The influence of death-certificate errors on cancer mortality trends

International Nuclear Information System (INIS)

Ron, E.; Hoel, D.G.; Carter, R.L.; Mabuchi, Kiyohiko.

1993-06-01

Over the past few years, several reports have suggested a recent increase in cancer mortality based on death-certificate diagnoses. To explore the effect of death-certificate errors on temporal trends in cancer mortality rates, we analyzed the data from the Atomic Bomb Casualty Commission/Radiation Effects Research Foundation's autopsy program in Hiroshima and Nagasaki. This series includes 5886 autopsies conducted between 1961 and 1987. Our analyses were focused on lymphoma, cancer of the breast, neoplasms of the brain, multiple myeloma, and melanoma (172 cases, total) because of concern over reports of their increased mortality. These 172 autopsy cases were referred to as Cancers of Interest. A significant increase in detection rates was observed for these Cancers of Interest primarily due to a large rise in mortality between 1976 and 1987. For the remaining cancers excluding stomach and lung (defined as Other), the pattern was similar to that seen for Cancers of Interest, but the fluctuation over time was not statistically significant. Confirmation rates generally increased with time except for Cancers of Interest. As a measure of bias in mortality rates due to death-certification errors and as a method to quantify under- or overestimation of death-certificate-based mortality rates,an adjustment factor (confirmation rate divided by detection rate) was calculated. The higher the adjustment factor, the greater the need to compensate for underreporting. For Cancers of Interest the adjustment factor decreased dramatically over time, but it did not change significantly for Other cancers. When the adjustment factors for Cancers of Interest and Other were compared, a statistically significant difference was found. For Cancers of Interest, a significant interaction between type of cancer and period was seen. Our findings indicate that considerable care must be shown when interpreting temporal trends in cancer vital statistics. (author)

Using multiple cause-of-death data to investigate associations and causality between conditions listed on the death certificate.

Science.gov (United States)

Redelings, Matthew D; Wise, Matthew; Sorvillo, Frank

2007-07-01

Death rarely results from only one cause, and it can be caused by a variety of factors. Multiple cause-of-death data files can list as many as 20 contributing causes of death in addition to the reported underlying cause of death. Analysis of multiple cause-of-death data can provide information on associations between causes of death, revealing common combinations of events or conditions which lead to death. Additionally, physicians report the causal train of events through which they believe that different conditions or events may have led to each other and ultimately caused death. In this paper, the authors discuss methods used in studying associations between reported causes of death and in investigating commonly reported causal pathways between events or conditions listed on the death certificate.

Using death certificates and medical examiner records for adolescent occupational fatality surveillance and research: a case study.

Science.gov (United States)

Rauscher, Kimberly J; Runyan, Carol W; Radisch, Deborah

2012-01-01

Death certificates and medical examiner records have been useful yet imperfect data sources for work-related fatality research and surveillance among adult workers. It is unclear whether this holds for work-related fatalities among adolescent workers who suffer unique detection challenges in part because they are not often thought of as workers. This study investigated the utility of using these data sources for surveillance and research pertaining to adolescent work-related fatalities. Using the state of North Carolina as a case study, we analyzed data from the death certificates and medical examiner records of all work-related fatalities data among 11- to 17-year-olds between 1990-2008 (N = 31). We compared data sources on case identification, of completeness, and consistency information. Variables examined included those on the injury (e.g., means), occurrence (e.g., place), demographics, and employment (e.g., occupation). Medical examiner records (90%) were more likely than death certificates (71%) to identify adolescent work-related fatalities. Data completeness was generally high yet varied between sources. The most marked difference being that in medical examiner records, type of business/industry and occupation were complete in 72 and 67% of cases, respectively, while on the death certificates these fields were complete in 90 and 97% of cases, respectively. Taking the two sources together, each field was complete in upward of 94% of cases. Although completeness was high, data were not always of good quality and sometimes conflicted across sources. In many cases, the decedent's occupation was misclassified as "student" and their employer as "school" on the death certificate. Even though each source has its weaknesses, medical examiner records and death certificates, especially when used together, can be useful for conducting surveillance and research on adolescent work-related fatalities. However, extra care is needed by data recorders to ensure that

Occupation recorded on certificates of death compared with self-report: the Atherosclerosis Risk in Communities (ARIC Study

Directory of Open Access Journals (Sweden)

Wolf Susanne H

2007-08-01

Full Text Available Abstract Background Death certificates are a potential source of sociodemographic data for decedents in epidemiologic research. However, because this information is provided by the next-of-kin or other proxies, there are concerns about validity. Our objective was to assess the agreement of job titles and occupational categories derived from death certificates with that self-reported in mid and later life. Methods Occupation was abstracted from 431 death certificates from North Carolina Atherosclerosis Risk in Communities Study participants who died between 1987 and 2001. Occupations were coded according to 1980 Bureau of Census job titles and then grouped into six 1980 census occupational categories. This information was compared with the self-reported occupation at midlife as reported at the baseline examination (1987–89. We calculated percent agreement using standard methods. Chance-adjusted agreement was assessed by kappa coefficients, with 95% confidence intervals. Results Agreement between death certificate and self-reported job titles was poor (32%, while 67% of occupational categories matched the two sources. Kappa coefficients ranged from 0.53 for technical/sales/administrative jobs to 0.68 for homemakers. Agreement was lower, albeit nonsignificant, for women (kappa = 0.54, 95% Confidence Interval, CI = 0.44–0.63 than men (kappa = 0.62, 95% CI = 0.54–0.69 and for African-Americans (kappa = 0.47, 95% CI = 0.34–0.61 than whites (kappa = 0.63, 95% CI = 0.57–0.69 but varied only slightly by educational attainment. Conclusion While agreement between self- and death certificate reported job titles was poor, agreement between occupational categories was good. This suggests that while death certificates may not be a suitable source of occupational data where classification into specific job titles is essential, in the absence of other data, it is a reasonable source for constructing measures such as occupational SES that are based on

Linking Halal Food Certification and Business Performance

DEFF Research Database (Denmark)

Ab Talib, Mohamed Syazwan; Chin, Thoo Ai; Fischer, Johan

2017-01-01

role of HFC in influencing operational and financial performance. It would entice more food companies to become Halal certified that opens up an opportunity to a lucrative Halal food industry. It also empirically justifies that a religion-based food certification has the ability to influence business...... manufacturing companies in Malaysia participated in the study. Data were gathered through a structured questionnaire and were analysed using partial least squares structural equation modelling technique. Findings The study proved that HFC has a positive relationship with operational performance. Additionally......, operational performance mediates the relationship between HFC and financial performance. Altogether, this signifies that Halal food certificate implementation positively influences business performance. Practical implications By linking HFC and business performance, managers may be aware of the significant...

Medical certification of death in South Africa--moving forward.

Science.gov (United States)

Burger, E H; Groenewald, P; Rossouw, A; Bradshaw, D

2015-01-01

Despite improvements to the Death Notification Form (DNF) used in South Africa (SA), the quality of cause-of-death information remains suboptimal. To address these inadequacies, the government ran a train-the-trainer programme on completion of the DNF, targeting doctors in public sector hospitals. Training materials were developed and workshops were held in all provinces. This article reflects on the lessons learnt from the training and highlights issues that need to be addressed to improve medical certification and cause-of-death data in SA. The DNF should be completed truthfully and accurately, and confidentiality of the information on the form should be maintained. The underlying cause of death should be entered on the lowest completed line in the cause-of-death section, and if appropriate, HIV should be entered here. Exclusion clauses for HIV in life insurance policies with Association of Savings and Investments South Africa companies were scrapped in 2005. Interactive workshops provide a good learning environment, but are logistically challenging. More use should be made of online training resources, particularly with continuing professional development accreditation and helpline support. In addition, training in the completion of the DNF should become part of the curriculum in all medical schools, and part of the orientation of interns and community service doctors in all facilities.

Linking mortuary data improves vital statistics on cause of death of children under five years in the Western Cape Province of South Africa.

Science.gov (United States)

Groenewald, Pam; Bradshaw, Debbie; Neethling, Ian; Martin, Lorna J; Dempers, Johan; Morden, Erna; Zinyakatira, Nesbert; Coetzee, David

2016-01-01

Reducing child mortality requires good information on its causes. Whilst South African vital registration data have improved, the quality of cause-of-death data remains inadequate. To improve this, data from death certificates were linked with information from forensic mortuaries in Western Cape Province. A local mortality surveillance system was established in 2007 by the Western Cape Health Department to improve data quality. Cause-of-death data were captured from copies of death notification forms collected at Department of Home Affairs Offices. Using unique identifiers, additional forensic mortuary data were linked with mortality surveillance system records. Causes of death were coded to the ICD-10 classification. Causes of death in children under five were compared with those from vital registration data for 2011. Cause-of-death data were markedly improved with additional data from forensic mortuaries. The proportion of ill-defined causes was halved (25-12%), and leading cause rankings changed. Lower respiratory tract infections moved above prematurity to rank first, accounting for 20.8% of deaths and peaking in infants aged 1-3 months. Only 11% of deaths from lower respiratory tract infections occurred in hospital, resulting in 86% being certified in forensic mortuaries. Road traffic deaths increased from 1.1-3.1% (27-75) and homicides from 3 to 28. The quality and usefulness of cause-of-death information for children in the WC was enhanced by linking mortuary and vital registration data. Given the death profile, interventions are required to prevent and manage LRTI, diarrhoea and injuries and to reduce neonatal deaths. © 2015 John Wiley & Sons Ltd.

JNIH-ABCC Life Span Study, Hiroshima 1950-59. Multiple causes of death stated in medical certificates

Energy Technology Data Exchange (ETDEWEB)

Ishida, Morihiro; Jablon, S

1962-08-22

The applicability to the JNIH-ABCC Life Span Study of secondary causes shown in Hiroshima death certificates is discussed. The analysis is based on 5526 death certificates reported among members of Selection I and II of the Life Span Study sample. Secondary causes appear to be of only limited usefulness to the Life Span Study. Factors such as age, sex, exposure status, which may influence the frequency of entry of secondary causes in medical certificates are analyzed. Age is the only factor which shows a significant relationship and this may be interpreted as resulting from the fact that chronic diseases with multiple illnesses are most prevalent among persons at older ages. The number of secondary causes in the present study is too small to delineate in detail the pattern of complications or contributory causes. However, 9 cases of malignant neoplasms were entered only as complications and were missed in the primary tabulation, representing only about one percent of all malignancies. Secondary causes shown in the death certificates and associated causes found at postmortem examination seem not to be comparably distributed, thus raising a serious problem as to the applicability of the former to the Life Span Study. Both the magnitude and accuracy of entry of the secondary causes are influenced greatly by the ease with which illnesses may be detected clinically. 9 references, 12 tables.

[More than a decade improving medical and judicial certification in mortality statistics of death causes].

Science.gov (United States)

Cirera, Lluís; Salmerón, Diego; Martínez, Consuelo; Bañón, Rafael María; Navarro, Carmen

2018-06-06

After the return of Spain to democracy and the regional assumption of government powers, actions were initiated to improve the mortality statistics of death causes. The objective of this work was to describe the evolution of the quality activities improvements into the statistics of death causes on Murcia's region during 1989 to 2011. Descriptive epidemiological study of all death documents processed by the Murcia mortality registry. Use of indicators related to the quality of the completion of death in medical and judicial notification; recovery of information on the causes and circumstances of death; and impact on the statistics of ill-defined, unspecific and less specific causes. During the study period, the medical notification without a temporary sequence on the death certificate (DC) has decreased from 46% initial to 21% final (p less than 0.001). Information retrieval from sources was successful in 93% of the cases in 2001 compared to 38%, at the beginning of the period (p less than 0.001). Regional rates of ill-defined and unspecific causes fell more than national ones, and they were in the last year with a differential of 10.3 (p less than 0.001) and 2.8 points (p=0.001), respectively. The medical death certification improved in form and suitability. Regulated recovery of the causes of death and circumstances corrected medical and judicial information. The Murcia's region presented lower rates in less specified causes and ill-defined entities than national averages.

Accidental drug deaths in Fulton County, Georgia, 2002: characteristics, case management and certification issues.

Science.gov (United States)

Graham, Jason K; Hanzlick, Randy

2008-09-01

Historically, the duty of the medical examiner in assigning cause and manner of death in drug-related death cases has been fraught with controversial challenges. The lack of standardization in certifying drug-related deaths may involve differences among practicing forensic pathologists in their approach to such cases. The central objectives of the present study include characterization of current drug death patterns and the variability among medical examiners with respect to autopsy performance and death certification practices in one county medical examiner's office. Death certificates, scene information/investigative reports, autopsy reports, and toxicological laboratory results for each of the 100 cases of drug-related death occurring in 2002 in Fulton County, Georgia were reviewed. Comparison of overall autopsy rates and autopsy rates in drug-related death cases for each medical examiner individually and for the group collectively was performed. In examining cocaine-related deaths (most common), statistical analysis was performed for comparison of drug concentrations (cocaine and benzoylecgonine) between deaths certified as cocaine toxicity (poisoning) versus cocaine-complicating disease or causing an adverse event such as cerebral hemorrhage. Causes of accidental drug deaths included cocaine 40%, mixed drug intoxication 37%, opioids 10%, ethanol 7%, and prescription medication (nonopioid) 5%. Overall total autopsy rates in 2002 for each of the 6 independent medical examiners ranged from 51% to 69% (mean 64%), whereas autopsy rates in drug-related death ranged from 55% to 91% (mean 81%). In review of the subset of 40 cocaine-related deaths, 25% were certified as cocaine toxicity (poisoning), with the remaining 75% certified as cocaine-complicating disease or causing and adverse event. Autopsy rates in cocaine-related deaths were as follows: cocaine toxicity 80%, cocaine-complicating disease 77.3%, and cocaine causing adverse event 62.5%. Thirty-eight percent of

Objective structured clinical examination "Death Certificate" station - Computer-based versus conventional exam format.

Science.gov (United States)

Biolik, A; Heide, S; Lessig, R; Hachmann, V; Stoevesandt, D; Kellner, J; Jäschke, C; Watzke, S

2018-04-01

One option for improving the quality of medical post mortem examinations is through intensified training of medical students, especially in countries where such a requirement exists regardless of the area of specialisation. For this reason, new teaching and learning methods on this topic have recently been introduced. These new approaches include e-learning modules or SkillsLab stations; one way to objectify the resultant learning outcomes is by means of the OSCE process. However, despite offering several advantages, this examination format also requires considerable resources, in particular in regards to medical examiners. For this reason, many clinical disciplines have already implemented computer-based OSCE examination formats. This study investigates whether the conventional exam format for the OSCE forensic "Death Certificate" station could be replaced with a computer-based approach in future. For this study, 123 students completed the OSCE "Death Certificate" station, using both a computer-based and conventional format, half starting with the Computer the other starting with the conventional approach in their OSCE rotation. Assignment of examination cases was random. The examination results for the two stations were compared and both overall results and the individual items of the exam checklist were analysed by means of inferential statistics. Following statistical analysis of examination cases of varying difficulty levels and correction of the repeated measures effect, the results of both examination formats appear to be comparable. Thus, in the descriptive item analysis, while there were some significant differences between the computer-based and conventional OSCE stations, these differences were not reflected in the overall results after a correction factor was applied (e.g. point deductions for assistance from the medical examiner was possible only at the conventional station). Thus, we demonstrate that the computer-based OSCE "Death Certificate" station

Combining diagnostic categories to improve agreement between death certificate and autopsy classifications of cause of death for atomic bomb survivors, 1950-87

International Nuclear Information System (INIS)

Carter, R.L.; Ron, E.; Mabuchi, Kiyohiko.

1993-05-01

Several investigators have observed less-than-desirable agreement between death certificate diagnoses and autopsy diagnoses for most specific causes of death, and even for some causes grouped by major disease category. Our results from data on 5130 autopsies of members of the Life Span Study cohort of atomic bomb survivors in Hiroshima and Nagasaki conducted prior to September 1987 were equally discouraging. Among diseases with more than 10 cases observed, confirmation rates ranged from 13 % to 97 % and detection rates from 6 % to 90 %. Both rates were greater than 70 % for only 6 of 60 disease categories studied and for only 1 of 16 categories defined by major International Classification of Disease categories (neoplasms). This deficiency suggests cautious interpretation of results from studies based on death certificate diagnoses. To determine whether any groupings of diagnoses might meet acceptable accuracy requirements, we applied a hierarchical clustering method to data from these 5130 cohort members. The resulting classification system had 10 categories: breast cancer; other female cancers; cancers of the digestive organs; cancer of the larynx; leukemia; nasal, ear, or sinus cancer; tongue cancer; external causes; vascular disease; and all other causes. Confirmation and detection rates for each of these categories were at least 66 %. Although the categories are broad, particularly for nonneoplastic diseases, further divisions led to unacceptable accuracy rates for some of the resulting diagnostic groups. Using the derived classification system, there was 72 % agreement overall between death certificate and autopsy diagnoses compared to 53 % agreement for a second system obtained by grouping strictly by major disease category. Eighty-seven percent agreement was observed for a similar classification system with vascular disease grouped with all other nonneoplastic diseases. Further agglomeration achieved very little additional improvement. (J.P.N.)

BID links ferroptosis to mitochondrial cell death pathways

NARCIS (Netherlands)

Neitemeier, Sandra; Jelinek, Anja; Laino, Vincenzo; Hoffmann, Lena; Eisenbach, Ina; Eying, Roman; Ganjam, Goutham K; Dolga, Amalia M; Oppermann, Sina; Culmsee, Carsten

2017-01-01

Ferroptosis has been defined as an oxidative and iron-dependent pathway of regulated cell death that is distinct from caspase-dependent apoptosis and established pathways of death receptor-mediated regulated necrosis. While emerging evidence linked features of ferroptosis induced e.g. by

A computer case definition for sudden cardiac death.

Science.gov (United States)

Chung, Cecilia P; Murray, Katherine T; Stein, C Michael; Hall, Kathi; Ray, Wayne A

2010-06-01

To facilitate studies of medications and sudden cardiac death, we developed and validated a computer case definition for these deaths. The study of community dwelling Tennessee Medicaid enrollees 30-74 years of age utilized a linked database with Medicaid inpatient/outpatient files, state death certificate files, and a state 'all-payers' hospital discharge file. The computerized case definition was developed from a retrospective cohort study of sudden cardiac deaths occurring between 1990 and 1993. Medical records for 926 potential cases had been adjudicated for this study to determine if they met the clinical definition for sudden cardiac death occurring in the community and were likely to be due to ventricular tachyarrhythmias. The computerized case definition included deaths with (1) no evidence of a terminal hospital admission/nursing home stay in any of the data sources; (2) an underlying cause of death code consistent with sudden cardiac death; and (3) no terminal procedures inconsistent with unresuscitated cardiac arrest. This definition was validated in an independent sample of 174 adjudicated deaths occurring between 1994 and 2005. The positive predictive value of the computer case definition was 86.0% in the development sample and 86.8% in the validation sample. The positive predictive value did not vary materially for deaths coded according to the ICO-9 (1994-1998, positive predictive value = 85.1%) or ICD-10 (1999-2005, 87.4%) systems. A computerized Medicaid database, linked with death certificate files and a state hospital discharge database, can be used for a computer case definition of sudden cardiac death. Copyright (c) 2009 John Wiley & Sons, Ltd.

BID links ferroptosis to mitochondrial cell death pathways

Directory of Open Access Journals (Sweden)

Sandra Neitemeier

2017-08-01

Full Text Available Ferroptosis has been defined as an oxidative and iron-dependent pathway of regulated cell death that is distinct from caspase-dependent apoptosis and established pathways of death receptor-mediated regulated necrosis. While emerging evidence linked features of ferroptosis induced e.g. by erastin-mediated inhibition of the Xc- system or inhibition of glutathione peroxidase 4 (Gpx4 to an increasing number of oxidative cell death paradigms in cancer cells, neurons or kidney cells, the biochemical pathways of oxidative cell death remained largely unclear. In particular, the role of mitochondrial damage in paradigms of ferroptosis needs further investigation.In the present study, we find that erastin-induced ferroptosis in neuronal cells was accompanied by BID transactivation to mitochondria, loss of mitochondrial membrane potential, enhanced mitochondrial fragmentation and reduced ATP levels. These hallmarks of mitochondrial demise are also established features of oxytosis, a paradigm of cell death induced by Xc- inhibition by millimolar concentrations of glutamate. Bid knockout using CRISPR/Cas9 approaches preserved mitochondrial integrity and function, and mediated neuroprotective effects against both, ferroptosis and oxytosis. Furthermore, the BID-inhibitor BI-6c9 inhibited erastin-induced ferroptosis, and, in turn, the ferroptosis inhibitors ferrostatin-1 and liproxstatin-1 prevented mitochondrial dysfunction and cell death in the paradigm of oxytosis. These findings show that mitochondrial transactivation of BID links ferroptosis to mitochondrial damage as the final execution step in this paradigm of oxidative cell death. Keywords: Ferroptosis, BID, Mitochondria, CRISPR, Oxytosis, Neuronal death

Occupational risk factors for brain tumors. A case-referent death-certificate analysis

Energy Technology Data Exchange (ETDEWEB)

Thomas, T.L.; Fontham, E.T.; Norman, S.A.; Stemhagen, A.; Hoover, R.N.

1986-04-01

Numerous studies have suggested that employment in the oil refining and chemical manufacturing industries may be associated with excess brain tumor risk. A case-referent study was undertaken to evaluate brain tumor risk by occupation and industry in three geographic areas (northern New Jersey, Philadelphia, and the Gulf Coast of Louisiana) with a heavy concentration of these industries. Seven hundred and eighteen white men dying from brain tumor at age 30 years or older were ascertained from death certificates for 1978-1981. The referents were men who died of other causes, excluding epilepsy and stroke. Usual occupation and industry were obtained from the death certificates, and the maximum likelihood estimates of the relative risk were calculated for specific industries and occupations. Small nonsignificant excess risks of brain tumors were seen among persons whose usual employment was in the petroleum refining, electrical equipment manufacturing, health services, and educational services industries. Compared with other white-collar professionals, health diagnosticians, teachers, and artists/designers had a significantly elevated brain tumor risk. Among blue-collar workers, the only group with a significantly elevated brain tumor risk was precision metal workers, who are exposed to metal dusts and fumes and substances used as coolants, lubricants, and degreasers.

Causes of deaths data, linkages and big data perspectives.

Science.gov (United States)

Rey, Grégoire; Bounebache, Karim; Rondet, Claire

2018-07-01

The study of cause-specific mortality data is one of the main sources of information for public health monitoring. In most industrialized countries, when a death occurs, it is a legal requirement that a medical certificate based on the international form recommended by World Health Organization's (WHO) is filled in by a physician. The physician reports the causes of death that directly led or contributed to the death on the death certificate. The death certificate is then forwarded to a coding office, where each cause is coded, and one underlying cause is defined, using the rules of the International Classification of Diseases and Related Health Problems, now in its 10th Revision (ICD-10). Recently, a growing number of countries have adopted, or have decided to adopt, the coding software Iris, developed and maintained by an international consortium 1 . This whole standardized production process results in a high and constantly increasing international comparability of cause-specific mortality data. While these data could be used for international comparisons and benchmarking of global burden of diseases, quality of care and prevention policies, there are also many other ways and methods to explore their richness, especially when they are linked with other data sources. Some of these methods are potentially referring to the so-called "big data" field. These methods could be applied both to the production of the data, to the statistical processing of the data, and even more to process these data linked to other databases. In the present note, we depict the main domains in which this new field of methods could be applied. We focus specifically on the context of France, a 65 million inhabitants country with a centralized health data system. Finally we will insist on the importance of data quality, and the specific problematics related to death certification in the forensic medicine domain. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All

BID links ferroptosis to mitochondrial cell death pathways.

Science.gov (United States)

Neitemeier, Sandra; Jelinek, Anja; Laino, Vincenzo; Hoffmann, Lena; Eisenbach, Ina; Eying, Roman; Ganjam, Goutham K; Dolga, Amalia M; Oppermann, Sina; Culmsee, Carsten

2017-08-01

Ferroptosis has been defined as an oxidative and iron-dependent pathway of regulated cell death that is distinct from caspase-dependent apoptosis and established pathways of death receptor-mediated regulated necrosis. While emerging evidence linked features of ferroptosis induced e.g. by erastin-mediated inhibition of the X c - system or inhibition of glutathione peroxidase 4 (Gpx4) to an increasing number of oxidative cell death paradigms in cancer cells, neurons or kidney cells, the biochemical pathways of oxidative cell death remained largely unclear. In particular, the role of mitochondrial damage in paradigms of ferroptosis needs further investigation. In the present study, we find that erastin-induced ferroptosis in neuronal cells was accompanied by BID transactivation to mitochondria, loss of mitochondrial membrane potential, enhanced mitochondrial fragmentation and reduced ATP levels. These hallmarks of mitochondrial demise are also established features of oxytosis, a paradigm of cell death induced by X c - inhibition by millimolar concentrations of glutamate. Bid knockout using CRISPR/Cas9 approaches preserved mitochondrial integrity and function, and mediated neuroprotective effects against both, ferroptosis and oxytosis. Furthermore, the BID-inhibitor BI-6c9 inhibited erastin-induced ferroptosis, and, in turn, the ferroptosis inhibitors ferrostatin-1 and liproxstatin-1 prevented mitochondrial dysfunction and cell death in the paradigm of oxytosis. These findings show that mitochondrial transactivation of BID links ferroptosis to mitochondrial damage as the final execution step in this paradigm of oxidative cell death. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Mortality incidence estimation using federal death certificate and natality data with an application to Tay-Sachs disease.

Science.gov (United States)

Jalal, Kabir; Carter, Randy L

2015-09-01

For confidentiality reasons, US federal death certificate data are incomplete with regards to the dates of birth and death for the decedents, making calculation of total lifetime of a decedent impossible and thus estimation of mortality incidence difficult. This paper proposes the use of natality data and an imputation-based method to estimate age-specific mortality incidence rates in the face of this missing information. By utilizing previously determined probabilities of birth, a birth date and death date are imputed for every decedent in the dataset. Thus, the birth cohort of each individual is imputed, and the total on-study time can be calculated. This idea is implemented in two approaches for estimation of mortality incidence rates. The first is an extension of a person-time approach, while the second is an extension of a life table approach. Monte Carlo simulations showed that both approaches perform well in comparison to the ideal complete data methods, but that the person-time method is preferred. An application to Tay-Sachs disease is demonstrated. It is concluded that the imputation methods proposed provide valid estimates of the incidence of death from death certificate data without the need for additional assumptions under which usual mortality rates provide valid estimates. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Nosological Inaccuracies in death certification in Northern Ireland. A comparative study between hospital doctors and general practitioners.

OpenAIRE

Armour, A.; Bharucha, H.

1997-01-01

We aimed to audit nosological inaccuracies in death certification in Northern Ireland and to compare performance of hospital doctors and general practitioners. Nosology is the branch of medicine which treats of the classification of disease. 1138 deaths were registered in Northern Ireland in a 4-week period commencing 3/10/94. 195 of these were either registered by HM Coroners (HMC) or required further investigation by their staff; these cases were excluded from the study. The remaining 943 w...

We could learn much more from 1918 pandemic-the (mis)fortune of research relying on original death certificates.

Science.gov (United States)

Alonso, Wladimir J; Nascimento, Francielle C; Chowell, Gerardo; Schuck-Paim, Cynthia

2018-05-01

The analysis of historical death certificates has enormous potential for understanding how the health of populations was shaped by diseases and epidemics and by the implementation of specific interventions. In Brazil, the systematic archiving of mortality records was initiated only in 1944-hence the analysis of death registers before this time requires searching for these documents in public archives, notaries, parishes, and especially ancient cemeteries, which are often the only remaining source of information about these deaths. This article describes an effort to locate original death certificates in Brazil and document their organization, accessibility, and preservation. To this end, we conducted an exploratory study in 19 of the 27 Brazilian states, focusing on the period surrounding the 1918 influenza pandemic (1913-1921). We included 55 cemeteries, 22 civil archives, and one military archive. Apart from few exceptions, the results show the absence of a curatorial policy for the organization, access or even physical preservation of this material, frequently leading to unavailability, deterioration, and ultimately its complete loss. This study indicates the need to promote the preservation of a historical heritage that is a key to understanding historical epidemiological patterns and human responses to global health threats. Copyright © 2018 Elsevier Inc. All rights reserved.

5 CFR 880.205 - Determinations of death.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an authorized...

Place of death for people with HIV: a population-level comparison of eleven countries across three continents using death certificate data.

Science.gov (United States)

Harding, Richard; Marchetti, Stefano; Onwuteaka-Philipsen, Bregje D; Wilson, Donna M; Ruiz-Ramos, Miguel; Cardenas-Turanzas, Maria; Rhee, YongJoo; Morin, Lucas; Hunt, Katherine; Teno, Joan; Hakanson, Cecilia; Houttekier, Dirk; Deliens, Luc; Cohen, Joachim

2018-01-25

With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This 11 country study aimed to i) describe the number, proportion of all deaths, and demographics of HIV-related deaths; ii) identify place of death; iii) compare place of death to cancer patients iv), determine patient/health system factors associated with place of HIV-related death. In this retrospective analysis of death certification, data were extracted for the full population (ICD-10 codes B20-B24) for 1-year period: deceased's demographic characteristics, place of death, healthcare supply. i) 19,739 deaths were attributed to HIV. The highest proportion (per 1000 deaths) was for Mexico (9.8‰), and the lowest Sweden (0.2‰). The majority of deaths were among men (75%), and those aged <50 (69.1%). ii) Hospital was most common place of death in all countries: from 56.6% in the Netherlands to 90.9% in South Korea. The least common places were hospice facility (3.3%-5.7%), nursing home (0%-17.6%) and home (5.9%-26.3%).iii) Age-standardised relative risks found those with HIV less likely to die at home and more likely to die in hospital compared with cancer patients, and in most countries more likely to die in a nursing home. iv) Multivariate analysis found that men were more likely to die at home in UK, Canada, USA and Mexico; a greater number of hospital beds reduced the likelihood of dying at home in Italy and Mexico; a higher number of GPs was associated with home death in Italy and Mexico. With increasing comorbidity among people ageing with HIV, it is essential that end-of-life preferences are established and met. Differences in place of death according to country and diagnosis demonstrate the importance of ensuring a "good death" for people with HIV, alongside efforts to optimise treatment.

'Natural' and 'Unnatural' medical deaths and coronial law: A UK and international review of the medical literature on natural and unnatural death and how it applies to medical death certification and reporting deaths to coroners: Natural/Unnatural death: A Scientific Review.

Science.gov (United States)

Harris, Andrew

2017-07-01

In the United Kingdom, when people die, either a doctor writes an acceptable natural cause of death medical certificate, or a coroner (fiscal in Scotland) investigates the case, usually with an autopsy. An inquest may or may not follow. The concept of 'natural or unnatural cause' death is not internationally standardized. This article reviews scientific evidence as to what is a natural death or unnatural death and how that relates to the international classification of deaths. Whilst there is some consensus on the definition, its application in considering whether to report to the coroner is more difficult. Depictions of deaths in terminal care, medical emergencies and post-operative care highlight these difficulties. It secondly reviews to what extent natural and unnatural are criteria for notification of deaths in England and Wales and internationally. It concludes with consideration of how medical concepts of unnatural death relate in England and Wales to coroners' legal concepts of what is unnatural. Deaths that appear natural to clinicians and pathologists may be legally unnatural and vice versa. It is argued that the natural/unnatural dichotomy is not a good criterion for reporting deaths under medical care to coroners, but the notification of a medical cause of death, using the International Classification of Disease Codes and the medical professional view as to whether it is scientifically natural, is of great value to the coroner in deciding whether it is legally unnatural.

Study of recent and future trends in place of death in Belgium using death certificate data: a shift from hospitals to care homes

Directory of Open Access Journals (Sweden)

Deliens Luc

2011-04-01

Full Text Available Abstract Background Since most patients prefer out-of-hospital death, place of death can be considered an indicator of end-of-life care quality. The study of trends in place of death is necessary to examine causes of shifts, to evaluate efforts to alter place of death and develop future policies. This study aims to examine past trends and future projections of place of death. Methods Analysis of death certificates (decedents aged ≥ 1 year in Belgium (Flanders and Brussels Capital region 1998-2007. Trends in place of death were adjusted for cause of death, sociodemographic characteristics, environmental factors, numbers of hospital beds, and residential and skilled nursing beds in care homes. Future trends were based on age- and sex-specific mortality prognoses. Results Hospital deaths decreased from 55.1% to 51.7% and care home deaths rose from 18.3% to 22.6%. The percentage of home deaths remained stable. The odds of dying in a care home versus hospital increased steadily and was 1.65 (95%CI:1.53-1.78 in 2007 compared to 1998. This increase could be attributed to the replacement of residential beds by skilled nursing beds. Continuation of these trends would result in the more than doubling of deaths in care homes and a decrease in deaths at home and in hospital by 2040. Conclusions Additional end-of-life care resources in care homes largely explain the decrease in hospital deaths. Care homes will become the main locus of end-of-life care in the future. Governments should provide sufficient skilled nursing resources in care homes to fulfil the end-of-life care preferences and needs of patients.

Distinct mortality profile in systemic sclerosis: a death certificate study in Rio de Janeiro, Brazil (2006-2015) using a multiple causes of death analysis.

Science.gov (United States)

de Rezende, Rodrigo Poubel Vieira; Gismondi, Ronaldo Altenburg; Maleh, Haim Cesar; de Miranda Coelho, Elisa Mendes; Vieira, Carol Sartori; Rosa, Maria Luiza Garcia; Mocarzel, Luis Otavio

2017-12-16

The objective of this study was to assess the mortality profile related to SSc in the state of Rio de Janeiro, Brazil. We retrospectively examined all registered deaths in the region (2006-2015 period) in which the diagnosis of SSc was mentioned on any line of the death certificates (underlying cause of death [UCD], n = 223; non-UCD, n = 151). Besides the analysis of gender, age, and the causes of death, we also compared the mortality from UCDs between individuals whose death causes included SSc (cases) and those whose death causes did not include SSc (deceased controls). For the latter comparison, we used the mortality odds ratio to approximate the cause-specific standardized mortality ratio. We identified 1495 death causes among the 374 SSc cases. The mean age at death of the SSc cases (85% women) was significantly lower than that of the controls (n = 1,294,117) (58.7 vs. 65.5 years, respectively). The main death causes were circulatory system diseases, infections, and respiratory diseases (36%, 34%, and 21% of SSc cases, respectively). Compared to the deceased controls, there were proportionally more deaths among the SSc cases from pulmonary arterial hypertension, lung fibrosis, septicemia, gastrointestinal hemorrhage, other systemic connective tissue diseases, and heart failure (for death age causes in this predominantly non-Caucasian sample of SSc patients. Of interest, the percentage of infection-related deaths in our report was about three times higher than that in SSc studies with predominantly Caucasian populations.

Trends in bipolar disorder or depression as a cause of death on death certificates of US residents, 1999-2009.

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Polednak, Anthony P

2013-07-01

Temporal trends in mortality from bipolar disorder (BD) or depression in the US population, based on multiple causes (MC) rather than underlying cause (UC) alone on death certificates, apparently have not been examined. The annual US age-standardized rate (ASR) for deaths per 100,000 US residents age 15+ years, and age-specific rates, for BD or depression using MC versus UC alone was examined for 1999-2009; percentage change (PC) from 1999 to 2009 was calculated. The ASRs at age 15+ years were much higher using MC than UC alone. For BD using MC, the ASR increased from 1999 to 2009 (PC +69.2 %) with larger increases in age groups within 15-64 years (PCs about 200 %). For depression using MC, the ASR rose from 1999 to 2003 and then declined, but the decline was restricted to age 65+ years; the ASR at age 15-64 years increased from 1999 to 2009 (PC +55.5 %). For deaths at age 15-64 years with BD or depression as other than UC, the ASRs increased for external causes, cardiovascular diseases, external causes, and neoplasms as UC. The large increases in mortality from BD using MC are consistent with reported increases in BD prevalence rates in the US population. The temporal increases in death rates related to mood disorders at age 15-64 years may provide further support for the need for interventions to address the mediators of excess mortality identified from cohort studies.

Obesity-related mortality in France, Italy, and the United States: a comparison using multiple cause-of-death analysis.

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Barbieri, Magali; Désesquelles, Aline; Egidi, Viviana; Demuru, Elena; Frova, Luisa; Meslé, France; Pappagallo, Marilena

2017-07-01

We investigate the reporting of obesity on death certificates in three countries (France, Italy, and the United States) with different levels of prevalence, and we examine which causes are frequently associated with obesity. We use cause-of-death data for all deaths at ages 50-89 in 2010-2011. Since obesity may not be the underlying cause (UC) of death, we compute age- and sex-standardized death rates considering all mentions of obesity (multiple causes or MC). We use cluster analyses to identify patterns of cause-of-death combinations. Obesity is selected as UC in no more than 20% of the deaths with a mention of obesity. Mortality levels, whether measured from the UC or the MC, are weakly related to levels of prevalence. Patterns of cause-of-death combinations are similar across the countries. In addition to strong links with cardiovascular diseases and diabetes, we identify several less familiar associations. Considering all mentions on the deaths certificates reduces the underestimation of obesity-related mortality based on the UC only. It also enables us to describe the various mortality patterns involving obesity.

Community-Based Cause of Death Study Linked to Maternal and ...

International Development Research Centre (IDRC) Digital Library (Canada)

Community-Based Cause of Death Study Linked to Maternal and Child ... newborn, and child health "Know-Do Gap" in Ethiopia by piloting a low-cost, ... platform to decrease the cost, while increasing the quality and feasibility, of COD surveys.

Using the National Death Index to Identify Duplicate Cancer Incident Cases in Florida and New York, 1996–2005

Science.gov (United States)

Wohler, Brad; Qiao, Baozhen; MacKinnon, Jill A.; Schymura, Maria J.

2014-01-01

Introduction Cancer registries link incidence data to state death certificates to update vital status and identify missing cases; they also link these data to the National Death Index (NDI) to update vital status among patients who leave the state after their diagnosis. This study explored the use of information from NDI linkages to identify potential duplicate cancer cases registered in both Florida and New York. Methods The Florida Cancer Data System (FCDS) and the New York State Cancer Registry (NYSCR) linked incidence data with state and NDI death records from 1996 through 2005. Information for patients whose death occurred in the reciprocal state (the death state) was exchanged. Potential duplicate cases were those that had the same diagnosis and the same or similar diagnosis date. Results NDI identified 4,657 FCDS cancer patients who died in New York and 2,740 NYSCR cancer patients who died in Florida. Matching identified 5,030 cases registered in both states; 508 were death certificate-only (DCO) cases in the death state’s registry, and 3,760 (74.8%) were potential duplicates. Among FCDS and NYSCR patients who died and were registered in the registry of the reciprocal state, more than 50% were registered with the same cancer diagnosis, and approximately 80% had similar diagnosis dates (within 1 year). Conclusion NDI identified DCO cases in the death state’s cancer registry and a large proportion of potential duplicate cases. Standards are needed for assigning primary residence when multiple registries report the same case. The registry initiating the NDI linkage should consider sharing relevant information with death state registries so that these registries can remove erroneous DCO cases from their databases. PMID:25254985

Quantifying cause-related mortality by weighting multiple causes of death

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Moreno-Betancur, Margarita; Lamarche-Vadel, Agathe; Rey, Grégoire

2016-01-01

Abstract Objective To investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates. Methods We derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared. Findings On average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups. Conclusion A multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality. PMID:27994280

Leading causes of death among decedents with mention of schizophrenia on the death certificates in the United States.

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Lin, Jin-Jia; Liang, Fu-Weng; Li, Chung-Yi; Lu, Tsung-Hsueh

2018-01-30

Little is known about the changes in the ranking of leading cause of death (COD) among people died with schizophrenia across years in the United States (U.S.). This study aims to determine the ranking of leading COD among U.S. decedents with mention of schizophrenia by age from 2000 to 2015. The mortality multiple COD files maintained by the National Center for Health Statistics were used to identify decedents aged 15 years old and above with mention of schizophrenia anywhere on the death certificates to determine the number and proportion of deaths attributed to various underlying CODs. Of 13,289, 13,655, 14,135, and 15,033 people who died in 2000-2003, 2004-2007, 2008-2011and 2012-2015 with mention of schizophrenia, similar to all decedents, heart disease and cancer was the first and the second leading COD throughout the study years. Schizophrenia ranked the third in most years except in 2004-2007. The first leading COD for decedents with mention of schizophrenia aged 15-24, 25-44, 45-64, 65-74, and 75+ years old in 2012-2015 was suicide, accidents, heart disease, heart disease, and Alzheimer's disease and related dementia, respectively. Nevertheless, it was accidents, accidents, cancer, cancer, and heart disease, respectively for all decedents. The ranking of leading CODs among U.S. decedents with mention of schizophrenia changed across years and differed from all decedents by age, which suggest that different interventions should be designed accordingly. Copyright © 2018. Published by Elsevier B.V.

Esophageal cancer among Brazilian agricultural workers: case-control study based on death certificates.

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Meyer, Armando; Alexandre, Pedro Celso Braga; Chrisman, Juliana de Rezende; Markowitz, Steven B; Koifman, Rosalina Jorge; Koifman, Sergio

2011-03-01

Several studies suggest that agricultural workers are at higher risk to develop and die by certain types of cancer. Esophageal cancer is not commonly listed among these types. However, some recent studies indicated that if there is an association between agricultural working and esophageal cancer, it s more likely to be observed among workers highly exposed to pesticides. In the present study, the magnitude of the association between agricultural working and esophageal cancer mortality was evaluated in a high pesticide use area in Brazil, through a death certificate-based case-control study. Cases were individuals from both genders, 30-59 years old, for whom basic cause of death was ascertained as cancer of the esophagus. For each case, one control was randomly selected from all possible controls for which the basic cause of death was ascertained as different from neoplasm and diseases of the digestive system. In addition, controls matched their cases by sex, age, year of death, and state of residence. Crude and adjusted odds ratios were then calculated to estimate the magnitude of the risk. Results showed that, in general, agricultural workers were at significantly higher risk to die by esophageal cancer, when compared to non-agricultural workers. Stratified analysis also revealed that the magnitude of such risk was slightly higher among illiterate agricultural workers, and simultaneous adjustment for several covariates showed that the risk was quantitatively higher among younger southern agricultural workers. These results suggest the esophageal cancer may be included among those types of cancer etiologically associated to agricultural working. Copyright © 2010 Elsevier GmbH. All rights reserved.

Physicians' knowledge and practice on death certification in the North West Bank, Palestine: across sectional study.

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Qaddumi, Jamal A S; Nazzal, Zaher; Yacoub, Allam; Mansour, Mahmoud

2018-01-08

Mortality data are essential for many aspects of everyday public health practices at both national and international levels. Despite the current developments in various aspects of the medical field, the apparent inability of physicians to complete death notification forms (DNF) accurately is still worldwide concern. The aim of this study is to assess the physicians' knowledge and practice on completing the DNF. A self-administered questionnaire was distributed to 200 physicians in governmental and non-governmental hospitals in the North West-Bank in Palestine. Furthermore, a case scenario was included in the questionnaire and physicians were asked to fill the cause of death section. The percentage of errors committed while completing the cause of death section were computed. A Chi square test was used to assess the association between physicians' characteristics and their responses. Only 40.6% of the participants completed the cause of death section correctly. The immediate and underlying causes of death were correctly identified by 48.7% and 71.3% of physicians, respectively. Almost one-fifth (17.3%) of physicians wrote the mechanism of death without reporting the underlying cause of death and 14.7% of them reported the sequence of events leading to death incorrectly. Physicians' knowledge and practice on completing the DNF is poor and insufficient, which may seriously affect the accuracy of mortality data. Complicated cases, problems in the current design of the DNFs and lack of training were the most common factors contributing to inaccuracy in death certification. We recommend offering periodical training workshops on completing the DNF to all physicians, and developing a manual on completing the DNFs with clear instructions and guidelines.

Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.

Science.gov (United States)

Piper, J M; Mitchel, E F; Snowden, M; Hall, C; Adams, M; Taylor, P

1993-04-01

In 1989, the state of Tennessee adopted a new birth certificate which incorporates changes recommended by the National Center for Health Statistics in the revised US Standard Certificate of Live Birth. The data now being collected are intended to provide improved information for understanding maternal and infant health issues. To assess data quality, the authors compared information reported on the 1989 Tennessee birth certificates with the same data obtained from an ongoing case-control study in which the delivery hospital medical records of mothers and infants were reviewed by trained nurse abstractors using a structured data collection instrument. Cases (n = 1,016) were all infants born in Tennessee in 1989 with birth weights less than 1,500 g or other infants who died during the first 28 days of life. The infants were identified from linked birth-death certificate files. Control infants (n = 634) were randomly selected from the noncase population. The most reliable information obtained from birth certificates was descriptive demographic data and birth weight. The quality of information obtained from the new birth certificate checkboxes varied. Routine medical procedures were better reported on the birth certificates than relatively uncommon conditions and occurrences, even serious ones. Caution is needed in using birth certificate data for assessment of maternal medical risk factors, complications of labor and delivery, abnormal conditions of the newborn, and congenital anomalies, since sensitivity is low.

32 CFR 716.7 - Payment of the death gratuity.

Science.gov (United States)

2010-07-01

... certification and voucher for the death gratuity payment. The Comptroller General of the United States has... Certification and Voucher for Death Gratuity Payment, DD Form 397, in original and five copies, completing... 32 National Defense 5 2010-07-01 2010-07-01 false Payment of the death gratuity. 716.7 Section 716...

28 CFR 26.23 - Certification process.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Certification process. 26.23 Section 26.23 Judicial Administration DEPARTMENT OF JUSTICE DEATH SENTENCES PROCEDURES Certification Process for... mechanism for providing legal representation to indigent prisoners in state postconviction proceedings in...

The reliability of perinatal and neonatal mortality rates: Differential under-reporting in linked professional registers vs. Dutch civil registers

NARCIS (Netherlands)

Anthony, S.; Pal-de Bruin, K.M. van der; Graafmans, W.C.; Dorrepaal, C.A.; Borkent-Polet, M.; Hemel, O.J.S. van; Jansen, F.H.M.; Lya Ouden, A. den

2001-01-01

Official Dutch perinatal mortality rates are based on birth and death certificates. These civil registration data are not detailed enough for international comparisons or extensive epidemiological research. In this study, we linked and extrapolated three national incomplete, professional registers

A population-based study of homicide deaths in Ontario, Canada using linked death records.

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Lachaud, James; Donnelly, Peter D; Henry, David; Kornas, Kathy; Calzavara, Andrew; Bornbaum, Catherine; Rosella, Laura

2017-07-24

Homicide - a lethal expression of violence - has garnered little attention from public health researchers and health policy makers, despite the fact that homicides are a cause of preventable and premature death. Identifying populations at risk and the upstream determinants of homicide are important for addressing inequalities that hinder population health. This population-based study investigates the public health significance of homicides in Ontario, Canada, over the period of 1999-2012. We quantified the relative burden of homicides by comparing the socioeconomic gradient in homicides with the leading causes of death, cardiovascular disease (CVD) and neoplasm, and estimated the potential years of life lost (PYLL) due to homicide. We linked vital statistics from the Office of the Registrar General Deaths register (ORG-D) with Census and administrative data for all Ontario residents. We extracted all homicide, neoplasm, and cardiovascular deaths from 1999 to 2012, using International Classification of Diseases codes. For socioeconomic status (SES), we used two dimensions of the Ontario Marginalization Index (ON-Marg): material deprivation and residential instability. Trends were summarized across deprivation indices using age-specific rates, rate ratios, and PYLL. Young males, 15-29 years old, were the main victims of homicide with a rate of 3.85 [IC 95%: 3.56; 4.13] per 100,000 population and experienced an upward trend over the study period. The socioeconomic neighbourhood gradient was substantial and higher than the gradient for both cardiovascular and neoplasms. Finally, the PYLL due to homicide were 63,512 and 24,066 years for males and females, respectively. Homicides are an important cause of death among young males, and populations living in disadvantaged neighbourhoods. Our findings raise concerns about the burden of homicides in the Canadian population and the importance of addressing social determinants to address these premature deaths.

Certified causes of death in patients with mesothelioma in South East England

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Peto Julian

2009-01-01

Full Text Available Abstract Background Mesothelioma is a highly fatal cancer that is caused by exposure to asbestos fibres. In many populations, the occurrence of mesothelioma is monitored with the use of mortality data from death certification. We examine certified causes of death of patients who have been diagnosed with mesothelioma, and assess the validity of death certification data as a proxy for mesothelioma incidence. Methods We extracted mesothelioma registrations in the South East of England area between 2000 and 2004 from the Thames Cancer Registry database. We retained for analysis 2200 patients who had died at the time of analysis, after having excluded seven dead cases where the causes of death were not known to the cancer registry. The 2200 deaths were classified hierarchically to identify (1 mesothelioma deaths, (2 deaths certified as lung cancer deaths or (3 deaths from unspecified cancer, and (4 deaths from other causes. Results 87% of the patients had mesothelioma mentioned on the death certificate. 6% had no mention of mesothelioma but included lung cancer as a cause of death. Another 6% had no mention of mesothelioma or lung cancer, but included an unspecified cancer as a cause of death. Lastly, 2% had other causes of death specified on the death certificate. Conclusion This analysis suggests that official mortality data may underestimate the true occurrence of mesothelioma by around 10%.

The Danish registers of causes of death

DEFF Research Database (Denmark)

Juel, K; Helweg-Larsen, K

1999-01-01

In 1875 registration of causes of death in Denmark was established by the National Board of Health, and annual statistics of death have since been published. Until 1970 the national statistics were based upon punched cards with data collected from the death certificates. Since then the register has...... been fully computerized and includes individual based data of all deaths occurring among all residents in Denmark dying in Denmark. Furthermore, a microfilm of all death certificates from 1943 and onward is kept in the National Board of Health. The Danish Institute for Clinical Epidemiology (DICE) has...... established a computerized register of individual records of deaths in Denmark from 1943 and onwards. No other country covers computerized individual based data of death registration for such a long period, now 54 years. This paper describes the history of the registers, the data sources and access to data...

Reliability of cause of death coding: an international comparison.

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Antini, Carmen; Rajs, Danuta; Muñoz-Quezada, María Teresa; Mondaca, Boris Andrés Lucero; Heiss, Gerardo

2015-07-01

This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ≥ 60, issued in 2008 in the Valparaíso and Metropolitan regions, Chile. All causes of death were converted to ICD-10 codes in parallel by both coders. Concordance was analyzed with inter-coder agreement and Cohen's kappa coefficient by level of specification ICD-10 code for the underlying cause and the total causes of death coding. Inter-coder agreement was 76.4% for all causes of death and 80.6% for the underlying cause (agreement at the four-digit level), with differences by the level of specification of the ICD-10 code, by line of the death certificate, and by number of causes of death per certificate. Cohen's kappa coefficient was 0.76 (95%CI: 0.68-0.84) for the underlying cause and 0.75 (95%CI: 0.74-0.77) for the total causes of death. In conclusion, causes of death coding and inter-coder agreement for cardiovascular diseases in two regions of Chile are comparable to an external benchmark and with reports from other countries.

Correcting the Count: Improving Vital Statistics Data Regarding Deaths Related to Obesity.

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McCleskey, Brandi C; Davis, Gregory G; Dye, Daniel W

2017-11-15

Obesity can involve any organ system and compromise the overall health of an individual, including premature death. Despite the increased risk of death associated with being obese, obesity itself is infrequently indicated on the death certificate. We performed an audit of our records to identify how often "obesity" was listed on the death certificate to determine how our practices affected national mortality data collection regarding obesity-related mortality. During the span of nearly 25 years, 0.2% of deaths were attributed to or contributed by obesity. Over the course of 5 years, 96% of selected natural deaths were likely underreported as being associated with obesity. We present an algorithm for certifiers to use to determine whether obesity should be listed on the death certificate and guidelines for certifying cases in which this is appropriate. Use of this algorithm will improve vital statistics concerning the role of obesity in causing or contributing to death. © 2017 American Academy of Forensic Sciences.

Impact of documentation errors on accuracy of cause of death coding in an educational hospital in Southern Iran.

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Haghighi, Mohammad Hosein Hayavi; Dehghani, Mohammad; Teshnizi, Saeid Hoseini; Mahmoodi, Hamid

2014-01-01

Accurate cause of death coding leads to organised and usable death information but there are some factors that influence documentation on death certificates and therefore affect the coding. We reviewed the role of documentation errors on the accuracy of death coding at Shahid Mohammadi Hospital (SMH), Bandar Abbas, Iran. We studied the death certificates of all deceased patients in SMH from October 2010 to March 2011. Researchers determined and coded the underlying cause of death on the death certificates according to the guidelines issued by the World Health Organization in Volume 2 of the International Statistical Classification of Diseases and Health Related Problems-10th revision (ICD-10). Necessary ICD coding rules (such as the General Principle, Rules 1-3, the modification rules and other instructions about death coding) were applied to select the underlying cause of death on each certificate. Demographic details and documentation errors were then extracted. Data were analysed with descriptive statistics and chi square tests. The accuracy rate of causes of death coding was 51.7%, demonstrating a statistically significant relationship (p=.001) with major errors but not such a relationship with minor errors. Factors that result in poor quality of Cause of Death coding in SMH are lack of coder training, documentation errors and the undesirable structure of death certificates.

Maternal deaths in Denmark 2002-2006

DEFF Research Database (Denmark)

Bødker, Birgit; Hvidman, Lone; Weber, Tom

2009-01-01

OBJECTIVE: To describe a method for identification, classification and assessment of maternal deaths in Denmark and to identify substandard care. DESIGN: Register study and case audit based on data from the Registers of the Danish Medical Health Board, death certificates and hospital records. SET...

Social representations of obstetricians and neonatologists about fetal and early neonatal death certificate in the city of São Paulo.

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Schoeps, Daniela; Lefevre, Fernando; Silva, Zilda Pereira; Novaes, Hillegonda Maria Dutilh; Raspantini, Priscila Ribeiro; de Almeida, Márcia Furquim

2014-01-01

The insatisfactory completeness of the variables in the Death Certificate (DC) makes it difficult to obtain specific perinatal mortality indicators. To assess the social representation of physicians about the perinatal DC. Twenty-five physicians were interviewed in 15 hospitals in the city of São Paulo, in 2009. Qualitative analysis was performed with the Collective Subject Discourse technique. The DC is primarily considered according to its legal aspect. Physicians feel responsible for fulfilling the cause of death. The majority of them reported receiving help from other professionals to complete information on maternal characteristics and identification variables. There is lack of information on the mother's pre-natal conditions, which can make it difficult to identify the perinatal cause of death, mainly in the Unified Health System (SUS) hospitals. Some participants received specific DC training only when attending medical schools. The organization of medical work may affect the completion of the DC, especially in hospitals from SUS. Other professionals contributed to this task and their training can improve the quality of information.

[Cause-of-death statistics and ICD, quo vadis?

Science.gov (United States)

Eckert, Olaf; Vogel, Ulrich

2018-07-01

The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

[Prevalence of Down syndrome using certificates of live births and fetal deaths in México 2008-2011].

Science.gov (United States)

Sierra Romero, María Del Carmen; Navarrete Hernández, Eduardo; Canún Serrano, Sonia; Reyes Pablo, Aldelmo E; Valdés Hernández, Javier

Down syndrome (DS) or trisomy 21 is the most common genetic cause of mental retardation with the clinical presentation of a series of well-defined characteristics. Advanced maternal age has been associated with DS. The databases of all the certificates of live births and fetal deaths in Mexico were combined. Codes based on the International Classification of Diseases 10 th Revision (ICD-10) in Chapter XVII "Congenital malformations, deformations and chromosomal abnormalities" were selected. A database of 8,250,375 births during the period 2008-2011 was constructed: 99.2% were live births with 0.8% of fetal deaths and 3,076 cases diagnosed with DS. The importance of this report is to initiate an epidemiological surveillance of newborn cases of DS nationwide and by state using census information systems available in the country since 2008. An increased risk has been observed for having a child with DS since the mother is ≥ 35 years, as has been reported in other studies. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

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Amos Grünebaum

Full Text Available Over the last decade, planned home births in the United States (US have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status.The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States.This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM, nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board.Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53 than home births attended by certified midwives (NNM: 10.0/10,000; RR 1 and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]. The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2.This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal

Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

Science.gov (United States)

Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A

2016-01-01

Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States. This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life) in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams) without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM), nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board. Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53) than home births attended by certified midwives (NNM: 10.0/10,000; RR 1) and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]). The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2). This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal mortality rates

Cyclophilin D links programmed cell death and organismal aging in Podospora anserina.

Science.gov (United States)

Brust, Diana; Daum, Bertram; Breunig, Christine; Hamann, Andrea; Kühlbrandt, Werner; Osiewacz, Heinz D

2010-10-01

Cyclophilin D (CYPD) is a mitochondrial peptidyl prolyl-cis,trans-isomerase involved in opening of the mitochondrial permeability transition pore (mPTP). CYPD abundance increases during aging in mammalian tissues and in the aging model organism Podospora anserina. Here, we show that treatment of the P. anserina wild-type with low concentrations of the cyclophilin inhibitor cyclosporin A (CSA) extends lifespan. Transgenic strains overexpressing PaCypD are characterized by reduced stress tolerance, suffer from pronounced mitochondrial dysfunction and are characterized by accelerated aging and induction of cell death. Treatment with CSA leads to correction of mitochondrial function and lifespan to that of the wild-type. In contrast, PaCypD deletion strains are not affected by CSA within the investigated concentration range and show increased resistance against inducers of oxidative stress and cell death. Our data provide a mechanistic link between programmed cell death (PCD) and organismal aging and bear implications for the potential use of CSA to intervene into biologic aging. © 2010 The Authors Aging Cell © 2010 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland.

Review of errors in the issue of medical certificates of cause of death ...

African Journals Online (AJOL)

... significant errors in MCCD records, with the errors more likely in certificates issued by non-specialist medical officers. All the certificates audited had at least one minor error. Training of doctors on proper completion of MCCDs is strongly advocated. Funding: None of the authors received any financial support for this study.

Volatile substance misuse deaths in Washington State, 2003-2012.

Science.gov (United States)

Ossiander, Eric M

2015-01-01

Volatile substance misuse (VSM - also known as huffing or sniffing) causes some deaths, but because there are no specific cause-of-death codes for VSM, these deaths are rarely tabulated. Count and describe VSM deaths occurring in Washington State during 2003-2012. We used the textual cause-of-death information on death certificates to count VSM-associated deaths that occurred in Washington State during 2003-2012. We extracted records that contained words suggesting either a method of inhalation or a substance commonly used for VSM, and reviewed those records to identify deaths on which the inhalation of a volatile substance was mentioned. We conducted a descriptive analysis of those deaths. Fifty-six deaths involving VSM occurred in Washington State during 2003-2012. VSM deaths occurred primarily among adults age 20 and over (91%), males (88%), and whites (93%). Twelve different chemicals were associated with deaths, but 1 of them, difluoroethane, was named on 30 death certificates (54%), and its involvement increased during the study period. Gas duster products were named as the source of difluoroethane for 12 deaths; no source was named for the other 18 difluoroethane deaths. Most VSM deaths occurred among white male adults, and gas duster products containing difluoroethane were the primary source of inhalants. Approaches to deter VSM, such as the addition of bitterants to gas dusters, should be explored.

Certifications of citizenship: reflections through an African lens

DEFF Research Database (Denmark)

Hammar, Amanda

2018-01-01

A focus on certifications of citizenship as a range of inter-related practices of identity classification, categorisation, registration and validation, provides productive opportunities to explore the many ways that different authorities and/or different citizens engage with both the meaning...... and materiality of identity documents. At the heart of such practices is a complex politics of recognition that in turn is linked to the political economies of certification and of certificates themselves. A selection of African cases helps to highlight some of the paradoxes of certification – such as its...... and Asia and beyond, making transnational conversations especially meaningful for deeper understandings of the complexities of the authority-certification-citizenship nexus....

Disrupted day-night pattern of cardiovascular death in obstructive sleep apnea.

Science.gov (United States)

Martins, Emerson Ferreira; Martinez, Denis; da Silva, Fernando A Boeira Sabino; Sezerá, Lauren; da Rosa de Camargo, Rodrigo; Fiori, Cintia Zappe; Fuchs, Flávio Danni; Moraes, Ruy Silveira

2017-10-01

Obstructive sleep apnea (OSA) patients who suffer sudden cardiac death die predominantly during the night. We aimed to investigate whether all cardiovascular-related deaths display the same night-time peak as sudden cardiac death. Data from a large cohort of adults who underwent full-night polysomnography between 1985 and 2015 in a university-affiliated sleep clinic were analyzed. Time and cause of death of these patients and of persons from the general population were identified in death certificates from the State Health Secretariat. The day-night pattern of cardiovascular death was compared among groups of non-OSA, OSA (apnea-hypopnea index, AHI ≥5), CPAP users, and persons from the general population. Among 619 certificates, 160 cardiovascular-related deaths were identified. The time of death of the 142 persons with OSA was uniformly distributed over 24 h, with neither an identifiable peak nor a circadian pattern (Rayleigh test; P = 0.8); the same flat distribution was seen in those with purported CPAP use (n = 49). Non-OSA individuals presented a morning peak and a night nadir of deaths, clearer when analyzed in eight-hour intervals. The same pattern was observed in 92 836 certificates from the State general population, with cardiovascular deaths showing the expected morning peak, night nadir, and a significant circadian pattern (Rayleigh test; P < 0.001). In OSA patients, the distribution of cardiovascular-related deaths throughout the 24-h period is virtually flat, in contrast with the described nighttime peak of sudden cardiac death. OSA-related phenomena during nighttime might be blunting the mechanisms, arrhythmic or not, behind the morning peak of cardiovascular-related deaths. Copyright © 2017 Elsevier B.V. All rights reserved.

Obtaining your annual internal taxation certificate

CERN Document Server

2006-01-01

(cf. Article R IV 2.04 of the Staff Regulations) Your annual internal taxation certificate will state the taxable amount of your CERN remuneration, payments and other financial benefits and the amount of tax levied by the Organization during the previous financial year. In France, your tax return must be accompanied by this certificate. Current Members of the Personnel (including Members of the Personnel participating in a pre-retirement programme): - You will receive an e-mail containing a link to your printable annual certificate, which will be stored together with your pay and leave statements (e-Payslips). - You can also access your annual certificate via https://hrt.cern.ch (open 'My Payslips' at the bottom of the main menu.) - If you experience any technical difficulties in accessing your annual certificate (e.g. invalid AIS login or password), please contact CERN's AIS support team at ais.support@cern.ch. Former Members of the Personnel:- If you remember your AIS login and password, you can acc...

Sudden Cardiac Death

DEFF Research Database (Denmark)

Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

2017-01-01

Objectives This study sought to describe the use of pharmacotherapy in a nationwide cohort of young patients with sudden cardiac death (SCD). Background Several drugs have been associated with an increased risk of SCD and sudden arrhythmic death syndrome (SADS). It remains unclear how...... pharmacotherapy may contribute to the overall burden of SCD in the general population. Methods This was a nationwide study that included all deaths that occurred between 2000 and 2009 and between 2007 and 2009 in people age 1 to 35 years and 36 to 49 years, respectively. Two physicians identified all SCDs through...... review of death certificates. Autopsy reports were collected. Pharmacotherapy prescribed within 90 days before SCD was identified in the Danish Registry of Medicinal Product Statistics. Results We identified 1,363 SCDs; median age was 38 years (interquartile range: 29 to 45 years), and 72% (n = 975) were men...

[Coding Causes of Death with IRIS Software. Impact in Navarre Mortality Statistic].

Science.gov (United States)

Floristán Floristán, Yugo; Delfrade Osinaga, Josu; Carrillo Prieto, Jesus; Aguirre Perez, Jesus; Moreno-Iribas, Conchi

2016-08-02

There are few studies that analyze changes in mortality statistics derived from the use of IRIS software, an automatic system for coding multiple causes of death and for the selection of the underlying cause of death, compared to manual coding. This study evaluated the impact of the use of IRIS in the Navarre mortality statistic. We proceeded to double coding 5,060 death certificates corresponding to residents in Navarra in 2014. We calculated coincidence between the two encodings for ICD10 chapters and for the list of causes of the Spanish National Statistics Institute (INE-102) and we estimated the change on mortality rates. IRIS automatically coded 90% of death certificates. The coincidence to 4 characters and in the same chapter of the CIE10 was 79.1% and 92.0%, respectively. Furthermore, coincidence with the short INE-102 list was 88.3%. Higher matches were found in death certificate of people under 65 years. In comparison with manual coding there was an increase in deaths from endocrine diseases (31%), mental disorders (19%) and disease of nervous system (9%), while a decrease of genitourinary system diseases was observed (21%). The coincidence at level of ICD10 chapters coding by IRIS in comparison to manual coding was 9 out of 10 deaths, similar to what is observed in other studies. The implementation of IRIS has led to increased of endocrine diseases, especially diabetes and hyperlipidaemia, and mental disorders, especially dementias.

Burden of sudden cardiac death in persons aged 1 to 49 years

DEFF Research Database (Denmark)

Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

2014-01-01

: All deaths in persons aged 1 to 49 years were included in 2007 to 2009. Death certificates were reviewed by 2 physicians. History of previous admissions to hospital was assessed, and discharge summaries were read. Sudden unexpected death cases were identified and autopsy reports were collected...

Strangulation and Its Role in Multiple Causes of Death.

Science.gov (United States)

Hlavaty, Leigh; Sung, LokMan

2017-12-01

Forensic pathologists have a duty to determine the cause and manner of death and are bound by international guidelines in the completion of the death certificate. Sometimes, there are complex circumstances surrounding a death that cannot be captured in the structure of the death certificate and its requirement of listing only 1 cause of death per line. Cases may have multiple causes of death with comorbid medical conditions or inflicted injuries that equally contribute to the ultimate demise. Compared with other forms of homicide, autopsy evidence of strangulation will often be found with other life-threatening traumatic injuries. The Wayne County Medical Examiner's Office conducted a retrospective study of strangulation cases that came into the office from mid-2007 to the end of 2016. The purpose of the study was to examine patterns of injuries in strangulation cases and identify those with additional traumatic injuries of commensurate extent that required incorporation into the cause of death. A total of 43 strangulation cases were found, of which there were equal numbers of ligature and manual strangulations (19 each) and 5 cases in which the method was not specified, and decedents were divided: 63% female and 37% male. Fourteen of these cases were recognized to have multiple causes of death, where blunt force trauma was the most common additional cause, and the sex distribution weighed heavily toward the female (approximately 79%).

Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival?

Science.gov (United States)

Tervonen, Hanna E; Roder, David; Morrell, Stephen; You, Hui; Currow, David C

2017-06-01

Death Certificate Only (DCO) cancer cases are commonly excluded from survival analyses due to unknown survival time. This study examines whether socio-demographic factors are associated with DCO diagnosis, and the potential effects of excluding DCO cases on socio-demographic cancer survival disparities in NSW, Australia. NSW Cancer Registry data for cases diagnosed in 2000-2008 were used in this study. Logistic regression was used to estimate the odds of DCO registration by socio-demographic sub-group (socio-economic disadvantage, residential remoteness, country of birth, age at diagnosis). Cox proportional hazard regression was used to estimate the probability of death from cancer by socio-demographic subgroup when DCO cases were included and excluded from analyses. DCO cases consisted of 1.5% (n=4336) of all cases (n=299,651). DCO diagnosis was associated with living in socio-economically disadvantaged areas (most disadvantaged compared with least disadvantaged quintile: odds ratio OR 1.25, 95%CI 1.12-1.40), living in inner regional (OR 1.16, 95%CI 1.08-1.25) or remote areas (OR 1.48, 95%CI 1.01-2.19), having an unknown country of birth (OR 1.63, 95%CI 1.47-1.81) and older age. Including or excluding DCO cases had no significant impact on hazard ratios for cancer death by socio-economic disadvantage quintile or remoteness category, and only a minor impact on hazard ratios by age. Socio-demographic factors were associated with DCO diagnosis in NSW. However, socio-demographic cancer survival disparities remained unchanged or varied only slightly irrespective of including/excluding DCO cases. Further research could examine the upper limits of DCO proportions that significantly alter estimated cancer survival differentials if DCOs are excluded. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Sudden unexpected death in infancy in Denmark

DEFF Research Database (Denmark)

Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane

2011-01-01

Abstract Background. Incidence of sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS) differs among studies and non-autopsied cases are difficult to assess. Objectives. To investigate causes of sudden death in infancy in a nationwide setting. Validate the use...... of the ICD-10 code for SIDS (R95) in the Danish Cause of Death registry. Design. A retrospective analysis of all infant deaths (death certificates and autopsy reports were read. Results. We identified 192 SUDI cases (10% of total deaths, 0.42 per 1000 births......) with autopsy performed in 87% of cases. In total, 49% of autopsied SUDI cases were defined as SIDS (5% of all deaths, 0.22 per 1000 births); Cardiac cause of death was denoted in 24% of cases. The Danish Cause of Death Registry misclassified 30% of SIDS cases. Conclusions. A large proportion of infant deaths...

Surveillance for Violent Deaths - National Violent Death Reporting System, 17 States, 2013.

Science.gov (United States)

Lyons, Bridget H; Fowler, Katherine A; Jack, Shane P D; Betz, Carter J; Blair, Janet M

2016-08-19

In 2013, more than 57,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 17 U.S. states for 2013. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2013. NVDRS collects data from participating states regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 17 states that collected statewide data for 2013 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, North Carolina, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) from a single incident. For 2013, a total of 18,765 fatal incidents involving 19,251 deaths were captured by NVDRS in the 17 states included in this report. The majority (66.2%) of deaths were suicides, followed by homicides (23.2%), deaths of undetermined intent (8.8%), deaths involving legal intervention (1.2%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (Revision [ICD-10] and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Suicides occurred at higher rates among males, non-Hispanic whites, American Indian/Alaska Natives, persons aged 45-64 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, or physical

[Causes of death of German refugee children in 1945].

Science.gov (United States)

Lylloff, K

2000-02-28

In the last months of the second World War, 250,000 German refugees landed in Denmark. A third of them were children under the age of 15. Seven thousand German refugee children under the age of five died in Denmark in 1945. Using birth certificates and death certificates from the Danish national archives and burial lists from the German refugee cemetaries I have collected data to reveal causes of death, age distributions and time of the deaths of the 7000 fatal cases among children under the age of five. Three thousand children under the age of one, 2000 children one year old and 2000 children 2-4 years old died. Most of them died just before and after the German surrender, but many died in the months following the German surrender. The infant mortality was extremely high all during 1945. The infants died from diseases due to malnutrition, but the older the children the more likely the causes of death were due to infectious diseases such as pneumonia, measles, diphtheria and gastroenteritis.

Análise do preenchimento de declarações de óbitos em localidade do Estado do Rio Grande do Sul (Brasil, 1987 An analysis of death certificate information in a locality of the State of Rio Grande do Sul (Brazil, 1987

Directory of Open Access Journals (Sweden)

Irajá Carneiro Heckmann

1989-08-01

Full Text Available É analisado o preenchimento dos itens existentes nas declarações de óbito registradas para o Município de Viamão, Rio Grande do Sul, Brasil, durante 1987. Os itens foram sistematizados segundo as informações em branco, ignoradas ou incorretas. Observou-se uma pequena omissão no preenchimento dos dados de identificação do falecido, sendo maior no tocante aos antecedentes sociais e obstétricos, assistência médica e casos de morte violenta. Para melhorar o preenchimento das declarações de óbito sugere-se processo de sensibilização contínua do médico para a importância dos dados por ele assinalados, capacitação de funcionários administrativos que lidam com as declarações e realização de estudos de mortalidade setorizados por serviços de saúde.It was analyzed the quality of death certificate information for deaths registed in Viamão county (Rio Grande do Sul, Brazil during 1987, considering unfilled blanks, and unknown and incorrect responses. Small omissions were found in data identifying the person who had died; larger omissions in data concerning social and obstetric history, medical assistance, and violent deaths. To improve the quality of death certificate information it was suggested that physicians be continually reminded of the importance of giving the correct information on death certificates to allow for their later adequate administrative and research use.

Potencial epidemiológico da utilização das causas múltiplas de morte por meio de suas menções nas declarações de óbito, Brasil, 2003 Epidemiological potential of multiple-cause-of-death data listed on death certificates, Brazil, 2003

Directory of Open Access Journals (Sweden)

Augusto Hasiak Santo

2007-09-01

. A combinação das duas metodologias é mais útil do que o uso de uma delas isoladamente.OBJECTIVE: To evaluate the automated processing and the epidemiological potential of multiple-cause-of-death data listed on death certificates in Brazil in 2003. METHODS: Data were obtained from the Brazilian Mortality Information System. The distribution of the number of causes per death certificate was processed using the Multiple Cause of Death Tabulator software and expressed as a percentage of the total deaths in federation units, regions, and in the country as a whole. For the main causes of death identified in Brazil in 2003, we calculated the rate at which each cause was listed as the "underlying cause of death" in relation to the total times the cause was mentioned. RESULTS: The mean number of causes of death per certificate ranged from 2.07 in the state of Maranhão to 3.15 in the state of São Paulo, and from 2.45 in the Northeast to 2.99 in the Mid-West. For the entire country, the mean number of causes of death per certificate was 2.81. External causes and neoplasms, unattended deaths, human immunodeficiency virus, and alcoholic liver disease were listed as the underlying cause more than 90% of the times they were mentioned; neoplasms, Chagas’ disease, congenital malformations, ischemic heart diseases, and cerebrovascular diseases, between 70% to less than 90% of the times they were mentioned; and pneumonias, heart failure, alcohol dependence, malnutrition, hypertensive diseases, anemias, ill-defined causes, prematurity, septicemias, and respiratory failure, less than 40% of the times they were mentioned. CONCLUSIONS: Although underlying causes of death are still essential to analyze historical trends, compare countries, and to guide the prevention of death, multiple-cause-of-death-data offer a new insight into the study of mortality. The combination of the two methodologies is more useful than the isolated use of either approach.

The anticipation of death by violence: a psychological profile.

Science.gov (United States)

Mahoney, J; Kyle, D; Katz, G

1975-01-01

College students (n = 172) completed Cattell's personality factor questionnaire, Rotter's locus of control scale, Speilberger's trait anxiety measure, and Sabatini and Kastenbaum's self-completed death certificate. Comparison of profiles for subjects anticipating sudden violent death (SVD, n = 59) with those anticipating natural death (ND, n = 113) disclosed that the SVD group was characteristically more anxious and socially isolated. A sex-by-type of death interaction occurred for locus of control, with SVD females being the most external, suggesting that this group was more likely to "give up" in response to stress. The data support Shneidman's concept of subintentioned death in disclosing that several personality factors may be associated with violent death.

5 CFR 1330.404 - Certification criteria.

Science.gov (United States)

2010-01-01

... PERSONNEL MANAGEMENT HUMAN RESOURCES MANAGEMENT Performance Appraisal Certification for Pay Purposes § 1330... the performance expectations for individual senior employees derive from, and clearly link to, the... and budget priorities; (2) Consultation, so that the performance expectations for senior employees...

Automatic coding and selection of causes of death: an adaptation of Iris software for using in Brazil.

Science.gov (United States)

Martins, Renata Cristófani; Buchalla, Cassia Maria

2015-01-01

To prepare a dictionary in Portuguese for using in Iris and to evaluate its completeness for coding causes of death. Iniatially, a dictionary with all illness and injuries was created based on the International Classification of Diseases - tenth revision (ICD-10) codes. This dictionary was based on two sources: the electronic file of ICD-10 volume 1 and the data from Thesaurus of the International Classification of Primary Care (ICPC-2). Then, a death certificate sample from the Program of Improvement of Mortality Information in São Paulo (PRO-AIM) was coded manually and by Iris version V4.0.34, and the causes of death were compared. Whenever Iris was not able to code the causes of death, adjustments were made in the dictionary. Iris was able to code all causes of death in 94.4% death certificates, but only 50.6% were directly coded, without adjustments. Among death certificates that the software was unable to fully code, 89.2% had a diagnosis of external causes (chapter XX of ICD-10). This group of causes of death showed less agreement when comparing the coding by Iris to the manual one. The software performed well, but it needs adjustments and improvement in its dictionary. In the upcoming versions of the software, its developers are trying to solve the external causes of death problem.

Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

Science.gov (United States)

Hogan, Cathy

2014-01-01

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

Impact of unlinked deaths and coding changes on mortality trends in the Swiss National Cohort.

Science.gov (United States)

Schmidlin, Kurt; Clough-Gorr, Kerri M; Spoerri, Adrian; Egger, Matthias; Zwahlen, Marcel

2013-01-04

Results of epidemiological studies linking census with mortality records may be affected by unlinked deaths and changes in cause of death classification. We examined these issues in the Swiss National Cohort (SNC). The SNC is a longitudinal study of the entire Swiss population, based on the 1990 (6.8 million persons) and 2000 (7.3 million persons) censuses. Among 1,053,393 deaths recorded 1991-2007 5.4% could not be linked using stringent probabilistic linkage. We included the unlinked deaths using pragmatic linkages and compared mortality rates for selected causes with official mortality rates. We also examined the impact of the 1995 change in cause of death coding from version 8 (with some additional rules) to version 10 of the International Classification of Diseases (ICD), using Poisson regression models with restricted cubic splines. Finally, we compared results from Cox models including and excluding unlinked deaths of the association of education, marital status, and nationality with selected causes of death. SNC mortality rates underestimated all cause mortality by 9.6% (range 2.4%-17.9%) in the 85+ population. Underestimation was less pronounced in years nearer the censuses and in the 75-84 age group. After including 99.7% of unlinked deaths, annual all cause SNC mortality rates were reflecting official rates (relative difference between -1.4% and +1.8%). In the 85+ population the rates for prostate and breast cancer dropped, by 16% and 21% respectively, between 1994 and 1995 coincident with the change in cause of death coding policy. For suicide in males almost no change was observed. Hazard ratios were only negligibly affected by including the unlinked deaths. A sudden decrease in breast (21% less, 95% confidence interval: 12%-28%) and prostate (16% less, 95% confidence interval: 7%-23%) cancer mortality rates in the 85+ population coincided with the 1995 change in cause of death coding policy. Unlinked deaths bias analyses of absolute mortality rates

Impact of unlinked deaths and coding changes on mortality trends in the Swiss National Cohort

Directory of Open Access Journals (Sweden)

Schmidlin Kurt

2013-01-01

Full Text Available Abstract Background Results of epidemiological studies linking census with mortality records may be affected by unlinked deaths and changes in cause of death classification. We examined these issues in the Swiss National Cohort (SNC. Methods The SNC is a longitudinal study of the entire Swiss population, based on the 1990 (6.8 million persons and 2000 (7.3 million persons censuses. Among 1,053,393 deaths recorded 1991–2007 5.4% could not be linked using stringent probabilistic linkage. We included the unlinked deaths using pragmatic linkages and compared mortality rates for selected causes with official mortality rates. We also examined the impact of the 1995 change in cause of death coding from version 8 (with some additional rules to version 10 of the International Classification of Diseases (ICD, using Poisson regression models with restricted cubic splines. Finally, we compared results from Cox models including and excluding unlinked deaths of the association of education, marital status, and nationality with selected causes of death. Results SNC mortality rates underestimated all cause mortality by 9.6% (range 2.4% - 17.9% in the 85+ population. Underestimation was less pronounced in years nearer the censuses and in the 75–84 age group. After including 99.7% of unlinked deaths, annual all cause SNC mortality rates were reflecting official rates (relative difference between −1.4% and +1.8%. In the 85+ population the rates for prostate and breast cancer dropped, by 16% and 21% respectively, between 1994 and 1995 coincident with the change in cause of death coding policy. For suicide in males almost no change was observed. Hazard ratios were only negligibly affected by including the unlinked deaths. A sudden decrease in breast (21% less, 95% confidence interval: 12% - 28% and prostate (16% less, 95% confidence interval: 7% - 23% cancer mortality rates in the 85+ population coincided with the 1995 change in cause of death coding policy

Expression of ALS/FTD-linked mutant CCNF in zebrafish leads to increased cell death in the spinal cord and an aberrant motor phenotype.

Science.gov (United States)

Hogan, Alison L; Don, Emily K; Rayner, Stephanie L; Lee, Albert; Laird, Angela S; Watchon, Maxinne; Winnick, Claire; Tarr, Ingrid S; Morsch, Marco; Fifita, Jennifer A; Gwee, Serene S L; Formella, Isabel; Hortle, Elinor; Yuan, Kristy C; Molloy, Mark P; Williams, Kelly L; Nicholson, Garth A; Chung, Roger S; Blair, Ian P; Cole, Nicholas J

2017-07-15

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive, fatal neurodegenerative disease characterised by the death of upper and lower motor neurons. Approximately 10% of cases have a known family history of ALS and disease-linked mutations in multiple genes have been identified. ALS-linked mutations in CCNF were recently reported, however the pathogenic mechanisms associated with these mutations are yet to be established. To investigate possible disease mechanisms, we developed in vitro and in vivo models based on an ALS-linked missense mutation in CCNF. Proteomic analysis of the in vitro models identified the disruption of several cellular pathways in the mutant model, including caspase-3 mediated cell death. Transient overexpression of human CCNF in zebrafish embryos supported this finding, with fish expressing the mutant protein found to have increased levels of cleaved (activated) caspase-3 and increased cell death in the spinal cord. The mutant CCNF fish also developed a motor neuron axonopathy consisting of shortened primary motor axons and increased frequency of aberrant axonal branching. Importantly, we demonstrated a significant correlation between the severity of the CCNF-induced axonopathy and a reduced motor response to a light stimulus (photomotor response). This is the first report of an ALS-linked CCNF mutation in vivo and taken together with the in vitro model identifies the disruption of cell death pathways as a significant consequence of this mutation. Additionally, this study presents a valuable new tool for use in ongoing studies investigating the pathobiology of ALS-linked CCNF mutations. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Lupus - An Unrecognized Leading Cause of Death in Young Women: Population-based Study Using Nationwide Death Certificates, 2000-2015.

Science.gov (United States)

Yen, Eric Y; Singh, Ram R

2018-04-18

Mortality statistics from the Centers for Disease Control and Prevention (CDC) is used for planning healthcare policy and allocating resources. CDC uses this data to compile its annual leading-causes-of-death ranking based on a selected list of 113 causes. SLE is not included on this list. Since the cause-of-death ranking is a useful tool for assessing the relative burden of cause-specific mortality, we ranked SLE deaths among CDC's leading causes-of-death to see whether SLE is a significant cause of death among women. Death counts were obtained from the CDC's Wide-ranging Online Data for Epidemiologic Research database in U.S. female population, and then grouped by age and race/ethnicity. Data on the leading causes-of-death were obtained from the Web-based Injury Statistics Query and Reporting System database. During 2000 to 2015, there were 28,411 female deaths with SLE recorded as the underlying or contributing causes of death. SLE ranked among the top 20 leading-causes-of-death in females between 5 and 64 years of age. SLE ranked 10 th in the 15-24 years, 14 th in the 25-34 and the 35-44 years, and 15 th in the 10-14 years age groups. Among black and Hispanic females, SLE ranked 5 th in the 15-24 years, 6 th in the 25-34 years, and 8 th -9 th in the 35-44 years age groups, after excluding the three common external injury causes of death from analysis. SLE is among the leading-causes-of-death in young women, underscoring its impact as an important public health issue. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Measuring chronic liver disease mortality using an expanded cause of death definition and medical records in Connecticut, 2004.

Science.gov (United States)

Ly, Kathleen N; Speers, Suzanne; Klevens, R Monina; Barry, Vaughn; Vogt, Tara M

2014-10-16

Chronic liver disease (CLD) is a leading cause of death and is defined based on a specific set of underlying cause-of-death codes on death certificates. This conventional approach to measuring CLD mortality underestimates the true mortality burden because it does not consider certain CLD conditions like viral hepatitis and hepatocellular carcinoma. We measured how much the conventional CLD mortality case definition will underestimate CLD mortality and described the distribution of CLD etiologies in Connecticut. We used 2004 Connecticut death certificates to estimate CLD mortality two ways. One way used the conventional definition and the other used an expanded definition that included more conditions suggestive of CLD. We compared the number of deaths identified using this expanded definition with the number identified using the conventional definition. Medical records were reviewed to confirm CLD deaths. Connecticut had 29 314 registered deaths in 2004. Of these, 282 (1.0%) were CLD deaths identified by the conventional CLD definition while 616 (2.1%) were CLD deaths defined by the expanded definition. Medical record review confirmed that most deaths identified by the expanded definition were CLD-related (550/616); this suggested a 15.8 deaths/100 000 population mortality rate. Among deaths for which hepatitis B, hepatitis C and alcoholic liver disease were identified during medical record review, only 8.6%, 45.4% and 36.5%, respectively, had that specific cause-of-death code cited on the death certificate. An expanded CLD mortality case definition that incorporates multiple causes of death and additional CLD-related conditions will better estimate CLD mortality. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

CDC WONDER: Mortality - Infant Deaths

Data.gov (United States)

U.S. Department of Health & Human Services — The Mortality - Infant Deaths (from Linked Birth / Infant Death Records) online databases on CDC WONDER provide counts and rates for deaths of children under 1 year...

The therapeutic CD38 monoclonal antibody daratumumab induces programmed cell death via fcg receptor-mediated cross-linking

DEFF Research Database (Denmark)

Overdijk, Marije B.; Jansen, J. H. Marco; Nederend, Maaike

2016-01-01

RIIb as well as activating FcgRs induce DARA cross-linking-mediated PCD. In conclusion, our in vitro and in vivo data show that FcgRmediated cross-linking of DARA induces PCD of CD38-expressing multiple myeloma tumor cells, which potentially contributes to the depth of response observed in DARA......Emerging evidence suggests that FcgR-mediated cross-linking of tumor-bound mAbs may induce signaling in tumor cells that contributes to their therapeutic activity. In this study, we show that daratumumab (DARA), a therapeutic human CD38 mAb with a broad-spectrum killing activity, is able to induce...... programmed cell death (PCD) of CD38+ multiple myeloma tumor cell lines when cross-linked in vitro by secondary Abs or via an FcgR. By comparing DARA efficacy in a syngeneic in vivo tumor model using FcRg-chain knockout or NOTAM mice carrying a signaling-inactive FcRg-chain, we found that the inhibitory Fcg...

Sudden cardiac death in children (1-18 years)

DEFF Research Database (Denmark)

Winkel, Bo Gregers; Risgaard, Bjarke; Sadjadieh, Golnaz

2014-01-01

AIMS: Hitherto, sudden cardiac death in children (SCDc)-defined as sudden cardiac death (SCD) in the 1-18 years old-has been incompletely described in the general population. Knowledge on incidence rates, causes of death and symptoms prior to death is sparse and has been affected by reporting...... and referral bias. METHODS AND RESULTS: In a nationwide setting all deaths in children aged 1-18 years in Denmark in 2000-06 were included. To chart causes of death and incidence rates, death certificates and autopsy reports were collected and read. By additional use of the extensive healthcare registries...... in Denmark, we were also able to investigate prior disease and symptoms. During the 7-year study period there was an average of 1.11 million persons aged 1-18 years. There were a total of 1504 deaths (214 deaths per year) from 7.78 million person-years. A total of 114 (7.5%) were sudden and unexpected...

Scientific worker and licensed professional deaths in Alaska, 1990-2002

OpenAIRE

Conway, George A.; Moran, Katherine A.; Mode, Nicolle A.

2004-01-01

Objectives. Between 1990-2002, 797 Alaskans died while working. After a scientific survey team member drowned, we examined the hazards of traumatic death to scientific and professional workers in Alaska. Study design. Surveillance and analysis methods for acute traumatic occupational injuries: The Alaska Occupational Injury Surveillance System (AOISS) uses direct investigation, jurisdictional agency reports, and death certificates to gather data for active surveillance on occupational injury ...

Confiabilidade e validade das Declarações de Óbito por câncer de boca no Município de Teresina, Piauí, Brasil, no período de 2004 e 2005 Reliability and validity of death certificates specifying oral cancer as cause of death in Teresina, Piauí State, Brazil, 2004-2005

Directory of Open Access Journals (Sweden)

Luciana Tolstenko Nogueira

2009-02-01

Full Text Available A política de saúde brasileira depende da precisão dos dados contidos no sistema de informação em saúde. Com objetivo de avaliar a confiabilidade e validade da causa básica de morte por uma neoplasia específica, no Município de Teresina, Piauí, Brasil, foram utilizadas todas as Declarações de Óbito (DO que possuíam como causa básica de morte o câncer de boca nos anos de 2004 e 2005, contabilizando um total de 23 DO. Elas foram submetidas à nova codificação da causa básica mediante utilização de formulário direcionado à coleta de dados clínicos e de exames complementares para a confirmação do diagnóstico nos prontuários médicos. O diagnóstico foi confirmado pelo exame histopatológico e história clínica. Observou-se uma concordância simples de 91,3% e coeficiente kappa de 0,84. O valor preditivo positivo correspondeu a 90,9%. Assim, pode-se afirmar que as referidas estatísticas de mortalidade são válidas e confiáveis. Este estudo teve como limitação possíveis sub-registros de casos que tiveram como causa básica de morte a referida patologia, visto que tais dados não constam no sistema de informação em mortalidade de Teresina.Brazilian health policy depends on the accuracy of data in the health information system. This study aimed to assess the reliability and validity of data on underlying cause of death due to a specific neoplasm in the Municipality of Teresina, Piauí State, Brazil, based on all the death certificates from 2004 and 2005 that reported oral cancer as the underlying cause of death (total of 23 death certificates. The death certificates were recoded for underlying cause of death by using a form targeted at collecting clinical and laboratory data to confirm the medical diagnosis on patient charts. Diagnosis was confirmed by histopathologic examination and clinical history. Simple agreement was 91.3%, kappa coefficient 0.84, and positive predictive value 90.9%. Based on the findings, the

Preparation of qualified specialists for the field of it from D-Link

Directory of Open Access Journals (Sweden)

Pavel V. Romasevich

2017-12-01

Full Text Available The article is devoted to the consideration of D-Link's experience in the development and implementation of educational programs for the training of qualified specialists for the field of IT. To remain competitive, a specialist needs to be constantly trained, especially in such a rapidly changing field as IT. The training programs developed by D-Link for IT professionals help to gain knowledge about new technologies and their application in industrial conditions. You can confirm the high level of professionalism by getting the D-Link certificate. To obtain a certificate, you must pass one or two certification exams, depending on the chosen training course. Training of specialists engaged in the development, implementation and support of solutions based on D-Link solutions, in addition to the company's specialists, is carried out by authorized training centers and academic partners of D-Link. On the D-Link’s distance learning and certification portal, distance learning courses are available for studying. The article focuses on various forms of cooperation between D-Link and higher education institutions: the development of original teaching materials, the organization of distance learning and its integration into the learning process, the creation of laboratories to support practical classes and research activities, the management of course and diploma work, the organization of industrial practice.

Potential misclassification of causes of death from COPD

DEFF Research Database (Denmark)

Jensen, Henriette Hvide; Godtfredsen, Nina Skavlan; Lange, Peter

2006-01-01

Little is known about causes of death in chronic obstructive pulmonary disease (COPD) and the validity of mortality statistics in COPD. The present authors examined causes of death using data from the Copenhagen City Heart Study. Of the 12,979 subjects with sufficient data from the baseline...... examination during 1976-1978, 6,709 died before 2001. Of these, 242 died with COPD as cause of death. Among subjects with at least severe COPD at baseline, only 24.9% had COPD as cause of death and, in almost half of the cases where COPD was listed as cause of death, the subject had a normal forced expiratory...... COPD, CMH and smoking were predictors of COPD as underlying cause of death, ORs 2.3 (1.5-3.7) and 2.2 (1.4-3.6), respectively. It was concluded that chronic obstructive pulmonary disease is underreported on death certificates, that biases in the use of chronic obstructive pulmonary disease as cause...

Discrepant comorbidity between minority and white suicides: a national multiple cause-of-death analysis

Directory of Open Access Journals (Sweden)

Stack Steven

2009-03-01

Full Text Available Abstract Background Clinician training deficits and a low and declining autopsy rate adversely impact the quality of death certificates in the United States. Self-report and records data for the general population indicate that proximate mental and physical health of minority suicides was at least as poor as that of white suicides. Methods This cross-sectional mortality study uses data from Multiple Cause-of-Death (MCOD public use files for 1999–2003 to describe and evaluate comorbidity among black, Hispanic, and white suicides. Unintentional injury decedents are the referent for multivariate analyses. Results One or more mentions of comorbid psychopathology are documented on the death certificates of 8% of white male suicides compared to 4% and 3% of black and Hispanic counterparts, respectively. Corresponding female figures are 10%, 8%, and 6%. Racial-ethnic discrepancies in the prevalence of comorbid physical disease are more attenuated. Cross-validation with National Violent Death Reporting System data reveals high relative underenumeration of comorbid depression/mood disorders and high relative overenumeration of schizophrenia on the death certificates of both minorities. In all three racial-ethnic groups, suicide is positively associated with depression/mood disorders [whites: adjusted odds ratio (AOR = 31.9, 95% CI = 29.80–34.13; blacks: AOR = 60.9, 95% CI = 42.80–86.63; Hispanics: AOR = 34.7, 95% CI = 23.36–51.62] and schizophrenia [whites: AOR = 2.4, 95% CI = 2.07–2.86; blacks: AOR = 4.2, 95% CI = 2.73–6.37; Hispanics: AOR = 4.1, 95% CI = 2.01–8.22]. Suicide is positively associated with cancer in whites [AOR = 1.8, 95% CI = 1.69–1.93] and blacks [AOR = 1.8, 95% CI = 1.36–2.48], but not with HIV or alcohol and other substance use disorders in any group under review. Conclusion The multivariate analyses indicate high consistency in predicting suicide-associated comorbidities across racial-ethnic groups using MCOD data

Causes of death among cancer patients.

Science.gov (United States)

Zaorsky, N G; Churilla, T M; Egleston, B L; Fisher, S G; Ridge, J A; Horwitz, E M; Meyer, J E

2017-02-01

The purpose of our study was to characterize the causes of death among cancer patients as a function of objectives: (i) calendar year, (ii) patient age, and (iii) time after diagnosis. US death certificate data in Surveillance, Epidemiology, and End Results Stat 8.2.1 were used to categorize cancer patient death as being due to index-cancer, nonindex-cancer, and noncancer cause from 1973 to 2012. In addition, data were characterized with standardized mortality ratios (SMRs), which provide the relative risk of death compared with all persons. The greatest relative decrease in index-cancer death (generally from > 60% to deaths were stable (typically >40%) among patients with cancers of the liver, pancreas, esophagus, and lung, and brain. Noncancer causes of death were highest in patients with cancers of the colorectum, bladder, kidney, endometrium, breast, prostate, testis; >40% of deaths from heart disease. The highest SMRs were from nonbacterial infections, particularly among 1,000 for lymphomas, P death from index- and nonindex-cancers varies widely among primary sites. Risk of noncancer deaths now surpasses that of cancer deaths, particularly for young patients in the year after diagnosis. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Overview of recent developments in sustainable biomass certification

International Nuclear Information System (INIS)

Dam, Jinke van; Junginger, Martin; Faaij, Andre; Juergens, Ingmar; Best, Gustavo; Fritsche, Uwe

2008-01-01

The objective of this paper is to give a comprehensive review of initiatives on biomass certification from different viewpoints of stakeholders, including national governments (such as The Netherlands, the UK, Belgium and Germany), the EC, NGOs, companies, and international bodies up until October 2007. Furthermore, opportunities and restrictions in the development of biomass certification are described, including international trade law limitations, lack of adequate methodologies, stakeholder involvement requirements and certification costs. Next, five different approaches for the implementation of a biomass certification system are compared and discussed. Main differences are the voluntary or mandatory character and the geographical extent of the proposed strategies in terms of biomass end-use. It is concluded that criteria to ensure the sustainable production of biomass are needed urgently. To some extent criteria categories can be covered using existing systems, but others (such as GHG and energy balances, changing land-use) require the development of new methodologies. A gradual development of certification systems with learning (through pilot studies and research) and expansion over time, linked to the development of advanced methodologies can provide valuable experience, and further improve the feasibility and reliability of biomass certification systems. However, better international coordination between initiatives is required to improve coherence and efficiency in the development of sustainable biomass certification systems, to avoid the proliferation of standards and to provide a clearer direction in the approach to be taken. Finally, next to certification, alternative policy tools should be considered as well to ensure sustainable biomass production. (author)

Post-mortem toxicology in young sudden cardiac death victims

DEFF Research Database (Denmark)

Bjune, Thea; Risgaard, Bjarke; Kruckow, Line

2017-01-01

Aims: Several drugs increase the risk of ventricular fibrillation and sudden cardiac death (SCD). We aimed to investigate in detail the toxicological findings of all young SCD throughout Denmark. Methods and results: Deaths in persons aged 1-49 years were included over a 10-year period. Death...... certificates and autopsy reports were retrieved and read to identify cases of sudden death and establish cause of death. All medico-legal autopsied SCD were included and toxicological reports collected. Positive toxicology was defined as the presence of any substance (licit and/or illicit). All toxicological...... findings had previously been evaluated not to have caused the death (i.e. lethal concentrations were excluded). We identified 620 medico-legal autopsied cases of SCD, of which 77% (n = 477) were toxicologically investigated post-mortem, and 57% (n = 270) had a positive toxicology profile. Sudden cardiac...

Febrile seizures prior to sudden cardiac death

DEFF Research Database (Denmark)

Stampe, Niels Kjær; Glinge, Charlotte; Jabbari, Reza

2018-01-01

Aims: Febrile seizure (FS) is a common disorder affecting 2-5% of children up to 5 years of age. The aim of this study was to determine whether FS in early childhood are over-represented in young adults dying from sudden cardiac death (SCD). Methods and results: We included all deaths (n = 4595...... with FS was sudden arrhythmic death syndrome (5/8; 62.5%). Conclusion: In conclusion, this study demonstrates a significantly two-fold increase in the frequency of FS prior to death in young SCD cases compared with the two control groups, suggesting that FS could potentially contribute in a risk......) nationwide and through review of all death certificates, we identified 245 SCD in Danes aged 1-30 years in 2000-09. Through the usage of nationwide registries, we identified all persons admitted with first FS among SCD cases (14/245; 5.7%) and in the corresponding living Danish population (71 027/2 369 785...

Child Maltreatment Fatalities in Children under 5: Findings from the National Violence Death Reporting System

Science.gov (United States)

Klevens, Joanne; Leeb, Rebecca T.

2010-01-01

Objective: To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS). Study design: Two independent coders reviewed information from death certificates, medical…

Documenting death: public access to government death records and attendant privacy concerns.

Science.gov (United States)

Boles, Jeffrey R

2012-01-01

This Article examines the contentious relationship between public rights to access government-held death records and privacy rights concerning the deceased, whose personal information is contained in those same records. This right of access dispute implicates core democratic principles and public policy interests. Open access to death records, such as death certificates and autopsy reports, serves the public interest by shedding light on government agency performance, uncovering potential government wrongdoing, providing data on public health trends, and aiding those investigating family history, for instance. Families of the deceased have challenged the release of these records on privacy grounds, as the records may contain sensitive and embarrassing information about the deceased. Legislatures and the courts addressing this dispute have collectively struggled to reconcile the competing open access and privacy principles. The Article demonstrates how a substantial portion of the resulting law in this area is haphazardly formed, significantly overbroad, and loaded with unintended consequences. The Article offers legal reforms to bring consistency and coherence to this currently disordered area of jurisprudence.

Potential misclassification of causes of death from COPD

DEFF Research Database (Denmark)

Jensen, Henriette Hvide; Godtfredsen, Nina Skavlan; Lange, Peter

2006-01-01

Little is known about causes of death in chronic obstructive pulmonary disease (COPD) and the validity of mortality statistics in COPD. The present authors examined causes of death using data from the Copenhagen City Heart Study. Of the 12,979 subjects with sufficient data from the baseline...... examination during 1976-1978, 6,709 died before 2001. Of these, 242 died with COPD as cause of death. Among subjects with at least severe COPD at baseline, only 24.9% had COPD as cause of death and, in almost half of the cases where COPD was listed as cause of death, the subject had a normal forced expiratory...... volume in one second /forced vital capacity ratio at baseline. In COPD patients, having COPD on the death certificate was associated with chronic mucus hypersecretion (CMH) at baseline, an odds ratio (OR) of 3.6 (95% confidence interval 1.7-7.7), and being female (OR 2.7 (1.3-5.6)). In subjects without...

Deaths: Leading Causes for 2012.

Science.gov (United States)

Heron, Melonie

2015-08-31

This report presents final 2012 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2012," the National Center for Health Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2012. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2012, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2012 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

Factors related to the involvement of nurses in medical end-of-life decisions in Belgium: a death certificate study.

Science.gov (United States)

Inghelbrecht, Els; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

2008-07-01

Although nurses play an important role in end-of-life care for patients, they are not systematically involved in end-of-life decisions with a possible or certain life-shortening effect (ELDs). Until now we know little about factors relating to the involvement of nurses in these decisions. To explore which patient- and decision-characteristics are related to the consultation of nurses and to the administering of life-ending drugs by nurses in actual ELDs in institutions and home care, as reported by physicians. We sampled at random 5005 of all registered deaths in the second half of 2001--before euthanasia was legalized--in Flanders, Belgium. We mailed anonymous questionnaires to physicians who signed the death certificates and asked them to report on ELDs, including nurses' involvement. Response rate was 59% (n=2950). Physicians reported nurses involved in decision making more often in institutions than at home, and more often in care homes for the elderly than in hospitals (OR 1.70, 95% CI 1.15, 2.52). This involvement was more frequently when physicians intended to hasten the patient's death than when they had no such intention (institutions: OR 2.05, 95% CI 1.41, 2.99; home: OR 2.04, 95% CI 1.19, 3.49). In institutions, this involvement was also more likely where patients were of lower rather than higher education (OR 2.95, 95% CI 1.49, 5.84). The administering of life-ending drugs by nurses, as reported by physicians was also found more frequently in institutions than at home, and in institutions more frequently with lower rather than higher educated patients (p=.037). These findings raise questions about physicians' perception of the nurse's role in ELDs, but also about physicians' skills in interacting with all patients. Education and guidelines for physicians and nurses are needed to optimize good communication and to promote a clearer assignment of responsibilities concerning the execution of those decisions.

Using poison center exposure calls to predict methadone poisoning deaths.

Directory of Open Access Journals (Sweden)

Nabarun Dasgupta

Full Text Available PURPOSE: There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC. In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdose mortality. METHODS: We used PC call counts for methadone that were reported to the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS® System in 2006 and 2007. US death certificate data were used to identify deaths due to methadone. Linear regression was used to quantify the relationship of deaths and poison center calls. RESULTS: Compared to decedents, poison center callers tended to be younger, more often female, at home and less likely to require medical attention. A strong association was found with PC calls and methadone mortality (b=0.88, se=0.42, t=9.5, df=1, p<0.0001, R(2 =0.77. These findings were robust to large changes in a sensitivity analysis assessing the impact of underreporting of methadone overdose deaths. CONCLUSIONS: Our results suggest that calls to poison centers for methadone are correlated with poisoning mortality as identified on death certificates. Calls received by poison centers may be used for timely surveillance of mortality due to methadone. In the midst of the prescription opioid overdose epidemic, electronic surveillance tools that report in real-time are powerful public health tools.

Birth-death processes and associated polynomials

NARCIS (Netherlands)

van Doorn, Erik A.

2003-01-01

We consider birth-death processes on the nonnegative integers and the corresponding sequences of orthogonal polynomials called birth-death polynomials. The sequence of associated polynomials linked with a sequence of birth-death polynomials and its orthogonalizing measure can be used in the analysis

Cannabis, possible cardiac deaths and the coroner in Ireland.

LENUS (Irish Health Repository)

Tormey, W P

2012-01-10

BACKGROUND: The elevated risk of triggering a myocardial infarction by smoking cannabis is limited to the first 2 h after smoking. AIM: To examine the possible role of cannabis in cardiac deaths. CASES AND RESULTS: From 3,193 coroners\\' cases over 2 years, there were 13 cases where the clinical information was compatible with a primary cardiac cause of death. An inquest was held in three cases. Myocardial infarction was the primary cause of death in 54%. Other causes were sudden adult death syndrome, sudden death in epilepsy, and poisoning by alcohol and diazepam. Cannabis was mentioned once only on a death certificate, but not as a cause of death. Blood delta9-tetrahydrocannabinol-carboxylic acid was recorded in one case and in no case was plasma tetrahydrocannabinol (THC) measured. CONCLUSIONS: To attribute sudden cardiac death to cannabis, plasma THC should be measured in the toxicology screen in coroners\\' cases where urine cannabinoids are positive. A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis.

Cannabis, possible cardiac deaths and the coroner in Ireland.

Science.gov (United States)

Tormey, W P

2012-12-01

The elevated risk of triggering a myocardial infarction by smoking cannabis is limited to the first 2 h after smoking. To examine the possible role of cannabis in cardiac deaths. CASES AND RESULTS: From 3,193 coroners' cases over 2 years, there were 13 cases where the clinical information was compatible with a primary cardiac cause of death. An inquest was held in three cases. Myocardial infarction was the primary cause of death in 54%. Other causes were sudden adult death syndrome, sudden death in epilepsy, and poisoning by alcohol and diazepam. Cannabis was mentioned once only on a death certificate, but not as a cause of death. Blood delta9-tetrahydrocannabinol-carboxylic acid was recorded in one case and in no case was plasma tetrahydrocannabinol (THC) measured. To attribute sudden cardiac death to cannabis, plasma THC should be measured in the toxicology screen in coroners' cases where urine cannabinoids are positive. A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis.

A population-based case-control study of mesothelioma deaths among U.S. railroad workers.

Science.gov (United States)

Schenker, M B; Garshick, E; Muñoz, A; Woskie, S R; Speizer, F E

1986-09-01

We have completed a case-control analysis of mesothelioma deaths among current and retired U.S. railroad employees. Cause-specific death certificates were obtained for 87% of 15,059 deaths reported by the railroad retirement board, and 20 mesotheliomas were identified according to death certificate diagnosis. A 10:1 matched analysis with railroad workers dying of nonmalignant, nonaccidental causes yielded a very strong association with prior railroad work in jobs with potential asbestos exposure (odds ratio = 7.2, 95% lower confidence limit = 3.3). Consideration of railroad occupations with regular asbestos exposures (e.g., skilled trades, steam locomotive repair) yielded an odds ratio of 21.4 (95% lower confidence limit = 8.7), but the occupations with potential intermittent exposure (e.g., engineers, firemen, carmen) yielded a nonsignificant odds ratio of 2.3 (95% lower confidence limit = 0.5). Applying mesothelioma mortality rates from this study to the population of U.S. railroad workers at risk yields an estimate of 416 cases of mesothelioma occurring among U.S. railroad workers between 1981 and 2000.

The Linked CENTURY Study: linking three decades of clinical and public health data to examine disparities in childhood obesity.

Science.gov (United States)

Hawkins, Summer Sherburne; Gillman, Matthew W; Rifas-Shiman, Sheryl L; Kleinman, Ken P; Mariotti, Megan; Taveras, Elsie M

2016-03-09

Despite the need to identify the causes of disparities in childhood obesity, the existing epidemiologic studies of early life risk factors have several limitations. We report on the construction of the Linked CENTURY database, incorporating CENTURY (Collecting Electronic Nutrition Trajectory Data Using Records of Youth) Study data with birth certificates; and discuss the potential implications of combining clinical and public health data sources in examining the etiology of disparities in childhood obesity. We linked the existing CENTURY Study, a database of 269,959 singleton children from birth to age 18 years with measured heights and weights, with each child's Massachusetts birth certificate, which captures information on their mothers' pregnancy history and detailed socio-demographic information of both mothers and fathers. Overall, 74.2 % were matched, resulting in 200,343 children in the Linked CENTURY Study with 1,580,597 well child visits. Among this cohort, 94.0 % (188,334) of children have some father information available on the birth certificate and 60.9 % (121,917) of children have at least one other sibling in the dataset. Using maternal race/ethnicity from the birth certificate as an indicator of children's race/ethnicity, 75.7 % of children were white, 11.6 % black, 4.6 % Hispanic, and 5.7 % Asian. Based on socio-demographic information from the birth certificate, 20.0 % of mothers were non-US born, 5.9 % smoked during pregnancy, 76.3 % initiated breastfeeding, and 11.0 % of mothers had their delivery paid for by public health insurance. Using clinical data from the CENTURY Study, 22.7 % of children had a weight-for-length ≥ 95(th) percentile between 1 and 24 months and 12.0 % of children had a body mass index ≥ 95(th) percentile at ages 5 and 17 years. By linking routinely-collected data sources, it is possible to address research questions that could not be answered with either source alone. Linkage between a clinical

Green certificate system for heating - principal and practical challenges

International Nuclear Information System (INIS)

Eldegard, Tom

2002-01-01

A certificate system with an obligation to buying is a very relevant instrument in energy policy in order to stimulate the implementation of new renewable energy sources. This solution is widely supported; it is being institutionalized in many countries, especially in Europe and in the electricity sector, and the heating sector is soon to follow. This report discusses the broad lines of a possible green certificate system for the heating sector in Norway and concludes that it is might well be linked with a similar system for the electricity sector. For Norway, an isolated certificate system for the electricity sector would not be cost-effective. This is because this system would emphasize relatively expensive renewable electric energy rather than utilizing the large potential for replacing the electric heating of buildings with much cheaper renewable heat

Astrocytes expressing ALS‐linked mutant FUS induce motor neuron death through release of tumor necrosis factor‐alpha

Science.gov (United States)

Kia, Azadeh; McAvoy, Kevin; Krishnamurthy, Karthik; Trotti, Davide

2018-01-01

Mutations in fused in sarcoma (FUS) are linked to amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease affecting both upper and lower motor neurons. While it is established that astrocytes contribute to the death of motor neurons in ALS, the specific contribution of mutant FUS (mutFUS) through astrocytes has not yet been studied. Here, we used primary astrocytes expressing a N‐terminally GFP tagged R521G mutant or wild‐type FUS (WTFUS) and show that mutFUS‐expressing astrocytes undergo astrogliosis, damage co‐cultured motor neurons via activation of an inflammatory response and produce conditioned medium (ACM) that is toxic to motor neurons in isolation. Time lapse imaging shows that motor neuron cultures exposed to mutFUS ACM, but not WTFUS ACM, undergo significant cell loss, which is preceded by progressive degeneration of neurites. We found that Tumor Necrosis Factor‐Alpha (TNFα) is secreted into ACM of mutFUS‐expressing astrocytes. Accordingly, mutFUS astrocyte‐mediated motor neuron toxicity is blocked by targeting soluble TNFα with neutralizing antibodies. We also found that mutant astrocytes trigger changes to motor neuron AMPA receptors (AMPAR) that render them susceptible to excitotoxicity and AMPAR‐mediated cell death. Our data provide the first evidence of astrocytic involvement in FUS‐ALS, identify TNFα as a mediator of this toxicity, and provide several potential therapeutic targets to protect motor neurons in FUS‐linked ALS. PMID:29380416

Deaths: Leading Causes for 2011.

Science.gov (United States)

Heron, Melonie

2015-07-27

This report presents final 2011 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements ‘‘Deaths: Final Data for 2011,’’ the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2011. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2011, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2011 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission

Deaths: Leading Causes for 2015.

Science.gov (United States)

Heron, Melonie

2017-11-01

Objectives-This report presents final 2015 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2015," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2015. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Results-In 2015, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2015 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without

Deaths: Leading Causes for 2013.

Science.gov (United States)

Heron, Melonie

2016-02-16

This report presents final 2013 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2013," the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2013. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2013, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2013 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as

Medico legal investigations into sudden sniffing deaths linked with trichloroethylene.

Science.gov (United States)

Da Broi, Ugo; Colatutto, Antonio; Sala, Pierguido; Desinan, Lorenzo

2015-08-01

Sudden deaths attributed to sniffing trichloroethylene are caused by the abuse of this solvent which produces pleasant inebriating effects with rapid dissipation. In the event of repeated cycles of inhalation, a dangerous and uncontrolled systemic accumulation of trichloroethylene may occur, followed by central nervous system depression, coma and lethal cardiorespiratory arrest. Sometimes death occurs outside the hospital environment, without medical intervention or witnesses and without specific necroscopic signs. Medico legal investigations into sudden sniffing deaths associated with trichloroethylene demand careful analysis of the death scene and related circumstances, a detailed understanding of the deceased's medical history and background of substance abuse and an accurate evaluation of all autopsy and laboratory data, with close cooperation between the judiciary, coroners and toxicologists. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Cause of death and potentially avoidable deaths in Australian adults with intellectual disability using retrospective linked data.

Science.gov (United States)

Trollor, Julian; Srasuebkul, Preeyaporn; Xu, Han; Howlett, Sophie

2017-02-07

To investigate mortality and its causes in adults over the age of 20 years with intellectual disability (ID). Retrospective population-based standardised mortality of the ID and Comparison cohorts. The ID cohort comprised 42 204 individuals who registered for disability services with ID as a primary or secondary diagnosis from 2005 to 2011 in New South Wales (NSW). The Comparison cohort was obtained from published deaths in NSW from the Australian Bureau of Statistics (ABS) from 2005 to 2011. We measured and compared Age Standardised Mortality Rate (ASMR), Comparative Mortality Figure (CMF), years of productive life lost (YPLL) and proportion of deaths with potentially avoidable causes in an ID cohort with an NSW general population cohort. There were 19 362 adults in the ID cohort which experienced 732 (4%) deaths at a median age of 54 years. Age Standardised Mortality Rates increased with age for both cohorts. Overall comparative mortality figure was 1.3, but was substantially higher for the 20-44 (4.0) and 45-64 (2.3) age groups. YPLL was 137/1000 people in the ID cohort and 49 in the comparison cohort. Cause of death in ID cohort was dominated by respiratory, circulatory, neoplasm and nervous system. After recoding deaths previously attributed to the aetiology of the disability, 38% of deaths in the ID cohort and 17% in the comparison cohort were potentially avoidable. Adults with ID experience premature mortality and over-representation of potentially avoidable deaths. A national system of reporting of deaths in adults with ID is required. Inclusion in health policy and services development and in health promotion programmes is urgently required to address premature deaths and health inequalities for adults with ID. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Drug induced mortality: a multiple cause approach on Italian causes of death Register

Directory of Open Access Journals (Sweden)

Francesco Grippo

2015-04-01

Full Text Available Background: Drug-related mortality is a complex phenomenon that has several health, social and economic effects. In this paper trends of drug-induced mortality in Italy are analysed. Two approaches have been followed: the traditional analysis of the underlying cause of death (UC (data refers to the Istat mortality database from 1980 to 2011, and the multiple cause (MCanalysis, that is the analysis of all conditions reported on the death certificate (data for 2003-2011 period.Methods: Data presented in this paper are based on the Italian mortality register. The selection of Icd codes used for the analysis follows the definition of the European Monitoring Centre for Drugs and Drug Addiction. Using different indicators (crude and standardized rates, ratio multiple to underlying, the results obtained from the two approaches (UC and MC have been compared. Moreover, as a measure of association between drug-related causes and specific conditions on the death certificate, an estimation of the age-standardized relative risk (RR has been used.Results: In the years 2009-2011, the total number of certificates whit mention of drug use was 1,293, 60% higher than the number UC based. The groups of conditions more strongly associated with drug-related causes are the mental and behavioral disorders (especially alcohol consumption, viral hepatitis, cirrhosis and fibrosis of liver, AIDS and endocarditis.Conclusions : The analysis based on multiple cause approach shows, for the first time, a more detailed picture of the drug related death; it allows to better describe the mortality profiles and to re-evaluate  the contribution of a specific cause to death.

Taxation in France | Memorandum concerning the annual internal taxation certificate and the declaration of income for 2012

CERN Document Server

2013-01-01

You are reminded that the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that the members of the personnel are exempt from external taxation on salaries and emoluments paid by CERN.   I - Annual internal taxation certificate for 2012 The annual certificate of internal taxation for 2012, issued by the Finance, Procurement and Knowledge Transfer Department, is available since 15 February 2013. It is intended exclusively for the tax authorities. If you are currently a member of the CERN personnel you received an e-mail containing a link to your annual certificate, which you can print out if necessary. If you are no longer a member of the CERN personnel or are unable to access your annual certificate as indicated above, you will find information explaining how to obtain one at this link. In case of difficulty in obtaining your annual certificate, send an e-mail ex...

Deaths: leading causes for 2010.

Science.gov (United States)

Heron, Melonie

2013-12-20

This report presents final 2010 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2010. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2010, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Nephritis, nephrotic syndrome and nephrosis; Influenza and pneumonia; and Intentional self-harm (suicide). These 10 causes accounted for 75% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2010 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Necrotizing enterocolitis of newborn. Important variations in the leading causes of infant death are noted for the neonatal and post-neonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source

PROMOTION OF ECOLOGIC PRODUCT CERTIFICATION AS INSTRUMENT TO SPEED UP THE ECOLOGIC AGRICULTURE

Directory of Open Access Journals (Sweden)

George MOISE

2014-04-01

Full Text Available This paper present a vision about the possibility to speed up the conversion process to an ecological agriculture in Romania. The link from ecological products consumer and ecologic agricultural producer is also explained from point of view of certification process. Presenting the consumer mentality and principles and rules of organic farming and certification can open the way to a sustainable and ecological agriculture.

Use of primary diagnosis during hospitalization in the Unified Health System (Sistema Único de Saúde) to qualify information regarding the underlying cause of natural deaths among the elderly.

Science.gov (United States)

Cascão, Angela Maria; Jorge, Maria Helena Prado de Mello; Costa, Antonio José Leal; Kale, Pauline Lorena

2016-01-01

Ill-defined causes of death are common among the elderly owing to the high frequency of comorbidities and, consequently, to the difficulty in defining the underlying cause of death. To analyze the validity and reliability of the "primary diagnosis" in hospitalization to recover the information on the underlying cause of death in natural deaths among the elderly whose deaths were originally assigned to "ill-defined cause" in their Death Certificate. The hospitalizations occurred in the state of Rio de Janeiro, in 2006. The databases obtained in the Information Systems on Mortality and Hospitalization were probabilistically linked. The following data were calculated for hospitalizations of the elderly that evolved into deaths with a natural cause: concordance percentages, Kappa coefficient, sensitivity, specificity, and the positive predictive value of the primary diagnosis. Deaths related to "ill-defined causes" were assigned to a new cause, which was defined based on the primary diagnosis. The reliability of the primary diagnosis was good, according to the total percentage of consistency (50.2%), and fair, according to the Kappa coefficient (k = 0.4; p values per chapter and grouping of the International Classification of Diseases. The recovery of the information on the primary cause occurred in 22.6% of the deaths with ill-defined causes (n = 14). The methodology developed and applied for the recovery of the information on the natural cause of death among the elderly in this study had the advantage of effectiveness and the reduction of costs compared to an investigation of the death that is recommended in situations of non-linked and low positive predictive values. Monitoring the mortality profile by the cause of death is necessary to periodically update the predictive values.

Impact of a hospital-level intervention to reduce heart disease overreporting on leading causes of death.

Science.gov (United States)

Al-Samarrai, Teeb; Madsen, Ann; Zimmerman, Regina; Maduro, Gil; Li, Wenhui; Greene, Carolyn; Begier, Elizabeth

2013-05-16

The quality of cause-of-death reporting on death certificates affects the usefulness of vital statistics for public health action. Heart disease deaths are overreported in the United States. We evaluated the impact of an intervention to reduce heart disease overreporting on other leading causes of death. A multicomponent intervention comprising training and communication with hospital staff was implemented during July through December 2009 at 8 New York City hospitals reporting excessive heart disease deaths. We compared crude, age-adjusted, and race/ethnicity-adjusted proportions of leading, underlying causes of death reported during death certification by intervention and nonintervention hospitals during preintervention (January-June 2009) and postintervention (January-June 2010) periods. We also examined trends in leading causes of death for 2000 through 2010. At intervention hospitals, heart disease deaths declined by 54% postintervention; other leading causes of death (ie, malignant neoplasms, influenza and pneumonia, cerebrovascular disease, and chronic lower respiratory diseases) increased by 48% to 232%. Leading causes of death at nonintervention hospitals changed by 6% or less. In the preintervention period, differences in leading causes of death between intervention and nonintervention hospitals persisted after controlling for race/ethnicity and age; in the postintervention period, age accounted for most differences observed between intervention and nonintervention hospitals. Postintervention, malignant neoplasms became the leading cause of premature death (ie, deaths among patients aged 35-74 y) at intervention hospitals. A hospital-level intervention to reduce heart disease overreporting led to substantial changes to other leading causes of death, changing the leading cause of premature death. Heart disease overreporting is likely obscuring the true levels of cause-specific mortality.

Mortalidade feminina na região Sul do Município de São Paulo: qualidade da certificação médica dos óbitos Maternal mortality in Brazil: quality of medical certification of deaths

Directory of Open Access Journals (Sweden)

Arnaldo Augusto Franco de Siqueira

1999-10-01

Full Text Available OBJETIVO: Avaliar a qualidade da certificação médica dos óbitos de mulheres de 10 a 49 anos na região Sul do Município de São Paulo. MÉTODOS: Utilizou-se a metodologia Puffer para investigar as causas de óbito de todas as mulheres de 10 a 49 anos residentes na região e falecidas no ano de 1989 (num total de 664 óbitos. Foram comparadas as causas de morte relatadas nos atestados de óbitos originais com as refeitas. Calculou-se o grau de sensibilidade das causas e o índice de kappa. RESULTADOS: Obteve-se alta sensibilidade entre as declarações de óbito originais e corrigidas nos grupos de causas (CID-9 das "Doenças do Aparelho Circulatório" (91,9%, "Neoplasias" (89,7% e "Causas Externas" (84,1%. Houve outros com sensibilidades muito baixas. Desses, chama a atenção o capítulo "Transtornos Mentais" (34,3% que, de 11, passa a ter 32 óbitos em que, na maioria dos casos, não havia sido feito o diagnóstico de alcoolismo. Também o capítulo "Complicações da Gravidez, Parto e Puerpério" apresentou uma sensibilidade baixa (44,9%. O índice de kappa foi de 0,63, o que indica uma concordância total regular. DISCUSSÃO: Ainda é insatisfatória a qualidade da certificação médica dos óbitos na área estudada. Essa má qualidade pode afetar negativamente as propostas de intervenção, tornando pouco visíveis problemas tão sérios para a atenção à saúde da mulher.OBJECTIVE: To evaluate the quality of the medical certification of deaths of 10-49 year-old women, resident in the Southern region of the city of S. Paulo METHODS: The Puffer methodology was utilized to investigate the causes of death of all 10-49 year-old women, resident in the region, and deceased in the year 1989 (664 deaths in the total. The main causes of death in the original death certificates and the "new" causes of death arisen from the research were compared. The sensitivity and the kappa index were calculated. RESULTS: In some chapters of the

Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated.

Science.gov (United States)

Otterman, Gabriel; Lahne, Klara; Arkema, Elizabeth V; Lucas, Steven; Janson, Staffan; Hellström-Westas, Lena

2018-03-08

Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes, and this study examined the trends in Sweden. We analysed individual-level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000 to 2014, and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years. Child deaths from all causes were 7914, and 2006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100 000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-17 (0.9%). Childhood deaths showed a sustained decline from 2000 to 2014 in Sweden and a quarter were from external, ill-defined or unknown causes. Systematic, interagency death reviews could yield information that could prevent future deaths. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Community-Based Cause of Death Study Linked to Maternal and ...

International Development Research Centre (IDRC) Digital Library (Canada)

While Ethiopia has successfully reduced under-five childhood mortality, there have been slower gains in reducing neonatal (newborn) and maternal mortality rates. About 220,000 children and mothers die every year in Ethiopia. For most, the causes of death are unknown as fewer than 30% of Ethiopia's births and deaths ...

Nationwide study of sudden cardiac death in persons aged 1-35 years

DEFF Research Database (Denmark)

Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane

2011-01-01

Aims The aim of this investigation was to study the incidence of sudden cardiac death (SCD) in persons aged 1-35 years in a nationwide setting (5.38 million people) by systematic evaluation of all deaths. Methods and results All deaths in persons aged 1-35 years in Denmark in 2000-06 were included....... Death certificates were read independently by two physicians. The National Patient Registry was used to retrieve information on prior medical history. All autopsy reports were read and the cause of death was revised based on autopsy findings. We identified 625 cases of sudden unexpected death (10......% of all deaths), of which 156 (25%) were not autopsied. Of the 469 autopsied cases, 314 (67%) were SCD. The most common cardiac cause of death was ischaemic heart disease (13%); 29% of autopsied sudden unexpected death cases were unexplained. In 45% of SCD cases, the death was witnessed; 34% died during...

Comparison of cardiovascular mortality in the Great East Japan and the Great Hanshin-Awaji Earthquakes　- a large-scale data analysis of death certificates.

Science.gov (United States)

Takegami, Misa; Miyamoto, Yoshihiro; Yasuda, Satoshi; Nakai, Michikazu; Nishimura, Kunihiro; Ogawa, Hisao; Hirata, Ken-Ichi; Toh, Ryuji; Morino, Yoshihiro; Nakamura, Motoyuki; Takeishi, Yasuchika; Shimokawa, Hiroaki; Naito, Hiroaki

2015-01-01

Large earthquakes have been associated with cardiovascular disease (CVD) mortality. In Japan, the 1995 Great Hanshin-Awaji (H-A) Earthquake was an urban-underground-type earthquake, whereas the 2011 Great East Japan (GEJ) Earthquake was an ocean-trench type. In the present study, we examined how these different earthquake types affected CVD mortality. We examined death certificate data from 2008 to 2012 for 131 municipalities in Iwate, Miyagi, and Fukushima prefectures (n=320,348) and from 1992 to 1996 for 220 municipalities in Hyogo, Osaka, and Kyoto prefectures (n=592,670). A Poisson regression model showed significant increases in the monthly numbers of acute myocardial infarction (AMI)-related deaths (incident rate ratio [IRR] GEJ=1.34, P=0.001; IRR of H-A=1.57, Pdeaths (IRR of GEJ=1.42, Pdeaths remained significant only for H-A (IRR=1.13, P=0.029). When analyzing the standardized mortality ratio (SMR) after the earthquakes using the Cochran-Armitage trend test, seismic intensity was significantly associated with AMI mortality for 2 weeks after both the GEJ (P for trend=0.089) and H-A earthquakes (P for trend=0.005). Following the GEJ and H-A earthquakes, there was a sharp increase in CVD mortality. The effect of the disaster was sustained for months after the H-A earthquake, but was diminished after the GEJ Earthquake.

Contractual arrangements and food quality certifications in the Mexican avocado industry

Directory of Open Access Journals (Sweden)

J. J. Arana-Coronado

2013-03-01

Full Text Available The adoption of private quality certifications in agrifood supply chains often requires specific investments by producers which can be safeguarded by choosing specific contractual arrangements. Based on a survey data from avocado producers in Mexico, this paper aims to analyze the impact of transaction costs and relationship characteristics of the joint choice of contractual arrangements and quality certifications. Using a bivariate probit model, it shows that a producer’s decision to adopt private quality certifications is directly linked to high levels of asset specificity and price. In order to ensure the high level of specificity under the presence of low levels of price uncertainty, producers have relied on relational governance supported by the expectation of continuity in their bilateral relationships with buyers.

NETs: The missing link between cell death and systemic autoimmune diseases?

Directory of Open Access Journals (Sweden)

Felipe eAndrade

2013-01-01

Full Text Available For almost 20 years, apoptosis and secondary necrosis have been considered the major source of autoantigens and endogenous adjuvants in the pathogenic model of systemic autoimmune diseases. This focus is justified in part because initial evidence in systemic lupus erythematosus (SLE guided investigators toward the study of apoptosis, but also because other forms of cell death were unknown. To date, it is known that many other forms of cell death occur, and that they vary in their capacity to stimulate as well as inhibit the immune system. Among these, NETosis (an antimicrobial form of death in neutrophils in which nuclear material is extruded from the cell forming extracellular traps, is gaining major interest as a process that may trigger some of the immune features found in SLE, granulomatosis with polyangiitis (formerly Wegener’s granulomatosis and Felty’s syndrome. Although there have been volumes of very compelling studies published on the role of cell death in autoimmunity, no unifying theory has been adopted nor have any successful therapeutics been developed based on this important pathway. The recent inclusion of NETosis into the pathogenic model of autoimmune diseases certainly adds novel insights into this paradigm, but also reveals a previously unappreciated level of complexity and raises many new questions. This review discusses the role of cell death in systemic autoimmune diseases with a focus on apoptosis and NETosis, highlights the current short comings in our understanding of the vast complexity of cell death, and considers the potential shift in the cell death paradigm in autoimmunity. Understanding this complexity is critical in order to develop tools to clearly define the death pathways that are active in systemic autoimmune diseases, identify drivers of disease propagation, and develop novel therapeutics.

Study of recent and future trends in place of death in Belgium using death certificate data: a shift from hospitals to care homes

NARCIS (Netherlands)

Houttekier, D.; Cohen, J.; Surkyn, J.; Deliens, L.

2011-01-01

Background: Since most patients prefer out-of-hospital death, place of death can be considered an indicator of end-of-life care quality. The study of trends in place of death is necessary to examine causes of shifts, to evaluate efforts to alter place of death and develop future policies. This study

Incorporating the Last Four Digits of Social Security Numbers Substantially Improves Linking Patient Data from De-identified Hospital Claims Databases.

Science.gov (United States)

Naessens, James M; Visscher, Sue L; Peterson, Stephanie M; Swanson, Kristi M; Johnson, Matthew G; Rahman, Parvez A; Schindler, Joe; Sonneborn, Mark; Fry, Donald E; Pine, Michael

2015-08-01

Assess algorithms for linking patients across de-identified databases without compromising confidentiality. Hospital discharges from 11 Mayo Clinic hospitals during January 2008-September 2012 (assessment and validation data). Minnesota death certificates and hospital discharges from 2009 to 2012 for entire state (application data). Cross-sectional assessment of sensitivity and positive predictive value (PPV) for four linking algorithms tested by identifying readmissions and posthospital mortality on the assessment data with application to statewide data. De-identified claims included patient gender, birthdate, and zip code. Assessment records were matched with institutional sources containing unique identifiers and the last four digits of Social Security number (SSNL4). Gender, birthdate, and five-digit zip code identified readmissions with a sensitivity of 98.0 percent and a PPV of 97.7 percent and identified postdischarge mortality with 84.4 percent sensitivity and 98.9 percent PPV. Inclusion of SSNL4 produced nearly perfect identification of readmissions and deaths. When applied statewide, regions bordering states with unavailable hospital discharge data had lower rates. Addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy without compromising patient confidentiality. States maintaining centralized de-identified databases should add SSNL4 to data specifications. © Health Research and Educational Trust.

40 CFR 745.90 - Renovator certification and dust sampling technician certification.

Science.gov (United States)

2010-07-01

... sampling technician certification. 745.90 Section 745.90 Protection of Environment ENVIRONMENTAL PROTECTION... technician certification. (a) Renovator certification and dust sampling technician certification. (1) To become a certified renovator or certified dust sampling technician, an individual must successfully...

Linking definitions, mechanisms, and modeling of drought-induced tree death.

Science.gov (United States)

Anderegg, William R L; Berry, Joseph A; Field, Christopher B

2012-12-01

Tree death from drought and heat stress is a critical and uncertain component in forest ecosystem responses to a changing climate. Recent research has illuminated how tree mortality is a complex cascade of changes involving interconnected plant systems over multiple timescales. Explicit consideration of the definitions, dynamics, and temporal and biological scales of tree mortality research can guide experimental and modeling approaches. In this review, we draw on the medical literature concerning human death to propose a water resource-based approach to tree mortality that considers the tree as a complex organism with a distinct growth strategy. This approach provides insight into mortality mechanisms at the tree and landscape scales and presents promising avenues into modeling tree death from drought and temperature stress. Copyright © 2012 Elsevier Ltd. All rights reserved.

Teen Suicide and Changing Cause-of-Death Certification, 1953-1987.

Science.gov (United States)

Males, Mike

1991-01-01

Examined whether tripling in teenage suicides since 1950s represents increase in suicides or in skill of medical examiners. Examined firearms and poisoning death from 1953-87. Concludes that increase in youth suicide is less dramatic than reported, and suicide increase indicated among youths and adults occurred from 1964-71 and has since…

Climate certificates

International Nuclear Information System (INIS)

1998-10-01

Reduced emissions of climate gases at the lowest cost require international cooperation in order to ensure that the most cost-efficient measures are taken. A market for emission rights is one way of achieving this. However, creating the right conditions for such a market to operate requires an unambiguous definition of the product to be traded. In this PM, the Swedish Power Association sketches out how such a product could be defined, and how a market for the resulting unambiguously defined product could be operated internationally, in parallel with other markets for energy products. Trade in climate certificates could become a joint EU approach to achieving common results within the field of climate policy. The main features of the proposal are as follows: Electricity producers would be allowed to issue climate certificates for electricity produced without climate-affecting emissions, e.g. in wind power plants. 1 kWh of electricity produced without emissions would entitle the utility to issue a climate certificate for 1 kWh. Electricity from power stations having low emissions, e.g. modern natural gas-fired plants, would entitle the utility to issue certificates in proportion to how much lower their emissions were in comparison with those from conventional coal-fired power stations. The number of certificates would be reduced by an individual coefficient, related directly to the quantity of climate-affecting emissions from the plant concerned. They would be traded and noted on markets in the various member countries. The certificates would not be nationally restricted, but could be traded across borders. Exchanges would be authorised by national authorities, in accordance with overall EU directives. These authorised exchanges would act as certification bodies, checking that certificates had been properly issued in accordance with a corresponding volume of electricity production. Electricity and certificates could be purchased from different suppliers. The

TAXATION IN FRANCE - Memorandum concerning the annual internal taxation certificate and the declaration of income for 2011

CERN Document Server

2012-01-01

You are reminded that the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that the members of the personnel are exempt from external taxation on salaries and emoluments paid by CERN.   I - Annual internal taxation certificate for 2011 The annual certificate of internal taxation for 2011, issued by the Finance, Procurement and Knowledge Transfer Department, is available since 1st March 2012. It is intended exclusively for the tax authorities. If you are currently a member of the CERN personnel you received an e-mail containing a link to your annual certificate, which you can print out if necessary. If you are no longer a member of the CERN personnel or are unable to access your annual certificate as indicated above, you will find information explaining how to obtain one at the following link: https://cern.ch/admin-eguide/Impots/proc_impot_attestation_interne.asp. ...

Maternal morbidity and risk of death at delivery hospitalization.

Science.gov (United States)

Campbell, Katherine H; Savitz, David; Werner, Erika F; Pettker, Christian M; Goffman, Dena; Chazotte, Cynthia; Lipkind, Heather S

2013-09-01

To examine the effect of underlying maternal morbidities on the odds of maternal death during delivery hospitalization. We used data that linked birth certificates to hospital discharge diagnoses from singleton live births at 22 weeks of gestation or later during 1995-2003 in New York City. Maternal morbidities examined included prepregnancy weight more than 114 kilograms (250 pounds), chronic hypertension, pregestational or gestational diabetes mellitus, chronic cardiovascular disease, pulmonary hypertension, chronic lung disease, human immunodeficiency virus (HIV), and preeclampsia or eclampsia. Associations with maternal mortality were estimated using multivariate logistic regression. During the specified time period, 1,084,862 live singleton births and 132 maternal deaths occurred. Patients with increasing maternal age, non-Hispanic black ethnicity, self-pay or Medicaid, primary cesarean delivery, and premature delivery had higher rates of maternal mortality during delivery hospitalization. From the entire study population, 4.1% had preeclampsia or eclampsia (n=44,004), 1.8% had chronic hypertension (n=19,647), 1.1% of patients were classified as obese (n=11,936), 0.7% had pregestational diabetes (n=7,474), 0.4% had HIV (n=4,665), and 0.01% had pulmonary hypertension (n=166). Preeclampsia or eclampsia (adjusted odds ratio [OR], 8.1; 95% confidence interval [CI], 5.5-12.1), chronic hypertension (adjusted OR, 7.7; 95% CI 4.7-12.5), underlying maternal obesity (adjusted OR, 2.9; 95% CI 1.1-8.1), pregestational diabetes (adjusted OR, 3.3; 95% CI 1.3-8.1), HIV (adjusted OR, 7.7; 95% CI 3.4-17.8), and pulmonary hypertension (adjusted OR, 65.1; 95% CI 15.8-269.3) were associated with an increased risk of death during the delivery hospitalization. The presence of maternal disease significantly increases the odds of maternal mortality at the time of delivery hospitalization. II.

Transfer of residents to hospital prior to cardiac death: the influence of nursing home quality and ownership type.

Science.gov (United States)

Anic, Gabriella M; Pathak, Elizabeth Barnett; Tanner, Jean Paul; Casper, Michele L; Branch, Laurence G

2014-01-01

We hypothesised that among nursing home decedents, nursing home for-profit status and poor quality-of-care ratings, as well as patient characteristics, would lower the likelihood of transfer to hospital prior to heart disease death. Using death certificates from a large metropolitan area (Tampa Florida Metropolitan Statistical Area) for 1998-2002, we geocoded residential street addresses of heart disease decedents to identify 2172 persons who resided in nursing homes (n=131) at the time of death. We analysed decedent place of death as an indicator of transfer prior to death. Multilevel logistic regression modelling was used for analysis. Cause of death and decedent characteristics were obtained from death certificates. Nursing home characteristics, including state inspector ratings for multiple time points, were obtained from Florida's Agency for Healthcare Administration. Nursing home for-profit status, level of nursing care and quality-of-care ratings were not associated with the likelihood of transfer to hospital prior to heart disease death. Nursing homes >5 miles from a hospital were more likely to transfer decedents, compared with facilities located close to a hospital. Significant predictors of no transfer for nursing home residents were being white, female, older, less educated and widowed/unmarried. In this study population, contrary to our hypotheses, sociodemographic characteristics of nursing home decedents were more important predictors of no transfer prior to cardiac death than quality rankings or for-profit status of nursing homes.

No certificate, no chocolate

CERN Multimedia

Computer Security Team

2013-01-01

Are you already ready to use “certificates” to log into CERN or to connect to the global “eduroam” wireless network? No, I am not talking about your birth certificate, medical certificates or academic certificates. I am referring to “certificates” used for authentication where you would usually use a password.   These digital certificates are a valid alternative to cumbersome passwords. Like the aforementioned personal certificates, a digital certificate is an official document that proves who you are or your qualifications. Your personal digital CERN certificate is tied to your digital identity at CERN. In that respect, a digital certificate is like a password. It is a credential that you must not share with anybody else! With your digital certificate, I can impersonate you and take over your mailbox, your web sessions and more… Digital certificates bind your digital identity to a public/private-key infrastructu...

Improving hospital death certification in Viet Nam: results of a pilot study implementing an adapted WHO hospital death report form in two national hospitals.

Science.gov (United States)

Walton, Merrilyn; Harrison, Reema; Chevalier, Anna; Esguerra, Esmond; Van Duong, Dang; Chinh, Nguyen Duc; Giang, Huong

2016-01-01

Viet Nam does not have a system for the national collection of death data that meets international requirements for mortality reporting. It is identified as a 'no-report' country by the WHO. Verbal autopsy reports are used in the community but exclude deaths in hospitals. This project was undertaken in Bach Mai National General Hospital and Viet Duc Surgical and Trauma Hospital in Viet Nam from 1 March 2013 to 31 March 2015. In phase 1, a modified hospital death report form, consistent with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, was developed. Small group training in use of the report form was delivered to 427 doctors. In phase two, death data were collected, collated and analysed. In phase three, a random sample (7%) of all report forms was checked for accuracy and completeness against medical records. During the 23 months of the study, 3956 deaths were recorded. Across both hospitals, 222 distinct causes of deaths were recorded. Traumatic cerebral oedema was the immediate cause of death (15% of cases, 575/3956 patients), followed by septic shock (13%, 528/3956), brain compression (11%, 416/3956), intracerebral haemorrhage (8%, 336/3956) and pneumonia (5%, 186/3956); 67% (2639/3956) of patients were discharged home to die and 33% (1314/3956) of deaths were due to a road traffic accident, or injury at home or at work. This study confirms the viability of implementing a death report form system compliant with international standards in hospitals in Viet Nam and provides the foundation for introducing a national death report form scheme. These data are critical to comprehensive knowledge of causes of death in Viet Nam. Death data about patients discharged home to die is presented for the first time, with implications for countries where this is a cultural preference.

Óbitos em instituição asilar Deaths in nursing homes

Directory of Open Access Journals (Sweden)

Milton Luiz Gorzoni

2011-06-01

Full Text Available OBJETIVO: Definir as causas de morte em população internada em instituição de longa permanência para idosos (ILPI MÉTODOS: ILPI de 508 leitos com prontuários padronizados, reuniões periódicas sobre atestados de óbitos e com 12 médicos responsáveis pela supervisão e/ou emissão deles. Considerou-se o padrão deste procedimento suficientemente uniforme para análise dos prontuários e atestados de óbitos emitidos durante o ano de 2006, visando definir dados gerais (sexo e idade, causa da morte e causa(s básica(s. Análise estatística comparou casuísticas entre os dois sexos e faixas etárias ( 75 anos de idade. RESULTADOS: Ocorreram 118 óbitos durante o ano de 2006 (idade média: 74,5 ± 15,2 anos - 64 mulheres (idade média: 78,4 ± 14,4 anos e 54 homens (idade média: 69,8 ± 15,0 anos -, sendo as causas de morte: sepse( 41 óbitos, choque séptico (25, broncopneumonia (16, morte súbita (11, falência de múltiplos órgãos (9, outras causas (16 óbitos. As principais causas básicas foram infecciosas (63 óbitos - broncopneumonia (34, sepse (12, infecção urinária (7, úlceras de pressão infectadas (7, osteomielite (2 e colangite (1; seguidas da síndrome da imobilidade (42 óbitos. Observou-se significância estatística para a proporção de idosas > 75 anos e não houve para sazonalidade, causa de morte ou básica considerando-se infecciosas e não infecciosas versus homens e mulheres, maiores ou menores de 75 anos de idade. CONCLUSÃO: Óbitos em ILPI decorrem basicamente da somatória de imobilidade e infecções que evoluem para quadros sépticos.OBJECTIVE: To define the causes of death in a nursing home population. METHODS: The study selected a 508-bed nursing home with standard medical records, regular meetings concerning death certificates and 12 medical doctors in charge of supervising or issuing death certificates. The procedure standard (2006 death certificates was considered consistent enough to undergo the

Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark

DEFF Research Database (Denmark)

Gullach, Anders Juul; Risgaard, Bjarke; Lynge, Thomas Hadberg

2015-01-01

BACKGROUND: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled...... in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma. METHODS: Through the review of death certificates, we found 625 sudden...... individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack. Symptoms (chest pain, dyspnea, seizures, general malaise, syncope...

Assessment of Chain-of-Custody Certification in the Czech and Slovak Republic

Directory of Open Access Journals (Sweden)

Hubert Paluš

2017-10-01

Full Text Available Forest certification is a voluntary verification tool that has been gaining importance within the global sustainability issues as an independent verification tool for sustainable forest management and wood processing industry and as an influencer in private and public purchasing policies and a component of emerging wood harvesting and trade legality schemes. This study focuses on the chain-of-custody (CoC component of forest certification. A survey of CoC certified companies in the Czech Republic and Slovakia was carried out to explore the understanding of the concept and role of forest and CoC certification as an environmental, economic, and social tool. It aimed to determine expectations following from the implementation of CoC certification by companies and to identify difficulties in existing certified wood product supply chains and costs related to purchase and sales of certified forest products, respectively. Results indicate that respondents demonstrated a high level of understanding of the CoC concept and that they link forest certification mainly to the issues of legality, tracing the origin source of supply and promotion of sustainable utilisation of wood. The main expected benefits are linked to the improvement of an external company image followed by penetration of new markets and increase of sales volume. CoC is not considered a tool to improve internal company performance and efficiency. The key problems connected to certified supply chains relate to the sufficient quantity of certified forest products, low margins and overpriced certified material inputs. Respondents reported none or minimum price premiums for their certified products over non-certified alternatives. Several differences related to the understanding of the sustainable forest management concept and the level of price premium paid for certified inputs were identified between the PEFC (Programme for the Endorsement of Forest Certification and FSC (Forest Stewardship

Deaths related to lead poisoning in the United States, 1979-1998

International Nuclear Information System (INIS)

Kaufmann, R.B.; Staes, Catherine J.; Matte, Thomas D.

2003-01-01

This study was conducted to describe trends in US lead poisoning-relate deaths between 1979 and 1998. The predictive value of relevant ICD-9 codes was also evaluated. Multiple cause-of-death files were searched for record containing relevant ICD-9 codes, and underlying causes and demographic characteristics were assessed. For 1979-1988, death certificates were reviewed; lead source information was abstracted and accuracy of coding was determined. An estimated 200 lead poisoning-related deaths occurred from 1979 to 1998. Most were among males (74%), Blacks (67%), adults of age ≥45 years (76%), and Southerners (70%). The death rate was significantly lower in more recent years. An alcohol-related code was a contributing cause for 28% of adults. Only three of nine ICD-9 codes for lead poisoning were highl predictive of lead poisoning-related deaths. In conclusion, lead poisoning-related death rates have dropped dramatically since earlier decades and are continuing to decline. However, the findings imply that moonshine ingestion remains a source of high-dose lead exposure in adults

Sudden unexpected death in infancy: place and time of death.

Science.gov (United States)

Glasgow, J F T; Thompson, A J; Ingram, P J

2006-01-01

In recent years, many babies who die of Sudden Unexpected Death in Infancy (SUDI) in Northern Ireland are found dead in bed--i.e. co-sleeping--with an adult. In order to assess its frequency autopsy reports between April 1996 and August 2001 were reviewed and linked to temporal factors. The day and month of death, and the place where the baby was found were compared to a reference population of infant deaths between one week of age and the second birthday. Although the rate of SUDI was lower than the UK average, 43 cases of SUDI were identified, and two additional deaths with virtually identical autopsy findings that were attributed to asphyxia caused by suffocation due to overlaying. Thirty-two of the 45 (71%) were less than four months of age. In 30 of the 45 cases (67%) the history stated that the baby was bed sharing with others; 19 died sleeping in an adult bed, and 11 on a sofa or armchair. In 16 of the 30 (53%) there were at least two other people sharing the sleeping surface, and in one case, three. SUDI was twice as frequent at weekends (found dead Saturday-Monday mornings) compared to weekdays (psharing a place of sleep per se may not increase the risk of death, our findings may be linked to factors such as habitual smoking, consumption of alcohol or illicit drugs as reported in case-control studies. In advising parents on safer childcare practices, health professionals must be knowledgeable of current research and when, for example, giving advice on co-sleeping this needs to be person-specific cognisant of the risks within a household. New and better means of targeting such information needs to be researched if those with higher risk life-styles are to be positively influenced.

Leave for illness/accident or in the event of illness of a close relative - New medical certificate templates

CERN Multimedia

HR department

2016-01-01

Medical certificate templates are now available in the Admin e-guide (follow the “Forms and templates” link):    Medical certificate for illness/accident Medical certificate for a medical examination or treatment Medical certificate in the event of illness of a close relative These templates are provided for the convenience of members of the personnel and their use is recommended but not compulsory. Other forms of medical certificates issued by a medical doctor may also be submitted, provided they contain the same items of information as those given in the templates. More information on the applicable rules and on the way leave is managed at CERN can be found in the Admin e-guide web pages. Human Resources department HR.leave@cern.ch

Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy

DEFF Research Database (Denmark)

Lynge, Thomas Hadberg; Risgaard, Bjarke; Jabbari, Reza

2016-01-01

AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. METHODS AND RESULTS: Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years...... in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431...... autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought...

The place of death of patients with cancer in Kuwait.

Science.gov (United States)

Alshemmari, Salem H; Elbasmi, Amani A; Alsirafy, Samy A

2015-12-01

The place of death (PoD) has a significant effect on end-of-life care for patients dying of cancer. Little is known about the place of cancer deaths in our region. To identify the PoD of patients with cancer in Kuwait, we reviewed the death certificates submitted to the Kuwait Cancer Registry in 2009. Of 611 cancer deaths, 603 (98.7%) died in hospitals and only 6 (1%) patients died at home. More than half (57.3%) of inhospital deaths were in the Kuwait Cancer Control Center. Among those for whom the exact PoD within the hospital was identified (484 patients), 116 (24%) patients died in intensive care units and 12 (2.5%) patients died in emergency rooms. This almost exclusive inhospital death of patients with cancer in Kuwait is the highest ever reported. Research is needed to identify the reasons behind this pattern of PoD and to explore interventions promoting out-of-hospital death among terminally ill cancer patients in Kuwait. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Validity of parental work information on the birth certificate

Directory of Open Access Journals (Sweden)

Langlois Peter H

2008-03-01

Full Text Available Abstract Background In the most recent revision (2003 of the U.S. standard certificate of live births, the National Center for Health Statistics recommended that all states collect maternal and paternal usual occupation. Because such information might be useful in the surveillance of job-related risk areas, we assessed the quality of parental work information on the U.S. birth certificate. Methods Occupational histories obtained from maternal interviews with Texas (USA participants in the National Birth Defects Prevention Study were linked to and compared with parental work information on birth certificates. With occupational information from interviews serving as the gold standard, we assessed the quality of occupational information on the birth certificate with measures of sensitivity, specificity, and the kappa statistic. Results Of the 649 births available for study, parental occupation agreed between the birth certificate and interview for 77% of mothers and 63% of fathers with similar agreement by case-control status. Among occupations and industries with 10 or more workers by interview, sensitivity of the birth certificate information ranged from 35% to 100% for occupational groups and 55% to 100% for industrial sectors. Specificities of occupations/industries studied ranged from 93 to 100%. Kappa statistics for maternal occupations (0.76 to 0.90 and industries (0.59 to 0.94 were higher than those for paternal occupations (0.48 to 0.92 and industries (0.47 to 0.89. Mothers were frequently misclassified as homemakers or otherwise unemployed while the paternal information was often missing altogether on the birth certificate. Women who worked as health diagnosing and treating practitioners were the least likely (0% and women in food preparation or serving occupations were the most likely (65% to be misclassified as not employed on the birth certificate. Among fathers, the proportion of missing occupations was the lowest for occupations in

Dengue Deaths in Puerto Rico: Lessons Learned from the 2007 Epidemic

Science.gov (United States)

Tomashek, Kay M.; Gregory, Christopher J.; Rivera Sánchez, Aidsa; Bartek, Matthew A.; Garcia Rivera, Enid J.; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L.; Sun, Wellington

2012-01-01

Background The incidence and severity of dengue in Latin America has increased substantially in recent decades and data from Puerto Rico suggests an increase in severe cases. Successful clinical management of severe dengue requires early recognition and supportive care. Methods Fatal cases were identified among suspected dengue cases reported to two disease surveillance systems and from death certificates. To be included, fatal cases had to have specimen submitted for dengue diagnostic testing including nucleic acid amplification for dengue virus (DENV) in serum or tissue, immunohistochemical testing of tissue, and immunoassay detection of anti-DENV IgM from serum. Medical records from laboratory-positive dengue fatal case-patients were reviewed to identify possible determinants for death. Results Among 10,576 reported dengue cases, 40 suspect fatal cases were identified, of which 11 were laboratory-positive, 14 were laboratory-negative, and 15 laboratory-indeterminate. The median age of laboratory-positive case-patients was 26 years (range 5 months to 78 years), including five children aged Dengue was listed on the death certificate in only 5 instances. Conclusions During a dengue epidemic in an endemic area, none of the 11 laboratory-positive case-patients who died were managed according to current WHO Guidelines. Management issues identified in this case-series included failure to recognize warning signs for severe dengue and shock, prolonged ED stays, and infrequent patient monitoring. PMID:22530072

Programa piloto para la mejora de la certificación de las causas de muerte en atención primaria en Cataluña A pilot program to improve causes of death certification in primary care of Catalonia, Spain

Directory of Open Access Journals (Sweden)

Rafael Abós

2006-12-01

Full Text Available Objetivo: El programa piloto BEDTAR (Boletín Estadístico de Defunción en Tarragona evaluó el cambio en la calidad de la certificación de las defunciones, tras una intervención formativa a los médicos de atención primaria del Ámbito de Tarragona, en Cataluña. Diseño: Estudio evaluativo «antes-después» con intervención y sin grupo control. Emplazamiento y participantes: La población objeto de estudio estaba constituida por los médicos de la red reformada de atención primaria del AT. Material y métodos: Se iniciaba la sesión con el ejercicio «antes», que consistía en certificar 3 defunciones. Luego le seguía el seminario teórico-práctico y, finalmente, el ejercicio «después», en el que se certificaban de nuevo las defunciones del primer ejercicio. Las variables utilizadas para evaluar la calidad de la certificación fueron: certificación de las causas en secuencia lógica, posición correcta en el boletín estadístico de defunción de las causas inmediatas, intermedia y fundamental, uso del paro cardiorrespiratorio y otras entidades mal definidas, uso adecuado de las abreviaturas, letra ilegible, vocabulario y uso de toda la información disponible. Resultados: La participación final de los profesionales en el programa fue del 71% y la eficacia de cambio para la mejora global que podemos atribuir al programa fue del 59%. Conclusiones: El programa BEDTAR mejoró la calidad de la certificación y puso de manifiesto la relevancia y la aplicabilidad de los resultados obtenidos.Objective: The BEDTAR pilot program assessed changes in the quality of certification of death's causes after a training session for the primary care physicians in the Tarragona's Area of Catalonia, in the Northeast of the Iberian Peninsula. Design: Before-after evaluative study with intervention and without control group. Setting and participants: The study population was the physicians of the reformed primary health care network of the AT

Professional Certification

Science.gov (United States)

WaterSense recognizes certification programs for irrigation professionals that meet the specification criteria. Certification programs cover three areas: irrigation system design, installation and maintenance, and system auditing.

Causes of death in Vanuatu.

Science.gov (United States)

Carter, Karen; Tovu, Viran; Langati, Jeffrey Tila; Buttsworth, Michael; Dingley, Lester; Calo, Andy; Harrison, Griffith; Rao, Chalapati; Lopez, Alan D; Taylor, Richard

2016-01-01

The population of the Pacific Melanesian country of Vanuatu was 234,000 at the 2009 census. Apart from subsistence activities, economic activity includes tourism and agriculture. Current completeness of vital registration is considered too low to be usable for national statistics; mortality and life expectancy (LE) are derived from indirect demographic estimates from censuses/surveys. Some cause of death (CoD) data are available to provide information on major causes of premature death. Deaths 2001-2007 were coded for cause (ICDv10) for ages 0-59 years from: hospital separations (HS) (n = 636), hospital medical certificates (MC) of death (n = 1,169), and monthly reports from community health facilities (CHF) (n = 1,212). Ill-defined causes were 3 % for hospital deaths and 20 % from CHF. Proportional mortality was calculated by cause (excluding ill-defined) and age group (0-4, 5-14 years), and also by sex for 15-59 years. From total deaths by broad age group and sex from 1999 and 2009 census analyses, community deaths were estimated by deduction of hospital deaths MC. National proportional mortality by cause was estimated by a weighted average of MC and CHF deaths. National estimates indicate main causes of deaths <5 years were: perinatal disorders (45 %) and malaria, diarrhea, and pneumonia (27 %). For 15-59 years, main causes of male deaths were: circulatory disease 27 %, neoplasms 13 %, injury 13 %, liver disease 10 %, infection 10 %, diabetes 7 %, and chronic respiratory disease 7 %; and for females: neoplasms 29 %, circulatory disease 15 %, diabetes 10 %, infection 9 %, and maternal deaths 8 %. Infection included tuberculosis, malaria, and viral hepatitis. Liver disease (including hepatitis and cancer) accounted for 18 % of deaths in adult males and 9 % in females. Non-communicable disease (NCD), including circulatory disease, diabetes, neoplasm, and chronic respiratory disease, accounted for 52 % of premature deaths in adult

Gender differences in sudden cardiac death in the young-a nationwide study

DEFF Research Database (Denmark)

Winkel, Bo Gregers; Risgaard, Bjarke; Bjune, Thea

2017-01-01

Background: Hitherto, sudden cardiac death (SCD) in the young has been described with no distinction between genders. SCD occurs more often in men (SCDm) than women (SCDw), but this disparity is not understood and has not been investigated systematically in a nationwide setting. Our objective......=0.02) and died less often in a public place (16 vs. 26%, p=0.01). Age at death, ratios of autopsies and sudden unexplained deaths, and comorbidities, did not differ. Causes of SCD were largely comparable between genders. The incidence rate of SCDw was half of that of SCDm (1.8 vs. 3.6 per 100...... was to report gender differences in SCD in the young in a nationwide (Denmark) setting. Methods: All deaths in persons aged 1-35 years nationwide in Denmark between 2000 and 2009 were included. Death certificates and autopsy reports were obtained. The extensive health care registries in Denmark were used...

Dying in Hospital with Dementia and Pneumonia: A Nationwide Study Using Death Certificate Data

NARCIS (Netherlands)

Houttekier, D.; Reyniers, T.; Deliens, L.; Den Noortgate, N.; Cohen, J.

2014-01-01

Background: For people with dementia dying from pneumonia, hospitalization at the end of life may be of little benefit and result in unfavourable outcomes such as hospital death. Objective: The aim of this study is to estimate the incidence of and factors associated with hospital death in people

Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries.

Science.gov (United States)

Pivodic, Lara; Pardon, Koen; Morin, Lucas; Addington-Hall, Julia; Miccinesi, Guido; Cardenas-Turanzas, Marylou; Onwuteaka-Philipsen, Bregje; Naylor, Wayne; Ruiz Ramos, Miguel; Van den Block, Lieve; Wilson, Donna M; Loucka, Martin; Csikos, Agnes; Rhee, Yong Joo; Teno, Joan; Deliens, Luc; Houttekier, Dirk; Cohen, Joachim

2016-01-01

Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differences in the place of death. Death certificate data for all deaths in 2008 (age ≥1 year) in Belgium, Canada, the Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (Andalusia), the USA and Wales caused by cancer, heart/renal/liver failure, chronic obstructive pulmonary disease, diseases of the nervous system or HIV/AIDS were linked with national or regional healthcare statistics (N=2,220,997). 13% (Canada) to 53% (Mexico) of people died at home and 25% (the Netherlands) to 85% (South Korea) died in hospital. The strength and direction of associations between home death and cause of death, sociodemographic and healthcare availability factors differed between countries. Differences between countries in home versus hospital death were only partly explained by differences in these factors. The large differences between countries in and beyond Europe in the place of death of people in potential need of palliative care are not entirely attributable to sociodemographic characteristics, cause of death or availability of healthcare resources, which suggests that countries' palliative and end-of-life care policies may influence where people die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Description of deaths on Easter Island, 2000-2012 period.

Science.gov (United States)

Bravo, Eduardo Francisco; Saint-Pierre, Gustavo Enrique; Yaikin, Pabla Javiera; Meier, Martina Jose

2014-01-01

Easter Island is a small island of 180 km2, located 3,800 km from the Chilean coast and one of the most isolated inhabited places in the world. Since the mid-twentieth century, it has been undergoing an epidemiological transition in relation to the causes of death, from a predominance of infectious to non-communicable diseases (NCDs) such as cardiovascular ailments and cancer. The aim of this study is to describe the causes of death to Easter Island between 2000 and 2012, so the statistical records of Hanga Roa Hospital and death certificates were reviewed. The period under review of 13 years there was a total of 252 deaths, an average to 19.3 deaths per year. The most frequent causes of death found in the general population of Easter Island were cardiovascular diseases (25.4%), followed by neoplasms (23.4%), accidents (18.6%). Related to Rapa Nui people, cardiovascular and neoplastic diseases (both 26.7%) predominate, while in the population without belonging to the ethnic group the main causes were traumatic (25%) and cardiovascular (22.2%). Comparing the leading causes of death of Easter Island with mainland Chile, it can be seen how they resemble. Taking the island death profile, it is necessary to work on public health strategies aimed to this, considering that some of the causes are completely preventable.

Fas (CD95) expression and death-mediating function are induced by CD4 cross-linking on CD4+ T cells.

OpenAIRE

Desbarats, J; Freed, J H; Campbell, P A; Newell, M K

1996-01-01

The CD4 receptor contributes to T-cell activation by coligating major histocompatibility complex class II on antigen presenting cells with the T-cell receptor (TCR)/CD3 complex, and triggering a cascade of signaling events including tyrosine phosphorylation of intracellular proteins. Paradoxically, CD3 cross-linking prior to TCR stimulation results in apoptotic cell death, as does injection of anti-CD4 antibodies in vivo of CD4 ligation by HIV glycoprotein (gp) 120. In this report we investig...

One Decade of Unnatural Deaths in Yazd Province: 2003-2013

Directory of Open Access Journals (Sweden)

mohamad hassan lotfi

2016-02-01

Full Text Available Abstract Introduction: Death is defined as the permanent loss of all signs of life at any time after birth (Irrevocable disappearance of all vital signs after birth. Unnatural deaths seem to be either suspicious or  unexpected. Deaths that occur suddenly and their causes need to be investigated, are termed unnatural deaths. According to the death certificate contents of Ministry of Health and Forensics, if the cause of death is unnatural, the corpse will be submitted to the forensic medicine departments in 19 cases in order to determine the death cause and to issue the burial permit.   Material & Methods: In this descriptive study, the data were extracted from unnatural death cases in the province of Yazd during 2003 to 2013 recorded by Yazd Forensic Medicine. Results: During 2003 -2013, 5552 cases of unnatural deaths were recorded by the Forensic Medicine of Yazd, out of which 4373 cases of unnatural deaths were caused by road traffic accidents (outside and inside the city, 89 deaths from electrocution, 439 deaths from poisoning, 72 deaths from drowning, 129 deaths from asphyxia (by carbon monoxide, 56 deaths from work incidents, and 394 deaths from burns. The group of males aged 20-29 years allocated the highest number of unnatural deaths to themselves. Conclusion: Road traffic accidents are the second leading cause of unnatural deaths in Iran. The number of unnatural death incidents in men is more than women indicating that men are more exposed to risk factors than women, though regarding the deaths due to the burns, women are exposed to the high risk factors.

Qualidade das informações registradas nas declarações de óbito fetal em São Paulo, SP Calidad de las informaciones registradas en las declaraciones de óbito fetal en Sao Paulo, Sureste de Brasil Quality of information registered on fetal deaths certificates in São Paulo, Southeastern Brazil

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Marcia Furquim de Almeida

2011-10-01

muerte. La calidad de las informaciones generadas de autopsias depende del acceso a las informaciones hospitalarias.OBJECTIVE: To evaluate the quality of information registered on fetal death certificates. METHODS: Records were reviewed from 710 fetal deaths registered in the consolidated database of deaths from the State System for Data Analysis and the São Paulo State Secretary of Health, for deaths in São Paulo municipality (Southeastern Brazil during the first semester of 2008. Completeness was analyzed for variables on fetal death certificates issued by hospitals and autopsy service. The death certificates from a sub-sample of 212 fetal deaths in hospitals of the National Unified Health System (public were compared to medical records and to the records from Coroners Office. RESULTS: Among death certificates, 75% were issues by Coroners Office, with a greater frequency in public hospitals (78%. Completeness of variables on death certificates issued by hospitals was higher among non-public hospitals. There was greater completeness, agreement and sensitivity in death certificates issued by hospitals. There was low agreement and high specificity for variables related to maternal characteristics. Increased reporting of gender, birth weight and gestational age was observed in certificates issued by Coroners Office. Autopsies did not result in improved ascertainment of cause of death, with 65.7% identified as unspecified fetal death as 24.3% as intrauterine hypoxia, while death certificates by hospitals reported 18.1% as unspecified and 41.7% as intrauterine hypoxia. CONCLUSIONS: Completeness and the ascertainment of cause of fetal death need to be improved. The high proportion of autopsies did not improve information and ascertainment of cause of death. The quality of information generated by autopsies depends on access to hospital records.

Defining death: organ transplants, tradition and technology in Japan.

Science.gov (United States)

Feldman, E A

1988-01-01

This article explores Japanese attitudes about brain death and organ transplantation. First, ancient burial customs and death-related rituals associated with Shinto and Buddhism are examined. Next, contemporary attitudes towards the dead are discussed in the context of current controversies surrounding brain death and organ transplantation. Finally, an attempt is made to link the traditional Japanese views of death with modern medical dilemmas.

Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp.

Science.gov (United States)

Cuerda-Galindo, Esther; López-Muñoz, Francisco; Krischel, Matthis; Ley, Astrid

2017-01-01

Living conditions in Nazi concentration camps were harsh and inhumane, leading many prisoners to commit suicide. Sachsenhausen (Oranienburg, Germany) was a concentration camp that operated from 1936 to 1945. More than 200,000 people were detained there under Nazi rule. This study analyzes deaths classified as suicides by inmates in this camp, classified as homosexuals, both according to the surviving Nazi files. This collective was especially repressed by the Nazi authorities. Data was collected from the archives of Sachsenhausen Memorial and the International Tracing Service in Bad Arolsen. Original death certificates and autopsy reports were reviewed. Until the end of World War II, there are 14 death certificates which state "suicide" as cause of death of prisoners classified as homosexuals, all of them men aged between 23 and 59 years and of various religions and social strata. Based on a population of 1,200 prisoners classified as homosexuals, this allows us to calculate a suicide rate of 1,167/100,000 (over the period of eight years) for this population, a rate 10 times higher than for global inmates (111/100,000). However, our study has several limitations: not all suicides are registered; some murders were covered-up as suicides; most documents were lost during the war or destroyed by the Nazis when leaving the camps and not much data is available from other camps to compare. We conclude that committing suicides in Sachsenhausen was a common practice, although accurate data may be impossible to obtain.

Deconstructing Teacher Certification

Science.gov (United States)

Baines, Lawrence A.

2006-01-01

In this article, the author takes a close look at alternative certification programs and is convinced that, because they vary so extremely in their requirements, all of them cannot possibly be producing highly qualified teachers. Here, he talks about Non-University Certification Programs (NUCPs). These are alternative certification programs that…

A análise da mortalidade por causa básica e por causas múltiplas Analysis of mortality by underlying and multiple causes of death

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Ruy Laurenti

1974-12-01

Full Text Available Foram comentados alguns aspectos das estatísticas de mortalidade por causas básicas e por causas múltiplas. Utilizando uma amostra de óbitos ocorridos em hospitais e obtendo informações adicionais através dos prontuários médicos, foram refeitos os atestados comparando-os com os originais. Foi verificado que a causa básica está declarada incorretamente em 37,7% dos casos e que existem discordâncias que se compensam. O número médio de diagnósticos por atestados de óbito foi de 1,9, elevando-se para 2,9 quando se dispõem de informações adicionais. O número médio de diagnósticos adicionais que acompanhou a causa básica aumentou quanto mais longa foi a evolução da doença básica. A codificação de causas múltiplas tem como vantagens o reconhecimento de freqüências de doenças que raramente são consideradas básicas e as estatísticas de mortalidade por causas múltiplas não são afetadas pelas mudanças das regras de seleção da causa de morte.Some aspects of mortality statistics based on underlying and multiple causes of death are analysed. A sample was drawn for study from deaths ocurred in hospitals using the official death certificates. With the help of additional information taken from medical records the death certificates were filled out again and compared with the original ones showing that the basic cause of death was incorrectly stated in 37.7% of the official death certificates and that there were some counterbalancing divergences. The average number of diagnosis per official death certificate was 1.9. With additional information it went up to 2.9. The longer the evolution of the basic illness, the greater the increase of the average number of additional diagnosis accompanying the basic cause. The multiple causes of death classification allowed acknowledgement of rare causes of death that very seldomly appeared as underlying causes of death. The mortality statistics by causes are not affected by the changes

Polytrauma in the elderly: predictors of the cause and time of death

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Muwanga Cyrus

2010-05-01

Full Text Available Abstract Background Increasing age and significant pre-existing medical conditions (PMCs are independent risk factors associated with increased mortality after trauma. Our aim was to review all trauma deaths, identifying the cause and the relation to time from injury, ISS, age and PMCs. Methods A retrospective analysis of trauma deaths over a 6-year period at the study centre was conducted. Information was obtained from the Trauma Audit and Research Network (TARN dataset, hospital records, death certificates and post-mortem reports. The time and cause of death, ISS, PMCs were analysed for two age groups ( Results Patients ≥ 65 years old were at an increased risk of death (OR 6.4, 95% CI 5.2-7.8, p 15 and died within the first 24 hours of admission, irrespective of age, from causes directly related to their injuries. Twelve patients with an ISS of Conclusion Elderly patients with minor injuries and PMCs have an increased risk of death relative to their younger counterparts and are more likely to die of medical complications late in their hospital admission.

Lightning deaths: a retrospective review of New Mexico's cases, 1977-2009.

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Pincus, Jennifer L; Lathrop, Sarah L; Briones, Alice J; Andrews, Sam W; Aurelius, Michelle B

2015-01-01

To better understand lightning deaths, a retrospective review of electronic records from New Mexico's Office of the Medical Investigator database was performed between 1977 and 2009 to update and assess current risk factors. Information on demographics, circumstances, autopsy, and death certificates were collected and analyzed. Fifty-four decedents were identified, ages 2-71 years old (mean 34 years old), 42 males and 12 females. Common racial/ethnic groups were non-Hispanic Whites and American Indians (together comprising 72% of all cases). Physical findings were often related to the heat carried by the electrical current including clothing alterations (29.6%) and burning of skin (53.7%). Most deaths occurred on weekend afternoons in summer months, associated with recreational activities or agricultural work, and rural locations (77.8%). Utilizing the demographic information, clustered events, and associated outdoor activities will assist in creating public awareness and provide a framework to support targeted warnings in an attempt to prevent future deaths. © 2014 American Academy of Forensic Sciences.

Energy sales targets: An alternative to White Certificate schemes

International Nuclear Information System (INIS)

Passey, Robert; MacGill, Iain

2009-01-01

White Certificate schemes are currently being implemented or proposed in a growing number of jurisdictions as a means to drive greater energy efficiency uptake. After briefly discussing some of the strengths and weaknesses of such schemes, this paper outlines a proposed alternative approach-the use of Energy Sales Targets. This approach essentially involves the imposition of a cap on the greenhouse gas (GHG) emissions associated with annual energy sales and, in its simplest version, requires no tradeable certificates or permits. The proposed approach creates a clear measurable link between how compliance is enforced (the retailers' targets) and the desired outcomes of the scheme (measurable reductions in GHG emissions). This drives physical additionality of the scheme, including negation of any rebound effect within the covered sectors. It also avoids the need to define the activities eligible to create certificates, and likewise, no deeming, auditing, monitoring or verification would be required by government beyond ensuring retailer compliance-significantly reducing administration costs. There does not appear to be a clear precedent for this type of scheme anywhere in the world, and so this paper should be seen as a preliminary scoping of options that are deserving of more in-depth assessment.

Energy saving certificates

International Nuclear Information System (INIS)

2005-11-01

The French ministry of economy, finances and industry and the French agency of environment and energy mastery (Ademe) have organized on November 8, 2005, a colloquium for the presentation of the energy saving certificates, a new tool to oblige the energy suppliers to encourage their clients to make energy savings. This document gathers the transparencies presented at this colloquium about the following topics: state-of-the-art and presentation of the energy saving certificates system: presentation of the EEC system, presentation of the EEC standard operations; the energy saving certificates in Europe today: energy efficiency commitment in UK, Italian white certificate scheme, perspectives of the different European systems. (J.S.)

Trainer certification

International Nuclear Information System (INIS)

Couser, S.; Moore, J.

1988-01-01

A DOE Technical Safety Appraisal in October 1986 found that training at the Portsmouth Gaseous Diffusion Plant was fragmented and lacked uniformity. Training was localized in departments and was more often handled by line supervisors, etc. - with no certification. The Trainer Certification Program has provided the means for applying standard guidelines to ensure that training is designed, applied, and evaluated in a consistent, effective, and efficient manner. The program is in a state of substantial change and a target date for compliance is set for 1989. Trainer certification will provide both current and future resources to ensure consistent and effective training. 22 figures

Linking sudden oak death with spatial economic value transfer

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Tom Holmes; Bill Smith

2008-01-01

Sudden oak death (caused by Phytophthora ramorum) is currently having a dramatic impact on the flow of ecosystem services provided by trees and forests in California. Timber species in California are not thought to be at risk of mortality from this pathogen and, consequently, economic impacts accrue to non-market values of trees such as aesthetics,...

Developing an interdisciplinary certificate program in transportation planning, phase 2 : the eCertificate.

Science.gov (United States)

2011-11-01

This proposal extends the delivery of the recently developed graduate Certificate in Transportation : Planning to a wider audience through the establishment of an Executive Certificate Program by distance : (eCertificate). While the need for an inter...

Faith healers, myths and deaths.

Science.gov (United States)

Wasti, Harihar; Kanchan, Tanuj; Acharya, Jenash

2015-09-01

Science and myth have been closely linked and argued upon by philosophers, educationalists, scientists, enthusiasts and the general public. Faith healing, when added as an adjuvant or alternative aid to medical science, will not necessarily be confined to mere arguments and debates but may also give rise to series of complications, medical emergencies and even result in death. We present an unusual case where reliance on faith healing led to the death of a young man. © The Author(s) 2015.

Parasitic diseases as the cause of death of prisoners of war during the Korean War (1950-1953).

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Huh, Sun

2014-06-01

To determine the cause of death of prisoners of war during the Korean War (1950-1953), death certificates or medical records were analyzed. Out of 7,614 deaths, 5,013 (65.8%) were due to infectious diseases. Although dysentery and tuberculosis were the most common infectious diseases, parasitic diseases had caused 14 deaths: paragonimiasis in 5, malaria in 3, amoebiasis in 2, intestinal parasitosis in 2, ascariasis in 1, and schistosomiasis in 1. These results showed that paragonimiasis, malaria, and amoebiasis were the most fatal parasitic diseases during the early 1950s in the Korean Peninsula. Since schistosomiasis is not endemic to Korea, it is likely that the infected private soldier moved from China or Japan to Korea.

78 FR 64153 - Direct Certification and Certification of Homeless, Migrant and Runaway Children for Free School...

Science.gov (United States)

2013-10-28

...-0001] RIN 0584-AD60 Direct Certification and Certification of Homeless, Migrant and Runaway Children... interim rule entitled Direct Certification and Certification of Homeless, Migrant and Runaway Children for...

Coding ill-defined and unknown cause of death is 13 times more frequent in Denmark than in Finland

DEFF Research Database (Denmark)

Ylijoki-Sørensen, Seija; Sajantila, Antti; Lalu, Kaisa

2014-01-01

Exact cause and manner of death determination improves legislative safety for the individual and for society and guides aspects of national public health. In the International Classification of Diseases, codes R00-R99 are used for "symptoms, signs and abnormal clinical and laboratory findings......, not elsewhere classified" designated as "ill-defined" or "with unknown etiology". The World Health Organisation recommends avoiding the use of ill-defined and unknown causes of death in the death certificate as this terminology does not give any information concerning the possible conditions that led...... autopsy. Our study suggests that if all deaths in all age groups with unclear cause of death were systematically investigated with a forensic autopsy, only 2-3/1000 deaths per year would be coded as an ill-defined and unknown cause of death in national mortality statistics. At the same time the risk...

Causes of death in 2877 patients with myelodysplastic syndromes.

Science.gov (United States)

Nachtkamp, Kathrin; Stark, Romina; Strupp, Corinna; Kündgen, Andrea; Giagounidis, Aristoteles; Aul, Carlo; Hildebrandt, Barbara; Haas, Rainer; Gattermann, Norbert; Germing, Ulrich

2016-05-01

Patients with myelodysplastic syndromes face a poor prognosis. The exact causes of death have not been described properly in the past. We performed a retrospective analysis of causes of death using data of 3792 patients in the Düsseldorf registry who have been followed up for a median time of 21 months. Medical files as well as death certificates were screened and primary care physicians were contacted. Death after AML evolution, infection, and bleeding was considered to be clearly disease-related. Further categories of causes of death were heart failure, other possibly disease-related reasons, such as hemochromatosis, disease-independent reasons as well as cases with unclear causes of death. Median age at the time of diagnosis was 71 years. At the time of analysis, 2877 patients (75.9 %) had deceased. In 1212 cases (42.1 %), the exact cause of death could not be ascertained. From 1665 patients with a clearly documented cause of death, 1388 patients (83.4 %) succumbed directly disease-related (AML (46.6 %), infection (27.0 %), bleeding (9.8 %)), whereas 277 patients (16.6 %) died for reasons not directly related with myelodysplastic syndromes (MDS), including 132 patients with cardiac failure, 77 non-disease-related reasons, 23 patients with solid tumors, and 45 patients with possibly disease-related causes like hemochromatosis. Correlation with IPSS, IPSS-R, and WPSS categories showed a proportional increase of disease-related causes of death with increasing IPSS/IPSS-R/WPSS risk category. Likewise, therapy-related MDS were associated with a higher percentage of disease-related causes of death than primary MDS. This reflects the increasing influence of the underlying disease on the cause of death with increasing aggressiveness of the disease.

Age-based disparities in end-of-life decisions in Belgium: a population-based death certificate survey.

Science.gov (United States)

Chambaere, Kenneth; Rietjens, Judith A C; Smets, Tinne; Bilsen, Johan; Deschepper, Reginald; Pasman, H Roeline W; Deliens, Luc

2012-06-18

A growing body of scientific research is suggesting that end-of-life care and decision making may differ between age groups and that elderly patients may be the most vulnerable to exclusion of due care at the end of life. This study investigates age-related disparities in the rate of end-of-life decisions with a possible or certain life shortening effect (ELDs) and in the preceding decision making process in Flanders, Belgium in 2007, where euthanasia was legalised in 2002. Comparing with data from an identical survey in 1998 we also study the plausibility of the 'slippery slope' hypothesis which predicts a rise in the rate of administration of life ending drugs without patient request, especially among elderly patients, in countries where euthanasia is legal. We performed a post-mortem survey among physicians certifying a large representative sample (n = 6927) of death certificates in 2007, identical to a 1998 survey. Response rate was 58.4%. While the rates of non-treatment decisions (NTD) and administration of life ending drugs without explicit request (LAWER) did not differ between age groups, the use of intensified alleviation of pain and symptoms (APS) and euthanasia/assisted suicide (EAS), as well as the proportion of euthanasia requests granted, was bivariately and negatively associated with patient age. Multivariate analysis showed no significant effects of age on ELD rates. Older patients were less often included in decision making for APS and more often deemed lacking in capacity than were younger patients. Comparison with 1998 showed a decrease in the rate of LAWER in all age groups except in the 80+ age group where the rate was stagnant. Age is not a determining factor in the rate of end-of-life decisions, but is in decision making as patient inclusion rates decrease with old age. Our results suggest there is a need to focus advance care planning initiatives on elderly patients. The slippery slope hypothesis cannot be confirmed either in general or

Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys

OpenAIRE

Bhatia, Amiya; Ferreira, Leonardo Zanini; Barros, Alu?sio J. D.; Victora, Cesar Gomes

2017-01-01

Background Birth registration, and the possession of a birth certificate as proof of registration, has long been recognized as a fundamental human right. Data from a functioning civil registration and vital statistics (CRVS) system allows governments to benefit from accurate and universal data on birth and death rates. However, access to birth certificates remains challenging and unequal in many low and middle-income countries. This paper examines wealth, urban/rural and gender inequalities i...

COSPAS-SARSAT Beacon Certification Facility

Data.gov (United States)

Federal Laboratory Consortium — EPG's COSPAS-SARSAT Beacon Certification Facility is one of five certification facilities in the world. Formal certifications are available for all beacon types and...

Sustainability and Security: Timber Certification in Asia-Pacific Region

Directory of Open Access Journals (Sweden)

Antonina Ivanova

2008-10-01

Full Text Available The expansion of sustainable development initiatives since the 1990’s reflected an emphasis on integrated solutions to economic development, socio-political stability and environmental health in the global community. In the same context the traditional concept of security needed to be open in two directions. First, the notion of security should no longer be applied only to the military realm, but also to the economic, the societal, the environmental, and the political fields. Second, the referent object of the “security” should not be conceptualized solely in terms of the state, but should embrace the individual below the state, and the international system above it. The forests industry timber certification in Asia-Pacific region has been selected as a case study because it is an excellent example to illustrate the links between the sustainable development and the environmental security, including also certain elements of economic security. This article is presenting a critical overview of the forest industry and the status of timber certification globally, with an emphasis on Asia – Pacific countries applying the Systemic Thinking approach. In conclusion, an outlook is presented concerning the future of timber certification and possible impacts on security and sustainable development.

Death rates for acquired hypothyroidism and thyrotoxicosis in English populations (1979-2010): comparison of underlying cause and all certified causes.

Science.gov (United States)

Goldacre, M J; Duncan, M E

2013-03-01

Overt hypothyroidism and thyrotoxicosis have widespread systemic effects and are associated with increased mortality. Most death certificates that include them do not have the thyroid disease coded as the underlying cause of death. To describe regional (1979-2010) and national (1995-2010) trends in mortality rates for acquired hypothyroidism and thyrotoxicosis, analysing all certified causes of death (termed 'mentions') and not just the underlying cause. Analysis of death registration data. Analysis of data for the Oxford region (mentions available from 1979) and English national data (mentions available from 1995). The data were grouped in periods defined by different national rules for selecting the underlying cause of death (1979-83, 1984-92, 1993-2000 and 2001-10) and were also analysed as single calendar years. Mentions mortality for acquired hypothyroidism in the Oxford region declined significantly from 1979 to 2010: the average annual percentage change (AAPC) was -2.6% (95% confidence intervals -3.5, -1.8). Most of the decrease occurred during the 1980s. The AAPC in rates for later years in England (1995-2010) was non-significant at 0.2% (-0.7, 1.0). Mortality rates for thyrotoxicosis decreased significantly: the AAPC was -2.8% (-4.1, -1.5) in the Oxford region and -3.8% (-4.7, -3.0) in England. In England, between 2001 and 2010, hypothyroidism or thyrotoxicosis was coded as the underlying cause of death on, respectively, 17 and 24% of death certificates that included them. Mortality rates for hypothyroidism and thyrotoxicosis have fallen substantially. The fall is probably wholly or mainly a result of improved care.

Deaths from cerebrovascular diseases correlated to month of birth: elevated risk of death from subarachnoid hemorrhage among summer-born

Science.gov (United States)

Nonaka, K.; Imaizumi, Y.

It has been suggested that maternal nutrition, and fetal and infant growth have an important effect on the risk of cardiovascular disease in adult life. We investigated the population-based distribution of deaths from cerebrovascular diseases (ICD9 codes 430, 431, or 434) in Japan in 1986-1994 as a function of birth month, by examining death-certificate records. For a total of 853 981 people born in the years 1900-1959, the distribution of the number of deaths according to the month of birth was compared with the distribution expected from the monthly numbers of all births for each sex and for the corresponding birth decade. For those born between 1920 and 1949, there were significant discrepancies between the actual numbers of deaths from subarachnoid hemorrhage (ICD9 430) and the numbers expected, and these differences were related to the month of birth. Those born in summer, June-September, consistently had an elevated risk of death, particularly men, where the excess risk was 8%-23%. This tendency was also observed, less distinctly but significantly, for deaths from intracerebral hemorrhage (ICD9 431), but was not observed for those dying from occlusion of the cerebral arteries (ICD9 434). The observation that the risk of dying from subarachnoid hemorrhage was more than 10% higher among those born in the summer implies that at least one in ten deaths from subarachnoid hemorrhage has its origin at a perinatal stage. Although variations in hypertension in later life, which could possibly be ''programmed'' during the intra-uterine stages, could be an explanation for this observation, the disease-specific nature of the observation suggests the involvement of aneurysm formation, which is a predominant cause of subarachnoid hemorrhage.

Maternal deaths databases analysis: Ecuador 2003-2013

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Antonio Pino

2016-08-01

Full Text Available Background: Maternal mortality ratio in Ecuador is the only millennium goal on which national agencies are still making strong efforts to reach 2015 target. The purpose of the study was to process national maternal death databases to identify a specific association pattern of variable included in the death certificate. Design and methods: The study processed mortality databases published yearly by the National Census and Statistics Institute (INEC. Data analysed were exclusively maternal deaths. Data corresponds to the 2003-2013 period, accessible through INEC’s website. Comparisons are based on number of deaths and use an ecological approach for geographical coincidences. Results: The study identified variable association into the maternal mortality national databases showing that to die at home or in a different place than a hospital is closely related to women’s socioeconomic characteristics; there was an association with the absence of a public health facility. Also, to die in a different place than the usual residence could mean that women and families are searching for or were referred to a higher level of attention when they face complications. Conclusions: Ecuadorian maternal deaths showed Patterns of inequity in health status, health care provision and health risks. A predominant factor seems unclear to explain the variable association found processing national databases; perhaps every pattern of health systems development played a role in maternal mortality or factors different from those registered by the statistics system may remain hidden. Some random influences might not be even considered in an explanatory model yet.

Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study.

Science.gov (United States)

Soofi, Sajid Bashir; Ariff, Shabina; Khan, Ubaidullah; Turab, Ali; Khan, Gul Nawaz; Habib, Atif; Sadiq, Kamran; Suhag, Zamir; Bhatti, Zaid; Ahmed, Imran; Bhal, Rajiv; Bhutta, Zulfiqar Ahmed

2015-10-05

Globally, clinical certification of the cause of neonatal death is not commonly available in developing countries. Under such circumstances it is imperative to use available WHO verbal autopsy tool to ascertain causes of death for strategic health planning in countries where resources are limited and the burden of neonatal death is high. The study explores the diagnostic accuracy of WHO revised verbal autopsy tool for ascertaining the causes of neonatal deaths against reference standard diagnosis obtained from standardized clinical and supportive hospital data. All neonatal deaths were recruited between August 2006 -February 2008 from two tertiary teaching hospitals in Province Sindh, Pakistan. The reference standard cause of death was established by two senior pediatricians within 2 days of occurrence of death using the International Cause of Death coding system. For verbal autopsy, trained female community health worker interviewed mother or care taker of the deceased within 2-6 weeks of death using a modified WHO verbal autopsy tool. Cause of death was assigned by 2 trained pediatricians. The performance was assessed in terms of sensitivity and specificity. Out of 626 neonatal deaths, cause-specific mortality fractions for neonatal deaths were almost similar in both verbal autopsy and reference standard diagnosis. Sensitivity of verbal autopsy was more than 93% for diagnosing prematurity and 83.5% for birth asphyxia. However the verbal autopsy didn't have acceptable accuracy for diagnosing the congenital malformation 57%. The specificity for all five major causes of neonatal deaths was greater than 90%. The WHO revised verbal autopsy tool had reasonable validity in determining causes of neonatal deaths. The tool can be used in resource limited community-based settings where neonatal mortality rate is high and death certificates from hospitals are not available.

NCHS Data on Drug-poisoning Deaths

Science.gov (United States)

... Explore opportunities to link electronic death records to electronic health records. Develop capacity to support monthly reporting of drug- ... RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act OIG 1600 Clifton Road ...

Standard reference material certification: contribution of NAA with a TRIGA reactor

International Nuclear Information System (INIS)

Orvini, E.; Speziali, M.; Salvini, A.; Herborg, C.

2002-01-01

Pavia has cooperative links with the major international agencies devoted to the certification of SRMs or CRMs as the Bureau Communautaire de Reference (BCR), the European Institute for Reference Materials and Measurement (IRMM), the USA National Institute of Standards and Technology (NIST) and the International Atomic Energy Agency (IAEA). During these cooperative works, a large amount of analytical data obtained with NAA has been compared, and meaningful methodological information achieved with respect to accuracy and precision in the analysis of several elements at different concentrations in various matrices. Analytical data on As, Cd, Cr, Co, Cu, Cs, Fe, Zn, K, Sc, U, Th, Al, Sb, Mn, V, Hg, Sr, Rb, Se,Pt, all the Rare Earths and halogens Br, Cl, I, have been obtained and contributed for the final certification

A robust certification service for highly dynamic MANET in emergency tasks

DEFF Research Database (Denmark)

Ge, M; Lam, K Y; Gollmann, Dieter

2009-01-01

In emergency tasks, cross-agency operations being carried out in disaster-hit areas require some supporting communication system for command and control. Mobile Ad hoc Network (MANET) is a very suitable way to meet such communication requirements since it can function without any pre......-installed communication infrastructure. Owing to potential threats in the field environment and the unique features of MANET (e.g. the open nature of wireless links and the absence of security infrastructure), security of communications over MANET is a serious issue that is typically addressed by asymmetric cryptographic...... public keys in our scenario. For issuance and/or revocation of mission-specific certificate, a Mission-specific Certificate Authority (MCA), which consists of a collection of server nodes to operate the threshold cryptographic scheme, is proposed. Furthermore, to cater for the occurrence of network...

The Construction and Practice of Classified Talent Cultivation System Combining with Professional Certification

Science.gov (United States)

Jianwei, Yang; Aihua, Zhu; Yuanyuan, Zhang; Chunqing, Zhao

2016-01-01

According to the idea of CDIO engineering education, this paper, combing with professional certification, makes training plan of Urban Rail Transit Vehicles Engineering direction in our school on the basis of research on universities at home and abroad. It strengthens the teaching of basic subjects and increases the weeks of practice link in the…

Relative Risks for Lethal Prostate Cancer Based on Complete Family History of Prostate Cancer Death.

Science.gov (United States)

Albright, Frederick S; Stephenson, Robert A; Agarwal, Neeraj; Cannon-Albright, Lisa A

2017-01-01

There are few published familial relative risks (RR) for lethal prostate cancer. This study estimates RRs for lethal prostate cancer based on comprehensive family history data, with the goal of improving identification of those men at highest risk of dying from prostate cancer. We used a population-based genealogical resource linked to a statewide electronic SEER cancer registry and death certificates to estimate relative risks (RR) for death from prostate cancer based upon family history. Over 600,000 male probands were analyzed, representing a variety of family history constellations of lethal prostate cancer. RR estimates were based on the ratio of the observed to the expected number of lethal prostate cancer cases using internal rates. RRs for lethal prostate cancer based on the number of affected first-degree relatives (FDR) ranged from 2.49 (95% CI: 2.27, 2.73) for exactly 1 FDR to 5.30 (2.13, 10.93) for ≥3 affected FDRs. In an absence of affected FDRs, increased risk was also significant for increasing numbers of affected second-degree or third degree relatives. Equivalent risks were observed for similar maternal and paternal family history. This study provides population-based estimates of lethal prostate cancer risk based on lethal prostate cancer family history. Many family history constellations associated with two to greater than five times increased risk for lethal prostate cancer were identified. These lethal prostate cancer risk estimates hold potential for use in identification, screening, early diagnosis, and treatment of men at high risk for death from prostate cancer. Prostate77:41-48, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Risk factors for death in patients with severe asthma

Directory of Open Access Journals (Sweden)

Andréia Guedes Oliva Fernandes

2014-08-01

Full Text Available OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4. Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.

Association of missing paternal demographics on infant birth certificates with perinatal risk factors for childhood obesity

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Erika R. Cheng

2016-07-01

Full Text Available Abstract Background The role of fathers in the development of obesity in their offspring remains poorly understood. We evaluated associations of missing paternal demographic information on birth certificates with perinatal risk factors for childhood obesity. Methods Data were from the Linked CENTURY Study, a database linking birth certificate and well-child visit data for 200,258 Massachusetts children from 1980–2008. We categorized participants based on the availability of paternal age, education, or race/ethnicity and maternal marital status on the birth certificate: (1 pregnancies missing paternal data; (2 pregnancies involving unmarried women with paternal data; and (3 pregnancies involving married women with paternal data. Using linear and logistic regression, we compared differences in smoking during pregnancy, gestational diabetes, birthweight, breastfeeding initiation, and ever recording a weight for length (WFL ≥ the 95th percentile or crossing upwards ≥2 WFL percentiles between 0–24 months among the study groups. Results 11,989 (6.0 % birth certificates were missing paternal data; 31,323 (15.6 % mothers were unmarried. In adjusted analyses, missing paternal data was associated with lower birthweight (β -0.07 kg; 95 % CI: −0.08, −0.05, smoking during pregnancy (AOR 4.40; 95 % CI: 3.97, 4.87, non-initiation of breastfeeding (AOR 0.39; 95 % CI: 0.36, 0.42, and with ever having a WFL ≥ 95th percentile (AOR 1.10; 95 % CI: 1.01, 1.20. Similar associations were noted for pregnancies involving unmarried women with paternal data, but differences were less pronounced. Conclusions Missing paternal data on the birth certificate is associated with perinatal risk factors for childhood obesity. Efforts to understand and reduce obesity risk factors in early life may need to consider paternal factors.

Possible X linked congenital mitochondrial cardiomyopathy in three families.

OpenAIRE

Orstavik, K H; Skjörten, F; Hellebostad, M; Hågå, P; Langslet, A

1993-01-01

Familial cases of childhood congestive cardiomyopathy with X linked recessive inheritance and abnormalities of heart muscle mitochondria have been previously reported. We report here three families with possible X linked congestive cardiomyopathy and specific mitochondrial abnormalities. The heart disorder presented as endocardial fibroelastosis with neonatal death in two brothers in one family, and as heart failure and death in infancy in two brothers in the other two families. In one family...

7 CFR 205.404 - Granting certification.

Science.gov (United States)

2010-01-01

... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.404 Granting certification. (a) Within a reasonable... certified operation; (2) Effective date of certification; (3) Categories of organic operation, including... operation's organic certification continues in effect until surrendered by the organic operation or...

Memorandum from the HR and FI Departments and the Legal Service concerning the annual certificate of internal taxation for 2006

CERN Multimedia

2007-01-01

This memorandum follows on from the one published in Bulletin No. 10-11/2007 on 5 March 2007. Pursuant to the Staff Rules and Regulations in force in 2006 (Article R IV 2.04), an annual certificate of internal taxation for the 2006 financial year has been drawn up for members of the personnel. This certificate notably states the total amount of remuneration, payments and other financial benefits received by the member of the personnel concerned, as well as the amount of internal tax levied by the Organization for the same period. The annual certificate of internal taxation for 2006 is now available. If you are currently a member of the CERN personnel you will have received an e-mail containing a link to your annual certificate, which you may print, if necessary*. You can also access your annual certificate via http://hrt.cern.ch (open 'My Payslips' at the bottom of the main menu.) If you are no longer a member of the CERN personnel or are unable to access your annual certificate in the manner indicate...

Efficient linking of birth certificate and newborn screening databases for laboratory investigation of congenital cytomegalovirus infection and preterm birth: Florida, 2008.

Science.gov (United States)

DePasquale, John M; Freeman, Karen; Amin, Minal M; Park, Sohyun; Rivers, Samantha; Hopkins, Richard; Cannon, Michael J; Dy, Bonifacio; Dollard, Sheila C

2012-02-01

The objectives of this study are (1) to design an accurate method for linking newborn screening (NBS) and state birth certificate databases to create a de-identified study database; (2) To assess maternal cytomegalovirus (CMV) seroprevalence by measuring CMV IgG in newborn dried blood spots; (3) To assess congenital CMV infection among newborns and possible association with preterm birth. NBS and birth databases were linked and patient records were de-identified. A stratified random sample of records based on gestational age was selected and used to retrieve blood spots from the state NBS laboratory. Serum containing maternal antibodies was eluted from blood spots and tested for the presence of CMV IgG. DNA was extracted from blood spots and tested for the presence of CMV DNA. Analyses were performed with bivariable and multivariable logistic regression models. Linkage rates and specimen collection exceeded 98% of the total possible yielding a final database with 3,101 newborn blood spots. CMV seroprevalence was 91% among Black mothers, 83% among Hispanic mothers, 59% among White mothers, and decreased with increasing amounts of education. The prevalence of CMV infection in newborns was 0.45% and did not vary significantly by gestational age. Successful methods for database linkage, newborn blood spots collection, and de-identification of records can serve as a model for future congenital exposure surveillance projects. Maternal CMV seroprevalence was strongly associated with race/ethnicity and educational level. Congenital CMV infection rates were lower than those reported by other studies and lacked statistical power to examine associations with preterm birth.

Is Halal Certification Process “Green”?

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Mohd Rizal Razalli

2012-09-01

Full Text Available These days, the environmental perspective on operations is becoming more common. In fact, any effort in improving efficiency in the organization is closely related to sustainability of our environment. The Environmental Management System (EMS certification such as ISO 14001 has been accepted as the world standard. In addition to these ISO standards, there are other certifications such as Halal certification. There is no research that investigates the relationship between Halal Certification process and its effect on our environment. Hence, our main research question is that is Halal Certification process can be considered as environmental friendly? In this paper, we argue that Halal Certification also contributes towards green initiatives. We used EDC-UUM as our case study. EDC-UUM is actively seeking the Halal certification from Malaysian authority agency or JAKIM. In this study, we assessed the perception of the EDC-UUM staff on the issue of going green. The findings and implications are discussed in the paper. Keywords: halal certification, hotel operations, sustainability, green

The influence of trade associations and group certification programs on the hardwood certification movement

Science.gov (United States)

Iris B. Montague

2013-01-01

Forest certification has gained momentum around the world over the past two decades. Although there are advantages to being certified, many forest landowners and forest products manufacturers consider forest certification of U.S. forest and forest products unnecessary. Many believe that U.S. forests are already sustainably managed, the current certification systems are...

Green certificates causing inconvenience?

International Nuclear Information System (INIS)

Torgersen, Lasse

2002-01-01

From early 2002, producers of green energy in selected countries have been able to benefit from generous financial support in the Netherlands. Thus, there has been increased sale of green certificates from Norway and Sweden. But the condition that physical energy delivery should accompany the certificates has caused a marked rise in the price of energy in transit through Germany to the Netherlands. This article discusses the green certificate concept and the experience gained from the Netherlands. One conclusion is that if large-scale trade with green certificates is introduced in Europe without the condition of accompanying energy delivery, then producers of hydro-electric power in Norway and Sweden may be the losers

The Whys and Hows of Certification. Public Librarian Certification Law.

Science.gov (United States)

Wisconsin State Dept. of Public Instruction, Madison. Div. of Library Services.

Under Wisconsin state law (Administrative Code P1-6.03) any librarian employed in a public library system or any municipal public library, except in a city of the first class, supported in whole or in part by public funds, must hold state certification. Qualifications are delineated for three grades of certification: grade 1, for public libraries…

40 CFR 745.89 - Firm certification.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Firm certification. 745.89 Section 745... § 745.89 Firm certification. (a) Initial certification. (1) Firms that perform renovations for compensation must apply to EPA for certification to perform renovations or dust sampling. To apply, a firm must...

Influence of voluntary coffee certifications on cooperatives’ advisory services and agricultural practices of smallholder farmers in Costa Rica

DEFF Research Database (Denmark)

Snider, Anna; Kraus, Eva; Sibelet, Nicole

2016-01-01

level is adding new topics for group training, and certification issues are directly linked with practices such as maintaining a farm record book or wearing a mask when applying pesticides. Practices which compete with productivity are unlikely to change. Practical Implications: The results are useful......Purpose: This article explores how voluntary certifications influence the way cooperatives provide advisory services to their members and the influence of these services on agricultural practices. Design/Methodology/Approach: Case studies were conducted in four representative Costa Rican...... cooperatives interviewing twenty interviewed cooperative administrators and members to determine changes in advisory services and farming practices over the past twenty years and factors which influenced those changes. Findings: Certifications induce cooperatives to offer new services to support farmers...

40 CFR 85.1406 - Certification.

Science.gov (United States)

2010-07-01

... POLLUTION FROM MOBILE SOURCES Urban Bus Rebuild Requirements § 85.1406 Certification. (a) Certification... provide some level of particulate emission reduction, and will not cause the urban bus engine to fail to... urban bus engines. (c) Test equipment selection. Certification shall be based upon tests utilizing...

Population death sequences and Cox processes driven by interacting Feller diffusions

CERN Document Server

Wei Gang; Feng Jian Feng

2002-01-01

We carry out a complete study on the relationship between Cox processes driven by interacting Feller diffusions and death sequences of immigration-emigration linked population networks. It is first proved that the Cox process driven by a Feller diffusion is equivalent to the death sequence of a birth and death process. The conclusion is then generalized to the case of Cox processes driven by interacting Feller diffusions and death sequences of interacting populations.

Population death sequences and Cox processes driven by interacting Feller diffusions

International Nuclear Information System (INIS)

Wei Gang; Clifford, Peter; Feng Jianfeng

2002-01-01

We carry out a complete study on the relationship between Cox processes driven by interacting Feller diffusions and death sequences of immigration-emigration linked population networks. It is first proved that the Cox process driven by a Feller diffusion is equivalent to the death sequence of a birth and death process. The conclusion is then generalized to the case of Cox processes driven by interacting Feller diffusions and death sequences of interacting populations

Population death sequences and Cox processes driven by interacting Feller diffusions

Energy Technology Data Exchange (ETDEWEB)

Wei Gang [Department of Mathematics, Baptist University, Hong Kong (China); Clifford, Peter [Department of Statistics, 1 South Parks Road, Oxford (United Kingdom); Feng Jianfeng [COGS, Sussex University, Brighton (United Kingdom)

2002-11-08

We carry out a complete study on the relationship between Cox processes driven by interacting Feller diffusions and death sequences of immigration-emigration linked population networks. It is first proved that the Cox process driven by a Feller diffusion is equivalent to the death sequence of a birth and death process. The conclusion is then generalized to the case of Cox processes driven by interacting Feller diffusions and death sequences of interacting populations.

Certification trails for data structures

Science.gov (United States)

Sullivan, Gregory F.; Masson, Gerald M.

1993-01-01

Certification trails are a recently introduced and promising approach to fault detection and fault tolerance. The applicability of the certification trail technique is significantly generalized. Previously, certification trails had to be customized to each algorithm application; trails appropriate to wide classes of algorithms were developed. These certification trails are based on common data-structure operations such as those carried out using these sets of operations such as those carried out using balanced binary trees and heaps. Any algorithms using these sets of operations can therefore employ the certification trail method to achieve software fault tolerance. To exemplify the scope of the generalization of the certification trail technique provided, constructions of trails for abstract data types such as priority queues and union-find structures are given. These trails are applicable to any data-structure implementation of the abstract data type. It is also shown that these ideals lead naturally to monitors for data-structure operations.

The impact of a shade coffee certification program on forest conservation: a case study from a wild coffee forest in Ethiopia.

Science.gov (United States)

Takahashi, Ryo; Todo, Yasuyuki

2013-11-30

In recent years, shade coffee certification programs have attracted increasing attention from conservation and development organizations. Certification programs offer an opportunity to link environmental and economic goals by providing a premium price to producers and thereby contributing to forest conservation. However, the significance of the conservation efforts of certification programs remains unclear because of a lack of empirical evidence. The purpose of this study was to examine the impact of a shade coffee certification program on forest conservation. The study was conducted in the Belete-Gera Regional Forest Priority Area in Ethiopia, and remote sensing data of 2005 and 2010 were used to gauge the change of forest area. Using propensity score matching estimation, we found that forests under the coffee certification program were less likely to be deforested than forests without forest coffee. By contrast, the difference in the degree of deforestation between forests with forest coffee but not under the certification program and forests with no forest coffee is statistically insignificant. These results suggest that the certification program has had a large effect on forest protection, decreasing the probability of deforestation by 1.7 percentage points. Copyright © 2013 Elsevier Ltd. All rights reserved.

Spatial-temporal analysis of dengue deaths: identifying social vulnerabilities.

Science.gov (United States)

Silva, Maria do Socorro da; Branco, Maria Dos Remédios Freitas Carvalho; Aquino, José; Queiroz, Rejane Christine de Sousa; Bani, Emanuele; Moreira, Emnielle Pinto Borges; Medeiros, Maria Nilza Lima; Rodrigues, Zulimar Márita Ribeiro

2017-01-01

Currently, dengue fever, chikungunya fever, and zika virus represent serious public health issues in Brazil, despite efforts to control the vector, the Aedes aegypti mosquito. This was a descriptive and ecological study of dengue deaths occurring from 2002 to 2013 in São Luis, Maranhão, Brazil. Geoprocessing software was used to draw maps, linking the geo-referenced deaths with urban/social data at census tract level. There were 74 deaths, concentrated in areas of social vulnerability. The use of geo-technology tools pointed to a concentration of dengue deaths in specific intra-urban areas.

Verbal autopsy of 80,000 adult deaths in Tamilnadu, South India

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Peto Richard

2004-10-01

Full Text Available Abstract Background Registration of the fact of death is almost complete in the city of Chennai and not so in the rural Villupuram district in Tamilnadu, India. The cause of death is often inadequately recorded on the death certificate in developing countries like India. A special verbal autopsy (VA study of 48 000 adult (aged ≥ 25 yrs deaths in the city of Chennai (urban during 1995–97 and 32 000 in rural Villupuram during 1997–98 was conducted to arrive at the probable underlying cause of death to estimate cause specific mortality. Methods A ten day training on writing verbal autopsy (VA report for adult deaths was given to non-medical graduates with at least 15 years of formal education. They interviewed surviving spouse/close associates of the deceased to write a verbal autopsy report in local language (Tamil on the complaints, symptoms, signs, duration and treatment details of illness prior to death. Each report was reviewed centrally by two physicians independently. Random re-interviewing of 5% of the VA reports was done to check the reliability and reproducibility of the VA report. The validity of VA diagnosis was assessed only for cancer deaths. Results Verbal autopsy reduced the proportion of deaths attributed to unspecified and unknown causes from 54% to 23% (p Conclusion A ten day training programme to write verbal autopsy report with adequate feed back sessions and random sampling of 5% of the verbal autopsy reports for re-interview worked very well in Tamilnadu, to arrive at the probable underlying cause of death reliably for deaths in early adult life or middle age (25–69 years and less reliably for older ages (70+. Thus VA is practicable for deaths in early adult life or middle age and is of more limited value in old age.

Board Certification in Counseling Psychology

Science.gov (United States)

Crowley, Susan L.; Lichtenberg, James W.; Pollard, Jeffrey W.

2012-01-01

Although specialty board certification by the American Board of Professional Psychology (ABPP) has been a valued standard for decades, the vast majority of counseling psychologists do not pursue board certification in the specialty. The present article provides a brief history of board certification in general and some historical information about…

Birth of Identity: Understanding the Value and Policy Considerations of Using Birth Certificates for Identity Resolution

Science.gov (United States)

Duncan, Jeffrey Dean

2015-01-01

Exchanging patient-specific information across heterogeneous information systems is a critical but increasingly complex and expensive challenge. Lacking a universal unique identifier for healthcare, patient records must be linked using combinations of identity attributes such as name, date of birth, and sex. A state's birth certificate registry…

Research and Rhetoric on Teacher Certification

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Linda Darling-Hammond

2002-09-01

Full Text Available In October, 2001, the Baltimore-based Abell Foundation issued a report purporting to prove that there is "no credible research that supports the use of teacher certification as a regulatory barrier to teaching" and urging the discontinuation of certification in Maryland. The report argued that large inequities in access to certified teachers for poor and minority students are not a problem because research linking teacher education to student achievement is flawed. In July, 2002, the U.S. Secretary of Education cited the Abell Foundation paper in his Annual Report on Teacher Quality as the sole source for concluding that teacher education does not contribute to teacher effectiveness. The Secretary's report then recommended that requirements for education coursework be eliminated from certification standards, and attendance at schools of education and student teaching be made optional. This article documents the many inaccuracies in the Abell Foundation paper and describes the actual findings of many of the studies it purports to review, as well as the findings of other studies it ignores. It details misrepresentations of a number of studies, including inaccurate statements about their methods and findings, false claims about their authors' views, and distortions of their data and conclusions. The article addresses methodological issues regarding the validity and interpretation of research. Finally, the article presents data challenging the Abell Foundation's unfounded claims that uncertified teachers are as effective as certified teachers, that teacher education makes no difference to teacher effectiveness, that verbal ability is the most important determinant of teaching effectiveness, that private schools staffed by uncertified teachers are more effective than public schools, and that untrained teachers are more qualified than prepared teachers. It concludes with a discussion of the policy issues that need to be addressed if all students are

Long-term mortality and causes of death among hospitalized Swedish drug users.

Science.gov (United States)

Fugelstad, Anna; Annell, Anders; Ågren, Gunnar

2014-06-01

To study long-term mortality and causes of death in a cohort of drug users in relation to main type of drug use and HIV-status. A total of 1640 hospitalized drug users in Stockholm was followed up from 1985 to the end of 2007. The mortality was compared with the general Swedish population and hazard ratios (HR) for the main risk indicators were calculated. The causes of death were studied, using information from death certificates. 630 persons died during the observation period. The Standard Mortality Ratio (SMR) was 16.1 (males 13.8, females 18.5). The crude mortality rate was 2.0 % (males 2.2% and females 1.5%). The mortality rate was higher in heroin users than among amphetamine users, HR 1.96, controlled for age and other risk factors. The mortality rate among individuals infected with the human immunodeficiency virus (HIV) was high (4.9 %), HR 2.64, compared with HIV-negative individuals. Most of the deaths were from other causes than acquired immune deficiency syndrome. One-third of deaths (227) were caused by heroin intoxication. The number of deaths from HIV-related causes decreased after 1996, when highly active anti-retroviral therapy was introduced. In all, there were 92 HIV-related deaths. Deaths from natural causes increased during the observation period. The SMR was highest for cardiovascular and gastrointestinal diseases. The results indicate a correlation between amphetamine use and death from cerebral haemorrhage. A high proportion of natural deaths were alcohol-related. The death rate among illicit drug users was persistently high. Alcohol consumption was a contributing factor to premature death. © 2014 the Nordic Societies of Public Health.

Age-based disparities in end-of-life decisions in Belgium: a population-based death certificate survey

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Chambaere Kenneth

2012-06-01

Full Text Available Abstract Background A growing body of scientific research is suggesting that end-of-life care and decision making may differ between age groups and that elderly patients may be the most vulnerable to exclusion of due care at the end of life. This study investigates age-related disparities in the rate of end-of-life decisions with a possible or certain life shortening effect (ELDs and in the preceding decision making process in Flanders, Belgium in 2007, where euthanasia was legalised in 2002. Comparing with data from an identical survey in 1998 we also study the plausibility of the ‘slippery slope’ hypothesis which predicts a rise in the rate of administration of life ending drugs without patient request, especially among elderly patients, in countries where euthanasia is legal. Method We performed a post-mortem survey among physicians certifying a large representative sample (n = 6927 of death certificates in 2007, identical to a 1998 survey. Response rate was 58.4%. Results While the rates of non-treatment decisions (NTD and administration of life ending drugs without explicit request (LAWER did not differ between age groups, the use of intensified alleviation of pain and symptoms (APS and euthanasia/assisted suicide (EAS, as well as the proportion of euthanasia requests granted, was bivariately and negatively associated with patient age. Multivariate analysis showed no significant effects of age on ELD rates. Older patients were less often included in decision making for APS and more often deemed lacking in capacity than were younger patients. Comparison with 1998 showed a decrease in the rate of LAWER in all age groups except in the 80+ age group where the rate was stagnant. Conclusion Age is not a determining factor in the rate of end-of-life decisions, but is in decision making as patient inclusion rates decrease with old age. Our results suggest there is a need to focus advance care planning initiatives on elderly patients. The

ENVIRONMENTAL MANAGEMENT SYSTEMS CERTIFICATION

Directory of Open Access Journals (Sweden)

Aniko Miler-Virc

2012-12-01

Full Text Available ISO 14001 prescribes the requirements for a system, not environmental performance itself. Similarly, certification is of the management system itself, not environmental performance. An audit is not conducted to ascertain whether your flue gas emissions are less than X part per million nitrous oxide or that your wastewater effluent contains less that Y milligrams of bacteria per litre. Consequently, the procces of auditing the system for compliance to the standard entails checking to see that all of the necessary components of a functioning system are present and working properly.           A company can have a complete and fully functional EMS as prescribed by ISO 14001 without being certified. As certification can add to the time and expense of EMS development, it is important for you to establish, in advance, whether certification is of net benefit to you. Although most companies that develop an EMS do in fact certify, there are cases where certification does not add immediate value. Certification is not always beneficial to small and medium sized companies. Certification is not always necessary for companies with one or two large clients with environmental demands who are satisfied that you have a functional EMS (second-party declaration. Whatever decision you make, it is important to remember that just as a driver′s licence does not automatically make you a good driver, ISO 14001 certification does not automatically make your company environmentally benign or ensure that you will continually improve environmental performance. The system is only as good as the people who operate it.

Product-oriented Software Certification Process for Software Synthesis

Science.gov (United States)

Nelson, Stacy; Fischer, Bernd; Denney, Ewen; Schumann, Johann; Richardson, Julian; Oh, Phil

2004-01-01

The purpose of this document is to propose a product-oriented software certification process to facilitate use of software synthesis and formal methods. Why is such a process needed? Currently, software is tested until deemed bug-free rather than proving that certain software properties exist. This approach has worked well in most cases, but unfortunately, deaths still occur due to software failure. Using formal methods (techniques from logic and discrete mathematics like set theory, automata theory and formal logic as opposed to continuous mathematics like calculus) and software synthesis, it is possible to reduce this risk by proving certain software properties. Additionally, software synthesis makes it possible to automate some phases of the traditional software development life cycle resulting in a more streamlined and accurate development process.

Certificate Transparency with Privacy

Directory of Open Access Journals (Sweden)

Eskandarian Saba

2017-10-01

Full Text Available Certificate transparency (CT is an elegant mechanism designed to detect when a certificate authority (CA has issued a certificate incorrectly. Many CAs now support CT and it is being actively deployed in browsers. However, a number of privacy-related challenges remain. In this paper we propose practical solutions to two issues. First, we develop a mechanism that enables web browsers to audit a CT log without violating user privacy. Second, we extend CT to support non-public subdomains.

Transit management certificate program.

Science.gov (United States)

2012-07-01

TTI worked closely with the Landscape Architecture and Urban Planning Department : (LAUP) of Texas A&M University (TAMU) to develop a transit management certificate : focus for the current Graduate Certificate in Transportation Planning (CTP) housed ...

General practitioners' use of sickness certificates.

Science.gov (United States)

Roope, Richard; Parker, Gordon; Turner, Susan

2009-12-01

At present, sickness certification is largely undertaken by general practitioners (GPs). Guidance from the Department of Work and Pensions (DWP) is available to help with this task; however, there has been little formal evaluation of the DWP's guidance in relation to day-to-day general practice. To assess GPs' training, knowledge and application of the DWP's sickness certification guidelines. A structured questionnaire was sent to GPs within a (former) primary care trust (PCT). It probed demographics, training and knowledge of sickness certification guidelines. Case histories and structured questions were used to assess current practice. In this group of 113 GPs, there was a low awareness and use of the DWP's guidelines and Website relating to sickness certification. The majority of the GPs (63%) had received no training in sickness certification, and the mean length of time for those who had received training was 4.1 h. Most GPs also felt that patients and GPs have equal influence on the duration of sickness certification. This evidence of variable practice indicates that GPs should have more guidance and education in sickness certification. Closer sickness certification monitoring through existing GP computer systems may facilitate an improvement in practice that benefits patients and employers. The DWP, medical educators and PCTs may all have an additional role in further improving sickness certification practice.

Leading Causes of Death among Asian American Subgroups (2003-2011.

Directory of Open Access Journals (Sweden)

Katherine G Hastings

Full Text Available Our current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups.We examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese and non-Hispanic Whites (NHWs from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%. Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer's disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs.Our findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

Leading Causes of Death among Asian American Subgroups (2003-2011).

Science.gov (United States)

Hastings, Katherine G; Jose, Powell O; Kapphahn, Kristopher I; Frank, Ariel T H; Goldstein, Benjamin A; Thompson, Caroline A; Eggleston, Karen; Cullen, Mark R; Palaniappan, Latha P

2015-01-01

Our current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups. We examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and non-Hispanic Whites (NHWs) from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%). Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer's disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs. Our findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

Maternal Mortality Ratio and Causes of Death in IRI Between 2009 and 2012

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Marzieh Vahiddastjerdy

2016-12-01

Full Text Available Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran.Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9 during pregnancy, labor, and 42 days after parturition.Results: During 3 years, there were 5094317 deliveries and 941 maternal deaths (MMR of 18.5 per 1000000 live births. We had access to pertained data of 896 cases (95.2% for review in our study. Of 896 reported deaths, 549 were classified as direct, 302 as indirect and 45 as unknown. Hemorrhage was the most common cause of maternal mortality, followed by Preeclampsia, Eclampsia and sepsis. Among all indirect causes, cardio -vascular diseases were responsible for 10% of maternal deaths, followed by thromboembolism, HTN and renal diseases.Conclusion: Although maternal mortality ratio in IRI could be comparable with the developed countries but its pattern is following developing countries and with this study we had provided reliable data for other prospective studies.

Haloperidol and sudden cardiac death in dementia: autopsy findings in psychiatric inpatients.

Science.gov (United States)

Ifteni, Petru; Grudnikoff, Eugene; Koppel, Jeremy; Kremen, Neil; Correll, Christoph U; Kane, John M; Manu, Peter

2015-12-01

Treatment with haloperidol has been shown, in studies using death certificates and prescription files, to be associated with an excess of sudden cardiac deaths, and regulatory warnings highlight this risk in patients with dementia. We used autopsy findings to determine whether the rate of sudden cardiac death is greater in cases of unexpected deaths of patients with dementia treated with haloperidol. From 1989 through 2013, 1219 patients with a primary diagnosis of dementia with behavioral disturbance were admitted to a psychiatric hospital, and 65 (5.3%) died suddenly. Sixty-five patients (5.3%) died unexpectedly. Complete post-mortem examinations after the sudden death were performed in 55 (84.6%) patients. Twenty-seven of the autopsied cases (49.1%) had been treated with haloperidol orally (2.2 mg ± 2.1 mg/day), the only antipsychotic used in this cohort. Univariable comparisons and multivariable regression analyses compared the groups of patients with or without sudden cardiac death. The leading causes of death were sudden cardiac death (32.7%), myocardial infarction (25.5% of patients), pneumonia (23.6%), and stroke (10.9%). Patients with sudden cardiac death and those with anatomically established cause of death were similar regarding the use of haloperidol (p = 0.5). Sudden cardiac death patients were more likely to suffer from Alzheimer's dementia (p = 0.027) and to have a past history of heart disease (p = 0.0094), and less likely to have been treated with a mood stabilizer (p = 0.024), but none of these variables were independent predictors of sudden cardiac death. Autopsy data suggest that oral haloperidol is not associated with increased risk of sudden cardiac death in psychiatric inpatients with dementia. Copyright © 2015 John Wiley & Sons, Ltd.

Prevention of Surgical Fires: A Certification Course for Healthcare Providers.

Science.gov (United States)

Fisher, Marquessa

2015-08-01

An estimated 550 to 650 surgical fires occur annually in the United States. Surgical fires may have severe consequences, including burns, disfigurement, long-term medical care, or death. This article introduces a potential certification program for the prevention of surgical fires. A pilot study was conducted with a convenience sample of 10 anesthesia providers who participated in the education module. The overall objective was to educate surgical team members and to prepare them to become certified in surgical fire prevention. On completion of the education module, participants completed the 50-question certification examination. The mean pretest score was 66%; none of the participants had enough correct responses (85%) to be considered competent in surgical fire prevention. The mean post- test score was 92.80%, with all participants answering at least 85% of questions correct. A paired-samples t test showed a statistically significant increase in knowledge: t (df = 9) = 11.40; P = .001. Results of the pilot study indicate that this course can remediate gaps in knowledge of surgical fire prevention for providers. Their poor performance on the pretest suggests that many providers may not receive sufficient instruction in surgical fire prevention.

Transglutaminase induction by various cell death and apoptosis pathways.

Science.gov (United States)

Fesus, L; Madi, A; Balajthy, Z; Nemes, Z; Szondy, Z

1996-10-31

Clarification of the molecular details of forms of natural cell death, including apoptosis, has become one of the most challenging issues of contemporary biomedical sciences. One of the effector elements of various cell death pathways is the covalent cross-linking of cellular proteins by transglutaminases. This review will discuss the accumulating data related to the induction and regulation of these enzymes, particularly of tissue type transglutaminase, in the molecular program of cell death. A wide range of signalling pathways can lead to the parallel induction of apoptosis and transglutaminase, providing a handle for better understanding the exact molecular interactions responsible for the mechanism of regulated cell death.

Spatial-temporal analysis of dengue deaths: identifying social vulnerabilities

Directory of Open Access Journals (Sweden)

Maria do Socorro da Silva

Full Text Available Abstract: INTRODUCTION Currently, dengue fever, chikungunya fever, and zika virus represent serious public health issues in Brazil, despite efforts to control the vector, the Aedes aegypti mosquito. METHODS: This was a descriptive and ecological study of dengue deaths occurring from 2002 to 2013 in São Luis, Maranhão, Brazil. Geoprocessing software was used to draw maps, linking the geo-referenced deaths with urban/social data at census tract level. RESULTS: There were 74 deaths, concentrated in areas of social vulnerability. CONCLUSIONS: The use of geo-technology tools pointed to a concentration of dengue deaths in specific intra-urban areas.

Converse Barrier Certificate Theorem

DEFF Research Database (Denmark)

Wisniewski, Rafael; Sloth, Christoffer

2013-01-01

This paper presents a converse barrier certificate theorem for a generic dynamical system.We show that a barrier certificate exists for any safe dynamical system defined on a compact manifold. Other authors have developed a related result, by assuming that the dynamical system has no singular...... points in the considered subset of the state space. In this paper, we redefine the standard notion of safety to comply with generic dynamical systems with multiple singularities. Afterwards, we prove the converse barrier certificate theorem and illustrate the differences between ours and previous work...

76 FR 22785 - Direct Certification and Certification of Homeless, Migrant and Runaway Children for Free School...

Science.gov (United States)

2011-04-25

... [FNS-2008-0001] RIN 0584-AD60 Direct Certification and Certification of Homeless, Migrant and Runaway... concerning the certification of certain children who are homeless, runaway, or migratory. This rule affects... children who are homeless, runaway, or migratory, as determined by the homeless coordinator for homeless or...

Investigating weaknesses in Android certificate security

Science.gov (United States)

Krych, Daniel E.; Lange-Maney, Stephen; McDaniel, Patrick; Glodek, William

2015-05-01

Android's application market relies on secure certificate generation to establish trust between applications and their users; yet, cryptography is often not a priority for application developers and many fail to take the necessary security precautions. Indeed, there is cause for concern: several recent high-profile studies have observed a pervasive lack of entropy on Web-systems leading to the factorization of private keys.1 Sufficient entropy, or randomness, is essential to generate secure key pairs and combat predictable key generation. In this paper, we analyze the security of Android certificates. We investigate the entropy present in 550,000 Android application certificates using the Quasilinear GCD finding algorithm.1 Our results show that while the lack of entropy does not appear to be as ubiquitous in the mobile markets as on Web-systems, there is substantial reuse of certificates only one third of the certificates in our dataset were unique. In other words, we find that organizations frequently reuse certificates for different applications. While such a practice is acceptable under Google's specifications for a single developer, we find that in some cases the same certificates are used for a myriad of developers, potentially compromising Android's intended trust relationships. Further, we observed duplicate certificates being used by both malicious and non-malicious applications. The top 3 repeated certificates present in our dataset accounted for a total of 11,438 separate APKs. Of these applications, 451, or roughly 4%, were identified as malicious by antivirus services.

Drugs + HIV, Learn the Link

Medline Plus

Full Text Available ... causes (AIDS) are often linked and referred to as "HIV/AIDS." HIV can be transferred between people ... years, HIV is no longer a death sentence, as it was when the epidemic began. This is ...

Trends in mortality burden of hepatocellular carcinoma, cirrhosis, and fulminant hepatitis before and after roll-out of the first pilot vaccination program against hepatitis B in Peru: An analysis of death certificate data.

Science.gov (United States)

Ramírez-Soto, Max Carlos; Ortega-Cáceres, Gutia; Cabezas, César

2017-07-05

The first pilot vaccination program against hepatitis B in Peru was implemented in the hyperendemic Abancay province in 1991. To assess the impact of vaccination on mortality rates of hepatitis B-related hepatocellular carcinoma (HCC), cirrhosis, and fulminant hepatitis, we compared mortality trends before (1960-1990) and after (1991-2012) roll-out of the vaccination program, using death certificate data from the Municipalidad Provincial de Abancay. Our results showed that, following program roll-out, the overall mortality rates (per 100,000 population) decreased from 9.20 to 3.30 for HCC (95% CI, 1.28-10.48%; P<0.014), from 16.0 to 6.3 for cirrhosis (95% CI, 3.20-16.10%; P<0.004), and from 34.80 to 1.28 for fulminant hepatitis (95% CI, 16.70-50.30%; P<0.001). The absolute number of deaths attributable to cirrhosis (10 [8.80%] vs. 0.0%; P<0.001) and fulminant hepatitis (83 [40.0%] vs. 5 [19.20%]; P<0.026) decreased in 5-14-year-old children following vaccination. These findings showed reduced mortality rates of hepatitis B-related liver diseases, particularly cirrhosis and fulminant hepatitis in children under 15years, following implementation of the vaccination program against hepatitis B. Copyright © 2017 Elsevier Ltd. All rights reserved.

7 CFR 205.405 - Denial of certification.

Science.gov (United States)

2010-01-01

... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.405 Denial of certification. (a) When the certifying... organic program. (e) An applicant for certification who has received a written notification of... 7 Agriculture 3 2010-01-01 2010-01-01 false Denial of certification. 205.405 Section 205.405...

7 CFR 205.401 - Application for certification.

Science.gov (United States)

2010-01-01

... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.401 Application for certification. A person seeking... certification to a certifying agent. The application must include the following information: (a) An organic... 7 Agriculture 3 2010-01-01 2010-01-01 false Application for certification. 205.401 Section 205.401...

14 CFR 147.39 - Display of certificate.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Display of certificate. 147.39 Section 147...) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS Operating Rules § 147.39 Display of certificate. Each holder of an aviation maintenance technician school certificate and ratings...

40 CFR 89.105 - Certificate of conformity.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certificate of conformity. 89.105... and Certification Provisions § 89.105 Certificate of conformity. Every manufacturer of a new nonroad compression-ignition engine must obtain a certificate of conformity covering the engine family, as described...

Converse Barrier Certificate Theorems

DEFF Research Database (Denmark)

Wisniewski, Rafael; Sloth, Christoffer

2016-01-01

This paper shows that a barrier certificate exists for any safe dynamical system. Specifically, we prove converse barrier certificate theorems for a class of structurally stable dynamical systems. Other authors have developed a related result by assuming that the dynamical system has neither...

ECOTOURISM CERTIFICATION PROGRAMS: STANDARDS AND BENEFITS

Directory of Open Access Journals (Sweden)

Mariia Holub

2015-11-01

Full Text Available The problem of researching the ecotourism certification processes in the world is very up-to-date nowadays. The relevance of the research is stipulated by current state of environ-mental pollutants, the development of sustainable politics implementation and the fact that now people aware of real danger of environmental catastrophe that threatens the survival of civilization. That’s why the purpose of the article is conducting a complex analysis of foreign ecotourism certi-fication programs. Moreover, it is necessary to study the evolution of ecotourism development to understand the key issues of this problem. The object of this article is the analysis of ecotourism certification worldwide. The subject of the article is the detection of theoretical, methodological and practical aspects of implementation of effective ecotourism certification programs in Ukraine. To clarify all aspects of studying this issue it is necessary to use such theoretical and methodological basis as: modern theories of the genesis and evolution of ecological tourism, logical and analogy analysis, historical method, hypothetical method, classification and graphical method. Using such methods it was found that the development of ecotourism formation has taking three evolutionary steps, which affected the creation of its definition. This fact reveals the classification of different types of sustainable tourism and provides an impetus of ecotourism certification studies. Moreover, it was identified that there is a logical regularity in ecotourism certification programs all over the world. As the result, it was found that practically all the ecotourism certification processes are functioning successfully nowadays. By the way, it can be observed the rapid increase in the amount of ecocertified companies. Moreover, the programs which were analyzed in this article were divided into several steps (depends on the ecotourism certification program following which a company can

40 CFR 90.106 - Certificate of conformity.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certificate of conformity. 90.106... Standards and Certification Provisions § 90.106 Certificate of conformity. (a)(1) Except as provided in § 90... certificate of conformity covering such engines; however, engines manufactured during an annual production...

40 CFR 91.106 - Certificate of conformity.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certificate of conformity. 91.106... Provisions § 91.106 Certificate of conformity. (a) Every manufacturer of a new marine SI engine produced... obtain a certificate of conformity covering each engine family. The certificate of conformity must be...

48 CFR 33.207 - Contractor certification.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Contractor certification... CONTRACTING REQUIREMENTS PROTESTS, DISPUTES, AND APPEALS Disputes and Appeals 33.207 Contractor certification. (a) Contractors shall provide the certification specified in paragraph (c) of this section when...

WASTE CERTIFICATION PROGRAM PLAN - REVISION 7

International Nuclear Information System (INIS)

MORGAN, LK

2002-01-01

The primary changes that have been made to this revision reflect the relocation of the Waste Certification Official (WCO) organizationally from the Quality Services Division (QSD) into the Laboratory Waste Services (LWS) Organization. Additionally, the responsibilities for program oversight have been differentiated between the QSD and LWS. The intent of this effort is to ensure that those oversight functions, which properly belonged to the WCO, moved with that function; but retain an independent oversight function outside of the LWS Organization ensuring the potential for introduction of organizational bias, regarding programmatic and technical issues, is minimized. The Waste Certification Program (WCP) itself has been modified to allow the waste certification function to be performed by any of the personnel within the LWS Waste Acceptance/Certification functional area. However, a single individual may not perform both the technical waste acceptance review and the final certification review on the same 2109 data package. Those reviews must be performed by separate individuals in a peer review process. There will continue to be a designated WCO who will have lead programmatic responsibility for the WCP and will exercise overall program operational oversite as well as determine the overall requirements of the certification program. The quality assurance organization will perform independent, outside oversight to ensure that any organizational bias does not degrade the integrity of the waste certification process. The core elements of the previous WCP have been retained, however, the terms and process structure have been modified.. There are now two ''control points,'' (1) the data package enters the waste certification process with the signature of the Generator Interface/Generator Interface Equivalent (GI/GIE), (2) the package is ''certified'', thus exiting the process. The WCP contains three steps, (1) the technical review for waste acceptance, (2) a review of the

Death and Death Anxiety

OpenAIRE

Gonca Karakus; Zehra Ozturk; Lut Tamam

2012-01-01

Although death and life concepts seem so different from each other, some believe that death and life as a whole that death is accepted as the goal of life and death completes life. In different cultures, societies and disciplines, there have been very different definitions of death which changes according to personality, age, religion and cultural status of the individual. Attitudes towards death vary dramatically according to individuals. As for the death anxiety, it is a feeling which start...

Meteorological conditions and sports deaths at school in Japan, 1993 1998

Science.gov (United States)

Hoshi, Akio; Inaba, Yutaka

2005-03-01

We evaluated the association between meteorological conditions and sports deaths at elementary, junior high and senior high schools. Data were collected from attached documents such as accident reports and death certificate records in the National Agency for the Advancement of Sports and Health in Japan. Evaluation of seasonal variation showed a significant concentration of deaths from heat disorders and drowning in July and August. When heart disease was evaluated according to the sports situation, significant seasonal variation with a high number of deaths in September December was observed in sports events. Concerning circadian variation, deaths from heart disease showed a high peak at 10:00 11:00 a.m. in physical education classes and sports events, and at 2:00 5:00 p.m. in sports club activities. Analysis using a multiple logistic model showed a significantly lower odds ratio from heart disease and a significantly higher odds ratio from heat disorders at a wet bulb globe temperature of ≥21.0°C than at activities was significantly lower on days with rainfall than on days without rainfall. According to the school categories in heart diseases, the odds ratio in girls in elementary school was significantly higher than that in boys, but the odds ratio in girls in senior high school was significantly lower than that in boys.

How the 2008 stock market crash and seasons affect total and cardiac deaths in Los Angeles County.

Science.gov (United States)

Schwartz, Bryan Glen; Pezzullo, John Christopher; McDonald, Scott Andrew; Poole, William Kenneth; Kloner, Robert Alan

2012-05-15

Various stressors trigger cardiac death. The objective was to investigate a possible relation between a stock market crash and cardiac death in a large population within the United States. We obtained daily stock market data (Dow Jones Industrial Average Index), death certificate data for daily deaths in Los Angeles County (LA), and annual LA population estimates for 2005 through 2008. The 4 years death rate curves (2005 through 2008) were averaged into a single curve to illustrate annual trends. Data were "deseasonalized" by subtracting from the daily observed value the average value for that day of year. There was marked seasonal variation in total and cardiac death rates. Even in the mild LA climate, death rates were higher in winter versus summer including total death (+17%), circulatory death (+24%), coronary heart disease death (+28%), and myocardial infarction death (+38%) rates (p stock market crash in October 2008 did not affect death rates in LA. Death rates remained at or below seasonal averages during the stock market crash. In conclusion, after correcting for seasonal variation, the stock market crash in October 2008 was not associated with an increase in total or cardiac death in LA. Annual coronary heart disease death rates continue to decrease. However, seasonal variation (specifically winter) remains a trigger for death and coronary heart disease death even in LA where winters are mild. Copyright © 2012 Elsevier Inc. All rights reserved.

42 CFR 493.638 - Certificate fees.

Science.gov (United States)

2010-10-01

... for quality control, quality assurance, and proficiency testing purposes) and specialties tested, with... collected by HHS under the laboratory program must be sufficient to cover the general costs of administering... certificates and certificates of compliance, the costs include issuing the certificates, collecting the fees...

Employment certificates on HRT

CERN Multimedia

HR Department

2008-01-01

As part of the ongoing drive to simplify and streamline administrative procedures and processes, the IT and HR Departments have made employment certificates available on a self-service basis on the HRT application, in the main menu under "My self services". All members of the personnel can thus obtain a certificate of employment or association, in French or in English, for the present or past contractual period. The HR Department’s Records Office remains responsible for issuing any special certificates that might be required. IT-AIS (Administrative Information Services) HR-SPS (Services, Procedures & Social) Records Office – Tel. 73700

Non-Canonical Cell Death Induced by p53

Directory of Open Access Journals (Sweden)

Atul Ranjan

2016-12-01

Full Text Available Programmed cell death is a vital biological process for multicellular organisms to maintain cellular homeostasis, which is regulated in a complex manner. Over the past several years, apart from apoptosis, which is the principal mechanism of caspase-dependent cell death, research on non-apoptotic forms of programmed cell death has gained momentum. p53 is a well characterized tumor suppressor that controls cell proliferation and apoptosis and has also been linked to non-apoptotic, non-canonical cell death mechanisms. p53 impacts these non-canonical forms of cell death through transcriptional regulation of its downstream targets, as well as direct interactions with key players involved in these mechanisms, in a cell type- or tissue context-dependent manner. In this review article, we summarize and discuss the involvement of p53 in several non-canonical modes of cell death, including caspase-independent apoptosis (CIA, ferroptosis, necroptosis, autophagic cell death, mitotic catastrophe, paraptosis, and pyroptosis, as well as its role in efferocytosis which is the process of clearing dead or dying cells.

EAS Telecommunications Certification Bodies (TCB)

Data.gov (United States)

Federal Communications Commission — EAS (Equipment Authorization System). A Telecommunication Certification Body (TCB) is an accredited product certification body with the authority to issue Grants of...

Incidence and other epidemiological characteristics of sudden cardiac death in northwest Greece.

Science.gov (United States)

Goudevenos, J A; Papadimitriou, E D; Papathanasiou, A; Makis, A C; Pappas, K; Sideris, D A

1995-03-24

Sudden cardiac death (SCD) has not been investigated separately in Greece. The aim of this study is to describe the epidemiological characteristics of people dying suddenly out of hospital in an area of Greece. In 1990, a population based study was started to detect the cases of people dying suddenly out of hospital (Greece (Ioannina area: 160,000 inhabitants). During a 3.5 year period, 283 potential cases aged 30-70 years were identified by monitoring the mortality in the emergency rooms of the two hospitals of the area, the coroner's office and the death certificates from the Government Department of Statistics. The diagnosis of SCD was established in 223 (183 men, 40 women; mean ages 59 and 61 years respectively) after visiting and interviewing the relatives and/or the family doctors within 12 days (range 1-28) after the death. SCD in the study accounts for 50% of all cardiovascular deaths and is the most common cause of death after neoplasia. The most common place of death was home (151 cases, 68%), and in 174 cases (78%) deaths occurred while the patients were relaxing or during routine activities. Prodromal symptoms were reported in 57 cases (26%). The time of day of death showed a circadian variation, with a peak in the late morning from 9:00 to 12:00. Ninety four (42%) had a prior history of heart disease. One hundred and ninety one cases (86%) occurred in the subgroup of age 50-70 years.(ABSTRACT TRUNCATED AT 250 WORDS)

46 CFR 107.211 - Original Certificate of Inspection.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Original Certificate of Inspection. 107.211 Section 107... INSPECTION AND CERTIFICATION Inspection and Certification § 107.211 Original Certificate of Inspection. (a) The owner or builder of a unit applies for an inspection for an original Certificate of Inspection by...

16 CFR 1207.9 - Product certification.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Product certification. 1207.9 Section 1207.9 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR SWIMMING POOL SLIDES § 1207.9 Product certification. (a) Certification shall be in accordance...

Death analysis of residents in an area of twenty kilometers around Qinshan nuclear power station

International Nuclear Information System (INIS)

Ma Mingqiang; Lu Zhunrong; Zheng Wen; Sun Peizhi

2001-01-01

Objective: To set up a data bank for residents health condition 20 kilometers within around Qinshan nuclear power station. Methods: Combining with retrospective investigation, the relevant data were acquired from medical certification for resident's death reported by all local disease surveillance. Results: The mortality rate of these residents from 1988 to 1999 was 6.92%. The first course of mortality was diseases of respiratory system, the second of circulatory system, and the third was malignant tumor. The first 5 death causes among all male and female persons were diseases of respiratory system and circulatory system, malignant tumor, injuries and poisoning, diseases of digestive system. The mortality rate for malignant tumor was 121.33/100000 (the standard death rate is : 100.13/100000), and liver cancer was the first death cause, while lung and stomach cancers, the second and the third, respectively. The main death causes in juvenile and youth was leukemia, but liver cancer and lung cancer were the main courses of death in the middle-aged, and in old people, lung and liver cancers. Conclusion: The chronic non-infectious diseases in respiratory system, circulatory system etc, are the major death causes in the residents, the mortality rate for malignant tumor in them is lower than that reported by provincial disease surveillance station

Perceived value of national certification for pediatric nurses.

Science.gov (United States)

Messmer, Patricia R; Hill-Rodriguez, Deborah; Williams, Arthur R; Ernst, Mary E; Tahmooressi, Jill

2011-09-01

This study evaluated whether pediatric nurses who were certified valued national certifications to a greater degree than those who were not certified. The Gaberson, Schroeter, Killen, and Valentine (2003) Perceived Value of Certification Tool (PVCT) was used to measure nurses' perceptions of certification. The PVCT includes 18 certification-related value statements, using a five-point Likert scale response ranging from strongly agree to strongly disagree. A principal factor analysis was performed to identify clusters of related variables. Certified pediatric nurses valued national certifications to a greater degree than those who were not certified. More favorable views of certification were moderately associated with favorable views of the effects of certification on salary. The PVCT was found to have one factor, not two, as previously reported in the literature. Lower perceived relationships were reported between certification and salary, clinical competence, and consumer confidence compared with feelings of professionalism and personal satisfaction. Efforts to improve the relationship between certification and its perceived value at one institution were addressed. More attention may be needed to strengthen relationships, perceived or otherwise, between certification and competency skills, public awareness, and compensation of nurses for holding national certification. Copyright 2011, SLACK Incorporated.

14 CFR 125.7 - Display of certificate.

Science.gov (United States)

2010-01-01

... OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT General § 125.7 Display of certificate. (a) The certificate holder must display a true copy of the certificate in each of its aircraft. (b... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Display of certificate. 125.7 Section 125.7...

The electricity certificate system, 2008

Energy Technology Data Exchange (ETDEWEB)

2008-07-01

The electricity certificate system is now in its sixth year. Since the start, both the system and the market have developed, and have undergone a number of changes. In January 2007, the Swedish Energy Agency published a report on the system, 'The electricity certificate system, 2006', to provide easily accessible information on the development of the system and to improve general understanding of it. With the passing of another year, it is now time for the third edition, 'The electricity certificate system, 2008', describing the market status of the electricity certificate system, with statistics from 2003 to 2007. This year's special theme chapter describes current support systems for renewable electricity production throughout the EU. The report also contains expanded information and statistics on biofuels, together with a new chapter that describes planned expansion of renewable electricity production up to 2012. The chapter on consumers' contribution to renewable electricity production has also been updated. A new feature this year is provided in the form of a number of tables at the end of the report, complementing the text. Through annual publication of the report, we hope to create a means of continuously developing the statistical material and analyses, in order to assist those involved in the market, and all other interested persons, to follow achievement of the objectives set out in the Government's Bill No. 205/06:154, 'Renewable electricity with green certificates'. We welcome views on the content and presentation of the report in order further to improve it. The target for the certificate system is to increase, by 2016, the annual production of electricity from renewable sources by 17 TWh relative to its production in 2002. So far, the actual production of renewable electricity is less than the indicative stage target for 2007. Nevertheless, progress is regarded as good, as there are many planned projects

Certification and the Branding of HRD

Science.gov (United States)

Carliner, Saul

2012-01-01

Although calls continue to establish certification, several certifications for human resource development (HRD) practitioners already exist, although none use the name HRD. This Forum explores what those certification programs are and what their availability means to the development of the HRD "brand" (the impressions of the service derived from…

Interactions of White Certificates for energy efficiency and other energy and climate policy instruments

International Nuclear Information System (INIS)

Oikonomou, V.

2010-01-01

The EU and its member states are developing their own policies targeting at energy supply, energy demand and environmental goals that are indirectly linked to energy use. As these policies are implemented in an already policy crowded environment, interactions of these instruments take place, which can be complementary competitive or self exclusive. As a starting point, we test White Certificates for energy efficiency improvement in the end-use sectors. Our main research questions are: (1) to provide a general explanatory framework for analyzing energy and climate policy interactions by employing suitable methods, and (2) to evaluate these methods and draw conclusions for policy makers when introducing White Certificates with other policy instruments stressing the critical condition that affect their performance. A core lesson is that when evaluating ex-ante instruments, a variety of economic and technological methods must be applied. Based on these methods, several endogenous and exogenous conditions affect the performance of White Certificates schemes with other policy instruments. Due to the innovative character of White Certificates and the uncertainty of hidden costs embedded into it, ex-ante evaluations should focus not only on the effectiveness and efficiency of the scheme, but on several other criteria which express the political acceptability and socioeconomic effects. We argue finally that White Certificates can make effective use of market forces and can assist in overcoming market barriers towards energy efficiency, and we expect that under certain preconditions, it can be integrated with other policy instruments and allows to achieve cost effectively multiple environmental objectives.

Modeling landowner behavior regarding forest certification

Science.gov (United States)

David C. Mercker; Donald G. Hodges

2008-01-01

Nonindustrial private forest owners in western Tennessee were surveyed to assess their awareness, acceptance, and perceived benefits of forest certification. More than 80 percent of the landowners indicated a willingness to consider certification for their lands. A model was created to explain landowner behavior regarding their willingness to consider certification....

40 CFR 82.161 - Technician certification.

Science.gov (United States)

2010-07-01

... shall address the subject areas listed in appendix D. (c) Program Approval. Persons may seek approval of... the closed-book certification exam, within 30 days. Programs providing Type I certification using the... percent or higher on the certification exam, no later than 30 days after the program has received the exam...

Alternative Cell Death Pathways and Cell Metabolism

Directory of Open Access Journals (Sweden)

Simone Fulda

2013-01-01

Full Text Available While necroptosis has for long been viewed as an accidental mode of cell death triggered by physical or chemical damage, it has become clear over the last years that necroptosis can also represent a programmed form of cell death in mammalian cells. Key discoveries in the field of cell death research, including the identification of critical components of the necroptotic machinery, led to a revised concept of cell death signaling programs. Several regulatory check and balances are in place in order to ensure that necroptosis is tightly controlled according to environmental cues and cellular needs. This network of regulatory mechanisms includes metabolic pathways, especially those linked to mitochondrial signaling events. A better understanding of these signal transduction mechanisms will likely contribute to open new avenues to exploit our knowledge on the regulation of necroptosis signaling for therapeutic application in the treatment of human diseases.

Indicators for early assessment of palliative care in lung cancer patients: a population study using linked health data.

Science.gov (United States)

Kelly, Maria; O'Brien, Katie M; Lucey, Michael; Clough-Gorr, Kerri; Hannigan, Ailish

2018-02-26

Analysing linked, routinely collected data may be useful to identify characteristics of patients with suspected lung cancer who could benefit from early assessment for palliative care. The aim of this study was to compare characteristics of newly diagnosed lung cancer patients dying within 30 days of diagnosis (short term survivors) with those surviving more than 30 days. To identify indicators for early palliative care assessment we distinguished between characteristics available at diagnosis (age, gender, smoking status, marital status, comorbid disease, admission type, tumour stage and histology) from those available post diagnosis. A second aim was to examine the association between receiving any tumour-directed treatment, place of death and survival time. A retrospective observational population based study comparing lung cancer patients who died within 30 days of diagnosis (short term survivors) with those who survived longer using Chi-squared tests and logistic regression. Incident lung cancer (ICD-03:C34) patients diagnosed 2005-2012 inclusive who died before 01-01-2014 (n = 14,228) were identified from the National Cancer Registry of Ireland linked to death certificate data and acute hospital episode data. One in five newly diagnosed lung cancer patients died within 30 days of diagnosis. After adjusting for stage and histology, death within 30 days was higher in patients who were aged 80 years or older (adjusted OR 2.46; 95%CI 2.05-3.96; p < 0.001), patients with emergency admissions at diagnosis (adjusted OR 2.96; 95%CI 2.61-3.37; p < 0.001) and patients with any comorbidities at diagnosis (adjusted OR 1.32 95%CI 1.15-1.52; p < 0.001). Overall, 75% of those who died within 30 days died in hospital compared to 43% of longer term survivors. We have shown a high proportion of lung cancer patients who die within 30 days of diagnosis are older, have comorbidities and are admitted through the emergency department. These characteristics

Radiation protection supervisors certification in Brazil

International Nuclear Information System (INIS)

Mendonca Costa, Eduardo; Arraes Monteiro, Iara

2008-01-01

In order to accomplish its legal assignments CNEN certifies the qualification of radiation protection supervisors. The current certification process is presented and discussed in this paper. This paper discusses the main points of the certification process including: knowledge tests, stake holder's communication, standards, supervisor responsibilities and profiles. The importance of safety certification of nuclear facilities and radiation protection of public individuals and workers are also discussed. Taking into account the characteristics of the Brazilian Nuclear program, the future improvements and goals in the certification process is also presented. (author)

General practitioners' experiences with sickness certification: a comparison of survey data from Sweden and Norway

Directory of Open Access Journals (Sweden)

Winde Lee D

2012-03-01

Full Text Available Abstract Background In most countries with sickness insurance systems, general practitioners (GPs play a key role in the sickness-absence process. Previous studies have indicated that GPs experience several tasks and situations related to sickness certification consultations as problematic. The fact that the organization of primary health care and social insurance systems differ between countries may influence both GPs' experiences and certification. The aim of the present study was to gain more knowledge of GPs' experiences of sickness certification, by comparing data from Sweden and Norway, regarding frequencies and aspects of sickness certification found to be problematic. Methods Statistical analyses of cross-sectional survey data of sickness certification by GPs in Sweden and Norway. In Sweden, all GPs were included, with 3949 (60.6% responding. In Norway, a representative sample of GPs was included, with 221 (66.5% responding. Results Most GPs reported having consultations involving sickness certification at least once a week; 95% of the GPs in Sweden and 99% of the GPs in Norway. A majority found such tasks problematic; 60% of the GPs in Sweden and 53% in Norway. In a logistic regression, having a higher frequency of sickness certification consultations was associated with a higher risk of experiencing them as problematic, in both countries. A higher rate of GPs in Sweden than in Norway reported meeting patients wanting a sickness certification without a medical reason. GPs in Sweden found it more problematic to discuss the advantages and disadvantages of sick leave with patients and to issue a prolongation of a sick-leave period initiated by another physician. GPs in Norway more often worried that patients would go to another physician if they did not issue a certificate, and a higher proportion of Norwegian GPs found it problematic to handle situations where they and their patient disagreed on the need for sick leave. Conclusions The

Modeling of a green certificate market

International Nuclear Information System (INIS)

Marchenko, O.V.

2008-01-01

The paper considers one of the economic mechanisms, stimulating the introduction of renewable energy sources (RES) - a green certificate market. A mathematical model was developed to describe a supply and demand balance in the electricity and green certificate markets simultaneously. The sellers of certificates are RES owners, who obtain certificates for each unit of electricity produced, and the buyers are consumers, who are obliged by law to buy a certain share of this electricity. Equilibrium structures of the power system including RES with stochastic operation conditions are calculated. The prices of electricity and certificates, as well as the total economic effect of the system are determined taking into account external costs (environmental damages). The paper shows that a mechanism of green certificates is not an ideal means for minimizing the impact of energy on the environment: the economic effect turns out to be smaller than the maximum possible one. However, this deviation is relatively small, therefore the green certificate market allows the external effects to be partially taken into account. Such a market creates incentives for investors, electricity producers and consumers to make power sources mix, modes of electricity production and consumption closer to the optimum ones in terms of the economy as a whole. (author)

Maintenance of Certification for Radiation Oncology

International Nuclear Information System (INIS)

Kun, Larry E.; Ang, Kian; Erickson, Beth; Harris, Jay; Hoppe, Richard; Leibel, Steve; Davis, Larry; Hattery, Robert

2005-01-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements of the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development

Alternative Certification Pathways: Filling a Gap?

Science.gov (United States)

Ludlow, Carlyn

2013-01-01

The purpose of this article is to examine the proliferation of alternative certification pathways through an analysis of the role and history of teacher certification and supply followed by a synthesis of national, regional, and state research studies on alternative routes to certification programs and a review of studies conducted on well-known…

AutoCAD 2014 review for certification official certification preparation

CERN Document Server

ASCENT center for technical knowledge

2014-01-01

The AutoCAD® 2014 Review for Certification book is intended for users of AutoCAD® preparing to complete the AutoCAD 2014 Certified Professional exam. This book contains a collection of relevant instructional topics, practice exercises, and review questions from the Autodesk Official Training Guides (AOTG) from ASCENT - Center for Technical Knowledge pertaining specifically to the Certified Professional exam topics and objectives. This book is intended for experienced users of AutoCAD in preparation for certification. New users of AutoCAD should refer to the AOTG training guides from ASCENT, such as AutoCAD/AutoCAD LT 2014 Fundamentals, for more comprehensive instruction.

Certification of Markets, Markets of Certificates: Tracing Sustainability in Global Agro-Food Value Chains

NARCIS (Netherlands)

Mol, A.P.J.; Oosterveer, P.J.M.

2015-01-01

There is a blossoming of voluntary certification initiatives for sustainable agro-food products and production processes. With these certification initiatives come traceability in supply chains, to guarantee the sustainability of the products consumed. No systematic analysis exists of traceability

Subclinical hyperthyroidism and sudden unexpected death in epilepsy.

Science.gov (United States)

Scorza, Fulvio A; Arida, Ricardo M; Cysneiros, Roberta M; Terra, Vera C; de Albuquerque, Marly; Machado, Hélio R; Cavalheiro, Esper A

2010-04-01

Epilepsy is the most common serious neurological condition and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but high seizure frequency is a potential risk factor. Additionally, potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures or transmission of epileptic activity to the heart via the autonomic nervous system potentially play a role. In parallel, several studies have shown a link between hormones and epilepsy. However, exact knowledge regarding the association of thyroid hormones and epilepsy is lacking. As subclinical hyperthyroidism has been linked with increased risk of cardiovascular disease, we propose in this paper that SUDEP, at least in some cases, could be related with subclinical thyroid dysfunction. (c) 2009 Elsevier Ltd. All rights reserved.

Mortality and causes of death among workers exposed to phosgene in 1943-45

International Nuclear Information System (INIS)

Polednak, A.P.; Hollis, D.R.

1985-01-01

Mortality and causes of death from death certificates were analyzed among workers exposed to phosgene while working at a uranium-processing plant in Tennessee in 1943-45. Standardized mortality ratios (SMRs) were calculated by using death rates for U.S. white males. As of 1979, SMRs for all causes and for various selected causes were similar in 694 male chemical workers chronically exposed to low levels of phosgene in 1943-45 and in 9280 male controls who worked at the same plant. SMRs for diseases of the respiratory system were 107 (14 observed vs. 13.07 expected) in the chemical workers and 119 (292 observed vs. 245.75 expected) in the controls. In a group of 106 males who were acutely exposed to high levels of phosgene, there were 41 deaths observed vs. 33.87 expected (SMR = 121; 95% confidence limits = 86 and 165). One death, occurring within 24 hours of exposure, was from pulmonary edema due to phosgene poisoning (coded to accidental causes). Five deaths were coded to diseases of the respiratory system (SMR = 266; 95% CL = 86 and 622); in 2 of these 5 deaths, bronchitis due to phosgene exposure had been reported in 1945. Among 91 female workers with acute high-level phosgene exposure, frequencies of symptoms and early health effects (pneumonitis and bronchitis) differed from those reported for the 106 male cases; preliminary data on vital status of these females are too incomplete for analysis, and further follow-up is needed

Differences Between Rural and Urban Areas in Mortality Rates for the Leading Causes of Infant Death: United States, 2013-2015.

Science.gov (United States)

Ely, Danielle M; Hoyert, Donna L

2018-02-01

The leading causes of infant death vary by age at death but were consistent from 2005 to 2015 (1-6). Previous research shows higher infant mortality rates in rural counties compared with urban counties and differences in cause of death for individuals aged 1 year and over by urbanization level (4,5,7,8). No research, however, has examined if mortality rates from the leading causes of infant death differ by urbanization level. This report describes the mortality rates for the five leading causes of infant, neonatal, and postneonatal death in the United States across rural, small and medium urban, and large urban counties defined by maternal residence, as reported on the birth certificate for combined years 2013-2015. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Mortality atlas of the main causes of death in Switzerland, 2008-2012.

Science.gov (United States)

Chammartin, Frédérique; Probst-Hensch, Nicole; Utzinger, Jürg; Vounatsou, Penelope

2016-01-01

Analysis of the spatial distribution of mortality data is important for identification of high-risk areas, which in turn might guide prevention, and modify behaviour and health resources allocation. This study aimed to update the Swiss mortality atlas by analysing recent data using Bayesian statistical methods. We present average pattern for the major causes of death in Switzerland. We analysed Swiss mortality data from death certificates for the period 2008-2012. Bayesian conditional autoregressive models were employed to smooth the standardised mortality rates and assess average patterns. Additionally, we developed models for age- and gender-specific sub-groups that account for urbanisation and linguistic areas in order to assess their effects on the different sub-groups. We describe the spatial pattern of the major causes of death that occurred in Switzerland between 2008 and 2012, namely 4 cardiovascular diseases, 10 different kinds of cancer, 2 external causes of death, as well as chronic respiratory diseases, Alzheimer's disease, diabetes, influenza and pneumonia, and liver diseases. In-depth analysis of age- and gender-specific mortality rates revealed significant disparities between urbanisation and linguistic areas. We provide a contemporary overview of the spatial distribution of the main causes of death in Switzerland. Our estimates and maps can help future research to deepen our understanding of the spatial variation of major causes of death in Switzerland, which in turn is crucial for targeting preventive measures, changing behaviours and a more cost-effective allocation of health resources.

Development of new NDT certification scheme in Singapore

International Nuclear Information System (INIS)

Wong, B.S.; Prabhakaran, K.G.; Babu, S.K.; Kuppuswamy, N.

2009-01-01

Nondestructive testing plays a vital role in Singapore Industry either it is construction or it it oil and gas. To cope up with the future demands for nondestructive testing personnel and cater to the local industry needs for qualified and certified NDT operators, Nondestructive Testing Society (Singapore)-NDTSS launched the SGNDT Certification Scheme. The aim of the organization is to promote and standardize the quality of NDT through education and training based on a scheme that is on par with internationally recognized 3rd party certifications. The certification also provides a greater confidence to the clients and end users who utilize the NDT test results provided by the certified operators. NDE certification in Singapore varies from industries and currently relies on the in-house certification scheme based on SNT-TC-1A where organizations find it difficult to standardize the skill and reliability of operators. NDE Certification system varies globally from countries to countries. A proper certification system is required to produce successful NDT Practitioners to suit the local industry. This paper outlines the development of Singapore NDT Certification Scheme (SGNDT), the operations, levels of qualification, the method of operation and control measures. The Training and Certification committee, Quality Management system within the certification scheme and the current system practiced in Singapore are discussed in this paper. The paper also highlights the importance of third party certification scheme. (author)

7 CFR 205.400 - General requirements for certification.

Science.gov (United States)

2010-01-01

...) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.400 General requirements for certification. A person seeking to receive or maintain organic certification under the... 7 Agriculture 3 2010-01-01 2010-01-01 false General requirements for certification. 205.400...

BIX Certificates: Cryptographic Tokens for Anonymous Transactions Based on Certificates Public Ledger

Directory of Open Access Journals (Sweden)

Sead Muftic

2016-12-01

Full Text Available With the widespread use of Internet, Web, and mobile technologies, a new category of applications and transactions that requires anonymity is gaining increased interest and importance. Examples of such new applications are innovative payment systems, digital notaries, electronic voting, documents sharing, electronic auctions, medical applications, and many others. In addition to anonymity, these applications and transactions also require standard security services: identification, authentication, and authorization of users and protection of their transactions. Providing those services in combination with anonymity is an especially challenging issue, because all security services require explicit user identification and authentication. To solve this issue and enable applications with security and also anonymity we introduce a new type of cryptographically encapsulated objects called BIX certificates. “BIX” is an abbreviation for “Blockchain Information Exchange.” Their purpose is equivalent to X.509 certificates: to support security services for users and transactions, but also enhanced with anonymity. This paper describes the structure and attributes of BIX certificate objects and all related protocols for their creation, distribution, and use. The BIX Certification Infrastructure (BCI as a distributed public ledger is also briefly described.

78 FR 30273 - Export Trade Certificate of Review

Science.gov (United States)

2013-05-22

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 84-24A12] Export Trade Certificate of Review ACTION: Notice of Application to Amend the Export Trade Certificate of Review Issued to... application to amend an Export Trade Certificate of Review (``Certificate''). This notice summarizes the...

78 FR 62585 - Export Trade Certificate of Review

Science.gov (United States)

2013-10-22

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 89-5A018] Export Trade Certificate of Review ACTION: Notice of Application to amend the Export Trade Certificate of Review Issued to... received an application to amend an Export Trade Certificate of Review (``Certificate''). This notice...

78 FR 36747 - Export Trade Certificate of Review

Science.gov (United States)

2013-06-19

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 89-4A018] Export Trade Certificate of Review ACTION: Notice of Application to amend the Export Trade Certificate of Review Issued to... received an application to amend an Export Trade Certificate of Review (``Certificate''). This notice...

78 FR 72865 - Export Trade Certificate of Review

Science.gov (United States)

2013-12-04

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 92-12A001] Export Trade Certificate of Review ACTION: Notice of application to amend the Export Trade Certificate of Review issued to..., has received an application to amend an Export Trade Certificate of Review (``Certificate''). This...

78 FR 36745 - Export Trade Certificate of Review

Science.gov (United States)

2013-06-19

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 87-9A001] Export Trade Certificate of Review ACTION: Notice of Application to amend the Export Trade Certificate of Review Issued to..., has received an application to amend an Export Trade Certificate of Review (``Certificate''). This...

Directory of certificates of compliance for radioactive materials packages. Certificates of compliance

International Nuclear Information System (INIS)

1979-10-01

This volume contains all Certificates of Compliance for radioactive material packages effective September 14, 1979. Purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory

77 FR 12562 - Export Trade Certificate of Review

Science.gov (United States)

2012-03-01

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 10-2A001] Export Trade Certificate of Review ACTION: Notice of Application (10-2A001) to Amend the Export Trade Certificate of Review..., has received an application to amend an Export Trade Certificate of Review (``Certificate''). This...

Architect’s Certification: A Problem?

Directory of Open Access Journals (Sweden)

Yong Kum Weng

2015-01-01

Full Text Available Currently the problems of some architects issuing fraudulent progress certificates for Malaysia’s housing projects result in many house buyers losing their life savings. Unfortunately, these house buyers still remain contractually responsible for all the associated, present and future financial obligations such as their bank loans. Fraudulent certification is the most frequent incident of complaints amongst the range of problems complained about to the Board of Architects, Malaysia or Lembaga Arkitek Malaysia (LAM. This paper highlights the underlying pertinent issues such as when an architect does not fully understand the ramifications, or exercise due care when performing the certifier’s role with its inherent responsibilities under the Housing Development Act (HDA and Housing Development Regulations (HDR. Also at what stage the architect is legally required to issue progressive work completion certificates, particularly the scope ranging from the inception stage through to the completion stage. This includes the relevant housing laws and regulations that enshrine the architects’ professional status and confers legal certification duties. This is designed to protect the public interest, yet many architects fail to perform this duty inde-pendently, or impartially and fairly to the new house buyers and the public at-large. Recognizing the systemic weakness, the elements that contribute to the fraudulent certification and illustrates how the fraudulent certification exploits the trust of house buyers. In the analysis, a quantitative framework was used to measure, quantify and discuss the best all round outcomes.

46 CFR 91.60-40 - Duration of Convention certificates.

Science.gov (United States)

2010-10-01

... VESSELS INSPECTION AND CERTIFICATION Certificates Under International Convention for Safety of Life at Sea... period of not more than 60 months. (1) A Cargo Ship Safety Construction Certificate. (2) A Cargo Ship Safety Equipment Certificate. (3) A Safety Management Certificate. (4) A Cargo Ship Safety Radio...

Certification Manual for Wisconsin Public Librarians. Bulletin No. 94111.

Science.gov (United States)

Lamb, Donald K.

This manual contains the guidelines and procedures for public librarian certification and certification renewal in Wisconsin. Certification is not required for library personnel other than administrators, but nonadministrators may apply for certification at the level for which they are eligible. Requirements for voluntary library certification are…

Tradable green certificates in Flanders (Belgium)

International Nuclear Information System (INIS)

Verbruggen, Aviel

2004-01-01

The paper provides details on green certificate systems in Belgium. The Flemish region has established a system and the Walloon region is preparing a slightly different one. The lack of uniformity and consequently of transparency in one country emphasises the need for more EU leadership in the field. The main part of the article analyses the established Flemish system. Green certificates are complementary to other instruments that promote renewable electricity, e.g. direct subventions on the feed-in price of green electricity or direct subventions on capital investments. Certificates execute a forcing effect on the actual development of green power if the imposed shares of green power in total sales are significant and if the fine level is at the height to enforce the quota. If the fine is too low the incentive effect turns into a financing tax effect. When the green certificate system does the job it is designed for, i.e. operating at the edge of the RES-E development and organise the transition from a non-sustainable to a sustainable power system, certificate prices will be high and reduce end-use consumption of electricity. A segmentation of the RES-E sector along the various RES-E technologies is a necessity to keep any certificate system affordable, effective and efficient. One can segment the tradable certificate market or one can assign a different number of certificates to a different RES-E technology project. Both solutions require an intensive follow-up of cost structures and of other policy measures (subventions), but given the infant state of understanding and experience segmenting markets may be best in the nearby years. (Author)

Design and implementation of PKI-based certification authority

Science.gov (United States)

Zheng, Ying; Bai, Qinghai; Zhao, Linna; Chun, Hua; Chen, Jing

2015-12-01

PKI achieves the management of public key by certificates. It combines the user's public key and his or her identification formation through a trusted third-party organization CA, in order to authenticate the user's identity on the Internet, thus ensuring the authenticity, integrity, confidentiality, and non- repudiation of the information transmitted on the Internet. CA is the most critical agency in the PKI system, mainly responsible for issuing and managing certificates. On the basis of the actual needs of an enterprise, in this paper the author designs and develops a small-sized PKI-based Certification Authority equipped with the functions of root CA initialization, certificate application, certificate issuance, certificate revocation, and the generation of certificate revocation list. The author also points out the problems that need to be mentioned in the design and development.

46 CFR 153.15 - Conditions under which the Coast Guard issues a Certificate of Inspection or Certificate of...

Science.gov (United States)

2010-10-01

... Certificate of Inspection required under § 153.900 for a United States ship to carry a hazardous material or... Certificate of Inspection or Certificate of Compliance. 153.15 Section 153.15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS CARRYING BULK LIQUID, LIQUEFIED...

Analysis of the green certificate market

International Nuclear Information System (INIS)

Storeboe, Inger Oeydis

2001-04-01

This report studies the advantages and disadvantages of a separate financial market for the environmental advantages in the production of electricity from renewable energy sources. This market solution is evaluated against other financial systems used to promote the production of green electricity. By starting from a general equilibrium model for the green certificate market, the report discusses how the adaptation in the certificate market is influenced by changes in the market conditions. The certificate market is combined with a quota market for carbon dioxide, with and without international trade with electricity and certificate and market power in the production of electricity from renewable energy sources

Postmortem computed tomography for detecting causes of sudden death in infants and children. Retrospective review of cases

International Nuclear Information System (INIS)

Oyake, Yuji; Aoki, Takeshi; Shiotani, Seiji; Kohno, Mototsugu; Ohashi, Noriyoshi; Akutsu, Hiroyoshi; Yamazaki, Kentaro

2006-01-01

The aim of this study was to investigate the usefulness of postmortem computed tomography (PMCT) in detecting causes of sudden death in infants and children. Our subjects were 15 nontraumatically deceased patients (nine boys and six girls, ranging in age from 20 days after birth to 12 years old, mean age 1.6 years), who had been in a state of cardiopulmonary arrest on arrival at our hospital. PMCT was performed within 2 h after certification of death: head (15 cases), chest (11 cases), and abdomen (12 cases). Blood was collected from 11 of the patients at the time of cardiopulmonary resuscitation. An autopsy was conducted on two. PMCT did not show any traumatic changes indicating child abuse. It was difficult to presume the cause of death with PMCT alone, but the cause of death in 14 of 15 cases could be presumed by combining information from their medical history, clinical course before death, PMCT findings, laboratory data, and bacterial culture. The remaining subject was classified as cause unknown. The causes of sudden death in infants and children were detected at a high rate when we comprehensively investigated the PMCT and other examination findings. (author)

7 CFR 205.406 - Continuation of certification.

Science.gov (United States)

2010-01-01

..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.406 Continuation of certification. (a) To continue... 7 Agriculture 3 2010-01-01 2010-01-01 false Continuation of certification. 205.406 Section 205.406...

7 CFR 1421.110 - Commodity certificate exchanges.

Science.gov (United States)

2010-01-01

... commodity certificate for the marketing assistance loan collateral. (b) The exchange rate is the lesser of... assistance loan collateral. (3) Immediately exchanging the purchased commodity certificate for the outstanding loan collateral. (e) The authority to make commodity certificates available to the producer will...

A software product certification model

NARCIS (Netherlands)

Heck, P.M.; Klabbers, M.D.; van Eekelen, Marko

2010-01-01

Certification of software artifacts offers organizations more certainty and confidence about software. Certification of software helps software sales, acquisition, and can be used to certify legislative compliance or to achieve acceptable deliverables in outsourcing. In this article, we present a

Burden and Risk Factors for Cold-Related Illness and Death in New York City

Directory of Open Access Journals (Sweden)

Kathryn Lane

2018-03-01

Full Text Available Exposure to cold weather can cause cold-related illness and death, which are preventable. To understand the current burden, risk factors, and circumstances of exposure for illness and death directly attributed to cold, we examined hospital discharge, death certificate, and medical examiner data during the cold season from 2005 to 2014 in New York City (NYC, the largest city in the United States. On average each year, there were 180 treat-and-release emergency department visits (average annual rate of 21.6 per million and 240 hospital admissions (29.6 per million for cold-related illness, and 15 cold-related deaths (1.8 per million. Seventy-five percent of decedents were exposed outdoors. About half of those exposed outdoors were homeless or suspected to be homeless. Of the 25% of decedents exposed indoors, none had home heat and nearly all were living in single-family or row homes. The majority of deaths and illnesses occurred outside of periods of extreme cold. Unsheltered homeless individuals, people who use substances and become incapacitated outdoors, and older adults with medical and psychiatric conditions without home heat are most at risk. This information can inform public health prevention strategies and interventions.

Certification of thermal solar systems in the Netherlands and monitoring the results of certification

NARCIS (Netherlands)

Ree, B.G.C. van der

1996-01-01

Due to the rapid growth of the solar energy market in the Netherlands, quality control of solar systems is well under way. An important tool to improve the infrastructure of the solar market is certification of solar energy systems. Certification in the Netherlands is being developed in two projects

Epidemiologic Risk Factors for Suicide and Attempted Suicide in the U.S. Air Force: Using Administrative Data Systems and Multiple Cause of Death Information to Improve Prevention Policy

National Research Council Canada - National Science Library

Copley, Gary

2000-01-01

...) which uses multiple cause of death (certificate) information. The AFMR was fotmd to be the most valid and reliable source of mortality information, largely due to the "120-day retiree" sub-cohort missed by the official data...

13 CFR 120.644 - Transfers of Certificates.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Transfers of Certificates. 120.644 Section 120.644 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Miscellaneous Provisions § 120.644 Transfers of Certificates. (a) General rule. Certificates are...

7 CFR 946.60 - Inspection and certification.

Science.gov (United States)

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Inspection and certification. 946.60 Section 946.60... WASHINGTON Order Regulating Handling Inspection and Certification § 946.60 Inspection and certification. (a... this subpart, each handler who first ships potatoes shall, prior to making shipment, cause each...

Aplicabilidad del análisis por causa múltiple de muerte para el cáncer cervicouterino: la experiencia en México Applicability of the analysis by multiple cause of death by cervical cancer: the experience in Mexico

Directory of Open Access Journals (Sweden)

Lilia Patricia Bustamante-Montes

2011-12-01

Full Text Available Objecto. Explora-se a aplicabilidad da análise por causa múltipla de morte para o estudo do cancro cervicouterino. Métodos. Desenho de mortalidade proporcional para analisar todas as causas consignadas na totalidade dos certificados de morte por cancro cervicouterino de mulheres maiores de 18 anos do Estado de México (367, e 515 certificados de mulheres falecida por outras causas. Resultados. Encontrou-se uma razão de causa básica/múltipla de 2.9 nos certificados de morte, isto é pela cada causa básica encontraram-se 2.9 As mulheres falecidas por cancro cervicouterino morrem cinco anos dantes que as que morrem por outras causas (pObjective. The study explores the applicability of the multiple-cause-of-death analysis for cervical-uterine cancer. Methods. A proportional mortality hazard design and the analysis of all causes of death due to cervical-uterine cancer from 367 death certificates of women older than 18 years of age from the State of Mexico, and 515 age and year adjusted sample of death certificates of women from the same region who died from other causes. Results. A basic multiple cause of death of 2.9 was observed in the death certificates, i.e., for every basic cause there were 2.9 multiple causes. When adjusting the multiple-causes-of-death analysis for cervical-uterine cancer by age, education, marital and insurability status, the most contributing and associated causes of death were malignant tumors from unspecified sites [OR=18.98 (2.28-157.56 and OR=14.25 (1.67-121.0] respectively; Diabetes Mellitus as a contributing [OR=1.82 (1.02-3.27 and associated cause [OR=7.78 (1.46-41.37], and systemic arterial hypertension as an associated cause [OR=3.00 (1.40-6.47]. Conclusions. The multiple-cause-of-death analysis is an adequate to observe the diseases that contribute condition and are associated to the cervical-uterine cancer.

47 CFR 76.1502 - Certification.

Science.gov (United States)

2010-10-01

... sufficient time to comply with the Commission's notification requirements. (b) Certifications must be... certification in its cable franchise area, a statement that the applicant is qualified to operate an open video... that the applicant will comply with the Commission's notice and enrollment requirements for...

40 CFR 68.185 - Certification.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Certification. 68.185 Section 68.185 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... certification that, to the best of the signer's knowledge, information, and belief formed after reasonable...

Emergency Teacher Certification. ERIC Digest.

Science.gov (United States)

Ashburn, Elizabeth A.

Emergency certification involves the issuance of teaching licenses to individuals who have not completed a traditional college or university teacher education program. This two-page information review examines the problems arising from emergency certification and its relationship to student achievement. Some alternatives to emergency certification…

Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

Directory of Open Access Journals (Sweden)

Flick Louise H

2005-07-01

Full Text Available Abstract Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths, socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954 were compared to those for older women (20–35 years, n = 28,899. Logistic regression was used to estimate adjusted odds ratios (OR and 95% confidence intervals (CI for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48, neonatal (1.69, 1.24–2.31 and post-neonatal mortality (2.47, 1.70–3.59 were significantly higher for younger adolescent (12–17 years than older (20–34 years mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid, the risk of post-neonatal mortality (1.73, 1.14–2.64 but not neonatal mortality (1.43, 0.98–2.08 remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk.

12 CFR 563.74 - Mutual capital certificates.

Science.gov (United States)

2010-01-01

... the funds for redemption are raised by the issuance of mutual capital certificates approved pursuant... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Mutual capital certificates. 563.74 Section 563...-OPERATIONS Securities and Borrowings § 563.74 Mutual capital certificates. (a) General. No savings...

19 CFR 191.10 - Certificate of delivery.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Certificate of delivery. 191.10 Section 191.10... TREASURY (CONTINUED) DRAWBACK General Provisions § 191.10 Certificate of delivery. (a) Purpose; when... other party a certificate of delivery, certified by the importer or other party through whose possession...

Analysis on the training effect of criteria and practical guidance for determination of brain death: evoked potentials

Directory of Open Access Journals (Sweden)

Yan ZHANG

2015-12-01

Full Text Available Objective To analyze the training results of short-latency somatosensory-evoked potential (SLSEP for brain death determination and to improve the training program. Methods A total of 101 trainees received theoretical training, simulation skills training, bedside skills training and test analysis for SLSEP in brain death determination. The composition of trainees was analyzed and the error rates of 6 knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional category, professional qualification and hospital level, on the error rates. Results Among them, trainees of 30-49 years old occupied 76.24% (77/101, most of them were from third grade, grade A hospitals (98.02%, 99/101, and 78 trainees (77.23% were from Department of Neurology. There were 82 clinicians (81.19%, 31 (30.69% had senior certificate and 42 (41.58% had intermediate certificate. Total error rate of 6 knowledge points was 4.50% (91/2020. Of the 6 knowledge points, the error rate of pitfalls was the highest (9.41%, 19/202, followed by result determination (5.94% , 12/202, recording techniques (4.75% , 24/505, procedures (3.96%, 32/808, sequence of confirmatory tests (1.98%, 2/101 and environmental conditions (0.99%, 2/202. Univariate and multivariate Logistic regression analyses showed that age (OR = 1.566, 95% CI: 1.116-2.197; P = 0.009 and professional qualification (OR = 1.669, 95% CI: 1.163-2.397; P = 0.005 were independent risk factors associated with high error rates. Conclusions The differences between brain death determination and routine check of SLSEP should be paid more attention to improve the quality of determination for brain death by SLSEP.  DOI: 10.3969/j.issn.1672-6731.2015.12.007

Descriptive epidemiology of chronic liver disease in northeastern Italy: an analysis of multiple causes of death.

Science.gov (United States)

Fedeli, Ugo; Schievano, Elena; Lisiero, Manola; Avossa, Francesco; Mastrangelo, Giuseppe; Saugo, Mario

2013-10-10

The analysis of multiple causes of death data has been applied in the United States to examine the population burden of chronic liver disease (CLD) and to assess time trends of alcohol-related and hepatitis C virus (HCV)-related CLD mortality. The aim of this study was to assess the mortality for CLD by etiology in the Veneto Region (northeastern Italy). Using the 2008-2010 regional archive of mortality, all causes registered on death certificates were extracted and different descriptive epidemiological measures were computed for HCV-related, alcohol-related, and overall CLD-related mortality. The crude mortality rate of all CLD was close to 40 per 100,000 residents. In middle ages (35 to 74 years) CLD was mentioned in about 10% and 6% of all deaths in males and females, respectively. Etiology was unspecified in about half of CLD deaths. In females and males, respectively, HCV was mentioned in 44% and 21% and alcohol in 11% and 26% of overall CLD deaths. A bimodal distribution with age was observed for HCV-related proportional mortality among females, reflecting the available seroprevalence data. Multiple causes of death analyses can provide useful insights into the burden of CLD mortality according to etiology among different population subgroups.

Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys.

Science.gov (United States)

Bhatia, Amiya; Ferreira, Leonardo Zanini; Barros, Aluísio J D; Victora, Cesar Gomes

2017-08-18

Birth registration, and the possession of a birth certificate as proof of registration, has long been recognized as a fundamental human right. Data from a functioning civil registration and vital statistics (CRVS) system allows governments to benefit from accurate and universal data on birth and death rates. However, access to birth certificates remains challenging and unequal in many low and middle-income countries. This paper examines wealth, urban/rural and gender inequalities in birth certificate coverage. We analyzed nationally representative household surveys from 94 countries between 2000 and 2014 using Demographic Health Surveys and Multiple Indicator Cluster Surveys. Birth certificate coverage among children under five was examined at the national and regional level. Absolute measures of inequality were used to measure inequalities in birth certificate coverage by wealth quintile, urban/rural residence and sex of the child. Over four million children were included in the analysis. Birth certificate coverage was over 90% in 29 countries and below 50% in 36 countries, indicating that more than half the children under five surveyed in these countries did not have a birth certificate. Eastern & Southern Africa had the lowest average birth certificate coverage (26.9%) with important variability among countries. Significant wealth inequalities in birth certificate coverage were observed in 74 countries and in most UNICEF regions, and urban/rural inequalities were present in 60 countries. Differences in birth certificate coverage between girls and boys tended to be small. We show that wealth and urban/rural inequalities in birth certificate coverage persist in most low and middle income countries, including countries where national birth certificate coverage is between 60 and 80%. Weak CRVS systems, particularly in South Asia and Africa lead rural and poor children to be systematically excluded from the benefits tied to a birth certificate, and prevent these

DGNB Building Certification Companion

DEFF Research Database (Denmark)

Møller, Renate Skovgaard; Rhodes, Michael K.; Larsen, Tine Steen

2017-01-01

for sustainable buildings. The literature describes several barriers of entry preventing actors in the industry from seeking sustainability certifications and prioritizing design methods, supporting sustainability in greater numbers. In the newly developed tool, “DGNB building certification companion: Sustainable......-language, easily digestible summaries of various topics regarding sustainability and the DGNB certification scheme. The identified barriers are described in the tool followed by a solution to overcome them. The tool, tested at multiple stages of development and moulded by many individuals both within and outside...... was that this is a desired product on the market. This new approach is expected to dramatically reduce misunderstandings, conflicts, and mistakes during a sustainable design process, helping the design team plan a project to possibly obtain the highest DGNB score if desired and properly documented....

DGNB BUILDING CERTIFICATION COMPANION

DEFF Research Database (Denmark)

Møller, Renate Skovgaard; Rhodes, Michael K.; Larsen, Tine Steen

2018-01-01

for sustainable buildings. The literature describes several barriers of entry preventing actors in the industry from seeking sustainability certifications and prioritizing design methods, supporting sustainability in greater numbers. In the newly developed tool, “DGNB building certification companion: Sustainable......-language, easily digestible summaries of various topics regarding sustainability and the DGNB certification scheme. The identified barriers are described in the tool followed by a solution to overcome them. The tool, tested at multiple stages of development and moulded by many individuals both within and outside...... was that this is a desired product on the market. This new approach is expected to dramatically reduce misunderstandings, conflicts, and mistakes during a sustainable design process, helping the design team plan a project to possibly obtain the highest DGNB score if desired and properly documented....

Soy production and certification

DEFF Research Database (Denmark)

Tomei, Julia; Semino, Stella Maris; Paul, Helena

2010-01-01

With the rising emphasis on biofuels as a potential solution to climate change, this paper asks whether certification schemes, developed to promote sustainable feedstock production, are able to deliver genuine sustainability benefits. The Round Table on Responsible Soy (RTRS) is a certification...... the social and environmental impacts of soybean production can be mitigated by the RTRS. It concludes that at present certification schemes are unlikely to be able to address either the institutional challenges associated with their implementation or the detrimental impacts of the additional demand generated...... scheme that aims to promote responsible soy production through the development of principles and criteria. However, can and does this initiative address the negative impacts associated with the intensive production of soy? Taking the example of soy biodiesel produced in Argentina, this paper asks whether...

A Baseline Method for Genealogical Entity Resolution

NARCIS (Netherlands)

Efremova, J.; Ranjbar-Sahraei, B.; Oliehoek, F.A.; Calders, T.; Tuyls, K.

2014-01-01

In this paper we study the application of entity resolution (ER) techniques on a real-world multi-source genealogical dataset. Our goal is to identify all persons involved in various notary acts and link them to their birth, marriage and death certificates. In order to evaluate the performance of a

Investigation of a baseline method for genealogical entity resolution

NARCIS (Netherlands)

Efremova, I.; Ranjbar-Sahraei, B.; Oliehoek, F.A.; Calders, T.G.K.; Tuyls, K.P.

2014-01-01

In this paper we study the application of entity resolution (ER) techniques on a real-world multi-source genealogical dataset. Our goal is to identify all persons involved in various notary acts and link them to their birth, marriage and death certificates. In order to evaluate the performance of a

Tabulador de causas múltiplas de morte Multiple causes- of-death tabulator

Directory of Open Access Journals (Sweden)

Augusto H. Santo

1999-08-01

Full Text Available O uso de causas múltiplas de morte vem sendo atualmente preconizado para descrever e analisar os determinantes patológicos da mortalidade em populações, como complemento ao uso tradicional da causa básica de morte. O estudo das causas múltiplas pode realizar-se por meio da apresentação de todas as menções das causas básicas e associadas de morte e por meio de associações de causas. Um programa para microcomputador foi desenvolvido para processar bancos de dados contendo as causas de morte informadas no Modelo Internacional de Atestado Médico de Causa de Morte, denominado Tabulador de Causas Múltiplas, que gera uma tabela matriz a partir da qual podem ser derivadas as demais formas de apresentação e análise, além de poder ser usado como instrumento de crítica dos dados de mortalidade.The use of multiple-causes-of-death is currently being recommended in order to describe and analyze the pathological determinants of mortality in populations, as a supplement to the traditional use of the underlying cause of death. Multiple-causes-of-death can be studied by presenting all underlying and associated causes mentioned, and by means of associations of causes of death. Microcomputer software has been developed to process data files containing causes of death informed by physicians on the International Form of Medical Certificate of Causes of Death. The Multiple Cause of Death Tabulator software generates a matrix table from which the above forms of presentation and analysis can be achieved and mortality data be edited.

Does Teacher Preparation Matter? Evidence about Teacher Certification, Teach for America, and Teacher Effectiveness.

OpenAIRE

Linda Darling-Hammond; Deborah J. Holtzman; Su Jin Gatlin; Julian Vasquez Heilig

2005-01-01

Recent debates about the utility of teacher education have raised questions about whether certified teachers are, in general, more effective than those who have not met the testing and training requirements for certification, and whether some candidates with strong liberal arts backgrounds might be at least as effective as teacher education graduates. This study examines these questions with a large student-level data set from Houston, Texas that links student characteristics and achievement ...

12 CFR 411.110 - Certification and disclosure.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Certification and disclosure. 411.110 Section 411.110 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES NEW RESTRICTIONS ON LOBBYING General § 411.110 Certification and disclosure. (a) Each person shall file a certification, and a disclosure...

Green certificates and carbon trading in the Netherlands

International Nuclear Information System (INIS)

Boots, M.

2003-01-01

The combination of trading schemes for green certificates and for carbon, as they are implemented and planned in the Netherlands, imply a complete separation of green certificates and CO 2 markets. This means that the costs of CO 2 reduction will be reflected in the spot price of electricity and that the price of green certificates only reflects the additional cost of RE development. However, since the green certificate scheme is already implemented, while the carbon trading scheme is not, it is unclear if currently the green certificate value includes the CO 2 reduction value of RE production. It is important that buyers and sellers in the market for green certificates agree on what they are trading, therefore this issue should be clarified

40 CFR 92.208 - Certification.

Science.gov (United States)

2010-07-01

... the construction of a locomotive or locomotive engine, where such step may reasonably be expected to... POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Certification Provisions § 92.208 Certification. (a) This paragraph (a) applies to manufacturers of new locomotives and new locomotive engines. If, after a review of...

The death of Adolf Hitler--forensic aspects.

Science.gov (United States)

Marchetti, Daniela; Boschi, Ilaria; Polacco, Matteo; Rainio, Juha

2005-09-01

The death of Adolf Hitler is one of the unsolved mysteries of the twentieth century. Numerous historians and journalists have attempted to piece together the details, but despite the interest in the forensic literature regarding the identification of the body, there has not been much scientific debate about the alleged cause of death--cyanide poisoning, gunshot injury, or both. The available literature concerning Hitler's cause of death is incomplete because the toxicological analysis has not been performed and because the skull bone fragment with a gunshot wound possibly from Hitler's corpse has not been properly examined. This has given basis for various theories, which are reviewed. We believe that mtDNA analysis of the skull fragments and of Hitler's jaw, now filed in Moscow, and samples from maternal relatives of Hitler are crucial linking the skull fragment with the gunshot wound to Hitler.

[Maternal deaths related to social vulnerabilities. Results from the French confidential enquiry into maternal deaths, 2010-2012].

Science.gov (United States)

Tessier, V; Leroux, S; Guseva-Canu, I

2017-12-01

The theme of deprivation is new for the ENCMM. In view of the perceived increase in the number of maternal deaths that may be related to a deprivation situation, we sought to understand the main dimensions that could contribute to maternal death in this context, in order to propose a definition. The selection of cases made a posteriori is mainly based on a qualitative judgment. Between 2010 and 2012, among the deaths evaluated by the CNEMM, one or more elements related to social vulnerability were identified in 8.6% of the cases (18 deaths). The direct criteria used were the concepts of "deprivation" or "social difficulties", difficulties of housing, language barriers and isolation. The absence of prenatal care was retained as an indirect marker. We excluded cases where psychiatric pathology and/or addiction were predominant. Of the 18 cases identified with deprivation factors, death was considered "unavoidable" in 2 cases (11%), "certainly avoidable" or "possibly avoidable" in 13 cases (72%). In 3 cases (17%), avoidability could not be determined. Avoidability was related to the content and adequacy of care in 11 cases out of 13 (85%) and the patient's interaction with the health care system in 10 of 18 cases (56%). The analysis of maternal deaths among women in precarious situations points out that the link between socio-economic deprivation and poor maternal health outcomes potentially includes a specific risk of maternal death. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

[The accuracy of the causes of death and the estimated trend: the case of cervix uteri].

Science.gov (United States)

Mancuso, Pamela; Sacchettini, Claudio; Vicentini, Massimo; Caroli, Stefania; Giorgi Rossi, Paolo

2016-01-01

reduction in cervical cancer mortality is the ultimate goal of the screening. Quality of death certificate reports has been improved over time, but they are still inaccurate, making it difficult to assess time trends in mortality. to evaluate the accuracy of the topographic coding of causes of death and to estimate the mortality time trend for cervical cancer through the method of incidence-based mortality (IBM) using cancer registry (CR) data. from the mortality registry (MR), we extracted data on deaths for cervix uteri cancer, corpus uteri cancer, and uterus cancer not otherwise specified (NOS) referred to residents in Reggio Emilia (Emilia-Romagna Region, Northern Italy) from 1997 to 2013. Deaths were checked with the CR to verify the topographical site of the primary tumour. Furthermore, by using CR data, we constructed a cohort of incident cervical cancer cases diagnosed between 1997 and 2009 with a 5-year follow-up. We calculated cause-specific IBM (excluding ovary) and IBM for all cause, crude and standardized, and annual percentage change (APC). out of 369 deaths for uterine cancer, 269 were reported in the RT: 32 for cervix uteri cancer, 76 for corpus uteri cancer, 161 for uterus cancer NOS. 28 of the 32 persons who died for cervical cancer were incidents for cervix uteri cancer. 63 of the 76 who died for corpus uteri cancer were incidents for corpus uteri cancer. Of the 161 who died of uterus cancer NOS, 80 were incidents for corpus uteri cancer, 45 for cervix uteri cancer, 28 for uterus cancer NOS, 5 for vagina cancer, and 3 for cancer of other non-specified organs. Applying these proportions of misclassification, we can estimate that the real number of cervical cancer deaths is 2.4 folds the number of cases reported in the MR as cervical cancer. IBM for all causes decreased significantly over the years (APC: -9.5; 95%CI -17.1;-1.1); cause-specific IBM decreases, but not significantly (APC: -5.1; 95%IC -16.1;+7.3). There is no improvement in survival (r

Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark.

Science.gov (United States)

Risgaard, Bjarke; Lynge, Thomas Hadberg; Wissenberg, Mads; Jabbari, Reza; Glinge, Charlotte; Gislason, Gunnar Hilmar; Haunsø, Stig; Winkel, Bo Gregers; Tfelt-Hansen, Jacob

2015-05-01

On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. The purpose of this study was to report the risk factors and causes of SNCD. We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD. We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD. The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1.3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]). Sudden death among individuals aged caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

20 CFR 656.24 - Labor certification determinations.

Science.gov (United States)

2010-04-01

... certification applications. (2) If the labor certification presents a special or unique problem, the Director of... opportunity as a college or university teacher, the U.S. worker must be at least as qualified as the alien. (3... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Labor certification determinations. 656.24...

32 CFR 537.20 - Certification to Congress.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Certification to Congress. 537.20 Section 537.20... BEHALF OF THE UNITED STATES § 537.20 Certification to Congress. Admiralty claims, including claims for... of the Army for approval and if in excess of $500,000 for certification to Congress for final...

Place and Cause of Death in Centenarians: A Population-Based Observational Study in England, 2001 to 2010

Science.gov (United States)

Evans, Catherine J.; Ho, Yuen; Daveson, Barbara A.; Hall, Sue; Higginson, Irene J.; Gao, Wei

2014-01-01

Background Centenarians are a rapidly growing demographic group worldwide, yet their health and social care needs are seldom considered. This study aims to examine trends in place of death and associations for centenarians in England over 10 years to consider policy implications of extreme longevity. Methods and Findings This is a population-based observational study using death registration data linked with area-level indices of multiple deprivations for people aged ≥100 years who died 2001 to 2010 in England, compared with those dying at ages 80-99. We used linear regression to examine the time trends in number of deaths and place of death, and Poisson regression to evaluate factors associated with centenarians’ place of death. The cohort totalled 35,867 people with a median age at death of 101 years (range: 100–115 years). Centenarian deaths increased 56% (95% CI 53.8%–57.4%) in 10 years. Most died in a care home with (26.7%, 95% CI 26.3%–27.2%) or without nursing (34.5%, 95% CI 34.0%–35.0%) or in hospital (27.2%, 95% CI 26.7%–27.6%). The proportion of deaths in nursing homes decreased over 10 years (−0.36% annually, 95% CI −0.63% to −0.09%, p = 0.014), while hospital deaths changed little (0.25% annually, 95% CI −0.06% to 0.57%, p = 0.09). Dying with frailty was common with “old age” stated in 75.6% of death certifications. Centenarians were more likely to die of pneumonia (e.g., 17.7% [95% CI 17.3%–18.1%] versus 6.0% [5.9%–6.0%] for those aged 80–84 years) and old age/frailty (28.1% [27.6%–28.5%] versus 0.9% [0.9%–0.9%] for those aged 80–84 years) and less likely to die of cancer (4.4% [4.2%–4.6%] versus 24.5% [24.6%–25.4%] for those aged 80–84 years) and ischemic heart disease (8.6% [8.3%–8.9%] versus 19.0% [18.9%–19.0%] for those aged 80–84 years) than were younger elderly patients. More care home beds available per 1,000 population were associated with fewer deaths in hospital (PR 0.98, 95% CI 0.98�

The Functional Role of Music in Communicating Death through/in YouTube Videos

Directory of Open Access Journals (Sweden)

Panagiotis Pentaris

2014-09-01

Full Text Available Since the establishment of thanatology, the science of death, in the early 20th century, death has not only been considered a controversial subject, but it has also been regarded as a taboo topic. Various ways of communicating death have developed over the last few decades. With the advent of different mass and social media and their increasing impact on everyday life in the 21st century, death can now be communicated via a number of media platforms, such as television, radio, and online videos. This type of communication is underpinned by a series of dimensions, in particular music, that shape the conveyed message. Music has been extensively used in the dissemination of information in the wider media outlet. It is widely seen as a means of evoking emotions and of facilitating the process of assimilating information that is communicated via media. This paper seeks to discuss the functional role of music in communicating death in online video platforms. In particular, the example of the YouTube platform is used to identify the links between death, music and video platforms. This paper is part of a large-scale study on the functional role of music in communicating death through YouTube videos. It is suggested that music may serve as a link between media and death. The conclusions that are drawn in this paper are supported by the authors’ current and ongoing study and critical analysis of the deployment of music in the communication of death.

9 CFR 156.6 - Certificates.

Science.gov (United States)

2010-01-01

... products, if the inspector finds that the requirements as stated in the certification have been met. The... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Certificates. 156.6 Section 156.6 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE...

Introduction of China's Compulsory Product Certification System (Ⅰ)

Institute of Scientific and Technical Information of China (English)

无

2004-01-01

@@ Why does China establish a new Compulso-ry Product Certification System? For a long time, our compulsory product certification system has had problems such as lack of a unified management department, repeated assessments,repeated charging and no separation between certification activities and behaviors of law enforcement.The most obvious problem is that two certification management systems exist respectively for domestic products and imported products.

Converse Theorems for Safety and Barrier Certificates

OpenAIRE

Ratschan, Stefan

2017-01-01

An important tool for proving safety of dynamical systems is the notion of a barrier certificate. In this paper we prove that every robustly safe ordinary differential equation has a barrier certificate. Moreover, we show a construction of such a barrier certificate based on a set of states that is reachable in finite time.

Combating pharmacist shortage through labor certification.

Science.gov (United States)

Maswoswe, J J; Stewart, K R; Enigbokan, M; Egbunike, I; Jackson, D M

1994-06-01

Several solutions, ranging from increased technician duties to salary raises, automation, and increasing job satisfaction, have been presented in the literature as methods of assuaging the pharmacist shortage. Although a significant portion of pharmacy graduates from American pharmacy colleges are foreign nationals, no marketing strategies have been elucidated in the retention and recruitment of foreign nationals through labor certification. Labor certifications are generally approved by the Secretary of Labor if the following factors have been verified: 1) there are not sufficient United States workers who are able, willing, qualified, and available for employment; and 2) the employment of the foreign national will not adversely affect the wages and working conditions of U.S. workers similarly employed. When properly understood, the labor certification process is a test of the job market where foreigners, by virtue of their skills and qualifications, attain certification which subsequently leads to permanent residency (green card). The objective of this report is to elucidate the tedious yet effective method of retaining American-educated foreign nationals through labor certification.

Implementation of thermographers' certification in Brazil

Science.gov (United States)

dos Santos, Laerte; Alves, Luiz M.; da Costa Bortoni, Edson

2011-05-01

In recent years Brazil has experienced extraordinary growth despite the recent economic global crisis. The demand for infrared thermography products and services has accompanied this growth. Like other non-destructive testing and inspection, the results obtained by thermography are highly dependent on the skills of thermographer. Therefore, it is very important to establish a serious and recognized process of certification to assess thermographers' qualifications and help services suppliers to establish credibility with their customers and increase the confidence of these costumers on the quality of these services. The Brazilian Society of Non-Destructive Testing and Inspection, ABENDI, a non-profitable, private technical-scientific entity, recognized nationally and internationally, has observed the necessity of starting a process for certification of thermographers in Brazil. With support of a work group composed by experts from oil and energy industries, transportation, universities and manufactures, the activities started in 2005. This paper describes the economic background required for installation of the certification process, its initial steps, the main characteristics of the Brazilian certification and the expectation for initiating the certification process.

Software Quality Certification: identifying the real obstacles

Directory of Open Access Journals (Sweden)

Megan Baker

1996-05-01

Full Text Available A case study of software certification reveals the real difficulty of certifying quality beyond superficial assessment - readers are invited to form their own conclusions. AS 3563 Software Quality Management System is the Australian version of ISO 9001, developed specifically for the software industry. For many Australian software houses, gaining certification with AS 3563 is a priority since certification has become a prerequisite to doing business with government departments and major corporations. However, the process of achieving registration with this standard is a lengthy and resource intensive process, and may have little impact on actual software quality. This case study recounts the experience of the consulting arm of one of Australia's accounting firms in its quest for certification. By using a number of specific management strategies this company was able to successfully implement AS 3563 in less than half the time usually taken to achieve certification - a feat for which its management should be congratulated. However, because the focus of the project was on gaining certification, few internal benefits have been realised despite the successful implementation of the standard.

Internal medicine board certification and career pathways in Japan.

Science.gov (United States)

Koike, Soichi; Matsumoto, Masatoshi; Ide, Hiroo; Kawaguchi, Hideaki; Shimpo, Masahisa; Yasunaga, Hideo

2017-05-08

Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification. It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine. Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.

12 CFR 4.65 - Certification.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Certification. 4.65 Section 4.65 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY ORGANIZATION AND FUNCTIONS, AVAILABILITY...; Contracting for Goods and Services § 4.65 Certification. (a) Objective. To preserve the integrity and foster...

Harmonisation of wind turbine certification in Europe JOULE project EWTC

Energy Technology Data Exchange (ETDEWEB)

Nath, C [Germanischer Lloyd, Hamburg (Germany); Eriksson, C [Det Norske Veritas, Hellerup (Denmark); Hulle, F van [Frans van Hulle, Petten (Netherlands); Skamris, C [Risoe National Lab., Roskilde (Denmark); Stam, W [CIWI Holland, Arnheim (Netherlands); Vionis, P [CRES, Attki (Greece)

1999-03-01

Wind turbine certification requirements are currently fairly divers within Europe. Therefore the leading European certification bodies initiated a JOULE project to harmonise the certification procedure on the basis of the current set of IEC/EN 61400 series standards. The paper presents a review of the state of the art of wind turbine certification in European countries and an outline of the sturcture of the project. The main steps of the project are (a) the collection of differences in certification practices by round robin certification of three wind turbine types; (b) assessment of the different certification results and (c) the development of a harmonised certification procedure. (au) EU-JOULE-3. 19 refs.

Photovoltaic module certification/laboratory accreditation criteria development

Energy Technology Data Exchange (ETDEWEB)

Osterwald, C.R. [National Renewable Energy Lab., Golden, CO (United States); Hammond, R.L.; Wood, B.D.; Backus, C.E.; Sears, R.L. [Arizona State Univ., Tempe, AZ (United States); Zerlaut, G.A. [SC-International Inc., Phoenix, AZ (United States); D`Aiello, R.V. [RD Associates, Tempe, AZ (United States)

1995-04-01

This document provides an overview of the structure and function of typical product certification/laboratory accreditation programs. The overview is followed by a model program which could serve as the basis for a photovoltaic (PV) module certification/laboratory accreditation program. The model covers quality assurance procedures for the testing laboratory and manufacturer, third-party certification and labeling, and testing requirements (performance and reliability). A 30-member Criteria Development Committee was established to guide, review, and reach a majority consensus regarding criteria for a PV certification/laboratory accreditation program. Committee members represented PV manufacturers, end users, standards and codes organizations, and testing laboratories.

Nursing Informatics Certification Worldwide: History, Pathway, Roles, and Motivation

Science.gov (United States)

Cummins, M. R.; Gundlapalli, A. V.; Murray, P.; Park, H.-A.; Lehmann, C. U.

2016-01-01

Summary Introduction Official recognition and certification for informatics professionals are essential aspects of workforce development. Objective: To describe the history, pathways, and nuances of certification in nursing informatics across the globe; compare and contrast those with board certification in clinical informatics for physicians. Methods (1) A review of the representative literature on informatics certification and related competencies for nurses and physicians, and relevant websites for nursing informatics associations and societies worldwide; (2) similarities and differences between certification processes for nurses and physicians, and (3) perspectives on roles for nursing informatics professionals in healthcare Results The literature search for ‘nursing informatics certification’ yielded few results in PubMed; Google Scholar yielded a large number of citations that extended to magazines and other non-peer reviewed sources. Worldwide, there are several nursing informatics associations, societies, and workgroups dedicated to nursing informatics associated with medical/health informatics societies. A formal certification program for nursing informatics appears to be available only in the United States. This certification was established in 1992, in concert with the formation and definition of nursing informatics as a specialty practice of nursing by the American Nurses Association. Although informatics is inherently interprofessional, certification pathways for nurses and physicians have developed separately, following long-standing professional structures, training, and pathways aligned with clinical licensure and direct patient care. There is substantial similarity with regard to the skills and competencies required for nurses and physicians to obtain informatics certification in their respective fields. Nurses may apply for and complete a certification examination if they have experience in the field, regardless of formal training. Increasing

78 FR 16779 - Type Certification Procedures for Changed Products

Science.gov (United States)

2013-03-19

...-8994; Amdt. No. 21-96] RIN 2120-AK19 Type Certification Procedures for Changed Products AGENCY: Federal... requirements for the certification of changes to type-certificated products. The revision required the... entitled, ``Type Certification Procedures for Changed Products'' (December 4, 2012, 77 FR 71691). The 2000...

13 CFR 120.612 - Loans eligible to back Certificates.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Loans eligible to back Certificates. 120.612 Section 120.612 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Certificates § 120.612 Loans eligible to back Certificates. (a) Pool Certificates...

Taxation in France - Memorandum concerning the annual internal taxation certificate and the declaration of income for 2015

CERN Multimedia

2016-01-01

You are reminded that the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that the members of the personnel are exempt from national taxation on salaries and emoluments paid by CERN.   For any other income, the Organization would like to remind members of the personnel that they must comply with the national legislation applicable to them (cf. Article S V 2.02 of the Staff Rules). I - Annual internal taxation certificate for 2015 The annual certificate of internal taxation for 2015, issued by the Finance and Administration Processes Department, is available since 19 February 2016. It is intended exclusively for the tax authorities. If you are currently a member of the CERN personnel you received an e-mail containing a link to your annual certificate, which you can print out if necessary. If you are no longer a member of the CERN personnel or are unable to access your an...

Taxation in France: Memorandum concerning the annual internal taxation certificate and the declaration of income for 2014

CERN Document Server

HR Department

2015-01-01

You are reminded that the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that the members of the personnel are exempt from national taxation on salaries and emoluments paid by CERN.   For any other income, the Organization would like to remind members of the personnel that they must comply with the national legislation applicable to them (cf. Article S V 2.02 of the Staff Rules). I - Annual internal taxation certificate for 2014 The annual certificate of internal taxation for 2014, issued by the Finance, Procurement and Knowledge Transfer Department, has been available since 20 February 2015. It is intended exclusively for the tax authorities. 1. If you are currently a member of the CERN personnel, you will have received an e-mail containing a link to your annual certificate, which you can print out if necessary. 2. If you are no longer a member of the CERN pers...

Taxation in France: Memorandum concerning the annual internal taxation certificate and the declaration of income for 2013

CERN Multimedia

2014-01-01

You are reminded that the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that the members of the personnel are exempt from national taxation on salaries and emoluments paid by CERN.   For any other income, the Organization would like to remind members of the personnel that they must comply with the national legislation applicable to them (cf. Article S V 2.02 of the Staff Rules).   I - Annual internal taxation certificate for 2013 The annual certificate of internal taxation for 2013, issued by the Finance, Procurement and Knowledge Transfer Department, is available since 21 February 2014. It is intended exclusively for the tax authorities. If you are currently a member of the CERN personnel you received an e-mail containing a link to your annual certificate, which you can print out if necessary. If you are no longer a member of the CERN personnel or are ...

Guidelines for developing certification programs for newly generated TRU waste

International Nuclear Information System (INIS)

Whitty, W.J.; Ostenak, C.A.; Pillay, K.K.S.; Geoffrion, R.R.

1983-05-01

These guidelines were prepared with direction from the US Department of Energy (DOE) Transuranic (TRU) Waste Management Program in support of the DOE effort to certify that newly generated TRU wastes meet the Waste Isolation Pilot Plant (WIPP) Waste Acceptance Criteria. The guidelines provide instructions for generic Certification Program preparation for TRU-waste generators preparing site-specific Certification Programs in response to WIPP requirements. The guidelines address all major aspects of a Certification Program that are necessary to satisfy the WIPP Waste Acceptance Criteria and their associated Compliance Requirements and Certification Quality Assurance Requirements. The details of the major element of a Certification Program, namely, the Certification Plan, are described. The Certification Plan relies on supporting data and control documentation to provide a traceable, auditable account of certification activities. Examples of specific parts of the Certification Plan illustrate the recommended degree of detail. Also, a brief description of generic waste processes related to certification activities is included

Linking families and facilities for care at birth: What works to avert intrapartum-related deaths?

Science.gov (United States)

Lee, Anne CC; Lawn, Joy E.; Cousens, Simon; Kumar, Vishwajeet; Osrin, David; Bhutta, Zulfiqar A.; Wall, Steven N.; Nandakumar, Allyala K.; Syed, Uzma; Darmstadt, Gary L.

2012-01-01

Background Delays in receiving effective care during labor and at birth may be fatal for the mother and fetus, contributing to 2 million annual intrapartum stillbirths and intrapartum-related neonatal deaths each year. Objective We present a systematic review of strategies to link families and facilities, including community mobilization, financial incentives, emergency referral and transport systems, prenatal risk screening, and maternity waiting homes. Results There is moderate quality evidence that community mobilization with high levels of community engagement can increase institutional births and significantly reduce perinatal and early neonatal mortality. Meta-analysis showed a doubling of skilled birth attendance and a 35% reduction in early neonatal mortality. However, no data are available on intrapartum-specific outcomes. Evidence is limited, but promising, that financial incentive schemes and community referral/transport systems may increase rates of skilled birth attendance and emergency obstetric care utilization; however, impact on mortality is unknown. Current evidence for maternity waiting homes and risk screening is low quality. Conclusions Empowering communities is an important strategy to reduce the large burden of intrapartum complications. Innovations are needed to bring the poor closer to obstetric care, such as financial incentives and cell phone technology. New questions need to be asked of “old” strategies such as risk screening and maternity waiting homes. The effect of all of these strategies on maternal and perinatal mortality, particularly intrapartum-related outcomes, requires further evaluation. PMID:19815201

Enacting Third-Party Certification: A Case Study of Science and Politics in Organic Shrimp Certification

Science.gov (United States)

Konefal, Jason; Hatanaka, Maki

2011-01-01

As third-party certification has become a prominent governance mechanism, conflicting understandings of it have emerged. Proponents advance third-party certification as a technical and objective governance mechanism, while critics argue that politics and relations of power characterize it. We reject this dichotomization both in terms of how TPC is…

Certification of medical librarians, 1949--1977 statistical analysis.

Science.gov (United States)

Schmidt, D

1979-01-01

The Medical Library Association's Code for Training and Certification of Medical Librarians was in effect from 1949 to August 1977, a period during which 3,216 individuals were certified. Statistics on each type of certificate granted each year are provided. Because 54.5% of those granted certification were awarded it in the last three-year, two-month period of the code's existence, these applications are reviewed in greater detail. Statistics on each type of certificate granted each year are provided. Because 54.5% of those granted certification were awarded it in the last three-year, two-month period of the code's existence, these applications are reviewed in greater detail. Statistics on MLA membership, sex, residence, library school, and method of meeting requirements are detailed. Questions relating to certification under the code now in existence are raised.

77 FR 71691 - Type Certification Procedures for Changed Products

Science.gov (United States)

2012-12-04

...-8994; Amdt. No. 21-96] RIN 2120-AK19 Type Certification Procedures for Changed Products AGENCY: Federal... regulations for the certification of changes to type-certificated products. That amendment was to enhance... (certification) of the entire changed product. Therefore, Sec. 21.101 is amended to replace ``changed product...

21 CFR 80.37 - Treatment of batch pending certification.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Treatment of batch pending certification. 80.37 Section 80.37 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL COLOR ADDITIVE CERTIFICATION Certification Procedures § 80.37 Treatment of batch pending certification...

Green certificates and greenhouse gas emissions certificates - Instruments of the liberalized electricity market in Romania

International Nuclear Information System (INIS)

Matei, Magdalena; Salisteanu, Cornel; Enescu, Diana; Ene, Simona; Matei, Lucian; Marinescu, Mihai

2006-01-01

Governmental Decision No. 443/2003 and GD 1892 / 2004 aimed to the harmonization of the Romanian legislative framework with EU Directive 2001/77/EC which purposes to promote an increasing in the contribution of RES to electricity production in the internal market for electricity. In Romania's case green certificate system was adopted with mandatory quotas for suppliers as a national target for 2010 of 33 % of total consumption to be covered by electricity produced from renewable energy sources. The annual maximum and minimum value for Green Certificates trading is 24 Euro/certificate and 42 Euro/certificate, respectively. Suppliers are obliged to buy yearly a number of Green certificates equal with the mandatory quota multiplied with the amount of electricity sold yearly to their final consumers. The additional price received for the Green Certificates sold is determined on a parallel market, separated from the electricity market, where the environmental benefits of the 'clean' electricity production are traded. The regulator can modify these quotas established by Government Decision when the installed capacity in the power plants which use RES cannot secure the demand of Green Certificates; This system was introduced in November 2005. The number of issued green certificates in 2005 was only 345, so by ANRE Order no. 46 / 2005, the mandatory quota for 2005 was reduced at 2.6% from legal quota established for 2005. In the first month of 2006 5997 Green Certificates were sold at the price of 146 RON. Emissions trading is the most compatible flexible mechanisms of Kyoto Protocol with deregulated electricity markets. The Directive 2003/87/CE referring at CO 2 emission trading within Europe came into force and till 31 March 2004 all the countries had to present to the Commission their national plan to comply with Directive's rules. There is great uncertainty worldwide on how GHG emissions reduction and trading schemes will develop. Previous visions of a single (Kyoto

Saramago’s Death with Interruptions: A Path to Reconsider Essential Dilemmas Linked to Health Law

OpenAIRE

Sandra Mabel Wierzba

2014-01-01

What would happen if somewhere people would stop dying? In Saramago’s Death with interruptions, after the initial joy associated to the possibility of eternal life, anxiety and conflict invade the community. The end of death not only shakes Philosophy and Religion foundations, but it impacts on various legal institutions as well. In this paper, we consider the notion of Justice from the Right to Health perspective. In particular, we analyse the concept of “euthanasia" and the curr...

Dying To Be Thin: Attachment to Death in Anorexia Nervosa

Directory of Open Access Journals (Sweden)

Yael Latzer

2005-01-01

Full Text Available Anorexia Nervosa (AN usually follows a prolonged course accompanied by significant morbidity and high mortality. AN patients have been found to have elevated and attempted suicide rates, with suicide being the second most common cause of death in AN after the complications of the disorder itself. The suicide risk in AN is similar to that in major depression or conduct disorder and linked mainly to longer duration of illness, lower weight, bingeing and purging, impulsivity-related manifestations, comorbid substance abuse, and affective disorder. This paper reviews suicidal tendency and disturbed body image, death and eating disorders, and attachment and death with clinical implications related to AN.

45 CFR 170.457 - Authorized testing and certification methods.

Science.gov (United States)

2010-10-01

... TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification Program for HIT...

Environmental aspects of the forest management certification process

CSIR Research Space (South Africa)

Scott, DF

2000-01-01

Full Text Available Certification has been responsible for a very large improvement in the standard of forest management in South Africa. The reasons for the positive role of certification are set out briefly below. Firstly, and most importantly, certification has...

Directory of certificates of compliance for radioactive materials packages: Certificates of compliance

International Nuclear Information System (INIS)

1987-11-01

This directory contains a Summary Report of the US Nuclear Regulatory Commission's Certificates of Compliance (Volume 2) for Radioactive Material Packages effective October 1, 1987. This directory makes available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the back of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2

Symptoms Before Sudden Arrhythmic Death Syndrome: A Nationwide Study Among the Young in Denmark.

Science.gov (United States)

Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke; Lynge, Thomas Hadberg; Engstrøm, Thomas; Albert, Christine M; Haunsø, Stig; Winkel, Bo Gregers; Tfelt-Hansen, Jacob

2015-07-01

No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation of SADS. We have previously identified all of the autopsied sudden cardiac deaths (SCD; n = 314) in Danes aged 1-35 years between 2000 and 2006. After comprehensive pathological and toxicological investigation did not reveal a cause of SCD, 136 of the patients were identified as SADS. The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among these, 30 (22%) had contacted the healthcare system. Antecedent symptoms (symptoms >24 hours before death) were present in 34 (25%) patients. Prodromal symptoms (symptoms ≤24 hours before death) were present in 23 (17%) patients. Cardiac symptoms included chest pain (n = 16, 12%), dyspnea (n = 18, 13%), palpitations (n = 2, 1%), presyncope/syncope (n = 23, 17%), and aborted SCD (n = 2, 1%). In addition, seizures (n = 25, 18%) were prevalent. In 61 (45%) SADS cases, no previous medical history were recorded. In this unselected, nationwide study of 136 young SADS patients, 35% had experienced cardiac symptoms before death, most commonly presyncope/syncope, but only one out of five had contacted a healthcare provider with cardiac symptoms. © 2015 Wiley Periodicals, Inc.

Cause-Specific Mortality and Death Certificate Reporting in Adults with Moderate to Profound Intellectual Disability

Science.gov (United States)

Tyrer, F.; McGrother, C.

2009-01-01

Background: The study of premature deaths in people with intellectual disability (ID) has become the focus of recent policy initiatives in England. This is the first UK population-based study to explore cause-specific mortality in adults with ID compared with the general population. Methods: Cause-specific standardised mortality ratios (SMRs) and…

Causes of death among undocumented migrants in Sweden, 1997–2010

Directory of Open Access Journals (Sweden)

Anna Wahlberg

2014-06-01

Full Text Available Background: Undocumented migrants are one of the most vulnerable groups in Swedish society, where they generally suffer from poor health and limited health care access. Due to their irregular status, such migrants are an under-researched group and are not included in the country's Cause of Death Register (CDR. Objective: To determine the causes of death among undocumented migrants in Sweden and to ascertain whether there are patterns in causes of death that differ between residents and undocumented migrants. Design: This is a cross-sectional study of death certificates issued from 1997 to 2010 but never included in the CDR from which we established our study sample of undocumented migrants. As age adjustments could not be performed due to lack of data, comparisons between residents and undocumented migrants were made at specific age intervals, based on the study sample's mean age at death±a half standard deviation. Results: Out of 7,925 individuals surveyed, 860 were classified as likely to have been undocumented migrants. External causes (49.8% were the most frequent cause of death, followed by circulatory system diseases, and then neoplasms. Undocumented migrants had a statistically significant increased risk of dying from external causes (odds ratio [OR] 3.57, 95% confidence interval [CI]: 2.83–4.52 and circulatory system diseases (OR 2.20, 95% CI: 1.73–2.82 compared to residents, and a lower risk of dying from neoplasms (OR 0.07, 95% CI: 0.04–0.14. Conclusions: We believe our study is the first to determine national figures on causes of death of undocumented migrants. We found inequity in health as substantial differences in causes of death between undocumented migrants and residents were seen. Legal ambiguities regarding health care provision must be addressed if equity in health is to be achieved in a country otherwise known for its universal health coverage.

24 CFR 232.610 - Certification of cost requirements.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Certification of cost requirements... ASSISTED LIVING FACILITIES Eligibility Requirements-Supplemental Loans To Finance Purchase and Installation of Fire Safety Equipment Cost Certification Requirements § 232.610 Certification of cost requirements...

Autodesk Revit Architecture 2014 review for certification official certification preparation

CERN Document Server

ASCENT center for technical knowledge

2014-01-01

The Autodesk® Revit® Architecture 2014 Review for Certification guide is intended for users of the Autodesk Revit Architecture software who are preparing to complete the Autodesk Revit Architecture 2014 Certified Professional exam. This guide contains a collection of relevant instructional topics, practices, and review questions from the Autodesk Official Training Guides (AOTG) training guides created by ASCENT - Center for Technical Knowledge® and pertaining specifically to the Certified Professional exam topics and objectives. This training guide is intended for experienced users of the Autodesk Revit Architecture software in preparation for certification. New users of the software should refer to the AOTG training guides from ASCENT, such as Autodesk Revit Architecture 2014 Fundamentals, for more comprehensive instruction.

Accounting Changes on Green Certificates in Romania

Directory of Open Access Journals (Sweden)

Sava Raluca

2017-01-01

Full Text Available The purpose of green certificates is to get more renewable electric energy into the energy market at the expense of traditional energy, which in most countries is based on fossil fuel. These renewable technologies are too expensive to enter the market on commercial terms. A key feature of the scheme is that producers of energy based on new renewable energy sources receive certificates from the authorities, proportional to their output. The users of electric energy are required to buy a certain amount of these certificates when they buy electricity. Green certificates may in principle contribute to a reduction of the production of traditional energy.

48 CFR 1609.471 - Contractor certification.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Contractor certification... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Debarment, Suspension, and Ineligibility 1609.471 Contractor certification. All FEHBP carriers and applicant carriers...

Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers.

Science.gov (United States)

Rampatige, Rasika; Mikkelsen, Lene; Hernandez, Bernardo; Riley, Ian; Lopez, Alan D

2014-11-01

To systematically review the reliability of hospital data on cause of death and encourage periodic reviews of these data using a standard method. We searched Google Scholar, Pubmed and Biblioteca Virtual de la Salud for articles in English, Spanish and Portuguese that reported validation studies of data on cause of death. We analysed the results of 199 studies that had used medical record reviews to validate the cause of death reported on death certificates or by the vital registration system. The screened studies had been published between 1983 and 2013 and their results had been reported in English (n = 124), Portuguese (n = 25) or Spanish (n = 50). Only 29 of the studies met our inclusion criteria. Of these, 13 had examined cause of death patterns at the population level - with a view to correcting cause-specific mortality fractions - while the other 16 had been undertaken to identify discrepancies in the diagnosis for specific diseases before and after medical record review. Most of the selected studies reported substantial misdiagnosis of causes of death in hospitals. There was wide variation in study methodologies. Many studies did not describe the methods used in sufficient detail to be able to assess the reproducibility or comparability of their results. The assumption that causes of death are being accurately reported in hospitals is unfounded. To improve the reliability and usefulness of reported causes of death, national governments should do periodic medical record reviews to validate the quality of their hospital cause of death data, using a standard.

Mortality and causes of death in children referred to a tertiary epilepsy center.

Science.gov (United States)

Grønborg, Sabine; Uldall, Peter

2014-01-01

Patients with epilepsy, including children, have an increased mortality rate when compared to the general population. Only few studies on causes of mortality in childhood epilepsy exist and pediatric SUDEP rate is under continuous discussion. To describe general mortality, incidence of sudden unexpected death in epilepsy (SUDEP), causes of death and age distribution in a pediatric epilepsy patient population. The study retrospectively examined the mortality and causes of death in 1974 patients with childhood-onset epilepsy at a tertiary epilepsy center in Denmark over a period of 9 years. Cases of death were identified through their unique civil registration number. Information from death certificates, autopsy reports and medical notes were collected. 2.2% (n = 43) of the patient cohort died during the study period. This includes 9 patients with SUDEP (8 SUDEP cases per 10,000 patient years). 9 patients died in the course of neurodegenerative disease and 28 children died of various causes. Epilepsy was considered drug resistant in more than 95% of the deceased patients, 90% were diagnosed with intellectual disability. Mortality of patients that underwent dietary epilepsy treatment was slightly higher than in the general cohort. There were no epilepsy-related deaths due to drowning. This study confirms that SUDEP must not be disregarded in the pediatric age group. The vast majority of SUDEP cases in this study displays numerous risk factors similar to those described in adult epilepsy patients. Including SUDEP, only 30% of the mortality was directly seizure related. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Environmental certification for more sustainable imports

International Nuclear Information System (INIS)

Henry, Lucile; Monnoyer-Smith, Laurence; Demeulenaere, Laurence

2017-12-01

As France imports high quantities of products which have environmental impacts abroad due to extraction, transformations, and transports of used materials, and which are not visible for consumers, environmental certification could be a mean to reduce these impacts as it would allow consumers to identify the less polluting products, and incite producers to put such products on the market. After having discussed these issues, the author outlines key factors of success for such a certification, briefly identifies required adjustments at the technical level (requirement level, cost anticipation), and at the social and political level. She also evokes accompanying measures, and outlines that environmental certification is only a tool among others such as partnership agreements currently being negotiated between the European Union and other countries, or a combination of certification and cooperation with extracting countries (as practiced by Germany)

47 CFR 2.1043 - Changes in certificated equipment.

Science.gov (United States)

2010-10-01

... certificated or formerly type accepted AM broadcast stereophonic exciter-generator with a certificated or... interconnection of a multiplexing exciter with a certificated or formerly type accepted AM broadcast transmitter... generators to a type accepted FM broadcast transmitter, provided the transmitter exciter is designed for...

77 FR 2036 - Export Trade Certificate of Review

Science.gov (United States)

2012-01-13

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 92-10A001] Export Trade Certificate of Review ACTION: Notice of issuance of an Export Trade Certificate of Review to Aerospace... an amended Export Trade Certificate of Review to Aerospace Industries of America on September 27...

78 FR 78816 - Export Trade Certificate of Review

Science.gov (United States)

2013-12-27

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 87-9A001] Export Trade Certificate of Review ACTION: Notice of Issuance of an Amended Export Trade Certificate of Review to... issued an amended Export Trade Certificate of Review to Independent Film and Television Alliance (``IFTA...

On the origin of death: Paul and Augustine meet Charles Darwin

Directory of Open Access Journals (Sweden)

Izak J.J. Spangenberg

2013-08-01

Full Text Available Ever since the 4th century, Christian theologians have linked Romans 5:12–21 with Genesis 2–3. Augustine (354–430, one of the Latin fathers of the Church, propagated the idea of ‘original sin’ according to his reading of these chapters. This idea eventually became a fixed doctrine in Western Christianity and a large number of Christians still believe and proclaim that humans would have lived for ever but for the misconduct of Adam and Eve. They also proclaim that Jesus, through his obedience, death and resurrection, re-established God’s original creation plan. Death was conquered and eternal life can be inherited by all who believe in Jesus as saviour and second Adam. However, since both the introduction of the theory of evolution into biology and the paradigm shift in biblical studies (at the end of the 19th century, the view that death was to be linked to ‘original sin’ came under severe criticism. This article argues that Romans 5:12–21 and Genesis 2–3 do not support the idea of ‘original sin’ and that death is a normal part of life on earth, as argued by evolutionary biologists and proclaimed by many Old Testament texts.

Validación de "infarto de miocardio" como causa de muerte en certificados de defunción, Barquisimeto, Estado Lara, Venezuela Validation of "myocardial infarction" as cause of death on death certificates in Barquisimeto, Lara state, Venezuela

Directory of Open Access Journals (Sweden)

Ricardo Granero

1997-09-01

Full Text Available Las tasas de mortalidad por cardiopatía isquémica (CI han sido utilizadas ampliamente en el diagnóstico de la salud cardiovascular de regiones y países. Sin embargo, su validez ha sido cuestionada fundamentalmente por lo que le da origen: el certificado de defunción (CDD. El presente estudio tiene el objetivo de establecer la validez del diagnóstico "infarto de miocardio (IM" como causa de muerte en los CDD de muertes intra-hospitalarias en la ciudad de Barquisimeto, Estado Lara, Venezuela. Entre julio de 1991 y junio de 1992, se identificaron todos los CDD con las características mencionadas, se trató de ubicar la historia clínica correspondiente a cada caso y cualquier otra información clínica pertinente. Se registraron 247 CDD elegibles y se ubicó información clínica adecuada en 136 casos (55%. Aplicando los criterios del Proyecto MONICA, se encontraron M-definitivo en 62 casos (45,6%, IM-probable en 31 casos (22,8% y No-IM en 43 casos (31,6%. Los resultados indican que existe un sobre registro de casos de muerte por IM del 32% (intervalo de confianza del 95% = 23,8-39,4. A la luz de estos resultados es necesario estudiar los factores que inciden en la exactitud de los diagnósticos IM en los CDD. Con esto tendríamos elementos para revisar las normas y los procedimientos empleados en la producción y manejo de los CDD, así como preparar un programa de educación para mejorar la precisión de los mismos.Death rates due to Ischemic Heart Disease (IHD are widely used to assess regional and national cardiovascular health status. However, their validity is questionable, essentially because they are based on death certificates (DCs. The present study was conducted in the Greater Metropolitan Area of Barquisimeto (Lara State, Venezuela, from June 1991 to July 1992. The purpose was to establish the validity of the diagnosis of myocardial infarction in DCs of intrahospital deaths. Efforts were made to locate all clinical charts and any

Accidents and undetermined deaths: re-evaluation of nationwide samples from the Scandinavian countries.

Science.gov (United States)

Tøllefsen, Ingvild Maria; Thiblin, Ingemar; Helweg-Larsen, Karin; Hem, Erlend; Kastrup, Marianne; Nyberg, Ullakarin; Rogde, Sidsel; Zahl, Per-Henrik; Østevold, Gunvor; Ekeberg, Øivind

2016-05-27

National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts

78 FR 13861 - Export Trade Certificate of Review

Science.gov (United States)

2013-03-01

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 85-17A18] Export Trade Certificate of Review ACTION: Notice of Issuance of an Amended Export Trade Certificate of Review to U.S..., Office of Competition and Economic Analysis (OCEA), has issued an amended Export Trade Certificate of...

77 FR 61744 - Export Trade Certificate of Review

Science.gov (United States)

2012-10-11

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 10-3A001] Export Trade Certificate of Review ACTION: Notice of Issuance of an Export Trade Certificate of Review to Alaska Longline... Commerce issued an amended Export Trade Certificate of Review to the Alaska Longline Cod Commission (``ALCC...

78 FR 25060 - Export Trade Certificate of Review

Science.gov (United States)

2013-04-29

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 92-11A001] Export Trade Certificate of Review ACTION: Notice of Issuance of an amended Export Trade Certificate of Review to Aerospace... issued an amended Export Trade Certificate of Review to Aerospace Industries Association of America on...

13 CFR 120.611 - Pools backing Pool Certificates.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Pools backing Pool Certificates. 120.611 Section 120.611 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set...

78 FR 5778 - Export Trade Certificate of Review

Science.gov (United States)

2013-01-28

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 92-11A01] Export Trade Certificate of Review ACTION: Notice of Application (92-11A01) to amend the Export Trade Certificate of Review... of Commerce, has received an application to amend an Export Trade Certificate of Review...

System certification: An alternative to package certification?

International Nuclear Information System (INIS)

Luna, R.E.; Jefferson, R.J.

1992-01-01

One precept of the current radioactive material transportation regulations is that the package is the primary protection for the public. A packaging is chosen to provide containment, shielding, and criticality control suitable to the quantity and characteristics of the radionuclide being transported. Occasionally, radioactive materials requiring transport are not of a mass or size that would allow the materials to be shipped in an appropriate packaging. This is a particular problem for materials that should be shipped in a Type B package, but because such packages are designed and certified for specific contents, the package is usually fairly expensive, available in relatively small numbers, and often requires a fairly long period to achieve certification or amended certification for new contents. Where the shipment to be made is relatively infrequent, there may be economic and time penalties that may hamper shipment or force the shipper into uneconomic or high risk options. However, there is recognition of such situations in the International Atomic Energy Agency (IAEA) regulations under the provisions for Special Arrangement

PMP Certification All-In-One Desk Reference For Dummies

CERN Document Server

Stackpole, Cynthia Snyder

2011-01-01

Be as prepared as possible to take the PMP certification exam The PMP certification is the most popular project management certification available, but also a very difficult certification to obtain with very demanding requirements. That's where this All-in-One reference comes in. Packed with valuable information for taking the exam, the nine books in one covers everything from the certification process to gathering information for the application and signing up to take the exam, as well as studying for the most pertinent parts of the Project Management Body of Knowledge (PMBOK), and review que

Temporal correlation between opiate seizures in East/Southeast Asia and B.C. heroin deaths: a transoceanic model of heroin death risk.

Science.gov (United States)

McLean, Mark E

2003-01-01

Because heroin supply changes cannot be measured directly, their impact on populations is poorly understood. British Columbia has experienced an injection drug use epidemic since the 1980s that resulted in 2,590 illicit drug deaths from 1990-1999. Since previous work indicates heroin seizures can correlate with supply and B.C. receives heroin only from Southeast Asia, this study examined B.C. heroin deaths against opiate seizures in East/Southeast Asia. Opiate seizures in East/Southeast Asia and data from two B.C. mortality datasets containing heroin deaths were examined. The Pearson correlation coefficient for seizures against each mortality dataset was determined. Opiate seizures, all illicit drug deaths and all opiate deaths concurrently increased twice and decreased twice from 1989-1999, and all reached new peak values in 1993. Three B.C. sub-regions exhibited illicit drug deaths rate trends concurrent with the three principal datasets studied. The Pearson correlation coefficient for opiate-induced deaths against opiate seizures from 1980-1999 was R=0.915 (popiate seizures from 1987-1999 was R=0.896 (popiate seizures in East/Southeast Asia were very strongly correlated with B.C. opiate and illicit drug deaths. The number of B.C. heroin-related deaths may be strongly linked to heroin supply. Enforcement services are not effective in preventing harm caused by heroin in B.C.; therefore, Canada should examine other methods to prevent harm. The case for harm reduction is strengthened by the ineffectiveness of enforcement and the unlikelihood of imminent eradication of heroin production in Southeast Asia.

14 CFR 121.437 - Pilot qualification: Certificates required.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Pilot qualification: Certificates required... Pilot qualification: Certificates required. (a) No pilot may act as pilot in command of an aircraft (or... pilots) unless he holds an airline transport pilot certificate and an appropriate type rating for that...

77 FR 28853 - Export Trade Certificate of Review

Science.gov (United States)

2012-05-16

... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 10-2A001] Export Trade Certificate of Review ACTION: Notice of issuance of an Export Trade Certificate of Review to Alaska Longline... Export Trade Certificate of Review Alaska Longline Cod Commission (``ALCC'') on May 7, 2012. This is the...

46 CFR 115.910 - Passenger Ship Safety Certificate.

Science.gov (United States)

2010-10-01

...) The route specified on the Certificate of Inspection and the SOLAS Passenger Ship Safety Certificate... 46 Shipping 4 2010-10-01 2010-10-01 false Passenger Ship Safety Certificate. 115.910 Section 115... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS INSPECTION AND...

49 CFR 179.11 - Welding certification.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Welding certification. 179.11 Section 179.11 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... Design Requirements § 179.11 Welding certification. (a) Welding procedures, welders and fabricators shall...

THE THIRD PARTY CERTIFICATION SYSTEM FOR ORGANIC PRODUCTS

Directory of Open Access Journals (Sweden)

Adina-Roxana MUNTEANU

2015-12-01

Full Text Available In the context of an increasing organic trade worldwide, the organic standards and the certification of the organic practices are ever more important and relevant for both business and consumers. The certification by third parties of the organic operators is meant to ensure the application of an organic standard. However, the documented fraud cases are proof that the current system can undergo further improvement. The current paper gives an overview of the mechanisms of certification and inspection worldwide and discusses the issues raised by third party certification of the organic operators in the European context. Moreover, the paper reviews the major arguments for the effectiveness of the third party certification and also points to the improvement possibilities of the systems.

Certification of a weld produced by friction stir welding

Science.gov (United States)

Obaditch, Chris; Grant, Glenn J

2013-10-01

Methods, devices, and systems for providing certification of friction stir welds are disclosed. A sensor is used to collect information related to a friction stir weld. Data from the sensor is compared to threshold values provided by an extrinsic standard setting organizations using a certification engine. The certification engine subsequently produces a report on the certification status of the weld.

Cylindromatosis mediates neuronal cell death in vitro and in vivo.

Science.gov (United States)

Ganjam, Goutham K; Terpolilli, Nicole Angela; Diemert, Sebastian; Eisenbach, Ina; Hoffmann, Lena; Reuther, Christina; Herden, Christiane; Roth, Joachim; Plesnila, Nikolaus; Culmsee, Carsten

2018-01-19

The tumor-suppressor cylindromatosis (CYLD) is a deubiquitinating enzyme and key regulator of cell proliferation and inflammation. A genome-wide siRNA screen linked CYLD to receptor interacting protein-1 (RIP1) kinase-mediated necroptosis; however, the exact mechanisms of CYLD-mediated cell death remain unknown. Therefore, we investigated the precise role of CYLD in models of neuronal cell death in vitro and evaluated whether CYLD deletion affects brain injury in vivo. In vitro, downregulation of CYLD increased RIP1 ubiquitination, prevented RIP1/RIP3 complex formation, and protected neuronal cells from oxidative death. Similar protective effects were achieved by siRNA silencing of RIP1 or RIP3 or by pharmacological inhibition of RIP1 with necrostatin-1. In vivo, CYLD knockout mice were protected from trauma-induced brain damage compared to wild-type littermate controls. These findings unravel the mechanisms of CYLD-mediated cell death signaling in damaged neurons in vitro and suggest a cell death-mediating role of CYLD in vivo.

7 CFR 1250.530 - Certification of exempt producers.

Science.gov (United States)

2010-01-01

... section 2103 of the Organic Foods Production Act of 1990 (7 U.S.C. 6502), a signed certification that the... 7 Agriculture 10 2010-01-01 2010-01-01 false Certification of exempt producers. 1250.530 Section... RESEARCH AND PROMOTION Rules and Regulations Registration, Certification and Reports § 1250.530...

29 CFR 570.12 - Revoked certificates of age.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Revoked certificates of age. 570.12 Section 570.12 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS CHILD LABOR REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION Certificates of Age § 570.12 Revoked certificates of age...

46 CFR 176.910 - Passenger Ship Safety Certificate.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Passenger Ship Safety Certificate. 176.910 Section 176... 100 GROSS TONS) INSPECTION AND CERTIFICATION International Convention for Safety of Life at Sea, 1974, as Amended (SOLAS) § 176.910 Passenger Ship Safety Certificate. (a) A vessel, which carries more than...

Medical Certification System -

Data.gov (United States)

Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

5th international conference on certification and standardization in NDT

International Nuclear Information System (INIS)

2007-01-01

This CD-ROM contains 30 lectures (in form of manuscripts or abstracts) and 6 posters with the following topics: 1. Some Critical Remarks from German Chemical Industry on Certification and Accreditation in NDT. 2. Global Impact of International Standard ISO 9712. 3. Maintaining Concurrent Compliance with Multiple NDT Personnel Certification Standards. 4. The Revision of the New Approach. 5. Comparison between prEN 473 Currently Submitted to Formal Vote and ISO 9712:2005. 6. Accreditation and Certification - a Contradiction?. 7. The Way We Were. 8. EFNDT-Question-Data-Bank (QDB). 9. NDT Certification in Turkey as an European Country- How It Couldn't Work as the Only Example?. 10. Validation of Practical Examination Specimens. 11. Examination Bank Structure for Radiographic Testing (RT) - An Example. 12. About the New Classification of NDT Methods Based on Positions of Risks and Equipment Life Assessment. 13. Olympus NDT Training Academy. 14. Harmonisation of Personnel Certification Schemes for Non-destructive Testing in the Asia-Pacific Region. 15. How EFNDT Can Help in Accreditation or Recognition/Approval of NDT Certification Bodies? 16. SNT-TC-1A - 40 Years of Employer Certification for NDT Personnel. 17. The Same NDT Certification Scheme for Everybody: a Dream or a Need. 18. 19. Personnel Certification for Thermographers - Status and Trends. 20. Guided Wave Training and Certification. 21. Examination Radiographs and Master Reports for the Industrial Sectors 6 and 7. 22. New Standards ISO 24497 on the Metal Magnetic Memory Method. The Program of Personnel Training and Certification. 23. The Use of the Psychometrics in NDT Certification Programs. 24. EFNDT Guidelines ''Overall NDT Quality System''. 25. The Role of the Forum for National Aerospace NDT Boards. 26. Don't Forget, We Are Supposed to Be Representing Industry. 27. Don't Forget, We Are Supposed to Be Representing Industry. 28. The Need for Standardization in NDT Personnel Certification. 29. NDT

40 CFR 86.007-30 - Certification.

Science.gov (United States)

2010-07-01

... of its franchise agreement with the manufacturer and the dealer certification requirements of § 85... contrary to the terms of its franchise agreement with the manufacturer and the dealer certification... part because a manufacturer has located its facility in a foreign jurisdiction where local law...

5 CFR 430.404 - Certification criteria.

Science.gov (United States)

2010-01-01

... MANAGEMENT Performance Appraisal Certification for Pay Purposes § 430.404 Certification criteria. (a) To be... system(s) must provide for the following: (1) Alignment, so that the performance expectations for... that the performance expectations for senior employees meet the requirements of 5 CFR part 430...

29 CFR 1926.29 - Acceptable certifications.

Science.gov (United States)

2010-07-01

... Acceptable certifications. (a) Pressure vessels. Current and valid certification by an insurance company or... by an insurance company or regulatory authority attesting to the safe installation, inspection, and... types of pressure vessels and similar equipment are contained in subparts F and O of this part. ...

Solid low-level waste certification strategy

International Nuclear Information System (INIS)

Smith, M.A.

1991-08-01

The purpose of the Solid Low-Level Waste (SLLW) Certification Program is to provide assurance that SLLW generated at the ORNL meets the applicable waste acceptance criteria for those facilities to which the waste is sent for treatment, handling, storage, or disposal. This document describes the strategy to be used for certification of SLLW or ORNL. The SLLW Certification Program applies to all ORNL operations involving the generation, shipment, handling, treatment, storage and disposal of SLLW. Mixed wastes, containing both hazardous and radioactive constituents, and transuranic wastes are not included in the scope of this document. 13 refs., 3 figs

15 CFR 50.60 - Request for certification.

Science.gov (United States)

2010-01-01

... set cost of the product (one certificate). Certification fees may increase somewhat if the customer.... These governmental units include a variety of legally defined general- and special-purpose governmental...

[Optimization of registry of deaths from chronic kidney disease in agricultural communities in Central America].

Science.gov (United States)

Escamilla-Cejudo, José Antonio; Báez, Jorge Lara; Peña, Rodolfo; Luna, Patricia Lorena Ruiz; Ordunez, Pedro

2016-11-01

Several Central American countries are seeing continued growth in the number of deaths from chronic kidney disease of nontraditional causes (CKDnT) among farm workers and there is underreporting. This report presents the results of a consensus process coordinated by the Pan American Health Organization/World Health Organization (PAHO/WHO), the United States Centers for Disease Control and Prevention (CDC), and the Latin American Society of Nephrology and Hypertension (SLANH). This consensus seeks to increase the probability of detecting and recording deaths from these causes. There has been recognition of the negative impact of the lack of a standardized instrument and the lack of training in the medical profession for adequate registration of the cause or causes of death. As a result of the consensus, the following has been proposed: temporarily use a code from the Codes for Special Purposes in the International Classification of Diseases (ICD-10); continue to promote use of the WHO international standardized instrument for recording causes and preceding events related to death; increase training of physicians responsible for filling out death certificates; take action to increase the coverage and quality of information on mortality; and create a decision tree to facilitate selection of CKDnT as a specific cause of death, while presenting the role that different regional and subregional mechanisms in the Region of the Americas should play in order to improve CKD and CKDnT mortality records.

The electricity certificate system, 2007

Energy Technology Data Exchange (ETDEWEB)

2007-07-01

The electricity certificate system is a market based support system to assist the expansion of electricity production in Sweden from renewable energy sources and peat. Its objective is to increase the production of electricity from such sources by 17 TWh by 2016 relative to the production level in 2002. It is part of the country's overall objective of moving Sweden towards a more ecologically sustainable energy system. This report describes the market status of the electricity certificate system, and includes statistics from 2003 to 2006. It is our aim to create a forum for continuously developing the statistical material and analyses, in order to assist those involved in the market, and all other interested persons, to follow achievement of the objectives set out in the Government's Bill No. 2005/06:154, Renewable Electricity with Green Certificates. It is also our aim that, in future, each issue of the report should include a more in depth theme article on some particular subject. This year the report provides expanded information and statistics on wind power. Electricity certificates are issued to those who produce electricity from various renewable energy sources, and from peat, and who have had their production plants approved by the Swedish Energy Agency. To date, certificates have been issued to producers of electricity from biofuels and peat, wind power, hydro power and solar energy. Production from the renewable sources amounted to 11.6 TWh in 2006, which is 5.1 TWh more than corresponding production in 2002

Representations of Death in a Changing World: An Anthropological Perusal of Death Rites of Gurungs in Nepal

Directory of Open Access Journals (Sweden)

Prakash Upadhyay

2015-12-01

Full Text Available People have developed ceremonies and rituals to help make sense or celebrate an alteration in position, circumstance or relationship. However, over time some have become diluted or rejected for whom they are intended. In majority of cultures, the greatest effort is given to the death rite of passage– and yet paradoxically it is the one that is now most often distorted or lost. This study attempted to describe the multiple aspects of changes that are occurring in Gurung death rite. Gurungs are followers of ‘Bonism’ but they are under the profound influence of Tibetan Mahayani Lamaism. Gurung community is changing from Mechanical to Organic Solidarity in which the Mechanical Unity of their traditional culture is transforming to loosely united Organic Solidarity of body. Gurung death rites have been influenced by many rudiments--migration, urbanization and modernization due to which there has been the emergence of deformed usages and behaviors in death rite. Urbanization impact on death rite is closely linked to modernization and the sociological process of rationalization, a speedy and historic transformation of Gurung social roots whereby predominantly rural Gurung culture is being rapidly modified by urban ostentatious culture. However, there is very vital element of unity, cooperation, sympathy and we feeling among the Gurungs owing to death rite that has tied all Gurungs under a shared and endorsed bond. It has created a reciprocal relationship between the living and dead-- both depending upon each other. Death rituals have been a means of co-ordination creating solidarity through ‘Syaisyai’ which is a social institution for uniting the Gurungs. This bond between giver and gift, the act of giving creates a social bond in Gurung community with an obligation to reciprocate on part of the recipient.

Causes of Death among AIDS Patients after Introduction of Free Combination Antiretroviral Therapy (cART) in Three Chinese Provinces, 2010-2011.

Science.gov (United States)

Wang, Liyan; Ge, Lin; Wang, Lu; Morano, Jamie P; Guo, Wei; Khoshnood, Kaveh; Qin, Qianqian; Ding, Zhengwei; Sun, Dingyong; Liu, Xiaoyan; Luo, Hongbing; Tillman, Jonas; Cui, Yan

2015-01-01

Although AIDS-related deaths have had significant economic and social impact following an increased disease burden internationally, few studies have evaluated the cause of AIDS-related deaths among patients with AIDS on combination anti-retroviral therapy (cART) in China. This study examines the causes of death among AIDS-patients in China and uses a methodology to increase data accuracy compared to the previous studies on AIDS-related mortality in China, that have taken the reported cause of death in the National HIV Registry at face-value. Death certificates/medical records were examined and a cross-sectional survey was conducted in three provinces to verify the causes of death among AIDS patients who died between January 1, 2010 and June 30, 2011. Chi-square analysis was conducted to examine the categorical variables by causes of death and by ART status. Univariate and multivariate logistic regression were used to evaluate factors associated with AIDS-related death versus non-AIDS related death. This study used a sample of 1,109 subjects. The average age at death was 44.5 years. AIDS-related deaths were significantly higher than non-AIDS and injury-related deaths. In the sample, 41.9% (465/1109) were deceased within a year of HIV diagnosis and 52.7% (584/1109) of the deceased AIDS patients were not on cART. For AIDS-related deaths (n = 798), statistically significant factors included CD4 count causes compared to those who didn't initiate ART at all.

21 CFR 1311.20 - Coordinators for CSOS digital certificate holders.

Science.gov (United States)

2010-04-01

... application that the DEA Certification Authority provides and submit the following: (1) Two copies of... Certification Authority, all digital certificate activities are the responsibility of the registrant with whom... designated, coordinators must identify themselves, on a one-time basis, to the Certification Authority. If a...

The electricity certificate system, 2009

Energy Technology Data Exchange (ETDEWEB)

Joehnemark, Maria; Oestberg, Roger; Johansson, Martin

2009-07-01

Over the years, the electricity certificate system has been maturing and consolidating, so that it is today an effective and functional policy measure that has won wide acceptance from all parties concerned. The long term approach and security of the system are attracting an increasing number of investors, which is described more fully in this report. This year's special theme chapter, Investing in Renewable Energy, presents the status of the system from an investment point of view. In addition to this chapter, the report includes, as always, an introduction to how the certificate system works, together with an updating with the latest statistics. A quick glance at external factors that can affect the system indicates that there are several that may do so in the future. Just the fact that the climate problem is still high on the political agenda, despite strong competition from economic crises, shows that there is a need for more renewable energy. The EU Renewable Energy Directive, which was adopted at the end of 2008, requires the Swedish energy system to deliver 49 % of its output from renewable sources by 2020. In addition, the Energy Bill adopted by the Swedish Parliament identifies the electricity certificate system as one of the most important means of achieving the country's objectives. Taken together, this indicates that there are many factors that will further strengthen the role of the certificate system in the next few years. If we look at the system itself, we can see that a number of important changes have been made since the previous report. With effect from 1st January 2009, the definition of electricity-intensive industries has changed, bringing it more closely in line with the definition used in energy taxation. Since 1st May, the rules have changed concerning entitlement to a new allocation period of certificates after a plant has been substantially modified. In addition, certificates can now be allocated for increases in output from

General certification procedure of formation organizations

CERN Document Server

Int. At. Energy Agency, Wien

2002-01-01

This document presents the procedure dealing with the certification of formation organizations dispensing the formation and the risks prevention to the personnel of A or B category in nuclear facilities. This certification proves the organization ability to satisfy the ''F'' specification of the CEFRI. (A.L.B.)

9 CFR 93.913 - Health certificate.

Science.gov (United States)

2010-01-01

... who issues the health certificate. (2) Cleaning and disinfection must be sufficient to neutralize any VHS virus to which shipping containers may have been exposed. (3) The cleaning and disinfection protocols used must be referenced in the health certificate or in a separate cleaning and disinfection...

Zinc release contributes to hypoglycemia-induced neuronal death.

Science.gov (United States)

Suh, Sang Won; Garnier, Philippe; Aoyama, Koji; Chen, Yongmei; Swanson, Raymond A

2004-08-01

Neurons exposed to zinc exhibit activation of poly(ADP-ribose) polymerase-1 (PARP-1), an enzyme that normally participates in DNA repair but promotes cell death when extensively activated. Endogenous, vesicular zinc in brain is released to the extracellular space under conditions causing neuronal depolarization. Here, we used a rat model of insulin-induced hypoglycemia to assess the role of zinc release in PARP-1 activation and neuronal death after severe hypoglycemia. Zinc staining with N-(6-methoxy-8-quinolyl)-para-toluenesulfonamide (TSQ) showed depletion of presynaptic vesicular zinc from hippocampal mossy fiber terminals and accumulation of weakly bound zinc in hippocampal CA1 cell bodies after severe hypoglycemia. Intracerebroventricular injection of the zinc chelator calcium ethylene-diamine tetraacetic acid (CaEDTA) blocked the zinc accumulation and significantly reduced hypoglycemia-induced neuronal death. CaEDTA also attenuated the accumulation of poly(ADP-ribose), the enzymatic product of PARP-1, in hippocampal neurons. These results suggest that zinc translocation is an intermediary step linking hypoglycemia to PARP-1 activation and neuronal death.

40 CFR 94.210 - Amending the application and certificate of conformity.

Science.gov (United States)

2010-07-01

... certificate of conformity. 94.210 Section 94.210 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Certification Provisions § 94.210 Amending the application and certificate of conformity. (a) The manufacturer... for certification are to be made to a product line covered by a certificate of conformity. This...

Methodologies for certification of transuranic waste packages

International Nuclear Information System (INIS)

Christensen, R.N.; Kok, K.D.

1980-10-01

The objective of this study was to postulate methodologies for certification that a waste package is acceptable for disposal in a licensed geologic repository. Within the context of this report, certification means the overall process which verifies that a waste package meets the criteria or specifications established for acceptance for disposal in a repository. The overall methodology for certification will include (1) certifying authorities, (2) tests and procedures, and (3) documentation and quality assurance programs. Each criterion will require a methodology that is specific to that criterion. In some cases, different waste forms will require a different methodology. The purpose of predicting certification methodologies is to provide additional information as to what changes, if any, are needed for the TRU waste in storage

Cerebrovascular and hypertensive diseases as multiple causes of death in Brazil from 2004 to 2013.

Science.gov (United States)

Villela, P B; Klein, C H; Oliveira, G M M

2018-06-02

The proportion of deaths attributed to hypertensive diseases (HYPDs) was only 50% of that registered for cerebrovascular diseases (CBVDs) in 2013 in Brazil. This article aims to evaluate mortality related to HYPDs and CBVDs as multiple causes of death, in Brazil from 2004 to 2013. Analysis of historical series of secondary data obtained from Brazilian official registries. Data about the deaths were obtained from the Mortality Information System of the Brazilian Ministry of Health, available on the DATASUS website. CBVDs and HYPDs were evaluated according to their mentions as the underlying cause of death or entry in any line of the death certificates (DCs), according to their International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. When CBVDs were the underlying causes of death, HYPDs were mentioned in 40.9% of the DCs. When HYPDs were the underlying causes of death, CBVDs were mentioned in only 5.0%. When CBVDs were mentioned without HYPDs, they were selected as the underlying cause of death 74.4% of the time. When HYPDs were mentioned in DCs without CBVDs, HYPDs were selected 30.0% of the time. In 2004, the frequency of any mention of HYPDs relative to the frequency of HYPDs cited as underlying causes increased fourfold and was followed by a plateau until 2013. In contrast, the frequency of any mention of CBVDs relative to the frequency of CBVDs as underlying causes decreased in the same period. Because this study was based on DC records, it was limited by the way these documents were completed, which may have included lack of record of the causes related to the sequence that culminated in death. When deaths related to HYPDs were evaluated as multiple causes of death, they were mentioned up to four times more often than when they were selected as underlying causes of death. This reinforces the need for better control of hypertension to prevent deaths. Copyright © 2018 The Royal Society for Public Health. Published by

40 CFR 91.122 - Amending the application and certificate of conformity.

Science.gov (United States)

2010-07-01

... certificate of conformity. 91.122 Section 91.122 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Standards and Certification Provisions § 91.122 Amending the application and certificate of conformity. (a... to a certificate of conformity or changes are to be made to a product line covered by a certificate...

Access control based on attribute certificates for medical intranet applications.

Science.gov (United States)

Mavridis, I; Georgiadis, C; Pangalos, G; Khair, M

2001-01-01

Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy.

Overview of the DOE packaging certification process

Energy Technology Data Exchange (ETDEWEB)

Liu, Y.Y.; Carlson, R.D. [Argonne National Lab., IL (United States); Carlson, R.W. [Lawrence Livermore National Lab., CA (United States); Kapoor, A. [USDOE, Washington, DC (United States)

1995-12-31

This paper gives an overview of the DOE packaging certification process, which is implemented by the Office of Facility Safety Analysis, under the Assistance Secretary for Environment, Safety and Health, for packagings that are not used for weapons and weapons components, nor for naval nuclear propulsion. The overview will emphasize Type B packagings and the Safety Analysis Report for Packaging (SARP) review that parallels the NRC packaging review. Other important elements in the DOE packaging certification program, such as training, methods development, data bases, and technical assistance, are also emphasized, because they have contributed significantly to the improvement of the certification process since DOE consolidated its packaging certification function in 1985. The paper finishes with a discussion of the roles and functions of the DOE Packaging Safety Review Steering Committee, which is chartered to address issues and concerns of interest to the DOE packaging and transportation safety community. Two articles related to DOE packaging certification were published earlier on the SARP review procedures and the DOE Packaging Review Guide. These articles may be consulted for additional information.

49 CFR 172.204 - Shipper's certification.

Science.gov (United States)

2010-10-01

... the certification the words “herein-named” may be substituted for the words “above-named”. (2) “I... respects in proper condition for transport according to applicable international and national governmental... national governmental regulations. Note to paragraph (c)(1): In the certification, the word “packed” may be...

34 CFR 34.21 - Employer certification.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Employer certification. 34.21 Section 34.21 Education Office of the Secretary, Department of Education ADMINISTRATIVE WAGE GARNISHMENT § 34.21 Employer... by the Secretary of the Treasury. (b) The employer must complete and return the certification to us...