphical method developed by Gabriel to display the rows and columns of a matrix is applied to tables of age- and period-specific cancer mortality rates. It is particularly useful when the pattern of age-specific rates changes with time. Trends in age-specific rates and changes in the age distribution are identified as projections. Three examples [from England and Wales] are given."

  8. Child Mortality and Reproductive Patterns in Bolivia, 1993-1998

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    Pinto Aguirre, Guido

    2007-01-01

    Full Text Available The objective of the present study is to examine the effects of several reproductive and demographic factors on child survival in Bolivia, one of the most impoverished nations in all of Latin America. We model the joint effects of maternal age, parity, pace of childbearing, duration of breastfeeding, and use of modern contraception on child mortality. Data for this research come from “Demographic and Health Survey” (DHS carried out during 1998. The results obtained in this paper support the evidence found in other studies: breastfeeding and the pace of childbearing are the most important reproductive patterns affecting child mortality risks, and their strong, consistent effects tend to persist even after the introduction of various socioeconomic variables as controls: short preceding birth intervals and short durations of breastfeeding increase the risk of death during the first two years of life.

  9. Temporal trends (1977-2007 and ethnic inequity in child mortality in rural villages of southern Guinea Bissau

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    Boone Peter

    2011-09-01

    Full Text Available Abstract Background Guinea Bissau is one of the poorest countries in the world, with one of the highest under-5 mortality rate. Despite its importance for policy planning, data on child mortality are often not available or of poor quality in low-income countries like Guinea Bissau. Our aim in this study was to use the baseline survey to estimate child mortality in rural villages in southern Guinea Bissau for a 30 years period prior to a planned cluster randomised intervention. We aimed to investigate temporal trends with emphasis on historical events and the effect of ethnicity, polygyny and distance to the health centre on child mortality. Methods A baseline survey was conducted prior to a planned cluster randomised intervention to estimate child mortality in 241 rural villages in southern Guinea Bissau between 1977 and 2007. Crude child mortality rates were estimated by Kaplan-Meier method from birth history of 7854 women. Cox regression models were used to investigate the effects of birth periods with emphasis on historical events, ethnicity, polygyny and distance to the health centre on child mortality. Results High levels of child mortality were found at all ages under five with a significant reduction in child mortality over the time periods of birth except for 1997-2001. That period comprises the 1998/99 civil war interval, when child mortality was 1.5% higher than in the previous period. Children of Balanta ethnic group had higher hazard of dying under five years of age than children from other groups until 2001. Between 2002 and 2007, Fula children showed the highest mortality. Increasing walking distance to the nearest health centre increased the hazard, though not substantially, and polygyny had a negligible and statistically not significant effect on the hazard. Conclusion Child mortality is strongly associated with ethnicity and it should be considered in health policy planning. Child mortality, though considerably decreased during

  10. Iowa Child Care Quality Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

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    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Iowa's Child Care Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile is divided into the following categories: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family Child Care Programs;…

  11. Spacing, crowding, and child mortality in Guinea-Bissau.

    Science.gov (United States)

    Aaby, P; Bukh, J; Lisse, I M; Smits, A J

    1983-07-16

    Evidence from a comparative survey of the Balantas in the Tombali region and the Mandingas and Fulas in the Oio region of Guinea-Bissau suggests that overcrowding is a risk factor for child health because the severity of infections increases when 2 or more children are sick simultaneously. Rural Mandingas and Fulas breastfeed for 30 months on average, while rural Balantas do so for 38 months. All groups abstain from sexual intercourse during lactation, resulting in fewer children among Balantas. Polygamy increases crowding in all groups, but adult Balanta men have separate households while Mandinga brothers often live together in the same household. On average, there were .93 children under 5 in Balanta households but 1.91 in Mandinga households. Each wife ideally has her own room among Balanta households, but Mandinga wives live together, with up to 10 women in the same circular hut. Balanta children leave their mothers' bed when the mother gives birth to another child, while Mandinga and Fula mothers may have several children in bed at the same time. Among Balantas an average of .17 persons slept in bed with a mother and child, while among the Mandingas .66 and among the Fulas .69 did so. The weight-for-age as a percentage of the World Health Organization standard for Balantas and Mandingas-Fulas respectively was 106% and 105% at 0-2 months; 104% and 92% at 3-5 months; 90% and 82% at 6-17 months; 86% and 77% at 18-35 months breastfed; and 89% and 81% at 18-35 months weaned. During 1980-81, when no major epidemics occurred, Balanta children under 6 months had a higher survival rate for the following year than did Mandinga and Fula children, with the mortality difference occuring while all children were still breastfed. 8% of Balanta children, 16% of Mandinga children, and 24% of Fula children died within 1 year of examination. Nutritional status did not determine risk of death, but variation in the severity of infection caused by overcrowding may have done so

  12. Health insurance and child mortality in rural Burkina Faso

    Directory of Open Access Journals (Sweden)

    Anja Schoeps

    2015-04-01

    Full Text Available Background: Micro health insurance schemes have been implemented across developing countries as a means of facilitating access to modern medical care, with the ultimate aim of improving health. This effect, however, has not been explored sufficiently. Objective: We investigated the effect of enrolment into community-based health insurance on mortality in children under 5 years of age in a health and demographic surveillance system in Nouna, Burkina Faso. Design: We analysed the effect of health insurance enrolment on child mortality with a Cox regression model. We adjusted for variables that we found to be related to the enrolment in health insurance in a preceding analysis. Results: Based on the analysis of 33,500 children, the risk of mortality was 46% lower in children enrolled in health insurance as compared to the non-enrolled children (HR=0.54, 95% CI 0.43–0.68 after adjustment for possible confounders. We identified socioeconomic status, father's education, distance to the health facility, year of birth, and insurance status of the mother at time of birth as the major determinants of health insurance enrolment. Conclusions: The strong effect of health insurance enrolment on child mortality may be explained by increased utilisation of health services by enrolled children; however, other non-observed factors cannot be excluded. Because malaria is a main cause of death in the study area, early consultation of health services in case of infection could prevent many deaths. Concerning the magnitude of the effect, implementation of health insurance could be a major driving factor of reduction in child mortality in the developing world.

  13. Mortality rate in type 2 myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt

    2014-01-01

    , all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality......BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients. METHODS: During a 1-year period...... as the end point. RESULTS: A total of 3762 consecutive patients were studied, of whom 488 (13%) had a myocardial infarction. In 119 patients a type 2 myocardial infarction was diagnosed. After a median of 2.1 years (interquartile range, 1.6-2.5 years), 150 patients had died, with a mortality rate of 49% (58...

  14. The Impact of Anemia on Child Mortality: An Updated Review

    Directory of Open Access Journals (Sweden)

    Samuel P. Scott

    2014-12-01

    Full Text Available Iron deficiency anemia and child mortality are public health problems requiring urgent attention. However, the degree to which iron deficiency anemia contributes to child mortality is unknown. Here, we utilized an exhaustive article search and screening process to identify articles containing both anemia and mortality data for children aged 28 days to 12 years. We then estimated the reduction in risk of mortality associated with a 1-g/dL increase in hemoglobin (Hb. Our meta-analysis of nearly 12,000 children from six African countries revealed a combined odds ratio of 0.76 (0.62–0.93, indicating that for each 1-g/dL increase in Hb, the risk of death falls by 24%. The feasibility of a 1-g/dL increase in Hb has been demonstrated via simple iron supplementation strategies. Our finding suggests that ~1.8 million deaths in children aged 28 days to five years could be avoided each year by increasing Hb in these children by 1 g/dL.

  15. Inpatient child mortality by travel time to hospital in a rural area of Tanzania

    OpenAIRE

    Manongi, R; Mtei, F; Mtove, G; Nadjm, B; Muro, F; Alegana, V; Noor, AM; J. Todd; Reyburn, H.

    2014-01-01

    ObjectiveTo investigate the association, if any, between child mortality and distance to the nearest hospital. MethodsThe study was based on data from a 1-year study of the cause of illness in febrile paediatric admissions to a district hospital in north-east Tanzania. All villages in the catchment population were geolocated, and travel times were estimated from availability of local transport. Using bands of travel time to hospital, we compared admission rates, inpatient case fatality rates ...

  16. Urban poverty and infant mortality rate disparities.

    Science.gov (United States)

    Sims, Mario; Sims, Tammy L; Bruce, Marino A

    2007-04-01

    This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.

  17. Child mortality in the Netherlands in the past decades: An overview of external causes and the role of public health policy

    NARCIS (Netherlands)

    Gijzen, S.; Boere-Boonekamp, M.M.; Hoir, M.P. L; Need, A.

    2014-01-01

    Among European countries, the Netherlands has the second lowest child mortality rate from external causes. We present an overview, discuss possible explanations, and suggest prevention measures. We analyzed mortality data from all deceased children aged 0-19 years for the period 1969-2011. Child mor

  18. Child mortality in the Netherlands in the past decades: an overview of external causes and the role of public health policy

    NARCIS (Netherlands)

    Gijzen, Sandra; Boere-Boonekamp, Magda M.; L'Hoir, Monique P.; Need, Ariana

    2014-01-01

    Among European countries, the Netherlands has the second lowest child mortality rate from external causes. We present an overview, discuss possible explanations, and suggest prevention measures. We analyzed mortality data from all deceased children aged 0–19 years for the period 1969–2011. Child mor

  19. Sex differences in child and adolescent mortality in the Nordic countries, 1981--2000

    DEFF Research Database (Denmark)

    Gissler, Mika; Rahkonen, Ossi; Mortensen, Laust;

    2009-01-01

    Unlike the situation for infant and adult mortality, there are only a few studies on child and adolescent mortality. The purpose of this study was to examine sex differences in child and adolescent mortality by age and cohort in four Nordic countries over a 20-year period....

  20. Mortality hazard rates and life expectancy

    NARCIS (Netherlands)

    J.S. Cramer; R. Kaas

    2013-01-01

    We consider the relation between mortality hazards and life expectancy for men and women in the Netherlands and in England. Halving the lifetime mortality hazards increases life expectancy at birth by only 9%.

  1. Correlations between Google search data and Mortality Rates

    OpenAIRE

    Risk, James

    2012-01-01

    Inspired by correlations recently discovered between Google search data and financial markets, we show correlations between Google search data mortality rates. Words with negative connotations may provide for increased mortality rates, while words with positive connotations may provide for decreased mortality rates, and so statistical methods were employed to determine to investigate further.

  2. QT-Interval Duration and Mortality Rate

    Science.gov (United States)

    Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo

    2012-01-01

    Background Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval–corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to <410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds) with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population. PMID:22025428

  3. Equity and geography: the case of child mortality in Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Anna E Bauze

    Full Text Available BACKGROUND: Recent assessments show continued decline in child mortality in Papua New Guinea (PNG, yet complete subnational analyses remain rare. This study aims to estimate under-five mortality in PNG at national and subnational levels to examine the importance of geographical inequities in health outcomes and track progress towards Millennium Development Goal (MDG 4. METHODOLOGY: We performed retrospective data validation of the Demographic and Health Survey (DHS 2006 using 2000 Census data, then applied advanced indirect methods to estimate under-five mortality rates between 1976 and 2000. FINDINGS: The DHS 2006 was found to be unreliable. Hence we used the 2000 Census to estimate under-five mortality rates at national and subnational levels. During the period under study, PNG experienced a slow reduction in national under-five mortality from approximately 103 to 78 deaths per 1,000 live births. Subnational analyses revealed significant disparities between rural and urban populations as well as inter- and intra-regional variations. Some of the provinces that performed the best (worst in terms of under-five mortality included the districts that performed worst (best, with district-level under-five mortality rates correlating strongly with poverty levels and access to services. CONCLUSIONS: The evidence from PNG demonstrates substantial within-province heterogeneity, suggesting that under-five mortality needs to be addressed at subnational levels. This is especially relevant in countries, like PNG, where responsibility for health services is devolved to provinces and districts. This study presents the first comprehensive estimates of under-five mortality at the district level for PNG. The results demonstrate that for countries that rely on few data sources even greater importance must be given to the quality of future population surveys and to the exploration of alternative options of birth and death surveillance.

  4. Maternal bereavement: the heightened mortality of mothers after the death of a child.

    Science.gov (United States)

    Espinosa, Javier; Evans, William N

    2013-07-01

    Using a 9-year follow-up of 69,224 mothers aged 20-50 from the National Longitudinal Mortality Survey, we investigate whether there is heightened mortality of mothers after the death of a child. Results from Cox proportional hazard models indicate that the death of a child produces a statistically significant hazard ratio of 2.3. There is suggestive evidence that the heightened mortality is concentrated in the first two years after the death of a child. We find no difference in results based on mother's education or marital status, family size, the child's cause of death or the gender of the child.

  5. Calculating the Rate of Senescence From Mortality Data

    DEFF Research Database (Denmark)

    Koopman, Jacob J E; Rozing, Maarten P; Kramer, Anneke;

    2016-01-01

    The rate of senescence can be inferred from the acceleration by which mortality rates increase over age. Such a senescence rate is generally estimated from parameters of a mathematical model fitted to these mortality rates. However, such models have limitations and underlying assumptions. Notably...

  6. Determinants of infant and child mortality in Zimbabwe: Results of multivariate hazard analysis

    Directory of Open Access Journals (Sweden)

    Joshua Kembo

    2009-10-01

    Full Text Available This study addresses important issues in infant and child mortality in Zimbabwe. The objective of the paper is to determine the impact of maternal, socioeconomic and sanitation variables on infant and child mortality. Results show that births of order 6+ with a short preceding interval had the highest risk of infant mortality. The infant mortality risk associated with multiple births was 2.08 times higher relative to singleton births (p<0.001. Socioeconomic variables did not have a distinct impact on infant mortality. Determinants of child mortality were different in relative importance from those of infant mortality. This study supports health policy initiatives to stimulate use of family planning methods to increase birth spacing. These and other results are expected to assist policy makers and programme managers in the child health sector to formulate appropriate strategies to improve the situation of children under 5 in Zimbabwe.

  7. PRESSING MORTALITY RATE THROUGH SCREENING oral cancer

    Directory of Open Access Journals (Sweden)

    L. K. Widnyani Wulan Laksmi

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Based on World Health Organization (WHO data, oral cancer is one of malignancy with the highest mortality. In USA, there are more than 30.000 new cases every year. We can find many risk factors of oral cancer in our daily living. Moreover, it’s easy to find the main risk factors in our society, they are smoking, alcohol consumption, tobacco consumtion, viral infection, and bad oral hygiene. For the early stadium, Five-years survival rate is about 82% and 61% for all stadium. But, more than 50% of oral cancer has been distributed (metastatic regionally and also into the other organ far away from the oral itself when it’s detected. It will decrease 5-years survival rate to be less than 50%. So that, it’s really important to detect the oral cancer at the earlier stadium. Screening is the way to find the earlier stadium. Screening is done by some methods, start from the anamnesis, physical examination, toluidine blue staining, endoscopy, cytology, telomerase examination, and also PET-scan if it’s possible (because of the financial reasons. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  8. Putting child mortality on a map: towards an understanding of inequity in health

    DEFF Research Database (Denmark)

    Tottrup, C; Tersbøl, Britt Pinkowski; Lindeboom, W;

    2009-01-01

    OBJECTIVES: To map and analyse geographical (spatial) variations of child mortality trends in mainland Tanzania. METHODS: We used a geographic information system to integrate data on child mortality and associated risk factors. We then applied spatial statistics to quantify the spatial component ...

  9. Mortality of marine planktonic copepods : global rates and patterns

    DEFF Research Database (Denmark)

    Hirst, A.G.; Kiørboe, Thomas

    2002-01-01

    in broadcast spawners, while mortality in sac spawners is invariant with body size. Although the magnitude of copepod mortality does lie close to the overall general pattern for pelagic animals, copepod mortality scaling is much weaker, implying that small copepods are avoiding some mortality agent....../s that other pelagic animals of a similar size do not, We compile direct in situ estimates of copepod mortality and compare these with our indirect predictions; we find the predictions generally match the field measurements well with respect to average rates and patterns. Finally, by comparing in situ adult...

  10. Infant mortality in India: use of maternal and child health services in relation to literacy status.

    Science.gov (United States)

    Gokhale, Medha K; Rao, Shobha S; Garole, Varsha R

    2002-06-01

    Slow reduction in infant mortality rate in the last couple of decades is a major concern in India. State-level aggregate data from the National Family Health Survey 1992 and micro-level data on rural mothers (n=317) were used for examining the influence of female literacy on reduction of infant mortality through increased use of maternal and child health (MCH) services. Illiteracy of females was strongly associated with all variables relating to maternal care and also with infant mortality rate. States were grouped into best, medium, and worst on the basis of female illiteracy (about 11%, 48.5%, and 75% respectively). Infant mortality rate (per 1,000 livebirths) was significantly (phigher among the worst group (90.99) than that among the medium (64.2) and the best (24.0) groups. Use of maternal health services increased in the worst to become the best groups for tetanus toxoid (from 48.0% to 84.4%), iron and folic acid tablets (36.6% to 76.2%), hospitalized deliveries (14.2% to 69.7%), and childcare services, such as vaccination (23.8% to 64.9%). Illiteracy of females had a more detrimental impact on rural than on urban areas. In the event of high female illiteracy, male literacy was beneficial for improving the use of services for reducing infant mortality rate. The micro-level study supported all major findings obtained for the national-level aggregate data. Programmes, like providing free education to girls, will yield long-term health benefits.

  11. Child mortality estimation: methods used to adjust for bias due to AIDS in estimating trends in under-five mortality.

    Science.gov (United States)

    Walker, Neff; Hill, Kenneth; Zhao, Fengmin

    2012-01-01

    In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.

  12. Child mortality estimation: methods used to adjust for bias due to AIDS in estimating trends in under-five mortality.

    Directory of Open Access Journals (Sweden)

    Neff Walker

    Full Text Available In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions gives results qualitatively similar to those of other studies.

  13. Motor neuron disease mortality in Great Britain continues to rise: examination of mortality rates 1975 - 2004.

    Science.gov (United States)

    Day, Thomas G; Scott, Martin; Perring, Roslyn; Doyle, Pat

    2007-12-01

    Motor neuron disease (MND) mortality rates are rising in Europe and the USA. The most comprehensive UK study was conducted more than 15 years ago. This study examines trends in mortality from MND in England & Wales, and Scotland, between 1975 and 2004. Age, gender, and cause-specific mortality rates were calculated for the period 1975-2004 using national data from England & Wales, and Scotland. Rates were directly age-standardized to the European standard population. Trends in mortality rates over time were examined for men and women separately, as well as by the age groups 0-59 years, and 60 or more years. MND mortality rates rose steadily over the 30-year period 1975-2004 in both sexes in England & Wales, and Scotland. There is a clear upward trend in all four groups (p for trend <0.001). All increases were largely restricted to the age group 60 years and above, with rates showing increases of 70-80%, and no evidence of a flattening of this trajectory. Rates for the 0-59 years age group remained stable over the period. There is evidence of a narrowing of the male-female gap in mortality rates for the age group over 60 years in England and Wales.

  14. Maternal reading skills and child mortality in Nigeria: a reassessment of why education matters.

    Science.gov (United States)

    Smith-Greenaway, Emily

    2013-10-01

    Mother's formal schooling-even at the primary level-is associated with lower risk of child mortality, although the reasons why remain unclear. This study examines whether mother's reading skills help to explain the association in Nigeria. Using data from the Demographic and Health Survey, the analysis demonstrates that women's reading skills increase linearly with years of primary school; however, many women with several years of formal school are unable to read at all. The results further show that mother's reading skills help to explain the relationship between mother's formal schooling and child mortality, and that mother's reading skills are highly associated with child mortality. The study highlights the need for more data on literacy and for more research on whether and how mother's reading skills lower child mortality in other contexts.

  15. Effects of Parental Union Dissolution on Child Mortality and Child Schooling in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Jean-François Kobiané

    2013-10-01

    Full Text Available Background: Family structure and union dissolution has been one of the most thoroughly studied determinants of children's wellbeing worldwide. To date, however, few of these studies have examined sub-Saharan Africa, especially countries in West Africa where marital breakdowns are not uncommon. Objective: We attempt to examine the effects of a mother's divorce and widowhood on children's risk of mortality under age 5 and on their probability of entering primary school. Methods: Survival data analysis methods, specifically Kaplan-Meier and piecewise exponential models, are used for analysis, based on data come from the 2000 Migration and Urban Integration Survey of Burkina Faso. Results: Compared to those of intact families, children of divorced parents experience higher estimated mortality risks under age 5 and a lower probability of entering school, even after controlling for various other factors. This effect is large and significant during the first two years after the divorce. The death of the father is also found to greatly reduce a child's likelihood of entering school, but its effect on mortality is not significant. Conclusions: The results indicate that the family context plays an important role in determining two important aspects of children's welfare: their probabilities of dying before age 5 and of entering school. Comments: Children of divorced parents or a deceased father are living in precarious situations and their specific needs should be taken into account in policies in order to improve the wellbeing of all children. Attention must be directed to the first two years following the union dissolution.

  16. Trends and patterns of modern contraceptive use and relationships with high-risk births and child mortality in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Abdoulaye Maïga

    2015-11-01

    Full Text Available Background: In sub-Saharan Africa, few studies have stressed the importance of spatial heterogeneity analysis in modern contraceptive use and the relationships with high-risk births. Objective: This paper aims to analyse the association between modern contraceptive use, distribution of birth risk, and under-five child mortality at both national and regional levels in Burkina Faso. Design: The last three Demographic and Health Surveys – conducted in Burkina Faso in 1998, 2003, and 2010 – enabled descriptions of differentials, trends, and associations between modern contraceptive use, total fertility rates (TFR, and factors associated with high-risk births and under-five child mortality. Multivariate models, adjusted by covariates of cultural and socio-economic background and contact with health system, were used to investigate the relationship between birth risk factors and modern contraceptive prevalence rates (mCPR. Results: Overall, Burkina Faso's modern contraception level remains low (15.4% in 2010, despite significant increases during the last decade. However, there are substantial variations in mCPR by region, and health facility contact was positively associated with mCPR increase. Women's fertility history and cultural and socio-economic background were also significant factors in predicting use of modern contraception. Low modern contraceptive use is associated with higher birth risks and increased child mortality. This association is stronger in the Sahel, Est, and Sud-Ouest regions. Even though all factors in high-risk births were associated with under-five mortality, it should be stressed that short birth spacing ranked as the highest risk in relation to mortality of children. Conclusions: Programmes that target sub-national differentials and leverage women's health system contacts to inform women about family planning opportunities may be effective in improving coverage, quality, and equity of modern contraceptive use. Improving

  17. Prediction of mortality rates using a model with stochastic parameters

    Science.gov (United States)

    Tan, Chon Sern; Pooi, Ah Hin

    2016-10-01

    Prediction of future mortality rates is crucial to insurance companies because they face longevity risks while providing retirement benefits to a population whose life expectancy is increasing. In the past literature, a time series model based on multivariate power-normal distribution has been applied on mortality data from the United States for the years 1933 till 2000 to forecast the future mortality rates for the years 2001 till 2010. In this paper, a more dynamic approach based on the multivariate time series will be proposed where the model uses stochastic parameters that vary with time. The resulting prediction intervals obtained using the model with stochastic parameters perform better because apart from having good ability in covering the observed future mortality rates, they also tend to have distinctly shorter interval lengths.

  18. Immunization coverage and infant mortality rate in developing countries.

    Science.gov (United States)

    Shimouchi, A; Ozasa, K; Hayashi, K

    1994-01-01

    We examined whether immunization coverage (IMC) is one of the predictors of infant mortality rate (IMR), as a single indicator representing the availability of primary health care (PHC) services in developing countries. Multiple regression analysis showed that partial correlation coefficients for IMR with immunization coverage (-0.224), logarithm of per capita GNP (-0.294), total fertility rate (0.269), and adult literacy rate (-0.325) were all statistically significant (p immunization coverage is one of the main predictors of the infant mortality rate. It represents one of the health intervention components which can be used as a proxy indicator of the availability of PHC service in developing countries.

  19. Abolishing inequity, a necessity for poverty reduction and the realisation of child mortality targets.

    Science.gov (United States)

    Målqvist, Mats

    2015-02-01

    The first Millennium Development Goal (MDG 1) due in 2015 concerns poverty reduction. It has been claimed to be fulfilled on a global level, but still more than 1 billion people are living in abject poverty. There is a strong link between the economy and child survival, and only a minority of countries will have reached the MDG target for child mortality reduction by 2015. This paper discusses the relationship between poverty and child survival. It argues that a focus on equity is necessary to further reduce child mortality, through poverty reduction in absolute terms and also through targeting interventions for increased child survival to disadvantaged populations. The political will to actually achieve real change for those in greatest need is crucial but not to be taken for granted, and the distribution rather than the generation of wealth needs to be made a priority in the post-MDG era.

  20. Assessing the Impact of U.S. Food Assistance Delivery Policies on Child Mortality in Northern Kenya

    Science.gov (United States)

    Nikulkov, Alex; Barrett, Christopher B.; Mude, Andrew G.; Wein, Lawrence M.

    2016-01-01

    The U.S. is the main country in the world that delivers its food assistance primarily via transoceanic shipments of commodity-based in-kind food. This approach is costlier and less timely than cash-based assistance, which includes cash transfers, food vouchers, and local and regional procurement, where food is bought in or nearby the recipient country. The U.S.’s approach is exacerbated by a requirement that half of its transoceanic food shipments need to be sent on U.S.-flag vessels. We estimate the effect of these U.S. food assistance distribution policies on child mortality in northern Kenya by formulating and optimizing a supply chain model. In our model, monthly orders of transoceanic shipments and cash-based interventions are chosen to minimize child mortality subject to an annual budget constraint and to policy constraints on the allowable proportions of cash-based interventions and non-US-flag shipments. By varying the restrictiveness of these policy constraints, we assess the impact of possible changes in U.S. food aid policies on child mortality. The model includes an existing regression model that uses household survey data and geospatial data to forecast the mean mid-upper-arm circumference Z scores among children in a community, and allows food assistance to increase Z scores, and Z scores to influence mortality rates. We find that cash-based interventions are a much more powerful policy lever than the U.S.-flag vessel requirement: switching to cash-based interventions reduces child mortality from 4.4% to 3.7% (a 16.2% relative reduction) in our model, whereas eliminating the U.S.-flag vessel restriction without increasing the use of cash-based interventions generates a relative reduction in child mortality of only 1.1%. The great majority of the gains achieved by cash-based interventions are due to their reduced cost, not their reduced delivery lead times; i.e., the reduction of shipping expenses allows for more food to be delivered, which reduces

  1. Increased cardiovascular disease mortality rates in traumatic lower limb amputees.

    Science.gov (United States)

    Modan, M; Peles, E; Halkin, H; Nitzan, H; Azaria, M; Gitel, S; Dolfin, D; Modan, B

    1998-11-15

    We evaluated the 24-year mortality rates of male traumatic lower limb amputees (n = 201) of the Israeli army, wounded between 1948 and 1974 compared with a cohort sample representing the general population (n = 1,832). Mortality rates were significantly higher (21.9% vs 12.1%, p amputees than in controls. Cardiovascular disease (CVD) mortality was the main cause for this difference. The prevalence of selected risk factors for CVD was determined in 101 surviving amputees (aged 50 to 65 years) and a sample of the controls (n = 96) matched by age and ethnic origin. Amputees had higher plasma insulin levels (during fasting and in response to oral glucose loading) and increased blood coagulation activity. No differences were found in rates of current symptoms of ischemic heart disease or of cerebrovascular disease, obesity, hypertension, altered plasma lipoprotein profile, impaired physical activity, smoking, or nutritional habits. Traumatic lower limb amputees had increased mortality rates due to CVD. Surviving amputees had hyperinsulinemia, increased coagulability, and increased sympathetic and parasympathetic responses (described previously). These established CVD risk factors may explain the excess mortality due to CVD in traumatic amputees.

  2. Child mortality estimation 2013: an overview of updates in estimation methods by the United Nations Inter-agency Group for Child Mortality Estimation.

    Directory of Open Access Journals (Sweden)

    Leontine Alkema

    Full Text Available BACKGROUND: In September 2013, the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME published an update of the estimates of the under-five mortality rate (U5MR and under-five deaths for all countries. Compared to the UN IGME estimates published in 2012, updated data inputs and a new method for estimating the U5MR were used. METHODS: We summarize the new U5MR estimation method, which is a Bayesian B-spline Bias-reduction model, and highlight differences with the previously used method. Differences in UN IGME U5MR estimates as published in 2012 and those published in 2013 are presented and decomposed into differences due to the updated database and differences due to the new estimation method to explain and motivate changes in estimates. FINDINGS: Compared to the previously used method, the new UN IGME estimation method is based on a different trend fitting method that can track (recent changes in U5MR more closely. The new method provides U5MR estimates that account for data quality issues. Resulting differences in U5MR point estimates between the UN IGME 2012 and 2013 publications are small for the majority of countries but greater than 10 deaths per 1,000 live births for 33 countries in 2011 and 19 countries in 1990. These differences can be explained by the updated database used, the curve fitting method as well as accounting for data quality issues. Changes in the number of deaths were less than 10% on the global level and for the majority of MDG regions. CONCLUSIONS: The 2013 UN IGME estimates provide the most recent assessment of levels and trends in U5MR based on all available data and an improved estimation method that allows for closer-to-real-time monitoring of changes in the U5MR and takes account of data quality issues.

  3. Child Mortality Estimation 2013: An Overview of Updates in Estimation Methods by the United Nations Inter-Agency Group for Child Mortality Estimation

    Science.gov (United States)

    Alkema, Leontine; New, Jin Rou; Pedersen, Jon; You, Danzhen

    2014-01-01

    Background In September 2013, the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) published an update of the estimates of the under-five mortality rate (U5MR) and under-five deaths for all countries. Compared to the UN IGME estimates published in 2012, updated data inputs and a new method for estimating the U5MR were used. Methods We summarize the new U5MR estimation method, which is a Bayesian B-spline Bias-reduction model, and highlight differences with the previously used method. Differences in UN IGME U5MR estimates as published in 2012 and those published in 2013 are presented and decomposed into differences due to the updated database and differences due to the new estimation method to explain and motivate changes in estimates. Findings Compared to the previously used method, the new UN IGME estimation method is based on a different trend fitting method that can track (recent) changes in U5MR more closely. The new method provides U5MR estimates that account for data quality issues. Resulting differences in U5MR point estimates between the UN IGME 2012 and 2013 publications are small for the majority of countries but greater than 10 deaths per 1,000 live births for 33 countries in 2011 and 19 countries in 1990. These differences can be explained by the updated database used, the curve fitting method as well as accounting for data quality issues. Changes in the number of deaths were less than 10% on the global level and for the majority of MDG regions. Conclusions The 2013 UN IGME estimates provide the most recent assessment of levels and trends in U5MR based on all available data and an improved estimation method that allows for closer-to-real-time monitoring of changes in the U5MR and takes account of data quality issues. PMID:25013954

  4. Hypothermia and normothermia effects on mortality rate of cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Ali Rahdari

    2015-12-01

    Full Text Available Introduction: Cardiopulmonary bypass is associated with higher risk of mortality and morbidity, thus it should be investigated regarding the major risk factors. Temperature management have a significant role in postoperative cerebral and neurological complications; however the optimum temperature during cardiopulmonary surgery is not certainly detected. This systematic review has investigated the differences between hypothermia and normothermia regarding postoperative mortality. Method: PubMed was searched for the relevant articles. Only English language articles were included with no time limitation. Data regarding in-hospital patient deaths provided in each article mostly within 30 days after the surgery, were extracted and compared based on relative risk reduction (RRR, absolute risk reduction (ARR, and number needed to treat (NNT.Result: Totally, 28 articles were retrieved and extracted. The mortality rate was zero in hypothermic and normotehrmic groups of 8/28 included studies, thus the RRR, ARR, and NNT could not be calculated. There were no significant differences between investigated groups of each included studies regarding the patients’ age, gender, and preoperative conditions.Conclusions: No significant difference was obtained between two studied groups. Similar prevalence of death observed between hypothermic and normothermic groups might be due to the sample size of studies, or the subsequent cares performed in intensive care units that assist to reduce the postoperative mortality rate. According to the obtained results, both of these procedures might be similarly safe regarding mortality rate.

  5. Inequality in child mortality across different states of India: a comparative study.

    Science.gov (United States)

    De, Partha; Dhar, Arpita

    2013-12-01

    The burden of social inequality falls disproportionately on child health and survival. This inequality raises the question of how wide this gap is, or what its relation is with the level of child mortality. Whether these disparities are increasing or declining with the development and how they differ from region to region or from state to state within the country needs to be looked into. As a measure of inequality and to compare the disparities between different states of India, concentration curves and indices are constructed from infant and under five mortality data classified under different quintiles of wealth index from the National Family Health Survey (NFHS-3) data of India. Inequality measures indicate that inequality in child mortality is more concentrated in the comparatively developed states than the poorer states in India.

  6. Morbidity and mortality rates after emergency abdominal surgery

    DEFF Research Database (Denmark)

    Tolstrup, Mai-Britt; Watt, Sara Kehlet; Gögenur, Ismail

    2016-01-01

    PURPOSE: Emergency abdominal surgery results in a high rate of post-operative complications and death. There are limited data describing the emergency surgical population in details. We aimed to give a detailed analyses of complications and mortality in a consecutive group of patients undergoing ...

  7. Epidemiology of Eating Disorders : Incidence, Prevalence and Mortality Rates

    NARCIS (Netherlands)

    Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    2012-01-01

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms rela

  8. Fiscal decentralisation and infant mortality rate: the Colombian case.

    Science.gov (United States)

    Soto, Victoria Eugenia; Farfan, Maria Isabel; Lorant, Vincent

    2012-05-01

    There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised.

  9. Juvenile marriages, child-brides and infant mortality among Serbian gypsies

    Directory of Open Access Journals (Sweden)

    Čvorović Jelena

    2011-01-01

    Full Text Available Gypsies/Roma make up the largest minority in Europe. Roma communities tend to be segregated and characterized by poverty, unemployment, poor education, and poor quality housing. So far, the European strategy for Gypsy/Roma integration proved insufficient because it fails to account to the normative nature of the isolationist and ethnocentric nature of certain elements of Gypsy culture, as well as the deep and mutual distrust between Gypsies and non-Gypsies within European countries. In Serbia, the Gypsy population tends to suffer disproportionately from higher rates of poverty, unemployment, illiteracy, and disease. At the same time, the Serbian Gypsy women average an infant mortality rate between 10-20%. For most of these girls/women, endogamous, arranged marriages are negotiated at an early age, usually without their consent. Among these women, a certain level of infant mortality is “expected”, following an underinvestment in some children manifested in their care, feeding, and the response to their illnesses. These juvenile arranged marriages, subsequent reproduction and child mortality are culturally self-sufficient and hence pose a challenge for international human rights: while many Gypsy girls/women are being denied the right to choose whom and when to marry, the Gypsy community itself openly accepts juvenile arranged marriage as a preservation strategy and means of cultural, economic, and societal maintenance and independence. Although efforts to improve education, health, living conditions, encourage employment and development opportunities for Gypsies/Roma are essential, these objectives cannot be attained without directing the changes needed within Gypsy/Roma culture itself. The initial point for change must come from an increased sense of responsibility among the Gypsies themselves.

  10. Inequalities in child mortality in Mozambique: differentials by parental socio-economic position

    DEFF Research Database (Denmark)

    Macassa, Gloria; Ghilagaber, Gebrenegus; Bernhardt, Eva

    2003-01-01

    and natural disasters) and the implementation of the Economic Structural Adjustment Programme that have also affected the health of women and their children during the years covered by this study. Other measures of socio-economic position applicable to the rural African setting should be investigated....... statistical association with postneonatal and child mortality. However, maternal education as a measure of socio-economic position was not statistically significantly associated with child mortality. This finding may partly be explained by the extreme hardships experienced by the country (civil war...

  11. Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau

    DEFF Research Database (Denmark)

    Mølbak, K; Aaby, P; Ingholt, L;

    1992-01-01

    An investigation of child mortality in a semi-urban community, Bandim II, in the capital of Guinea Bissau was carried out from April 1987 to March 1990. 153 deaths were recorded among 1426 live-born children who were followed for 2753 child-years. The under-five mortality risk was 215 per 1000...... children (95% confidence interval [CI] 176-264), infant mortality 94 per 1000 (95% CI 73-115), and perinatal mortality 52 per 1000 (95% CI 41-63). By prospective registration of morbidity, post-mortem interviews, and examination of available hospital records, a presumptive cause of death was established...... in 86% of the deaths. Persistent and acute diarrhoea were the most frequent causes of death, accounting for 43 and 31 deaths per 1000 children, respectively. Fever deaths (possibly malaria), neonatal deaths, acute respiratory infections, and measles were other frequent causes. The access to health...

  12. Consequences of intimate partner violence against women on under-five child mortality in Bangladesh.

    Science.gov (United States)

    Hossain, Md Akhtar; Sumi, Nahid Sultana; Haque, M Ershadul; Bari, Wasimul

    2014-05-01

    It is well established that intimate partner violence (IPV) against women adversely affects maternal morbidity and mortality. But a limited number of studies were found in the literature regarding the association between IPV and under-five child mortality. In this article, using Bangladesh Demographic and Health Survey (BDHS) 2007 data, we examined the effect of IPV on under-five child mortality. A product-limit approach was used for bivariate survival analysis, and Cox proportional hazard multiple regression models were used to investigate the effect of IPV controlling potential confounders. In bivariate analysis, the variables exposure to IPV, mother's age at birth, mother's education, residence type, division, number of children, wealth index, occupation, access to media, and decision autonomy were found to be potential risk factors for child mortality. Results indicated that women exposed to IPV were more likely to experience under-five child mortality compared with women not exposed. The unadjusted hazard ratio for IPV was 1.21 (95% confidence interval [CI] = [1.09, 1.35]) with p value < .01, whereas it was 1.16 (95% CI = [1.04, 1.29]) with p value < .01 and 1.13 (95% CI = [1.01, 1.26]) with p value < .05 in two adjusted models. These results implied that IPV against women is a problem not only for women but also for their children's survival.

  13. Infant and child mortality in India in the last two decades: a geospatial analysis.

    Directory of Open Access Journals (Sweden)

    Abhishek Singh

    Full Text Available BACKGROUND: Studies examining the intricate interplay between poverty, female literacy, child malnutrition, and child mortality are rare in demographic literature. Given the recent focus on Millennium Development Goals 4 (child survival and 5 (maternal health, we explored whether the geographic regions that were underprivileged in terms of wealth, female literacy, child nutrition, or safe delivery were also grappling with the elevated risk of child mortality; whether there were any spatial outliers; whether these relationships have undergone any significant change over historical time periods. METHODOLOGY: The present paper attempted to investigate these critical questions using data from household surveys like NFHS 1992-1993, NFHS 1998-1999 and DLHS 2002-2004. For the first time, we employed geo-spatial techniques like Moran's-I, univariate LISA, bivariate LISA, spatial error regression, and spatiotemporal regression to address the research problem. For carrying out the geospatial analysis, we classified India into 76 natural regions based on the agro-climatic scheme proposed by Bhat and Zavier (1999 following the Census of India Study and all estimates were generated for each of the geographic regions. RESULT/CONCLUSIONS: This study brings out the stark intra-state and inter-regional disparities in infant and under-five mortality in India over the past two decades. It further reveals, for the first time, that geographic regions that were underprivileged in child nutrition or wealth or female literacy were also likely to be disadvantaged in terms of infant and child survival irrespective of the state to which they belong. While the role of economic status in explaining child malnutrition and child survival has weakened, the effect of mother's education has actually become stronger over time.

  14. Maternal ratings of child health and child obesity, variations by mother's race/ethnicity and nativity.

    Science.gov (United States)

    Baker, Elizabeth H; Altman, Claire E

    2015-05-01

    We examined whether indicators of child health, focusing on obesity, are associated with maternal ratings of child health (MRCH) and its variation by mother's ethnicity/nativity, focusing on Hispanics. The early childhood longitudinal study, kindergarten cohort kindergarten-eighth grade waves (n = 48,814) and nested general linear mixed modeling are used to examine excellent MRCH. The only indicator of child health that varies by mother's ethnicity/nativity for MRCH is child obesity. Child obesity did not influence MRCH for foreign-born Hispanic mothers, especially among less acculturated mothers, though significant differences among immigrants by acculturation were not found. However, among native-born white, black, and Hispanic mothers child obesity was associated with a lower likelihood of excellent MRCH even after controls for socioeconomic characteristics, family characteristics, and other indicators of child health are included. MRCH reflect not only child's actual health, but also the mother's perception of what contributes to poor child health. Our findings suggest that less acculturated foreign-born Hispanic mothers are less likely to associate child obesity with poor child health. Cultural orientations that prefer heavier children or are unlikely to associate child obesity with poor child health may contribute to the higher levels of obesity found among their children.

  15. Mortality child and migration in Chiapas, México

    OpenAIRE

    Lópes Gonzáles, Olga Lidia; Salvatierra Izaba, Benito; Nazar Beutelspacher, Austreberta; Sánchez Pérez, Héctor Javier

    2010-01-01

    The aim of this study was to analyze, in causal terms, the relationship between infant mortality and migration in four socio-economic areas of the Soconusco region in Chiapas, Mexico. The analysis of this study was based on the results of a socio-demographic and population-based health survey that took place in Soconusco, Chiapas in 1996-97. Different socioeconomic, cultural and productive areas were contrasted. The analysis of linear and logistic regression was conducted to identify the effe...

  16. Are infant mortality rate declines exponential? The general pattern of 20th century infant mortality rate decline

    Directory of Open Access Journals (Sweden)

    Opuni Marjorie

    2009-08-01

    Full Text Available Abstract Background Time trends in infant mortality for the 20th century show a curvilinear pattern that most demographers have assumed to be approximately exponential. Virtually all cross-country comparisons and time series analyses of infant mortality have studied the logarithm of infant mortality to account for the curvilinear time trend. However, there is no evidence that the log transform is the best fit for infant mortality time trends. Methods We use maximum likelihood methods to determine the best transformation to fit time trends in infant mortality reduction in the 20th century and to assess the importance of the proper transformation in identifying the relationship between infant mortality and gross domestic product (GDP per capita. We apply the Box Cox transform to infant mortality rate (IMR time series from 18 countries to identify the best fitting value of lambda for each country and for the pooled sample. For each country, we test the value of λ against the null that λ = 0 (logarithmic model and against the null that λ = 1 (linear model. We then demonstrate the importance of selecting the proper transformation by comparing regressions of ln(IMR on same year GDP per capita against Box Cox transformed models. Results Based on chi-squared test statistics, infant mortality decline is best described as an exponential decline only for the United States. For the remaining 17 countries we study, IMR decline is neither best modelled as logarithmic nor as a linear process. Imposing a logarithmic transform on IMR can lead to bias in fitting the relationship between IMR and GDP per capita. Conclusion The assumption that IMR declines are exponential is enshrined in the Preston curve and in nearly all cross-country as well as time series analyses of IMR data since Preston's 1975 paper, but this assumption is seldom correct. Statistical analyses of IMR trends should assess the robustness of findings to transformations other than the log

  17. Regional inequalities of child mortality in peninsular Malaysia with special reference to the differentials between Perlis and Kuala Terengganu.

    Science.gov (United States)

    Brehm, U

    1993-05-01

    In Peninsular Malaysia child mortality rates (5q0) vary from 13 to 63 per thousand at district level. The spatial pattern is closely associated with the regional distribution of socio-economic factors. But due to multicollinearity it is difficult to isolate the influence of socio-economic variables from other variables by employing aggregated data. However, individual data collected in a case-control-study that was conducted in Perlis and Kuala Terengganu confirm the important role of socio-economic factors. So it should be possible to achieve a further reduction of child mortality by raising the income and educational level of the under-privileged groups. Apart from that, as the case of Perlis shows, the provision of family planning and preventive medical services may also contribute to lower child mortality independent from socio-economic changes. But, as the comparison with Kuala Terengganu shows, the utilization of family planning and preventive medical services is not only influenced by the accessibility to, but also by the socio-culturally determined acceptability of such services.

  18. Health system determinants of infant, child and maternal mortality: A cross-sectional study of UN member countries

    Directory of Open Access Journals (Sweden)

    Muldoon Katherine A

    2011-10-01

    Full Text Available Abstract Objective Few studies have examined the link between health system strength and important public health outcomes across nations. We examined the association between health system indicators and mortality rates. Methods We used mixed effects linear regression models to investigate the strength of association between outcome and explanatory variables, while accounting for geographic clustering of countries. We modelled infant mortality rate (IMR, child mortality rate (CMR, and maternal mortality rate (MMR using 13 explanatory variables as outlined by the World Health Organization. Results Significant protective health system determinants related to IMR included higher physician density (adjusted rate ratio [aRR] 0.81; 95% Confidence Interval [CI] 0.71-0.91, higher sustainable access to water and sanitation (aRR 0.85; 95% CI 0.78-0.93, and having a less corrupt government (aRR 0.57; 95% CI 0.40-0.80. Out-of-pocket expenditures on health (aRR 1.29; 95% CI 1.03-1.62 were a risk factor. The same four variables were significantly related to CMR after controlling for other variables. Protective determinants of MMR included access to water and sanitation (aRR 0.88; 95% CI 0.82-0.94, having a less corrupt government (aRR 0.49; 95%; CI 0.36-0.66, and higher total expenditures on health per capita (aRR 0.84; 95% CI 0.77-0.92. Higher fertility rates (aRR 2.85; 95% CI: 2.02-4.00 were found to be a significant risk factor for MMR. Conclusion Several key measures of a health system predict mortality in infants, children, and maternal mortality rates at the national level. Improving access to water and sanitation and reducing corruption within the health sector should become priorities.

  19. Child Mortality as Predicted by Nutritional Status and Recent Weight Velocity in Children under Two in Rural Africa.

    LENUS (Irish Health Repository)

    2012-01-31

    WHO has released prescriptive child growth standards for, among others, BMI-for-age (BMI-FA), mid-upper arm circumference-for-age, and weight velocity. The ability of these indices to predict child mortality remains understudied, although growth velocity prognostic value underlies current growth monitoring programs. The study aims were first to assess, in children under 2, the independent and combined ability of these indices and of stunting to predict all-cause mortality within 3 mo, and second, the comparative abilities of weight-for-length (WFL) and BMI-FA to predict short-term (<3 mo) mortality. We used anthropometry and survival data from 2402 children aged between 0 and 24 mo in a rural area of the Democratic Republic of Congo with high malnutrition and mortality rates and limited nutritional rehabilitation. Analyses used Cox proportional hazard models and receiver operating characteristic curves. Univariate analysis and age-adjusted analysis showed predictive ability of all indices. Multivariate analysis without age adjustment showed that only very low weight velocity [HR = 3.82 (95%CI = 1.91, 7.63); P < 0.001] was independently predictive. With age adjustment, very low weight velocity [HR = 3.61 (95%CI = 1.80, 7.25); P < 0.001] was again solely retained as an independent predictor. There was no evidence for a difference in predictive ability between WFL and BMI-FA. This paper shows the value of attained BMI-FA, a marker of wasting status, and recent weight velocity, a marker of the wasting process, in predicting child death using the WHO child growth standards. WFL and BMI-FA appear equivalent as predictors.

  20. Child mortality related to seroconversion or lack of seroconversion after measles vaccination

    DEFF Research Database (Denmark)

    Aaby, Peter; Pedersen, I R; Knudsen, K

    1989-01-01

    children) were excluded from the analysis (P less than 0.01). The difference in mortality was particularly marked among children vaccinated in the age group 9 to 11 months. This as well as other community studies suggest that measles vaccination reduces child mortality from the age of vaccination......When blood samples were analyzed for seroconversion after measles vaccination, it was discovered that the vaccine had been ineffective for a certain period. During the 2 years between vaccination and the time of seroanalysis, nonseroconverters had a significantly higher mortality than...

  1. Mortality in parents after death of a child in Denmark: A nationwide follow-up study

    DEFF Research Database (Denmark)

    Li, Jiong; Precht, Dorthe Hansen; Mortensen, Preben Bo

    2003-01-01

    BACKGROUND: Little is known about the effect of parental bereavement on physical health. We investigated whether the death of a child increased mortality in parents. METHODS: We undertook a follow-up study based on national registers. From 1980 to 1996, we enrolled 21062 parents in Denmark who ha...

  2. Water for Life: The Impact of the Privatization of Water Services on Child Mortality.

    Science.gov (United States)

    Galiani, Sebastian; Gertler, Paul; Schargrodsky, Ernesto

    2005-01-01

    While most countries are committed to increasing access to safe water and thereby reducing child mortality, there is little consensus on how to actually improve water services. One important proposal under discussion is whether to privatize water provision. In the 1990s Argentina embarked on one of the largest privatization campaigns in the world,…

  3. [Child victims of house fires in France. Mortality, morbidity, prevention].

    Science.gov (United States)

    Leveque, B; Lareng, L; Julien, H; Lavaud, J; Wassermann, D; Latarjet, J

    1993-10-01

    Children injuries by house fires in France are the cause of a severe mortality (sixty deaths in average each year) and of a morbidity for the survival due to smoke toxicity (oxygen deprivation and inhalation of toxic gases--CO and HCN) and to thermal burns. Epidemiological studies show that young children (0 to 4) are specially concerned by this threat and that the deaths occurred more often in some part of France (Nord-Pas-de-Calais Region). A special strategy for this prevention should be applied in France, the same available in USA, Sweden and UK, including information on the behavior one should have with children: never leave them alone and escape with them as soon as possible out of the smoke. The usefulness of smoke detectors should be confirmed by French administration and recommended to the public, since they have had effective results in other countries.

  4. Population attributable risks of patient, child and organizational risk factors for perinatal mortality in hospital births.

    Science.gov (United States)

    Poeran, Jashvant; Borsboom, Gerard J J M; de Graaf, Johanna P; Birnie, Erwin; Steegers, Eric A P; Bonsel, Gouke J

    2015-04-01

    The main objective of this study was to estimate the contributing role of maternal, child, and organizational risk factors in perinatal mortality by calculating their population attributable risks (PAR). The primary dataset comprised 1,020,749 singleton hospital births from ≥22 weeks' gestation (The Netherlands Perinatal Registry 2000-2008). PARs for single and grouped risk factors were estimated in four stages: (1) creating a duplicate dataset for each PAR analysis in which risk factors of interest were set to the most favorable value (e.g., all women assigned 'Western' for PAR calculation of ethnicity); (2) in the primary dataset an elaborate multilevel logistic regression model was fitted from which (3) the obtained coefficients were used to predict perinatal mortality in each duplicate dataset; (4) PARs were then estimated as the proportional change of predicted- compared to observed perinatal mortality. Additionally, PARs for grouped risk factors were estimated by using sequential values in two orders: after PAR estimation of grouped maternal risk factors, the resulting PARs for grouped child, and grouped organizational factors were estimated, and vice versa. The combined PAR of maternal, child and organizational factors is 94.4 %, i.e., when all factors are set to the most favorable value perinatal mortality is expected to be reduced with 94.4 %. Depending on the order of analysis, the PAR of maternal risk factors varies from 1.4 to 13.1 %, and for child- and organizational factors 58.7-74.0 and 7.3-34.3 %, respectively. In conclusion, the PAR of maternal-, child- and organizational factors combined is 94.4 %. Optimization of organizational factors may achieve a 34.3 % decrease in perinatal mortality.

  5. Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water

    Directory of Open Access Journals (Sweden)

    Madise Nyovani

    2007-08-01

    Full Text Available Abstract Background Improvements in child survival have been very poor in sub-Saharan Africa (SSA. Since the 1990s, declines in child mortality have reversed in many countries in the region, while in others, they have either slowed or stalled, making it improbable that the target of reducing child mortality by two thirds by 2015 will be reached. This paper highlights the implications of urban population growth and access to health and social services on progress in achieving MDG 4. Specifically, it examines trends in childhood mortality in SSA in relation to urban population growth, vaccination coverage and access to safe drinking water. Methods Correlation methods are used to analyze national-level data from the Demographic and Health Surveys and from the United Nations. The analysis is complemented by case studies on intra-urban health differences in Kenya and Zambia. Results Only five of the 22 countries included in the study have recorded declines in urban child mortality that are in line with the MDG target of about 4% per year; five others have recorded an increase; and the 12 remaining countries witnessed only minimal decline. More rapid rate of urban population growth is associated with negative trend in access to safe drinking water and in vaccination coverage, and ultimately to increasing or timid declines in child mortality. There is evidence of intra-urban disparities in child health in some countries like Kenya and Zambia. Conclusion Failing to appropriately target the growing sub-group of the urban poor and improve their living conditions and health status – which is an MDG target itself – may result in lack of improvement on national indicators of health. Sustained expansion of potable water supplies and vaccination coverage among the disadvantaged urban dwellers should be given priority in the efforts to achieve the child mortality MDG in SSA.

  6. Effect of hyperglycemia on mortality rates in critically ill children

    Directory of Open Access Journals (Sweden)

    Seongkuk Kim

    2010-03-01

    Full Text Available Purpose : To verify the effect of hyperglycemia on mortality rates in critically ill children and to identify the blood glucose level that influences prognosis. Methods : From July 2006 to June 2008, a total of 206 patients who were admitted to the pediatric intensive care unit (PICU at Asan Medical Center and who survived for more than 7 days were retrospectively reviewed. We analyzed the maximum glucose value within 7 days in PICU, PRISM-III score and SOFA score within 24 hours, and mortality. We did not perform an adjustment analysis of drugs affecting glucose level. Results : The maximum glucose level within 7 days in PICU was higher in the nonsurvival group than in the survival group. Using 4 cutoff values (125, 150, 175, and 200 mg/dL, the mortality of patients with hyperglycemia was found to be 13.0 %, 14.4%, 19.8%, and 21.1%, respectively, and the cutoff values of 175 and 200 mg/dL revealed significant differences in mortalities between the hyperglycemic and normoglycemic groups. The PRISM-III score was not significantly different between the hyperglycemic and normoglycemic groups under a glucose cutoff value of 175 mg/dL, but the SOFA score was higher in the hyperglycemic group. Under a glucose cutoff value of 200 mg/dL, the PRISM-III score was higher in the hyperglycemic group, and the SOFA score did not differ between the 2 groups. Conclusion : Hyperglycemia with a maximal glucose value ?#241;75 mg/dL during the first 7 days after PICU admission was associated with increased mortality in critically ill children.

  7. High mortality rates after non-elective colon cancer resection

    DEFF Research Database (Denmark)

    Bakker, I S; Snijders, H S; Grossmann, Irene

    2016-01-01

    AIM: Colon cancer resection in a non-elective setting is associated with high rates of morbidity and mortality. The aim of this retrospective study is to identify risk factors for overall mortality after colon cancer resection with a special focus on non-elective resection. METHOD: Data were...... obtained from the Dutch Surgical Colorectal Audit. Patients undergoing colon cancer resection in the Netherlands between January 2009 and December 2013 were included. Patient, treatment and tumour factors were analyzed in relation to the urgency of surgery. The primary outcome was the thirty day...... gender, and with high comorbidity, advanced tumours, perforated tumours, a tumour in the right or transverse colon and postoperative anastomotic leakage were at risk of postoperative death. In non-elective resections, a right-sided tumour and postoperative anastomotic leakage were associated with high...

  8. Genetic determination of mortality rate in Danish dairy cows

    DEFF Research Database (Denmark)

    Maia, Rafael Pimentel; Ask, Birgitte; Madsen, Per

    2014-01-01

    introduction of genetic material from other populations. The correlations between the sire components for death rate and slaughter rate were negative and small for the 3 populations, suggesting the existence of specific genetic mechanisms for each culling reason and common concurrent genetic mechanisms....... In the Holstein population the effects of the changes in the level of heterozygosity, breed composition and the increasing genetic trend act in the same direction increasing the death rate in the recent years. In the Jersey population, the effects of the level of heterozygosity and the breed proportion were small......, and only the increasing genetic trend can be pointed as a genetic cause to the observed increase in the mortality rate. In the Red Danish population neither the time-development pattern of the genetic trend nor the changes in the level of heterozygosity and breed composition could be causing the observed...

  9. Impact of the economic crisis and increase in food prices on child mortality: exploring nutritional pathways.

    Science.gov (United States)

    Christian, Parul

    2010-01-01

    The current economic crisis and food price increase may have a widespread impact on the nutritional and health status of populations, especially in the developing world. Gains in child survival over the past few decades are likely to be threatened and millennium development goals will be harder to achieve. Beyond starvation, which is one of the causes of death in famine situations, there are numerous nutritional pathways by which childhood mortality can increase. These include increases in childhood wasting and stunting, intrauterine growth restriction, and micronutrient deficiencies such as that of vitamin A, iron, and zinc when faced with a food crisis and decreased food availability. These pathways are elucidated and described. Although estimates of the impact of the current crisis on child mortality are yet to be made, data from previous economic crises provide evidence of an increase in childhood mortality that we review. The current situation also emphasizes that there are vast segments of the world's population living in a situation of chronic food insecurity that are likely to be disproportionately affected by an economic crisis. Nutritional and health surveillance data are urgently needed in such populations to monitor both the impacts of a crisis and of interventions. Addressing the nutritional needs of children and women in response to the present crisis is urgent. But, ensuring that vulnerable populations are also targeted with known nutritional interventions at all times is likely to have a substantial impact on child mortality.

  10. Regional variations in mortality rates of pancreatic cancer in China:Results from 1990-1992 national mortality survey

    Institute of Scientific and Technical Information of China (English)

    Ke-Xin Chen; Peizhong Peter Wang; Si-Wei Zhang; Lian-Di Li; Feng-Zhu Lu; Xi-Shan Hao

    2003-01-01

    AIM: To examine the regional variations in mortality rates of pancreatic cancer in China.METHODS: Aggregated mortality data of pancreatic cancer were extracted from the 1990-1992 national death of all causes and its mortality survey in China. Age specific and standardized mortality rates were calculated at both national and provincial levels with selected characteristics including sex and residence status.RESULTS: Mortality of pancreatic cancer ranked the ninth and accounted for 1.38 percent of the total malignancy deaths. The crude and age standardized mortality rates of pancreatic cancer in China in the period of 1990-1992 were 1.48/100 000 and 1.30/100 000, respectively. Substantial regional variations in mortality rates across China were observed with adjusted mortality rates ranging from 0.43/100 000 to 3.70/100 000 with an extremal value of 8.7.Urban residents had significant higher pancreatic mortality than rural residents.CONCLUSION: The findings of this study show different mortality rates of this disease and highlight the importance of further investigation on factors, which might contribute to the observed epidemiological patterns.

  11. Mortality rate associated with hospital acquired infections among burn patients

    Directory of Open Access Journals (Sweden)

    Saima Aslam Bharwana

    2016-09-01

    Full Text Available Hospital acquired infections (HAIs are the major contributors of mortality associated with burn injuries. The aim of this research was to document the antecedents affiliated with major burn injuries, hospitalization and mortality in burn patients. We performed a single center prospective study of patients admitted during 3 months period (April-June 2014 in burn wards of government hospital. There were 100 patients in this investigation which were observed weekly. The inclusion criterion was based on the shifting of patients from emergency to the wards after initial treatment of more than 24 h. Variables included were age and gender of the patient, the percent total body surface area (%TBSA burn, the cause of the burn. Mean age of patients was 30.29 years. More females (55.67% were admitted than males (44.32%. The total body surface area (%TBSA burnt were from 15%- 95% respectively moreover children were more sensitive to hospital acquired infections (HAIs and mortality rate was 34% in children with mean age of 5 years and disability of body parts were 42% among 75% were females. Whereas the most common (HAIs were primary blood stream (PBS with mean value of 30.50, wound infections (WIS were at second prevalence with mean value of 27.50, followed by sepsis (S and pneumonia (P 10.33, eye infections (EIs 4.833 and urinary tract infections (UTIs 2.667. Factors significantly (p-value= 0.000 associated with increased duration of hospitalization caught HAIs mortality include the age and gender of the patient, the cause of burn, inhalation injury, the region affected and %TBSA burnt. It concluded that the mortality was very much dependent on age and gender of the patient, burn causes, affected area as well as %TBSA burnt are considerable factors in determining the relationship of HAIs and whether the patients will survive or knuckle to injuries. Better compliance techniques, stricter control over disinfection and sterilization practices and usage of

  12. Child mortality in Stockholm during 1885-1910

    DEFF Research Database (Denmark)

    Burström, B; Diderichsen, Finn; Smedman, L

    1999-01-01

    on the risk of measles death. Individual entries in a population-based register and on death certificates for children aged 0-15 years living in one parish in Stockholm in 1885, 1891, and 1910 (n = 36,718) were used to analyze cause-specific and overall death rates in relation to household size and the number...... of children in the household, using Cox regression analysis. Bivariate analysis identified significant relations between crowding and the cause-specific risk of death, which were subsequently tested while controlling for other known risk factors for childhood death. Significant negative associations between...... crowding and the risk of death from pneumonia and bronchitis disappeared when controlling for other risk factors. A negative association between the risk of overall death and large household size became significantly positive when controlling for other risk factors. The increased risk of death from measles...

  13. Dietary restriction of rodents decreases aging rate without affecting initial mortality rate a meta-analysis

    NARCIS (Netherlands)

    Simons, Mirre J. P.; Koch, Wouter; Verhulst, Simon

    2013-01-01

    Dietary restriction (DR) extends lifespan in multiple species from various taxa. This effect can arise via two distinct but not mutually exclusive ways: a change in aging rate and/or vulnerability to the aging process (i.e. initial mortality rate). When DR affects vulnerability, this lowers mortalit

  14. The difference transport makes to child mortality and preventive healthcare efforts: Riders for Health.

    Science.gov (United States)

    Coleman, Barry J; Howard, Emma; Jenkinson, Astrid

    2011-02-01

    The 20th and 21st century witnessed the development of many sophisticated vaccinations and other key preventive health interventions, and yet child mortality in sub-Saharan Africa remains unacceptably high. One of the barriers identified to reducing child mortality in rural regions of Africa is distance and lack of transportation. In order to address this, a growing charitable organisation, Riders for Health (http://www.riders.org) has developed a reliable and cost-effective system for managing vehicles used in all types of healthcare delivery. The system intends to ensure that the delivery of health interventions is never undermined by failing vehicles no matter how harsh the terrain. The system provides reliable transport in direct support of partner healthcare goals and, in so doing, maintains a supply of appropriately managed vehicles, particularly motorcycles. Thereby health workers are empowered, their productivity and coverage enhanced and the efficiency of health interventions they promote maximised.

  15. [Infant and child morbidity and mortality due to diarrheal disease in central Africa].

    Science.gov (United States)

    Keuzeta, J J; Merlin, M; Josse, R; Mouanda, V; Kouka Bemba, D

    1988-06-01

    Diarrheal diseases in Central African countries have often been identified as the 2nd leading cause of death after measles and the 2nd leading cause of morbidity after malaria. These diseases are responsible for death rates in children under 5 that range from 58/1000 in urban centers to 150 in rural areas, and they impose heavy costs on the health services for both pediatric beds and intravenous rehydration. Diarrhea contributes to malnutrition and to high fertility rates among parents who believe they must have many children to insure survival of a few. To study patterns of diarrheal disease in the region, 10 sites with different characteristics were selected for survey. 9 surveys of locations with widely varying climatic, ecologic, demographic, and socioeconomic conditions have been completed, 3 in Cameroon, 1 in the Central African Republic, 2 in Congo, 1 in Gabon, and 2 in Chad. All but 1 of the surveys were conducted between October 1983 and March 1985. The methodology was based on the cluster sampling recommended by the World Health Organization, which has the advantages of relative speed, moderate cost, and low personnel requirements. The clusters were either a village in rural areas or a section of an urban area. Interviewers obtained information about the number of children under 5 in the household, the number who had diarrhea in the previous 15 days and the treatment given, the number dying in the 12 months preceding the survey and the cause of death, whether diarrhea was a factor, and the age of the child at the time of death. A total of 63,107 children under 5 belonging to 33,051 households were surveyed. 12,732 episodes of diarrhea in the preceding 15 days were reported. It was estimated that each child in the region had an average of 4.8 episodes of diarrhea per year. The rate of diarrheal morbidity varied significantly by climatic zone. A follow-up survey of diarrheal morbidity figures from sentinel health centers is underway to determine the

  16. Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation

    Directory of Open Access Journals (Sweden)

    Tanya Doherty

    2015-12-01

    Full Text Available Malawi is estimated to have achieved its Millennium Development Goal (MDG 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI programme of support (2007–2013. We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI 189 to 249 in the period 1991–1995 to 119 deaths (95% CI 105 to 132 in the period 2006–2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24% and increased household coverage of insecticide–treated bednets (19%. These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub–Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community–based delivery platform, can lead to significant reductions in child mortality.

  17. The role of vitamin A in reducing child mortality and morbidity and improving growth

    Directory of Open Access Journals (Sweden)

    RAMAKRISHNAN USHA

    1998-01-01

    Full Text Available This is an update of knowledge on the role of the vitamin A status in determining child mortality, morbidity and growth. Recent information confirms the earlier conclusion of Beaton et al. that a 23% reduction in young child mortality results following improvements in the vitamin A status. Studies show that the mortality effect is primarily due to reductions in deaths due to acute gastroenteritis and measles but not acute respiratory infections (ARI and malaria. While improvement of the vitamin A status enhances the survival of older preschool children, it remains unclear whether it benefits infants (i.e. <6 months. Vitamin A supplementation does not reduce the overall incidence and prevalence of common childhood illness; however, it reduces the incidence of more severe episodes of diarrhea. Also, vitamin A supplementation either during and/or immediately after the illness does not improve its symptomatology. Finally, contrary to earlier expectations, recently completed, placebo-controlled randomized interventions have failed to detect improvements in child growth.

  18. Disparities in death: Inequality in cause-specific infant and child mortality in Stockholm, 1878-1926

    DEFF Research Database (Denmark)

    Molitoris, Joseph John

    2017-01-01

    socioeconomic groups. OBJECTIVE The aim of this study is to examine the development of socioeconomic inequalities in cause-specific infant and child mortality during Stockholm’s demographic transition. METHODS Using an individual-level longitudinal population register for Stockholm, Sweden between 1878 and 1926......Abstract BACKGROUND The decline of child mortality during the late nineteenth century is one of the most significant demographic changes in human history. There is evidence, however, suggesting the substantial reductions in mortality during the era did little to reduce mortality inequality between...

  19. Effects of the integrated Community Case Management of Childhood Illness Strategy on Child Mortality in Ethiopia: A Cluster Randomized Trial.

    Science.gov (United States)

    Amouzou, Agbessi; Hazel, Elizabeth; Shaw, Bryan; Miller, Nathan P; Tafesse, Mengistu; Mekonnen, Yared; Moulton, Lawrence H; Bryce, Jennifer; Black, Robert E

    2016-03-01

    We conducted a cluster randomized trial of the effects of the integrated community case management of childhood illness (iCCM) strategy on careseeking for and coverage of correct treatment of suspected pneumonia, diarrhea, and malaria, and mortality among children aged 2-59 months in 31 districts of the Oromia region of Ethiopia. We conducted baseline and endline coverage and mortality surveys approximately 2 years apart, and assessed program strength after about 1 year of implementation. Results showed strong iCCM implementation, with iCCM-trained workers providing generally good quality of care. However, few sick children were taken to iCCM providers (average 16 per month). Difference in differences analyses revealed that careseeking for childhood illness was low and similar in both study arms at baseline and endline, and increased only marginally in intervention (22.9-25.7%) and comparison (23.3-29.3%) areas over the study period (P = 0.77). Mortality declined at similar rates in both study arms. Ethiopia's iCCM program did not generate levels of demand and utilization sufficient to achieve significant increases in intervention coverage and a resulting acceleration in reductions in child mortality. This evaluation has allowed Ethiopia to strengthen its strategic approaches to increasing population demand and use of iCCM services.

  20. Estimation of mortality rates in stage-structured population

    CERN Document Server

    Wood, Simon N

    1991-01-01

    The stated aims of the Lecture Notes in Biomathematics allow for work that is "unfinished or tentative". This volume is offered in that spirit. The problem addressed is one of the classics of statistical ecology, the estimation of mortality rates from stage-frequency data, but in tackling it we found ourselves making use of ideas and techniques very different from those we expected to use, and in which we had no previous experience. Specifically we drifted towards consideration of some rather specific curve and surface fitting and smoothing techniques. We think we have made some progress (otherwise why publish?), but are acutely aware of the conceptual and statistical clumsiness of parts of the work. Readers with sufficient expertise to be offended should regard the monograph as a challenge to do better. The central theme in this book is a somewhat complex algorithm for mortality estimation (detailed at the end of Chapter 4). Because of its complexity, the job of implementing the method is intimidating. Any r...

  1. Rates of Very Preterm Birth in Europe and Neonatal Mortality Rates

    DEFF Research Database (Denmark)

    2008-01-01

    OBJECTIVE: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in ten European regions. DESIGN: Comparison of 10 separate geographically defined European populations, from nine European countries, over a one year period (seven months......) a standardised rate of very preterm delivery and b) the existing death rate for babies born at this gestation in the individual region. This produced much greater homogeneity in terms of neonatal mortality. CONCLUSIONS: Variation in the rate of very preterm delivery has a major influence on reported neonatal...

  2. Strategies to reduce infant mortality rate in India.

    Science.gov (United States)

    Ghai, O P

    1985-01-01

    As a systems approach is needed to develop strategies to reduce the infant mortality rate (IMR), it is appropriate to analyze the present situation in India, reasons for low IMR in some Indian states vis-a-vis others, the status in some neighboring countries, and the cost effectiveness of various available technological interventions and their organizational constraints. A 1981 survey revealed 1) a low IMR for the state of Kerala, one which was comparable with Western nations, despite the fact that nearly half of the population in Kerala lived below the poverty line; 2) a very high IMR for the state of Uttar Pradesh, even though the number of people living below the poverty line was not significantly by different from the state of Kerala; and a moderate IMR reduction in the state of Punjab, even though only 15% of the population was below the poverty line. Favorable factors for low IMR appear to be a high female literacy rate, good medical and educational facilities close to the place of residence, and an excellent transportation and communication system. To significantly reduce IMR in a short period of time, it is necessary to adopt certain immediate measures. Nearly 55% of infant deaths occur in the 1st month of life, and these generally are not amenable to general measures and technological interventions. The problem is difficult, but a solution can be found by reaching a broad consensus among professionals and administrators. The major recommendations of a seminar on the Strategies for Reducing infant Mortality in India, held during January 1984, were: provide antenatal care to 100% of pregnant women; work for early registration of pregnancy and identification of high risk pregnancies; immunize 100% of pregnant women with tetanus toxoid; make available intrapartum care for all pregnant women; delineate anticipated job requirements, duties, and functions of village level health workers; make presterilized packaged delivery kits available to all female health

  3. Scaling Up Family Planning to Reduce Maternal and Child Mortality: The Potential Costs and Benefits of Modern Contraceptive Use in South Africa

    Science.gov (United States)

    Chola, Lumbwe; McGee, Shelley; Tugendhaft, Aviva; Buchmann, Eckhart; Hofman, Karen

    2015-01-01

    Introduction Family planning contributes significantly to the prevention of maternal and child mortality. However, many women still do not use modern contraception and the numbers of unintended pregnancies, abortions and subsequent deaths are high. In this paper, we estimate the service delivery costs of scaling up modern contraception, and the potential impact on maternal, newborn and child survival in South Africa. Methods The Family Planning model in Spectrum was used to project the impact of modern contraception on pregnancies, abortions and births in South Africa (2015-2030). The contraceptive prevalence rate (CPR) was increased annually by 0.68 percentage points. The Lives Saved Tool was used to estimate maternal and child deaths, with coverage of essential maternal and child health interventions increasing by 5% annually. A scenario analysis was done to test impacts when: the change in CPR was 0.1% annually; and intervention coverage increased linearly to 99% in 2030. Results If CPR increased by 0.68% annually, the number of pregnancies would reduce from 1.3 million in 2014 to one million in 2030. Unintended pregnancies, abortions and births decrease by approximately 20%. Family planning can avert approximately 7,000 newborn and child and 600 maternal deaths. The total annual costs of providing modern contraception in 2030 are estimated to be US$33 million and the cost per user of modern contraception is US$7 per year. The incremental cost per life year gained is US$40 for children and US$1,000 for mothers. Conclusion Maternal and child mortality remain high in South Africa, and scaling up family planning together with optimal maternal, newborn and child care is crucial. A huge impact can be made on maternal and child mortality, with a minimal investment per user of modern contraception. PMID:26076482

  4. Cohort-specific trends in stroke mortality in seven European countries were related to infant mortality rates

    NARCIS (Netherlands)

    Amiri, M.; Kunst, A. E.; Janssen, F.; Mackenbach, J. P.

    2006-01-01

    Objectives: To assess, in a population-based study, whether secular trends in cardiovascular disease mortality in seven European countries were correlated with past trends in infant mortality rate (IMR) in these countries. Study Design and Setting: Data on ischemic heart disease (IHD) and stroke mor

  5. Gaming in risk-adjusted mortality rates: effect of misclassification of risk factors in the benchmarking of cardiac surgery risk-adjusted mortality rates

    NARCIS (Netherlands)

    Siregar, S.; Groenwold, R.H.; Versteegh, M.I.; Noyez, L.; Burg, W.J.P.P. ter; Bots, M.L.; Graaf, Y. van der; Herwerden, L.A. van

    2013-01-01

    OBJECTIVE: Upcoding or undercoding of risk factors could affect the benchmarking of risk-adjusted mortality rates. The aim was to investigate the effect of misclassification of risk factors on the benchmarking of mortality rates after cardiac surgery. METHODS: A prospective cohort was used comprisin

  6. Sex Differences in Parent and Child Pain Ratings during an Experimental Child Pain Task

    Directory of Open Access Journals (Sweden)

    Erin C Moon

    2008-01-01

    Full Text Available Research in the field of pediatric pain has largely ignored the role of fathers in their children’s pain experiences. The first objective of the present study was to examine the effect of the presence of mothers versus fathers on children’s subjective ratings, facial expressions and physiological responses to acute pain. The second objective was to examine whether child and parent sex influence parents’ proxy ratings of their children’s pain. The final objective was to compare levels of agreement between mothers’ and fathers’ assessments of their children’s pain. Participants included 73 children (37 boys, 36 girls, four to 12 years of age, along with 32 fathers and 41 mothers. Children undertook the cold pressor pain task while observed by one of their parents. During the task, the children’s heart rates and facial expressions were recorded. Children provided self-reports and parents provided proxy reports of child pain intensity using the seven-point Faces Pain Scale. Neither child nor parent sex had a significant impact on children’s subjective reports, facial expressions or heart rates in response to acute pain. Fathers gave their sons higher pain ratings than their daughters, whereas mothers’ ratings of their sons’ and daughters’ pain did not differ. Kappa statistics and t tests revealed that fathers tended to be more accurate judges of their children’s pain than mothers. Overall, this research highlights the importance of examining both parent and child sex differences in pediatric pain research.

  7. Parental Rheumatoid Arthritis, Child Mortality and Case Fatality A Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Rom, Ane L; Wu, Chunsen; Olsen, Jørn;

    2017-01-01

    OBJECTIVE: We have reported increased long term morbidity in children of parents with rheumatoid arthritis (RA). Here we assess child mortality and case fatality in the same cohort. METHODS: All singletons born in Denmark from 1977 to 2008 were identified through linkage of Danish National...... did the risk of death below the ages of 5 years, 3 years, or 1 year. Below the age of 5 years, 6,106 children of parents with RA were diagnosed with respiratory diseases and 3,320 with infectious diseases. Case fatalities in children with these diseases were not significantly higher than those...

  8. Putting the "M" back in the Maternal and Child Health Bureau: reducing maternal mortality and morbidity.

    Science.gov (United States)

    Lu, Michael C; Highsmith, Keisher; de la Cruz, David; Atrash, Hani K

    2015-07-01

    Maternal mortality and severe morbidity are on the rise in the United States. A significant proportion of these events are preventable. The Maternal Health Initiative (MHI), coordinated by the Maternal and Child Health Bureau at the Health Resources and Services Administration, is intensifying efforts to reduce maternal mortality and severe morbidity in the U.S. Through a public-private partnership, MHI is taking a comprehensive approach to improving maternal health focusing on five priority areas: improving women's health before, during and beyond pregnancy; improving the quality and safety of maternity care; improving systems of maternity care including both clinical and public health systems; improving public awareness and education; and improving surveillance and research.

  9. Air pollution and child mortality: a time-series study in São Paulo, Brazil.

    Science.gov (United States)

    Conceição, G M; Miraglia, S G; Kishi, H S; Saldiva, P H; Singer, J M

    2001-06-01

    Although most available evidence relating air pollution and mortality was obtained for adults, pollution has been also associated with increased mortality in children, but in a significantly smaller number of studies. This study was designed to evaluate the association between child mortality and air pollution in the city of São Paulo, Brazil, from 1994 to 1997. Daily records of mortality due to respiratory diseases for children under 5 years of age were obtained from the municipal mortality information improvement program. Daily concentrations of sulfur dioxide (SO(2)), carbon monoxide (CO), inhalable particulate matter less than 10 microm in diameter (PM(10)), and ozone were obtained from the state air pollution controlling agency. Information on minimum daily temperature and on relative humidity were obtained from the Institute of Astronomy and Geophysics of the University of São Paulo. Statistical analysis was performed through generalized additive models considering a Poisson response distribution and a log link. Explanatory variables were time, temperature, humidity, and pollutant concentrations. The loess smoother was applied to time (in order to model seasonality) and temperature. Significant associations between mortality and concentrations of CO, SO(2), and PM(10) were detected. The coefficients (and standard errors) of these three pollutants were 0.0306 (0.0076), 0.0055 (0.0016), and 0.0014 (0.0006), respectively. The observed associations were dose dependent and quite evident after a short period of exposure (2 days). According to the proposed model and considering the mean of the pollutant concentration during the period of the study, the estimated proportions of respiratory deaths attributed to CO, SO(2), and PM(10), when considered individually, are around 15, 13, and 7%, respectively.

  10. KONDISI KESEHATAN LINGKUNGAN DI INDONESIA DAN ANGKA KEMATIAN BAYI, ANGKA KEMATIAN ANAK BALITA SERTA ANGKA KEMATIAN BALITA MENURUT DATA SUSENAS 1998, 2001 DAN 2003 (Environmental Health and Child Mortality in Indonesia Based on Susenas Data of 1998, 2001

    Directory of Open Access Journals (Sweden)

    Supraptini Supraptini

    2012-11-01

    Full Text Available Environmental Health and Child Mortality in Indonesia Based on Susenas Data of 1998, 2001 and 2003.Environmental health related disease are still problem in Indonesia and these factors are importence in the public daily life. Childhood mortality rate which include Infant Mortality Rate (IMR, Child Mortality Rate (CMR and Under five Mortality Rate have been used as social welfare and public health indicators. Registration system for death in lndonesia not good enough, so we count number of death using indirect methode so we used data survey. National Social and Economics Survey (NSES/Susenas as one of data survey which every year collected can used to analysis and count the environmental health related with number of death include childhood mortality rate. Data used for this analysis is NSES Modul 1998, 2001 and 2003 and the analysis unit is house hold. The scoring of healthy housing based upon the total scoring of 8 parameters and divided into 3 categories e.g good, moderate, and bad. The result showed that the factor of environment health 'bad' categories produced IMR, CMR, and Under live Mortality rate was higest. Environmental health 'good' categories in Indonesia contributed for decreasing CMR (age 1-4 years, in Java Bali especially to decreasing for Under five Mortality Rate (age 1-59 months. But in East Indonesian Area for five years (1998-2003 or 'good' categories there are increasing tor IMR, CMR, and Under five Mortality Rate. In urban or rural area there are not different environmental health 'good' categories will be contributed for decreasing death, exepted for CMR (age 1-4 years in urban area there are the same for 'good' categories or 'moderate' categories. The trend of IMR,CMR and Under five Mortality Rate increasing in 2001 but decreasing in 2003. Indonesian IMR in 2001 at seven grade in ASEAN after Singapore, Malaysia, Brunei Darussalam, Thailand, The Philippines, and Vietnam.Keywords: Enviromental health, Infant Mortality Rate

  11. North Carolina Star Rated License System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of North Carolina's Star Rated License System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  12. Age-specific trends in cardiovascular mortality rates in the Netherlands between 1980 and 2009

    OpenAIRE

    Peeters, Anna; Nusselder, Wilma; Stevenson, Christopher; Boyko, Edward; Moon, Lynelle; Tonkin, Andrew

    2011-01-01

    textabstractRecent analyses suggest the decline in coronary heart disease mortality rates is slowing in younger age groups in countries such as the US and the UK. This work aimed to analyse recent trends in cardiovascular mortality rates in the Netherlands. Analysis was of annual all circulatory, ischaemic heart disease (IHD), and cerebrovascular disease mortality rates between 1980 and 2009 for the Netherlands. Data were stratified by sex and 10-year age group (age 35-85+). The annual rate o...

  13. Survival and mortality rates among Danes with MS

    DEFF Research Database (Denmark)

    Brønnum-Hansen, H; Stenager, Egon; Hansen, Thomas;

    2006-01-01

    people with MS, representing more than 200,000 person-years of observation, have been analysed. Overall, mortality was almost three times higher and life expectancy 10 years less among people with MS than for the general population. However, excess mortality has declined significantly since 1950.......Long-term survival and trends in overall and cause-specific excess mortality among people with MS have been studied using the Danish Multiple Sclerosis Registry, which contains information about all Danish MS patients since the mid-20th Century. A total of 4254 deaths among approximately 10,000...

  14. Adjusted effects of domestic violence, tobacco use, and indoor air pollution from use of solid fuel on child mortality.

    Science.gov (United States)

    Pandey, Shanta; Lin, Yuan

    2013-10-01

    Studies that have separately examined the consequences of gender based violence upon women, use of solid fuel for cooking, and mother and father's use of tobacco on child health have concluded that they serve as risk factors for maternal and child health. Some authors have implied that these studies may have run the risk of overestimating the burden of disease of one factor over another. In this paper, we included all four factors in the same model to estimate their adjusted effects on child mortality, controlling for the demographic factors. The data come from 2005 to 2006 National Family Health Survey of India that interviewed a nationally representative sample of 39,257 couples. Of the four factors, mothers' use of tobacco presented the highest risk for child mortality (OR = 1.42; CI = 1.27-1.60) followed by fathers' use of tobacco (OR = 1.23; CI = 1.12-1.36), households' use of solid fuel for cooking (OR = 1.23; CI = 1.06-1.43), and physical abuse upon mothers (OR = 1.20; CI = 1.10-1.32). Among the households that used solid fuel for cooking, improved cookstoves users experienced 28 % lower odds of child mortality (OR = 0.72; CI = 0.61-0.86) compared to nonusers of improved cookstoves. Additionally, increase in age of mothers at birth of first child, parents' education, and household wealth served as protective factors for child mortality. To prevent child death, programs should focus on reducing couple's use of tobacco, protecting women from physical abuse, and helping households switch from solid to liquid fuel. Moreover, a significant reduction in child death could be attained by improving girls' education, and delaying their age at marriage and first birth.

  15. Child mortality from solid-fuel use in India: a nationally-representative case-control study - article no. 491

    Energy Technology Data Exchange (ETDEWEB)

    Bassani, D.G.; Jha, P.; Dhingra, N.; Kumar, R. [St. Michaels Hospital, Toronto, ON (Canada)

    2010-08-17

    Most households in low and middle income countries, including in India, use solid fuels (coal/coke/lignite, firewood, dung, and crop residue) for cooking and heating. Such fuels increase child mortality, chiefly from acute respiratory infection. There are, however, few direct estimates of the impact of solid fuel on child mortality in India. Methods: We compared household solid fuel use in 1998 between 6790 child deaths, from all causes, in the previous year and 609 601 living children living in 1.1 million nationally-representative homes in India. Analyses were stratified by child's gender, age (neonatal, post-neonatal, 1-4 years) and colder versus warmer states. We also examined the association of solid fuel to non-fatal pneumonias. Solid fuel use was very common (87% in households with child deaths and 77% in households with living children). After adjustment for demographic factors and living conditions, solid-fuel use significantly increase child deaths at ages 1-4 (prevalence ratio (PR) boys: 1.30, 95%CI 1.08-1.56; girls: 1.33, 95%CI 1.12-1.58). More girls than boys died from exposure to solid fuels. Solid fuel use was also associated with non-fatal pneumonia (boys: PR 1.54 95%CI 1.01-2.35; girls: PR 1.94 95%CI 1.13-3.33). Child mortality risks, from all causes, due to solid fuel exposure were lower than previously, but as exposure was common solid, fuel caused 6% of all deaths at ages 0-4, 20% of deaths at ages 1-4 or 128 000 child deaths in India in 2004. Solid fuel use has declined only modestly in the last decade. Aside from reducing exposure, complementary strategies such as immunization and treatment could also reduce child mortality from acute respiratory infections.

  16. Social Audits for Community Action: A tool to Initiate Community Action for Reducing Child Mortality

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    Nandan D

    2005-01-01

    Full Text Available Research question : (i What is the community′s perception (assessment & analysis of causes underlying neonatal, infant and under five deaths? (ii What action does the community take thereafter? Objectives : To stimulate the community to assess and analyze the causes and underlying social delays responsible for neonatal, infant and under five deaths in their villages and subsequently take collective action to prevent these deaths in future using Social Audits for Community Action (SACA. Design : Retrospective Participatory study. Setting : Rural community development blocks, district Agra, Uttar Pradesh. Material and Methods : SACA were conducted in a total of 152 villages of Fathehpur Sikri and Bichpuri blocks of district Agra, U.P. One SACA was conducted in each of the 211 anganwadi catchment areas, wherein 10-15 women from different socio-clusters of the community participated in a participatory discussion on issues pertaining to number of births and deaths of children less than five years of age in the last one-year. Results : 7656 live births and 749 under-five deaths were reported during the year 2002. The neonatal, infant and under-five mortality rate was 39.4, 73.5 and 85 per 1,000 live births respectively. Hypothermia, pneumonia, birth asphyxia, prematurity and low birth weight emerged as major causes of neonatal deaths. Majority of deaths of infants and children 1-5 years of age were found to have occurred due to severe malnutrition and diarrhoea. The community realized that majority of deaths occurred because of the delay in recognition of the seriousness of problem, delay in taking decision to seek appropriate care and delay in arranging transport/money. Subsequently, behaviour change communication strategies were re-defined to help community assess signs of illness and take preparedness measures to prevent child deaths in future. Conclusion : Strategies like dialoguing with the community using social audits for community action is

  17. An examination of black/white differences in the rate of age-related mortality increase

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    Andrew Fenelon

    2013-09-01

    Full Text Available BACKGROUND The rate of mortality increase with age among adults is typically used as a measure of the rate of functional decline associated with aging or senescence. While black and white populations differ in the level of mortality, mortality also rises less rapidly with age for blacks than for whites, leading to the well-known black/white mortality "crossover". OBJECTIVE This paper investigates black/white differences in the rate of mortality increase with age for major causes of death in order to examine the factors responsible for the black/white crossover. METHODS The analysis considers two explanations for the crossover: selective survival and age misreporting. Mortality is modeled using a Gompertz model for 11 causes of death from ages 50-84 among blacks and whites by sex. RESULTS Mortality increases more rapidly with age for whites than for blacks for nearly all causes of death considered. The all-cause mortality rate of mortality increase is nearly two percentage points higher for whites. The analysis finds evidence for both selective survival and age misreporting, although age misreporting is a more prominent explanation among women. CONCLUSIONS The black/white mortality crossover reflects large differences in the rate of age-related mortality increase. Instead of reflecting the impact of specific causes of death, this pattern exists across many disparate disease conditions, indicating the need for a broad explanation.

  18. Trends of incidence and mortality rates of stroke from 1983 to 2000 in Hanzhong rural population

    Institute of Scientific and Technical Information of China (English)

    龙泳; 高保林; 张景霞; 杨军; 黄久仪; 胡继新; 徐德忠; 卢娟

    2003-01-01

    Objective: To explore the trends of incidence and mortality rates of stroke in Hanzhong rural population. Methods: Acting as the WHO MONICA project. Results: The incidence rate of stroke was 152.9/100 000. There was decline trend in male(P<0.05). The mortality rate of stroke was 115.9/100 000. There was no significant decline trend during 18-year period (P<0.05). The incidence and mortality rates of stroke of male were higher than those of female(P<0.05).The incidence and mortality rates were all increased with age(P<0.01). Conclusion: It must stick to the long- term prevention measures to decrease incidence rate, and improve the condition of medical treatment to reduce the mortality rate in rural population.

  19. Tennessee Star-Quality Child Care Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  20. Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009

    Directory of Open Access Journals (Sweden)

    Ruffo Freitas-Junior

    2012-07-01

    Full Text Available OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO. Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%. Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%, Rio Grande do Sul (APC = -0.8% and Rio de Janeiro (APC = -0.6% presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%, Paraiba (APC=11.9%, and Piaui (APC=10.9%. CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.

  1. Elevated resting heart rate, physical fitness and all-cause mortality

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Suadicani, Poul; Hein, Hans Ole

    2013-01-01

    To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max).......To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max)....

  2. Child Acute Malnutrition and Mortality in Populations Affected by Displacement in the Horn of Africa, 1997–2009

    Directory of Open Access Journals (Sweden)

    Paul Spiegel

    2012-03-01

    Full Text Available Drought and conflict in the Horn of Africa are causing population displacement, increasing risks of child mortality and malnutrition. Humanitarian agencies are trying to mitigate the impact, with limited resources. Data from previous years may help guide decisions. Trends in different populations affected by displacement (1997–2009 were analyzed to investigate: (1 how elevated malnutrition and mortality were among displaced compared to host populations; (2 whether the mortality/malnutrition relation changed through time; and (3 how useful is malnutrition in identifying high mortality situations. Under-five mortality rates (usually from 90-day recall, as deaths/10,000/day: U5MR and global acute malnutrition (wasting prevalences, < −2SDs of references plus edema: GAM were extracted from reports of 1,175 surveys carried out between 1997–2009 in the Horn of Africa; these outcome indicators were analyzed by livelihood (pastoral, agricultural and by displacement status (refugee/internally displaced, local resident/host population, mixed; associations between these indicators were examined, stratifying by status. Patterns of GAM and U5MR plotted over time by country and livelihood clarified trends and showed substantial correspondence. Over the period GAM was steady but U5MR generally fell by nearly half. Average U5MR was similar overall between displaced and local residents. GAM was double on average for pastoralists compared with agriculturalists (17% vs. 8%, but was not different between displaced and local populations. Agricultural populations showed increased U5MR when displaced, in contrast to pastoralist. U5MR rose sharply with increasing GAM, at different GAM thresholds depending on livelihood. Higher GAM cut-points for pastoralists than agriculturalists would better predict elevated U5MR (1/10,000/day or emergency levels (2/10,000/day in the Horn of Africa; cut-points of 20–25% GAM in pastoral populations and 10–15% GAM in

  3. Child acute malnutrition and mortality in populations affected by displacement in the Horn of Africa, 1997-2009.

    Science.gov (United States)

    Mason, John B; White, Jessica M; Heron, Linda; Carter, Jennifer; Wilkinson, Caroline; Spiegel, Paul

    2012-03-01

    Drought and conflict in the Horn of Africa are causing population displacement, increasing risks of child mortality and malnutrition. Humanitarian agencies are trying to mitigate the impact, with limited resources. Data from previous years may help guide decisions. Trends in different populations affected by displacement (1997-2009) were analyzed to investigate: (1) how elevated malnutrition and mortality were among displaced compared to host populations; (2) whether the mortality/malnutrition relation changed through time; and (3) how useful is malnutrition in identifying high mortality situations. Under-five mortality rates (usually from 90-day recall, as deaths/10,000/day: U5MR) and global acute malnutrition (wasting prevalences, Africa; these outcome indicators were analyzed by livelihood (pastoral, agricultural) and by displacement status (refugee/internally displaced, local resident/host population, mixed); associations between these indicators were examined, stratifying by status. Patterns of GAM and U5MR plotted over time by country and livelihood clarified trends and showed substantial correspondence. Over the period GAM was steady but U5MR generally fell by nearly half. Average U5MR was similar overall between displaced and local residents. GAM was double on average for pastoralists compared with agriculturalists (17% vs. 8%), but was not different between displaced and local populations. Agricultural populations showed increased U5MR when displaced, in contrast to pastoralist. U5MR rose sharply with increasing GAM, at different GAM thresholds depending on livelihood. Higher GAM cut-points for pastoralists than agriculturalists would better predict elevated U5MR (1/10,000/day) or emergency levels (2/10,000/day) in the Horn of Africa; cut-points of 20-25% GAM in pastoral populations and 10-15% GAM in agriculturalists are suggested. The GAM cut-points in current use do not vary by livelihood, and this needs to be changed, tailoring cut points to livelihood

  4. Forecasting Age-Specific Brain Cancer Mortality Rates Using Functional Data Analysis Models

    Directory of Open Access Journals (Sweden)

    Keshav P. Pokhrel

    2015-01-01

    Full Text Available Incidence and mortality rates are considered as a guideline for planning public health strategies and allocating resources. We apply functional data analysis techniques to model age-specific brain cancer mortality trend and forecast entire age-specific functions using exponential smoothing state-space models. The age-specific mortality curves are decomposed using principal component analysis and fit functional time series model with basis functions. Nonparametric smoothing methods are used to mitigate the existing randomness in the observed data. We use functional time series model on age-specific brain cancer mortality rates and forecast mortality curves with prediction intervals using exponential smoothing state-space model. We also present a disparity of brain cancer mortality rates among the age groups together with the rate of change of mortality rates. The data were obtained from the Surveillance, Epidemiology and End Results (SEER program of the United States. The brain cancer mortality rates, classified under International Classification Disease code ICD-O-3, were extracted from SEER*Stat software.

  5. Factors Contributing to Maternal and Child Mortality Reductions in 146 Low- and Middle-Income Countries between 1990 and 2010.

    Directory of Open Access Journals (Sweden)

    David M Bishai

    Full Text Available From 1990-2010, worldwide child mortality declined by 43%, and maternal mortality declined by 40%. This paper compares two sources of progress: improvements in societal coverage of health determinants versus improvements in the impact of health determinants as a result of technical change.This paper decomposes the progress made by 146 low- and middle-income countries (LMICs in lowering childhood and maternal mortality into one component due to better health determinants like literacy, income, and health coverage and a second component due to changes in the impact of these health determinants. Health determinants were selected from eight distinct health-impacting sectors. Health determinants were selected from eight distinct health-impacting sectors. Regression models are used to estimate impact size in 1990 and again in 2010. Changes in the levels of health determinants were measured using secondary data.The model shows that respectively 100% and 89% of the reductions in maternal and child mortality since 1990 were due to improvements in nationwide coverage of health determinants. The relative share of overall improvement attributable to any single determinant varies by country and by model specification. However, in aggregate, approximately 50% of the mortality reductions were due to improvements in the health sector, and the other 50% of the mortality reductions were due to gains outside the health sector.Overall, countries improved maternal and child health (MCH from 1990 to 2010 mainly through improvements in the societal coverage of a broad array of health system, social, economic and environmental determinants of child health. These findings vindicate efforts by the global community to obtain such improvements, and align with the post-2015 development agenda that builds on the lessons from the MDGs and highlights the importance of promoting health and sustainable development in a more integrated manner across sectors.

  6. A Count for Quality: Child Care Center Directors on Rating and Improvement Systems

    Science.gov (United States)

    Schulman, Karen; Matthews, Hannah; Blank, Helen; Ewen, Danielle

    2012-01-01

    Quality Rating and Improvement Systems (QRIS)--a strategy to improve families' access to high-quality child care--assess the quality of child care programs, offer incentives and assistance to programs to improve their ratings, and give information to parents about the quality of child care. These systems are operating in a growing number of…

  7. Measuring child mortality from maternity histories collected at time of childbirth. Case of the EMIS surveys.

    Science.gov (United States)

    Mbacke, C S

    1991-01-01

    A researcher has developed a new research methodology to indirectly estimate infant mortality using data from conditional samples which usually are from hospitals or health centers. This methodology is different from other similar methodologies in that it groups mothers by parity instead of age or marital duration. Parity is used since it is more likely to be accurately mortality levels by the mean length of the birth interval. Mortality patterns are not sensitive to the length of the birth interval. He uses data from the 1983 EMIS follow up survey conducted in Bobodioulasso, Burkina Faso and 1919, 1924, and 1933 data from birth registration areas in the United States to demonstrate the new methodology. The methodology shows that the estimated infant mortality rate (IMR) remained basically the same between 1968-1974 in Bobodioulasso (199-122) and began to fall in 1975. By 1983, it had fallen to 88. These results reflect the estimate from the EMIS survey. The methodology demonstrates that, in the US, estimated trends in IMR agreed with observed IMRs. The new methodology derived IMRs fell in the US between 1919-1932 from 92.8-65.5. Since maternity clinics and hospitals in many Sub-Saharan African countries maintain records with answers to routine questions, the new methodology can analyze these data to determine infant mortality trends. Yet conditional samples are not necessarily representative of the whole population. Thus researchers could apply data from unconditional samples such as those from the World Fertility Survey and the Demographic and Health Surveys to a variety of indirect estimation methods discussed in this report to complement the estimated trends of the conditional samples.

  8. CHARACTERISTICS OF MORTALITY RATES FROM BREAST AND OVARIAN CANCER IN JAPAN

    Institute of Scientific and Technical Information of China (English)

    LI Xiang-ming李湘鸣; LUO Fang-ni罗方妮; Akio Sato

    2004-01-01

    Objective: Breast and ovarian cancer is rare in Japan compared with other developed countries but their mortality rates are increasing. It is necessary to examine the experience of Japan as a guide to further prevent breast and ovarian cancer in our country. Methods: We conducted an epidemiological study of breast and ovarian cancer in the past 50 years to investigate the trends and characteristics of the mortality rates in Japan. The numbers of age-specific death from breast and ovarian cancer and the population of 5-year groups were obtained from the Vital Statistics of Japan. The truncated age specific mortality rates were calculated according to the patterns of age specific mortality rates from both cancers. Age adjustments were made to the standard world population. Results: In the past 50 years, mortality rates of breast and ovarian cancer increased about 2 or 6 fold, respectively. This increase was most marked over 50 years old. The death pattern of breast cancer was same as that of ovarian cancer, but that of ovarian cancer changed greatly with time. The birth cohort study had some interesting findings. Common to breast and ovarian cancer, the later the year of birth, the higher the mortality rates from both malignancies in later life. Conclusion: The increase of the yearly mortality rates from breast and ovarian cancer might be due to changes in lifestyle and environmental factors. We are very concerned about dietary practices. Further investigation is needed to clarify the possible causes of animal food.

  9. Association of Urban Slum Residency with Infant Mortality and Child Stunting in Low and Middle Income Countries

    Directory of Open Access Journals (Sweden)

    Hmwe Hmwe Kyu

    2013-01-01

    Full Text Available This study aimed to (i examine the contextual influences of urban slum residency on infant mortality and child stunting over and above individual and household characteristics and (ii identify factors that might modify any adverse effects. We obtained data from Demographic and Health Surveys conducted in 45 countries between 2000 and 2009. The respondents were women (15–49 years and their children (0–59 months. Results showed that living in a slum neighborhood was associated with infant mortality (OR = 1.34, 95% CI = 1.15–1.57 irrespective of individual and household characteristics and this risk was attenuated among children born to women who had received antenatal care from a health professional (OR = 0.79, 95% CI = 0.63–0.99. Results also indicated that increasing child age exacerbated the risk for stunting associated with slum residency (OR = 1.19, 95% CI = 1.16–1.23. The findings suggest that improving material circumstances in urban slums at the neighborhood level as well as increasing antenatal care coverage among women living in these neighborhoods could help reduce infant mortality and stunted child growth. The cumulative impact of long-term exposure to slum neighborhoods on child stunting should be corroborated by future studies.

  10. Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates

    Science.gov (United States)

    ... for non-Hispanic white women. For non-Hispanic black women, preterm-related causes of death account for most of their higher infant mortality ... Infant mortality rates were higher for non-Hispanic black than for non-Hispanic ... of the causes of death shown in ( Figure 3 ). The largest difference was ...

  11. Annual all-cause mortality rate for patients with diabetic kidney disease in Singapore

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    Yee Gary Ang

    2016-06-01

    Conclusion: Our study estimated the annual all-cause mortality rate for Singaporean patients with diabetic kidney disease by CKD stages and identified predictors of all-cause mortality. This study has affirmed the poor prognosis of these patients and an urgency to intervene early so as to retard the progression to later stages of CKD.

  12. How are mortality rates affected by population density?

    CERN Document Server

    Wang, Lei; Di, Zengru; Roehner, Bertrand M

    2013-01-01

    Biologists have found that the death rate of cells in culture depends upon their spatial density. Permanent "Stay alive" signals from their neighbours seem to prevent them from dying. In a previous paper (Wang et al. 2013) we gave evidence for a density effect for ants. In this paper we examine whether there is a similar effect in human demography. We find that although there is no observable relationship between population density and overall death rates, there is a clear relationship between density and the death rates of young age-groups. Basically their death rates decrease with increasing density. However, this relationship breaks down around 300 inhabitants per square kilometre. Above this threshold the death rates remains fairly constant. The same density effect is observed in Canada, France, Japan and the United States. We also observe a striking parallel between the density effect and the so-called marital status effect in the sense that they both lead to higher suicide rates and are both enhanced fo...

  13. The effect of health programs on breastfeeding and child mortality in Peninsular Malaysia.

    Science.gov (United States)

    Anderson, K H

    1984-01-01

    Examining household behavior in Peninsular Malaysia, this study attempts to determine if the availability of certain government health programs significantly alters breastfeeding and if these changes in input prices significantly affect mortality rates and fertility decisions. To explain the interrelationships, an economic model of the demand for infant survival and fertility and the derived demand for breastfeeding is developed. Using household and community level data, the demand equations are then estimated and the results discussed in relation to the predictions of the model and the prospect of additional government inputs. The theoretical model predicts that, if income effects are small: a decline in the price of children (hospital distance) will increase fertility, decrease survival and reduce breastfeeding; a decline in the price of health goods inputs (hospital distance and sanitation) will reduce fertility and increase survival; and a decline in the price of contraceptives (family planning distance) will reduce fertility but increase survival and breastfeeding. The empirical results support some of the model's predictions. In communities with modern sanitation, breastfeeding was shorter on average, as predicted, but differences in mortality were not detected and fertility was actually higher. The latter effect can result from an income effect in the price decline that exceeds the cross substitution effect. Distance to a hospital was positively associated with breastfeeding length. This is expected if the effect of distance on the price of children exceeds the effect of distance on the price of survival. Hospital distance had no impact on either survival or fertility. Distance to a family planning clinic had no effect on breastfeeding or fertility but had a slight positive association with mortality. This positive relationship is expected if fertility and survival are substitutes. Parental schooling and race also are important in determining demand. As

  14. The color of child mortality in Brazil, 1950-2000: social progress and persistent racial inequality.

    Science.gov (United States)

    Wood, Charles H; Magno de Carvalho, José Alberto; Guimarães Horta, Cláudia Júlia

    2010-01-01

    Now that racism has been officially recognized in Brazil, and some universities have adopted affirmative-action admission policies, measures of the magnitude of racial inequality and analyses that identify the factors associated with changes in racial disparities over time assume particular relevance to the conduct of public debate. This study uses census data from 1950 to 2000 to estimate the probability of death in the early years of life, a robust indicator of the standard of living among the white and Afro-Brazilian populations. Associated estimates of the average number of years of life expectancy at birth show that the 6.6-year advantage that the white population enjoyed in the 1950s remained virtually unchanged throughout the second half of the twentieth century, despite the significant improvements that accrued to both racial groups. The application of multivariate techniques to samples selected from the 1960, 1980, and 2000 census enumerations further shows that, controlling for key determinants of child survival, the white mortality advantage persisted and even increased somewhat in 2000. The article discusses evidence of continued racial inequality during an era of deep transformation in social structure, with reference to the challenges of skin color classification in a multiracial society and the evolution of debates about color, class, and discrimination in Brazil.

  15. A comprehensive hip fracture program reduces complication rates and mortality

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Moltke, Finn Borgbjerg; Schousboe, B.

    2008-01-01

    to nutrition, fluid and oxygen therapy, and urinary retention. RESULTS: In the intervention group, the rate of any in-hospital postoperative complication Was reduced from 33% to 20% (odds ratio = 0.61, 95% confidence interval 0.4-0.9; P = .002). Rates of confusion (P = .02), pneumonia (P = .03), and urinary...... community dwellers before the fracture and 159 (29.7%) were admitted from nursing homes. INTERVENTION: The fast-track treatment and care program included a switch from systemic opiates to a local femoral nerve catheter block; an earlier assessment by the anesthesiologist; and more-systematic approach...

  16. Why Are Child Poverty Rates Higher in Britain than in Germany? A Longitudinal Perspective

    Science.gov (United States)

    Jenkins, Stephen P.; Schluter, Christian

    2003-01-01

    We analyze why child poverty rates were much higher in Britain than in Western Germany during the 1990s, using a framework focusing on poverty transition rates. Child poverty exit rates were significantly lower, and poverty entry rates significantly higher, in Britain. We decompose these cross-national differences into differences in the…

  17. Impact of HIV/Aids on Child Mortality before the Highly Active Antiretroviral Therapy Era: A Study in Pointe-Noire, Republic of Congo

    Directory of Open Access Journals (Sweden)

    Camille Lallemant

    2010-01-01

    Full Text Available Few studies have documented the contribution of HIV/AIDS to mortality among children under 15 years. From June 30 to October 19, 2001, all child deaths (n=588 registered to the morgue and/or hospitals of the city of Pointe-Noire, Congo, were investigated using a combined approach including an interview of relatives and postmortem clinical and biological HIV diagnosis. Twenty-one percent of children were HIV positive, while 10.5% of deaths were attributed to AIDS. The most common causes of death in HIV-infected children were pneumonia (30%, pyrexia (22%, diarrhoea (16% and wasting syndrome (16%. Infant mortality rate was estimated 6.3 times higher in children born to HIV-infected mothers compared to HIV-uninfected mothers. This study provides a direct measure of HIV/AIDS as impact on child mortality using a rapid and reliable method. A significant number of deaths could be prevented if HIV infection was diagnosed earlier and infants were provided with antiretroviral treatments.

  18. [Trends in mortality rates from non-Hodgkin lymphoma in Southeast Brazil, 1980-2007].

    Science.gov (United States)

    Luz, Laércio Lima; Mattos, Inês Echenique

    2011-07-01

    Mortality rates from non-Hodgkin lymphoma (NHL) have declined in many countries in recent decades. However, mortality estimates for Brazil indicate an increase in these rates. This study aimed to analyze NHL mortality trends for 1980-2007 in individuals 20 years and older in State capitals in Southeast Brazil. Population data were obtained from the Mortality Information System and the Health Statistics Division of the Unified National Health System (DATASUS). Age-related mortality trends were analyzed using polynomial regression models. In the 60 and older age group, a statistically significant upward linear trend was observed for Belo Horizonte and São Paulo in 1980-2007. When analyzed in two different periods, 1980-1995 and 1996-2007, statistically significant increases in NHL mortality rates were only observed in the former period. These results suggest that the increase in 1980-2007 may have resulted from the rising mortality rates from 1980 to 1995, since no statistically significant trends were observed in the latter period.

  19. Child/Pet Maltreatment: Adolescents' Ratings of Parent and Owner Behaviors.

    Science.gov (United States)

    Roscoe, Bruce; And Others

    1986-01-01

    Results from an investigation of 614 adolescents' ratings of forms of child and pet maltreatment indicated that adolescents were highly critical of acts which constitute maltreatment, more critical of abusive than neglectful acts, less tolerant of child abuse than pet abuse, but more tolerant of physical force directed toward a child if they had…

  20. Analysis of selected social determinants of health and their relationships with maternal health service coverage and child mortality in Vietnam

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2016-02-01

    Full Text Available Introduction: Achieving a fair and equitable distribution of health in the population while progressing toward universal health coverage (UHC is a key focus of health policy in Vietnam. This paper describes health barriers experienced by women (and children by inference in Vietnam, and measures how UHC, with reference to maternal health services and child mortality rates, is affected by selected social determinants of health (SDH, termed ‘barriers’. Methods: Our study uses a cross-sectional design with data from the 2011 Vietnam Multiple Indicator Cluster Survey. The study sample includes 11,663 women, aged 15–49 years. Weighted frequency statistics are cross-tabulated with socioeconomic characteristics of the population to describe the extent and distribution of health barriers experienced by disadvantaged women and children in Vietnam. A subset of women who had a live birth in the preceding two years (n=1,383 was studied to assess the impact of barriers to UHC and health. Six multiple logistic regressions were run using three dependent variables in the previous two years: 1 antenatal care, 2 skilled birth attendants, and 3 child death in the previous 15 years. Independent predictor variables were: 1 low education (incomplete secondary education, 2 lack of access to one of four basic amenities. In a second set of regressions, a constructed composite barrier index replaced these variables. Odds ratios (ORs and 95% confidence intervals (95% CI were used to report regression results. Results: In Vietnam, about 54% of women aged 15–49 years in 2011, had low education or lacked access to one of four basic amenities. About 38% of poor rural women from ethnic minorities experienced both barriers, compared with less than 1% of rich urban women from the ethnic majority. Incomplete secondary education or lack of one of four basic amenities was a factor significantly associated with lower access to skilled birth attendants (OR=0.28, 95% CI: 0.14

  1. 45 CFR 284.20 - What information will we use to determine the child poverty rate in each State?

    Science.gov (United States)

    2010-10-01

    ... child poverty rate in each State? 284.20 Section 284.20 Public Welfare Regulations Relating to Public... TERRITORY'S CHILD POVERTY RATE IS THE RESULT OF THE TANF PROGRAM § 284.20 What information will we use to determine the child poverty rate in each State? (a) General. We will determine the child poverty rate...

  2. [Survey of suicidal mortality rate in several districts of Sichuan province].

    Science.gov (United States)

    Hu, Z; Liu, X; Huo, K; Zhang, W

    1992-09-01

    A survey of the suicidal mortality rates in two cities and six districts in Sichuan province was carried out from 1980 to 1988 by the authors. The average suicidal mortality rate (ASMR) in these districts from 1980 to 1988 was 15.5/10(5), and the population and suicidal mortality rate positively correlated, r = 0.53. The ASMR in the male was 14.9/10(5), in the female 17.1/10(5), in the urban area 9.4/10(5), in the rural area 21/10(5), and the ASMR in the urban area was higher than that in the rural area (P < 0.05). The peak age of suicidal mortality was around twenty years.

  3. Mortality rate in children born to mothers and fathers with celiac disease: a nationwide cohort study.

    Science.gov (United States)

    Zugna, Daniela; Richiardi, Lorenzo; Stephansson, Olof; Cnattingius, Sven; Ludvigsson, Jonas F

    2013-06-15

    Celiac disease (CD) is associated with increased mortality rate and adverse pregnancy outcome, but little is known about offspring mortality rate. In this nationwide retrospective cohort study, we identified persons whose biopsy-verified CD was diagnosed in Sweden in 1969-2008. We compared mortality rates in children born to mothers with and without CD (n = 16,121 vs. n = 61,782) and children born to fathers with and without CD (n = 9,289 vs. n = 32,984). Median age of offspring at end of follow-up was 28.7 (range, 16.7-39.7) years. We also examined mortality rates in children born to mothers with undiagnosed CD (later CD diagnosis; n = 12,919) and diagnosed CD (n = 3,202) to determine if intrauterine exposures associated with CD could affect offspring mortality rate. We estimated hazard ratios for death by using Cox regression. Death rates were independent of maternal CD (60 deaths per 100,000 person-years in children of mothers with CD, vs. 54 in controls) and paternal CD (53 deaths per 100,000 person-years in children of fathers with CD, vs. 53 in controls). Corresponding adjusted hazard ratios were 1.09 (95% confidence interval: 0.95, 1.26) for maternal CD and 1.02 (95% confidence interval: 0.85, 1.23) for paternal CD. Death rates were similar in children born to mothers with undiagnosed CD and in children whose mothers had diagnosed CD during pregnancy. Parental CD does not seem to influence mortality rate in offspring, which suggests that neither genetic influences of CD nor intrauterine conditions have adverse effects on offspring mortality rate.

  4. Birth rates among male cancer survivors and mortality rates among their offspring : a population-based study from Sweden

    NARCIS (Netherlands)

    Tang, Siau-Wei; Liu, Jenny; Juay, Lester; Czene, Kamila; Miao, Hui; Salim, Agus; Verkooijen, Helena M; Hartman, Mikael

    2016-01-01

    BACKGROUND: With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring. METHODS: From the Swedish Multi-generation Register and Cancer Register, we identified

  5. Trends in the modes of delivery and their impact on perinatal mortality rates

    Directory of Open Access Journals (Sweden)

    Duarte Geraldo

    2004-01-01

    Full Text Available OBJECTIVE: To determine changes in the incidence of vaginal deliveries, cesarean sections, and forceps deliveries and their potential association with fetal, early neonatal, and perinatal mortality rates over time. METHODS: A retrospective study was carried out and the occurrence of deliveries supervised by university services between January 1991 and December 2000 was determined. Data regarding fetal, early neonatal, and perinatal deaths were assessed using obstetric and pediatric records and autopsy reports. RESULTS: Of a total of 33,360 deliveries, the incidence of vaginal deliveries, cesarean sections, and forceps deliveries was relatively steady (around 60, 30, and 10%, respectively while, at the same time, there was a marked reduction in fetal mortality (from 33.3 to 13.0?, early neonatal mortality (from 30.6 to 9.0?, and perinatal mortality (from 56.4 to 19.3?. CONCLUSIONS: The marked reduction in perinatal mortality rates seen during the study period without an increase in cesarean sections indicates that the decrease in perinatal mortality was not impacted by cesarean section rates. The plausible hypothesis seems to be that the reduction in perinatal mortality of deliveries performed under the supervision of university services was more likely to be associated with better neonatal care rather than the mode of delivery.

  6. Increased mortality rate and suicide in Swedish former elite male athletes in power sports.

    Science.gov (United States)

    Lindqvist, A-S; Moberg, T; Ehrnborg, C; Eriksson, B O; Fahlke, C; Rosén, T

    2014-12-01

    Physical training has been shown to reduce mortality in normal subjects, and athletes have a healthier lifestyle after their active career as compared with normal subjects. Since the 1950s, the use of anabolic androgenic steroids (AAS) has been frequent, especially in power sports. The aim of the present study was to investigate mortality, including causes of death, in former Swedish male elite athletes, active 1960-1979, in wrestling, powerlifting, Olympic lifting, and the throwing events in track and field when the suspicion of former AAS use was high. Results indicate that, during the age period of 20-50 years, there was an excess mortality of around 45%. However, when analyzing the total study period, the mortality was not increased. Mortality from suicide was increased 2-4 times among the former athletes during the period of 30-50 years of age compared with the general population of men. Mortality rate from malignancy was lower among the athletes. As the use of AAS was marked between 1960 and 1979 and was not doping-listed until 1975, it seems probable that the effect of AAS use might play a part in the observed increased mortality and suicide rate. The otherwise healthy lifestyle among the athletes might explain the low malignancy rates.

  7. Maternal mortality rate and causes in Kermanshah province (2001-2012

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    Mehrangiz Jamshidpour

    2014-10-01

    Full Text Available Background: Maternal mortality is one of the most important indicators that is indicative of the status of development of countries. This study was aimed to investigate the rate and causes of maternal mortality in Kermanshah province. Methods: In this cross-sectional study, the maternal mortality records including demographic information, indicators of pregnancy and delivery, and mortality causes from 2001 to 2012 were extracted via census from the family health unit of the health deputy. To determine mortality rates, maternal deaths in every year were divided by the number of live births. Data were analyzed by Stata software. Results: The maternal mortality rate in Kermanshah was 25.9 deaths per one hundred thousand live births. The highest rate was reported in 2003 (53.4 and the lowest rate in 2012 (14.6 per one hundred thousand live births. Most deceased mothers were urban residents (66.7% with the age range of 18-35 years (64.6%, and high-risk pregnancies (65.3%. The most common cause of maternal death was bleeding (23.2%. There was a significant relationship between cause of death and urban-rural status, so that the most common causes in urban areas were complications of obstetric interventions whereas the most common cause in rural areas was bleeding (P= 0.008. Conclusion: Based on the results, the mortality rate of pregnant mothers is declining in Kermanshsh. However, given the most common cause of death (bleeding and high percentage of high-risk pregnancies, immediate and effective measures by healthcare personnel to prevent postpartum maternal mortality and adequate and appropriate care during pregnancy and after delivery are required to considered.

  8. A comparison of determinants of infant mortality rate (IMR) between countries with high and low IMR.

    Science.gov (United States)

    Megawangi, R; Barnett, J B

    1993-06-01

    Weighted least squares regressions and pooled regression models were used to examine the determinants of infant mortality in developing countries. Data were obtained from the UNICEF's "State of the World's Children, 1987" for 87 countries with data on gross national product, percentage of literate females, percentage of low birth weight infants, daily caloric supply per capita as a percentage of the daily requirement, percentage of population with access to drinking water, total fertility rate, and the population to nurses ratio. Data was unavailable on breast feeding practices and government expenditures on health. Weighted procedures were used because of heteroscadascity problems: total fertility rate was associated with the variance in the error term. The results of pooled data showed that the female literacy rate had the strongest impact on infant mortality, followed by access to clean water and the number of population per nursing person. The impact of female literacy was still strong in high infant mortality countries when controls for gross national product were included. Puzzling findings were the negative sign of low birth weight and the insignificant effect of the total fertility rate. The suggestion was that low birth weight may be expressed already in the level of education and availability of health programs. Fertility's lack of wide variations may explain the insignificant effect. Findings showed that infant mortality was 22.19% higher in countries with gross national product under $500. In low infant mortality countries, none of the environmental variables significantly explained infant mortality. Low birth weight increased its impact on infant mortality among these countries but was still not significant. The findings suggested that infant mortality was most affected by low birth weight and amount of population per nurse in more affluent countries. Environmental factors were more important in explaining high levels of infant mortality in less

  9. Modelling small-area inequality in premature mortality using years of life lost rates

    Science.gov (United States)

    Congdon, Peter

    2013-04-01

    Analysis of premature mortality variations via standardized expected years of life lost (SEYLL) measures raises questions about suitable modelling for mortality data, especially when developing SEYLL profiles for areas with small populations. Existing fixed effects estimation methods take no account of correlations in mortality levels over ages, causes, socio-ethnic groups or areas. They also do not specify an underlying data generating process, or a likelihood model that can include trends or correlations, and are likely to produce unstable estimates for small-areas. An alternative strategy involves a fully specified data generation process, and a random effects model which "borrows strength" to produce stable SEYLL estimates, allowing for correlations between ages, areas and socio-ethnic groups. The resulting modelling strategy is applied to gender-specific differences in SEYLL rates in small-areas in NE London, and to cause-specific mortality for leading causes of premature mortality in these areas.

  10. Calculating the Rate of Senescence From Mortality Data: An Analysis of Data From the ERA-EDTA Registry.

    Science.gov (United States)

    Koopman, Jacob J E; Rozing, Maarten P; Kramer, Anneke; Abad, José M; Finne, Patrik; Heaf, James G; Hoitsma, Andries J; De Meester, Johan M J; Palsson, Runolfur; Postorino, Maurizio; Ravani, Pietro; Wanner, Christoph; Jager, Kitty J; van Bodegom, David; Westendorp, Rudi G J

    2016-04-01

    The rate of senescence can be inferred from the acceleration by which mortality rates increase over age. Such a senescence rate is generally estimated from parameters of a mathematical model fitted to these mortality rates. However, such models have limitations and underlying assumptions. Notably, they do not fit mortality rates at young and old ages. Therefore, we developed a method to calculate senescence rates from the acceleration of mortality directly without modeling the mortality rates. We applied the different methods to age group-specific mortality data from the European Renal Association-European Dialysis and Transplant Association Registry, including patients with end-stage renal disease on dialysis, who are known to suffer from increased senescence rates (n = 302,455), and patients with a functioning kidney transplant (n = 74,490). From age 20 to 70, senescence rates were comparable when calculated with or without a model. However, when using non-modeled mortality rates, senescence rates were yielded at young and old ages that remained concealed when using modeled mortality rates. At young ages senescence rates were negative, while senescence rates declined at old ages. In conclusion, the rate of senescence can be calculated directly from non-modeled mortality rates, overcoming the disadvantages of an indirect estimation based on modeled mortality rates.

  11. Fetal alcohol spectrum disorders: a population based study of premature mortality rates in the mothers.

    Science.gov (United States)

    Li, Qing; Fisher, Wayne W; Peng, Chun-Zi; Williams, Andrew D; Burd, Larry

    2012-08-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers' death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44-7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09-0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment.

  12. Fetal Alcohol Spectrum Disorders: A Population Based Study of Premature Mortality Rates in the Mothers

    Science.gov (United States)

    Li, Qing; Fisher, Wayne W.; Peng, Chun-Zi; Williams, Andrew D.

    2017-01-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers’ death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44–7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09–0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment. PMID:21710184

  13. The effect of neighbourhood mortality shocks on fertility preferences: a spatial econometric approach.

    Science.gov (United States)

    Owoo, Nkechi S; Agyei-Mensah, Samuel; Onuoha, Emily

    2015-07-01

    According to the demographic transition theory, fertility rates fall in response to declines in child mortality rates. Although national statistics indicate that child mortality rates have been declining over time, Ghana's fertility rates appear to have stalled. This paper hypothesises that women's fertility behaviours may be more responsive to child mortality experiences at more localised levels. Using all rounds of the Ghana Demographic and Health Surveys (1988-2008) and employing a variety of spatial and empirical estimation techniques, results indicate that in addition to own-child mortality, neighbourhood child mortality shocks are also a determinant of women's fertility in Ghana. Women in neighbourhoods with large child mortality shocks may desire more children as an "insurance" against future losses, as a result of their increased perceptions of own-child mortality risks.

  14. A Hierarchical Distance Sampling Approach to Estimating Mortality Rates from Opportunistic Carcass Surveillance Data

    OpenAIRE

    2013-01-01

    Distance sampling is widely used to estimate the abundance or density of wildlife populations. Methods to estimate wildlife mortality rates have developed largely independently from distance sampling, despite the conceptual similarities between estimation of cumulative mortality and the population density of living animals. Conventional distance sampling analyses rely on the assumption that animals are distributed uniformly with respect to transects and thus require randomized placement of tr...

  15. Infant mortality rates according to socioeconomic status in a Brazilian city

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    Marcelo Zubaran Goldani

    2001-06-01

    Full Text Available OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381 and infant deaths (total of 731 that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05. These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head, in particular the post-neonatal mortality rate (chi-square for trend, p<0.05. Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.

  16. Infant mortality rates according to socioeconomic status in a Brazilian city

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    Goldani Marcelo Zubaran

    2001-01-01

    Full Text Available OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381 and infant deaths (total of 731 that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05. These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head, in particular the post-neonatal mortality rate (chi-square for trend, p<0.05. Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.

  17. In Sickness but Not in Health: Self-Ratings, Identity, and Mortality

    Science.gov (United States)

    Idler, Ellen; Leventhal, Howard; McLaughlin, Julie; Leventhal, Elaine

    2004-01-01

    Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study…

  18. Location matters: trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys.

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    Andrew Hodge

    Full Text Available Considerable improvements in life expectancy and other human development indicators in Indonesia are thought to mask considerable disparities between populations in the country. We examine the existence and extent of these disparities by measuring trends and inequalities in the under-five mortality rate and neonatal mortality rate across wealth, education and geography.Using data from seven waves of the Indonesian Demographic and Health Surveys, direct estimates of under-five and neonatal mortality rates were generated for 1980-2011. Absolute and relative inequalities were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. Disparities were assessed by levels of rural/urban location, island groups, maternal education and household wealth.Declines in national rates of under-five and neonatal mortality have accorded with reductions of absolute inequalities in clusters stratified by wealth, maternal education and rural/urban location. Across these groups, relative inequalities have generally stabilised, with possible increases with respect to mortality across wealth subpopulations. Both relative and absolute inequalities in rates of under-five and neonatal mortality stratified by island divisions have widened.Indonesia has made considerable gains in reducing under-five and neonatal mortality at a national level, with the largest reductions happening before the Asian financial crisis (1997-98 and decentralisation (2000. Hasty implementation of decentralisation reforms may have contributed to a slowdown in mortality rate reduction thereafter. Widening inequities between the most developed provinces of Java-Bali and those of other island groupings should be of particular concern for a country embarking on an ambitious plan for universal health coverage by 2019. A focus on addressing the key supply side barriers to accessing health care and on the social determinants of health in remote and

  19. Land tenure patterns and child health in southern Brazil: the relationship between agricultural production, malnutrition and child mortality.

    Science.gov (United States)

    Victora, C G; Vaughan, J P

    1985-01-01

    The relationships between infant mortality, malnutrition, and land tenure patterns in the State of Rio Grande do Sul, Brazil, were investigated with data from demographic and agricultural censuses, vital statistics, and dietary surveys, complemented by a large nutritional survey in urban and rural areas. These studies employed a variety of analytical methods and revealed that young children in areas with large ranches, livestock-raising, and a high proportion of agricultural wage-earners presented a higher mortality and had a poorer nutritional status than children in areas with small properties, crop agriculture, and self-employed family workers. Children of landowners showed least malnutrition and the smaller risk of death compared to children of laborers, although the differential seems to have narrowed in recent years. The main conclusion is that land tenure patterns play a very important role in determining early mortality and malnutrition in this Brazilian state.

  20. High Rates of All-cause and Gastroenteritis-related Hospitalization Morbidity and Mortality among HIV-exposed Indian Infants

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    Tripathy Srikanth

    2011-07-01

    Full Text Available Abstract Background HIV-infected and HIV-exposed, uninfected infants experience a high burden of infectious morbidity and mortality. Hospitalization is an important metric for morbidity and is associated with high mortality, yet, little is known about rates and causes of hospitalization among these infants in the first 12 months of life. Methods Using data from a prevention of mother-to-child transmission (PMTCT trial (India SWEN, where HIV-exposed breastfed infants were given extended nevirapine, we measured 12-month infant all-cause and cause-specific hospitalization rates and hospitalization risk factors. Results Among 737 HIV-exposed Indian infants, 93 (13% were HIV-infected, 15 (16% were on HAART, and 260 (35% were hospitalized 381 times by 12 months of life. Fifty-six percent of the hospitalizations were attributed to infections; gastroenteritis was most common accounting for 31% of infectious hospitalizations. Gastrointestinal-related hospitalizations steadily increased over time, peaking around 9 months. The 12-month all-cause hospitalization, gastroenteritis-related hospitalization, and in-hospital mortality rates were 906/1000 PY, 229/1000 PY, and 35/1000 PY respectively among HIV-infected infants and 497/1000 PY, 107/1000 PY, and 3/1000 PY respectively among HIV-exposed, uninfected infants. Advanced maternal age, infant HIV infection, gestational age, and male sex were associated with higher all-cause hospitalization risk while shorter duration of breastfeeding and abrupt weaning were associated with gastroenteritis-related hospitalization. Conclusions HIV-exposed Indian infants experience high rates of all-cause and infectious hospitalization (particularly gastroenteritis and in-hospital mortality. HIV-infected infants are nearly 2-fold more likely to experience hospitalization and 10-fold more likely to die compared to HIV-exposed, uninfected infants. The combination of scaling up HIV PMTCT programs and implementing proven health

  1. Disparities in Mortality Rates Among US Infants Born Late Preterm or Early Term, 2003–2005

    Science.gov (United States)

    Gazmararian, Julie A.; Shapiro-Mendoza, Carrie K.

    2015-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34–36 weeks gestation) and early term (37–38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003–2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85,9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk. PMID:23519825

  2. Vermont STep Ahead Recognition System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Vermont's STep Ahead Recognition System (STARS) prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for All Child Care Programs;…

  3. Heart rate at rest, exercise capacity, and mortality risk in veterans.

    Science.gov (United States)

    Pittaras, Andreas M; Faselis, Charles; Doumas, Michael; Myers, Jonathan; Kheirbek, Raya; Kokkinos, John Peter; Tsimploulis, Apostolos; Aiken, Monica; Kokkinos, Peter

    2013-11-15

    Heart rate (HR) at rest has been associated inversely with mortality risk. However, fitness is inversely associated with mortality risk and both increased fitness and β-blockade therapy affect HR at rest. Thus, both fitness and β-blockade therapy should be considered when HR at rest-mortality risk association is assessed. From 1986 to 2011, we assessed HR at rest, fitness, and mortality in 18,462 veterans (mean age = 58 ± 11 years) undergoing a stress test. During a median follow-up period of 10 years (211,398 person-years), 5,100 died, at an average annual mortality of 24.1 events/1,000 person-years. After adjusting for age, body mass index, cardiac risk factors, medication, and exercise capacity, we noted approximately 11% increase in risk for each 10 heart beats. To assess the risk in a wide and clinically relevant spectrum, we established 6 HR at rest categories per 10 heart beat intervals ranging from rest of ≥70 beats/min (hazard ratio 1.14, confidence interval 1.04 to 1.25; p rest of ≥100 beats/min. Similar trends were noted when for subjects aged rest-mortality risk association was direct and independent. A progressive increase in risk was noted >70 beats/min for the entire cohort, those treated with β blockers, and those aged <60 and ≥60 years. Mortality risk was overestimated slightly when fitness status was not considered.

  4. Mortality rate of gastric cancer in the population of Belgrade for 1990-2002 period

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    Šipetić Sandra B.

    2005-01-01

    Full Text Available Background. Worldwide, gastric cancer is the fourth leading cause of diseases, and the second leading cause of cancer deaths. Aim. To analyze the differences between men and women in mortality rate of gastric cancer in Belgrade from 1990−2002. Methods. Mortality rates standardized directly to the „World population“, and regression analysis were used. Results. In Belgrade population, 29.2% out the total number of deaths attributable to cancer were caused by gastric cancer. Gastric cancer was the second most common cause of death among digestive tract cancers. In women, in the period between 1990 and 1993, an average annual decline of mortality was 9.0% (95% confidence interval (CI = 5.9−13.1, and between 1994 and 2002, an average annual increase was 10.3% (CI = 8.4−12.6. Mortality rate series of gastric cancer in men did not fit any of the usual trend functions. The male/female gastric cancer mortality ratio was 1.7 : 1. Mortality rates for gastric cancer rose with age in both sexes and they were highest in the age group of 70 and more years. From 1990−2002, in both sexes aged 70 years and more, mortality from gastric cancer rose by 67.2% (CI = 58.0−76.4 in men and by 69.6% (CI = 60.6−78.6 in women. During the same period, the death rates in men decreased by 75.9 % (CI = 67.5−84.4 in the age group of 30−39 years, and by 48.1% (CI = 38.4−57.9 in women aged 50−59 years. In both sexes mortality rate series of all other age groups did not fit any of the usual trend functions. Conclusions. The increase in mortality rate of gastric in women over the past few years, showed the necessity of instituting primary and secondary preventive measures.

  5. Trends in corrected lung cancer mortality rates in Brazil and regions

    Science.gov (United States)

    Malta, Deborah Carvalho; de Abreu, Daisy Maria Xavier; de Moura, Lenildo; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth

    2016-01-01

    ABSTRACT OBJECTIVE To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. METHODS The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. RESULTS Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. CONCLUSIONS Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. PMID:27355467

  6. Differential Neonatal and Postneonatal Infant Mortality Rates across US Counties: The Role of Socioeconomic Conditions and Rurality

    Science.gov (United States)

    Sparks, P. Johnelle; McLaughlin, Diane K.; Stokes, C. Shannon

    2009-01-01

    Purpose: To examine differences in correlates of neonatal and postneonatal infant mortality rates, across counties, by degree of rurality. Methods: Neonatal and postneonatal mortality rates were calculated from the 1998 to 2002 Compressed Mortality Files from the National Center for Health Statistics. Bivariate analyses assessed the relationship…

  7. Adherence to clinical practice guidelines on community acquired pneumonia and its relation to mortality rates.

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    María Caridad Fragoso Marchante

    2010-08-01

    Full Text Available Background: Community acquired pneumonia is a common disease that is associated with significant morbidity and mortality rates. In the General University Hospital ´´Dr. Gustavo Aldereguía Lima¨ in Cienfuegos, there are guidelines for the management of patients with community-acquired pneumonia, but no studies have been conducted as to the relation between their compliance and the mortality rate. Objective: To assess the adherence to guidelines for diagnosis and treatment of community-acquired pneumonia and its relation to mortality in hospitalized patients. Methods: A descriptive, observational and prospective case series study was conducted in all patients with a diagnosis of pneumonia or bronchopneumonia at the moment of admission and discharge from June 2006 to May 31, 2007. The relation between the different variables and the mortality rate was analyzed as to the different types of risks and the overall compliance with the guidelines for each risk with mortality. A multivariate analysis (logistic regression was performed, with a 95% confidence interval. Results: The results are presented in tables of numbers and percent. Variables independently associated with mortality were: age (over 65 years old people, radiological lesions in more than one lobe or bilateral, atypical pneumonia debut, negative assessments as to the adherence to guidelines and inadequate treatments. Conclusion: The variables included in the study were enough to explain the final outcome of the patients, so it could be determined, for the first time in Cienfuegos, that the non-compliance with the guidelines of good clinical practice is related to mortality rates.

  8. Social Practices of Juvenile Survival and Mortality: Child Care Arrangements in Mexico City.

    Science.gov (United States)

    Gigengack, Roy

    1994-01-01

    Sketches the problems of urban "street" children in Mexico City, the emergence of collective child care arrangements, and the failure of the state to provide for child welfare. Describes community-based approaches arising in the absence of government action. (SK)

  9. Canadian suicide mortality rates: first-generation immigrants versus Canadian-born.

    Science.gov (United States)

    Strachan, J; Johansen, H; Nair, C; Nargundkar, M

    1990-01-01

    This article examines suicide mortality rates and trends in Canada for first-generation immigrants and the Canadian-born population. Data are analyzed by age, sex and country of birth. Since 1950, suicide rates worldwide for both men and women have been increasing. In North America and most of Europe, suicide has been one of the major causes of death for many years. In Canada, suicide rates are also rising. However, this increase is due entirely to a rise in the rate for men; the rate for women has remained relatively stable. Several differences are apparent between the rates for the Canadian-born population and those for first-generation immigrants. For example, three times as many Canadian-born men as women commit suicide. For first-generation immigrants, the ratio is two to one. Suicide mortality rates for the Canadian-born are higher than those for first-generation immigrants in every age group except for the 65 and over groups. Canadian born males have higher ASMR than first generation immigrant males. The rates for women show that first-generation immigrant women have higher suicide mortality rates than their Canadian-born counterparts, and that the highest rate for all women is for immigrants born in Asia.

  10. The Potential Impact of Changes in Fertility on Infant, Child, and Maternal Mortality. World Bank Staff Working Papers No. 698 and Population and Development Series No. 23.

    Science.gov (United States)

    Trussell, James; Pebley, Anne R.

    The relationship between changes in the timing and quantity of fertility, such as those that might result from an effective family planning program in developing countries, and changes in child and maternal mortality is examined. Results from five multivariate studies estimate the changes in mortality that might occur from altering maternal age,…

  11. Changes in causes of death and mortality rates among children in Greenland from 1987 - 91 to 1992 - 99

    DEFF Research Database (Denmark)

    Aaen-Larsen, Birger; Bjerregaard, Peter

    2003-01-01

    This study analysed the spontaneous trends in mortality among children in Greenland from 1987 - 91 to 1992 - 99 and describes the changes in the causes of death, mortality rates, and variation between regions....

  12. Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People

    DEFF Research Database (Denmark)

    Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn

    2016-01-01

    -rated, nurse-rated and physician-rated health's association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus......) were included as geriatric giants. Participants provided a score for life satisfaction and were followed up for vital status. Concordance of self-rated health with physician-rated (k = .3 [.0]) and nurse-rated health (k = .2 [.0]) was low. All three ratings were associated with the geriatric giants...... to life satisfaction than physician's and nurse's ratings. We conclude that professionals' health ratings are more reflective of physical health whereas self-rated health reflects more the older person's mental health, but all three health ratings are useful in research....

  13. Gaussian and Affine Approximation of Stochastic Diffusion Models for Interest and Mortality Rates

    Directory of Open Access Journals (Sweden)

    Marcus C. Christiansen

    2013-10-01

    Full Text Available In the actuarial literature, it has become common practice to model future capital returns and mortality rates stochastically in order to capture market risk and forecasting risk. Although interest rates often should and mortality rates always have to be non-negative, many authors use stochastic diffusion models with an affine drift term and additive noise. As a result, the diffusion process is Gaussian and, thus, analytically tractable, but negative values occur with positive probability. The argument is that the class of Gaussian diffusions would be a good approximation of the real future development. We challenge that reasoning and study the asymptotics of diffusion processes with affine drift and a general noise term with corresponding diffusion processes with an affine drift term and an affine noise term or additive noise. Our study helps to quantify the error that is made by approximating diffusive interest and mortality rate models with Gaussian diffusions and affine diffusions. In particular, we discuss forward interest and forward mortality rates and the error that approximations cause on the valuation of life insurance claims.

  14. Postneonatal and child mortality among twins in Southern and Eastern Africa

    NARCIS (Netherlands)

    A. Justesen; A.E. Kunst (Anton)

    2000-01-01

    textabstractBACKGROUND: Few studies have evaluated the difference in mortality between twins and singleton children during the postneonatal and childhood period in sub-Saharan Africa. The aim of this study was to quantify the excess mortality of twins during the postneo

  15. Determining Optimal Strategies to Reduce Maternal and Child Mortality in Rural Areas in Western China: an Assessment Using the Lives Saved Tool.

    Science.gov (United States)

    Jiang, Zhen; Guo, Su Fang; Scherpbier, Robert W; Wen, Chun Mei; Xu, Xiao Chao; Guo, Yan

    2015-08-01

    China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China.

  16. A Hierarchical Distance Sampling Approach to Estimating Mortality Rates from Opportunistic Carcass Surveillance Data.

    Science.gov (United States)

    Bellan, Steve E; Gimenez, Olivier; Choquet, Rémi; Getz, Wayne M

    2013-04-01

    Distance sampling is widely used to estimate the abundance or density of wildlife populations. Methods to estimate wildlife mortality rates have developed largely independently from distance sampling, despite the conceptual similarities between estimation of cumulative mortality and the population density of living animals. Conventional distance sampling analyses rely on the assumption that animals are distributed uniformly with respect to transects and thus require randomized placement of transects during survey design. Because mortality events are rare, however, it is often not possible to obtain precise estimates in this way without infeasible levels of effort. A great deal of wildlife data, including mortality data, is available via road-based surveys. Interpreting these data in a distance sampling framework requires accounting for the non-uniformity sampling. Additionally, analyses of opportunistic mortality data must account for the decline in carcass detectability through time. We develop several extensions to distance sampling theory to address these problems.We build mortality estimators in a hierarchical framework that integrates animal movement data, surveillance effort data, and motion-sensor camera trap data, respectively, to relax the uniformity assumption, account for spatiotemporal variation in surveillance effort, and explicitly model carcass detection and disappearance as competing ongoing processes.Analysis of simulated data showed that our estimators were unbiased and that their confidence intervals had good coverage.We also illustrate our approach on opportunistic carcass surveillance data acquired in 2010 during an anthrax outbreak in the plains zebra of Etosha National Park, Namibia.The methods developed here will allow researchers and managers to infer mortality rates from opportunistic surveillance data.

  17. Blastomycosis Mortality Rates, United States, 1990–2010

    Centers for Disease Control (CDC) Podcasts

    2015-01-05

    Diana Khuu discusses Blastomycosis Mortality Rates, United States, 1990–2010.  Created: 1/5/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/7/2015.

  18. A Needs Assessment of Health Issues Related to Maternal Mortality Rates in Afghanistan: A Pilot Study.

    Science.gov (United States)

    Naim, Ali; Feldman, Robert; Sawyer, Robin

    2015-01-01

    Maternal death rates in Afghanistan were among the highest in the world during the reign of the Taliban. Although these figures have improved, current rates are still alarming. The aim of this pilot study was to develop a needs assessment of the major health issues related to the high maternal mortality rates in Afghanistan. In-depth interviews were conducted with managerial midwives, clinical midwives, and mothers. Results of the interviews indicate that the improvement in the maternal mortality rate may be attributed to the increase in the involvement of midwives in the birthing process. However, barriers to decreasing maternal mortality still exist. These include transportation, access to care, and sociocultural factors such as the influence of the husband and mother-in-law in preventing access to midwives. Therefore, any programs to decrease maternal mortality need to address infrastructure issues (making health care more accessible) and sociocultural factors (including husbands and mother-in-laws in maternal health education). However, it should be noted that these findings are based on a small pilot study to help develop a larger scale need assessment.

  19. Pollution Sources and Mortality Rates across Rural-Urban Areas in the United States

    Science.gov (United States)

    Hendryx, Michael; Fedorko, Evan; Halverson, Joel

    2010-01-01

    Purpose: To conduct an assessment of rural environmental pollution sources and associated population mortality rates. Methods: The design is a secondary analysis of county-level data from the Environmental Protection Agency (EPA), Department of Agriculture, National Land Cover Dataset, Energy Information Administration, Centers for Disease Control…

  20. Rest/activity rhythms and mortality rates in older men: MrOS Sleep Study.

    Science.gov (United States)

    Paudel, Misti L; Taylor, Brent C; Ancoli-Israel, Sonia; Blackwell, Terri; Stone, Katie L; Tranah, Greg; Redline, Susan; Cummings, Steven R; Ensrud, Kristine E

    2010-01-01

    An association between increased risk of mortality and disruptions in rest/activity circadian rhythms (RAR) has been shown among adults with dementia and with metastatic colorectal cancer. However, the association among a more general population of older adults has not been studied. Our study population consisted of 2964 men aged > or = 67 yrs of age enrolled in the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study. Rest/activity patterns were measured with wrist actigraphy. RAR parameters were computed and expressed as quintiles, and included acrophase (time of peak activity level), amplitude (peak-to-nadir difference), mesor (middle of the peak), pseudo F-value (overall circadian rhythmicity), beta (steepness), and alpha (peak-to-trough width). After adjustment for multiple potential confounders, men in the lowest quintile of pseudo F-value had a 57% higher mortality rate (hazard ratio [HR] = 1.57, 95% CI, 1.03-2.39) than men in the highest quintile. This association was even stronger with increased risk of cardiovascular disease-related mortality (CVD) (HR = 2.32, 95% CI, 1.04-5.22). Additionally, men in the lowest quintile of acrophase had a 2.8-fold higher rate of CVD-related mortality (HR = 2.84, 95% CI, 1.29-6.24). There was no evidence of independent associations with amplitude, mesor, alpha, beta, and mortality risk. Older men with less robust RAR and earlier acrophase timing have modestly higher all-cause and CVD-related mortality rates. Further research should examine potential biological mechanisms underlying this association.

  1. Hostility Ratings by Parents at Risk for Child Abuse: Impact of Chronic and Temporary Schema Activation

    Science.gov (United States)

    Farc, Maria-Magdalena; Crouch, Julie L.; Skowronski, John J.; Milner, Joel S.

    2008-01-01

    Objective: Two studies examined whether accessibility of hostility-related schema influenced ratings of ambiguous child pictures. Based on the social information processing model of child physical abuse (CPA), it was expected that CPA risk status would serve as a proxy for chronic accessibility of hostile schema, while priming procedures were used…

  2. Quality of Child Care Using the Environment Rating Scales: A Meta-Analysis of International Studies

    Science.gov (United States)

    Vermeer, Harriet J.; van IJzendoorn, Marinus H.; Cárcamo, Rodrigo A.; Harrison, Linda J.

    2016-01-01

    The current study provides a systematic examination of child care quality around the globe, using the Environment Rating Scales (ERS). Additional goals of this study are to examine associations between ERS process quality and structural features (group size, caregiver-child ratio) that underpin quality and between ERS and more proximal aspects of…

  3. Therapeutic leukapheresis in hyperleucocytic leukaemias: lack of correlation between degree of cytoreduction and early mortality rate.

    Science.gov (United States)

    Porcu, P; Danielson, C F; Orazi, A; Heerema, N A; Gabig, T G; McCarthy, L J

    1997-08-01

    The clinical and laboratory data of 48 leukapheresis-treated patients with hyperleucocytic leukaemia (HL) was reviewed to assess the correlation between the degree of leucoreduction and early mortality. Leukapheresis resulted in > 50% leucoreductions and postapheresis WBC counts < 100 x 10(9)/l in most patients (64.5%). Patients presenting with neurological, respiratory or renal complications had higher early mortality rates than patients without such complications, despite similar initial WBC counts and comparable leucoreductions. Thus, in these patients, more efficient leucoreduction was not associated with improved early survival.

  4. Mortalidad por envenenamiento en niños Child mortality by poisoning

    Directory of Open Access Journals (Sweden)

    Martha Híjar

    1998-07-01

    in the Mexican Republic, in the years from 1979-1994. Material and methods. Secondary sources were employed. Analyzed variables were: age, sex, year, external cause of trauma and poisoning according to the 9th International Classification of Diseases: E850-E858, E860-E869 and E905. Tendencies by specific causes were analyzed with a Poisson regression model and relative risk by age, sex and district were obtained. Results. A total of 11 272 children under 15 years of age were recorded. The main causes were poisoning and toxic reactions caused by venomous plants or animals (E905; accidental poisoning by household gas or carbon monoxide (E868; and accidental poisoning by other drugs (E858. The relative risk was highest in age group <1 year; the values were RR 29.6, CI 95% 29.2-33.4; RR 3.47, CI 95% 2.86-4.22 and RR 31.86, CI 95% 24.8-40.9. Risk was similar for both sexes except for E905. The state of Aguascalientes consistently presented the highest risk values and the state of Nuevo Leon, the lowest. Conclusions. Poisoning is an important cause of child mortality. Considering that most of these deaths can potentially be prevented since they occur at home it is recommended that responsible adults can build protection into their environment and into the way society operates. Prevention should involve a multidisciplinary approach since the phenomenon has multiple causes and possible solutions.

  5. Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries

    Directory of Open Access Journals (Sweden)

    Johan Fritzell

    2013-01-01

    Full Text Available A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes.

  6. Cross-temporal and cross-national poverty and mortality rates among developed countries.

    Science.gov (United States)

    Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

    2013-01-01

    A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes.

  7. Infant mortality in Israel during 1950-2000: rates, causes, demographic characteristics and trends.

    Science.gov (United States)

    Amitai, Yona; Haklai, Ziona; Tarabeia, Jalal; Green, Manfred S; Rotem, Naama; Fleisher, Eve; Leventhal, Alex

    2005-03-01

    We evaluated the trends and risk factors in infant mortality in Israel over five decades (1950-2000), based on data obtained from the official notifications of live births, and death certificates. Until the 1960s the main cause of infant mortality was infectious disease; this was replaced by congenital anomalies in Moslems and Druzes, and preterm birth in Jews and Christians. In 2000, there were 746 infant deaths, and the national infant mortality rate (IMR) was 5.4 per 1000 live births (Jews 3.9; [95% CI 3.5, 4.3]; Moslems 9.2 [8.3, 10.3]; Christians 3.6 [1.4, 5.8]; Druzes 6.3 [3.6, 9.0]). Between 1955 and 2000 the overall IMR declined sevenfold (absolute declines of 56.8, 56.3, 45.0 and 28.3 per 1000 live births, in Moslems, Druzes, Christians and Jews, respectively). The reduction in IMRs between 1990 and 2000 in all religious groups (>45%) exceeded the goal set by the World Summit for Children in 1990 of 33%. In 2000, the main risk factors were birthweight Today, infant mortality in Israel represents a unique combination of high rate of congenital malformations among Moslems, where consanguineous marriages are common, and medical termination of pregnancy of malformed fetuses are infrequent; and relatively high IMRs from preterm birth in Jews, associated with high rates of assisted reproduction.

  8. High maternal and neonatal mortality rates in northern Nigeria: an 8-month observational study

    Directory of Open Access Journals (Sweden)

    Guerrier G

    2013-08-01

    Full Text Available Gilles Guerrier,1 Bukola Oluyide,2 Maria Keramarou,1 Rebecca Grais1 1Epicentre, Paris, France; 2Médecins Sans Frontières, Paris, France Background: Despite considerable efforts to reduce the maternal mortality ratio, numerous pregnant women continue to die in many developing countries, including Nigeria. We conducted a study to determine the incidence and causes of maternal mortality over an 8-month period in a rural-based secondary health facility located in Jahun, northern Nigeria. Methods: A retrospective observational study was performed in a 41-bed obstetric ward. From October 2010 to May 2011, demographic data, obstetric characteristics, and outcome were collected from all pregnant women admitted. The total number of live births during the study period was recorded in order to calculate the maternal mortality ratio. Results: There were 2,177 deliveries and 39 maternal deaths during the study period, with a maternal mortality ratio of 1,791/100,000 live births. The most common causes of maternal mortality were hemorrhage (26%, puerperal sepsis (19%, and obstructed labor (5%. No significant difference (P = 0.07 in mean time to reach the hospital was noted between fatal cases (1.9 hours, 95% confidence interval [CI] 1.1–2.6 and nonfatal cases (1.4 hours, 95% CI 1.4–1.5. Two hundred and sixty-six women were admitted presenting with stillbirth. Maternal mortality was higher for unbooked patients than for booked patients (odds ratio 5.1, 95% CI 3.5–6.2, P < 0.0001. The neonatal mortality rate was calculated at 46/1,000 live births. The main primary causes of neonatal deaths were prematurity (44% and birth asphyxia (22%. Conclusion: Maternal and neonatal mortality remains unacceptably high in this setting. Reducing unbooked emergencies should be a priority with continuous programs including orthodox practices in order to meet the fifth Millennium Development Goal. Keywords: fetal mortality, maternal mortality, Nigeria, antenatal care

  9. An Investigation of the Mortality Rate and Risk Factors in Newborn Infants With Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Sabzehei

    2016-08-01

    Full Text Available Background One of the serious challenges facing neonatal medicine is meconium aspiration syndrome, delays in the treatment of which can lead to high mortality. Objectives This study was designed and conducted with the aim of determining the mortality rate and risk factors affecting this rate in newborn infants with meconium aspiration syndrome. Methods This study was conducted as a retrospective descriptive research on newborn infants with meconium aspiration syndrome hospitalized at the neonatal intensive care unit (NICU of Fatemieh and Be’sat hospitals in Hamadan city during a 10-year period from 2004 to 2014. Demographic information of the mother and the newborn, hospitalization course, the need for mechanical ventilation, and complications and outcomes of disease were extracted and were analyzed using the SPSS software version 22. Results Sixty-three newborn infants, diagnosed with meconium aspiration syndrome, were entered in this study, 40% of them were male, 85.7% wighed more than 2500 g, and 17.5% were post term, 25.3% had a five-minute Apgar Score (AS5min of less than seven, 39.6% were nonvigorous at birth, 31.8% needed to be placed on mechanical ventilation, and 14.3% died during the hospitalization course. There was a significant relationship between the need for mechanical ventilation, nonvigorous state at the birth, complications of disease and mortality rate. Conclusions Despite the progress made in medicine, meconium aspiration syndrome is still one of the causes of newborn infants’ mortality. The mortality and morbidity rates can be reduced by improvement in perinatal care, prevention of post term delivery, timely caesarean and effective neonatal resuscitation at birth.

  10. Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

    Directory of Open Access Journals (Sweden)

    Kadim S. Bachtiar

    2008-06-01

    Full Text Available Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. (Med J Indones 2008; 17: 107-13Keywords: cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia

  11. Technology use, cesarean section rates, and perinatal mortality at Danish maternity wards

    DEFF Research Database (Denmark)

    Lidegaard, O; Jensen, L M; Weber, Tom

    1994-01-01

    Fifty-eight Danish maternity units, managing 99% of Danish deliveries, participated in a cross sectional study to assess the relationship between use of birth-related technologies, cesarean section rates and perinatal mortality for births after 35 completed weeks of gestation. A regional technology...... index (0-10) was calculated for each maternity unit according to its use of ante and intra partum fetal heart rate monitoring (FHM), hormone analysis (human placental lactogen (HPL) and/or estriol (O3)), fetal blood samples (scalp-pH), intrauterine catheter and umbilical cord-pH. Maternity units using......, and unplanned cesarean section rates in the eight regions were all without significant association to the perinatal mortality in the same regions. For births after the 35th completed week of gestation, this study could not confirm a relationship between different degrees of use of birth-related technologies...

  12. Rates of very preterm birth in Europe and neonatal mortality rates.

    NARCIS (Netherlands)

    Field, D.; Draper, E.S.; Fenton, A.; Papiernik, E.; Zeitlin, J.; Blondel, B.; Cuttini, M.; Maier, R.F.; Weber, T.; Carrapato, M.; Kollee, L.A.A.; Gadzin, J.; Reempts, P. Van

    2009-01-01

    OBJECTIVE: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in 10 European regions. DESIGN: Comparison of 10 separate geographically defined European populations, from nine European countries, over a 1-year period (7 months in one reg

  13. Rates of very preterm birth in Europe and neonatal mortality rates

    NARCIS (Netherlands)

    Field, D.; Draper, E. S.; Fenton, A.; Papiernik, E.; Zeitlin, J.; Blondel, B.; Cuttini, M.; Maier, R. F.; Weber, T.; Carrapato, M.; Kollee, L.; Gadzin, J.; Van Reempts, P.

    2009-01-01

    Objective: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in 10 European regions. Design: Comparison of 10 separate geographically defined European populations, from nine European countries, over a 1-year period (7 months in one reg

  14. 45 CFR 284.50 - What information will we use to determine the child poverty rate in each Territory?

    Science.gov (United States)

    2010-10-01

    ... child poverty rate in each Territory? 284.50 Section 284.50 Public Welfare Regulations Relating to... STATE OR TERRITORY'S CHILD POVERTY RATE IS THE RESULT OF THE TANF PROGRAM § 284.50 What information will we use to determine the child poverty rate in each Territory? (a) Our intent is that, to the...

  15. Preventable infant mortality and quality of health care: maternal perception of the child's illness and treatment

    Directory of Open Access Journals (Sweden)

    Hadad Salime

    2002-01-01

    Full Text Available This study used a qualitative methodology to analyze the discourse of mothers from Greater Metropolitan Belo Horizonte, Minas Gerais, Brazil, whose infant children had died from what were considered avoidable causes (diarrhea, malnutrition, and pneumonia, seeking to elucidate the factors associated with utilization of health care services. Identification of the illness by the mother was related to perception of specific alterations in the child's state of health. Analysis of the alterations helped identify the principal characteristics ascribed to each alteration and their relationship to the search for treatment. The authors also studied the mother's assessment of treatment received at health care facilities; 43.0% of the cases involved problems related to the structure of health care services or the attending health care professionals. In 46.0% of the cases, mothers associated the child's death with flaws in the health care service. The study group showed a variety of interpretations of illness, often distinct from the corresponding biomedical concepts. The fact that attending health care personnel overlooked or underrated the mother's perception of the illness and the lack of communications between health care personnel and the child's family had an influence on the child's evolution and subsequent death.

  16. Technology use, cesarean section rates, and perinatal mortality at Danish maternity wards

    DEFF Research Database (Denmark)

    1994-01-01

    Fifty-eight Danish maternity units, managing 99% of Danish deliveries, participated in a cross sectional study to assess the relationship between use of birth-related technologies, cesarean section rates and perinatal mortality for births after 35 completed weeks of gestation. A regional technology...... FHM had a 15% higher cesarean section rate (not planned) than units not using FHM (p ... a technology index was calculated for eight regions in Denmark, weighting the index of each unit in a region according to its number of deliveries. There was no association between the technology index in these eight regions in Denmark and their cesarean section rates. Use of FHM, technology index...

  17. Reduced All-Cause Child Mortality After General Measles Vaccination Campaign in Rural Guinea-Bissau

    DEFF Research Database (Denmark)

    Fisker, Ane Bærent; Rodrigues, Amabelia; Martins, Cesario

    2015-01-01

    BACKGROUND: Randomised trials have shown that measles vaccine (MV) prevents non-measles deaths. MV-campaigns are conducted to eliminate measles infection.The overall mortality effect of MV-campaigns has not been studied. METHODS: Bandim Health Project (BHP) surveys children aged 0-4 years in rural...... Guinea-Bissau through a health and demographic surveillance system. A nationalMV-campaign in 2006 targeted children aged 6 months-15 years. In a Cox proportional-hazards model with age as underlying time-scale we compared mortality for children aged 6-59 months after the campaign with mortality...... in the same age group during the two previous years. RESULTS: 8158 children aged 6-59 months were under BHP surveillance during the 2006-campaign and 7999 and 8108 during similar periods in 2004 and 2005. At least 90% of the eligible children received MV in the campaign. There were 161 non-accident deaths...

  18. Estimates of Age-Specific Mortality Rates from Sequential Cross-Sectional Data in Malawi

    Directory of Open Access Journals (Sweden)

    Henry V. Doctor

    2012-01-01

    Full Text Available This paper uses a method for estimating age-specific event rates for adults (15–49 years in Malawi between 1977 and 1998. This method, which is based on the development of unstable populations, is similar to the “variable-r” methods. Data from Malawi demonstrate mortality reduction nearly for all age groups between 1977 and 1987 for males whereas for females the reduction was observed for age groups 15–19 and 40–44. Contrary to this finding, the 1987–1998 intercensal period shows that mortality increased at a higher rate in the ages 20 and above for males than females. However, the increase for the females is much higher in the 1987–1998 intercensal period than in the 1977–1987 intercensal period. These findings may be related to the onset and effect of the AIDS epidemic. Implications for future research are discussed.

  19. Negative Trends in Transport-related Mortality Rates in Broiler Chickens.

    Science.gov (United States)

    Vecerek, Vladimir; Voslarova, Eva; Conte, Francesca; Vecerkova, Lenka; Bedanova, Iveta

    2016-12-01

    The high incidence of deaths during transport for slaughter is associated with poor welfare and represents a considerable loss to the poultry industry. In the period from 2009 to 2014, all shipments of broiler chickens to poultry processing plants were monitored in the Czech Republic and the numbers of chickens transported and those dying as a result of their transport were recorded and analysed. Overall transport-related mortality of broiler chickens transported for slaughter in the Czech Republic was 0.37%. It ranged from 0.31% to 0.72%, the increase approximately corresponding to the increasing transport distance. Statistically highly significant (prates in individual seasons of the year. The greatest mortality (0.55%) was associated with transports carried out in winter months whereas the lowest death losses (0.30%) were found in chickens transported for slaughter in summer months. Our study revealed greater transport-related mortality rates in broiler chickens transported for slaughter in the Czech Republic than expected when considering earlier studies. The most pronounced increases were found in transports for shorter distances and in winter months. However, an increase was found at all transport distances monitored except for distances exceeding 300 km and all seasons except for summer. Furthermore, a general increasing tendency in chicken losses during the monitored period was found. The particularly alarming finding is that the mortality of broiler chickens being transported to processing plants has been showing a long-term increasing tendency over the last two decades. Further research should focus on the identification of specific factors leading to such high and growing mortality rates and developing practical guidelines to improve the welfare of the birds in transit accordingly.

  20. Case fatality ratio and mortality rate trends of community-onset Staphylococcus aureus bacteraemia

    DEFF Research Database (Denmark)

    Tom, S; Galbraith, J C; Valiquette, L;

    2014-01-01

    Lethal outcomes can be expressed as a case fatality ratio (CFR) or as a mortality rate per 100 000 population per year (MR). Population surveillance for community-onset methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus bacteraemia was conducted in Canada, Australia......-onset S. aureus bacteraemia, particularly MSSA, is associated with major disease burden. This study highlights complementary information provided by evaluating both CFR and MR....

  1. Mortality Rates and Causes of Death of Convicted Dutch Criminals 25 Years Later

    OpenAIRE

    Nieuwbeerta, Paul; PIQUERO, ALEX R.

    2008-01-01

    Extant theory hypothesizes that offenders have greater risk of premature and unnatural death than nonoffenders, but few studies have assessed this hypothesis; those doing so have relied on U.S. samples of male offenders typically followed until midlife. This article examines the relation between criminal conduct and mortality rates in the Netherlands using data from the Criminal Careers and Life Course Study, which traces the life course and criminal careers of 4,615 males and females convict...

  2. Thymus size at 6 months of age and subsequent child mortality

    DEFF Research Database (Denmark)

    Garly, M.L.; Trautner, S.L.; Marx, C.;

    2008-01-01

    OBJECTIVE: To examine determinants of thymus size at age 6 months and investigate whether thymus size at this age is a determinant of subsequent mortality. STUDY DESIGN: Thymus size was measured by transsternal sonography in 923 6-month-old children participating in a measles vaccination trial in...

  3. Reducing high maternal mortality rates in western China: a novel approach.

    Science.gov (United States)

    Gyaltsen Gongque Jianzan, Kunchok; Gyal Li Xianjia, Lhusham; Gipson, Jessica D; Kyi Cai Rangji, Tsering; Pebley, Anne R

    2014-11-01

    Among the Millennium Development Goals, maternal mortality reduction has proven especially difficult to achieve. Unlike many countries, China is on track to meeting these goals on a national level, through a programme of institutionalizing deliveries. Nonetheless, in rural, disadvantaged, and ethnically diverse areas of western China, maternal mortality rates remain high. To reduce maternal mortality in western China, we developed and implemented a three-level approach as part of a collaboration between a regional university, a non-profit organization, and local health authorities. Through formative research, we identified seven barriers to hospital delivery in a rural Tibetan county of Qinghai Province: (1) difficulty in travel to hospitals; (2) hospitals lack accommodation for accompanying families; (3) the cost of hospital delivery; (4) language and cultural barriers; (5) little confidence in western medicine; (6) discrepancy in views of childbirth; and (7) few trained community birth attendants. We implemented a three-level intervention: (a) an innovative Tibetan birth centre, (b) a community midwife programme, and (c) peer education of women. The programme appears to be reaching a broad cross-section of rural women. Multilevel, locally-tailored approaches may be essential to reduce maternal mortality in rural areas of western China and other countries with substantial regional, socioeconomic, and ethnic diversity.

  4. Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia

    NARCIS (Netherlands)

    Warnier, Miriam J.; Rutten, Frans H.; De Boer, Anthonius; Hoes, Arno W.; De Bruin, Marie L.

    2014-01-01

    Background: Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non-

  5. A comparison of mortality rates in three prospective studies from Copenhagen with mortality rates in the central part of the city, and the entire country. Copenhagen Center for Prospective Population Studies

    DEFF Research Database (Denmark)

    Andersen, Lars Bo; Vestbo, Jørgen; Juel, Knud

    1998-01-01

    in the Copenhagen City Heart Study, whereas mortality rates in the Glostrup Population Studies were similar to rates for the whole country. The mortality rates among participants were lower than in the whole sample, and differences existed in relation to region and selection criteria of the cohorts. The Copenhagen...... Male Study, where only employed men were included, showed the lowest mortality rates, and higher rates were found in the study from the central part of the City (the Copenhagen City Heart Study) compared to the study from the suburbs (the Glostrup Population Studies). The difference between mortality...... rates in the cohorts and in Copenhagen City decreased with increasing age. The SMR converged towards 1.00 with increasing observation time. In conclusion, high participation rates were found in all three studies, resulting in SMR values for participants only slightly lower than in the source population...

  6. Cancer mortality rates among first and second generation migrants in the Netherlands: convergence toward the rates of the native Dutch population.

    NARCIS (Netherlands)

    Stirbu, I.; Kunst, A.E.; Vlems, F.A.; Devillé, W.; Nijhuis, H.G.J.; Coebergh, J.W.

    2006-01-01

    This study investigates the difference in cancer mortality rates between migrant groups and the native Dutch population, and determines the extent of convergence of cancer mortality rates according to migrants' generation, age at migration and duration of residence. Data were obtained from the natio

  7. Geomagnetic storms link to the mortality rate in the Smolyan region for the period 1988--2009

    Science.gov (United States)

    Simeonova, Siyka G. 1; Georgieva, Radostina C. 2; Dimitrova, Boryana H. 2; Slavcheva, Radka G. 2; Kerimova, Bojena P. 2; Georgiev, Tsvetan B. 34

    We present correlations and trends of 10 parameters of annual mortality rate (1 to common mortality rate, 5 to cardiovascular reasons and 4 to "accidental" reasons (car accidents, suicides, infections)) with respect to 6 parameters of annual solar and geomagnetic activity (Wolf index, number of geomagnetic storms, duration of the storms, amplitude of the storms). During the period of observation, characterized by a 3-4-fold decrease of the mean geomagnetic activity (in terms of the number and the duration of the storms) and with a strong variations of the amplitude of the storms (about an almost constant mean values for the period), there is a 1.3-fold decrease in the urban population, a 1.5-fold increase of the common mortality rate, a 1.8-fold increase of the cardiovascular mortality rate and a 1.1-fold decrease of the "accidental" mortality rates. During the years 2003-2005 we observe about 2-fold temporary increase in the storm amplitudes. During the years 2007-2008, characterized by extremely low geomagnetic activity, we observe a surprising temporary increase of the common and the cardiovascular mortality rates 1.1 and 1.3-fold, respectively (Figures 1-4). We point out 3 main results. (1) The available data shows notable increase in the mortality rates while there is generally a decrease of the solar or geomagnetic activity during the studied period (Figures 5-9). We explain this anti-correlation with the domination of the increasing mortality rates as an effect of the advance in the mean age of the population (due to immigration of young people and decrease of new-borns), hiding an eventual display of the solar and geomagnetic influence on the mortality rates. Using this data we can not reveal influence of the long-time (10-20 years) change of the average solar and geomagnetic activity on the mortality rate. (2) Excluding the unusual years 2007 and 2008, we establish that with respect to the years with low geomagnetic activity (1993, 1995, 1996, 1999), in

  8. Exploring the association between short/long preceding birth intervals and child mortality: using reference birth interval children of the same mother as comparison

    OpenAIRE

    Kozuki, Naoko; Walker, Neff

    2013-01-01

    Background This study used data from recent Demographic and Health Surveys (DHS) to examine the impact of short or long preceding birth intervals on neonatal and under-five mortality. In order to minimize the effect of selection issues, we examined child mortality outcomes of the same mother, comparing short or long interval births against births with what had previously been considered optimal intervals. Methods We analyzed 47 DHS datasets from low- and middle-income countries. For each data...

  9. Exacerbation rate, health status and mortality in COPD – a review of potential interventions

    Directory of Open Access Journals (Sweden)

    Terence AR Seemungal

    2009-05-01

    Full Text Available Terence AR Seemungal1, John R Hurst2, Jadwiga A Wedzicha21Department of Clinical Medical Sciences, University of the West Indies, St. Augustine Campus, Trinidad and Tobago; 2Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, University College London, UKAbstract: COPD is prevalent in Western society and its incidence is rising in the developing world. Acute exacerbations of COPD, about 50% of which are unreported, lead to deterioration in quality of life and contribute significantly to disease burden. Quality of life deteriorates with time; thus, most of the health burden occurs in more severe disease. COPD severity and frequent and more severe exacerbations are all related to an increased risk of mortality. Inhaled corticosteroids (ICS have similar effects on quality of life but ICS/long-acting bronchodilator combinations and the long-acting antimuscarinic tiotropium all improve health status and exacerbation rates and are likely to have an effect on mortality but perhaps only with prolonged use. Erythromycin has been shown to decrease the rate of COPD exacerbations. Pulmonary rehabilitation and regular physical activity are indicated in all severities of COPD and improve quality of life. Noninvasive ventilation is associated with improved quality of life. Long-term oxygen therapy improves mortality but only in hypoxic COPD patients. The choice of an inhaler device is a key component of COPD therapy and this requires more attention from physicians than perhaps we are aware of. Disease management programs, characterized as they are by patient centeredness, improve quality of life and decrease hospitalization rates. Most outcomes in COPD can be modified by interventions and these are well tolerated and have acceptable safety profiles.Keywords: COPD, exacerbation, health burden, mortality, inhaled steroids, long-acting bronchodilators, long-acting antimuscarinic agents, macrolide, disease management program

  10. Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.

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    Benjamin P George

    Full Text Available Encephalitis rates by etiology and acute-phase outcomes for encephalitis in the 21st century are largely unknown. We sought to evaluate cause-specific rates of encephalitis hospitalizations and predictors of inpatient mortality in the United States.Using the Nationwide Inpatient Sample (NIS from 2000 to 2010, a retrospective observational study of 238,567 patients (mean [SD] age, 44.8 [24.0] years hospitalized within non-federal, acute care hospitals in the U.S. with a diagnosis of encephalitis was conducted. Hospitalization rates were calculated using population-level estimates of disease from the NIS and population estimates from the United States Census Bureau. Adjusted odds of mortality were calculated for patients included in the study.In the U.S. from 2000-2010, there were 7.3±0.2 encephalitis hospitalizations per 100,000 population (95% CI: 7.1-7.6. Encephalitis hospitalization rates were highest among females (7.6±0.2 per 100,000 and those 65 years of age with rates of 13.5±0.9 and 14.1±0.4 per 100,000, respectively. Etiology was unknown for approximately 50% of cases. Among patients with identified etiology, viral causes were most common (48.2%, followed by Other Specified causes (32.5%, which included predominantly autoimmune conditions. The most common infectious agents were herpes simplex virus, toxoplasma, and West Nile virus. Comorbid HIV infection was present in 7.7% of hospitalizations. Average length of stay was 11.2 days with mortality of 5.6%. In regression analysis, patients with comorbid HIV/AIDS or cancer had increased odds of mortality (odds ratio [OR]  = 1.70; 95% CI: 1.30-2.22 and OR = 2.26; 95% CI: 1.88-2.71, respectively. Enteroviral, postinfectious, toxic, and Other Specified causes were associated with lower odds vs. herpes simplex encephalitis.While encephalitis and encephalitis-related mortality impose a considerable burden in the U.S. in the 21st Century, the reported demographics of hospitalized

  11. Sex differences in child and adolescent mortality by parental education in the Nordic countries

    DEFF Research Database (Denmark)

    Gissler, Mika; Rahkonen, Ossi; Mortensen, Laust Hvas

    2012-01-01

    by age and country, and how much of the sex differences can be explained by external causes of death. Methods Data on all live-born children were received from national birth registries for 1981-2000 (Denmark: n=1¿184¿926; Norway: n=1¿090¿127; and Sweden n=1¿961¿911) and for 1987-2000 (Finland: n=841...... is needed to study whether the share of avoidable deaths is higher among children whose parents have had a shorter education time....... mortality than girls. The children of mothers and fathers who had had the shortest education time had the highest mortality for both sexes and for all ages and countries. The differences between the groups with longer than basic education were smaller, particularly among older children and girls...

  12. Is there a relationship between insect metabolic rate and mortality of mealworms Tenebrio molitor L. after insecticide exposure?

    OpenAIRE

    Justyna MALISZEWSKA; TĘGOWSKA, Eugenia

    2016-01-01

    Pesticides are known to affect insects metabolic rate and CO2 release patterns. In the presented paper metabolic rate and mortality of mealworms Tenebrio molitor L. exposed to four different insecticides was evaluated, to find out whether there is a relationship between mealworms sensitivity to pesticides and their metabolic rate. Tenebrio molitor mortality was determined after intoxication with pyrethroid, oxadiazine, neonicotinoid and organophosphate. Metabolic rate before and after intoxic...

  13. Status and trend of tree growth and mortality rate at the CONECOFOR plots, 1997-2004

    Directory of Open Access Journals (Sweden)

    Gianfranco Fabbio

    2013-11-01

    Full Text Available The circumference of trees in the CONECOFOR permanent monitoring plots (PMPs were measured by three surveys carried out in 1997, 2000 and 2005. Plots were arranged into forest types according to tree species, management system and stand structure: beech (Fagus sylvatica L. and spruce (Picea abies K. high forests, aged coppice forests and transitory crops (deciduous, evergreen oaks and beech. Diameter distribution, basal area, basal area increment, tree mortality rate and in-growth were calculated per layer (dominant, intermediate, dominated within each PMP, to point out relative contributions and changes. A range in relative annual growth was detected both within and between types over the monitored period, but an obvious reduction of annual increment was found in two/thirds of plots over 2000-04 as compared to 1997-99. Current mortality, mostly allocated into the dominated and intermediate layers, can be explained as “regular” due to overstocking and high inter-tree competition in almost all of the observed case-studies. Opposite patterns were found to occur as for stand growth vs. mortality rate between coppice forests and the other types owing to the different dynamics of tree competition in progress. Drought 2003 is the likely large-scale factor determining the reduced annual growth course over the second period.

  14. Seasonal survival rates and causes of mortality of Little Owls in Denmark

    DEFF Research Database (Denmark)

    Thorup, Kasper; Pedersen, Dorthe; Sunde, Peter

    2013-01-01

    the causes of current survival rates, we estimated age- and season-specific survival rates and causes of mortality in Danish Little Owls on the basis of ringed birds 1920–2002, radio tagged adult and juveniles 2005–2008 and nest surveys 2006–2008. We estimate that 32 % of all eggs fledge and survive to 2...... strongly associated with anthropogenically modified landscapes, is declining fast and may soon face extinction. The population decline is ultimately associated with reduced survival of independent offspring, but reduced survival rates of adults may possibly contribute to the observed decline. To explore...... weeks post hatching (age of ringing) and 47 %of the nestlings from ringing to fledging. Fifty-five percentage of the radio-tracked fledged young survived to dispersal, i.e. a total survival rate from egg to dispersal of 8 %. Analyses of combined ringing and radio tracking data showed a lower survival...

  15. Heart Rate as a Moderator between Child Abuse Potential and Reactive and Proactive Aggression

    OpenAIRE

    Tanaka, Akiho

    2006-01-01

    Previous research regarding the biosocial approach to aggression suggests that the interaction between biological and environmental variables contribute to aggression. However, this particular relationship has not yet been fully explored in children. Therefore, this study examined the moderating influence of psychophysiological activity, particularly resting heart rate (HR) and HR variability (HRV), on the relationship between child abuse potential (CAP) and child reactive and proactive aggre...

  16. Emotional Indicators on the Bender-Gestalt and the Devereux Child Behavior Rating Scale

    Science.gov (United States)

    Gregory Mary K.

    1977-01-01

    A heterogeneous group of elementary school children referred for psycho-educational diagnosis were rated on the Devereux Child Behavior Rating Scale and the Bender Visual-Motor Gestalt Test, scoring for Koppitz Emotional Indicators. Findings suggests that certain DCB factors may be more predictive of emotional problems than others in the scale.…

  17. Measuring Parenting Dimensions in Middle Childhood Multitrait-Multimethod Analysis of Child, Mother, and Father Ratings

    NARCIS (Netherlands)

    Kuppens, Sofie; Grietens, Hans; Onghena, Patrick; Michiels, Daisy

    2009-01-01

    Questionnaire ratings were used to obtain child, mother, and father ratings on three major parenting dimensions (behavioral control, psychological control, and support) in a sample of 600 children aged 8-to-10 years old. Results indicated that mothers, fathers, and children were able to reliably dif

  18. Virginia Star Quality Initiative: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Virginia's Star Quality Initiative prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  19. Delaware Stars for Early Success. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Delaware's Stars for Early Success prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  20. Kentucky STARS for KIDS NOW: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Kentucky's STARS for KIDS NOW prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  1. Pennsylvania Keystone STARS: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Pennsylvania's Keystone STARS prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  2. High Mortality Rate of Stomach Cancer Caused Not by High Incidence but Delays in Diagnosis in Aomori Prefecture, Japan

    Science.gov (United States)

    Matsuzaka, Masashi; Tanaka, Rina; Sasaki, Yoshihiro

    2016-10-01

    Background: There are substantial differences in the mortality rates of stomach cancer among the 47 prefectures in Japan, and Aomori prefecture is one of the most severely impacted. The aims of this study were to determine the incidence and mortality rates of stomach cancer in Aomori prefecture in comparison with Japan as a whole and cast light on reasons underlying variation. Methods: Data on stomach cancer cases were extracted from the Aomori Cancer Registry Database. Incidence rates for specific stages at the time of diagnosis were cited from Monitoring of Cancer Incidence in Japan, and mortality rates for stomach cancer in Aomori prefecture and the whole of Japan were obtained from Vital Statistics. Age-standardised incidence and mortality rates were calculated using the direct method. Results: The age-standardised incidence rate of stomach cancer in Aomori prefecture was higher than in the whole of Japan for males but lower for females. However, the age-standardised mortality rates were higher in Aomori prefecture in both sexes. The proportion of localised cancers was lower in Aomori prefecture than in the whole of Japan for most age groups. Conclusions: The lower rate for localised cancer suggests that higher age-standardised mortality rates are due to delays in diagnosis, despite an attendance rate for stomach cancer screening was higher in Aomori prefecture than in the whole of Japan. One plausible explanation for the failure of successful early detection might be poor quality control during screening implementation that impedes early detection.

  3. Maternal Mortality and Female Literacy Rates in Developing Countries during 1970–2000: A Latent Growth Curve Analysis

    Directory of Open Access Journals (Sweden)

    Vijayan K. Pillai

    2013-01-01

    Full Text Available Background. The gross longitudinal relationship between female literacy and maternal mortality ratios has not been adequately investigated even though the knowledge of the relationship is crucial for designing maternal mortality reduction programs through female literacy campaigns and improvements. The objective of the study was to examine the dynamic relationship between female literacy and mortality ratios. A longitudinal study design spanning three decades, 1970–2000, was used. Country level data on 143 nations belonging to six geographical regions for the duration 1970–2000 were secured from websites hosted by global agencies such as World Bank and the United Nations were utilized. Maternal mortality ratios (1970–2000 ranged from 147 to 271 across the six regions. The longitudinal relationship between female literacy rates and maternal mortality ratios was examined using a latent growth curve approach. The study found that rates of change in female literacy and maternal mortality ratios are negatively related. Steady rates of increase in female literacy were associated with declining maternal mortality ratios as well. We find that female literacy programs are of immense value in reducing maternal mortality ratios given their ability to yield sustained reductions in mortality levels in developing countries.

  4. Mortality, Rehospitalisation and Violent Crime in Forensic Psychiatric Patients Discharged from Hospital: Rates and Risk Factors.

    Directory of Open Access Journals (Sweden)

    Seena Fazel

    Full Text Available To determine rates and risk factors for adverse outcomes in patients discharged from forensic psychiatric services.We conducted a historical cohort study of all 6,520 psychiatric patients discharged from forensic psychiatric hospitals between 1973 and 2009 in Sweden. We calculated hazard ratios for mortality, rehospitalisation, and violent crime using Cox regression to investigate the effect of different psychiatric diagnoses and two comorbidities (personality or substance use disorder on outcomes.Over mean follow-up of 15.6 years, 30% of patients died (n = 1,949 after discharge with an average age at death of 52 years. Over two-thirds were rehospitalised (n = 4,472, 69%, and 40% violently offended after discharge (n = 2,613 with a mean time to violent crime of 4.2 years. The association between psychiatric diagnosis and outcome varied-substance use disorder as a primary diagnosis was associated with highest risk of mortality and rehospitalisation, and personality disorder was linked with the highest risk of violent offending. Furthermore comorbid substance use disorder typically increased risk of adverse outcomes.Violent offending, premature mortality and rehospitalisation are prevalent in patients discharged from forensic psychiatric hospitals. Individualised treatment plans for such patients should take into account primary and comorbid psychiatric diagnoses.

  5. Rates of thoracic trauma and mortality due to accidents in Brazil

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    Cury Francisco

    2009-01-01

    Full Text Available Aim: To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil. Materials and Methods: This prospective study was performed at the Regional Trauma Center in Sγo Josι do Rio Preto over a 1-year period, from 1 st July 2004 to 30 th June 2005. We included all patients attending the center′s emergency room with thoracic trauma and an anatomic injury scale (AIS ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis. Results:There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12% deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4% car crashes, 75 (20.1% falls, 46 (12.3% motorbike accidents, 40 (10.7% stabbings, 22 (5.9% accidents involving pedestrians, 21 (5.6% bicycle accidents, 17 (4.6% shootings, and 54 (14.5% other types of accident. The severity of the injuries was classified according to the AIS: 224 (60% were grade 2, 101 (27% were grade 3, 27 (7.2% were grade 4, 18 (4.9% were grade 5, and 3 were (0.8% grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents. Conclusion: Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate.

  6. Assessing the trend of HIV/AIDS mortality rate in Asia and North Africa: an application of latent growth models.

    Science.gov (United States)

    Zayeri, F; Talebi Ghane, E; Borumandnia, N

    2016-02-01

    Over the last 30 years, HIV/AIDS has emerged as a major global health challenge. This study evaluates the change of HIV/AIDS mortality rates in Asian and North African countries from 1990 to 2010 using the Global Burden of Disease (GBD) study. HIV/AIDS mortality rates were derived from the GBD database from 1990 to 2010, for 52 countries in Asia and North Africa. First, a Latent Growth Model was employed to assess the change in AIDS mortality rate over time in six different regions of Asia, and also the change in AIDS mortality rate over time for males and females in Asia and North Africa. Finally, Latent Growth Mixture Models (LGMMs) were applied to identify distinct groups in which countries within each group have similar trends over time. Our results showed that increase in mortality rate over time for males is about three times greater than for females. The highest and lowest trend of AIDS mortality rates were observed in South-East Asia and high-income Asia-Pacific regions, respectively. The LGMM allocated most countries in the South and South-East region into two classes with the highest trend of AIDS mortality rates. Although the HIV/AIDS mortality rates are decreasing in some countries and clusters, the general trend in the Asian continent is upwards. Therefore, it is necessary to provide programmes to achieve the goal of access to HIV prevention measures, treatment, care, and support for high-risk groups, especially in countries with a higher trend of AIDS mortality rates.

  7. Marital fertility decline in the Netherlands: child mortality, real wages, and unemployment, 1860-1939.

    Science.gov (United States)

    Schellekens, Jona; van Poppel, Frans

    2012-08-01

    Previous studies of the fertility decline in Europe are often limited to an earlier stage of the marital fertility decline, when the decline tended to be slower and before the large increase in earnings in the 1920s. Starting in 1860 (before the onset of the decline), this study follows marital fertility trends until 1939, when fertility reached lower levels than ever before. Using data from the Historical Sample of the Netherlands (HSN), this study shows that mortality decline, a rise in real income, and unemployment account for the decline in the Netherlands. This finding suggests that marital fertility decline was an adjustment to social and economic change, leaving little room for attitudinal change that is independent of social and economic change.

  8. A comparison of Child-Pugh, APACHE II and APACHE III scoring systems in predicting hospital mortality of patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Romanos John

    2003-05-01

    Full Text Available Abstract Background The aim of this study was to assess the prognostic accuracy of Child-Pugh and APACHE II and III scoring systems in predicting short-term, hospital mortality of patients with liver cirrhosis. Methods 200 admissions of 147 cirrhotic patients (44% viral-associated liver cirrhosis, 33% alcoholic, 18.5% cryptogenic, 4.5% both viral and alcoholic were studied prospectively. Clinical and laboratory data conforming to the Child-Pugh, APACHE II and III scores were recorded on day 1 for all patients. Discrimination was evaluated using receiver operating characteristic (ROC curves and area under a ROC curve (AUC. Calibration was estimated using the Hosmer-Lemeshow goodness-of-fit test. Results Overall mortality was 11.5%. The mean Child-Pugh, APACHE II and III scores for survivors were found to be significantly lower than those of nonsurvivors. Discrimination was excellent for Child-Pugh (ROC AUC: 0.859 and APACHE III (ROC AUC: 0.816 scores, and acceptable for APACHE II score (ROC AUC: 0.759. Although the Hosmer-Lemeshow statistic revealed adequate goodness-of-fit for Child-Pugh score (P = 0.192, this was not the case for APACHE II and III scores (P = 0.004 and 0.003 respectively Conclusion Our results indicate that, of the three models, Child-Pugh score had the least statistically significant discrepancy between predicted and observed mortality across the strata of increasing predicting mortality. This supports the hypothesis that APACHE scores do not work accurately outside ICU settings.

  9. Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis

    NARCIS (Netherlands)

    Nitsch, D.; Grams, M.; Sang, Y.; Black, C.; Cirillo, M.; Djurdjev, O.; Iseki, K.; Jassal, S.K.; Kimm, H.; Kronenberg, F.; Oien, C.M.; Levey, A.S.; Levin, A.; Woodward, M.; Hemmelgarn, B.R.; Wetzels, J.F.

    2013-01-01

    OBJECTIVE: To assess for the presence of a sex interaction in the associations of estimated glomerular filtration rate and albuminuria with all-cause mortality, cardiovascular mortality, and end stage renal disease. DESIGN: Random effects meta-analysis using pooled individual participant data. SETTI

  10. Postnatal growth rates covary weakly with embryonic development rates and do not explain adult mortality probability among songbirds on four continents

    Science.gov (United States)

    Martin, Thomas E.; Oteyza, Juan C.; Mitchell, Adam E.; Potticary, Ahva L.; Lloyd, P.

    2016-01-01

    Growth and development rates may result from genetic programming of intrinsic processes that yield correlated rates between life stages. These intrinsic rates are thought to affect adult mortality probability and longevity. However, if proximate extrinsic factors (e.g., temperature, food) influence development rates differently between stages and yield low covariance between stages, then development rates may not explain adult mortality probability. We examined these issues based on study of 90 songbird species on four continents to capture the diverse life-history strategies observed across geographic space. The length of the embryonic period explained little variation (ca. 13%) in nestling periods and growth rates among species. This low covariance suggests that the relative importance of intrinsic and extrinsic influences on growth and development rates differs between stages. Consequently, nestling period durations and nestling growth rates were not related to annual adult mortality probability among diverse songbird species within or among sites. The absence of a clear effect of faster growth on adult mortality when examined in an evolutionary framework across species may indicate that species that evolve faster growth also evolve physiological mechanisms for ameliorating costs on adult mortality. Instead, adult mortality rates of species in the wild may be determined more strongly by extrinsic environmental causes.

  11. Is there a relationship between insect metabolic rate and mortality of mealworms Tenebrio molitor L. after insecticide exposure?

    Directory of Open Access Journals (Sweden)

    Justyna MALISZEWSKA

    2016-09-01

    Full Text Available Pesticides are known to affect insects metabolic rate and CO2 release patterns. In the presented paper metabolic rate and mortality of mealworms Tenebrio molitor L. exposed to four different insecticides was evaluated, to find out whether there is a relationship between mealworms sensitivity to pesticides and their metabolic rate. Tenebrio molitor mortality was determined after intoxication with pyrethroid, oxadiazine, neonicotinoid and organophosphate. Metabolic rate before and after intoxication with insecticides was also determined. The highest CO2 production and mortality rate was observed after mealworms exposition to neonicotinoid insecticide. The results suggest that high CO2 release after intoxication is adequate to the intensity of the non-specific action of the xenobiotic (e.g. hyperactivity of neuromuscular system, rather than the intensity of detoxification processes, and it is correlated with mealworms mortality.

  12. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    Science.gov (United States)

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  13. Modeling Atmospheric Emissions and Calculating Mortality Rates Associated with High Volume Hydraulic Fracturing Transportation

    Science.gov (United States)

    Mathews, Alyssa

    Emissions from the combustion of fossil fuels are a growing pollution concern throughout the global community, as they have been linked to numerous health issues. The freight transportation sector is a large source of these emissions and is expected to continue growing as globalization persists. Within the US, the expanding development of the natural gas industry is helping to support many industries and leading to increased transportation. The process of High Volume Hydraulic Fracturing (HVHF) is one of the newer advanced extraction techniques that is increasing natural gas and oil reserves dramatically within the US, however the technique is very resource intensive. HVHF requires large volumes of water and sand per well, which is primarily transported by trucks in rural areas. Trucks are also used to transport waste away from HVHF well sites. This study focused on the emissions generated from the transportation of HVHF materials to remote well sites, dispersion, and subsequent health impacts. The Geospatial Intermodal Freight Transport (GIFT) model was used in this analysis within ArcGIS to identify roadways with high volume traffic and emissions. High traffic road segments were used as emissions sources to determine the atmospheric dispersion of particulate matter using AERMOD, an EPA model that calculates geographic dispersion and concentrations of pollutants. Output from AERMOD was overlaid with census data to determine which communities may be impacted by increased emissions from HVHF transport. The anticipated number of mortalities within the impacted communities was calculated, and mortality rates from these additional emissions were computed to be 1 in 10 million people for a simulated truck fleet meeting stricter 2007 emission standards, representing a best case scenario. Mortality rates due to increased truck emissions from average, in-use vehicles, which represent a mixed age truck fleet, are expected to be higher (1 death per 341,000 people annually).

  14. Mortality Rate for Children under 5 Years of Age in Zhejiang Province, China from 1997 to 2012.

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    Weifang Zhang

    Full Text Available This is a population based descriptive study that examined the trends in childhood mortality among under five children and the major causes under five mortality in Zhejiang Province, China.A population-based survey was conducted through a province-level surveillance network. The mortality rate and leading causes of death for children under 5 years of age were analyzed. The trend in the mortality rate for children under five and cause-specific mortality rates were analyzed by chi-square with SPSS 13.0 software.In Zhejiang Province, during 1997-2012, mortality rates in neonates, postneonatal infants, and children under 5 years were reduced by 64.2% (from 7.85 to 2.81 per 1000 livebirths, 66.7% (from 12.73 to 4.24 per 1000 livebirths, and 63% (from 15.76 to 5.85 per 1000 livebirths, respectively. The mortality rates in children under 5 years of age decreased by 59.5% (from 11.09 to 4.49 per 1000 livebirths and 65.8% (from 19.30 to 6.61 per 1000 livebirths in urban and rural areas, respectively. Prematurity/low birth weight and congenital heart disease were in the top five causes of death in children under 5 years of age during 1997-2012.Zhejiang province has achieved great progress in the reduction of mortality rates in children under five-years-old during the past two decades. The future tasks on reduction of mortality rate still rely on how to improve the management of premature birth/low birth weight, reduce birth defects and prevent accidental deaths in Zhejiang Province.

  15. Survived infancy but still vulnerable: spatial-temporal trends and risk factors for child mortality in the Agincourt rural sub-district, South Africa, 1992-2007

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    Benn Sartorius

    2011-05-01

    Full Text Available Targeting of health interventions to poor children at highest risk of mortality are promising approaches for enhancing equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatio-temporal analysis was performed to identify risk factors associated with child (1-4 years mortality in the Agincourt sub-district, South Africa, to assess temporal changes in child mortality patterns within the study site between 1992 and 2007, and to produce all-cause and cause-specific mortality maps to identify high risk areas. Demographic, maternal, paternal and fertility-related factors, household mortality experience, distance to health care facility and socio-economic status were among the examined risk factors. The analysis was carried out by fitting a Bayesian discrete time Bernoulli survival geostatistical model using Markov chain Monte Carlo simulation. Bayesian kriging was used to produce mortality risk maps. Significant temporal increase in child mortality was observed due to the HIV epidemic. A distinct spatial risk pattern was observed with higher risk areas being concentrated in poorer settlements on the eastern part of the study area, largely inhabited by former Mozambican refugees. The major risk factors for childhood mortality, following multivariate adjustment, were mother’s death (especially when due to HIV and tuberculosis, greater number of children under 5 years living in the same household and winter season. This study demonstrates the use of Bayesian geostatistical models for accurately quantifying risk factors and producing maps of child mortality risk in a health and demographic surveillance system. According to the space-time analysis, the southeast and upper central regions of the site appear to have the highest mortality risk. The results inform policies to address health inequalities in the Agincourt sub-district and to

  16. Effect of marital status on death rates. Part 2: Transient mortality spikes

    CERN Document Server

    Richmond, Peter

    2015-01-01

    We examine what happens in a population when it experiences an abrupt change in surrounding conditions. Several cases of such "abrupt transitions" for both physical and living social systems are analyzed from which it can be seen that all share a common pattern. First, a steep rising death rate followed by a much slower relaxation process during which the death rate decreases as a power law (with an exponent close to 0.7). This leads us to propose a general principle which can be summarized as follows: "ANY abrupt change in living conditions generates a mortality spike which acts as a kind of selection process." This we term the Transient Shock conjecture. It provides a qualitative model which leads to testable predictions. For example, marriage certainly brings about a major change in environmental and social conditions and according to our conjecture one would expect a mortality spike in the months following marriage. At first sight this may seem an unlikely proposition but we demonstrate (by three differen...

  17. Uneven futures of human lifespans: reckonings from Gompertz mortality rates, climate change, and air pollution.

    Science.gov (United States)

    Finch, Caleb E; Beltrán-Sánchez, Hiram; Crimmins, Eileen M

    2014-01-01

    The past 200 years have enabled remarkable increases in human lifespans through improvements in the living environment that have nearly eliminated infections as a cause of death through improved hygiene, public health, medicine, and nutrition. We argue that the limit to lifespan may be approaching. Since 1997, no one has exceeded Jeanne Calment's record of 122.5 years, despite an exponential increase of centenarians. Moreover, the background mortality may be approaching a lower limit. We calculate from Gompertz coefficients that further increases in longevity to approach a life expectancy of 100 years in 21st century cohorts would require 50% slower mortality rate accelerations, which would be a fundamental change in the rate of human aging. Looking into the 21st century, we see further challenges to health and longevity from the continued burning of fossil fuels that contribute to air pollution as well as global warming. Besides increased heat waves to which elderly are vulnerable, global warming is anticipated to increase ozone levels and facilitate the spread of pathogens. We anticipate continuing socioeconomic disparities in life expectancy.

  18. Civil wars and mortality rates of military commanders: a historical-demographic study

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    Pavlov Yu. A.

    2014-09-01

    Full Text Available In this paper I would like to accomplish the following tasks: to compare mortality rates of generals in US civil war and Russia one; to explore the maximum life spans of military commanders; and to analyze changes in occupational mobility of commanders before and after the civil war. Both published materials and databases were used to determine mortality rates of generals. Civil wars are a vivid example of meritocracy. They evolve new military talents and give new political leaders. Civil wars are always a turning point in professional and social mobility. After some years of bitter fighting not everyone can pick up the threads. For some, the war was a step towards fame and fortune, for others a step towards disaster, obscurity and misery. History of civil wars suggests that men who started the war as young military leaders actually lived less than those who were in adulthood when the war began. Those who went through all the ordeals, even in the face of economic and political reconstruction (in the U.S., emigration or political repression (in the USSR could live to be very old.

  19. Parenting stress and external stressors as predictors of maternal ratings of child adjustment.

    Science.gov (United States)

    Ostberg, Monica; Hagekull, Berit

    2013-06-01

    This study sought to disentangle the effects of different kinds of stress on maternal ratings of child externalizing and internalizing problems, social inhibition, and social competence, with a primary focus on parenting stress. The relations were explored in a sample consisting of mothers of 436 children (Mage  = 7 years) in Sweden. Half the sample had had early clinical contacts during infancy due to child regulation problems, and the rest were mothers without known such early contacts. Demographic factors, family stressors, and parenting stress were examined in stress - adjustment models. Family stressors were clinical contact during infancy, current child and parent health problems, recent negative life events, and insufficient social support. Parenting stress as a mediator of the effect of other stressors on rated child adjustment was tested as was social support as a moderator of the effect of parenting stress on adjustment. The results showed that a higher parenting stress level was associated with maternal ratings of more externalizing and internalizing behaviors, more social inhibition, and lower social competence. Other family stressors and background variables were also found to be of importance, mainly for externalizing and internalizing problems and to some extent for social competence. Social inhibition had a unique relation to parenting stress only. Parenting stress mediated effects of other stressors in twelve models, whereas social support had no moderating effect on the link between parenting stress and child adjustment. Thus, parenting stress seems to be an important overarching construct. Clinical implications are proposed.

  20. Brain cancer mortality rates increase with Toxoplasma gondii seroprevalence in France

    Science.gov (United States)

    Vittecoq, Marion; Elguero, Eric; Lafferty, Kevin D.; Roche, Benjamin; Brodeur, Jacques; Gauthier-Clerc, Michel; Missé, Dorothée; Thomas, Frédéric

    2012-01-01

    The incidence of adult brain cancer was previously shown to be higher in countries where the parasite Toxoplasma gondii is common, suggesting that this brain protozoan could potentially increase the risk of tumor formation. Using countries as replicates has, however, several potential confounding factors, particularly because detection rates vary with country wealth. Using an independent dataset entirely within France, we further establish the significance of the association between T. gondii and brain cancer and find additional demographic resolution. In adult age classes 55 years and older, regional mortality rates due to brain cancer correlated positively with the local seroprevalence of T. gondii. This effect was particularly strong for men. While this novel evidence of a significant statistical association between T. gondii infection and brain cancer does not demonstrate causation, these results suggest that investigations at the scale of the individual are merited.

  1. Community interventions to reduce child mortality in Dhanusha, Nepal: study protocol for a cluster randomized controlled trial

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    Costello Anthony

    2011-06-01

    Full Text Available Abstract Background Neonatal mortality remains high in rural Nepal. Previous work suggests that local women's groups can effect significant improvement through community mobilisation. The possibility of identification and management of newborn infections by community-based workers has also arisen. Methods/Design The objective of this trial is to evaluate the effects on newborn health of two community-based interventions involving Female Community Health Volunteers. MIRA Dhanusha community groups: a participatory intervention with women's groups. MIRA Dhanusha sepsis management: training of community volunteers in the recognition and management of neonatal sepsis. The study design is a cluster randomized controlled trial involving 60 village development committee clusters allocated 1:1 to two interventions in a factorial design. MIRA Dhanusha community groups: Female Community Health Volunteers (FCHVs are supported in convening monthly women's groups. Nine groups per cluster (270 in total work through two action research cycles in which they (i identify local issues around maternity, newborn health and nutrition, (ii prioritise key problems, (iii develop strategies to address them, (iv implement the strategies, and (v evaluate their success. Cycle 1 focuses on maternal and newborn health and cycle 2 on nutrition in pregnancy and infancy and associated postpartum care practices. MIRA Dhanusha sepsis management: FCHVs are trained to care for vulnerable newborn infants. They (i identify local births, (ii identify low birth weight infants, (iii identify possible newborn infection, (iv manage the process of treatment with oral antibiotics and referral to a health facility to receive parenteral gentamicin, and (v follow up infants and support families. Primary outcome: neonatal mortality rates. Secondary outcomes: MIRA Dhanusha community group: stillbirth, infant and under-two mortality rates, care practices and health care seeking behaviour, maternal

  2. The relation of ambulatory heart rate with all-cause mortality among middle-aged men: a prospective cohort study.

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    Mette Korshøj

    Full Text Available The aim of this study was to investigate the association between average 24-hour ambulatory heart rate and all-cause mortality, while adjusting for resting clinical heart rate, cardiorespiratory fitness, occupational and leisure time physical activity as well as classical risk factors. A group of 439 middle-aged male workers free of baseline coronary heart disease from the Belgian Physical Fitness Study was included in the analysis. Data were collected by questionnaires and clinical examinations from 1976 to 1978. All-cause mortality was collected from the national mortality registration with a mean follow-up period of 16.5 years, with a total of 48 events. After adjustment for all before mentioned confounders in a Cox proportional hazards regression analysis, a significant increased risk for all-cause mortality was found among the tertile of workers with highest average ambulatory heart rate compared to the tertile with lowest ambulatory heart rate (Hazard ratio = 3.21, 95% confidence interval: 1.22-8.44. No significant independent association was found between resting clinic heart rate and all-cause mortality. The study indicates that average 24-hour ambulatory heart rate is a strong predictor of all-cause mortality independent from resting clinic heart rate, cardiorespiratory fitness, occupational and leisure time physical activity and other classical risk factors among healthy middle-aged workers.

  3. The impact of the worldwide Millennium Development Goals campaign on maternal and under-five child mortality reduction: ‘Where did the worldwide campaign work most effectively?’

    Science.gov (United States)

    Cha, Seungman

    2017-01-01

    ABSTRACT Background: As the Millennium Development Goals campaign (MDGs) came to a close, clear evidence was needed on the contribution of the worldwide MDG campaign. Objective: We seek to determine the degree of difference in the reduction rate between the pre-MDG and MDG campaign periods and its statistical significance by region. Design: Unlike the prevailing studies that measured progress in 1990–2010, this study explores by percentage how much MDG progress has been achieved during the MDG campaign period and quantifies the impact of the MDG campaign on the maternal and under-five child mortality reduction during the MDG era by comparing observed values with counterfactual values estimated on the basis of the historical trend. Results: The low accomplishment of sub-Saharan Africa toward the MDG target mainly resulted from the debilitated progress of mortality reduction during 1990–2000, which was not related to the worldwide MDG campaign. In contrast, the other regions had already achieved substantial progress before the Millennium Declaration was proclaimed. Sub-Saharan African countries have seen the most remarkable impact of the worldwide MDG campaign on maternal and child mortality reduction across all different measurements. In sub-Saharan Africa, the MDG campaign has advanced the progress of the declining maternal mortality ratio and under-five mortality rate, respectively, by 4.29 and 4.37 years. Conclusions: Sub-Saharan African countries were frequently labeled as ‘off-track’, ‘insufficient progress’, or ‘no progress’ even though the greatest progress was achieved here during the worldwide MDG campaign period and the impact of the worldwide MDG campaign was most pronounced in this region in all respects. It is time to learn from the success stories of the sub-Saharan African countries. Erroneous and biased measurement should be avoided for the sustainable development goals to progress. PMID:28168932

  4. Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; de Boer, Anthonius

    2014-01-01

    BACKGROUND: Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non...... and information on complications (exacerbation of COPD or pneumonia) by scrutinizing patient files of general practitioners. Multivariable cox regression analysis was performed. RESULTS: During the follow-up 132 (33%) patients died. The overall mortality rate was 50/1000 py (42-59). The major causes of death were...... did not result in an increased risk of exacerbations or pneumonia. This may indicate that the increased mortality risk of COPD is related to non-pulmonary causes. Future randomized controlled trials are needed to investigate whether heart-rate lowering agents are worthwhile for COPD patients....

  5. Does adding variceal status to the Child-Turcotte-Pugh score improve its performance in predicting mortality in cirrhosis?

    Science.gov (United States)

    Fan, Xiaoli; Wen, Maoyao; Shen, Yi; Wang, Wanqin; Yang, Xiaoxue; Yang, Li

    2016-09-01

    The Child-Turcotte-Pugh (CTP) score is widely used worldwide to predict outcomes across a broad spectrum of liver diseases, mainly cirrhosis. Portal hypertension and variceal bleed are significant causes of morbidity and mortality in cirrhotic patients, although the variceal status is not incorporated into the classical CTP score. We sought to determine whether the inclusion of variceal status, specifically the Child-Turcotte-Pugh-Kumar (CTPK) score, would improve the utility of the classical CTP score to predict the clinical outcomes of cirrhotic patients in a single but high-volume center in China.We retrospectively analyzed the records of 253 patients from January 1, 2014 to December 31, 2014 and performed follow-up for at least 12 months. The CTPK score and the CTP score were obtained as soon as possible after the patient's admission. Telephone follow-up was performed to assess survival situations.At 3 and 12 months, the cumulative number of deaths was 9.1% (n = 23) and 13.8% (n = 35), respectively. In the multivariate Cox proportional hazards models, the CTPK score was independently associated with death within 3 and 12 months after adjusting for potential confounders. The predictive ability related to the 2 scores was evaluated by the area under the receiver operating characteristic curve (AUC-ROC) respectively. At 3 months of enrollment, the AUCs of CTPK and CTP were 0.814 and 0.838, respectively. At 12 months of enrollment, the AUCs of CTPK and CTP were 0.825 and 0.840, respectively. No significant difference between time points was observed. Both the CTPK score and the CTP score displayed prognostic value in cirrhotic patients, as the Kaplan-Meier analysis showed that the CTPK score could clearly discriminate patients in the intermediate term (P < 0.001).The CTPK score provides reliable prediction of mortality in Chinese cirrhotic patients for both short-term and medium-term prognoses, although it is not superior to the CTP score. Therefore, the CTP

  6. Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Patients with Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcelo Rodrigues dos; Sayegh, Ana Luiza Carrari; Groehs, Raphaela Vilar Ramalho; Fonseca, Guilherme [Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo (Brazil); Trombetta, Ivani Credidio [Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo (Brazil); Universidade Nove de Julho (UNINOVE) (Brazil); Barretto, Antônio Carlos Pereira [Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo (Brazil); Arap, Marco Antônio [Faculdade de medicina da Universidade de São Paulo - Urologia (Brazil); Negrão, Carlos Eduardo [Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo (Brazil); Escola de Educação Física e Esporte da Universidade de São Paulo, São Paulo, SP (Brazil); Middlekauff, Holly R. [Division of Cardiology - David Geffen School of Medicine - University of California (United States); Alves, Maria-Janieire de Nazaré Nunes, E-mail: janieire.alves@incor.usp.br [Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo (Brazil)

    2015-09-15

    Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown. We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF. Total testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients. Length of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58–4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67–8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23–8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001). These results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT.

  7. Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.

    Directory of Open Access Journals (Sweden)

    Yemisrach B Okwaraji

    Full Text Available BACKGROUND: There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a remote area of rural north-western Ethiopia. METHODS AND FINDINGS: This study involved a randomly selected cross sectional survey of 2,058 households. Data were collected during home visits to all resident women of reproductive age (15-49 years. A geographic information system (GIS was used to map all households and the only health centre in the district. The analysis was restricted to 2,206 rural children who were under the age of five years during the five years before the survey. Data were analysed using random effects Poisson regression. 90.4% (1,996/2,206 of children lived more than 1.5 hours walk from the health centre. Children who lived ≥1.5 hrs from the health centre had a two to three fold greater risk of death than children who lived <1.5 hours from the health centre (children with travel time 1.5-<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95-5.6], travel time 2.5-<3.5 hrs adjRR 3.1[1.3-7.4] and travel time 3.5-<6.5 hrs adjRR 2.5[1.1-6.2]. CONCLUSION: Distance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas.

  8. The effect of levamisole on mortality rate among patients with severe burn injuries

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    Mohammad Javad Fatemi

    2013-01-01

    Full Text Available Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years was 33.29 ± 11.39 years (Mean ± SD, and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8% patients in the control group and 50 (58.8% patients in the treatment group (P = 0.8. Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.

  9. The effect of levamisole on mortality rate among patients with severe burn injuries

    Science.gov (United States)

    Fatemi, Mohammad Javad; Salehi, Hamid; Akbari, Hossein; Alinejad, Faranak; Saberi, Mohsen; Mousavi, Seyed Jaber; Soltani, Majid; Taghavi, Shahrzad; Payandan, Hossein

    2013-01-01

    Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA) were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years) was 33.29 ± 11.39 years (Mean ± SD), and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8%) patients in the control group and 50 (58.8%) patients in the treatment group (P = 0.8). Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption. PMID:24381625

  10. The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

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    Vali A Mehrzad

    2012-01-01

    Full Text Available Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen. Materials and Methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS 19. Results: Out of the 25 patients, 8 patients (32% had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases. According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40% had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT. On the other hand, 13 patients (52%, who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment. Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

  11. Is the Physical Availability of Alcohol and Illicit Drugs Related to Neighborhood Rates of Child Maltreatment?

    Science.gov (United States)

    Freisthler, Bridget; Needell, Barbara; Gruenewald, Paul J.

    2005-01-01

    Objective: This study examines how the availability of alcohol and illicit drugs (as measured by alcohol outlet density and police incidents of drug sales and possessions) is related to neighborhood rates of child abuse and neglect, controlling for other neighborhood demographic characteristics. Method: Data from substantiated reports of child…

  12. Family Child Care Environment Rating Scale Revised Edition (FCCERS-R)

    Science.gov (United States)

    Harms, Thelma; Cryer, Debby; Clifford, Richard M.

    2007-01-01

    Featuring a new spiral binding, the FCCERS-R is a thorough revision of the widely used program quality assessment instrument, "The Family Day Care Rating Scale." Designed for use in family child care programs, it is suitable for programs serving children from infancy through school-age. Following extensive input from users of the…

  13. A Typology of Teacher-Rated Child Behavior: Revisiting Subgroups over 10 Years Later

    Science.gov (United States)

    DiStefano, Christine A.; Kamphaus, Randy W.; Mindrila, Diana L.

    2010-01-01

    The purpose of this article was to examine a typology of child behavior using the Behavioral Assessment System for Children, Teacher Rating Scale (BASC TRS-C, 2nd edition; Reynolds & Kamphaus, 2004). The typology was compared with the solution identified from the 1992 BASC TRS-C norm dataset. Using cluster analysis, a seven-cluster solution…

  14. Determining the Independent Risk Factors and Mortality Rate of Nosocomial Infections in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Fesih Aktar

    2016-01-01

    Full Text Available The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs, there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus, Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs.

  15. Determining the Independent Risk Factors and Mortality Rate of Nosocomial Infections in Pediatric Patients.

    Science.gov (United States)

    Aktar, Fesih; Tekin, Recep; Güneş, Ali; Ülgen, Cevat; Tan, İlhan; Ertuğrul, Sabahattin; Köşker, Muhammet; Balık, Hasan; Karabel, Duran; Yolbaş, Ilyas

    2016-01-01

    The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs), there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus, Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs.

  16. Heart rate-corrected QT interval helps predict mortality after intentional organophosphate poisoning.

    Directory of Open Access Journals (Sweden)

    Shou-Hsuan Liu

    Full Text Available INTRODUCTION: In this study, we investigated the outcomes for patients with intentional organophosphate poisoning. Previous reports indicate that in contrast to normal heart rate-corrected QT intervals (QTc, QTc prolongation might be indicative of a poor prognosis for patients exposed to organophosphates. METHODS: We analyzed the records of 118 patients who were referred to Chang Gung Memorial Hospital for management of organophosphate poisoning between 2000 and 2011. Patients were grouped according to their initial QTc interval, i.e., normal (0.44 s. Demographic, clinical, laboratory, and mortality data were obtained for analysis. RESULTS: The incidence of hypotension in patients with prolonged QTc intervals was higher than that in the patients with normal QTc intervals (P = 0.019. By the end of the study, 18 of 118 (15.2% patients had died, including 3 of 75 (4.0% patients with normal QTc intervals and 15 of 43 (34.9% patients with prolonged QTc intervals. Using multivariate-Cox-regression analysis, we found that hypotension (OR = 10.930, 95% CI = 2.961-40.345, P = 0.000, respiratory failure (OR = 4.867, 95% CI = 1.062-22.301, P = 0.042, coma (OR = 3.482, 95% CI = 1.184-10.238, P = 0.023, and QTc prolongation (OR = 7.459, 95% CI = 2.053-27.099, P = 0.002 were significant risk factors for mortality. Furthermore, it was revealed that non-survivors not only had longer QTc interval (503.00±41.56 versus 432.71±51.21 ms, P = 0.002, but also suffered higher incidences of hypotension (83.3 versus 12.0%, P = 0.000, shortness of breath (64 versus 94.4%, P = 0.010, bronchorrhea (55 versus 94.4%, P = 0.002, bronchospasm (50.0 versus 94.4%, P = 0.000, respiratory failure (94.4 versus 43.0%, P = 0.000 and coma (66.7 versus 11.0%, P = 0.000 than survivors. Finally, Kaplan-Meier analysis demonstrated that cumulative mortality was higher among patients with prolonged QTc

  17. Case fatality ratio and mortality rate trends of community-onset Staphylococcus aureus bacteraemia.

    Science.gov (United States)

    Tom, S; Galbraith, J C; Valiquette, L; Jacobsson, G; Collignon, P; Schønheyder, H C; Søgaard, M; Kennedy, K J; Knudsen, J D; Ostergaard, C; Lyytikäinen, O; Laupland, K B

    2014-10-01

    Lethal outcomes can be expressed as a case fatality ratio (CFR) or as a mortality rate per 100 000 population per year (MR). Population surveillance for community-onset methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus bacteraemia was conducted in Canada, Australia, Sweden and Denmark to evaluate 30-day CFR and MR trends between 2000 and 2008. The CFR was 20.3% (MSSA 20.2%, MRSA 22.3%) and MR was 3.4 (MSSA 3.1, MRSA 0.3) per 100 000 per year. Although MSSA CFR was stable the MSSA MR increased; MRSA CFR decreased while its MR remained low during the study. Community-onset S. aureus bacteraemia, particularly MSSA, is associated with major disease burden. This study highlights complementary information provided by evaluating both CFR and MR.

  18. Longitudinal Changes in Vascular Risk Markers and Mortality Rates among a Latino Population with Hypertension.

    Science.gov (United States)

    Pflederer, Matthew C; Long, Carlin S; Beaty, Brenda; Havranek, Edward P; Mehler, Philip S; Keniston, Angela; Krantz, Mori J

    2016-04-01

    Vascular markers such as pulse-wave velocity and carotid intima-media thickness (CIMT) might improve the prediction of incident cardiovascular disease beyond traditional risk factors. These vascular markers have not been well characterized in minority populations and might be more useful than inflammatory biomarkers. We conducted a prospective, longitudinal cohort study among hypertensive patients in an urban safety-net hospital. We evaluated inflammatory biomarkers, arterial pulse-wave velocity, and carotid intima-media thickness at baseline, 1 year, and 2 years. The primary outcome variable was CIMT. Generalized linear mixed-effects models were used to evaluate associations between CIMT and predictive variables accounting for the correlation of multiple measurements within subjects over time. For our secondary outcome, we used administrative and National Death Index data to determine all-cause death, and univariate relationships were evaluated. Among 175 subjects, 117 were Latino (67%) and 117 were female (67%). Pulse-wave velocity and CIMT regressed over time (both P <0.001) and were highly correlated (P <0.001). Only pulse-wave velocity (P=0.002) and total cholesterol (P=0.03) were associated with CIMT in time-varying covariate analysis. At a median follow-up period of 80 months, 17 of 175 subjects had died (10%). Higher baseline CIMT and pulse-wave velocity were associated with increased mortality rates (both P <0.01). No serum inflammatory marker was significantly correlated with longitudinal changes in CIMT or death. In conclusion, both arterial stiffness and preclinical carotid atherosclerosis were associated with increased mortality rates and might be useful risk-stratification markers among this minority population.

  19. Delayed effects of obese and overweight population conditions on all-cause adult mortality rate in the USA

    Directory of Open Access Journals (Sweden)

    Albert A Okunade

    2016-09-01

    Full Text Available Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMI to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System (BRFSS data of the 50 US states and the District of Columbia (DC estimates empirical regression models linking the US adult population overweight and obesity rates separately to the all-cause mortality rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid from unexpended caloric intakes (net energy storage provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality. Cross-sectional and panel data regression models are separately estimated for the delayed effects of obese and overweight BMIs on the all-cause mortality rate. Controlling for the independent effects of economic, socio-demographic and other factors on the all-cause mortality rate, our findings confirm that the estimated panel data models are more appropriate. The panel data regression results reveal that the obesity-mortality link strengthens significantly after multiple years in the condition. The faster mortality response to obesity detected here is conjectured to arise from the significantly more obese. Compared with past studies postulating a static (rather than delayed effects, the statistically significant lagged effects of adult population BMI pathology in this study are novel and insightful. And, as expected, these lagged effects are more severe in the obese than overweight population segment. Public health policy implications of this social science study findings agree with those of the clinical sciences literature advocating timely lifestyle modification interventions (e.g., smoking cessation to slow premature mortality linked to unhealthy BMIs.

  20. Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age–period–cohort analysis

    Directory of Open Access Journals (Sweden)

    Giancarlo Pesce

    2016-03-01

    Full Text Available Chronic lower respiratory diseases (CLRDs are a major cause of morbidity and mortality worldwide. The objectives of this study were to estimate the trends in CLRD mortality in Italy, and the specific contributions of age, time period and birth cohort in driving these trends. Population and cause-of-death data in Italy between 1979 and 2010 were collected from the World Health Organization website. Age-specific mortality rates for CLRDs, and effects for age, time period and birth cohort on mortality trends were estimated using age–period–cohort models. Chronic obstructive pulmonary disease (COPD and chronic bronchitis represent nearly 98% of the deaths from CLRDs. Despite the overall number of deaths have been stable (in men or increasing (in women, the age-standardised rates have been steadily decreasing from 1979 to 2010, passing from 104.3 to 55.4 per 100 000 person-years in men and from 32.2 to 19.6 per 100 000 person-years in women. The average relative annual decrease was −3.6% in men and −2.7% in women. Since the end of the 1990s, the decreasing trend of CLRD mortality has started to level off, in particular in women. The decrease in CLRD mortality rates has been more accentuated in more recent cohorts and in younger age groups. Both birth cohort and time period significantly affected the CLRD mortality rates, suggesting that changes in the spread of risk factors (smoking habits, early-life and occupational exposures across different birth cohorts, as well as in advanced in healthcare and medical practice, may have played a major role in secular changes in COPD mortality rates in Italy.

  1. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ..., 2010, at 75 FR 41793. Child and Adult Care Food Program (CACFP) [Per meal rates in whole or fractions... 48 FR 29114, June 24, 1983.) This notice has been determined to be not significant and was reviewed... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  2. Mortality in Asia.

    Science.gov (United States)

    1981-01-01

    Although the general trend in mortality between 1950 and 1975 in South and East Asia has been downward, there is considerable country-to-country variation in the rate of decline. In countries where combined economic, social, and political circumstances resulted in controlling the disease spectrum (e.g., China, Malaysia, Sri Lanka), mortality levels declined to those seen in low-mortality countries. In most of the large countries of the region however, mortality declined at a slower rate, even slowing down considerably in the 1970's while the death rates remained high (e.g., India, Bangladesh, Thailand, Philippines); this slowing down of mortality level is attributed essentially to the poverty-stricken masses of society which were not able to take advantage of social, technological, and health-promoting behavioral changes conducive to mortality decline. Infant mortality levels, although declining since 1950, followed the same dismal pattern of the general mortality level. The rate varies from less than 10/1000 live births (Japan) to more than 140/1000 (Bangladesh, Laos, Nepal). Generally, rural areas exhibited higher infant mortality than urban areas. The level of child mortality declines with increases in the mother's educational level in Bangladesh, India, Indonesia, Sri Lanka, and Thailand. The largest decline in child mortality occurs when at least 1 parent has secondary education. The premature retardation of mortality decline is caused by several factors: economic development, nutrition and food supply, provision and adequacy of health services, and demographic trends. The outlook for the year 2000 for most of Asia's countries will depend heavily on significant population increases. In most countries, particularly in South Asia, population is expected to increase by 75%, much of it in rural areas and among poorer socioeconomic groups. In view of this, Asia's health planners and policymakers will have to develop health policies which will strike a balance

  3. Increased non-Gaussianity of heart rate variability predicts cardiac mortality after an acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Junichiro eHayano

    2011-09-01

    Full Text Available Non-Gaussianity index (λ is a new index of heart rate variability (HRV that characterizes increased probability of the large heart rate deviations from its trend. A previous study has reported that increased λ is an independent mortality predictor among patients with chronic heart failure. The present study examined predictive value of λ in patients after acute myocardial infarction (AMI. Among 670 post-AMI patients, we performed 24-hr Holter monitoring to assess λ and other HRV predictors, including standard deviation of normal-to-normal interval, very-low frequency power, scaling exponent α1 of detrended fluctuation analysis, deceleration capacity, and heart rate turbulence (HRT. At baseline, λ was not correlated substantially with other HRV indices (|r| <0.4 with either indices and was decreased in patients taking β-blockers (P = 0.04. During a median follow up period of 25 months, 45 (6.7% patients died (32 cardiac and 13 non-cardiac and 39 recurrent nonfatal AMI occurred among survivors. While all of these HRV indices but λ were significant predictors of both cardiac and non-cardiac deaths, increased λ predicted exclusively cardiac death (RR [95% CI], 1.6 [1.3-2.0] per 1 SD increment, P <0.0001. The predictive power of increased λ was significant even after adjustments for clinical risk factors, such as age, diabetes, left ventricular function, renal function, prior AMI, heart failure, and stroke, Killip class, and treatment ([95% CI], 1.4 [1.1-2.0] per 1 SD increment, P = 0.01. The prognostic power of increased λ for cardiac death was also independent of all other HRV indices and the combination of increased λ and abnormal HRT provided the best predictive model for cardiac death. Neither λ nor other HRV indices was an independent predictor of AMI recurrence. Among post-AMI patients, increased λ is associated exclusively with increased cardiac mortality risk and its predictive power is independent of clinical risk factors and

  4. Agricultural adjuvants: acute mortality and effects on population growth rate of Daphnia pulex after chronic exposure.

    Science.gov (United States)

    Stark, John D; Walthall, William K

    2003-12-01

    Acute and chronic toxicity of eight agricultural adjuvants (Bond, Kinetic, Plyac, R-11, Silwet L-77, Sylgard 309, X-77, and WaterMaxx) to Daphnia pulex were evaluated with 48-h acute lethal concentration estimates (LC50) and a 10-d population growth-rate measurement, the instantaneous rate of increase (r1). Based on LC50, the order of toxicity was R-11 > X-77 = Sylgard 309 = Silwet L-77 > Kinetic > Bond > Plyac > WaterMaxx; all LC50 estimates were higher than the expected environmental concentration (EEC) of 0.79 mg/L, indicating that none of these adjuvants should cause high levels of mortality in wild D. pulex populations. Extinction, defined as negative population growth rate, occurred after exposure to 0.9 mg/L R-11, 13 mg/L X-77, 25 mg/L Kinetic, 28 mg/L Silwet, 18 mg/L Sylgard, 450 mg/L Bond, 610 mg/L Plyac, and 1,600 mg/L WaterMaxx. Concentrations that caused extinction were substantially below the acute LC50 for R-11, Kinetic, Plyac, X-77, and Bond. The no-observable-effects concentration (NOEC) and lowest-observable-effects concentration (LOEC) for the number of offspring per surviving female after exposure to R-11 were 0.5 and 0.75 mg/L, respectively. The NOEC and LOEC for population size after exposure to R-11 were (1.25 and 0.5 mg/L, respectively. Both of these values were lower than the EEC, indicating that R-11 does have the potential to cause damage to D. pulex populations after application at recommended field rates. The wide range of concentrations causing extinction makes it difficult to generalize about the potential impacts that agricultural adjuvants might have on aquatic ecosystems. Therefore, additional studies that examine effects on other nontarget organisms and determine residues in aquatic ecosystems may be warranted.

  5. Identification of genomic loci associated with resting heart rate and shared genetic predictors with all-cause mortality

    NARCIS (Netherlands)

    Eppinga, Ruben N.; Hagemeijer, Yanick; Burgess, Stephen; Hinds, David A.; Stefansson, Kari; Gudbjartsson, Daniel F.; van Veldhuisen, Dirk J.; Munroe, Patricia B.; Verweij, Niek; van der Harst, Pim

    2016-01-01

    Resting heart rate is a heritable trait correlated with life span. Little is known about the genetic contribution to resting heart rate and its relationship with mortality. We performed a genome-wide association discovery and replication analysis starting with 19.9 million genetic variants and study

  6. 20 CFR 229.42 - When a child can no longer be included in computing an annuity rate under the overall minimum.

    Science.gov (United States)

    2010-04-01

    ... secondary school, and not disabled; or (f) The month before the month the child becomes entitled to an... annuity rate under the overall minimum. A child's inclusion in the computation of the overall minimum rate... second month after the month the child's disability ends, if the child is 18 years old or older, and...

  7. Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services.

    Science.gov (United States)

    Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew

    2014-05-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed.

  8. Decreasing systolic blood pressure and declining mortality rates in an untreated population

    DEFF Research Database (Denmark)

    Andersen, Ulla O; Marott, Jacob L; Jensen, Gorm B

    2011-01-01

    The aim of the present study was to evaluate developments in 30 years mortality risk that may be associated with developments in population systolic blood pressure (SBP) and to evaluate possible secular trends in BP-associated mortality risk in the untreated population.......The aim of the present study was to evaluate developments in 30 years mortality risk that may be associated with developments in population systolic blood pressure (SBP) and to evaluate possible secular trends in BP-associated mortality risk in the untreated population....

  9. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008

    Science.gov (United States)

    Chen, Brian K.; Yang, Chun-Yuh

    2014-01-01

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result. PMID:24503974

  10. [Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)].

    Science.gov (United States)

    Aba, Y T; Cissé, L; Abalé, A K; Diakité, I; Koné, D; Kadiané, J; Diallo, Z; Kra, O; Oulaï, S; Bissagnéné, E

    2016-08-01

    The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.

  11. Variation in bird-window collision mortality and scavenging rates within an urban landscape

    Science.gov (United States)

    Annual avian mortality from collisions with windows and buildings is estimated to range from a million to a billion birds in the United States alone. However, estimates of mortality based on carcass counts suffer from bias due to imperfect detection and carcass scavenging. We stu...

  12. Prevalence of Anemia and Its Impact on Mortality and Hospitalization Rate in Predialysis Patients

    NARCIS (Netherlands)

    Voormolen, N.; Grootendorst, D. C.; Urlings, T. A. J.; Boeschoten, E. W.; Sijpkens, Y. W.; Huisman, R. M.; Krediet, R. T.; Dekker, F. W.

    2010-01-01

    Background/Aim: Anemia is associated with increased mortality and morbidity in both early and very late stages of chronic kidney disease (CKD). The aim of this study was to assess whether anemia is a risk factor for mortality or hospitalization in CKD stage 4-5 predialysis patients not yet on dialys

  13. Prediction of hospital mortality by changes in the estimated glomerular filtration rate (eGFR).

    LENUS (Irish Health Repository)

    Berzan, E

    2015-03-01

    Deterioration of physiological or laboratory variables may provide important prognostic information. We have studied whether a change in estimated glomerular filtration rate (eGFR) value calculated using the (Modification of Diet in Renal Disease (MDRD) formula) over the hospital admission, would have predictive value. An analysis was performed on all emergency medical hospital episodes (N = 61964) admitted between 1 January 2002 and 31 December 2011. A stepwise logistic regression model examined the relationship between mortality and change in renal function from admission to discharge. The fully adjusted Odds Ratios (OR) for 5 classes of GFR deterioration showed a stepwise increased risk of 30-day death with OR\\'s of 1.42 (95% CI: 1.20, 1.68), 1.59 (1.27, 1.99), 2.71 (2.24, 3.27), 5.56 (4.54, 6.81) and 11.9 (9.0, 15.6) respectively. The change in eGFR during a clinical episode, following an emergency medical admission, powerfully predicts the outcome.

  14. Eisenmenger's syndrome in pregnancy: does heparin prophylaxis improve the maternal mortality rate?

    Science.gov (United States)

    Pitts, J A; Crosby, W M; Basta, L L

    1977-03-01

    Seven consecutive patients with Eisenmenber's syndrome, cared for by the obstetric team in conjunction with the cardiology service, were reviewed to assess the possible role of prophylactic heparin therapy and intensive care on the outcome of these patients. In each patient, the diagnosis of Eisenmenger's syndrome was established by the demonstration of equal pulmonary arterial and aortic pressures with a predominantly right-to-left shunt at cardiac catheterization. Five of the seven patients died as follows: Three patients died between the fifth and eighth post-partum days, one patient died during the twenty-sixth week of pregnancy, and one patient died on the fifth postoperative day following tubal ligation. All of these five patients received prophylactic heparin therapy. In three patients, heparin therapy was complicated by excessive bleeding during the postoperative or postpartum period. Autopsy examination in two patients revealed no evidence of thrombosis in the main pulmonary arteries and no pulmonary infarction, contrary to the antemortem clinical suspicion. The two survivors did not receive prophylactic heparin. They comprised one patient who had normal delivery and one patient who underwent tubal ligation and induction of abortion. We conclude that the prohibitive mortality rate of Eisenmenger's syndrome during pregnancy, puerpurium, or surgical procedures probably cannot be modified with prophylactic heparin therapy. Anticoagulant treatment does not prevent deterioration of patients and probably compounds the problem by causing significant bleeding.

  15. Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings.

    Science.gov (United States)

    Siddiqi, Arjumand; Jones, Marcella K; Erwin, Paul Campbell

    2015-04-01

    As the struggle continues to explain the relatively high rates of infant mortality (IMR) exhibited in the United States, a renewed emphasis is being placed on the role of possible 'contextual' determinants. Cross-sectional and short time-series studies have found that higher income inequality is associated with higher IMR at the state level. Yet, descriptively, the longer-term trends in income inequality and in IMR seem to call such results into question. To assess whether, over the period 1990-2007, state-level income inequality is associated with state-level IMR; to examine whether the overall effect of income inequality on IMR over this period varies by state; to test whether the association between income inequality and IMR varies across this time period. IMR data--number of deaths per 1000 live births in a given state and year--were obtained from the U.S. Centers for Disease Control Wonder database. Income inequality was measured using the Gini coefficient, which varies from zero (complete equality) to 100 (complete inequality). Covariates included state-level poverty rate, median income, and proportion of high school graduates. Fixed and random effects regressions were conducted to test hypotheses. Fixed effects models suggested that, overall, during the period 1990-2007, income inequality was inversely associated with IMR (β = -0.07, SE (0.01)). Random effects models suggested that when the relationship was allowed to vary at the state-level, it remained inverse (β = -0.05, SE (0.01)). However, an interaction between income inequality and time suggested that, as time increased, the effect of income inequality had an increasingly positive association with total IMR (β = 0.009, SE (0.002)). The influence of state income inequality on IMR is dependent on time, which may proxy for time-dependent aspects of societal context.

  16. Incidence and mortality rates of selected infection-related cancers in Puerto Rico and in the United States

    Directory of Open Access Journals (Sweden)

    Romero Carlos J

    2010-05-01

    Full Text Available Abstract Background In 2002, 17.8% of the global cancer burden was attributable to infections. This study assessed the age-standardized incidence and mortality rates of stomach, liver, and cervical cancer in Puerto Rico (PR for the period 1992-2003 and compared them to those of Hispanics (USH, non-Hispanic Whites (NHW, and non-Hispanic Blacks (NHB in the United States (US. Methods Age-standardized rates [ASR(World] were calculated based on cancer incidence and mortality data from the PR Cancer Central Registry and SEER, using the direct method and the world population as the standard. Annual percent changes (APC were calculated using the Poisson regression model from 1992-2003. Results The incidence and mortality rates from stomach, liver and cervical cancer were lower in NHW than PR; with the exception of mortality from cervical cancer which was similar in both populations. Meanwhile, the incidence rates of stomach, liver and cervical cancers were similar between NHB and PR; except for NHB women who had a lower incidence rate of liver cancer than women in PR. NHB had a lower mortality from liver cancer than persons in PR, and similar mortality from stomach cancer. Conclusions The burden of liver, stomach, and cervical cancer in PR compares to that of USH and NHB and continues to be a public health priority. Public health efforts are necessary to further decrease the burden of cancers associated to infections in these groups, the largest minority population groups in the US. Future studies need to identify factors that may prevent infections with cancer-related agents in these populations. Strategies to increase the use of preventive strategies, such as vaccination and screening, among minority populations should also be developed.

  17. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ..., 2009, at 74 FR 34295. Child and Adult Care Food Program (CACFP) Lunch and Centers Breakfast supper \\1... related notice published at 48 FR 29114, June 24, 1983.) This notice has been determined to be not... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  18. The influence of unemployment and divorce rate on child help-seeking behavior about violence, relationships, and other issues

    NARCIS (Netherlands)

    van Dolen, W.M.; Weinberg, C.B.; Ma, L.

    2013-01-01

    Objective This study examined the influence of community unemployment and divorce rate on child help-seeking behavior about violence and relationships via a telephone and Internet helpline. Methods Time series analysis was conducted on monthly call volumes to a child helpline (‘De Kindertelefoon’) i

  19. The Influence of Unemployment and Divorce Rate on Child Help-Seeking Behavior about Violence, Relationships, and Other Issues

    Science.gov (United States)

    van Dolen, Willemijn M.; Weinberg, Charles B.; Ma, Leiming

    2013-01-01

    Objective: This study examined the influence of community unemployment and divorce rate on child help-seeking behavior about violence and relationships via a telephone and Internet helpline. Methods: Time series analysis was conducted on monthly call volumes to a child helpline ("De Kindertelefoon") in the Netherlands from 2003 to 2008 and on the…

  20. Trends in Mortality Rate from Cardiovascular Disease in Brazil, 1980-2012

    Science.gov (United States)

    Mansur, Antonio de Padua; Favarato, Desidério

    2016-01-01

    Background Studies have questioned the downward trend in mortality from cardiovascular diseases (CVD) in Brazil in recent years. Objective to analyze recent trends in mortality from ischemic heart disease (IHD) and stroke in the Brazilian population. Methods Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. Risk of death was adjusted by the direct method, using as reference the world population of 2000. We analyzed trends in mortality from CVD, IHD and stroke in women and men in the periods of 1980-2006 and 2007-2012. Results there was a decrease in CVD mortality and stroke in women and men for both periods (p < 0.001). Annual mortality variations for periods 1980-2006 and 2007-2012 were, respectively: CVD (total): -1.5% and -0.8%; CVD men: -1.4% and -0.6%; CVD women: -1.7% and -1.0%; DIC (men): -1.1% and 0.1%; stroke (men): -1.7% and -1.4%; DIC (women): -1.5% and 0.4%; stroke (women): -2.0% and -1.9%. From 1980 to 2006, there was a decrease in IHD mortality in men and women (p < 0.001), but from 2007 to 2012, changes in IHD mortality were not significant in men [y = 151 + 0.04 (R2 = 0.02; p = 0.779)] and women [y = 88-0.54 (R2 = 0.24; p = 0.320). Conclusion Trend in mortality from IHD stopped falling in Brazil from 2007 to 2012. PMID:27223642

  1. The impact of changes in self-rated general health on 28-year mortality among middle-aged Danes

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert; Kreiner, Svend

    2009-01-01

    . DESIGN: Prospective population study started in 1976 with follow-up in 1981, 1987, and 1996. SETTING: Suburban area of Copenhagen. SUBJECTS: A total of 1198 individuals born in 1936. MAIN OUTCOME MEASURE: All-cause mortality. RESULTS: Among participants with two consecutive SRH ratings the mortality rate...... per 1000 observation years was 7.6 (95% CI 6.4; 8.9), 8.5 (95% CI 7.1; 10.2), and 8.9 (95% CI 6.4; 10.3) after the 45-, 51-, and 60-year examination. Decline in SRH between two time-points was in bivariate Cox regression analyses associated with an increased mortality risk, the association increasing...

  2. Interactions between hatch dates, growth rates, and mortality of Age-0 native Rainbow Smelt and nonnative Alewife in Lake Champlain

    Science.gov (United States)

    Parrish, Donna; Simonin, Paul W.; Rudstam, Lars G.; Pientka, Bernard; Sullivan, Patrick J.

    2016-01-01

    Timing of hatch in fish populations can be critical for first-year survival and, therefore, year-class strength and subsequent species interactions. We compared hatch timing, growth rates, and subsequent mortality of age-0 Rainbow Smelt Osmerus mordax and Alewife Alosa pseudoharengus, two common open-water fish species of northern North America. In our study site, Lake Champlain, Rainbow Smelt hatched (beginning May 26) almost a month earlier than Alewives (June 20). Abundance in the sampling area was highest in July for age-0 Rainbow Smelt and August for age-0 Alewives. Late-hatching individuals of both species grew faster than those hatching earlier (0.6 mm/d versus 0.4 for Rainbow Smelt; 0.7 mm/d versus 0.6 for Alewives). Mean mortality rate during the first 45 d of life was 3.4%/d for age-0 Rainbow Smelt and was 5.5%/d for age-0 Alewives. Alewife mortality rates did not differ with hatch timing but daily mortality rates of Rainbow Smelt were highest for early-hatching fish. Cannibalism is probably the primary mortality source for age-0 Rainbow Smelt in this lake. Therefore, hatching earlier may not be advantageous because the overlap of adult and age-0 Rainbow Smelt is highest earlier in the season. However, Alewives, first documented in Lake Champlain in 2003, may increase the mortality of age-0 Rainbow Smelt in the summer, which should favor selection for earlier hatching.

  3. Bifurcation of Positive Equilibria in Nonlinear Structured Population Models with Varying Mortality Rates

    CERN Document Server

    Walker, Christoph

    2010-01-01

    A parameter-dependent model involving nonlinear diffusion for an age-structured population is studied. The parameter measures the intensity of the mortality. A bifurcation approach is used to establish existence of positive equilibrium solutions.

  4. Effect of dietary protein levels on growth performance, mortality rate and clinical blood parameters in mink (Mustela vison)

    DEFF Research Database (Denmark)

    Damgaard, B.M.; Clausen, T.N.; Dietz, Hans Henrik

    1998-01-01

    performance, mortality rate, hepatic fatty infiltration, weights of body and liver, relative weight of liver, haematocrit values, plasma activities of alanine-aminotransferase (ALAT), aspartate-aminotransferase (ASAT) and creatine-kinase (CK), and plasma concentrations of chemical parameters were studied...

  5. Association of soil arsenic and nickel exposure with cancer mortality rates, a town-scale ecological study in Suzhou, China.

    Science.gov (United States)

    Chen, Kai; Liao, Qi Lin; Ma, Zong Wei; Jin, Yang; Hua, Ming; Bi, Jun; Huang, Lei

    2015-04-01

    Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population.

  6. 45 CFR 284.21 - What will we do if the State's child poverty rate increased five percent or more over the two...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false What will we do if the State's child poverty rate... IN A STATE OR TERRITORY'S CHILD POVERTY RATE IS THE RESULT OF THE TANF PROGRAM § 284.21 What will we do if the State's child poverty rate increased five percent or more over the two-year period? (a)...

  7. Accidental ingestion of E-cigarette liquid nicotine in a 15-month-old child: an infant mortality case of nicotine intoxication

    Science.gov (United States)

    Seo, An Deok; Kim, Dong Chan; Yu, Hee Joon

    2016-01-01

    Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents. PMID:28194215

  8. How Macroeconomic Instability Lowers Child Survival

    OpenAIRE

    2011-01-01

    The reduction of child mortality is one of the most universally accepted millennium goals. However, a significant debate came out on the means of reaching it and on its realism with regard to the situation of most of the least developed countries. The recommendations made for the achievement of this are mainly medical ones. However, without underestimating the importance of these measures, in particular vaccinations, it seems increasingly obvious that the rate of reduction of child mortality ...

  9. Changes in hospitalization rate and mortality after acute myocardial infarction in Denmark after diagnostic criteria and methods changed

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Rasmussen, Søren; Madsen, Mette

    2004-01-01

    AIMS: To analyse the effect of the change in diagnostic criteria for acute myocardial infarction (AMI) and the use of troponin as a diagnostic marker on the hospitalization rate and mortality of hospitalized AMI patients from 1994 to 2001. METHODS AND RESULTS: Patients (> or =30 years) admitted.......9%) for men and from 1648 to 2020 per million inhabitants (22.6%) for women. Troponin use was associated with a significant 14% increase in hospitalization rate in this period [rate ratio 1.14, 95% confidence interval (CI) 1.11-1.18]. The effect of troponin was greatest among patients 70 years and older (rate...

  10. Growth and mortality rates of yellowfin tuna, Thunnus albacares (Perciformes: Scombridae, in the eastern and central Pacific Ocean

    Directory of Open Access Journals (Sweden)

    Guoping Zhu

    2011-04-01

    Full Text Available Age and growth parameters were estimated for the yellowfin tuna Thunnus albacares (Bonnaterre, 1788. Atotal of 443 individuals were sampled from China longline fisheries in the eastern and central Pacific Ocean from February to November 2006. The von Bertalanffy growth parameters were estimated at L∞ = 175.9 cm fork length, k = 0.52 year-1, and t0 = 0.19 year. The total mortality rate (Z was estimated to be from 1.19 to 1.93 year-1, the fishing mortality (F and the natural mortality (M were calculated to be 0.91 year-1 and 0.65 year-1, respectively. The rate of exploitation (U was estimated to be 0.46. This study provides estimates of growth and mortality rate for yellowfin tuna in the eastern and central Pacific Ocean, which may be used as biological input parameters in future stock assessments for the oceanic region. However, age analysis with other techniques, additional validation of the size composition and stock structure are also needed.

  11. Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

    Directory of Open Access Journals (Sweden)

    Carolina Verdan

    2014-04-01

    Full Text Available We describe a three-year experience with patients with dementia. Method: clinical, cognitive and functional evaluation was performed by a multidisciplinary team for persons above 60 years. Mortality was assessed after three years. Results: Mini-Mental State Examination (MMSE (n=2,074 was 15.7 (8.4. Male patients MMSE (n=758 was 15.6 (8.3 and female's (n=1315 was 15.8 (8.3. Instrumental Activities of Daily Living Scale (n=2023 was 16.5 (7.6; females (n=1277 was 16.9 (7.2 and males (n=745 was 15.7(8.2. From these patients, 12.6% (n=209 died within three years. Baseline cognition of patients still alive was higher (p<0.001 than MMSE of those who died [MMSE=16.3 (8.1 vs. 10.6 (7.6]. Mortality rate decreased 6% (IR=0.94 for each additional point on MMSE. Higher functional status decreases the mortality rate approximately 11% (IR=0.89 independently of age, gender, and education. Conclusion: Three-year mortality rates are dependent on baseline functional and cognitive status

  12. District of Columbia Going for the Gold Tiered Rate Reimbursement System. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of District of Columbia's Going for the Gold Tiered Rate Reimbursement Systemp repared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for…

  13. Poor self-rated health did not increase permanent nursing home placement or mortality in people with mild Alzheimer's disease

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild;

    2016-01-01

    analysis: In the fully adjusted models HR was 0.63 (95 % CI 0.38-1.05) and 1.28 (95 % CI 0.67-2.45), respectively. Conclusions. When poor SRH was present we found no increased risk for NH placement or death among elderly people with mild AD. SRH is a widely used parameter in clinical and epidemiological......Background: Self-rated health (SRH) has in many population-based studies predicted adverse health outcomes, e.g. morbidity, permanent nursing home (NH) placement, and mortality. However, the predictive value of SRH to NH placement and mortality among elderly people is not consistent. This may...... be due to cognitive impairment. Since the SRH item is widely used, it is important to know whether SRH has different predictive value among people with cognitive impairments. We aimed to examine SRH and the risk of permanent NH placement and mortality among people with mild Alzheimer’s disease (AD...

  14. Typology and description of the endemic areas with a long-time and smallest colorectal mortality rates within Silesia voivodeship

    Directory of Open Access Journals (Sweden)

    Brunon Zemła

    2013-09-01

    Full Text Available Background: In the years 1999–2009, in Silesia voivodeship, 7339 males and 6635 females were died for the colorectal cancers (C18–C21, by ISCD&HRP, X revision. Mortality, especially among men increase. Mortality, among both sexes, is very unequal, taking into account a small administrative units (counties. Therefore an attempt looking for endemic areas with a long – time biggest and smallest mortality rates. Materials and methods: For the 13 974 cases of deaths because of the colorectal cancer, and at used demographic data, the following mortality rates were calculated to be average for 11 years period (in this two periods extreme, each 4-years: a age specific (for 5-years age groups, b crude rates („intensity rates” for all ages and a particular administrative unit type of counties, c age-adjusted (standardized rates by direct M. Spiegelman’s method and the age structure of „world population” according to M. Segi’s and M. Kurihara’s method and modified by R. Doll’s. Age – adjusted mortality rates for particular counties (R1 to the whole voivodeship (R2 were compared with used 95% confidence interval for the ratio (R1/R2 according to O.S. Miettinen’s method. Basing on the data the endemic areas with a biggest and smallest cancer colorectal rates were described. Results: In the years 1999–2009 within Silesia voivodeship 13974 patients died because of the colorectal cancers, i.e. 52.5% males and 47.5% females. Standardized mortality rate for whole Silesia voivodeship is 20.9 per 100 thousands among males and 12.1/100 thousands among females (at the small increase between two periods comparising, i.e. 1999–2002:2006–2009 for females, and bigger among males. Standardized, average minimum mortality rate for the colorectal cancers for the whole Silesia voivodeship and the period 1999–2009 is 17.1/100 thousands for males (bieruńsko-lędziński county and 10.0/100 thousands for females (myszkowski county; and maximum

  15. NCHS - Infant Mortality Rates, by Race: United States, 1915-2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — All birth data by race before 1980 are based on race of the child; starting in 1980, birth data by race are based on race of the mother. Birth data are used to...

  16. Experimental warming and precipitation interactively modulate the mortality rate and timing of spring emergence of a gallmaking Tephritid fly.

    Science.gov (United States)

    Xi, Xinqiang; Li, Dongbo; Peng, Youhong; Eisenhauer, Nico; Sun, Shucun

    2016-08-31

    Global climate change is mostly characterized by temperature increase and fluctuating precipitation events, which may affect the spring phenology and mortality rate of insects. However, the interaction effect of temperature and precipitation on species performance has rarely been examined. Here we studied the response of the gall-making Tephritid fly Urophora stylata (Diptera: Tephritidae) to artificial warming, changes in precipitation, and the presence of galls. Our results revealed a significant interaction effect of warming, precipitation, and galls on the life-history traits of the focal species. Specifically, when the galls were intact, warming had no effect on the phenology and increased the mortality of the fly under decreased precipitation, but it significantly advanced the timing of adult emergence and had no effect on the mortality under increased precipitation. When galls were removed, warming significantly advanced the timing of emergence and increased fly mortality, but precipitation showed no effect on the phenology and mortality. In addition, gall removal significantly increased adult fresh mass for both females and males. Our results indicate that the effect of elevated temperature on the performance of species may depend on other environmental conditions, such as variations in precipitation, and species traits like the formation of galls.

  17. A study on health problems, etiology, morbidity rate and mortality rate of goats under village environments in 3 provinces of Southern Thailand

    Directory of Open Access Journals (Sweden)

    Choldumrongkul, S.

    2007-03-01

    Full Text Available The causes and influence of factors on, health problems, morbidity and mortality rate of Thai native and Anglo-Nubian crossbred goats raised by farmers in southern Thailand, were studied. Out of 620 goatsduring the period of study (January 2003 - January 2004, There were 464 sick cases and 65 goats died (10.48%. Major causes were helminthiasis, pneumonitis, mellioidosis, infections, weak-starvation complex,predator and accident. The morbidity rate of postweaning goats (3 months-1 year by helminthiasis especially in the light rainy season was higher than that for other causes and season. The mortality rate forpostweaning goats from pneumonitis in the heavy rainy season was greater than that from other causes. Genotype and birth weight of preweaning kids significantly (P0.05

  18. Prediction of mortality rate of trauma patients in emergency room at Cipto Mangunkusumo Hospital by several scoring systems

    Directory of Open Access Journals (Sweden)

    Pande M.W. Tirtayasa

    2013-12-01

    Full Text Available Background: Trauma management is well recognized as one of the main challenges in modern health care. Easy-to-use trauma scoring systems inform physicians of the severity of trauma and help them to decide the course of trauma management. The aim of this study was to find the most applicable trauma scoring system which can be used by physicians by comparing prediction of the mortality rate using: 1triage-revised trauma score (T-RTS; 2 mechanism, Glasgow coma scale (GCS, age, and arterial pressure (MGAP; and GCS, age, and systolic blood pressure (GAP scoring system on trauma patients in emergency room (ER at Cipto Mangunkusumo Hospital.Methods: The data were collected retrospectively from medical records of trauma patients who came to the resuscitation area in ER at Cipto Mangunkusumo Hospital throughout 2011. As many as 185 patients were managed. The inclusion criteria were all trauma patients who came to the resuscitation area in ER. All referred patients, patients under eighteen, and uncompleted data were excluded. The data were calculated based on each scoring system. The outcome (death or alive was collected on first 24 hours following admission.Results: There were 124 cases analyzed, with mean of age of 32.4 years and total mortality rate up to 23 cases (18.5%. The mortality rate of low risk group on T-RTS, MGAP, and GAP was 5%, 1.3%, and 1.4% respectively (p = 1.000. The mortality rate of intermediate risk group on T-RTS, MGAP, and GAP was 39.4%, 32.1%, and 36.3%, respectively (p = 0.841. Mortality rate of high risk group on T-RTS, MGAP, and GAP was 100%, 72.2%, and 85.7% respectively (p = 0.782.Conclusion: There was no difference on T-RTS, MGAP, and GAP scoring system in predicting mortality rate. T-RTS is the most applicable trauma scoring system since it does not differ the age and mechanism of trauma. (Med J Indones. 2013;22:227-31. doi: 10.13181/mji.v22i4.603 Keywords: GAP, MGAP, T-RTS, Trauma scoring system

  19. The influence of prenatal screening and termination of pregnancy on perinatal mortality rates

    NARCIS (Netherlands)

    Pal-de Bruin, K.M. van der; Graafmans, W.; Biermans, M.C.J.; Richardus, J.H.; Zijlstra, A.G.; Reefhuis, J.; Mackenbach, J.P.; Verloove-Vanhorick, S.P.

    2002-01-01

    Objectives This study concerns the possible effect of practice of prenatal screening of congenital anomalies followed by termination of pregnancy on the perinatal mortality between European countries. Methods Data of nine region-specific EUROCAT registries from five European countries were used to c

  20. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations...

  1. Impact on mortality and cancer incidence rates of using random invitation from population registers for recruitment to trials

    Directory of Open Access Journals (Sweden)

    Woolas Robert

    2011-03-01

    to use the various mortality and incidence rates presented as guides for calculating event rates and power in RCTs involving women. Trial Registration This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978. Medical Research Council (grant no. G990102, Cancer Research UK (grant no. C1479/A2884 and Department of Health

  2. Land tenure and child health in Rio Grande do Sul: the relationship between agricultural production, malnutrition and mortality.

    Science.gov (United States)

    Victora, C G; Vaughan, J P

    1997-01-01

    "Four different approaches were applied to test the hypothesis that patterns of land tenure and agricultural production in Rio Grande do Sul [Brazil] are important infant mortality determinants. These studies have employed various data sources on distinct analytical levels.... The results...provide reliable evidence of there being a strong relationship between the degree of concentration of land tenure and agricultural production on the one hand, and malnutrition and infant mortality on the other."

  3. Impact of Socioeconomic and Health System Factors on Infant Mortality Rate in Organization of the Petroleum Exporting Countries (OPEC: Evidence from 2004 to 2013

    Directory of Open Access Journals (Sweden)

    Satar Rezaei

    2015-04-01

    Full Text Available Background: infant mortality rate is one of the main health indicators for assessing the health system’s performance over the world. We aim to examine the socioeconomic and health system factors affect infant mortality in OPEC from 2004 to 2013. Methods: was used to examine the effects of some of the key explanatory factors (total fertility rate per women, GDP per capita (current US$, public health expenditure as % of total health expenditure and female labor force participation rate on infant mortality in OPEC from 2004 to 2013.  These data were obtained from World Bank and World Health Organization data bank. Results: our results showed the total fertility rate had a positive and significant impact on infant mortality in the studied period. Also, there are negative significant associations between GDP per capita and public health expenditure with infant mortality. We did not observe any relationship between infant mortality and female labour force participation rate in the studied countries from 2004 to 2013. Conclusion: total fertility rate per women, GDP per capita (current US$, public health expenditure as % of total health expenditure were identified as the main factors affecting on infant mortality in OPEC over the ten years (2004-2013. This study enables health policy-makers to better understand the factors affecting on infant mortality and thereby take necessary steps in managing and decreasing the infant mortality rate in the studied countries.

  4. A simple risk stratification model that predicts 1-year postoperative mortality rate in patients with solid-organ cancer.

    Science.gov (United States)

    Chou, Wen-Chi; Wang, Frank; Cheng, Yu-Fan; Chen, Miao-Fen; Lu, Chang-Hsien; Wang, Cheng-Hsu; Lin, Yung-Chang; Yeh, Ta-Sen

    2015-11-01

    This study aimed to construct a scoring system developed exclusively from the preoperative data that predicts 1-year postoperative mortality in patients with solid cancers. A total of 20,632 patients who had a curative resection for solid-organ cancers between 2007 and 2012 at Chang Gung Memorial Hospital Linkou Medical Center were included in the derivation cohort. Multivariate logistic regression analysis was performed to develop a risk model that predicts 1-year postoperative mortality. Patients were then stratified into four risk groups (low-, intermediate-, high-, and very high-risk) according to the total score (0-43) form mortality risk analysis. An independent cohort of 16,656 patients who underwent curative cancer surgeries at three other hospitals during the same study period (validation cohort) was enrolled to verify the risk model. Age, gender, cancer site, history of previous cancer, tumor stage, Charlson comorbidity index, American Society of Anesthesiologist score, admission type, and Eastern Cooperative Oncology Group performance status were independently predictive of 1-year postoperative mortality. The 1-year postoperative mortality rates were 0.5%, 3.8%, 14.6%, and 33.8%, respectively, among the four risk groups in the derivation cohort (c-statistic, 0.80), compared with 0.9%, 4.2%, 14.6%, and 32.6%, respectively, in the validation cohort (c-statistic, 0.78). The risk stratification model also demonstrated good discrimination of long-term survival outcome of the four-tier risk groups (P model not only predicts 1-year postoperative mortality but also differentiates long-term survival outcome between the risk groups.

  5. Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors

    OpenAIRE

    2014-01-01

    Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Ut...

  6. Examining mortality risk and rate of ageing among Polish Olympic athletes: a survival follow-up from 1924 to 2012

    Science.gov (United States)

    Lin, Yuhui; Gajewski, Antoni; Poznańska, Anna

    2016-01-01

    Objectives Population-based studies have shown that an active lifestyle reduces mortality risk. Therefore, it has been a longstanding belief that individuals who engage in frequent exercise will experience a slower rate of ageing. It is uncertain whether this widely-accepted assumption holds for intense wear-and-tear. Here, using the 88 years survival follow-up data of Polish Olympic athletes, we report for the first time on whether frequent exercise alters the rate of ageing. Design Longitudinal survival data of male elite Polish athletes who participated in the Olympic Games from year 1924 to 2010 were used. Deaths occurring before the end of World War II were excluded for reliable estimates. Setting and participants Recruited male elite athletes N=1273 were preassigned to two categorical birth cohorts—Cohort I 1890–1919; Cohort II 1920–1959—and a parametric frailty survival analysis was conducted. An event-history analysis was also conducted to adjust for medical improvements from year 1920 onwards: Cohort II. Results Our findings suggest (1) in Cohort I, for every threefold reduction in mortality risk, the rate of ageing decelerates by 1%; (2) socioeconomic transitions and interventions contribute to a reduction in mortality risk of 29% for the general population and 50% for Olympic athletes; (3) an optimum benefit gained for reducing the rate of ageing from competitive sports (Cohort I 0.086 (95% CI 0.047 to 0.157) and Cohort II 0.085 (95% CI 0.050 to 0.144)). Conclusions This study further suggests that intensive physical training during youth should be considered as a factor to improve ageing and mortality risk parameters. PMID:27091824

  7. The impact of fiscal decentralization on infant mortality rates: evidence from OECD countries.

    Science.gov (United States)

    Jiménez-Rubio, Dolores

    2011-11-01

    This study re-examines the hypothesis that shifts towards more decentralization would be accompanied by improvements in population health on a panel of 20 OECD countries over a thirty year period (1970-2001). Decentralization is proxied using a conventional indicator of revenue decentralization and a new measure of fiscal decentralization that reflects better than previous measures the existence of autonomy in the decision-making authority of lower tiers of government, a crucial issue in the decentralization process. The results show a considerable and positive effect of fiscal decentralization on infant mortality only if a substantial degree of autonomy in the sources of revenue is devolved to local governments. The proportion of health care expenditure on GDP and, in particular, education, were found to have a larger contribution to the reduction of infant mortality in the sample of OECD countries analysed over the period of study.

  8. MORTALITY RATE AND OUTCOME FACTORS IN MIXED CRYOGLOBULINAEMIA: THE IMPACT OF HEPATITIS C VIRUS

    OpenAIRE

    Salvadori, Stefano; Della Rossa, Alessandra; et, al.

    2010-01-01

    Objectives: Mixed cryoglobulinaemia (MC) is a chronic small-vessel vasculitis. Shortly after the discovery of hepatitis C virus (HCV) in 1989, an association between HCV infection and MC was being increasingly reported, suggesting the potential pathogenetic implication of HCV in most of the cases that had been previously diagnosed as essential MC. A number of studies have pointed out prognostic factors linked to mortality in this disorder. None of them, however, have clarified the impact of H...

  9. Decreased glomerular filtration rate is associated with mortality and cardiovascular events in patients with hypertension: a prospective study.

    Directory of Open Access Journals (Sweden)

    Rui Zhang

    Full Text Available BACKGROUND: Few studies reported the associations between decreased glomerular filtration rate (GFR and mortality, coronary heart disease (CHD, and stroke in hypertensive patients. We aim to assess the associations between GFR and mortality, CHD, and stroke in hypertensive patients and to evaluate whether low GFR can improve the prediction of these outcomes in addition to conventional cardiovascular risk factors. METHODS AND FINDINGS: This is an observational prospective study and 3,711 eligible hypertensive patients aged ≥5 years from rural areas of China were used for the present analysis. The associations between eGFR and outcomes, followed by a median of 4.9 years, were evaluated using Cox proportional hazards models adjusting for other potential confounders. Low eGFR was independently associated with risk of all-cause mortality, cardiovascular mortality, and incident stroke [multivariable adjusted hazard ratios (95% confidence intervals for eGFR <60 ml/min/1.73 m(2 relative to eGFR ≥90 ml/min/1.73 m(2 were 1.824 (1.047-3.365, 2.371 (1.109-5.068, and 2.493 (1.193-5.212, respectively]. We found no independent association between eGFR and the risk of CHD. For 4-year all-cause and cardiovascular mortality, integrated discrimination improvement (IDI was positive when eGFR were added to traditional risk factors (1.51%, P = 0.016, and 1.99%, P = 0.017, respectively. For stroke and CHD events, net reclassification improvements (NRI were 5.9% (P = 0.012 and 1.8% (P = 0.083 for eGFR, respectively. CONCLUSIONS: We have established an inversely independent association between eGFR and all-cause mortality, cardiovascular mortality, and stroke in hypertensive patients in rural areas of China. Further, addition of eGFR significantly improved the prediction of 4-year mortality and stroke over and above that of conventional risk factors. We recommend that eGFR be incorporated into prognostic assessment for patients with hypertension in

  10. Space and panic: the application of space syntax to understand the relationship between mortality rates and spatial configuration in Banda Aceh during the tsunami 2004

    NARCIS (Netherlands)

    Fakhrurrazi, F.; Van Nes, A.

    2012-01-01

    The aim of this paper is to reveal the correlation between mortality rates from the tsunami of 2004 and the spatial structure of Banda Aceh’s street net. Structurally, the city is divided up in several small villages, which consists of a couple of urban blocks. The mortality rates for each of these

  11. Studies on growth rate and grazing mortality rate by microzooplankton of size-fractionated phytoplankton in spring and summer in the Jiaozhou Bay, China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Liyong; SUN Jun; LIU Dongyan; YU Zishan

    2005-01-01

    Dilution experiments were performed to examine the growth rate and grazing mortality rate of size-fractionated phytoplankton at three typical stations, inside and outside the bay, in the spring and summer of 2003 in the Jiaozhou Bay, China. In spring, the phytoplankton community structure was similar among the three stations, and was mainly composed of nanophytoplankton, such as, Skeletonema costatum and Cylindrotheca closterium. The structure became significantly different for the three stations in summer, when the dominant species at Stas A, B and C were Chaetoceros curvisetus, Pseudo-nitzschia delicatissima, C. affinis, C. debilis, Coscinodiscus oculus-iridis and Paralia sulcata respectively. Tintinnopsis beroidea and T. tsingtaoensis were the dominant species in spring, whereas the microzooplankton was apparently dominated by Strombidium sp. in summer. Pico- and nanophytoplankton had a relatively greater growth rate than microzooplankton both in spring and summer. The growth rate and grazing mortality rate were 0.18~0.44 and 0.12~1.47 d-1 for the total phytoplankton and 0.20~0.55 and 0.21~0.37 d-1 for nanophytoplankton in spring respectively. In summer,the growth rate and grazing mortality rate were 0.38~0.71 and 0.27~0.60 d-1 for the total phytoplankton and 0.11~1.18 and 0.41~0.72d-1 for nano- and microphytoplankton respectively. The carbon flux consumed by microzooplankton per day was 7.68~39.81 mg/m3 in spring and 12.03~138.22 mg/m3 in summer respectively. Microzooplankton ingested 17.56%~92.19% of the phytoplankton standing stocks and 31.77%~467.88% of the potential primary productivity in spring; in contrast, they ingested 34.60%~83.04% of the phytoplankton standing stocks and 71.28%~98.80% of the potential primary productivity in summer. Pico- and nanophytoplankton appeared to have relatively greater rates of growth and grazing mortality than microphytoplankton during the experimental period. The grazing rate of

  12. Household Size and Water Availability as Demographic Predictors of Maternal and Child Mortality in Delta State: Implications for Health Education

    Science.gov (United States)

    Ogbe, Joseph O.

    2010-01-01

    The purpose of this study was to stimulate action to address and identify maternal, child and community needs towards the improvement in health of pregnant women, children and communities. Four null hypotheses were generated from the research questions while multiple regression analysis was used to analyse the data. The study found that household…

  13. Geographic access to care is not a determinant of child mortality in a rural Kenyan setting with high health facility density

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    Williams Thomas N

    2010-03-01

    Full Text Available Abstract Background Policy-makers evaluating country progress towards the Millennium Development Goals also examine trends in health inequities. Distance to health facilities is a known determinant of health care utilization and may drive inequalities in health outcomes; we aimed to investigate its effects on childhood mortality. Methods The Epidemiological and Demographic Surveillance System in Kilifi District, Kenya, collects data on vital events and migrations in a population of 220,000 people. We used Geographic Information Systems to estimate pedestrian and vehicular travel times to hospitals and vaccine clinics and developed proportional-hazards models to evaluate the effects of travel time on mortality hazard in children less than 5 years of age, accounting for sex, ethnic group, maternal education, migrant status, rainfall and calendar time. Results In 2004-6, under-5 and under-1 mortality ratios were 65 and 46 per 1,000 live-births, respectively. Median pedestrian and vehicular travel times to hospital were 193 min (inter-quartile range: 125-267 and 49 min (32-72; analogous values for vaccine clinics were 47 (25-73 and 26 min (13-40. Infant and under-5 mortality varied two-fold across geographic locations, ranging from 34.5 to 61.9 per 1000 child-years and 8.8 to 18.1 per 1000, respectively. However, distance to health facilities was not associated with mortality. Hazard Ratios (HR were 0.99 (95% CI 0.95-1.04 per hour and 1.01 (95% CI 0.95-1.08 per half-hour of pedestrian and vehicular travel to hospital, respectively, and 1.00 (95% CI 0.99-1.04 and 0.97 (95% CI 0.92-1.05 per quarter-hour of pedestrian and vehicular travel to vaccine clinics in children Conclusions Significant spatial variations in mortality were observed across the area, but were not correlated with distance to health facilities. We conclude that given the present density of health facilities in Kenya, geographic access to curative services does not influence

  14. Child Mortality after Discharge from a Health Facility following Suspected Pneumonia, Meningitis or Septicaemia in Rural Gambia: A Cohort Study.

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    Aakash Varun Chhibber

    Full Text Available To measure mortality and its risk factors among children discharged from a health centre in rural Gambia.We conducted a cohort study between 12 May 2008 and 11 May 2012. Children aged 2-59 months, admitted with suspected pneumonia, sepsis, or meningitis after presenting to primary and secondary care facilities, were followed for 180 days after discharge. We developed models associating post-discharge mortality with clinical syndrome on admission and clinical risk factors.One hundred and five of 3755 (2.8% children died, 80% within 3 months of discharge. Among children aged 2-11 and 12-59 months, there were 30 and 29 deaths per 1000 children per 180 days respectively, compared to 11 and 5 respectively in the resident population. Children with suspected pneumonia unaccompanied by clinically severe malnutrition (CSM had the lowest risk of post-discharge mortality. Mortality increased in children with suspected meningitis or septicaemia without CSM (hazard ratio [HR] 2.6 and 2.2 respectively. The risk of mortality greatly increased with CSM on admission: CSM with suspected pneumonia (HR 8.1; 95% confidence interval (CI 4.4 to 15, suspected sepsis (HR 18.4; 95% CI 11.3 to 30, or suspected meningitis (HR 13.7; 95% CI 4.2 to 45. Independent associations with mortality were: mid-upper arm circumference (MUAC of 11.5-13.0 cm compared to >13.0 cm (HR 7.2; 95% CI 3.0 to 17.0, MUAC 10.5-11.4 cm (HR 24; 95% CI 9.4 to 62, and MUAC <10.5 cm (HR 44; 95% CI 18 to 108, neck stiffness (HR 10.4; 95% CI 3.1 to 34.8, non-medical discharge (HR 4.7; 95% CI 2.0 to 10.9, dry season discharge (HR 2.0; 95% CI 1.2 to 3.3, while greater haemoglobin (HR 0.82; 0.73 to 0.91, axillary temperature (HR 0.71; 95% CI 0.58 to 0.87, and oxygen saturation (HR 0.96; 95% CI 0.93 to 0.99 were associated with reduced mortality.Gambian children experience increased mortality after discharge from primary and secondary care. Interventions should target both moderately and severely

  15. Cumulative dosages of antipsychotic drugs are associated with increased mortality rate in patients with Alzheimer's dementia

    DEFF Research Database (Denmark)

    Nielsen, R E; Lolk, A; Valentin, J B;

    2016-01-01

    mortality: more than 0 Daily Defined Dosage (DDDs) but less than 90: HR 2.20, 95% CI (2.14-2.27), P DDDs but less than 365: HR 1.81, 95% CI (1.74-1.89), P DDDs but less than 730: HR 1.38, 95% CI (1.428-1.49), P ... or equal to 730 DDDs: HR 1.06, 95% CI (0.95-1.18), P = 0.322, when controlling for proxy markers of severity, somatic and mental comorbid disorders. CONCLUSION: In this nationwide cohort study of 45 894 patients diagnosed with Alzheimer's dementia, we found that cumulative dosages of antipsychotic drugs...

  16. AGE-DEPENDENT ASPECTS OF ACUTE CORONARY HEART DISEASE INCIDENCE RATE AND MORTALITY IN MEN AND WOMEN

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    S. A. Boytsov

    2010-01-01

    Full Text Available Aim. To study gender and age characteristics of incidence rate, mortality and lethality in acute coronary heart disease (ACHD.Material and Methods. Analysis of the ACHD (ICD-10 codes: I21.0-I22.9, I20.0, I24 morbidity, mortality and lethality, depending on sex and age was performed in the population (n=285 736; 46% men of several city administrative districts of Voronezh, Ryazan and Khanty-Mansiysk. Morbidity, mortality and lethality were calculated on the basis of medical documentation as well as cases identified by the study protocol.Results. The ACHD morbidity and mortality in men were 1.99 and 1.79 times higher (p<0,001, respectively, than these in women. The studied parameters increase with age, reaching a maximum in 50-59 y.o., have a plateau in 60-79 y.o. and then they decrease. Morbidity and mortality in women increase with age, but reach a maximum in 70-79 y.o., being comparable with the male level, and then exceed it in ≥80 y.o. Age curve of lethality in men has J-alike shape with minimum in patients of 50-79 y.o. Women have a line age curve with minimum in patients of <50 y.o.Conclusion. The population of ACHD patients should be considered according to both the sex and age: <50, 50-79 and ≥80 y.o. Every of these population group has special epidemiological characteristics.

  17. Elevated Erythrocyte Sedimentation Rate Is Predictive of Interstitial Lung Disease and Mortality in Dermatomyositis: a Korean Retrospective Cohort Study.

    Science.gov (United States)

    Go, Dong Jin; Lee, Eun Young; Lee, Eun Bong; Song, Yeong Wook; Konig, Maximilian Ferdinand; Park, Jin Kyun

    2016-03-01

    Interstitial lung disease (ILD) is a major cause of death in patients with dermatomyositis (DM). This study was aimed to examine the utility of the erythrocyte sedimentation rate (ESR) as a predictor of ILD and prognostic marker of mortality in patients with DM. One hundred-and-fourteen patients with DM were examined, including 28 with clinically amyopathic DM (CADM). A diagnosis of ILD was made based on high resolution computed tomography (HRCT) scans. The association between elevated ESR and pulmonary impairment and mortality was then examined. ILD was diagnosed in 53 (46.5%) of 114 DM patients. Cancer was diagnosed in 2 (3.8%) of 53 DM patients with ILD and in 24 (92.3%) of those without ILD (P < 0.001). The median ESR (50.0 mm/hour) in patients with ILD was significantly higher than that in patients without ILD (29.0 mm/hour; P < 0.001). ESR was inversely correlated with forced vital capacity (Spearman ρ = - 0.303; P = 0.007) and carbon monoxide diffusing capacity (ρ = - 0.319; P = 0.006). DM patients with baseline ESR ≥ 30 mm/hour had significantly higher mortality than those with ESR < 30 mm/hour (P = 0.002, log-rank test). Patients with a persistently high ESR despite immunosuppressive therapy was associated with higher mortality than those with a normalized ESR (P = 0.039, log-rank test). Elevated ESR is associated with increased mortality in patients with DM due to respiratory failure. Thus, monitoring ESR should be an integral part of the clinical care of DM patients.

  18. New Mexico Look for the STARS--AIM HIGH: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of New Mexico's Look for the STARS--AIM HIGH prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  19. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients.

    Science.gov (United States)

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64-2.89) and 3.10 (2.35-4.08), respectively, for mortality, all P dependency, all P dependency after stroke.

  20. The Mortality Rate of Nosocomial Infection in Neonatal Intensive Care Unit (NICU of Taleghani Educational and Treatment Center, Tabriz, 2013

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    Parvin Abbasian

    2015-09-01

    Full Text Available Background and Objectives : Information about nosocomial infections (NIs is necessary for both appropriate management and establishment of preventative measures in hospitals. Neonates admitted to the Neonatal Intensive Care Unit (NICU are at high-risk of developing nosocomial infection. The aim of this study was to determine the mortality rate of nosocomial infections and the distribution of pathogens among newborns who were admitted to the neonatal intensive care unit in Taleghani educational and treatment center, Tabriz. Material and Methods : This was a cross-sectional study. The sampling method was census. The inclusion criteria were dead infants who developed signs of infection after 48 hours of hospitalization and those who had symptoms at the admission were excluded. Data were collected through hospital records and were analyzed using Excel software. Results: From 904 infants admitted to NICU, 39 (4.3% acquired hospital infection. Mortality from nosocomial infections in NICU was 20.5% that was 12% of the total deaths. Coagulase-negative staphylococcal Cook (37.5% and Escherichia coli (25% were the most commonly identified agents among dead neonates. Conclusion: For more reduction in nosocomial infection and its mortality rate, mercury hygiene principles and also optimizing bed spaces are recommended. ​

  1. The Impact of Extreme-Risk Cases on Hospitals’ Risk-Adjusted Percutaneous Coronary Intervention Mortality Ratings

    Science.gov (United States)

    Sherwood, Matthew W.; Brennan, J. Matthew; Ho, Kalon K.; Masoudi, Frederick A.; Messenger, John C.; Weaver, W. Douglas; Dai, David; Peterson, Eric D.

    2017-01-01

    OBJECTIVES The goal of this study was to examine the calibration of a validated risk-adjustment model in very high-risk percutaneous coronary intervention (PCI) cases and assess whether sites’ case mix affects their performance ratings. BACKGROUND There are concerns that treating PCI patients with particularly high-risk features such as cardiogenic shock or prior cardiac arrest may adversely impact hospital performance ratings. However, there is little investigation on the validity of these concerns. METHODS We examined 624,286 PCI procedures from 1,168 sites that participated in the CathPCI Registry in 2010. Procedural risk was estimated using the recently published Version 4 National Cardiovascular Data Registry (NCDR) PCI risk-adjusted mortality (RAM) model. We calculated observed/expected mortality using several risk classification methods, and simulated hospital performance after combining their highest risk cases over 2 years into a single year. RESULTS In 2010, crude in-hospital PCI mortality was 1.4%. The NCDR model was generally well calibrated among high risk, however there was slight overprediction of risk in extreme cases. Hospitals treating the highest overall expected risk PCI patients or those treating the top 20% of high-risk cases had lower (better) RAM ratings than centers treating lower-risk cases (1.25% vs. 1.51%). The observed/expected ratio for top-risk quintile versus low-risk quintile was 0.91 (0.87 to 0.96) versus 1.10 (1.03 to 1.17). Combining all the high-risk patients over a 2-year period into a single year also did not negatively impact the site’s RAM ratings. CONCLUSIONS Evaluation of a contemporary sample of PCI cases across the United States showed no evidence that treating high-risk PCI cases adversely affects hospital RAM rates. PMID:25499301

  2. Forty-Five-Year Mortality Rate as a Function of the Number and Type of Psychiatric Diagnoses Found in a Large Danish Birth Cohort

    DEFF Research Database (Denmark)

    Madarasz, Wendy; Manzardo, Ann; Mortensen, Erik Lykke;

    2012-01-01

    diagnostic categories. Mortality rates were examined as a function of number and type of co-occurring diagnoses. Results: Psychiatric outcomes for 1247 subjects were associated with 157 deaths. Early mortality risk in psychiatric patients correlated with the number of diagnostic categories (Wald χ² = 25.......0, df = 1, P schizophrenia and substance abuse, which had intrinsically high mortality rates with no comorbidities. Conclusions: Risk of early mortality among psychiatric patients appears to be a function of both...... the number and the type of psychiatric diagnoses....

  3. Restructuring fundamental predator-prey models by recognising prey-dependent conversion efficiency and mortality rates.

    Science.gov (United States)

    Li, Jiqiu; Montagnes, David J S

    2015-05-01

    Incorporating protozoa into population models (from simple predator-prey explorations to complex food web simulations) is of conceptual, ecological, and economic importance. From theoretical and empirical perspectives, we expose unappreciated complexity in the traditional predator-prey model structure and provide a parsimonious solution, especially for protistologists. We focus on how prey abundance alters two key components of models: predator conversion efficiency (e, the proportion of prey converted to predator, before mortality loss) and predator mortality (δ, the portion of the population lost though death). Using a well-established model system (Paramecium and Didinium), we collect data to parameterize a range of existing and novel population models that differ in the functional forms of e and δ. We then compare model simulations to an empirically obtained time-series of predator-prey population dynamics. The analysis indicates that prey-dependent e and δ should be considered when structuring population models and that both prey and predator biomass also vary with prey abundance. Both of these impact the ability of the model to predict population dynamics and, therefore, should be included in theoretical model evaluations and assessment of ecosystem dynamics associated with biomass flux.

  4. Poor self-rated health did not increase permanent nursing home placement or mortality in people with mild Alzheimer's disease

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild;

    2016-01-01

    Background: Self-rated health (SRH) has in many population-based studies predicted adverse health outcomes, e.g. morbidity, permanent nursing home (NH) placement, and mortality. However, the predictive value of SRH to NH placement and mortality among elderly people is not consistent. This may......). Methods: Data are from The Danish Alzheimer Intervention StudY (DAISY), a large randomized controlled trial of psychosocial intervention for patients with mild dementia and their caregivers with 3-years’ follow-up. Five out of 14 Danish counties participated and 321 home-living elderly (mean age: 76...... analysis: In the fully adjusted models HR was 0.63 (95 % CI 0.38-1.05) and 1.28 (95 % CI 0.67-2.45), respectively. Conclusions. When poor SRH was present we found no increased risk for NH placement or death among elderly people with mild AD. SRH is a widely used parameter in clinical and epidemiological...

  5. Long-term suicide mortality rates decrease in men and increase in women after the Niigata-Chuetsu earthquake in Japan.

    Science.gov (United States)

    Hyodo, Keiko; Nakamura, Kazutoshi; Oyama, Mari; Yamazaki, Osamu; Nakagawa, Izumi; Ishigami, Kazuo; Tsuchiya, Yasuo; Yamamoto, Masaharu

    2010-02-01

    A devastating earthquake causes psychological distress, and may increase suicide mortality thereafter, yet previous studies have made inconsistent conclusions regarding this issue. The purpose of the present study was to determine whether the 2004 Niigata-Chuetsu earthquake in Japan affected long-term mortality from suicide. We conducted a comparative study of suicide mortality rates during the 5-year period preceding and the 3-year period following the earthquake in the disaster area and a control area in Niigata Prefecture, by analyzing death certificate data from October 1, 1999, to September 30, 2007. In men, baseline suicide mortality rates (5 years preceding the earthquake) were 48.4 per 100,000 person-years in the disaster area and 46.1 in the control area, and suicide mortality rates during the 3-year period following the earthquake were 46.0 and 45.1, respectively. In women, baseline suicide mortality rates were 22.3 in the disaster area and 18.7 in the control area, and post-earthquake suicide mortality rates were 20.2 and 15.3, respectively. In consequence, the decrease in suicide mortality rate during the 3 years post-earthquake was significantly higher in the disaster area (2.5) than in the control area (1.0) (p = 0.0013) in men, whereas the decrease in suicide mortality rate was 2.1 in the disaster area and 3.0 in the control area (p = 0.1246) in women. We have concluded that the long-term mortality from suicide after the earthquake decreases in men and increases in women, suggesting that post-earthquake suicide mortality is sex-dependent. Post-earthquake suicide prevention strategies should more aggressively target women.

  6. Rate of deaths due to child abuse and neglect in children 0-3 years of age in Germany.

    Science.gov (United States)

    Banaschak, Sibylle; Janßen, Katharina; Schulte, Babette; Rothschild, Markus A

    2015-09-01

    In recent years, increasing attention has been paid to the issue of (fatal) child abuse and neglect, largely due to the media attention garnered by some headline-grabbing cases. If media statements are to be believed, such cases may be an increasing phenomenon. With these published accounts in mind, publicly available statistics should be analysed with respect to the question of whether reliable statements can be formulated based on these figures. It is hypothesised that certain data, e.g., the Innocenti report published by UNICEF in 2003, may be based on unreliable data sources. For this reason, the generation of such data, and the reliability of the data itself, should also be discussed. Our focus was on publicly available German mortality and police crime statistics (Polizeiliche Kriminalstatistik). These data were classified with respect to child age, data origin, and cause of death (murder, culpable homicide, etc.). In our opinion, the available data could not be considered in formulating reliable scientific statements about fatal child abuse and neglect, given the lack of detail and the flawed nature of the basic data. Increasing the number of autopsies of children 0-3 years of age should be considered as a means to ensure the capture of valid, practical, and reliable data. This could bring about some enlightenment and assist in the development of preemptive strategies to decrease the incidence of (fatal) child abuse and neglect.

  7. Assessing the Validity of the Qualistar Early Learning Quality Rating and Improvement System as a Tool for Improving Child-Care Quality

    Science.gov (United States)

    Zellman, Gail L.; Perlman, Michal; Le, Vi-Nhuan; Setodji, Claude Messan

    2008-01-01

    As a result of the generally low quality of child care in the United States and the increased emphasis on accountability in education policy, quality rating systems (QRSs) are proliferating in the child-care arena. QRSs assess child-care providers on multiple dimensions of quality and integrate these assessments into an easily understood summary…

  8. The model for end-stage liver disease score-based system predicts short term mortality better than the current Child-Turcotte-Pugh score-based allocation system during waiting for deceased liver transplantation.

    Science.gov (United States)

    Hong, Geun; Lee, Kwang-Woong; Suh, Sukwon; Yoo, Tae; Kim, Hyeyoung; Park, Min-Su; Choi, Youngrok; Yi, Nam-Joon; Suh, Kyung-Suk

    2013-08-01

    To adopt the model for end-stage liver disease (MELD) score-based system in Korea, the feasibility should be evaluated by analysis of Korean database. The aim of this study was to investigate the feasibility of the MELD score-based system compared with the current Child-Turcotte-Pugh (CTP) based-system and to suggest adequate cut-off to stratify waiting list mortality among Korean population. We included 788 adult patients listed in waiting list in Seoul National University Hospital from January 2008 to May 2011. The short-term survival until 6 months after registration was evaluated. Two hundred forty six (31.2%) patients underwent live donor liver transplantation and 353 (44.8%) patients were still waiting and 121 (15.4%) patients were dropped out due to death. Significant difference was observed when MELD score 24 and 31 were used as cut-off. Three-months survival of Status 2A was 70.2%. However, in Status 2A patients whose MELD score less than 24 (n=82), 86.6% of patients survived until 6 month. Furthermore, patients with high MELD score (≥31) among Status 2B group showed poorer survival rate (45.8%, 3-month) than Status 2A group. In conclusion, MELD score-based system can predict short term mortality better and select more number of high risk patients in Korean population.

  9. A comparative population-based study of prostate cancer incidence and mortality rates in Singapore, Sweden and Geneva, Switzerland from 1973 to 2006

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    Chen Cynthia

    2012-06-01

    Full Text Available Abstract Background Prostate cancer is the most commonly diagnosed malignancy in men in Sweden and Geneva, and the third most common in men in Singapore. This population-based study describes trends in the incidence and mortality rates of prostate cancer in Singapore, Sweden and Geneva (Switzerland from 1973 to 2006 and explores possible explanations for these different trends. Methods Data from patients diagnosed with prostate cancer were extracted from national cancer registries in Singapore (n = 5,172, Sweden (n = 188,783 and Geneva (n = 5,755 from 1973 to 2006. Trends of incidence and mortality were reported using the Poisson and negative binomial regression models. The age, period and birth-cohort were tested as predictors of incidence and mortality rates of prostate cancer. Results Incidence rates of prostate cancer increased over all time periods for all three populations. Based on the age-period-cohort analysis, older age and later period of diagnosis were associated with a higher incidence of prostate cancer, whereas older age and earlier period were associated with higher mortality rates for prostate cancer in all three countries. Conclusions This study demonstrated an overall increase in incidence rates and decrease in mortality rates in Singapore, Sweden and Geneva. Both incidence and mortality rates were much lower in Singapore. The period effect is a stronger predictor of incidence and mortality of prostate cancer than the birth-cohort effect.

  10. Health risk or resource? Gradual and independent association between self-rated health and mortality persists over 30 years.

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    Matthias Bopp

    Full Text Available BACKGROUND: Poor self-rated health (SRH is associated with increased mortality. However, most studies only adjust for few health risk factors and/or do not analyse whether this association is consistent also for intermediate categories of SRH and for follow-up periods exceeding 5-10 years. This study examined whether the SRH-mortality association remained significant 30 years after assessment when adjusting for a wide range of known clinical, behavioural and socio-demographic risk factors. METHODS: We followed-up 8,251 men and women aged ≥ 16 years who participated 1977-79 in a community based health study and were anonymously linked with the Swiss National Cohort (SNC until the end of 2008. Covariates were measured at baseline and included education, marital status, smoking, medical history, medication, blood glucose and pressure. RESULTS: 92.8% of the original study participants could be linked to a census, mortality or emigration record of the SNC. Loss to follow-up 1980-2000 was 5.8%. Even after 30 years of follow-up and after adjustment for all covariates, the association between SRH and all-cause mortality remained strong and estimates almost linearly increased from "excellent" (reference: hazard ratio, HR 1 to "good" (men: HR 1.07 95% confidence interval 0.92-1.24, women: 1.22, 1.01-1.46 to "fair" (1.41, 1.18-1.68; 1.39, 1.14-1.70 to "poor"(1.61, 1.15-2.25; 1.49, 1.07-2.06 to "very poor" (2.85, 1.25-6.51; 1.30, 0.18-9.35. Persons answering the SRH question with "don't know" (1.87, 1.21-2.88; 1.26, 0.87-1.83 had also an increased mortality risk; this was pronounced in men and in the first years of follow-up. CONCLUSIONS: SRH is a strong and "dose-dependent" predictor of mortality. The association was largely independent from covariates and remained significant after decades. This suggests that SRH provides relevant and sustained health information beyond classical risk factors or medical history and reflects salutogenetic rather than

  11. Prostate Cancer in South Africa: Pathology Based National Cancer Registry Data (1986–2006 and Mortality Rates (1997–2009

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    Chantal Babb

    2014-01-01

    Full Text Available Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA from the pathology based National Cancer Registry (1986–2006 and data on mortality (1997–2009 from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma. There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.

  12. Prostate cancer in South Africa: pathology based national cancer registry data (1986-2006) and mortality rates (1997-2009).

    Science.gov (United States)

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.

  13. Prostate Cancer in South Africa: Pathology Based National Cancer Registry Data (1986–2006) and Mortality Rates (1997–2009)

    Science.gov (United States)

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986–2006) and data on mortality (1997–2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252

  14. Desiccation as a mitigation tool to manage biofouling risks: trials on temperate taxa to elucidate factors influencing mortality rates.

    Science.gov (United States)

    Hopkins, Grant A; Prince, Madeleine; Cahill, Patrick L; Fletcher, Lauren M; Atalah, Javier

    2016-01-01

    The desiccation tolerance of biofouling taxa (adults and early life-stages) was determined under both controlled and 'realistic' field conditions. Adults of the ascidian Ciona spp. died within 24 h. Mortality in the adult blue mussel Mytilus galloprovincialis occurred within 11 d under controlled conditions, compared with 7 d when held outside. The Pacific oyster Crassostrea gigas was the most desiccation-tolerant taxon tested (up to 34 d under controlled conditions). Biofouling orientated to direct sunlight showed faster mortality rates for all the taxa tested. Mortality in Mytilus juveniles took up to 24 h, compared with 8 h for Ciona, with greater survival at the higher temperature (18.5°C) and humidity (~95% RH) treatment combination. This study demonstrated that desiccation can be an effective mitigation method for a broad range of fouling taxa, especially their early life-stages. Further work is necessary to assess risks from other high-risk species such as algae and cyst forming species.

  15. Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors

    Directory of Open Access Journals (Sweden)

    Anika L. Hines

    2014-12-01

    Full Text Available Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes.

  16. Positive Effect of SeptimebTM on Mortality Rate in Severe Sepsis: a Novel Non Antibiotic Strategy

    Directory of Open Access Journals (Sweden)

    Leila Kouti

    2012-09-01

    Full Text Available Background:Septimebis a new herbal-derived remedy, recently approved for its potential immunomodulatory effects.Regarding the key role of immune system in the pathogenesis of severe sepsis and lack of any standard treatment for improving survival of these patients;weevaluated the effect of Septimeb -as an adjutant to standard treatment-on inflammatory biomarkers and mortality rates in patients with severe sepsis.Methods:In this multicenter, randomized, single-blind trial, we assigned patients with severe sepsis and Acute Physiology and Chronic Health Evaluation (APACHE II score of more than 20 toreceive standard treatment of severe sepsis (control group or standard treatment plus Septimeb. This group was treated with Septimeb for 14 days then followed up for another14 days. APACHE score, Sequential Organ Failure Assessment (SOFA and Simplified Acute Physiology Score (SAPS were calculated daily. Blood samples were analyzed for interleukin 2 tumor necrosis factor-α, total antioxidant power, platelet growth factor and matrix metalloproteinase 2.Results:A total of 29 patients underwent randomization(13 in control group and 16 in Septimeb group. There was significant difference between the Septimeb and control group in the 14 days mortality rate(18.8% vs. 53.85 respectively, P=0.048. Compared to control group,Septimebwas significantly effective in improving SAPS(P= 0.029, SOFA(P=0.003 and APACHE II(P=0.008 scores. Inflammatory biomarkers didn’t change significantly between the two groups(P>0.05.Conclusion Septimeb reduces mortality rates among patients with severe sepsis and it could be added as a safe adjutant to standard treatment of sepsis.

  17. Fine-root mortality rates in a temperate forest: Estimates using radiocarbon data and numerical modeling

    Energy Technology Data Exchange (ETDEWEB)

    Riley, W.J.; Gaudinski, J.B.; Torn, M.S.; Joslin, J.D.; Hanson, P.J.

    2009-09-01

    We used an inadvertent whole-ecosystem {sup 14}C label at a temperate forest in Oak Ridge, Tennessee, USA to develop a model (Radix1.0) of fine-root dynamics. Radix simulates two live-root pools, two dead-root pools, non-normally distributed root mortality turnover times, a stored carbon (C) pool, and seasonal growth and respiration patterns. We applied Radix to analyze measurements from two root size classes (< 0.5 and 0.5-2.0 mm diameter) and three soil-depth increments (O horizon, 0-15 cm and 30-60 cm). Predicted live-root turnover times were < 1 yr and 10 yr for short- and long-lived pools, respectively. Dead-root pools had decomposition turnover times of 2 yr and 10 yr. Realistic characterization of C flows through fine roots requires a model with two live fine-root populations, two dead fine-root pools, and root respiration. These are the first fine-root turnover time estimates that take into account respiration, storage, seasonal growth patterns, and non-normal turnover time distributions. The presence of a root population with decadal turnover times implies a lower amount of belowground net primary production used to grow fine-root tissue than is currently predicted by models with a single annual turnover pool.

  18. NCHS - Infant and neonatal mortality rates: United States, 1915-2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rates are infants (under 1 year) and neonatal (under 28 days) deaths per 1,000 live births. http://blogs.cdc.gov/nchs-data-visualization/deaths-in-the-us/

  19. A propensity score analysis shows that empirical treatment with linezolid does not increase the thirty-day mortality rate in patients with Gram-negative bacteremia.

    Science.gov (United States)

    Ternavasio-de la Vega, Hugo-Guillermo; Mateos-Díaz, Ana-María; Martinez, Jose-Antonio; Almela, Manel; Cobos-Trigueros, Nazaret; Morata, Laura; De-la-Calle, Cristina; Sala, Marta; Mensa, Josep; Marcos, Miguel; Soriano, Alex

    2014-12-01

    The role of linezolid in empirical therapy of suspected bacteremia remains unclear. The aim of this study was to evaluate the influence of empirical use of linezolid or glycopeptides in addition to other antibiotics on the 30-day mortality rates in patients with Gram-negative bacteremia. For this purpose, 1,126 patients with Gram-negative bacteremia in the Hospital Clinic of Barcelona from 2000 to 2012 were included in this study. In order to compare the mortality rates between patients who received linezolid or glycopeptides, the propensity scores on baseline variables were used to balance the treatment groups, and both propensity score matching and propensity-adjusted logistic regression were used to compare the 30-day mortality rates between the groups. The overall 30-day mortality rate was 16.0% during the study period. Sixty-eight patients received empirical treatment with linezolid, and 1,058 received glycopeptides. The propensity score matching included 64 patients in each treatment group. After matching, the mortality rates were 14.1% (9/64) in patients who received glycopeptides and 21.9% (14/64) in those who received linezolid, and a nonsignificant association between empirical linezolid treatment and mortality rate (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.69 to 3.82; P = 0.275, McNemar's test) was found. This association remained nonsignificant when variables that remained unbalanced after matching were included in a conditional logistic regression model. Further, the stratified propensity score analysis did not show any significant relationship between empirical linezolid treatment and the mortality rate after adjustment by propensity score quintiles or other variables potentially associated with mortality. In conclusion, the propensity score analysis showed that empirical treatment with linezolid compared with that with glycopeptides was not associated with 30-day mortality rates in patients with Gram-negative bacteremia.

  20. Laboratory determined mortality, fecundity and growth rates of Thalia democratica Forskal and Dolioletta gegenbauri Uljanin (Tunicata, Thaliacea)

    Energy Technology Data Exchange (ETDEWEB)

    Deibel, D.

    1982-01-01

    Laboratory experiments are reported which provide information on culture conditions, mortality, fecundity and growth of Thalia democratica and Dolioletta gegenbauri in relation to simulated environmental conditions. Thaliacenas were maintained in laboratory culture at 20/sup 0/C. Culture vessels were 2.5 l glass bottles. Diets consisted of Isochrysis galbana and Peridinium trochoideum, offered alone or together at total concentrations of 0.25 to 0.70 mm/sup 3/ x 1/sup -/2exclamation. Laboratory released aggregate stages of Thalia were maintained for one week and gonozooid, phorozooid and oozooid stages of Dolioletta were reared for up to three weeks with daily mortality rates of 5-10%. There was no effect of diet on mortality rate. Thalia did not reproduce sexually but Dolioletta did routinely. Each Thalia solitary relased a mean (+/- SE) of 54 +/- 8 aggregates of 1.1-2.1 mm length. Each Dolioletta gonozooid produced 2-6 larvae 0.6-1.2 mm long, and each phorozooid released a mean of 31 +/- 11 gonozooids. Aggregate growth was exponential for 7 days, with daily exponential growth coefficients (k) ranging from 0.03-0.36. Gonozooids grew exponentially for 17 days with a range of k from 0.08-0.25, and phorozooids grew exponentially for 5 days with k ranging from 0.17-0.69. There was no effect of food concentration on k. Generation times of Thalia and Dolioletta were estimated to be from 3-6 weeks. These are probably maximum generation times for these two species in the Georgia Bight.

  1. The incidence, hospital expenditure, and, 30 day and 1 year mortality rates of spontaneous intracerebral hemorrhage in Taiwan.

    Science.gov (United States)

    Chan, Chien-Lung; Ting, Hsien-Wei; Huang, Hsin-Tsung

    2014-01-01

    The risks of morbidity and mortality are high in patients with spontaneous intracerebral hemorrhage (sICH). The medical care resources associated with sICH are also substantial. This study aimed to evaluate the medical expenditure for sICH patients in Taiwan. We analyzed the National Health Insurance Research Database from 2005 to 2010. The inclusion criterion was first-event sICH; traumatic ICH patients were excluded. Student's t-test, multiple linear regression and the chi-squared test were employed as the statistical methods. Our results showed that the incidence of sICH was 40.77 patients per 100,000 of population per year in Taiwan. The incidence increased with age and was greater in men than women. The mean hospital length of stay (LOS) of first-event sICH patients was 31.8 days; the mean LOS in the intensive care unit was 7.9 days; and the mean survival time was 60.4 months. The mortality rate within 30 days and within 1 year was 19.8 and 29.6%, respectively. The mean hospital expenditure of first-event sICH patients was USD $7572, and was highly correlated with LOS. In conclusion, the incidence of sICH in Taiwan is higher than that in white and black populations of northern America and some European countries and lower than that in the Asian populations of Japan and China. The features of male and female sICH patients differ. Our findings suggest that the hospital expenditure and mortality rate of sICH patients in Taiwan are comparable with those of other countries.

  2. KIDS Count Data Book, 1998: State Profiles of Child Well-Being.

    Science.gov (United States)

    Annie E. Casey Foundation, Baltimore, MD.

    This Kids Count data book examines state and national trends from the late 1980s in the well being of children in the United States. The statistical portrait is based on 10 indicators of child well being: (1) percent low birth-weight infants; (2) infant mortality rate; (3) child death rate; (4) teen accidental death, homicide, and suicide rates;…

  3. Effect of temperature on incubation period, embryonic mortality, hatch rate, egg water loss and partridge chick weight (Rhynchotus rufescens

    Directory of Open Access Journals (Sweden)

    Nakage ES

    2003-01-01

    Full Text Available The aim of this study was to determine the effects of incubation temperature (34.5; 35.5; 36.5; 37.5 and 38.5ºC, on incubation period, embryonic mortality, hatching rate, water loss and chick weight at hatch, using daily incubation of partridge (Rhynchotus rufescens eggs. The highest hatching percentage was obtained between 35.5 and 36.5ºC. Incubation length and temperature were inversely proportional. Water loss was lower in eggs incubated at low temperatures as compared to high temperatures. There was no difference among incubation temperatures in absolute and relative hatchling weights. Early embryonic mortality increased at low temperatures (36.5ºC. Our results show that, under conditions of daily incubation of eggs in the same incubator, higher hatching rate can be obtained using temperatures between 35.5ºC and 36.5ºC; incubation temperature is inversely proportional to incubation length, and absolute and relative weights of partridge chicks are not affected by incubation temperature.

  4. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ... June 30, 2013, on July 24, 2012, in the Federal Register at 77 FR 43229. Adjusted Payments The... related notice published at 48 FR 29114, June 24, 1983.) This notice has been determined to be not... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  5. Defining Treatment Response and Remission in Child Anxiety: Signal Detection Analysis Using the Pediatric Anxiety Rating Scale

    Science.gov (United States)

    Caporino, Nicole E.; Brodman, Douglas M.; Kendall, Philip C.; Albano, Anne Marie; Sherrill, Joel; Piacentini, John; Sakolsky, Dara; Birmaher, Boris; Compton, Scott N.; Ginsburg, Golda; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T.

    2013-01-01

    Objective: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. Method: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study…

  6. Psychometric Evaluation of Romanian Translations of the "Behavior Problems Inventory-01" and the "Nisonger Child Behavior Rating Form"

    Science.gov (United States)

    Mircea, Camelia E.; Rojahn, Johannes; Esbensen, Anna J.

    2010-01-01

    Psychometric properties of Romanian translations of the "Behavior Problems Inventory-01" ("BPI-01"; Rojahn, Matson, Lott, Esbensen, & Smalls, 2001) and the "Nisonger Child Behavior Rating Form" ("NCBRF"; Aman, Tasse, Rojahn, & Hammer, 1996) were explored. Respondents completed the instruments for 115…

  7. The Effect of Poverty, Gender Exclusion, and Child Labor on Out-of-School Rates for Female Children

    Science.gov (United States)

    Laborda Castillo, Leopoldo; Sotelsek Salem, Daniel; Sarr, Leopold Remi

    2014-01-01

    In this article, the authors analyze the effect of poverty, social exclusion, and child labor on out-of-school rates for female children. This empirical study is based on a dynamic panel model for a sample of 216 countries over the period 1970 to 2010. Results based on the generalized method of moments (GMM) of Arellano and Bond (1991) and the…

  8. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015

    DEFF Research Database (Denmark)

    2016-01-01

    of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio...... of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related...... to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources...

  9. Child maltreatment in numbers : a multimethod study of year prevalence rates and risk factors

    NARCIS (Netherlands)

    Euser, Saskia

    2013-01-01

    How often does child maltreatment occur in the Netherlands and which factors increase the risk of child maltreatment? In this thesis we describe the findings of two epidemiological studies aimed at answering these questions. First, in the Netherlands’ Prevalence study on Maltreatment of children and

  10. C-reactive protein level as a predictor of mortality in liver disease patients with bacteremia

    DEFF Research Database (Denmark)

    Janum, Sine H; Søvsø, Morten; Gradel, Kim O

    2011-01-01

    and no recorded liver disease from the same region and time period. Methods. Retrospective review of medical records with registration of demography, co-morbidity, bacteriological, biochemical and clinical findings, and Child-Turcotte-Pugh scores. The primary outcome was 30-day mortality. Results. Mortality...... was significantly higher in patients with chronic liver disease (mortality rate ratio 2.2; 95% confidence interval 1.2-3.9) and it was correlated to Child-Turcotte-Pugh scores. CRP levels were not different between the three Child-Turcotte-Pugh classes (p = 0.33), and no linear correlation with 30-day mortality...... was observed. Conclusion. Mortality associated with bacteremia is increased in patients with chronic liver disease and it is correlated with Child-Turcotte-Pugh score. The prognostic information of initial CRP levels in patients with chronic liver disease is weak. The clinical management of patients...

  11. Metropolitan social environments and pre-HAART/HAART era changes in mortality rates (per 10,000 adult residents among injection drug users living with AIDS.

    Directory of Open Access Journals (Sweden)

    Samuel R Friedman

    Full Text Available BACKGROUND: Among the largest US metropolitan areas, trends in mortality rates for injection drug users (IDUs with AIDS vary substantially. Ecosocial, risk environment and dialectical theories suggest many metropolitan areas characteristics that might drive this variation. We assess metropolitan area characteristics associated with decline in mortality rates among IDUs living with AIDS (per 10,000 adult MSA residents after highly active antiretroviral therapy (HAART was developed. METHODS: This is an ecological cohort study of 86 large US metropolitan areas from 1993-2006. The proportional rate of decline in mortality among IDUs diagnosed with AIDS (as a proportion of adult residents from 1993-1995 to 2004-2006 was the outcome of interest. This rate of decline was modeled as a function of MSA-level variables suggested by ecosocial, risk environment and dialectical theories. In multiple regression analyses, we used 1993-1995 mortality rates to (partially control for pre-HAART epidemic history and study how other independent variables affected the outcomes. RESULTS: In multivariable models, pre-HAART to HAART era increases in 'hard drug' arrest rates and higher pre-HAART income inequality were associated with lower relative declines in mortality rates. Pre-HAART per capita health expenditure and drug abuse treatment rates, and pre- to HAART-era increases in HIV counseling and testing rates, were weakly associated with greater decline in AIDS mortality. CONCLUSIONS: Mortality among IDUs living with AIDS might be decreased by reducing metropolitan income inequality, increasing public health expenditures, and perhaps increasing drug abuse treatment and HIV testing services. Given prior evidence that drug-related arrest rates are associated with higher HIV prevalence rates among IDUs and do not seem to decrease IDU population prevalence, changes in laws and policing practices to reduce such arrests while still protecting public order should be

  12. Measurement of a drowning incidence rate combining direct observation of an exposed population with mortality statistics.

    Science.gov (United States)

    Morgan, Damian; Ozanne-Smith, Joan

    2015-01-01

    Drowning risk factors may be identified by comparing drowning incidence rates for comparable at-risk populations but precise methods are lacking. To address this knowledge gap, an ecological study extrapolated crude time-duration exposure to water for a specified at-risk sample of surf bathers to estimate the bather population for all wave-dominated beaches in Victoria, Australia, over a four-year summer season period. An incidence rate was calculated using surf bather drowning deaths frequencies matched for time and location. For the sample, 47,341 hours of surf bathing were estimated from 177,528 bathing episodes. Generalising these results to Victoria, the crude drowning deaths incidence rate in the summer season was 0.41 per 1,000,000 person-hours of surf bathing (95% CI 0.37-0.45). Further application of the method, particularly in open water settings, may be used to identify candidate drowning risk factors to advance drowning prevention strategies.

  13. Diarrhea in Pre-Weaned Calves: Relative Risk Rates for Morbidity and Mortality in 13 Commercial Farms of Hot Arid Zone

    OpenAIRE

    M. A. Razzaque; Al-Mutawa, T; S.A. MOHAMMED

    2010-01-01

    Problem statement: In many hot arid countries, pregnant Holstein Friesian heifers are imported for herd replacement. The calves obtained from exotic cows are exposed to adverse climate in feedlot system resulting in very high morbidity and mortality rates. Diarrhea, dehydration and deaths are causing a major loss to the producers. This study examines the Risk Rates (RR) for morbidity and mortality in pre-weaned calves. Approach: Thirteen commercial dairy farms of small, me...

  14. Neighborhood racial composition and trajectories of child self-rated health: an application of longitudinal propensity scores.

    Science.gov (United States)

    Root, Elisabeth Dowling; Humphrey, Jamie L

    2014-11-01

    Children function within multiple socio-environmental contexts including family, school, and neighborhood. The role each of these contexts play in determining well-being is dynamic and changes throughout early-middle childhood. Recent literature on neighborhood context and health suggests that the life-course processes involved in building trajectories of health are not adequately captured in cross-sectional analysis, which has been the empirical focus of much of the research in this area. In this study we use a nationally representative longitudinal sample of approximately 21,400 United States school children derived from the Early Childhood Longitudinal Study--Kindergarten Cohort (ECLS-K) survey to examine the impact of longitudinal measures of neighborhood racial composition on child self-rated health between kindergarten and 8th grade. We employ two-level multilevel longitudinal logistic regression models with time-varying propensity scores to examine variation in the initial status and trajectories of child self-rated health between kindergarten and 8th grade. Since the ECLS-K tracked child mobility over time, we are able to model the impact of changes in neighborhood racial composition. We find significant differences in initial poor self-rated health by child race, household socioeconomic status and parental marital status but no evidence of a change in trajectory of health over time. Using time-varying propensity scores, we find no effect of neighborhood racial composition on initial health status or health status trajectories.

  15. Comparison of specific absorption rate induced in brain tissues of a child and an adult using mobile phone

    Science.gov (United States)

    Lu, Mai; Ueno, Shoogo

    2012-04-01

    The steady increase of mobile phone usage, especially mobile phones by children, has led to a rising concern about the possible adverse health effects of radio frequency electromagnetic field exposure. The objective of this work is to study whether there is a larger radio frequency energy absorption in the brain of a child compared to that of an adult. For this reason, three high-resolution models, two child head models (6 - and 11-year old) and one adult head model (34-year old) have been used in the study. A finite-difference time-domain method was employed to calculate the specific absorption rate (SAR) in the models from exposure to a generic handset at 1750 MHz. The results show that the SAR distributions in the human brain are age-dependent, and there is a deeper penetration of the absorbed SAR in the child's brain. The induced SAR can be significantly higher in subregions of the child's brain. In all of the examined cases, the SAR values in the brains of a child and an adult are well below the IEEE safety standard.

  16. Fractal analysis of heart rate variability and mortality after an acute myocardial infarction

    DEFF Research Database (Denmark)

    Tapanainen, Jari M; Thomsen, Poul Erik Bloch; Køber, Lars;

    2002-01-01

    The recently developed fractal analysis of heart rate (HR) variability has been suggested to provide prognostic information about patients with heart failure. This prospective multicenter study was designed to assess the prognostic significance of fractal and traditional HR variability parameters...... in a large, consecutive series of survivors of an acute myocardial infarction (AMI). A consecutive series of 697 patients were recruited to participate 2 to 7 days after an AMI in 3 Nordic university hospitals. The conventional time-domain and spectral parameters and the newer fractal scaling indexes of HR...... variability were analyzed from 24-hour RR interval recordings. During the mean follow-up of 18.4 +/- 6.5 months, 49 patients (7.0%) died. Of all the risk variables, a reduced short-term fractal scaling exponent (alpha(1)

  17. [Light pollution increases morbidity and mortality rate from different causes in male rats].

    Science.gov (United States)

    Bukalev, A V; Vinogradova, I A; Zabezhinskiĭ, M A; Semenchenko, A V; Anisimov, V N

    2012-01-01

    The influence of different light regimes (constant light--LL; constant darkness--DD; standard light regime--LD, 12 hours light 12 hours darkness; natural lightening of the North-West of Russia--NL) on the dynamics of life's morbidity rate, spontaneous tumorigenesis and frequency of some kinds of non-tumor pathology revealed at the post-mortem examination of male rats was studied. It was found out that the maintenance of animals at LL and NL conditions led to the increase of the number of infectious diseases, substantially faster development of spontaneous tumors and the increase of non-tumor diseases in comparison with the animals kept at LD (standard light) regime. Light deprivation (DD) led to substantial reduction of development of new growth, of non-tumor and infectious diseases in comparison with the similar parameters in standard light regime.

  18. Sex/gender and socioeconomic differences in the predictive ability of self-rated health for mortality.

    Directory of Open Access Journals (Sweden)

    Akihiro Nishi

    Full Text Available BACKGROUND: Studies have reported that the predictive ability of self-rated health (SRH for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups. METHODOLOGY/PRINCIPAL FINDINGS: The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking, symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI: 2.14-2.80] than in women (HR = 1.88 [95% CI: 1.44-2.47]; p for sex/gender interaction = 0.018. The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74-3.30] was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83-2.50]; p for education interaction = 0.549. CONCLUSIONS: The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than

  19. Age effects in monetary valuation of reduced mortality risks: the relevance of age-specific hazard rates.

    Science.gov (United States)

    Leiter, Andrea M

    2011-08-01

    This paper highlights the relevance of age-specific hazard rates in explaining the age variation in "value of statistical life" (VSL) figures. The analysis-which refers to a stated preference framework-contributes to the ongoing discussion of whether benefits resulting from reduced mortality risk should be valued differently depending on the age of the beneficiaries. By focussing on a life-threatening environmental phenomenon I show that the consideration of the individual's age-specific hazard rate is important. If a particular risk affects all individuals regardless of their age so that their hazard rate is age-independent, VSL is rather constant for people at different age; if hazard rate varies with age, VSL estimates are sensitive to age. The results provide an explanation for the mixed outcomes in empirical studies and illustrate in which cases an adjustment to age may or may not be justified. Efficient provision of live-saving measures requires that such differences to be taken into account.

  20. Low heart rate as a risk factor for child and adolescent proactive aggressive and impulsive psychopathic behavior.

    Science.gov (United States)

    Raine, Adrian; Fung, Annis Lai Chu; Portnoy, Jill; Choy, Olivia; Spring, Victoria L

    2014-01-01

    Although low resting heart rate has been viewed as a well-replicated biological correlate of child and adolescent antisocial behavior, little is known about how it interacts with psychosocial adversity in predisposing to both reactive-proactive aggression and psychopathy, and whether this relationship generalizes to an East Asian population. This study tests the hypothesis that low resting heart rate will be associated with aggression and psychopathic traits, and that heart rate will interact with adversity in predisposing to these antisocial traits. Resting heart rate was assessed in 334 Hong Kong male and female schoolchildren aged 11-17 years. A social adversity index was calculated from a psychosocial interview of the parent, while parents assessed their children on the Reactive-Proactive Aggression Questionnaire and the Antisocial Personality Screening Device. Low resting heart rate was significantly associated with higher proactive aggression, impulsive features of psychopathy, and total child psychopathy. Low resting heart rate interacted with high psychosocial adversity in explaining higher reactive (but not proactive) aggression, as well as impulsive psychopathy. These findings provide support for a biosocial perspective of reactive aggression and impulsive psychopathy, and document low resting heart rate as a robust correlate of both childhood impulsive psychopathic behavior and proactive aggression. To our knowledge, this study is the first to document low resting heart rate as a correlate of child psychopathy and the second to establish low heart rate as a risk factor of antisocial behavior in an East Asian population. The findings provide further evidence for both low resting heart rate as a potential biomarker for childhood psychopathic and aggressive behavior, and also a biosocial perspective on childhood antisocial behavior.

  1. Trends in the neonatal mortality rate in the last decade with respect to demographic factors and health care resources.

    Science.gov (United States)

    Govande, Vinayak; Ballard, Amy R; Koneru, Madhavi; Beeram, Madhava

    2015-07-01

    To understand factors contributing to the neonatal mortality rate (NMR), we studied trends in the NMR during 2000 to 2009 with respect to demographic factors and health care resources. Birth- and death-linked mortality data for 14,168 neonatal deaths that occurred between 2000 and 2009 were obtained from the Texas Department of Health and Human Services. Demographic factors and health care resource data were analyzed using analysis of variance, chi-square tests, and linear regression analysis. The average NMR increased from 3.37 in 2000 to 3.77 in 2009. The NMR in blacks ranged from 6.57 to 8.97 during the study period. Among the babies who died, the mean birthweight decreased from 1505 to 1275 g (P < 0.001) and the mean gestational age decreased from 28.4 to 27.8 weeks (P < 0.001). Cesarean section deliveries increased from 32.7% to 44.9% (P < 0.001). The percentage of mothers receiving prenatal care increased from 81.4% to 86.6% (P < 0.001). Mothers with a college education increased from 8.8% to 20.5% (P < 0.001). The median household income increased from $41,047 to $49,189 (P < 0.001). The number of neonatal intensive care unit beds increased from 33.4 to 56 per 10,000 births, and the number of neonatologists increased from 0.27 to 0.40 per 10,000 women of 15 to 44 years of age. In conclusion, the NMR didn't improve despite improvements in demographic factors and health care resources. Racial disparities persist, with a high NMR in the black population. We speculate a possible genetic predisposition related to ethnicity, and a potentially higher rate of extreme prematurity might have contributed to a high NMR in the study population.

  2. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

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    Tol Wietse A

    2011-08-01

    Full Text Available Abstract Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i purpose of instrument, (ii construct measured, (iii contents of construct, (iv local idioms employed, (v structure of response sets, and (vi comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS and Child PTSD Symptom Scale (CPSS in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64 aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old. The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS and Global Assessment of Psychosocial Disability (GAPD were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14; CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20. The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7, "feeling that life is not worth living" (DSRS.10, and

  3. Cross-national reliability of clinician-rated outcome measures in child and adolescent mental health services

    DEFF Research Database (Denmark)

    Hanssen-Bauer, Ketil; Gowers, Simon; Aalen, Odd O;

    2007-01-01

    Clinician-rated measures are in extensive use as routine outcome measures in child and adolescent mental health services. We investigated cross-national differences and inter-rater reliability of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), the Children's Global...... Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD). Thirty clinicians from 5 nations independently rated 20 written vignettes. The national groups afterwards established national consensus ratings. There were no cross-national differences in independent scores, but there were...

  4. Research report--Volunteer infant feeding and care counselors: a health education intervention to improve mother and child health and reduce mortality in rural Malawi.

    Science.gov (United States)

    Rosato, Mikey; Lewycka, Sonia; Mwansambo, Charles; Kazembe, Peter; Phiri, Tambosi; Chapota, Hilda; Vergnano, Stefania; Newell, Marie-Louise; Osrin, David; Costello, Anthony

    2012-06-01

    The aim of this report is to describe a health education intervention involving volunteer infant feeding and care counselors being implemented in Mchinji district, Malawi. The intervention was established in January 2004 and involves 72 volunteer infant feeding and care counselors, supervised by 24 government Health Surveillance Assistants, covering 355 villages in Mchinji district. It aims to change the knowledge, attitudes and behaviour of women to promote exclusive breastfeeding and other infant care practices. The main target population are women of child bearing age who are visited at five key points during pregnancy and after birth. Where possible, their partners are also involved. The visits cover exclusive breastfeeding and other important neonatal and infant care practices. Volunteers are provided with an intervention manual and picture book. Resource inputs are low and include training allowances and equipment for counselors and supervisors, and a salary, equipment and materials for a coordinator. It is hypothesized that the counselors will encourage informational and attitudinal change to enhance motivation and risk reduction skills and self-efficacy to promote exclusive breastfeeding and other infant care practices and reduce infant mortality. The impact is being evaluated through a cluster randomised controlled trial and results will be reported in 2012.

  5. Do differences in maternal age, parity and multiple births explain variations in fetal and neonatal mortality rates in Europe? - Results from the EURO-PERISTAT project

    NARCIS (Netherlands)

    Anthony, S.; Jacobusse, G.W.; Pal-De Bruin, K.M. van der; Buitendijk, S.; Zeitlin, J.

    2009-01-01

    Perinatal mortality rates differ markedly between countries in Europe. If population characteristics, such as maternal age, parity or multiple births, contribute to these differences, standardised rates may be useful for international comparisons of health status and especially quality of care. This

  6. Adjusting for overdispersion in piecewise exponential regression models to estimate excess mortality rate in population-based research

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    Miguel Angel Luque-Fernandez

    2016-10-01

    Full Text Available Abstract Background In population-based cancer research, piecewise exponential regression models are used to derive adjusted estimates of excess mortality due to cancer using the Poisson generalized linear modelling framework. However, the assumption that the conditional mean and variance of the rate parameter given the set of covariates x i are equal is strong and may fail to account for overdispersion given the variability of the rate parameter (the variance exceeds the mean. Using an empirical example, we aimed to describe simple methods to test and correct for overdispersion. Methods We used a regression-based score test for overdispersion under the relative survival framework and proposed different approaches to correct for overdispersion including a quasi-likelihood, robust standard errors estimation, negative binomial regression and flexible piecewise modelling. Results All piecewise exponential regression models showed the presence of significant inherent overdispersion (p-value <0.001. However, the flexible piecewise exponential model showed the smallest overdispersion parameter (3.2 versus 21.3 for non-flexible piecewise exponential models. Conclusion We showed that there were no major differences between methods. However, using a flexible piecewise regression modelling, with either a quasi-likelihood or robust standard errors, was the best approach as it deals with both, overdispersion due to model misspecification and true or inherent overdispersion.

  7. Nexus of Health and Development: Modelling Crude Birth Rate and Maternal Mortality Ratio Using Nighttime Satellite Images

    Directory of Open Access Journals (Sweden)

    Koel Roychowdhury

    2014-05-01

    Full Text Available Health and development are intricately related. Although India has made significant progress in the last few decades in the health sector and overall growth in GDP, there are still large regional differences in both health and development. The main objective of this paper is to develop techniques for the prediction of health indicators for all the districts of India and examine the correlations between health and development. The level of electrification and district domestic product (DDP are considered as two fundamental indicators of development in this research. These data, along with health metrics and the information from two nighttime satellite images, were used to propose the models. These successfully predicted the health indicators with less than a 7%–10% error. The chosen health metrics, such as crude birth rate (CBR and maternal mortality rate (MMR, were mapped for the whole country at the district level. These metrics showed very strong correlation with development indicators (correlation coefficients ranging from 0.92 to 0.99 at the 99% confidence interval. This is the first attempt to use Visible Infrared Imaging Radiometer Suite (VIIRS (satellite imagery in a socio-economic study. This paper endorses the observation that areas with a higher DDP and level of electrification have overall better health conditions.

  8. Estimating natural mortality rates and simulating fishing scenarios for Gulf of Mexico red grouper (Epinephelus morio) using the ecosystem model OSMOSE-WFS

    Science.gov (United States)

    Grüss, Arnaud; Schirripa, Michael J.; Chagaris, David; Velez, Laure; Shin, Yunne-Jai; Verley, Philippe; Oliveros-Ramos, Ricardo; Ainsworth, Cameron H.

    2016-02-01

    The ecosystem model OSMOSE-WFS was employed to evaluate natural mortality rates and fishing scenarios for Gulf of Mexico (GOM) red grouper (Epinephelus morio). OSMOSE-WFS represents major high trophic level (HTL) groups of species of the West Florida Shelf, is forced by the biomass of plankton and benthos groups, and has a monthly time step. The present application of the model uses a recently developed 'stochastic mortality algorithm' to resolve the mortality processes of HTL groups. OSMOSE-WFS predictions suggest that the natural mortality rate of juveniles of GOM red grouper is high and essentially due to predation, while the bulk of the natural mortality of adult red grouper results from causes not represented in OSMOSE-WFS such as, presumably, red tides. These results were communicated to GOM red grouper stock assessments. Moreover, OSMOSE-WFS indicate that altering the fishing mortality of GOM red grouper may have no global impact on the biomass of the major prey of red grouper, due to the high complexity and high redundancy of the modeled system. By contrast, altering the fishing mortality of GOM red grouper may have a large impact on the biomass of its major competitors. Increasing the fishing mortality of red grouper would increase the biomass of major competitors, due to reduced competition for food. Conversely, decreasing the fishing mortality of red grouper would diminish the biomass of major competitors, due to increased predation pressure on the juveniles of the major competitors by red grouper. The fishing scenarios that we evaluated may have slightly different impacts in the real world, due to some discrepancies between the diets of red grouper and its major competitors predicted by OSMOSE-WFS and the observed ones. Modifications in OSMOSE-WFS are suggested to reduce these discrepancies.

  9. Child Development

    Science.gov (United States)

    As children grow older, they develop in several different ways. Child development includes physical, intellectual, social, and emotional changes. Children grow and mature at very different rates. It's ...

  10. Determinants of efficiency in reducing child mortality in developing countries. The role of inequality and government effectiveness.

    Science.gov (United States)

    Ortega, Bienvenido; Sanjuán, Jesús; Casquero, Antonio

    2016-05-03

    The main aim of this article was to analyze the relationship of income inequality and government effectiveness with differences in efficiency in the use of health inputs to improve the under-five survival rate (U5SR) in developing countries. Robust Data Envelopment Analysis (DEA) and regression analysis were conducted using data for 47 developing countries for the periods 2000-2004, 2005-2009, and 2010-2012. The estimations show that countries with a more equal income distribution and better government effectiveness (i.e. a more competent bureaucracy and good quality public service delivery) may need fewer health inputs to achieve a specific level of the U5SR than other countries with higher inequality and worse government effectiveness.

  11. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults

    Science.gov (United States)

    Assari, Shervin

    2016-01-01

    Objectives: Despite the well-established association between self-rated health and mortality, research findings have been inconsistent regarding how men and women differ on this link. Using a national sample in the United States, this study compared American male and female older adults for the predictive role of baseline self-rated health on the short-term risk of mortality. Methods: This longitudinal study followed 1500 older adults (573 men (38.2%) and 927 women (61.8%)) aged 66 years or older for 3 years from 2001 to 2004. The main predictor of interest was self-rated health, which was measured using a single item in 2001. The outcome was the risk of all-cause mortality during the 3-year follow-up period. Demographic factors (race and age), socio-economic factors (education and marital status), and health behaviors (smoking and drinking) were covariates. Gender was the focal moderator. We ran logistic regression models in the pooled sample and also stratified by gender, with self-rated health treated as either nominal variables, poor compared to other levels (i.e. fair, good, or excellent) or excellent compared to other levels (i.e. good, fair, or poor), or an ordinal variable. Results: In the pooled sample, baseline self-rated health predicted mortality risk, regardless of how the variable was treated. We found a significant interaction between gender and poor self-rated health, indicating a stronger effect of poor self-rated health on mortality risk for men compared to women. Gender did not interact with excellent self-rated health on mortality. Conclusion: Perceived poor self-rated health better reflects risk of mortality over a short period of time for older men compared to older women. Clinicians may need to take poor self-rated health of older men very seriously. Future research should test whether the differential predictive validity of self-rated health based on gender is due to a different meaning of poor self-rated health for older men and women

  12. Reliability and Validity of Parent- and Child-Rated Anxiety Measures in Autism Spectrum Disorder

    Science.gov (United States)

    Kaat, Aaron J.; Lecavalier, Luc

    2015-01-01

    Autism spectrum disorder (ASD) and anxiety frequently co-occur. Research on the phenomenology and treatment of anxiety in ASD is expanding, but is hampered by the lack of instruments validated for this population. This study evaluated the self- and parent-reported Revised Child Anxiety and Depression Scale and the Multidimensional Anxiety Scale in…

  13. [Significance of trends in infant mortality rates in the municipality of São Paulo, SP (Brazil) in the last 30 years (1950-1979)].

    Science.gov (United States)

    Monteiro, C A

    1982-02-01

    The possible correlations between infant mortality statistics and those statistics related to the real value of the legal minimum salary and those on the extent of the public water supply system for the city of Sao Paulo, Brazil over the last 3 decades were studied with a view to determining the relationship between the historical trends in infant mortality rates and in the quality of life. The abovementioned factors, salary and water supply, are taken as factors of lesser and greater relevance for the overall picture of the living conditions among this population. The mortality decline in the 1950s and the increase in the 1960s were found significantly related to the trends in the real value of the legal minimum salary. However, the trend in mortality in the 1970s, with a notable fall from 1974, was found to be specifically related to the trends in water supply extension. One might conclude that during the 1950-79 period the implications relating to the quality of life to be drawn from infant mortality trends are diverse. It would seem erroneous to affirm that the reversal in high mortality from 1974 might signify an identical reversal of the deterioration of living conditions which led to the increase of mortality in the preceding period. (author's modified)

  14. Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates

    Directory of Open Access Journals (Sweden)

    Ana Carolina Souza-Oliveira

    Full Text Available Abstract Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14–70%. Aim This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP, including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. Methods This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. Findings De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Conclusion Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.

  15. Recanalization and Mortality Rates of Thrombectomy With Stent-Retrievers in Octogenarian Patients with Acute Ischemic Stroke

    Energy Technology Data Exchange (ETDEWEB)

    Parrilla, G., E-mail: gpr1972@gmail.com [Hospital Clínico Universitario Virgen de la Arrixaca, Service of Interventional Neuroradiology (Spain); Carreón, E. [Service of Neurology Hospital Clínico Universitario Virgen de la Arrixaca (Spain); Zamarro, J.; Espinosa de Rueda, M.; García-Villalba, B. [Hospital Clínico Universitario Virgen de la Arrixaca, Service of Interventional Neuroradiology (Spain); Marín, F. [Hospital Clínico Universitario Virgen de la Arrixaca, Department of Cardiology (Spain); Hernández-Fernández, F. [Hospital Clínico Universitario Virgen de la Arrixaca, Service of Interventional Neuroradiology (Spain); Morales, A. [Service of Neurology Hospital Clínico Universitario Virgen de la Arrixaca (Spain); Fernández-Vivas, M.; Núñez, R. [Hospital Clínico Universitario Virgen de la Arrixaca, Intensive Care Unit (Spain); Moreno, A. [Hospital Clínico Universitario Virgen de la Arrixaca, Service of Interventional Neuroradiology (Spain)

    2015-04-15

    BackgroundOur objective was to evaluate the effect of treatment with stent-retrievers in octogenarians suffering an acute ischemic stroke.MethodsA total of 150 consecutive patients with acute stroke who were treated with stent-retrievers between April 2010 and June 2012 were retrospectively reviewed. Patients were divided into those <80 years old (n = 116) and those ≥80 (n = 34). Baseline characteristics, procedure data, and endpoints (postprocedural NIHSS, death, and mRS at 3 months) were compared.ResultsHigh blood pressure, atrial fibrillation, and anticoagulation were more frequent in octogenarians (p = 0.01, 0.003, and 0.04 respectively). There were no differences between both groups regarding previous intravenous thrombolysis (32.4 vs. 48.3 %, p = 0.1), preprocedural NIHSS (18.1 vs. 16.8, p = 0.3), procedure time (74.5 (40–114) min vs. 63 (38–92) min, p = 0.2), revascularization time (380.5 (298–526.3) min vs. 350 (296.3–452.8), p = 0.3), TICI ≥ 2B (88.2 vs. 93.9 %, p = 0.1), and symptomatic haemorrhage (5.9 vs. 2.6 %, p = 0.3). Discharge NIHSS was higher in octogenarians (9.7 vs. 6.5, p = 0.03). Death and 3-month mRS ≥3 were more frequent in octogenarians (35.3 vs. 17.2 %, p = 0.02 and 73.5 vs. 37.1 %, p = 0.02). ICA-involvement and prolonged revascularization involved higher mortality (66.7 vs. 27.6 %, p = 0.03) and worse mRS (50 vs. 24.4 %, p = 0.06) in octogenarians.ConclusionsIn our series, treatment with stent-retrievers in octogenarians with acute ischemic stroke achieved good rates of recanalization but with a high mortality rate. ICA involvement and revascularization times beyond 6 hours associated to a worse prognosis. These data might be of value in the design of prospective studies evaluating the clinical efficacy of the endovascular treatments in octogenarians.

  16. Is the higher rate of parental child homicide in stepfamilies an effect of non-genetic relatedness?

    Institute of Scientific and Technical Information of China (English)

    Hans TEMRIN; Johanna NORDLUND; Mikael RYING; Birgitta S. TULLBERG

    2011-01-01

    In an evolutionary perspective individuals are expected to vary the degree of parental love and care in relation to the fitness value that a child represents. Hence, stepparents are expected to show less solicitude than genetically related parents, and this lack of genetic relatedness has been used to explain the higher frequencies of child abuse and homicide found in stepfamilies.However, other factors than non-genetic relatedness may cause this over-representation in stepfamilies. Here we use a 45-year data set of parental child homicides in Sweden to test two hypotheses related to the higher incidence in stepfamilies: 1) adults in different types of family differ in their general disposition to use violence, and 2) parents are more likely to kill stepchildren than genetically related children. Of the 152 perpetrators in biparental families there was an overrepresentation of perpetrators in stepfamilies (n=27) compared with the general population. We found support for the first hypothesis in that both general and violent crime rates were higher in stepfamilies, both in the general population and among perpetrators of child homicide. However, we found no support for the second hypothesis because of the 27 perpetrators in stepfamilies the perpetrator killed a genetically related child in 13 cases, a stepchild in 13 cases and both types of children in one case. Moreover, out of the 12 families where the perpetrator lived with both stepchildren and genetic children, there was no bias towards killing stepchildren. Thus, we found no evidence for an effect of non-genetic relatedness per se [Current Zoology 57 (3): 253-59, 2011].

  17. Is the higher rate of parental child homicide in stepfamilies an effect of non-genetic relatedness?

    Directory of Open Access Journals (Sweden)

    Hans TEMRIN, Johanna NORDLUND, Mikael RYING, Birgitta S. TULLBERG

    2011-06-01

    Full Text Available In an evolutionary perspective individuals are expected to vary the degree of parental love and care in relation to the fitness value that a child represents. Hence, stepparents are expected to show less solicitude than genetically related parents, and this lack of genetic relatedness has been used to explain the higher frequencies of child abuse and homicide found in stepfamilies. However, other factors than non-genetic relatedness may cause this over-representation in stepfamilies. Here we use a 45-year data set of parental child homicides in Sweden to test two hypotheses related to the higher incidence in stepfamilies: 1 adults in different types of family differ in their general disposition to use violence, and 2 parents are more likely to kill stepchildren than genetically related children. Of the 152 perpetrators in biparental families there was an overrepresentation of perpetrators in stepfamilies (n=27 compared with the general population. We found support for the first hypothesis in that both general and violent crime rates were higher in stepfamilies, both in the general population and among perpetrators of child homicide. However, we found no support for the second hypothesis because of the 27 perpetrators in stepfamilies the perpetrator killed a genetically related child in 13 cases, a stepchild in 13 cases and both types of children in one case. Moreover, out of the 12 families where the perpetrator lived with both stepchildren and genetic children, there was no bias towards killing stepchildren. Thus, we found no evidence for an effect of non-genetic relatedness per se [Current Zoology 57 (3: 253–259, 2011].

  18. Being born under adverse economic conditions leads to a higher cardiovascular mortality rate later in life: evidence based on individuals born at different stages of the business cycle

    DEFF Research Database (Denmark)

    van den Berg, Gerard J; Doblhammer-Reiter, Gabriele; Christensen, Kaare

    2011-01-01

    since the 1870s and including the cause of death. To capture exogenous variation of conditions early in life, we use the state of the business cycle around birth. We find significant negative effects of economic conditions around birth on the individual CV mortality rate at higher ages......We connect the recent medical and economic literatures on the long-run effects of early-life conditions by analyzing the effects of economic conditions on the individual cardiovascular (CV) mortality rate later in life, using individual data records from the Danish Twin Registry covering births....... There is no effect on the cancer-specific mortality rate. From variation within and between monozygotic and dizygotic twin pairs born under different conditions, we conclude that the fate of an individual is more strongly determined by genetic and household-environmental factors if early-life conditions are poor...

  19. What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2007-06-01

    Full Text Available Abstract Background Despite increasing interest and publication of risk-adjusted hospital mortality rates, the relationship with underlying quality of care remains unclear. We undertook a systematic review to ascertain the extent to which variations in risk-adjusted mortality rates were associated with differences in quality of care. Methods We identified studies in which risk-adjusted mortality and quality of care had been reported in more than one hospital. We adopted an iterative search strategy using three databases – Medline, HealthSTAR and CINAHL from 1966, 1975 and 1982 respectively. We identified potentially relevant studies on the basis of the title or abstract. We obtained these papers and included those which met our inclusion criteria. Results From an initial yield of 6,456 papers, 36 studies met the inclusion criteria. Several of these studies considered more than one process-versus-risk-adjusted mortality relationship. In total we found 51 such relationships in a widen range of clinical conditions using a variety of methods. A positive correlation between better quality of care and risk-adjusted mortality was found in under half the relationships (26/51 51% but the remainder showed no correlation (16/51 31% or a paradoxical correlation (9/51 18%. Conclusion The general notion that hospitals with higher risk-adjusted mortality have poorer quality of care is neither consistent nor reliable.

  20. Evaluation of annual survival and mortality rates and longevity of bottlenose dolphins (Tursiops truncatus) at the United States Navy Marine Mammal Program from 2004 through 2013.

    Science.gov (United States)

    Venn-Watson, Stephanie K; Jensen, Eric D; Smith, Cynthia R; Xitco, Mark; Ridgway, Sam H

    2015-04-15

    Objective-To evaluate annual survival and mortality rates and the longevity of a managed population of bottlenose dolphins (Tursiops truncatus). Design-Retrospective cohort study. Animals-103 bottlenose dolphins at the US Navy Marine Mammal Program (MMP). Procedures-Population age structures, annual survival and crude mortality rates, and median age at death for dolphins > 30 days old were determined from 2004 through 2013. Results-During 2004 through 2013, the annual survival rates for MMP dolphins ranged from 0.98 to 1.0, and the annual crude mortality rates ranged from 0% to 5%, with a mean of 2.7%. The median age at death was 30.1 years from 2004 through 2008 and increased to 32 years from 2009 through 2013. The maximum age for a dolphin in the study was 52 years. Conclusions and Clinical Relevance-Results indicated that the annual mortality rates were low and survival rates were high for dolphins in the MMP from 2004 through 2013 and that the median age at death for MMP dolphins during that time was over 10 years greater than that reported in free-ranging dolphins. These findings were likely attributable to the continually improving care and husbandry of managed dolphin populations.

  1. The relationship between Vitamin D, clinical outcomes and mortality rate in ICU patients: A prospective observational study

    Science.gov (United States)

    Vosoughi, Nooshin; Kashefi, Parviz; Abbasi, Behnood; Feizi, Awat; Askari, Gholamreza; Azadbakht, Leila

    2016-01-01

    Background: According to the high prevalence of Vitamin D deficiency, a few studies have been conducted to clarify the relationship between 25-hydroxyvitamin D (25(OH)D) and clinical outcomes in critically ill patients. The objective of this study was to determine this probable association. Materials and Methods: Serum 25(OH)D, C-reactive protein, malnutrition measurements, and Intensive Care Unit (ICU)-acquired infection from 185 patients in ICU were assessed in the first 24 h of admission and they were followed for the other outcomes. Results: About 93.5% of patients were classified as deficient and insufficient while the others were categorized in sufficient group. 25(OH)D status was not significantly associated with mortality rate (P = 0.66), and no significant differences in ventilation time were observed (P = 0.97). Sufficient group left the ICU sooner, but the difference was not significant (P = 0.75). Besides the results of relationship between 25(OH)D concentration and nutritional status (P = 0.69) were not significant. In addition, sufficient group suffered from infection more than insufficient patients, but this relationship was not significant (P = 0.11). Conclusion: In this study, we found that 25(OH)D insufficiency is common in ICU patients, but no significant association between low 25(OH)D levels and ICU outcomes were observed. Hence, because of vital roles of Vitamin D in human's body, comprehensive study should conduct to determine the decisive results. PMID:27904620

  2. The relationship between Vitamin D, clinical outcomes and mortality rate in ICU patients: A prospective observational study

    Directory of Open Access Journals (Sweden)

    Nooshin Vosoughi

    2016-01-01

    Full Text Available Background: According to the high prevalence of Vitamin D deficiency, a few studies have been conducted to clarify the relationship between 25-hydroxyvitamin D (25(OHD and clinical outcomes in critically ill patients. The objective of this study was to determine this probable association. Materials and Methods: Serum 25(OHD, C-reactive protein, malnutrition measurements, and Intensive Care Unit (ICU-acquired infection from 185 patients in ICU were assessed in the first 24 h of admission and they were followed for the other outcomes. Results: About 93.5% of patients were classified as deficient and insufficient while the others were categorized in sufficient group. 25(OHD status was not significantly associated with mortality rate (P = 0.66, and no significant differences in ventilation time were observed (P = 0.97. Sufficient group left the ICU sooner, but the difference was not significant (P = 0.75. Besides the results of relationship between 25(OHD concentration and nutritional status (P = 0.69 were not significant. In addition, sufficient group suffered from infection more than insufficient patients, but this relationship was not significant (P = 0.11. Conclusion: In this study, we found that 25(OHD insufficiency is common in ICU patients, but no significant association between low 25(OHD levels and ICU outcomes were observed. Hence, because of vital roles of Vitamin D in human′s body, comprehensive study should conduct to determine the decisive results.

  3. Influence of housing systems on stillbirth and mortality rate in preweaning pigs farrowed by different gilt breeds

    Directory of Open Access Journals (Sweden)

    Wiebke Wellbrock

    2010-01-01

    Full Text Available The aim of this paper was to investigate the influence of housing systems on stillbirth and mortality rate in preweaning pigs farrowed by different gilt breeds. The investigation included first farrowings of 225 Large White (LW gilts, 297 Swedish Landrace (SL gilts and 260 crossbreed gilts (LWxSL in the period of five years. Despite of positive influence of straw through decreased number of stillborn pigs, especially in LW gilts, in further process of production until weaning, less appropriate microclimatic conditions developed in farrowing houses with straw, especially if accompanied with poor ventilation, can result with higher number of perished pigs and lower number of weaned pigs. Most sensible to unsuitable microclimatic conditions in straw bedded farrowing houses, according to the number of perished pigs before weaning, were the pigs from SL gilts, while the pigs from crossbreed gilts LWxSL were the most resistant. These results suggest that adding straw requires special attention on influence of such production on microclimate conditions in pigs’ biozone in order to maintain its initial benefits in the time of farrowing through the whole preweaning period, especially in pure breeds of gilts.

  4. Multidimensional poverty and child survival in India.

    Directory of Open Access Journals (Sweden)

    Sanjay K Mohanty

    Full Text Available BACKGROUND: Though the concept of multidimensional poverty has been acknowledged cutting across the disciplines (among economists, public health professionals, development thinkers, social scientists, policy makers and international organizations and included in the development agenda, its measurement and application are still limited. OBJECTIVES AND METHODOLOGY: Using unit data from the National Family and Health Survey 3, India, this paper measures poverty in multidimensional space and examine the linkages of multidimensional poverty with child survival. The multidimensional poverty is measured in the dimension of knowledge, health and wealth and the child survival is measured with respect to infant mortality and under-five mortality. Descriptive statistics, principal component analyses and the life table methods are used in the analyses. RESULTS: The estimates of multidimensional poverty are robust and the inter-state differentials are large. While infant mortality rate and under-five mortality rate are disproportionately higher among the abject poor compared to the non-poor, there are no significant differences in child survival among educationally, economically and health poor at the national level. State pattern in child survival among the education, economical and health poor are mixed. CONCLUSION: Use of multidimensional poverty measures help to identify abject poor who are unlikely to come out of poverty trap. The child survival is significantly lower among abject poor compared to moderate poor and non-poor. We urge to popularize the concept of multiple deprivations in research and program so as to reduce poverty and inequality in the population.

  5. The logic of comparative life history studies for estimating key parameters, with a focus on natural mortality rate

    Science.gov (United States)

    Hoenig, John M; Then, Amy Y.-H.; Babcock, Elizabeth A.; Hall, Norman G.; Hewitt, David A.; Hesp, Sybrand A.

    2016-01-01

    There are a number of key parameters in population dynamics that are difficult to estimate, such as natural mortality rate, intrinsic rate of population growth, and stock-recruitment relationships. Often, these parameters of a stock are, or can be, estimated indirectly on the basis of comparative life history studies. That is, the relationship between a difficult to estimate parameter and life history correlates is examined over a wide variety of species in order to develop predictive equations. The form of these equations may be derived from life history theory or simply be suggested by exploratory data analysis. Similarly, population characteristics such as potential yield can be estimated by making use of a relationship between the population parameter and bio-chemico–physical characteristics of the ecosystem. Surprisingly, little work has been done to evaluate how well these indirect estimators work and, in fact, there is little guidance on how to conduct comparative life history studies and how to evaluate them. We consider five issues arising in such studies: (i) the parameters of interest may be ill-defined idealizations of the real world, (ii) true values of the parameters are not known for any species, (iii) selecting data based on the quality of the estimates can introduce a host of problems, (iv) the estimates that are available for comparison constitute a non-random sample of species from an ill-defined population of species of interest, and (v) the hierarchical nature of the data (e.g. stocks within species within genera within families, etc., with multiple observations at each level) warrants consideration. We discuss how these issues can be handled and how they shape the kinds of questions that can be asked of a database of life history studies.

  6. A Child Survival and Development Revolution?

    Science.gov (United States)

    Halpern, Robert

    1986-01-01

    Addresses the problems of child survival and development in developing countries by discussing the biomedical causes and the concomitant social determinants of high infant mortality rates. Describes four intervention strategies recommended by UNICEF: growth monitoring, oral rehydration therapy, breast feeding, and immunization. (HOD)

  7. Changes in mortality in Pakistan 1960-88.

    Science.gov (United States)

    Sathar, Z A

    1991-01-01

    General trends in Pakistan infant/child mortality, adult mortality, differentials in mortality, and prospects for future declines in mortality are presented. Future mortality declines are desired and recognized by government policy. Paucity of data and quality control issues cloud an accurate presentation of trends. The crude death rate (CDR) has nonetheless declined in 4 decades form 40-50/1000 in 1900 to 10-12/1000 in the late 1970s and early 1980s. The 1984-88 Pakistan Demographic Survey (PDS) reports a CDR of 10.8/1000. Life expectancy is expected to improve. The majority of deaths are infant/child related. Government policy aims to have 1 trained traditional birth attendant/village in order to improve maternal and child care. Although official statistics are in dispute, there is general agreement that infant mortality has declined particularly in neonatal mortality, i.e., infant mortality is now at 56-62/1000 and neonatal mortality 48/1000 in 1988. Data are derived from the Pakistan Fertility Survey (PFS), and Population Labor Force and Migration Survey (PLM) in the 1960-70s, the 1976-79 Population Growth Surveys (PGS), and the 1984-88 PDS. Lower death rates have also occurred among adults. Sex differentials in mortality have reversed, although the sex ratio still favors males; the improvement may be due to better reporting of female mortality. Life expectancy has improved for women, and there are gains over males. The disadvantage at 15-40 years has been eliminated. Differential mortality is expressed geographically, where urban mortality is much lower than in rural areas. There is a relationship between mothers who have some education and lower infant mortality. Labor force participation effects on mortality are dependent on the reasons for work: economic necessity or in pursuance of a career and supplemental income. Findings on the relationship between income or social class and mortality are equivocal. Improvements are dependent on further fertility

  8. Hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV infected patients from Rio de Janeiro, Brazil.

    Science.gov (United States)

    Coelho, Lara E; Ribeiro, Sayonara R; Veloso, Valdilea G; Grinsztejn, Beatriz; Luz, Paula M

    2016-12-03

    In this study, we evaluated trends in hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV-infected patients in Rio de Janeiro, Brazil, from 2007 through 2013. Among the 3991 included patients, 1861 hospitalizations occurred (hospitalization rate of 10.44/100 person-years, 95% confidence interval 9.98-10.93/100 person-years). Hospitalization rates decreased annually (per year incidence rate ratio 0.92, 95% confidence interval 0.89-0.95) as well as length of stay (median of 15 days in 2007 vs. 11 days in 2013, p-value for trend<0.001), and in-hospital mortality (13.4% in 2007 to 8.1% in 2013, p-value for trend=0.053). Our results show that, in a middle-income setting, hospitalization rates are decreasing over time and non-AIDS hospitalizations are currently more frequent than those related to AIDS. Notwithstanding, compared with high-income settings, our patients had longer length of stay and higher in-hospital mortality. Further studies addressing these outcomes are needed to provide information that may guide protocols and interventions to further reduce health-care costs and in-hospital mortality.

  9. Differing first year mortality rates of term births to White, African-American, and Mexican-American US-born and foreign-born mothers.

    Science.gov (United States)

    Collins, James W; Soskolne, Gayle R; Rankin, Kristin M; Bennett, Amanda C

    2013-12-01

    To determine whether maternal nativity (US-born versus foreign-born) is associated with the first year mortality rates of term births. Stratified and multivariable binomial regression analyses were performed on the 2003-2004 National Center for Health Statistics linked live birth-infant death cohort files. Only term (37-42 weeks) infants with non-Latina White, African-American, and Mexican-American mothers were studied. The infant mortality rate (mortality for non-LBW, term births to US-born (compared to foreign-born) for White, African-American, and Mexican-American mothers equaled 1.5 (1.3-1.7), 1.7 (1.5-2.1) and 1.6 (1.4-1.8), respectively. The IMR of term births to White, African-American, and Mexican-American mothers exceeds that of their counterparts with foreign-born mothers independent of traditional individual level risk factors.

  10. Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature.

    Science.gov (United States)

    Galloway, Helen; Newman, Emily

    2017-03-01

    There are contemporary indicators that parent proxy-ratings and child self-ratings of a child's quality of life (QoL) are not interchangeable. This review examines dual informant studies to assess parent-child agreement on the QoL of children with attention-deficit/hyperactivity disorder. A systematic search of four major databases (PsycINFO, MEDLINE, EMBASE and Cochrane databases) was completed, and related peer-reviewed journals were hand-searched. Studies which reported quantitative QoL ratings for matched parent and child dyads were screened in accordance with relevant inclusion and exclusion criteria. Key findings were extracted from thirteen relevant studies, which were rated for conformity to the recommendations of an adapted version of the STROBE statement guidelines for observational studies. In the majority of studies reviewed, children rated their QoL more highly than their parents. There was some evidence for greater agreement on the physical health domain than psychosocial domains.

  11. Methodology for determining whether an increase in a state's child poverty rate is the result of the TANF program--Administration for Children and Families, HHS. Proposed rule.

    Science.gov (United States)

    1998-09-23

    The Administration for Children and Families is proposing a methodology to determine the child poverty rate in each State. If a State experiences an increase in its child poverty rate of 5 percent or more as a result of its Temporary Assistance for Needy Families (TANF) program, the State must submit and implement a corrective action plan. This requirement is a part of the new welfare reform block grant program enacted in 1996.

  12. International child health

    DEFF Research Database (Denmark)

    Kruse, Alexandra Y; Høgh, Birthe

    2007-01-01

    International child health has improved. Better healthcare strategies, like IMCI, have contributed implementing basic interventions: vaccinations, nutrition supplement, oral rehydration and antibiotics. But 11 million children still die every year before they turn five, most from infectious...... diseases and neonatal complications, over half associated with malnutrition. Conditions we could prevent and treat. One of UN's Millennium Development Goals is to reduce child mortality. However child health is more than mortality and morbidity indicators, it includes growth and development. Udgivelsesdato...

  13. Trends and variations in the rates of hospital complications, failure-to-rescue and 30-day mortality in surgical patients in New South Wales, Australia, 2002-2009.

    Directory of Open Access Journals (Sweden)

    Lixin Ou

    Full Text Available BACKGROUND: Despite the increased acceptance of failure-to-rescue (FTR as an important patient safety indicator (defined as the percentage of deaths among surgical patients with treatable complications, there has not been any large epidemiological study reporting FTR in an Australian setting nor any evaluation on its suitability as a performance indicator. METHODS: We conducted a population-based study on elective surgical patients from 82 public acute hospitals in New South Wales, Australia between 2002 and 2009, exploring the trends and variations in rates of hospital complications, FTR and 30-day mortality. We used Poisson regression models to derive relative risk ratios (RRs after adjusting for a range of patient and hospital characteristics. RESULTS: The average rates of complications, FTR and 30-day mortality were 13.8 per 1000 admissions, 14.1% and 6.1 per 1000 admission, respectively. The rates of complications and 30-day mortality were stable throughout the study period however there was a significant decrease in FTR rate after 2006, coinciding with the establishment of national and state-level peak patient safety agencies. There were marked variations in the three rates within the top 20% of hospitals (best and bottom 20% of hospitals (worst for each of the four peer-hospital groups. The group comprising the largest volume hospitals (principal referral/teaching hospitals had a significantly higher rate of FTR in comparison to the other three groups of smaller-sized peer hospital groups (RR = 0.78, 0.57, and 0.61, respectively. Adjusted rates of complications, FTR and 30-day mortality varied widely for individual surgical procedures between the best and worst quintile hospitals within the principal referral hospital group. CONCLUSIONS: The decrease in FTR rate over the study period appears to be associated with a wide range of patient safety programs. The marked variations in the three rates between- and within- peer hospital groups

  14. REGIONAL TRENDS IN THE WORKING-AGE POPULATION MORTALITY RATE IN THE REPUBLIC OF SAKHA (YAKUTIA) IN 1990-2012.

    Science.gov (United States)

    Ivanova, A A; Kakorina, E P; Timofeev, L F; Potapov, A F; Aprosimov, L A

    2015-01-01

    Regions of the Russian Federation differ in climatic-geographic, medical-demographic and social-economic situations. One of the regions with distinct peculiarities is the Republic of Sakha (Yakutia). Ranking first by the territory (3,103.2 thousand sq x km), Yakutia is on the 81th place by the population density among regions of the Russian Federation (0.3 people per 1 km2).Yakutia is one of the most isolated and inaccessible regions of the world: 90% of the territory lacks all-the-year-round transportation. Regions of the republic, as well, differ significantly in the climatic conditions and the levels of social-economic development, which influences the population health indicators, including mortality. This survey aimed to study the trends of mortality in the working-age population in different groups of regions. To do this, basing on the statistical data, we compared the levels, trends and structure of mortality in 1990-2012. It was established that the different groups of regions show a significant variation in the working-age population mortality, depending on the social-economic conditions. Since 2000, the Arctic group of regions has demonstrated higher mortality in working-age men and women, especially of cardiovascular and digestive system diseases, and external causes. Lying beyond the Arctic Circle, these regions have severe conditions and a relatively low level of social-economic development. As for the rural regions, despite the relatively favourabe situation, they also show a high level of mortality of external causes. The industrial regions are characterized by higher social-economic development, better transport infrastructure, a satisfactory material base of medical institutions. They also have sufficient resources of health institutions, including the staff and modern equipment for treatment and diagnostics, as well as, which is critical, the full range of medical specialists. Thus, these regions demonstrate lower population mortality; however

  15. Mortality Causes in Children 1-59 Months in Iran

    Directory of Open Access Journals (Sweden)

    T Sanaei-Shoar

    2013-01-01

    Full Text Available Background: Mortality rate indicator for children under 5 years old is one of the important indicators in countries' development. Identifying the most common causes of mortality is one of the most important attempts to reduce mortality in children less than 5 years. The purpose of this study was to identify distribution of the mortality causes in Iranian children less than 5 years.Methods: This cross-sectional study has been carried out based on the results of data from the Child Mortality Surveillance System since 2007 to 2008. To determine the causes of death questionnaires have been designed which include personal data of the deceased child, medical history, and information on procedures at the time of hospitalization or death.Results: Of 5926 deaths on children under 5 years which the questionnaires were filled out, 63.2% were postneonatal deaths (1-11 month. Totally 60% of mortalities occurred in the rural areas and 52% of them had been among boys. The most common causes of mortality were the congenital and chromosomal abnormalities with 23.4%. The most incidences among diseases were respiratory system diseases.Conclusions: Carrying out more epidemiologic studies, providing health programs to control and prevent diseases with high incidences and delivering more specialized health facilities and services could be the proper strategies to reduce under 5 mortality rates in Iran.

  16. Mortality rates across 25-hydroxyvitamin D (25[OH]D levels among adults with and without estimated glomerular filtration rate <60 ml/min/1.73 m2: the third national health and nutrition examination survey.

    Directory of Open Access Journals (Sweden)

    Holly Kramer

    Full Text Available BACKGROUND: Previous studies exploring the association between 25[OH]D levels and mortality in adults with and without kidney disease utilized 25[OH]D thresholds that have recently been scrutinized by the Institute of Medicine Committee to Review Dietary References Intakes for Vitamin D and Calcium. OBJECTIVE: We explored all-cause mortality rates across the spectrum of 25[OH]D levels over an eighteen-year follow-up among adults with and without an estimated glomerular filtration rate (eGFR 20 ng/ml after adjustment for all covariates. CONCLUSIONS: Regardless of presence of eGFR <60 ml/min/1.73 m(2, mortality rates across groups with 25[OH]D levels 20-40 ng/ml are similar.

  17. Seven-Day Mortality Can Be Predicted in Medical Patients by Blood Pressure, Age, Respiratory Rate, Loss of Independence, and Peripheral Oxygen Saturation (the PARIS Score)

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Lassen, Annmarie Touborg; Knudsen, Torben

    2015-01-01

    BACKGROUND: Most existing risk stratification systems predicting mortality in emergency departments or admission units are complex in clinical use or have not been validated to a level where use is considered appropriate. We aimed to develop and validate a simple system that predicts seven....... The outcome was defined as seven-day all-cause mortality. 76 patients (2.5%) met the endpoint in the development cohort, 57 (2.0%) in the first validation cohort, and 111 (4.3%) in the second. Systolic blood Pressure, Age, Respiratory rate, loss of Independence, and peripheral oxygen Saturation were...

  18. A comparison of administrative and physiologic predictive models in determining risk adjusted mortality rates in critically ill patients.

    Directory of Open Access Journals (Sweden)

    Kyle B Enfield

    Full Text Available BACKGROUND: Hospitals are increasingly compared based on clinical outcomes adjusted for severity of illness. Multiple methods exist to adjust for differences between patients. The challenge for consumers of this information, both the public and healthcare providers, is interpreting differences in risk adjustment models particularly when models differ in their use of administrative and physiologic data. We set to examine how administrative and physiologic models compare to each when applied to critically ill patients. METHODS: We prospectively abstracted variables for a physiologic and administrative model of mortality from two intensive care units in the United States. Predicted mortality was compared through the Pearsons Product coefficient and Bland-Altman analysis. A subgroup of patients admitted directly from the emergency department was analyzed to remove potential confounding changes in condition prior to ICU admission. RESULTS: We included 556 patients from two academic medical centers in this analysis. The administrative model and physiologic models predicted mortalities for the combined cohort were 15.3% (95% CI 13.7%, 16.8% and 24.6% (95% CI 22.7%, 26.5% (t-test p-value<0.001. The r(2 for these models was 0.297. The Bland-Atlman plot suggests that at low predicted mortality there was good agreement; however, as mortality increased the models diverged. Similar results were found when analyzing a subgroup of patients admitted directly from the emergency department. When comparing the two hospitals, there was a statistical difference when using the administrative model but not the physiologic model. Unexplained mortality, defined as those patients who died who had a predicted mortality less than 10%, was a rare event by either model. CONCLUSIONS: In conclusion, while it has been shown that administrative models provide estimates of mortality that are similar to physiologic models in non-critically ill patients with pneumonia, our results

  19. Diarrhea in Pre-Weaned Calves: Relative Risk Rates for Morbidity and Mortality in 13 Commercial Farms of Hot Arid Zone

    Directory of Open Access Journals (Sweden)

    M. A. Razzaque

    2010-01-01

    Full Text Available Problem statement: In many hot arid countries, pregnant Holstein Friesian heifers are imported for herd replacement. The calves obtained from exotic cows are exposed to adverse climate in feedlot system resulting in very high morbidity and mortality rates. Diarrhea, dehydration and deaths are causing a major loss to the producers. This study examines the Risk Rates (RR for morbidity and mortality in pre-weaned calves. Approach: Thirteen commercial dairy farms of small, medium and large sizes were surveyed using 1,280 newborn calves. A survey was conducted for calves from their birth to weaning at 90 day. Parameters of the study were birth weights, colostrum feeding, growth rate, incidences of diseases, clinical symptoms, post-mortem findings and results of laboratory investigations of samples obtained from sick and dead calves. Calf housing and feeding management of 13 farms were investigated. Results: RR for morbidity and mortality ranged from 0.3-1.00 and being highest during the first week. Most common disease was diarrhea representing 90.6% of the total calves affected. Common pathogens causing diarrhea were E. coli, Salmonella sp. Klebsiella, Pasturella and rotavirus. Relationship between calf management and morbidity RR for diarrhea was significant (r2 = 627, p = 0.01 and the growth rate was positively correlated (r2 = 0.761, p = 0.1. Diarrhea caused a significant negative impact on gross margins of the calf enterprises. Conclusion: Colostrum feeding and housing management were the key factors for causing a high RR for morbidity and mortality. Gross margin loss was significantly influenced by morbidity and mortality RR of calves.

  20. Pedophiles' ratings of adult and child photographs using a semantic differential.

    Science.gov (United States)

    Hambridge, J A

    1994-03-01

    Recent knowledge of the widespread extent of child sexual abuse and its consequences has led to an increasing interest in the understanding and treatment of perpetrators. This study examined a group of pedophiles in an English Special Hospital to determine possible characteristics that make children attractive and adults unattractive to them, using Repertory Grid technique and Semantic Differential. A small number of significant findings suggest that pedophiles may perceive some children and women in an unusual way. The large number of insignificant findings are discussed with reference to the sensitivity of the instrument; the pedophiles' desire to give socially acceptable answers; and subject characteristics of low IQ and "psychopathic disorder." Future directions for research are suggested.

  1. [Improvement of child survival in Mexico: the diagonal approach].

    Science.gov (United States)

    Sepúlveda, Jaime; Bustreo, Flavia; Tapia, Roberto; Rivera, Juan; Lozano, Rafael; Olaiz, Gustavo; Partida, Virgilio; García-García, Ma de Lourdes; Valdespino, José Luis

    2007-01-01

    Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements.

  2. Improvement of child survival in Mexico: the diagonal approach.

    Science.gov (United States)

    Sepúlveda, Jaime; Bustreo, Flavia; Tapia, Roberto; Rivera, Juan; Lozano, Rafael; Oláiz, Gustavo; Partida, Virgilio; García-García, Lourdes; Valdespino, José Luis

    2006-12-01

    Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements.

  3. Do maternal ratings of appetite in infants predict later Child Eating Behaviour Questionnaire scores and body mass index?

    Science.gov (United States)

    Parkinson, Kathryn N; Drewett, Robert F; Le Couteur, Ann S; Adamson, Ashley J

    2010-02-01

    In a longitudinal birth cohort maternal ratings of children's appetite made at 6 weeks, 12 months and 5-6 years were correlated with one another and with subscales from the Child Eating Behaviour Questionnaire (CEBQ) at 5-6 years, and body mass index (BMI) at 6-8 years. Statistically significant correlations were found between the children's appetite ratings. Appetite ratings in infancy were also correlated with the CEBQ subscale scores at 5-6 years to a limited extent, but not with the BMI at 6-8 years. The appetite rating at 5-6 years and three of the CEBQ subscales were independently associated with BMI. Children with higher levels of Emotional Over-Eating and Desire to Drink had higher BMIs, and children with higher levels of Satiety Responsiveness had lower BMIs. These results provide further evidence that there are concurrent associations between appetite ratings in childhood and BMI but suggest that appetite ratings in infancy are related only weakly to later appetite measures and do not predict later BMI.

  4. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim; Gyawali, Bishal

    2016-01-01

    did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we...... examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time...... and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well...

  5. Hospitalization rate and 30-day mortality among patients with status asthmaticus in Denmark: a 16-year nationwide population-based cohort study

    Directory of Open Access Journals (Sweden)

    Strid JM

    2013-09-01

    Full Text Available Jennie Maria Christin Strid,1 Henrik Gammelager,1 Martin Berg Johansen,1 Else Tønnesen,2 Christian Fynbo Christiansen,11Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; 2Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus C, DenmarkObjective: Current data on hospitalization and prognosis of acute asthma and status asthmaticus are inconclusive. We aim to analyze the rate of first-time hospitalizations for status asthmaticus among patients of all ages, the proportion admitted to intensive care units (ICU, and the 30-day mortality over a 16-year period.Methods: In this population-based cohort study, we used medical registries to identify all first-time status asthmaticus hospitalizations in Denmark from 1996 through 2011. Data on comorbidities were also obtained. We computed yearly hospitalization rates overall and by gender and age groups, and estimated the proportion requiring ICU admission. We estimated 30-day age- and gender-standardized mortality. We examined potential misclassification from acute exacerbation of chronic obstructive pulmonary disease (COPD by excluding patients with preexisting or concurrent COPD.Results: Of the 5,001 patients identified with a first-time status asthmaticus hospitalization, 50.5% were male, 40.3% were ,15 years old, and 12.4% had comorbidity. The hospitalization rate increased from 48.0 per 1,000,000 person-years (PY (95% confidence interval [CI]: 45.1–51.1 PY during 1996–1999 to 70.1 per 1,000,000 PY (95% CI: 66.7–73.7 PY during 2008–2011. This may be explained by an increased hospitalization rate of children. The standardized 30-day mortality risk declined from 3.3% (95% CI: 2.5%–4.1% in 1996–1999 to 1.5% (95% CI: 0.9%–2.1% in 2008–2011. During 2005–2011, 10.1% of status asthmaticus patients were admitted to the ICU. Hospitalization rates and mortality risk decreased by excluding 939 patients also registered with

  6. Contribution of exposure, risk of crash and fatality to explain age- and sex-related differences in traffic-related cyclist mortality rates.

    Science.gov (United States)

    Martínez-Ruiz, Virginia; Jiménez-Mejías, Eladio; Amezcua-Prieto, Carmen; Olmedo-Requena, Rocío; Luna-del-Castillo, Juan de Dios; Lardelli-Claret, Pablo

    2015-03-01

    This study was designed to quantify the percent contribution of exposure, risk of collision and fatality rate to the association of age and sex with the mortality rates among cyclists in Spain, and to track the changes in these contributions with time. Data were analyzed for 50,042 cyclists involved in road crashes in Spain from 1993 to 2011, and also for a subset of 13,119 non-infractor cyclists involved in collisions with a vehicle whose driver committed an infraction (used as a proxy sample of all cyclists on the road). We used decomposition and quasi-induced exposure methods to obtain the percent contributions of these three components to the mortality rate ratios for each age and sex group compared to males aged 25-34 years. Death rates increased with age, and the main component of this increase was fatality (around 70%). Among younger cyclists, however, the main component of increased death rates was risk of a collision. Males had higher death rates than females in every age group: this rate increased from 6.4 in the 5-14 year old group to 18.8 in the 65-79 year old group. Exposure, the main component of this increase, ranged between 70% and 90% in all age categories, although the fatality component also contributed to this increase. The contributions of exposure, risk of crash and fatality to cyclist death rates were strongly associated with age and sex. Young male cyclists were a high-risk group because all three components tended to increase their mortality rate.

  7. Efficiency of Intergeneric Recombinants Between Bacillus Thuringiensis and Bacillus Subtilis for Increasing Mortality Rate in Cotten Leaf Worm

    Science.gov (United States)

    AlOtaibi, Saad Aied

    2012-12-01

    In this study , two strains of Bacillus belonging to two serotypes and four of their transconjugants were screened with respect to their toxicity against lepidopterous cotton pest. . Bacterial transconjugants isolated from conjugation between both strains were evaluated for their transconjugant efficiency caused mortality in Spodoptera littoralis larvae . Two groups of bioinsecticides ; crystals , crystals and spores have been isolated from Bacillusstrains and their transconjugants . Insecticidal crystal protein ( ICP ) was specific for lepidopteran insects because of the toxin sufficient both for insect specificity and toxicity . The toxicities of these two groups against larvae of Spodoptera littoralis was expressed as transconjugant efficiency , which related to the mean number of larvae died expressed as mortality percentage . The results showed transconjugant efficiency in reducing the mean number of Spodoptera littoralis larvae feeding on leaves of Ricinus communis sprayed with bioinsecticides of Bt transconjugants. Most values of positive transconjugant efficiency related to increasing mortality percentage are due to toxicological effects appeared in response to the treatments with crystals + endospores than that of crystals alone .This indicated that crystals + endospores was more effective for increasing mortality percentage than that resulted by crystals . Higher positive transconjugant efficiency in relation to the mid parents and better parent was appeared at 168 h of treatment . The results indicated that recombinant Bacillus thuringiensis are important control agents for lepidopteran pests , as well as , susceptibility decreased with larval development . The results also suggested a potential for the deployment of these recominant entomopathogens in the management of Spodoptera. littoralis larvae .

  8. Heart Rate Variability Density Analysis (Dyx) and Prediction of Long-Term Mortality after Acute Myocardial Infarction

    DEFF Research Database (Denmark)

    Jørgensen, Rikke Mørch; Abildstrøm, Steen Z; Levitan, Jacob

    2016-01-01

    new predictive information on mortality in survivors of acute myocardial infarction (MI). This study compares the prognostic significance of Dyx to that of traditional linear and nonlinear measures of HRV. METHODS AND RESULTS: In the Nordic ICD pilot study, patients with an acute MI were screened...

  9. Average County-Level IQ Predicts County-Level Disadvantage and Several County-Level Mortality Risk Rates

    Science.gov (United States)

    Barnes, J. C.; Beaver, Kevin M.; Boutwell, Brian B.

    2013-01-01

    Research utilizing individual-level data has reported a link between intelligence (IQ) scores and health problems, including early mortality risk. A growing body of evidence has found similar associations at higher levels of aggregation such as the state- and national-level. At the same time, individual-level research has suggested the…

  10. Mortality Rates in the General Irish Population Compared to Those with an Intellectual Disability from 2003 to 2012

    Science.gov (United States)

    McCarron, Mary; Carroll, Rachael; Kelly, Caraiosa; McCallion, Philip

    2015-01-01

    Background:Historically, there has been higher and earlier mortality among people with intellectual disability as compared to the general population, but there have also been methodological problems and differences in the available studies. Method: Data were drawn from the 2012 National Intellectual Disability Database and the Census in Ireland. A…

  11. A Comparison of Mortality Rates in a Large Population of Smokers and Non-smokers: based on the Presence or Absence of Coronary Artery Calcification

    Science.gov (United States)

    McEvoy, John W; Blaha, Michael J; Rivera, Juan J; Budoff, Matthew J; Khan, Atif N; Shaw, Leslee J; Berman, Daniel S; Raggi, Paolo; Min, James K; Rumberger, John A; Callister, Tracy Q; Blumenthal, Roger S.; Nasir, Khurram

    2015-01-01

    Objectives To further study the interplay between smoking status, Coronary Artery Calcium (CAC) and all-cause mortality. Background Prior studies have not directly compared the relative prognostic impact of CAC in smokers versus non-smokers. In particular, while zero CAC is a known favorable prognostic-marker, whether smokers without CAC have as good a prognosis as non-smokers without CAC is unknown. Given computed tomography (CT) screening for lung cancer appears effective in smokers, the relative prognostic implications of visualizing any CAC versus no CAC on such screening also deserve study. Methods Our study cohort consisted of 44,042 asymptomatic individuals referred for non-contrast cardiac CT (age 54±11 years, 54% males). Subjects were followed for a mean of 5.6 years. The primary endpoint was all-cause mortality. Results Approximately 14% (n=6020) of subjects were active smokers at enrollment. There were 901 deaths (2.05%) overall, with increased mortality in smokers vs. non-smokers (4.3% vs. 1.7%, p400). In multivariable analysis within these strata, we found mortality hazard ratios (HRs) of 3.8 (95% CI, 2.8-5.2), 3.5 (2.6-4.9), and 2.7 (2.1-3.5), respectively, in smokers compared to nonsmokers. At each stratum of elevated CAC score, mortality in smokers was consistently higher than mortality in non-smokers from the CAC stratum above. However, among the 19,898 individuals with CAC=0, the mortality HR for smokers without CAC was 3.6 (95% CI, 2.3-5.7), compared to non-smokers without CAC. Conclusion Smoking is a risk factor for death across the entire spectrum of subclinical coronary atherosclerosis. Smokers with any coronary calcification are at significantly increased future mortality risk than smokers without CAC. However, the absence of CAC may not be as useful a “negative risk factor” in active smokers; as this group has mortality rates similar to non-smokers with mild to moderate atherosclerosis. PMID:23058072

  12. THE LIS STUDY (LYUBERTSY STUDY OF MORTALITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. EVALUATION OF THE PHARMACOTHERAPY. PART 1. TREATMENT OF PATIENTS BEFORE MYOCARDIAL INFARCTION AND ITS INFLUENCE ON HOSPITAL MORTALITY RATE

    Directory of Open Access Journals (Sweden)

    S. Y. Marcevich

    2012-01-01

    Full Text Available Aim. To assess the patients’ pharmacotherapy preceding the acute myocardial infarction (AMI and to assess the effects of this therapy on hospital mortality. Material and methods. 1133 patients were enrolled into the LIS AMI register . All these patients experienced AMI leading to hospital admitting in the territory of one of the districts of the Moscow Region during 3 years. The pharmacotherapy that patients received before AMI was analyzed as well as the influence of different drugs on the hospital mortality risk. Results. 172 of 1133 patients (15.2% died in hospital. Before admission 21.4% of patients received β-blockers, 35.3% — ACE inhibitors, 15.7% — antiplatelet drugs, 1.9% — statins. Reduction in the hospital mortality rate was shown for β-blockers [relative risk (RR=0.542, confidence interval (CI =0.357–0.824] and ACE inhibitors (RR=0.710, CI=0.512–0.986. Conclusion. A significant part of patients with high risk of AMI does not receive drugs with proven positive effect on the life prognosis.

  13. THE LIS STUDY (LYUBERTSY STUDY OF MORTALITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. EVALUATION OF THE PHARMACOTHERAPY. PART 1. TREATMENT OF PATIENTS BEFORE MYOCARDIAL INFARCTION AND ITS INFLUENCE ON HOSPITAL MORTALITY RATE

    Directory of Open Access Journals (Sweden)

    S. Y. Marcevich

    2015-12-01

    Full Text Available Aim. To assess the patients’ pharmacotherapy preceding the acute myocardial infarction (AMI and to assess the effects of this therapy on hospital mortality. Material and methods. 1133 patients were enrolled into the LIS AMI register . All these patients experienced AMI leading to hospital admitting in the territory of one of the districts of the Moscow Region during 3 years. The pharmacotherapy that patients received before AMI was analyzed as well as the influence of different drugs on the hospital mortality risk. Results. 172 of 1133 patients (15.2% died in hospital. Before admission 21.4% of patients received β-blockers, 35.3% — ACE inhibitors, 15.7% — antiplatelet drugs, 1.9% — statins. Reduction in the hospital mortality rate was shown for β-blockers [relative risk (RR=0.542, confidence interval (CI =0.357–0.824] and ACE inhibitors (RR=0.710, CI=0.512–0.986. Conclusion. A significant part of patients with high risk of AMI does not receive drugs with proven positive effect on the life prognosis.

  14. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts.

    Science.gov (United States)

    van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C; Woodward, Mark; Levey, Andrew; de Jong, Paul; Gansevoort, Ron T; van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C; Woodward, Mark; Levey, Andrew S; de Jong, Paul E; Gansevoort, Ron T; Levey, Andrew; El-Nahas, Meguid; Eckardt, Kai-Uwe; Kasiske, Bertram L; Ninomiya, Toshiharu; Chalmers, John; Macmahon, Stephen; Tonelli, Marcello; Hemmelgarn, Brenda; Sacks, Frank; Curhan, Gary; Collins, Allan J; Li, Suying; Chen, Shu-Cheng; Hawaii Cohort, K P; Lee, Brian J; Ishani, Areef; Neaton, James; Svendsen, Ken; Mann, Johannes F E; Yusuf, Salim; Teo, Koon K; Gao, Peggy; Nelson, Robert G; Knowler, William C; Bilo, Henk J; Joosten, Hanneke; Kleefstra, Nanno; Groenier, K H; Auguste, Priscilla; Veldhuis, Kasper; Wang, Yaping; Camarata, Laura; Thomas, Beverly; Manley, Tom

    2011-06-01

    Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative meta-analysis of 10 cohorts with 266,975 patients selected because of increased risk for chronic kidney disease, defined as a history of hypertension, diabetes, or cardiovascular disease. Risk for all-cause mortality was not associated with eGFR between 60-105 ml/min per 1.73 m², but increased at lower levels. Hazard ratios at eGFRs of 60, 45, and 15 ml/min per 1.73 m² were 1.03, 1.38 and 3.11, respectively, compared to an eGFR of 95, after adjustment for albuminuria and cardiovascular risk factors. Log albuminuria was linearly associated with log risk for all-cause mortality without thresholds. Adjusted hazard ratios at albumin-to-creatinine ratios of 10, 30 and 300 mg/g were 1.08, 1.38, and 2.16, respectively compared to a ratio of five. Albuminuria and eGFR were multiplicatively associated with all-cause mortality, without evidence for interaction. Similar associations were observed for cardiovascular mortality. Findings in cohorts with dipstick data were generally comparable to those in cohorts measuring albumin-to-creatinine ratios. Thus, lower eGFR and higher albuminuria are risk factors for all-cause and cardiovascular mortality in high-risk populations, independent of each other and of cardiovascular risk factors.

  15. Cross-Cultural Aspect of Behavior Assessment System for Children-2, Parent Rating Scale-Child: Standardization in Korean Children

    Science.gov (United States)

    Song, Jungeun; Leventhal, Bennett L.; Koh, Yun-Joo; Cheon, Keun-Ah; Hong, Hyun Ju; Kim, Young-Key; Cho, Kyungjin; Lim, Eun-Chung; Park, Jee In

    2017-01-01

    Purpose Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. Materials and Methods Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. Results Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. Conclusion K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created. PMID:28120577

  16. Relationship between Estimated Glomerular Filtration Rate and Cardiovascular Mortality in a Japanese Cohort with Long-Term Follow-Up.

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    Kei Nagai

    Full Text Available Patients with renal impairment are at risk of not only end-stage kidney disease but also cardiovascular disease (CVD. The current definition of CKD stage G3a is eGFR 45-59 ml/min/1.73 m2 and of G3b is 30-44 ml/min/1.73 m2, and subjects in the CKD 3a category are considered to be at lower risk of mortality than are those in CKD 3b.We evaluated the outcome of 97,043 people (33,131 men and 63,912 women living in Ibaraki Prefecture who underwent annual community-based health checkups beginning in 1993 at age 40-80 years and who were followed for a mean of 17.1 years.The number of all-causes deaths was 20,534 (10,375 men and 10,159 women, of which 5,995 (2,695 men and 3,300 women were deaths due to CVD. Multivariable-adjusted hazard ratio for CVD death in the eGFR 45-49 ml/min/1.73 m2 category was significantly increased (1.82; 95% confidential interval, 1.23-2.69 in non-elderly men, whereas all-cause mortality and CVD mortality in elderly men with eGFR 45-49 ml/min/1.73m2 were non significant. In contrast, both in non-elderly women and in elderly women with eGFR 45-49 ml/min/1.73 m2 showed small, but significant, increases in the risks of all-cause mortality and CVD.We demonstrated proportionate increases in mortality with decreasing eGFR in a Japanese CKD population. Like patients in the CKD G3b subgroup, non-elderly men and women with an eGFR of 45-49 ml/min/1.73 m2 (i.e. a part of CKD G3a are at considerable risk of CVD mortality. Age dependent and eGFR dependent finer risk recognition were required for CVD prevention in clinical practice with regard to CKD patients.

  17. Field Monitoring of Cypermethrin Residual Effect on the Mortality Rates of the Phlebotomine Sand Fly Lutzomyia longipalpis in the State of Paraíba, Brazil

    Directory of Open Access Journals (Sweden)

    Laura Ney Marcelino Passerat De Silans

    1998-05-01

    Full Text Available In a visceral leishmaniasis endemic locality of northeast of Brasil where all settlements were treated with cypermethrin, a follow-up of Lutzomyia longipalpis populations was carried out by regular collections. The residual effect of the insecticide was studied using biological assays on three different types of walls. The results showed that the insecticides had an effect on intradomiciliar Lu. longipalpis populations limited to two months, and had no significant effect on peridomiciliar vector populations. The mortality rates of the tested sandflies were variable according to the type of wall. The decreasing of the insecticide effect was marked since the 3rd month, and mortality rates were identical whatever the type of wall since the 4th month. Unsufficient residual effect was detected after the 4th month.

  18. Risk Factors for Malformations and Impact on Reproductive Performance and Mortality Rates of Schmallenberg Virus in Sheep Flocks in the Netherlands

    OpenAIRE

    Luttikholt, Saskia; Veldhuis, Anouk; van den Brom, René; Moll, Lammert; Lievaart-Peterson, Karianne; Peperkamp, Klaas; Van Schaik, Gerdien; Vellema, Piet

    2014-01-01

    In Northwestern Europe, an epizootic outbreak of congenital malformations in newborn lambs due to infection with Schmallenberg virus (SBV) started at the end of 2011. The objectives of this study were to describe clinical symptoms of SBV infection, the effect of infection on mortality rates, and reproductive performance in sheep, as well as to identify and quantify flock level risk factors for SBV infections resulting in malformations in newborn lambs. A case-control study design was used, wi...

  19. A meta-analysis comparing the effect of PCV2 vaccines on average daily weight gain and mortality rate in pigs from weaning to slaughter.

    Science.gov (United States)

    Kristensen, Charlotte Sonne; Baadsgaard, Niels Peter; Toft, Nils

    2011-03-01

    The aim of this investigation was, through a meta-analysis, to review the published literature concerning the effect of PCV2 vaccination on the average daily weight gain (ADG) and on the mortality rate in pigs from weaning to slaughter. The review was restricted to studies investigating the effect of vaccines against PCV2 published from 2006 to 2008, identified using computerised literature databases. Only studies that met the following criteria were included: commercial vaccines were used, pigs or pens were assigned randomly to vaccination versus control groups in herds naturally infected with PCV2, and vaccinated and non-vaccinated pigs were housed together. Furthermore, it was a requirement that sample size, age at vaccination, and production period were stated. The levels of ADG and mortality rate had to be comparable to those seen in modern intensive swine production. In total, 107 studies were identified; 70 were excluded because they did not fulfil the inclusion criteria and 13 were identical to results published elsewhere. A significant effect of PCV2 vaccination on ADG was found for pigs in all production phases. The largest increase in ADG was found for finishing pigs (41.5g) and nursery-finishing pigs (33.6g) with only 10.6g increase in the nursery pigs. Mortality rate was significantly reduced for finishing pigs (4.4%) and nursery-finishing pigs (5.4%), but not for nursery pigs (0.25%). Herds negative for PRRS had a significantly larger increase in ADG compared to herds positive for PRRS. The PRRS status had no effect on mortality rate.

  20. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Mäkikallio, T H; Høiber, S; Køber, L;

    1999-01-01

    A number of new methods have been recently developed to quantify complex heart rate (HR) dynamics based on nonlinear and fractal analysis, but their value in risk stratification has not been evaluated. This study was designed to determine whether selected new dynamic analysis methods of HR.......17, 95% confidence interval 1.96 to 5.15, p negative predictive accuracies of 65% and 86%, respectively. In the multivariable Cox proportional hazards analysis, mortality was independently predicted by the reduced exponent alpha (p

  1. In Hospital and 3-Month Mortality and Functional Recovery Rate in Patients Treated for Hip Fracture by a Multidisciplinary Team

    Science.gov (United States)

    Rostagno, Carlo; Buzzi, Roberto; Campanacci, Domenico; Boccacini, Alberto; Cartei, Alessandro; Virgili, Gianni; Belardinelli, Andrea; Matarrese, Daniela; Ungar, Andrea; Rafanelli, Martina; Gusinu, Roberto; Marchionni, Niccolò

    2016-01-01

    Objectives Medical comorbidities affect outcome in elderly patients with hip fracture. This study was designed to preliminarily evaluate the usefulness of a hip-fracture unit led by an internal medicine specialist. Methods In-hospital and 3-month outcomes in patients with hip fracture were prospectively evaluated in 121 consecutive patients assessed before and followed after surgery by a multidisciplinary team led by internal medicine specialist; 337 consecutive patients were recalled from ICD-9 discharge records and considered for comparison regarding in-hospital mortality. Results In the intervention period, patients treated within 48 hours were 54% vs. 26% in the historical cohort (P<0.0001). In-hospital mortality remained stable at about 2.3 per 1000 person-days. At 3 months, 10.3% of discharged patients had died, though less than 8% of patients developed postoperative complications (mainly pneumonia and respiratory failure). The presence of more than 2 major comorbidities and the loss of 3 or more BADL were independent predictors of death. 50/105 patients recovered previous functional capacity, but no independent predictor of functional recovery could be identified. Mean length of hospital stay significantly decreased in comparison to the historical cohort (13.6± 4.7 vs 17 ± 5 days, p = 0.0001). Combined end-point of mortality and length of hospitalization < 12 days was significantly lower in study period (27 vs 34%, p <0.0132). Conclusions Identification and stabilization of concomitant clinical problems by internal medicine specialists may safely decrease time to surgery in frail subjects with hip fracture. Moreover, integrated perioperative clinical management may shorten hospital stay with no apparent increase in in-hospital mortality and ultimately improve the outcome. These results are to be confirmed by a larger study presently ongoing at our institution. PMID:27389193

  2. An ecological study of cancer mortality rates in the United States with respect to solar ultraviolet-B doses, smoking, alcohol consumption and urban/rural residence.

    Science.gov (United States)

    Grant, William B

    2010-04-01

    The Cohort Consortium Vitamin D Polling Project of Rarer Cancers (VDPP ) study failed to find a beneficial role of prediagnostic serum 25-hydroxyvitamin D [25(OH)D] levels on risk of seven types of rarer cancer: endometrial, esophageal, gastric, kidney, ovarian and pancreatic cancer and non-Hodgkin's lymphoma (NHL). However, ecological studies and studies of oral vitamin D intake have generally found solar ultraviolet B (UVB) and oral vitamin D inversely correlated with incidence and/or mortality rates of these cancers. To explore the discrepancy, I conducted an ecological study of cancer mortality rates for white Americans in the United States for 1950-1994 with data for 503 state economic areas in multiple linear regression analyses with respect to UVB for July, lung cancer, alcohol consumption and urban/rural residence. UVB was significantly inversely correlated with six types of cancer (not pancreatic cancer) in both periods. However, the adjusted R(2) values were much lower for cancers with lower mortality rates than those in an earlier ecological study that used state-averaged data. This finding suggests that the VDPP study may have had too few cases. Thus, the VDPP study should not be considered as providing strong evidence against the solar UVB-vitamin D-cancer hypothesis.

  3. Impact of Glasgow Coma Scale score and pupil parameters on mortality rate and outcome in pediatric and adult severe traumatic brain injury: a retrospective, multicenter cohort study.

    Science.gov (United States)

    Emami, Pedram; Czorlich, Patrick; Fritzsche, Friederike S; Westphal, Manfred; Rueger, Johannes M; Lefering, Rolf; Hoffmann, Michael

    2017-03-01

    OBJECTIVE Prediction of death and functional outcome is essential for determining treatment strategies and allocation of resources for patients with severe traumatic brain injury (TBI). The aim of this study was to evaluate, by using pupillary status and Glasgow Coma Scale (GCS) score, if patients with severe TBI who are ≤ 15 years old have a lower mortality rate and better outcome than adults with severe TBI. METHODS A retrospective cohort analysis of patients suffering from severe TBI registered in the Trauma Registry of the German Society for Trauma Surgery between 2002 and 2013 was undertaken. Severe TBI was defined as an Abbreviated Injury Scale of the head (AIShead) score of ≥ 3 and an AIS score for any other part of the body that does not exceed the AIShead score. Only patients with complete data (GCS score, age, and pupil parameters) were included. To assess the impact of GCS score and pupil parameters, the authors also used the recently introduced Eppendorf-Cologne Scale and divided the study population into 2 groups: children (0-15 years old) and adults (16-55 years old). Each patient's outcome was measured at discharge from the trauma center by using the Glasgow Outcome Scale. RESULTS A total of 9959 patients fulfilled the study inclusion criteria; 888 (8.9%) patients were ≤ 15 years old (median 10 years). The overall mortality rate and the mortality rate for patients with a GCS of 3 and bilaterally fixed and dilated pupils (19.9% and 16.3%, respectively) were higher for the adults than for the pediatric patients (85% vs 80.9%, respectively), although cardiopulmonary resuscitation rates were significantly higher in the pediatric patients (5.6% vs 8.8%, respectively). In the multivariate logistic regression analysis, no motor response (OR 3.490, 95% CI 2.240-5.435) and fixed pupils (OR 4.197, 95% CI 3.271-5.386) and bilateral dilated pupils (OR 2.848, 95% CI 2.282-3.556) were associated with a higher mortality rate. Patients ≤ 15 years old had a

  4. Usefulness of heart rate to predict one-year mortality in patients with atrial fibrillation and acute myocardial infarction (from the OMEGA trial).

    Science.gov (United States)

    Li, Jin; Becker, Ruediger; Rauch, Bernhard; Schiele, Rudolf; Schneider, Steffen; Riemer, Thomas; Diller, Frank; Gohlke, Helmut; Gottwik, Martin; Steinbeck, Gerhard; Sabin, Georg; Katus, Hugo A; Senges, Jochen

    2013-03-15

    In the setting of acute myocardial infarction and sinus rhythm, the heart rate (HR) has been demonstrated to correlate closely with mortality. In patients presenting with acute myocardial infarction and atrial fibrillation (AF) on admission, however, the prognostic relevance of the HR has not yet been systematically addressed. A post hoc subgroup analysis of the data from the OMEGA trial was conducted to analyze whether the admission HR determines the 1-year mortality in patients presenting with AF in the setting of acute myocardial infarction. Of 3,851 patients enrolled in the OMEGA study, 211 (6%) presented with AF on admission. This subgroup was dichotomized according to the admission HR (cutoff 95 beats/min). Multiple regression analysis revealed that an admission HR of ≥95 beats/min independently determined the 1-year mortality in patients with AF (odds ratio 4.69, 95% confidence interval 1.47 to 15.01; p = 0.01). In conclusion, this is the first study demonstrating that a high HR (≥95 beats/min) on admission in patients with AF and acute myocardial infarction is associated with an almost fivefold mortality risk.

  5. Asthma mortality in Danish children and young adults, 1973-1994

    DEFF Research Database (Denmark)

    Jørgensen, I M; Bülow, S; Jensen, V B

    2000-01-01

    Several reports indicate that asthma mortality has increased during the last few decades. International comparisons reveal some striking differences in the pattern of asthma mortality. The authors investigated the asthma mortality rate in the Danish child and youth population 1973-1994 and studied...... the validity of death certificates. The authors reviewed all death certificates coded as asthma death in the International Classification of Diseases (ICD 8-ICD 10 (1994)) and adjacent respiratory code numbers for the age group 1-19 yrs. Hospital records and autopsy reports were assessed to validate the cause...... of death. Age-standardized and age-specific mortality rates were calculated. From 1973 to 1987 there was a significant upward trend in the mortality. On subdivision, this trend was limited to the age group 15-19 yrs. Generally the mortality rate decreased from 1988 to 1994. Four per cent coded as asthma...

  6. A Meta-Analysis of Adult-Rated Child Personality and Academic Performance in Primary Education

    Science.gov (United States)

    Poropat, Arthur E.

    2014-01-01

    Background: Personality is reliably associated with academic performance, but personality measurement in primary education can be problematic. Young children find it difficult to accurately self-rate personality, and dominant models of adult personality may be inappropriate for children. Aims: This meta-analysis was conducted to determine the…

  7. Parent-child parallel nutritional status assessment using silhouette rating scales

    Directory of Open Access Journals (Sweden)

    Jorga Jagoda B.

    2004-01-01

    Full Text Available Introduction The aim of this study was to determine the validity of silhouettes in assessing genetic factors of obesity in school children aged 12-14. Material and methods 290 primary school students aged 12-14 from Belgrade had undergone body height and weight measurements as well as answering questionnaires. Silhouette rating scales were used to assess the nutritional status of students (6-silhouette scale and their parents (9-silhouette scale. Results Significant differences in body mass index (BMI were found among children whose parents had been rated "normal" and those rated “problematic”. BMI status and gender significantly affected assessment of the nutritional status. An interaction between factors was found (F (1.230 =7.017, p<0.01. The majority of children from the normal BMI category (64.5% selected silhouettes 3 and 4 to describe their current appearance. On the other hand, 70% of children with problematic BMI selected silhouettes 5 and 6. Girls generally selected significantly smaller silhouettes than boys. Girls within the problematic BMI category selected significantly bigger silhouettes for their mother's than the other children. Boys within the normal BMI category, selected significantly bigger silhouettes representing their father’s body size. Discussion According to the results, silhouette rating scales appear to be reliable in parallel assessment of the nutritional status of children and their parents. This subject can be further developed by acquiring data on parents` height and body mass.

  8. Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales

    Science.gov (United States)

    Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

    2012-01-01

    Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

  9. Resting heart rate is associated with cardiovascular and all-cause mortality after adjusting for inflammatory markers: The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Marott, Jacob L; Allin, Kristine H

    2012-01-01

    Aims: To investigate the association between resting heart rate (RHR) and markers of chronic low-grade inflammation. Also, to examine whether elevated resting heart rate is independently associated with cardiovascular and all-cause mortality in the general population, or whether elevated RHR...... is merely a marker of chronic low-grade inflammation. Methods and results: A group of 6518 healthy subjects from the the Danish general population were followed for 18 years during which 1924 deaths occurred. Subjects underwent assessment of baseline RHR, conventional cardiovascular risk factors, high...

  10. Diabetes Mellitus Increased Mortality Rates More in Gender-Specific than in Nongender-Specific Cancer Patients: A Retrospective Study of 149,491 Patients

    Directory of Open Access Journals (Sweden)

    Wen-Ko Chiou

    2012-01-01

    Full Text Available Aims. Hyperinsulinemia in overweight status, obesity, and type 2 diabetes mellitus (DM is often accompanied by cancer. Gender is important in cancer epidemiology, clinical presentation, and response to therapy in different histological types of malignancy. Insufficient information is available concerning gender differences in DM with organ-specific and nonorgan-specific cancers. This study aimed to analyze gender differences in hospitalized cancer patients with or without type 2 DM. Methods. We retrospectively reviewed ten years of patients hospitalized in one institution, enrolling 36,457 female and 50,004 male cancer patients of which 5,992 females and 8,345 males were diagnosed as type 2 DM. Results. Statistically significant increases in incidence of type 2 DM were found in patients of both genders with pancreatic, liver, and urinary tract cancer. Increased incidence of type 2 DM was found in lung and hematologic malignancies in females and prostate cancer in males. Increases in mortality rates of females with type 2 DM (2.98% were higher than those in males. DM increased mortality rates in gender-specific cancers from 1.91% (uterus, HR: 1.33 to 5.04% (ovary, HR: 1.49. Conclusion. Type 2 DM increased mortality of cancer patients of both genders, with higher increases in gender-specific than in nongender-specific cancers.

  11. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan.

    Science.gov (United States)

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-03-01

    Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997-2004) to 4.9 to 5.3/case in the later cohort (2005-2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10-1.18) and death (HR = 1.05, 95% CI = 1.01-1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82-6.73) and death (aOR = 1.75, 95% CI = 1.17-2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final

  12. Disparities in child health in the Arab region during the 1990s

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    Meyerson-Knox Sonya

    2008-11-01

    Full Text Available Abstract Background While Arab countries showed an impressive decline in child mortality rates during the past few decades, gaps in mortality by gender and socioeconomic status persisted. However, large socioeconomic disparities in child health were evident in almost every country in the region. Methods Using available tabulations and reliable micro data from national household surveys, data for 18 Arab countries were available for analysis. In addition to infant and child mortality, child health was measured by nutritional status, vaccination, and Acute Respiratory Infection (ARI. Within-country disparities in child health by gender, residence (urban/rural and maternal educational level were described. Child health was also analyzed by macro measures of development, including per capita GDP (PPP, female literacy rates, urban population and doctors per 100,000 people. Results Gender disparities in child health using the above indicators were less evident, with most showing clear female advantage. With the exception of infant and child survival, gender disparities demonstrated a female advantage, as well as a large urban advantage and an overall advantage for mothers with secondary education. Surprisingly, the countries' rankings with respect to disparities were not associated with various macro measures of development. Conclusion The tenacity of pervasive intra-country socioeconomic disparities in child health calls for attention by policy makers and health practitioners.

  13. The SPAIC-11 and SPAICP-11: Two Brief Child- and Parent-Rated Measures of Social Anxiety

    OpenAIRE

    Bunnell, Brian E.; Beidel,Deborah C.; LIU, LIWEN; Joseph, Dana L.; Higa-McMillan, Charmaine

    2015-01-01

    The Social Phobia and Anxiety Inventory for Children-11 (SPAIC-11) and Social Phobia and Anxiety Inventory for Children’s Parents-11 (SPAICP-11) were developed as brief versions of the Social Phobia and Anxiety Inventory - Child and Parent Versions via item response theory (IRT) using child and parent reports of social anxiety. A sample of 496 children was analyzed using IRT analyses, revealing 11 items that exhibit measurement equivalence across parent and child reports. Descriptive and psyc...

  14. Modal analysis of the deep-water solitary scleractinian, Desmophyllum dianthus, on SW Pacific seamounts: inferred recruitment periodicity, growth, and mortality rates

    Science.gov (United States)

    Thresher, R. E.; Adkins, J.; Thiagarajan, N.

    2011-12-01

    Little is known about the demography of corals inhabiting deep-sea features due to the logistical difficulties of working at the extreme depths they inhabit. To obtain basic information about growth, mortality, and recruitment dynamics for such a coral, we applied modal analysis to the size frequency distributions of live-caught and sub-fossil specimens of the widely distributed solitary cup coral, Desmophyllum dianthus, collected on SW Pacific seamounts. Comparison of live-caught material collected in 1997 and 2007-2009 indicated modal progression over time and an implied maximum age of approximately 190 years, which is similar to ages determined previously for D. dianthus using radiometric techniques. A log-linear decline in the number of individuals with increasing size further implies a constant adult mortality rate, of 15.1% per annum in 1997 and 9.2% per annum in 2007-2009. The spacing of size modes in the 2007-2009 samples suggests regularly episodic recruitment events, at 22- to 32-year intervals, which may relate to periodic variability in large-scale Southern Ocean circulation. Preliminary analyses of size frequency distributions of the sub-fossil material suggest that the trophodynamics, growth, and adult mortality schedules of D. dianthus in the SW Pacific have remained basically similar throughout the Holocene.

  15. Glomerular filtration rate and proteinuria: association with mortality and renal progression in a prospective cohort of a community-based elderly population.

    Directory of Open Access Journals (Sweden)

    Se Won Oh

    Full Text Available Limited prospective data are available on the importance of estimated glomerular filtration rate (GFR and proteinuria in the prediction of all-cause mortality (ACM in community-based elderly populations. We examined the relationship between GFR or proteinuria and ACM in 949 randomly selected community-dwelling elderly subjects (aged ≥65 years over a 5-year period. A spot urine sample was used to measure proteinuria by the dipstick test, and GFR was estimated using the chronic kidney disease-epidemiology collaboration (CKD-EPI equation. Information about mortality and causes of death was collected by direct enquiry with the subjects and from the national mortality data. Compared to subjects without proteinuria, those with proteinuria of grade ≥1+ had a 1.725-fold (1.134-2.625 higher risk of ACM. Compared to subjects with GFR ≥90 ml/min/1.73 m2, those with GFR<45 ml/min/1.73 m2 had a 2.357 -fold (1.170-4.750 higher risk for ACM. Among the 403 subjects included in the analysis of renal progression, the annual rate of GFR change during follow-up period was -0.52±2.35 ml/min/1.73 m2/year. The renal progression rate was 7.315-fold (1.841-29.071 higher in subjects with GFR<60 ml/min/1.73 m2 than in those with GFR ≥60 ml/min/1.73 m2. Among a community-dwelling elderly Korean population, decreased GFR of <45 ml/min/1.73 m2 and proteinuria were independent risk factors for ACM.

  16. Low rates of mother-to-child HIV transmission in a routine programmatic setting in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Maria H Kim

    Full Text Available BACKGROUND: The Tingathe program utilizes community health workers to improve prevention of mother-to-child transmission (PMTCT service delivery. We evaluated the impact of antiretroviral (ARV regimen and maternal CD4+ count on HIV transmission within the Tingathe program in Lilongwe, Malawi. METHODS: We reviewed clinical records of 1088 mother-infant pairs enrolled from March 2009 to March 2011 who completed follow-up to first DNA PCR. Eligibility for antiretroviral treatment (ART was determined by CD4+ cell count (CD4+ for women not yet on ART. ART-eligible women initiated stavudine-lamivudine-nevirapine. Early ART was defined as ART for ≥14 weeks prior to delivery. For women ineligible for ART, optimal ARV prophylaxis was maternal AZT ≥6 weeks+sdNVP, and infant sdNVP+AZT for 1 week. HIV transmission rates were determined for ARV regimens, and factors associated with vertical transmission were identified using bivariate logistic regression. RESULTS: Transmission rate at first PCR was 4.1%. Pairs receiving suboptimal ARV prophylaxis were more likely to transmit HIV (10.3%, 95% CI, 5.5-18.1%. ART was associated with reduced transmission (1.4%, 95% CI, 0.6-3.0%, with early ART associated with decreased transmission (no transmission, compared to all other treatment groups (p = 0.001. No association was detected between transmission and CD4+ categories (p = 0.337, trimester of pregnancy at enrollment (p = 0.100, or maternal age (p = 0.164. CONCLUSION: Low rates of MTCT of HIV are possible in resource-constrained settings under routine programmatic conditions. No transmissions were observed among women on ART for more than 14 weeks prior to delivery.

  17. Studying the Effective Factors of Mortality Rate in Babies Under One Year (Case Study: Kerman (Iran Villages during Third Development Project In 2005-2009

    Directory of Open Access Journals (Sweden)

    Abbas Ferdosi

    2012-12-01

    Full Text Available As infants are the most vulnerable people in a population, so their mortality is painful and difficult to bear. In revealing infants mortality, merely physiological factors aren’t effective. Health, economic and social factors had considerable effects on the frequencies of this index. This is a health index and also indicates economic, social and cultural development, as high rate of disease and mortality especially among infants and children not only shows low level of society’s health but also is a sign of lacking enough health training. The current research is documentary in which some questionnaires were used to gather needed information using available documents in health house and answering the questions in them. To determine the causal model of research some theories such as the relation of morality economic development, epidemiologic transition theory, population transition theory, medical technology development theory and ecologic theory were used. From all alive births during fourth development project (2005-2009 all through the villages of Kerman, 104 dead infants under one year (statistics and 150 alive infants under one year (sampling were selected, and a questionnaire was completed based on available information in files from health house by auxiliary nurses and some cases which weren’t in the files were completed referring their houses. Results of research indicated that dead infants in the first month of life are more than dead infants in the next months. Generally among independent variables, age, parents job, parents education history, family income, kind of house, distance of house from health house and nutrition have a meaningful relation to infants mortality.

  18. Length frequency distribution, mortality rate and reproductive biology of kawakawa (Euthynnus affinis-Cantor, 1849) in the coastal waters of Tanzania.

    Science.gov (United States)

    Johnson, M G; Tamatamah, A R

    2013-11-01

    This study explored important aspect of the basis for the highly complex population of kawakawa (Euthynnus affinis) within the coastal waters of Tanzania; by investigating length frequency distribution, mortality rate and reproductive characteristics. This information is essential for the sustainable management of the regionally-important recreational and economic E. affinis fishery. Fish were sampled on a monthly basis for two monsoon seasons using a ring net and artisanal fishermen boat. Maximum and minimum total length was 85 and 31 cm, respectively. Nonlinear least square fitting provided a complete set of von Bertalanffy growth estimates: L8 = 89.25 cm total length and K = 0.78. The estimated value of total mortality based on length converted catch curve using these growth parameters is Z = 1.78 year(-1). Natural mortality based on growth parameters and mean environmental temperature (T = 26.9 degrees C) is M = 1.09 year(-1). The estimated annual instantaneous fishing mortality (F = 0.69 year(-1)) was considerably grater than the target (Fopt = 0.43 year(-1)) and limit (Flimit = 0.58 year(-1)) biological reference point indicating that E. affinis is heavily overexploited. Reproductive aspects were assessed whereby female E. affinis was reported to reach maturity earlier than males which is an indication of phenotypic response toward a decline in population. Two peaks was revealed by the use of Gonad-Somatic Index (GSI), however an extended spawning period was noticed in a period between November to February following an increased water temperature. Although, these findings presents a snapshot concerning population structure and reproduction of E. affinis, further studies covering the entire coastal waters of Tanzania are recommended to aid the management and conservation strategies.

  19. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

    Directory of Open Access Journals (Sweden)

    Yadav Sudha

    1998-01-01

    Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

  20. Base Rates, Multiple Indicators, and Comprehensive Forensic Evaluations: Why Sexualized Behavior Still Counts in Assessments of Child Sexual Abuse Allegations

    Science.gov (United States)

    Everson, Mark D.; Faller, Kathleen Coulborn

    2012-01-01

    Developmentally inappropriate sexual behavior has long been viewed as a possible indicator of child sexual abuse. In recent years, however, the utility of sexualized behavior in forensic assessments of alleged child sexual abuse has been seriously challenged. This article addresses a number of the concerns that have been raised about the…

  1. Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium’s findings

    Science.gov (United States)

    Salgado Yepez, Estuardo; Bovera, Maria M; Rosenthal, Victor D; González Flores, Hugo A; Pazmiño, Leonardo; Valencia, Francisco; Alquinga, Nelly; Ramirez, Vanessa; Jara, Edgar; Lascano, Miguel; Delgado, Veronica; Cevallos, Cristian; Santacruz, Gasdali; Pelaéz, Cristian; Zaruma, Celso; Barahona Pinto, Diego

    2017-01-01

    AIM To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador. METHODS A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection (CLABSI) rate was 6.5 per 1000 central line (CL)-days, the ventilator-associated pneumonia (VAP) rate was 44.3 per 1000 mechanical ventilator (MV)-days, and the catheter-associated urinary tract infection (CAUTI) rate was 5.7 per 1000 urinary catheter (UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9 (CLABSI) and 5.3 (CAUTI)] and higher than NHSN rates [0.8 (CLABSI) and 1.3 (CAUTI)] - although device use ratios for CL and UC were higher than INICC and CDC/NSHN’s ratios. By contrast, despite the VAP rate was higher than INICC (16.5) and NHSN’s rates (1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates. PMID:28289522

  2. The SPAIC-11 and SPAICP-11: Two Brief Child- and Parent-Rated Measures of Social Anxiety

    Science.gov (United States)

    Bunnell, Brian E.; Beidel, Deborah C.; Liu, Liwen; Joseph, Dana L.; Higa-McMillan, Charmaine

    2015-01-01

    The Social Phobia and Anxiety Inventory for Children-11 (SPAIC-11) and Social Phobia and Anxiety Inventory for Children’s Parents-11 (SPAICP-11) were developed as brief versions of the Social Phobia and Anxiety Inventory - Child and Parent Versions via item response theory (IRT) using child and parent reports of social anxiety. A sample of 496 children was analyzed using IRT analyses, revealing 11 items that exhibit measurement equivalence across parent and child reports. Descriptive and psychometric data are provided for the child, parent, and combined total scores. Discriminant validity was demonstrated using logistic regression and receiver operating characteristic curve analyses. The SPAIC-11 and SPAICP-11 are psychometrically sound measures that are able to measure social anxiety invariantly across children and their parents. These brief measures which include combined parent and child perception of the child’s social anxiety may provide notable benefits to clinical research. PMID:26500188

  3. A short-term sublethal toxicity assay with zebra fish based on preying rate and its integration with mortality.

    Science.gov (United States)

    Abdel-moneim, Ahmed; Moreira-Santos, Matilde; Ribeiro, Rui

    2015-02-01

    Contaminant-induced feeding inhibition has direct and immediate consequences at higher levels of biological organization, by depressing the population consumption and thus hampering ecosystem functioning (e.g. grazing, organic matter decomposition). Thus, similarly to lethality and avoidance, feeding is mechanistically linked to ecosystem processes and is therefore an unequivocal ecologically meaningful response. The objective of the present study was to develop a short-term assay with the small freshwater fish Danio rerio, based on feeding. For this, a methodology to easily and precisely quantify feeding was first optimized: each fish was allowed to prey on ten live Daphnia magna juveniles, for 1h, just before the end of a 48-h exposure test period. Secondly, copper sensitivity of feeding relatively to survival and growth was evaluated. At the growth EC20 (40 μg L(-1)), feeding was inhibited by 53%, and at the feeding EC50 (36 μg L(-1)), mortality was negligible (1.3%). Integrating feeding and survival revealed a 97% depression in the population consumption at the LC50 (61 μg L(-1)). Thirdly, the influence of pH, conductivity and hardness on the feeding background variability was assessed by assaying waters collected at eight reference sites and was found to be negligible, within tested ranges. Fourthly, feeding assays with natural waters contaminated with acid mine drainage confirmed the integration of lethality and feeding to be pertinent at estimating contaminant effects at higher levels of biological organization.

  4. The impact of caregiver support on mortality following burn injury in the elderly.

    Science.gov (United States)

    Alsafran, Salman K; Davis, James S; Tankel, Susan; Varas, Robin; Quintana, Olga; Manning, Ron; Glenn, Candace; Pizano, Louis R; Namias, Nicholas; Schulman, Carl I

    2013-01-01

    Advances in burn care have decreased mortality in the past 20 years, but affecting elderly mortality rates (>65 years) remain challenging. This study evaluates the impact of home caregiver support on elderly burn patients' mortality. The authors retrospectively reviewed patients aged 65 and older admitted to their burn center from July 1995 to October 2004. Patient demographics, Injury Severity Score, TBSA, and patients' primary caregiver were collected. The outcomes were mortality, disposition, and length of stay and these were evaluated using univariate and subsequently multivariate regression. Significance was calculated at P ≤ .05. A total of 112 patients were included in the analysis. The mean age was 76±8. Male patients constituted 47%, whereas 53% were female patients, and mean TBSA was 21±16%. Thirty patients' primary caregiver was a spouse, for 38 it was a child, and 44 had no caregiver. Fifty-eight patients survived (51.7%), and 54 patients died (48.3%). Only 21% of the survivors had a child as their primary caregiver; however, 48% of the nonsurvivors had a child as the primary caregiver (P ≤ 0.05). On multivariate analysis, age, TBSA, and child as primary caregiver were all independent predictors of mortality. Having a child as a caregiver provided the largest impact, with an odds ratio of 4.4 (95% confidence interval, 1.2-15.62; P = .02).

  5. The unfinished health agenda: Neonatal mortality in Cambodia

    Science.gov (United States)

    Hong, Rathmony; Ahn, Pauline Yongeun; Rathavy, Tung; Gauthier, Ludovic; Hong, Rathavuth; Laillou, Arnaud

    2017-01-01

    Background Reduction of neonatal and under-five mortality rates remains a primary target in the achievement of universal health goals, as evident in renewed investments of Sustainable Development Goals. Various studies attribute declines in mortality to the combined effects of improvements in health care practices and changes in socio-economic factors. Since the early nineties, Cambodia has managed to evolve from a country devastated by war to a nation soon to enter the group of middle income countries. Cambodia's development efforts are reflected in some remarkable health outcomes such as a significant decline in child mortality rates and the early achievement of related Millennium Development Goals. An achievement acknowledged through the inclusion of Cambodia as one of the ten fast-track countries in the Partnership for Maternal, Newborn and Child Health. This study aims to highlight findings from the field so to provide evidence for future programming and policy efforts. It will be argued that to foster further advances in health, Cambodia will need to keep neonatal survival and health high on the agenda and tackle exacerbating inequities that arise from a pluralistic health system with considerable regional differences and socio-economic disparities. Methods/Findings Data was drawn from Demographic Health Surveys (2000, 2005, 2010, 2014). Information on a series of demographic and socio-economic household characteristics and on child anthropometry, feeding practices and child health were collected from nationally representative samples. To reach the required sample size, live-births that occurred over the past 10 years before the date of the interview were included. Demographic variables included: gender of the child, living area (urban or rural; four ecological regions (constructed by merging provinces and the capital), mother’s age at birth (asset-based index). Data on antenatal care, tetanus injection and skilled assistance at birth were used for the

  6. Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates.

    Directory of Open Access Journals (Sweden)

    Tom H Boyles

    Full Text Available BACKGROUND: Antibiotic consumption is a major driver of bacterial resistance. To address the increasing burden of multi-drug resistant bacterial infections, antibiotic stewardship programmes are promoted worldwide to rationalize antibiotic prescribing and conserve remaining antibiotics. Few studies have been reported from developing countries and none from Africa that report on an intervention based approach with outcomes that include morbidity and mortality. METHODS: An antibiotic prescription chart and weekly antibiotic stewardship ward round was introduced into two medical wards of an academic teaching hospital in South Africa between January-December 2012. Electronic pharmacy records were used to collect the volume and cost of antibiotics used, the patient database was analysed to determine inpatient mortality and 30-day re-admission rates, and laboratory records to determine use of infection-related tests. Outcomes were compared to a control period, January-December 2011. RESULTS: During the intervention period, 475.8 defined daily doses were prescribed per 1000 inpatient days compared to 592.0 defined daily doses/1000 inpatient days during the control period. This represents a 19.6% decrease in volume with a cost reduction of 35% of the pharmacy's antibiotic budget. There was a concomitant increase in laboratory tests driven by requests for procalcitonin. There was no difference in inpatient mortality or 30-day readmission rate during the control and intervention periods. CONCLUSIONS: Introduction of antibiotic stewardship ward rounds and a dedicated prescription chart in a developing country setting can achieve reduction in antibiotic consumption without harm to patients. Increased laboratory costs should be anticipated when introducing an antibiotic stewardship program.

  7. Demographic and clinical characteristics of red tag patients and their one-week mortality rate from the emergency department of the Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Ahmad, Rashidi; Rahmat, Rashdan; Hisamudin, Nik; Rahman, Nik Abdul; Noh, Abu Yazid Mohd; Mohammad, Nasir; Wahab, Sheik Farid Abdul; Zaini, Ida Zarina

    2009-11-01

    Early identification and rapid treatment of red tag patients may decrease morbidity and mortality. We examined the clinical characteristics, etiologies and one week mortality rate of red tag (life threatening and potentially life threatening illness) patients at the Hospital Universiti Sains Malaysai (HUSM). A cross-sectional study was conducted at the Emergency Department of the HUSM from 1 August 2006 to 31 January 2007; 440 eligible patients were analyzed. The group had a mean age of 47.2 +/- 22 years, with 67.3% of the patients being male. Twenty-three percent were trauma cases with motor vehicle accident being the major mechanism of injury. Fifty-four percent of the cases had cardiac related illnesses. The mean duration of stay in the Emergency Department (ED) was 3.9 +/- 1.5 hours. The survival rate at one week was 76.6%. The non-trauma group comprised 74.0% of death cases. Acute coronary syndrome and road traffic accidents comprised 22.0% of total death cases at one week. Red tag patients constitute a large proportion of ED cases and may remain in the ED for significant periods of time.

  8. Functional outcome, revision rates and mortality after primary total hip replacement--a national comparison of nine prosthesis brands in England.

    Directory of Open Access Journals (Sweden)

    Mark Pennington

    Full Text Available The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee, cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed, and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy.We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS ranging from 0 (worst to 48 (best in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both p<0.001. Patients with hybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7 and those with cemented prostheses the worst (37.7, 37.3 to 38.1. Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4% and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%. Differences in mortality according to prosthesis type were small and not significant (p = 0.06. Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best and cementless prostheses (p = 0.01, with Corail Pinnacle having the best. Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest.Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a benchmark in randomised trials.

  9. Reactions to perceived fairness: The impact of mortality salience and self-esteem on ratings of negative affect

    NARCIS (Netherlands)

    Bos, K. van den

    2001-01-01

    In correspondence with terror management theory, the findings of two experiments show that reminders of death lead to stronger effects of perceived fairness on ratings of negative affect. Furthermore, in line with the theory''s self-esteem mechanism, results of Experiment 1 suggest that state self-e

  10. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality

    NARCIS (Netherlands)

    Coresh, J.; Turin, T.C.; Matsushita, K.; Sang, Y.; Ballew, S.H.; Appel, L.J.; Arima, H.; Chadban, S.J.; Cirillo, M.; Djurdjev, O.; Green, J.A.; Heine, G.H.; Inker, L.A.; Irie, F.; Ishani, A.; Ix, J.H.; Kovesdy, C.P.; Marks, A.; Ohkubo, T.; Shalev, V.; Shankar, A.; Wen, C.P.; Jong, P.E. de; Iseki, K.; Stengel, B.; Gansevoort, R.T.; Levey, A.S.; Wetzels, J.F.M.

    2014-01-01

    IMPORTANCE: The established chronic kidney disease (CKD) progression end point of end-stage renal disease (ESRD) or a doubling of serum creatinine concentration (corresponding to a change in estimated glomerular filtration rate [GFR] of -57% or greater) is a late event. OBJECTIVE: To characterize th

  11. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality

    NARCIS (Netherlands)

    Coresh, Josef; Turin, Tanvir Chowdhury; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana H.; Appel, Lawrence J.; Arima, Hisatomi; Chadban, Steven J.; Cirillo, Massimo; Djurdjev, Ognjenka; Green, Jamie A.; Heine, Gunnar H.; Inker, Lesley A.; Irie, Fujiko; Ishani, Areef; Ix, Joachim H.; Kovesdy, Csaba P.; Marks, Angharad; Ohkubo, Takayoshi; Shalev, Varda; Shankar, Anoop; Wen, Chi Pang; de Jong, Paul E.; Iseki, Kunitoshi; Stengel, Benedicte; Gansevoort, Ron T.; Levey, Andrew S.

    2014-01-01

    IMPORTANCE: The established chronic kidney disease (CKD) progression end point of end-stage renal disease (ESRD) or a doubling of serum creatinine concentration (corresponding to a change in estimated glomerular filtration rate [GFR] of −57% or greater) is a late event. OBJECTIVE: To characterize th

  12. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses

    DEFF Research Database (Denmark)

    Christophersen, Mogens Teken; Dupont, Nana Hee; Berg-Sørensen, Kristina S.

    2014-01-01

    or social factors such as attitudes towards animal suffering and euthanasia. The aims of this study were to 1) describe and analyse characteristics in horses with signs of colic referred to the University Hospital for Large Animals (UHLA), University of Copenhagen, Denmark over a 10-year period and 2......) to compare these rates with those published in other comparable studies. Results: The overall survival rate for colic horses over the 10-year study period was 68% (confidence intervals (CI): 66 – 71%; 1087/1588). In the medical group, 1093 horses, short-term survival was 87% (CI: 85 – 89%). Thirty one...... % of referred horses were given diagnoses requiring surgical intervention (CI: 29 – 33%). In this group 32% of the horses were euthanized before surgery (CI: 28 – 36%; 159/495). Of the surgical cases 27% (CI: 23-31%) were euthanized or died during surgery. Of the horses that recovered from surgery 25% died...

  13. Under-5-mortality rate and causes of death in China, 2000 to 2010%中国2000-2010年5岁以下儿童死亡率和死亡原因分析

    Institute of Scientific and Technical Information of China (English)

    冯江; 袁秀琴; 朱军; 李小洪; 缪蕾; 何春花; 王艳萍

    2012-01-01

    目的 评估2000-2010年中国5岁以下儿童死亡率(U5MR)及主要死因别死亡率的变化,评价实现《中国儿童发展纲要(2001-2010年)》(纲要)目标的进展.方法 采用全国5岁以下儿童死亡监测网收集的2000-2010年以人群为基础的监测资料,计算不同地区的婴儿死亡率(IMR)、U5MR及其主要死因别死亡率.结果 2010年全国IMR和U5MR较2000年分别下降59.3%和58.7%,城市IMR和U5MR分别下降50.8%和47.1%,农村IMR和U5MR分别下降56.5%和56.0%.与2000年相比,2010年全国5岁以下儿童主要疾病的死因别死亡率均有下降,但城乡下降程度不同.位于前五位的死因是早产或低出生体重、肺炎、出生窒息、先天性心脏病和意外窒息,城乡儿童主要疾病顺位不完全相同.2010年农村IMR和U5MR均是城市的2.8倍,中、西部地区的IMR分别是东部的1.5倍和2.3倍,U5MR分别是东部的1.5倍和2.2倍.结论 2000-2010年全国IMR、U5MR及主要死因别死亡率有明显下降趋势,且实现了纲要中提出的目标,但缩小地区和人群差异是今后促进儿童健康面临的重大挑战.%Objective To assess the changes and the leading cause of deaths for children under 5 years old,in China,during 2000-2010,with the aim of evaluation on the progress in achieving the relative goal set by "National Program of Action for Child Development in China (2001-2010)",and understanding the related challenges.Methods Data used in this study were collected from the population-based National Maternal and Child' s Health Surveillance Network of China.Infant Mortality Rate (IMR),Under-5-mortality rate (U5MR) and the leading cause of deaths for under-5 children were analyzed.Results Nationwide IMR and U5MR in 2010 dropped by 59.3%and 58.7% respectively,compared to that in 2000.Decreases by 50.8% and 47.1% in IMR and U5MR were observed in urban areas,and 56.5% and 56.0% in rural areas during this period.Compared with data from 2000

  14. Relationship between Receipt of a Social Protection Grant for a Child and Second Pregnancy Rates among South African Women: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Molly Rosenberg

    Full Text Available Social protection programs issuing cash grants to caregivers of young children may influence fertility. Grant-related income could foster economic independence and/or increase access to job prospects, education, and health services, resulting in lower pregnancy rates. In the other direction, these programs may motivate family expansion in order to receive larger grants. Here, we estimate the net effect of these countervailing mechanisms among rural South African women.We constructed a retrospective cohort of 4845 women who first became eligible for the Child Support Grant with the birth of their first child between 1998 and 2008, with data originally collected by the Agincourt Health and Socio-Demographic Surveillance System in Mpumalanga province, South Africa. We fit Cox regression models to estimate the hazard of second pregnancy in women who reported grant receipt after birth of first child, relative to non-recipients. As a secondary analysis to explore the potential for grant loss to incentivize second pregnancy, we exploited a natural experiment created by a 2003 expansion of the program's age eligibility criterion from age seven to nine. We compared second pregnancy rates between (i women with children age seven or eight in 2002 (recently aged out of grant eligibility to (ii women with children age seven or eight in 2003 (remained grant-eligible.The adjusted hazard ratio for the association between grant exposure and second pregnancy was 0.66 (95% CI: 0.58, 0.75. Women with first children who aged out of grant eligibility in 2002 had similar second pregnancy rates to women with first children who remained grant-eligible in 2003 [IRR (95% CI: 0.9 (0.5, 1.4].Across both primary and secondary analyses, we found no evidence that the Child Support Grant incentivizes pregnancy. In harmony with South African population policy, receipt of the Child Support Grant may result in longer spacing between pregnancies.

  15. Abundance of the Quorum-Sensing Factor Ax21 in Four Strains of Stenotrophomonas maltophilia Correlates with Mortality Rate in a New Zebrafish Model of Infection.

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    Mario Ferrer-Navarro

    Full Text Available Stenotrophomonas maltophilia is a Gram-negative pathogen with emerging nosocomial incidence. Little is known about its pathogenesis and the genomic diversity exhibited by clinical isolates complicates the study of pathogenicity and virulence factors. Here, we present a strategy to identify such factors in new clinical isolates of S. maltophilia, incorporating an adult-zebrafish model of S. maltophilia infection to evaluate relative virulence coupled to 2D difference gel electrophoresis to explore underlying differences in protein expression. In this study we report upon three recent clinical isolates and use the collection strain ATCC13637 as a reference. The adult-zebrafish model shows discrimination capacity, i.e. from very low to very high mortality rates, with clinical symptoms very similar to those observed in natural S. maltophilia infections in fish. Strain virulence correlates with resistance to human serum, in agreement with previous studies in mouse and rat and therefore supporting zebrafish as a replacement model. Despite its clinical origin, the collection strain ATCC13637 showed obvious signs of attenuation in zebrafish, with null mortality. Multilocus-sequence-typing analysis revealed that the most virulent strains, UV74 and M30, exhibit the strongest genetic similitude. Differential proteomic analysis led to the identification of 38 proteins with significantly different abundance in the three clinical strains relative to the reference strain. Orthologs of several of these proteins have been already reported to have a role in pathogenesis, virulence or resistance mechanisms thus supporting our strategy. Proof of concept is further provided by protein Ax21, whose abundance is shown here to be directly proportional to mortality in the zebrafish infection model. Indeed, recent studies have demonstrated that this protein is a quorum-sensing-related virulence factor.

  16. Thirty years after Alma-Ata: a systematic review of the impact of community health workers delivering curative interventions against malaria, pneumonia and diarrhoea on child mortality and morbidity in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Lewin Simon

    2011-10-01

    Full Text Available Abstract Background Over thirty years have passed since the Alma-Ata Declaration on primary health care in 1978. Many governments in the first decade following the declaration responded by developing national programmes of community health workers (CHWs, but evaluations of these often demonstrated poor outcomes. As many CHW programmes have responded to the HIV/AIDS pandemic, international interest in them has returned and their role in the response to other diseases should be examined carefully so that lessons can be applied to their new roles. Over half of the deaths in African children under five years of age are due to malaria, diarrhoea and pneumonia - a situation which could be addressed through the use of cheap and effective interventions delivered by CHWs. However, to date there is very little evidence from randomised controlled trials of the impacts of CHW programmes on child mortality in Africa. Evidence from non-randomised controlled studies has not previously been reviewed systematically. Methods We searched databases of published and unpublished studies for RCTs and non-randomised studies evaluating CHW programmes delivering curative treatments, with or without preventive components, for malaria, diarrhoea or pneumonia, in children in sub-Saharan Africa from 1987 to 2007. The impact of these programmes on morbidity or mortality in children under six years of age was reviewed. A descriptive analysis of interventional and contextual factors associated with these impacts was attempted. Results The review identified seven studies evaluating CHWs, delivering a range of interventions. Limited descriptive data on programmes, contexts or process outcomes for these CHW programmes were available. CHWs in national programmes achieved large mortality reductions of 63% and 36% respectively, when insecticide-treated nets and anti-malarial chemoprophylaxis were delivered, in addition to curative interventions. Conclusions CHW programmes could

  17. Occupational mortality

    DEFF Research Database (Denmark)

    Lynge, Elsebeth

    2011-01-01

    INTRODUCTION: This paper aims to present the methods and main results from the Danish occupational mortality studies, and to set the Danish studies into the international context of occupational mortality studies. RESEARCH TOPICS: The first Danish occupational mortality study from 1970...

  18. Effect of a constant rate infusion of cytosine arabinoside on mortality in dogs with meningoencephalitis of unknown origin.

    Science.gov (United States)

    Lowrie, M; Thomson, S; Smith, P; Garosi, L

    2016-07-01

    Administration of cytosine arabinoside (CA) by continuous rate infusion (CRI) has pharmacokinetic and pharmacodynamic advantages over traditional intermittent dosing. Whether these advantages translate into clinical efficacy remains unknown. The aim of this study was to assess the efficacy and safety of CRI of CA in dogs with meningoencephalitis of unknown origin (MUO) and to compare outcomes with a group of historical control dogs treated with conventional intermittent subcutaneous (SC) administration of CA; both groups received adjunctive prednisolone. It was hypothesised that a CRI of CA for 24 h at 100 mg/m(2) would improve survival and lesion resolution compared with conventional SC delivery of 50 mg/m(2) every 12 h for 48 h. Eighty dogs with suspected MUO were recruited from consecutive dogs presenting with suspected MUO from 2006 to 2015. All dogs underwent routine clinical evaluation, magnetic resonance imaging of the brain and cerebrospinal fluid analysis. There were 39 dogs in the SC group and 41 dogs in the CRI group; baseline characteristics were similar in both groups. Survival at 3 months was 22/39 (44%) with SC delivery versus 37/41 (90%) with CRI. No dose-limiting toxicities were noted for either group. The resolution rate of magnetic resonance imaging and cerebrospinal fluid abnormalities at the 3 month re-examination were substantially improved in the CRI group versus the SC group. The CRI regimen produced a survival advantage over the SC route of administration without clinically significant toxicity. These data supports the routine use of CRI at first presentation for the treatment of MUO in dogs.

  19. Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia Septicemia mortal causada por Chromobacterium violaceum en una paciente pediátrica de Colombia

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    Pedro Martinez

    2007-12-01

    Full Text Available A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.Una niña de 4 años que vivía en Colombia presentó historia de fiebre y dolor abdominal severo por cuatro días. La paciente desarrollo neumonía, shock séptico, múltiple falla de órganos y muerte el quinto día de hospitalización. Chromobacterium violaceum fue aislado de cultivos de sangre y mostró resistencia a ampicilina, cefalosporinas, carbapenems y aminoglicosidos.

  20. Wall motion index, estimated glomerular filtration rate and mortality risk in patients with heart failure or myocardial infarction: a pooled analysis of 18,010 patients

    DEFF Research Database (Denmark)

    Schou, Morten; Torp-Pedersen, Christian; Gustafsson, Finn;

    2008-01-01

    AIMS: This study was designed to assess whether the prognostic significance of estimated glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF) interact in populations with heart failure (HF) and myocardial infarction (MI). METHODS: Patients were recruited from four...... screening registers (N=18,010) including patients admitted with HF or MI. Ten years follow-up was recorded and formal testing for interactions between eGFR and LVEF with respect to outcome was done. RESULTS: Twelve-thousand-and-ninety patients died. A significant interaction (P=0.010) was found and each...... of one parameter is inversely related to the level of the other. Statistical interactions are scale dependent and the relationship between chronic kidney disease stages I to V and mortality risk is J-shaped with an additive effect of LVSD....

  1. Epidemiological analysis of reproductive performances and kitten mortality rates in 5,303 purebred queens of 45 different breeds and 28,065 kittens in France.

    Science.gov (United States)

    Fournier, A; Masson, M; Corbière, F; Mila, H; Mariani, C; Grellet, A; Chastant-Maillard, S

    2016-11-03

    Reproduction management and performances are evaluated in the feline species only through a limited number of animals and studies. Our objective was to provide reference figures in purebred cats, from a large-scale sample. Data were collected from an online software dedicated to cattery management (Breeding Management System®, BMS, Royal Canin, Aimargues, France). Information was recorded on a voluntary basis by French breeders between 2011 and 2014. Data were anonymously transferred for analysis. A total of 9,063 oestrous periods (in contact with a male) from 5,303 queens (45 breeds) were recorded from 1,521 breeders. Most matings (70.1%) occurred during increasing day length periods. The mean age at mating (±SD) was 2.7 ± 1.6 years for queens and 2.9 ± 1.9 years for tomcats. Pregnancy rate (based on breeders declaration) was 85.2%. Among queens declared pregnant, 8.4% failed to maintain pregnancy. Globally, 78% of the mated females gave birth to 28,065 kittens within 7,075 L. Mean litter size was 4.0 ± 1.9 kittens among which 8.5% were stillborn. Neonatal and paediatric mortality rate was 8.2%. In total, 16.0% of kittens born died before weaning. The results of this study are based on the largest feline database ever analysed. The figures collected can thus be used as reference to define average reproductive performances in numerous breeds for cat breeders. Further analysis will identify factors influencing reproductive performances and early mortality in the feline species.

  2. Mortality versus Morbidity in the Demographic Transition

    OpenAIRE

    Aksan, Anna-Maria; Chakraborty, Shankha

    2014-01-01

    The link between the mortality and epidemiological transitions is used to identify the effect of the former on the fertility transition: a mortality transition that is not accompanied by improving morbidity causes slower demographic and economic change. In a model where children may die from infectious disease, childhood health affects human capital and noninfectious-disease-related adult mortality. When child mortality falls from lower prevalence, as it did in western Europe, labor productiv...

  3. Incidence and mortality rates in breast, corpus uteri, and ovarian cancers in Poland (1980–2013: an analysis of population-based data in relation to socio-economic changes

    Directory of Open Access Journals (Sweden)

    Banas T

    2016-09-01

    Full Text Available Tomasz Banas,1 Grzegorz Juszczyk,2 Kazimierz Pitynski,1 Dorota Nieweglowska,1 Artur Ludwin,1 Aleksandra Czerw2 1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, 2Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland Objectives: This study aimed to analyze incidence and mortality trends in breast cancer (BC, corpus uteri cancer (CUC, and ovarian cancer (OC in Poland in the context of sociodemographic changes.Materials and methods: Incidence and mortality data (1980–2013 were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960–2013 were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC.Results: A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980–1990 2.14, AAPC1990–1996 4.71, AAPC1996–2013 2.21, with a small but significant decrease in mortality after a slight increase (AAPC1980–1994 0.52, AAPC1994–2013 −0.66. During the period 1980–2013, a significant increase in CUC incidence (AAPC1980–1994 3.7, AAPC1994–2013 1.93 was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980–2006 −1.12, AAPC2006–2013 3.74. After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980–1994 2.98, AAPC1994–2013 −0.49, as did the mortality rate (AAPC1980–1994 0.52, AAPC1994–2013 −0.66.Conclusion: After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in

  4. Infant mortality rates according to socioeconomic status in a Brazilian city Mortalidade infantil e nível socioeconômico em uma cidade brasileira

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    Marcelo Zubaran Goldani

    2001-06-01

    Full Text Available OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381 and infant deaths (total of 731 that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, pOBJETIVO: Informações de bancos de dados municipais podem ser usadas para o planejamento de investigações que visem reduzir as desigualdades no cuidado à saúde. O objetivo do estudo foi determinar a distribuição da mortalidade infantil, segundo uma classificação geoeconômica urbana, usando dados coletados rotineiramente em nível municipal. MÉTODOS: Todos os nascidos vivos (42.381 crianças e todos os óbitos de menores de um ano de idade (731 casos, ocorridos no período entre 1994 e 1998 em Ribeirão Preto, SP, foram considerados para este estudo. Quatro diferentes áreas geoeconômicas foram definidas de acordo com a renda do chefe de família em cada zona administrativa urbana. RESULTADOS: As taxas de mortalidade infantil e de seus componentes neonatal e pós-neonatal, entre 1994 e 1998, apresentaram queda em Ribeirão Preto (chi² para tendência, p<0,05. Essas taxas relacionaram-se inversamente à distribuição de baixos salários (menor do que cinco salários-mínimos por chefe de família nas diversas regiões urbanas (chi² para tendência, p<0,05. A área mais pobre da cidade apresentou contínuo acréscimo de excesso de mortalidade infantil nesse período. CONCLUS

  5. Reducing neonatal mortality in India: critical role of access to emergency obstetric care.

    Directory of Open Access Journals (Sweden)

    Anu Rammohan

    Full Text Available BACKGROUND: Neonatal mortality currently accounts for 41% of all global deaths among children below five years. Despite recording a 33% decline in neonatal deaths between 2000 and 2009, about 900,000 neonates died in India in 2009. The decline in neonatal mortality is slower than in the post-neonatal period, and neonatal mortality rates have increased as a proportion of under-five mortality rates. Neonatal mortality rates are higher among rural dwellers of India, who make up at least two-thirds of India's population. Identifying the factors influencing neonatal mortality will significantly improve child survival outcomes in India. METHODS: Our analysis is based on household data from the nationally representative 2008 Indian District Level Household Survey (DLHS-3. We use probit regression techniques to analyse the links between neonatal mortality at the household level and households' access to health facilities. The probability of the child dying in the first month of birth is our dependent variable. RESULTS: We found that 80% of neonatal deaths occurred within the first week of birth, and that the probability of neonatal mortality is significantly lower when the child's village is closer to the district hospital (DH, suggesting the critical importance of specialist hospital care in the prevention of newborn deaths. Neonatal deaths were lower in regions where emergency obstetric care was available at the District Hospitals. We also found that parental schooling and household wealth status improved neonatal survival outcomes. CONCLUSIONS: Addressing the main causes of neonatal deaths in India--preterm deliveries, asphyxia, and sepsis--requires adequacy of specialised workforce and facilities for delivery and neonatal intensive care and easy access by mothers and neonates. The slow decline in neonatal death rates reflects a limited attention to factors which contribute to neonatal deaths. The suboptimal quality and coverage of Emergency

  6. Does intelligence account for the link between maternal literacy and child survival?

    Science.gov (United States)

    Sandiford, P; Cassel, J; Sanchez, G; Coldham, C

    1997-10-01

    The strong and consistent correlation between maternal education and child health is now well known, and numerous studies have shown that wealth and income cannot explain the link. Policy-makers have therefore assumed that the relationship is causal and explicitly advocate schooling as a child health intervention. However, there are other factors which could account for the apparent effect of maternal education on child morbidity and mortality, one of which is intelligence. This paper examines the effect of maternal intelligence on child health and looks at the degree to which it can explain the literacy associations with child survival and risk of malnutrition. The data are from a retrospective cohort study of 1294 mothers and their 7475 offspring, of whom 454 were women who had learned to read and write as adults in Nicaragua's literacy programme, 457 were illiterate, and 383 had become literate as young girls attending school. The women's intelligence was tested using Raven's Coloured Progressive Matrices. Acquisition of literacy was strongly related to intelligence. Statistically significant associations with maternal literacy were found for under five mortality, infant mortality, and the risk of low mid-upper-arm circumference (MUAC) for age, before and after controlling for a wide range of socio-economic factors. Under five, child (one to four years), infant and post-neonatal mortality plus the risk of low height for age were significantly correlated with intelligence, but only with infant and under mortality rates did the association remain significant after controlling for socio-economic factors. A significant interaction between intelligence and literacy for under five mortality was due to literacy having a strong effect in the women of low intelligence, and a negligible effect among those of high intelligence. This study provides evidence that intelligence is an important determinant of child health among the illiterate, and that education may have the

  7. Child poverty and changes in child poverty.

    Science.gov (United States)

    Chen, Wen-Hao; Corak, Miles

    2008-08-01

    This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.

  8. Understanding Differences in Black and White Child Poverty Rates. A Report of the Heritage Center for Data Analysis.

    Science.gov (United States)

    Rector, Robert; Johnson, Kirk A.; Fagan, Patrick F.

    This study uses National Longitudinal Survey of Youth (NLSY) data to analyze differences in black and white child poverty. The NLSY documents family income and underlying conditions such as employment, educational attainment, welfare use, and marriage or divorce. This analysis examines: time in poverty, time on welfare, time in a single parent…

  9. Mortality after shoulder arthroplasty

    DEFF Research Database (Denmark)

    Amundsen, Alexander; Rasmussen, Jeppe Vejlgaard; Olsen, Bo Sanderhoff

    2016-01-01

    BACKGROUND: The primary aim was to quantify the 30-day, 90-day, and 1-year mortality rates after primary shoulder replacement. The secondary aims were to assess the association between mortality and diagnoses and to compare the mortality rate with that of the general population. METHODS: The study...... included 5853 primary operations reported to the Danish Shoulder Arthroplasty Registry between 2006 and 2012. Information about deaths was obtained from the Danish Cause of Death Register and the Danish Civil Registration System. Age- and sex-adjusted control groups were retrieved from Statistics Denmark...

  10. Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center

    OpenAIRE

    Yoga Devaera

    2012-01-01

    Background Severe malnutrition contributes to child mortality rates, especially in children under five HIV infection further increases the risk of death. Objective To evaluate the impact of HIV infection on mortality, length of hospital stay and improvement of nutritional status in severely malnourished inpatients under five Methods This retrospective study included children aged less than 5 years and admitted to a terti ary hospital for severe malnutrition. We excluded thos...

  11. Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center

    OpenAIRE

    Yoga Devaera

    2012-01-01

    Background Severe malnutrition contributes to child mortality rates, especially in children under five years of age. Concomitant HIV infection further increases the risk of death. Objective To evaluate the impact of HIV infection on mortality, length of hospital stay and improvement of nutritional status in severely malnourished inpatients under five years of age. Methods This retrospective study included children aged less than 5 years and admitted to a tertiary hospital for severe m...

  12. The association between price of regular-grade gasoline and injury and mortality rates among occupants involved in motorcycle- and automobile-related motor vehicle collisions.

    Science.gov (United States)

    Hyatt, Eddie; Griffin, Russell; Rue, Loring W; McGwin, Gerald

    2009-09-01

    Motorcyclists have been reported to be more likely to die in a motor vehicle collision (MVC) than automobile occupants. With the recent increase in the pump price of gasoline, it has been reported that people are switching to motorcycles as main modes of transportation. This study evaluated the association between motor vehicle collision-related injury and mortality rates and increases in gasoline prices for occupants of automobiles and riders of motorcycles. There were an estimated 1,270,512 motorcycle MVC and 238,390,853 automobile MVC involved occupants in the U.S. from 1992 to 2007. Higher gasoline prices were associated with increased motorcycle-related injuries and deaths; however, this association no longer remained after accounting for changes in the number of registered vehicles. The current study observed that, while the number of injuries and fatalities in motorcycle-related MVCs increase with increasing gasoline price, rates remained largely unchanged. This suggests that the observed increase in motorcycle-related injuries and fatalities with increasing gasoline price is more a factor of the number of motorcycles on the road rather than operator characteristics.

  13. Audit of perinatal mortality at SSMCHRC-(Rural teaching hospital a retrospective study

    Directory of Open Access Journals (Sweden)

    M.S. Kokila

    2013-04-01

    Full Text Available Objective: To estimate magnitude, determinants of perinatal mortality and suggest remedial measures for its reduction. Background: Perinatal mortality is mirror reflection of maternal and child health and socioeconomic environment of community. It is influenced by various medicosocial preventable causes. It can be reduced by improving maternal and child health services and by health education. Methods: A retrospective hospital based study of perinatal deaths among 2333 deliveries was conducted from June 2008 to June 2010 in our hospital. Fetomaternal factors like maternal age, religion, residence, parity, mode of delivery, booking status, antenatal complications, baby’s sex, birth weight, congenital anomalies, neonatal complications influencing perinatal mortality rate were tabulated and analyzed. Cause of perinatal death was assessed. Results: perinatal mortality rate was 127.4/1000 total births. Maternal factors like age more than 35 years, muslim religion, inadequate antenatal care, primiparity, grand multiparity, induced deliveries and neonatal factors like low birth weight, prematurity were associated with increased perinatal mortality. The leading cause of stillbirth was antepartum hemorrhage and prematurity for neonatal mortality. Conclusion: Apart from clinical causes high perinatal mortality was due to poverty, illiteracy, lack of health awareness, inadequate antenatal care and delayed referral. Health education, identification of high risk mothers, timely referral, advanced life support of preterm neonates should significantly help to reduce perinatal deaths.

  14. Excess Early Mortality in Schizophrenia

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Nordentoft, Merete; Mortensen, Preben Bo

    2014-01-01

    Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality as ...

  15. Current evolutionary adaptiveness of psychiatric disorders: Fertility rates, parent-child relationship quality, and psychiatric disorders across the lifespan.

    Science.gov (United States)

    Jacobson, Nicholas C

    2016-08-01

    This study sought to evaluate the current evolutionary adaptiveness of psychopathology by examining whether these disorders impact the quantity of offspring or the quality of the parent-child relationship across the life span. Using the National Comorbidity Survey, this study examined whether DSM-III-R anxiety, posttraumatic stress, depressive, bipolar, substance use, antisocial, and psychosis disorders predicted later fertility and the quality of parent-child relationships across the life span in a national sample (N = 8,098). Using latent variable and varying coefficient models, the results suggested that anxiety in males and bipolar pathology in males and females were associated with increased fertility at younger ages. The results suggested almost all other psychopathology was associated with decreased fertility in middle to late adulthood. The results further suggested that all types of psychopathology had negative impacts on the parent-child relationship quality (except for antisocial pathology in males). Nevertheless, for all disorders, the impact of psychopathology on both fertility and the parent-child relationship quality was affected by the age of the participant. The results also showed that anxiety pathology is associated with a high-quantity, low-quality parenting strategy followed by a low-quantity, low-quality parenting strategy. Further, the results suggest that bipolar pathology is associated with an early high-quantity and a continued low-quality parenting strategy. Posttraumatic stress, depression, substance use, antisocial personality, and psychosis pathology are each associated with a low-quantity, low-quality parenting strategy, particularly in mid to late adulthood. These findings suggest that the evolutionary impact of psychopathology depends on the developmental context. (PsycINFO Database Record

  16. Risk factors for malformations and impact on reproductive performance and mortality rates of Schmallenberg virus in sheep flocks in the Netherlands.

    Science.gov (United States)

    Luttikholt, Saskia; Veldhuis, Anouk; van den Brom, René; Moll, Lammert; Lievaart-Peterson, Karianne; Peperkamp, Klaas; van Schaik, Gerdien; Vellema, Piet

    2014-01-01

    In Northwestern Europe, an epizootic outbreak of congenital malformations in newborn lambs due to infection with Schmallenberg virus (SBV) started at the end of 2011. The objectives of this study were to describe clinical symptoms of SBV infection, the effect of infection on mortality rates, and reproductive performance in sheep, as well as to identify and quantify flock level risk factors for SBV infections resulting in malformations in newborn lambs. A case-control study design was used, with 93 case flocks that had notified malformed lambs and 84 control flocks with no such lambs. Overall animal seroprevalence in case flocks was estimated at 82.0% (95% CI: 74.3-87.8), and was not significantly different from the prevalence in control flocks being 76.4% (95% CI: 67.2-83.6). The percentages of stillborn lambs or lambs that died before weaning, repeat breeders, and lambs with abnormal suckling behaviour were significantly higher in case flocks compared to control flocks. However, effect of SBV infection on mortality rates and reproductive performance seemed to be limited. Multivariable analysis showed that sheep flocks with an early start of the mating season, i.e. before August 2011 (OR = 33.1; 95% CI: 10.0-109.8) and in August 2011 (OR = 8.2; 95% CI: 2.7-24.6) had increased odds of malformations in newborn lambs caused by SBV compared to sheep flocks with a start of the mating season in October 2011. Other flock-level risk factors for malformations in newborn lambs were purchase of silage (OR 5.0; 95% CI: 1.7-15.0) and flocks with one or more dogs (OR = 3.3; 95% CI: 1.3-8.3). Delaying mating until October could be a potential preventive measure for naïve animals to reduce SBV induced losses. As duration of immunity after infection with SBV is expected to last for several years, future SBV induced congenital malformations are mainly expected in offspring of early mated seronegative animals.

  17. Risk factors for malformations and impact on reproductive performance and mortality rates of Schmallenberg virus in sheep flocks in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Saskia Luttikholt

    Full Text Available In Northwestern Europe, an epizootic outbreak of congenital malformations in newborn lambs due to infection with Schmallenberg virus (SBV started at the end of 2011. The objectives of this study were to describe clinical symptoms of SBV infection, the effect of infection on mortality rates, and reproductive performance in sheep, as well as to identify and quantify flock level risk factors for SBV infections resulting in malformations in newborn lambs. A case-control study design was used, with 93 case flocks that had notified malformed lambs and 84 control flocks with no such lambs. Overall animal seroprevalence in case flocks was estimated at 82.0% (95% CI: 74.3-87.8, and was not significantly different from the prevalence in control flocks being 76.4% (95% CI: 67.2-83.6. The percentages of stillborn lambs or lambs that died before weaning, repeat breeders, and lambs with abnormal suckling behaviour were significantly higher in case flocks compared to control flocks. However, effect of SBV infection on mortality rates and reproductive performance seemed to be limited. Multivariable analysis showed that sheep flocks with an early start of the mating season, i.e. before August 2011 (OR = 33.1; 95% CI: 10.0-109.8 and in August 2011 (OR = 8.2; 95% CI: 2.7-24.6 had increased odds of malformations in newborn lambs caused by SBV compared to sheep flocks with a start of the mating season in October 2011. Other flock-level risk factors for malformations in newborn lambs were purchase of silage (OR 5.0; 95% CI: 1.7-15.0 and flocks with one or more dogs (OR = 3.3; 95% CI: 1.3-8.3. Delaying mating until October could be a potential preventive measure for naïve animals to reduce SBV induced losses. As duration of immunity after infection with SBV is expected to last for several years, future SBV induced congenital malformations are mainly expected in offspring of early mated seronegative animals.

  18. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

    Salanave, B; Bouvier-Colle, M H; Varnoux, N;

    1999-01-01

    of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were....... This change was substantial in three countries (P maternal mortality rate for participating countries was 7.7 per...... and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers....

  19. Child maltreatment in Taiwan for 2004-2013: A shift in age group and forms of maltreatment.

    Science.gov (United States)

    Chen, Chih-Tsai; Yang, Nan-Ping; Chou, Pesus

    2016-02-01

    Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12-17 years, and girls aged 12-17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment.

  20. Persisting high hospital and community childhood mortality in an urban setting in Guinea-Bissau

    DEFF Research Database (Denmark)

    Veirum, Jens Erik; Biai, Sidu; Jakobsen, Marianne;

    2007-01-01

    minor improvements in acute case management of sick children attending the hospital would be expected to result in substantial reduction in overall childhood mortality. Persistently high acute in-hospital mortality reflects the need of immediate and appropriate care at the hospital. Treatment should......AIM: To describe paediatric hospitalization in a West African capital in relation to overall childhood mortality in the community and to evaluate the potential impact of improved management at the hospital. METHODS: Hospital data on child admissions in a 6-year period were linked to information...... in a community-based longitudinal surveillance system. Paediatric hospitalization rates, risk factors for hospitalizations, community mortality, in-hospital mortality and the proportion of deaths occurring at hospital were examined. RESULTS: Almost 15% of infants and 45% of children less than 5 years of age had...

  1. Cumulative mortality rates in Aedes polynesiensis after feeding on polynesian Wuchereria bancrofti carriers treated with single doses of ivermectin, diethylcarbamazine and placebo.

    Science.gov (United States)

    Cartel, J L; Sechan, Y; Spiegel, A; Nguyen, L; Barbazan, P; Martin, P M; Roux, J F

    1991-12-01

    During a therapeutic trial, batches of 672 to 1979 laboratory-bred Aedes polynesiensis, the mosquito vector of lymphatic filariasis in French Polynesia, were fed on Wuchereria bancrofti carriers one, three and six months after they had been treated with either single doses of ivermectin at 100 mcg/kg, diethylcarbamazine (DEC) at 3 and 6 mg/kg or placebo. High mortality rates were observed during the 15-day period following the blood-meal in mosquitoes fed on carriers treated with microfilaricidal drugs and were significantly higher in mosquitoes fed on carriers treated with ivermectin than in those fed on carriers treated with DEC. Though its intensity decreased with the passage of time, the phenomenon was observed in mosquitoes fed on carriers up to six months after treatment, especially in those fed on carriers treated with ivermectin. By decreasing the number of mosquitoes able to transmit the infection, this lethal effect on Ae. polynesiensis might represent an additional advantage of ivermectin in lymphatic filariasis control programs.

  2. Environmental Health and Primary Health Care in micro-territories: the infant mortality rate as a guide for the healthcare team

    Directory of Open Access Journals (Sweden)

    Herling Gregorio Aguilar Alonzo

    2013-06-01

    Full Text Available In the past 20 years, the Brazilian Unified Health System has improved primary health care and the implementation of environmental health surveillance. In Brazil, basic sanitation coverage has also improved. Macro-regional inequalities are known to exist, but there is little information about the micro-territories where primary care actions are being carried out. This study attempts to describe the influence of drinking water coverage (DWC, sanitation (SC and solid waste management services (SWMS on the infant mortality rate (IMR in areas covered by primary care facilities (PCF, within the Northwest Health District of Campinas/SP. An ecological study was conducted using secondary data for the year 2000. In the eight PCF, DWC varied between 96.3 % and 99.9 %, SC between 67 % and 99.8 %, and SWMS between 95.8 % and 99.9 %. The IMR varied between 5.5 ‰ and 22.9 ‰. An inverse relationship was found, in which the larger the DWC (R2= 0.73, SC (R2= 0.78 and SWMS (R2= 0.95 the lower was the IMR. In addition to other factors, basic sanitation affects the health of the population and, according to the results presented here, there are inequalities in the areas covered by the PCF. Therefore, managers and health professionals, especially those in primary care, should take these factors into consideration to set priorities, actions and targets for integral care, intersectoral collaboration and health surveillance.

  3. Legislation’s Influence on Judiciarization: Examining the Effects of Statutory Structure and Language on Rates of Court Use in Child Welfare Contexts

    Directory of Open Access Journals (Sweden)

    Angela Campbell

    2008-10-01

    Full Text Available This paper investigates the extent to which legislation influences decisions of child welfare workers regarding the referral of cases to court. It studies three Canadian jurisdictions: Quebec, Ontario, and Alberta, each of which takes a different legislative approach to the issue of court involvement in child protection. A critical examination of child welfare statutes in these provinces led to the prediction that rates of court use – or ‘judiciarization’ – would be highest in Quebec, followed by Ontario, and then Alberta. These predictions were then compared with data reflecting actual judiciarization rates in these three provinces for the year 2006. This data contradicted our initial predictions, in that Ontario’s rate of court use for child welfare cases was the highest of the three provinces, followed by Alberta, and then Quebec. Our research results thus suggest that legislation alone does not drive judiciarization in the child welfare context. As such, this paper illuminates the need for further study of the way in which child protection workers understand legislation as influencing their professional responsibilities and choices. Moreover, it indicates that further consideration is needed into how the use of judicial versus extra-judicial institutions might affect child welfare outcomes. Cet article examine la mesure dans laquelle la législation influence les décisions des travailleurs et travailleuses du bien-être de l’enfance quant à soumettre des cas aux tribunaux. On étudie trois territoires canadiens : le Québec, l’Ontario et l’Alberta, dont chacun prend une approche législative différente à la question de la participation des tribunaux dans la protection de l’enfance. Un examen critique des lois sur la protection de l’enfance dans ces provinces a amené à prédire que le taux d’utilisation des tribunaux – ou la «judiciarisation» - serait le plus élevé au Québec, suivi de l’Ontario puis de l

  4. Ambulatory ECG-based T-wave alternans and heart rate turbulence can predict cardiac mortality in patients with myocardial infarction with or without diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Li-na Ren

    2012-09-01

    Full Text Available Abstract Background Many patients who survive a myocardial infarction (MI remain at risk of sudden cardiac death despite revascularization and optimal medical treatment. We used the modified moving average (MMA method to assess the utility of T-wave alternans (TWA and heart rate turbulence (HRT as risk markers in MI patients with or without diabetes mellitus (DM. Methods We prospectively enrolled 248 consecutive patients: 96 with MI (post-MI patients; 77 MI with DM (post-MI + DM patients; 75 controls without cardiovascular disease (group control. Both TWA and HRT were measured on ambulatory electrocardiograms (AECGs. HRT was assessed by two parameters ─ turbulence onset (TO and turbulence slope (TS. HRT was considered positive when both TO ≥0% and TS ≤2.5 ms/R-R interval were met. The endpoint was cardiac mortality. Results TWA values differed significantly between MI and controls. Post-MI + DM patients had higher TWA values than post-MI patients (58 ± 21 μV VS 52 ± 18 μV, P = 0.029. Impaired HRT--increased TO and decreased TS were observed in MI patients with or without DM. During follow-up of 578 ± 146 days, cardiac death occurred in ten patients and three of them suffered sudden cardiac death (SCD. Multivariate analysis determined that a HRT-positive outcome [HR (95% CI: 5.01, 1.33–18.85; P = 0.017], as well as the combination of abnormal TWA (≥47 μV and positive HRT had significant association with the endpoint [HR (95% CI: 9.08, 2.21–37.2; P = 0.002]. Conclusion This study indicates that AECGs-based TWA and HRT can predict cardiac mortality in MI patients with or without DM. Combined analysis TWA and HRT may be a convenient and useful method of identifying patients at high risk for cardiovascular death.

  5. Spatio-temporal analysis of mortality among children under the age of five in Manhiça (Mozambique during the period 1997-2005

    Directory of Open Access Journals (Sweden)

    Nhacolo Ariel

    2011-02-01

    Full Text Available Abstract Background Reducing childhood mortality is the fourth goal of the Millennium Development Goals agreed at the United Nations Millennium Summit in September 2000. However, childhood mortality in developing countries remains high. Providing an accurate picture of space and time-trend variations in child mortality in a region might generate further ideas for health planning actions to achieve such a reduction. The purpose of this study was to examine the spatio-temporal variation for child mortality rates in Manhiça, a district within the Maputo province of southern rural Mozambique during the period 1997-2005 using a proper generalized linear mixed model. Results The results showed that childhood mortality in all the area was modified from year to year describing a convex time-trend but the spatial pattern described by the neighbourhood-specific underlying mortality rates did not change during the entire period from 1997 to 2005, where neighbourhoods with highest risks are situated in the peripheral side of the district. The spatial distribution, though more blurred here, was similar to the spatial distribution of child malaria incidence in the same area. The peak in mortality rates observed in 2001 could have been caused by the precipitation system that started in early February 2000, following which heavy rains flooded parts of Mozambique's southern provinces. However, the mortality rates at the end of the period returned to initial values. Conclusions The results of this study suggest that the health intervention programmes established in Manhiça to alleviate the effects of flooding on child mortality should cover a period of around five years and that special attention might be focused on eradicating malaria transmission. These outcomes also suggest the utility of suitably modelling space-time trend variations in a region when a point effect of an environmental factor affects all the study area.

  6. Mortality in spondylarthritis.

    Science.gov (United States)

    Prati, Clément; Claudepierre, Pascal; Pham, Thao; Wendling, Daniel

    2011-10-01

    Ankylosing spondylitis (AS) is a chronic inflammatory joint disease that can lead to chronic pain in axial and peripheral joints and to functional impairments after several years. Excess mortality has been reported in patients with AS. We reviewed recent studies of patients with AS who were treated and monitored according to the improved methods developed in the past few years, without radiation therapy. Our results do not support excess mortality in these patients. Long-term follow-up data from patients enrolled in biologics registries will provide additional information. Cardiovascular disease is the leading cause of death in patients with AS, as in the general population. However, the cardiovascular mortality rate may be slightly increased in patients with AS, probably as a result of dyslipidemia and early endothelial dysfunction. Similarly, and as expected, there is excess mortality related to the spinal disease itself and to renal and gastrointestinal disease. More surprisingly, alcohol abuse and injury or suicide cause excess mortality compared to the general population. In the absence of radiation or radium-224 therapy, and regardless of the other treatments used, the evidence does not support an increased rate of lymphoma or other malignancies compared to the general population. In this review, we discuss the causes and rates of mortality in patients with AS.

  7. Analysis on Monitoring Results of Maternal Mortality Rates from 2005 to 2011 and Discussion of the Related Experience%株洲市2005-2011年孕产妇死亡监测结果分析与经验探讨

    Institute of Scientific and Technical Information of China (English)

    王希; 谢乐瑜; 陈勇兰

    2012-01-01

    目的 探讨株洲市孕产妇死亡相关因素及降低死亡率的有效措施. 方法 株洲市妇幼保健院收集上报孕产妇个案调查表,结合十二表格评审法,对2005 - 2011年67例孕产妇进行死因评审分析. 结果 株洲市7年孕产妇死亡率整体逐年下降,2010年略微反弹,2011年降至历史最低.平均孕产妇死亡率:19.32/10万,死亡原因前三位的是:产科出血、妊娠合并内科疾病、羊水栓塞,其中栓塞性疾病发生呈增多趋势. 结论 健全的三级网络、加强各级医疗保健技术人员的业务水平,加强孕产妇的系统管理,注重高危面访工作,做好孕产妇死亡的评审工作,加大卫生行政部门监管力度,可有效降低孕产妇死亡率.%Objective To explore the related factors of maternal deaths in Zhuzhou City and the effective measures to reduce maternal mortality rates. Methods The maternal - case questionnaires were collected by Maternal and Child Health Hospital of Zhuzhou City. With twelve— form evaluation method, death causes of 67 maternal death — cases collected from 2005 to 2011 were assessed and analyzed. Results The maternal mortality rates in Zhuzhou City declined year by year during the period of 2005 - 2011, slightly rebounded in 2010, and then fell to the lowest level of the recorded history in 2011. The average maternal mortality rate was 19.32/100,000. The top three causes of death in order were obstetric hemorrhage, pregnancy with internal medical problems, and amniotic fluid embolism, among them, embolization cases showed an upward trend. Conclusions We can effectively reduce the maternal mortality rate through perfecting three- level network, increasing the professional levels of medical staff, strengthening the systematic management of maternal health, paying more attention to the interview of high— risk pregnant women, organizing the review of maternal deaths, and enhancing the supervision of public health by administrative

  8. Mortality and reduced growth hormone secretion

    DEFF Research Database (Denmark)

    Stochholm, Kirstine; Christiansen, Jens; Laursen, Torben

    2007-01-01

    BACKGROUND: Data regarding the mortality rates of patients with growth hormone deficiency (GHD), whether or not treated with growth hormone (GH), are limited, but an increased mortality rate among hypopituitary patients compared with the general population has been documented. Cardiovascular...

  9. Suicide rates: age-associated trends and their correlates

    Directory of Open Access Journals (Sweden)

    Ajit Shah

    2012-07-01

    Full Text Available BACKGROUND: Suicide rates traditionally increased with ageing. There is a paucity of studies examining factors associated with age-associated trends in suicide rates. METHODS: The relationship between suicide rates and ageing was examined by ascertaining suicide rates in the seven age-bands 16-24 years to 75+ years from the World Health Organization for 97 countries. The relationship between socio-economic status, income inequality, healthcare expenditure, child mortality rates and life expectancy and countries with an increase, a decline and no change in suicide rates with ageing was examined using data from the United Nations. RESULTS: In males and females there was a decline in 5 and 10 countries, an increase in 33 and 37 countries and no change in 59 and 50 countries respectively in suicide rates with ageing. Age-associated trends in suicide rates were significantly associated with socio-economic status (males or income inequality (females, per capita expenditure in healthcare, the proportion of gross-national domestic product spent on healthcare, child mortality rates and life expectancy. CONCLUSIONS: The current study, of factors associated with age-associated trends in suicide rates, confirmed a previously developed five sequential stage model to explain the relationship between elderly suicide rates and socio-economic status and income inequality, quality and quantity of healthcare services, child mortality rates and life expectancy.

  10. Child health in Greenland

    DEFF Research Database (Denmark)

    Niclasen, Birgit V L; Bjerregaard, Peter

    2007-01-01

    child mortality but the same morbidity pattern as in other Western societies was found. Negative health behaviour is frequent in schoolchildren. The influence of rapid cultural changes, and familial and societal factors related to social ill health, together with socioeconomic inequity, are of major...

  11. Comment l'instabilité macroéconomique diminue la survie des enfants. How Macroeconomic Instability Lowers Child Survival

    OpenAIRE

    2009-01-01

    The reduction of child mortality is one of the most universally accepted Millennium Goals. However, there is a significant debate on the means of reaching it and its realism with regard to the situation in most of the least developed countries. The recommendations made for the achievement of this goal are mainly medical ones. However, without underestimating the importance of these measures, in particular vaccinations, it seems increasingly obvious that the rate of reduction of child mortalit...