Value Systems Alignment Analysis in Collaborative Networked Organizations Management

Directory of Open Access Journals (Sweden)

Patricia Macedo

2017-11-01

Full Text Available The assessment of value systems alignment can play an important role in the formation and evolution of collaborative networks, contributing to reduce potential risks of collaboration. For this purpose, an assessment tool is proposed as part of a collaborative networks information system, supporting both the formation and evolution of long-term strategic alliances and goal-oriented networks. An implementation approach for value system alignment analysis is described, which is intended to assist managers in virtual and networked organizations management. The implementation of the assessment and analysis methods is supported by a set of software services integrated in the information system that supports the management of the networked organizations. A case study in the solar energy sector was conducted, and the data collected through this study allow us to confirm the practical applicability of the proposed methods and the software services.

National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity

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Gülmezoglu A Metin

2005-12-01

Full Text Available Abstract Background Despite the worldwide commitment to improving maternal health, measuring, monitoring and comparing maternal mortality estimates remain a challenge. Due to lack of data, international agencies have to rely on mathematical models to assess its global burden. In order to assist in mapping the burden of reproductive ill-health, we conducted a systematic review of incidence/prevalence of maternal mortality and morbidity. Methods We followed the standard methodology for systematic reviews. This manuscript presents nationally representative estimates of maternal mortality derived from the systematic review. Using regression models, relationships between study-specific and country-specific variables with the maternal mortality estimates are explored in order to assist further modelling to predict maternal mortality. Results Maternal mortality estimates included 141 countries and represent 78.1% of the live births worldwide. As expected, large variability between countries, and within regions and subregions, is identified. Analysis of variability according to study characteristics did not yield useful results given the high correlation with each other, with development status and region. A regression model including selected country-specific variables was able to explain 90% of the variability of the maternal mortality estimates. Among all country-specific variables selected for the analysis, three had the strongest relationships with maternal mortality: proportion of deliveries assisted by a skilled birth attendant, infant mortality rate and health expenditure per capita. Conclusion With the exception of developed countries, variability of national maternal mortality estimates is large even within subregions. It seems more appropriate to study such variation through differentials in other national and subnational characteristics. Other than region, study of country-specific variables suggests infant mortality rate, skilled birth

Measuring user similarity using electric circuit analysis: application to collaborative filtering.

Science.gov (United States)

Yang, Joonhyuk; Kim, Jinwook; Kim, Wonjoon; Kim, Young Hwan

2012-01-01

We propose a new technique of measuring user similarity in collaborative filtering using electric circuit analysis. Electric circuit analysis is used to measure the potential differences between nodes on an electric circuit. In this paper, by applying this method to transaction networks comprising users and items, i.e., user-item matrix, and by using the full information about the relationship structure of users in the perspective of item adoption, we overcome the limitations of one-to-one similarity calculation approach, such as the Pearson correlation, Tanimoto coefficient, and Hamming distance, in collaborative filtering. We found that electric circuit analysis can be successfully incorporated into recommender systems and has the potential to significantly enhance predictability, especially when combined with user-based collaborative filtering. We also propose four types of hybrid algorithms that combine the Pearson correlation method and electric circuit analysis. One of the algorithms exceeds the performance of the traditional collaborative filtering by 37.5% at most. This work opens new opportunities for interdisciplinary research between physics and computer science and the development of new recommendation systems.

Measuring user similarity using electric circuit analysis: application to collaborative filtering.

Directory of Open Access Journals (Sweden)

Joonhyuk Yang

Full Text Available We propose a new technique of measuring user similarity in collaborative filtering using electric circuit analysis. Electric circuit analysis is used to measure the potential differences between nodes on an electric circuit. In this paper, by applying this method to transaction networks comprising users and items, i.e., user-item matrix, and by using the full information about the relationship structure of users in the perspective of item adoption, we overcome the limitations of one-to-one similarity calculation approach, such as the Pearson correlation, Tanimoto coefficient, and Hamming distance, in collaborative filtering. We found that electric circuit analysis can be successfully incorporated into recommender systems and has the potential to significantly enhance predictability, especially when combined with user-based collaborative filtering. We also propose four types of hybrid algorithms that combine the Pearson correlation method and electric circuit analysis. One of the algorithms exceeds the performance of the traditional collaborative filtering by 37.5% at most. This work opens new opportunities for interdisciplinary research between physics and computer science and the development of new recommendation systems.

Collective Competence and Social Capital Analysis in Collaborative Networks

Directory of Open Access Journals (Sweden)

Janaina Macke

2010-06-01

Full Text Available The present paper addresses the issue of collective competence and social capital analysis for collaborative networks. The objective of the project is to understand how collaborative networks can be influenced considering the perspective of social capital and core competences. In this model we defend the emphasis on endogenous resources, once the technology is, in a general way, accessible to most of the companies and, therefore will not be a long term competitive advantage. The model shows that collaborative networks will be more competitive and successful if they invest in to core elements that are: organizational culture and people. Therefore, the model contributes for the researches in socio-organizational filed and provides a tool to evaluate collaborative networks.

Analysis of cerebrovascular mortality trends in Spain from 1980 to 2011.

Science.gov (United States)

Cayuela, A; Cayuela, L; Escudero-Martínez, I; Rodríguez-Domínguez, S; González, A; Moniche, F; Jiménez, M D; Montaner, J

2016-01-01

In recent decades, mortality rates for cerebrovascular diseases (CVD) have declined significantly in many countries. This study analyses changes in CVD mortality rates in Spain (1980-2011) to determine if previously observed trends remain. Data on CVD mortality rates and the population data needed for the analysis were provided by Spain's National Statistics Institute. We calculated age-specific mortality rate, age-standardised overall mortality, and age-truncated mortality (35-64 years) using the direct method and standard European population structure. Joinpoint analysis was used to estimate the percentage of annual change in rates and identify significant changes in trends. CVD mortality rate decreased considerably and continuously over the last 32 years in all age groups and in both sexes in Spain. For both sexes, joinpoint analysis identifies a final period with more marked decline: 2005-2011 in women (-6.3%) and 2007-2011 in men (-7.2%). CVD mortality rates displayed a marked and continuous decline in Spain between 1980 and 2011. Due to the ageing of the population, doctors expect an increase in CVD prevalence and therefore its magnitude in terms of disability and healthcare costs, which poses a challenge to our health system. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Principles and tools for collaborative entity-based intelligence analysis.

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Bier, Eric A; Card, Stuart K; Bodnar, John W

2010-01-01

Software tools that make it easier for analysts to collaborate as a natural part of their work will lead to better analysis that is informed by more perspectives. We are interested to know if software tools can be designed that support collaboration even as they allow analysts to find documents and organize information (including evidence, schemas, and hypotheses). We have modified the Entity Workspace system, described previously, to test such designs. We have evaluated the resulting design in both a laboratory study and a study where it is situated with an analysis team. In both cases, effects on collaboration appear to be positive. Key aspects of the design include an evidence notebook optimized for organizing entities (rather than text characters), information structures that can be collapsed and expanded, visualization of evidence that emphasizes events and documents (rather than emphasizing the entity graph), and a notification system that finds entities of mutual interest to multiple analysts. Long-term tests suggest that this approach can support both top-down and bottom-up styles of analysis.

Applying an Activity System to Online Collaborative Group Work Analysis

Science.gov (United States)

Choi, Hyungshin; Kang, Myunghee

2010-01-01

This study determines whether an activity system provides a systematic framework to analyse collaborative group work. Using an activity system as a unit of analysis, the research examined learner behaviours, conflicting factors and facilitating factors while students engaged in collaborative work via asynchronous computer-mediated communication.…

Analysis of underlying and multiple-cause mortality data.

Science.gov (United States)

Moussa, M A; El Sayed, A M; Sugathan, T N; Khogali, M M; Verma, D

1992-01-01

"A variety of life table models were used for the analysis of the (1984-86) Kuwaiti cause-specific mortality data. These models comprised total mortality, multiple-decrement, cause-elimination, cause-delay and disease dependency. The models were illustrated by application to a set of four chronic diseases: hypertensive, ischaemic heart, cerebrovascular and diabetes mellitus. The life table methods quantify the relative weights of different diseases as hazards to mortality after adjustment for other causes. They can also evaluate the extent of dependency between underlying cause of death and other causes mentioned on [the] death certificate using an extended underlying-cause model." (SUMMARY IN FRE AND ITA) excerpt

Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014).

Science.gov (United States)

Cayuela, A; Cayuela, L; Rodríguez-Domínguez, S; González, A; Moniche, F

2017-03-15

In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends. CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain. Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014). Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups. Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?

Science.gov (United States)

Yoo, Ri Na; Kye, Bong-Hyeon; Kim, Gun; Kim, Hyung Jin; Cho, Hyeon-Min

2017-10-01

Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

Sino-Canadian collaborations in stem cell research: a scientometric analysis.

Directory of Open Access Journals (Sweden)

Sarah E Ali-Khan

Full Text Available International collaboration (IC is essential for the advance of stem cell research, a field characterized by marked asymmetries in knowledge and capacity between nations. China is emerging as a global leader in the stem cell field. However, knowledge on the extent and characteristics of IC in stem cell science, particularly China's collaboration with developed economies, is lacking.We provide a scientometric analysis of the China-Canada collaboration in stem cell research, placing this in the context of other leading producers in the field. We analyze stem cell research published from 2006 to 2010 from the Scopus database, using co-authored papers as a proxy for collaboration. We examine IC levels, collaboration preferences, scientific impact, the collaborating institutions in China and Canada, areas of mutual interest, and funding sources. Our analysis shows rapid global expansion of the field with 48% increase in papers from 2006 to 2010. China now ranks second globally after the United States. China has the lowest IC rate of countries examined, while Canada has one of the highest. China-Canada collaboration is rising steadily, more than doubling during 2006-2010. China-Canada collaboration enhances impact compared to papers authored solely by China-based researchers This difference remained significant even when comparing only papers published in English.While China is increasingly courted in IC by developed countries as a partner in stem cell research, it is clear that it has reached its status in the field largely through domestic publications. Nevertheless, IC enhances the impact of stem cell research in China, and in the field in general. This study establishes an objective baseline for comparison with future studies, setting the stage for in-depth exploration of the dynamics and genesis of IC in stem cell research.

Sino-Canadian collaborations in stem cell research: a scientometric analysis.

Science.gov (United States)

Ali-Khan, Sarah E; Ray, Monali; McMahon, Dominique S; Thorsteinsdóttir, Halla

2013-01-01

International collaboration (IC) is essential for the advance of stem cell research, a field characterized by marked asymmetries in knowledge and capacity between nations. China is emerging as a global leader in the stem cell field. However, knowledge on the extent and characteristics of IC in stem cell science, particularly China's collaboration with developed economies, is lacking. We provide a scientometric analysis of the China-Canada collaboration in stem cell research, placing this in the context of other leading producers in the field. We analyze stem cell research published from 2006 to 2010 from the Scopus database, using co-authored papers as a proxy for collaboration. We examine IC levels, collaboration preferences, scientific impact, the collaborating institutions in China and Canada, areas of mutual interest, and funding sources. Our analysis shows rapid global expansion of the field with 48% increase in papers from 2006 to 2010. China now ranks second globally after the United States. China has the lowest IC rate of countries examined, while Canada has one of the highest. China-Canada collaboration is rising steadily, more than doubling during 2006-2010. China-Canada collaboration enhances impact compared to papers authored solely by China-based researchers This difference remained significant even when comparing only papers published in English. While China is increasingly courted in IC by developed countries as a partner in stem cell research, it is clear that it has reached its status in the field largely through domestic publications. Nevertheless, IC enhances the impact of stem cell research in China, and in the field in general. This study establishes an objective baseline for comparison with future studies, setting the stage for in-depth exploration of the dynamics and genesis of IC in stem cell research.

Evaluation of Remote Collaborative Manipulation for Scientific Data Analysis

OpenAIRE

Fleury , Cédric; Duval , Thierry; Gouranton , Valérie; Steed , Anthony

2012-01-01

International audience; In the context of scientific data analysis, we propose to compare a remote collaborative manipulation technique with a single user manipulation technique. The manipulation task consists in positioning a clipping plane in order to perform cross-sections of scientific data which show several points of interest located inside this data. For the remote collaborative manipulation, we have chosen to use the 3-hand manipulation technique proposed by Aguerreche et al. which is...

Trend Analysis of Cancer Mortality and Incidence in Panama, Using Joinpoint Regression Analysis.

Science.gov (United States)

Politis, Michael; Higuera, Gladys; Chang, Lissette Raquel; Gomez, Beatriz; Bares, Juan; Motta, Jorge

2015-06-01

Cancer is one of the leading causes of death worldwide and its incidence is expected to increase in the future. In Panama, cancer is also one of the leading causes of death. In 1964, a nationwide cancer registry was started and it was restructured and improved in 2012. The aim of this study is to utilize Joinpoint regression analysis to study the trends of the incidence and mortality of cancer in Panama in the last decade. Cancer mortality was estimated from the Panamanian National Institute of Census and Statistics Registry for the period 2001 to 2011. Cancer incidence was estimated from the Panamanian National Cancer Registry for the period 2000 to 2009. The Joinpoint Regression Analysis program, version 4.0.4, was used to calculate trends by age-adjusted incidence and mortality rates for selected cancers. Overall, the trend of age-adjusted cancer mortality in Panama has declined over the last 10 years (-1.12% per year). The cancers for which there was a significant increase in the trend of mortality were female breast cancer and ovarian cancer; while the highest increases in incidence were shown for breast cancer, liver cancer, and prostate cancer. Significant decrease in the trend of mortality was evidenced for the following: prostate cancer, lung and bronchus cancer, and cervical cancer; with respect to incidence, only oral and pharynx cancer in both sexes had a significant decrease. Some cancers showed no significant trends in incidence or mortality. This study reveals contrasting trends in cancer incidence and mortality in Panama in the last decade. Although Panama is considered an upper middle income nation, this study demonstrates that some cancer mortality trends, like the ones seen in cervical and lung cancer, behave similarly to the ones seen in high income countries. In contrast, other types, like breast cancer, follow a pattern seen in countries undergoing a transition to a developed economy with its associated lifestyle, nutrition, and body weight

A Framework for Collaborative Networked Learning in Higher Education: Design & Analysis

Directory of Open Access Journals (Sweden)

Ghassan F. Issa

2014-06-01

Full Text Available This paper presents a comprehensive framework for building collaborative learning networks within higher educational institutions. This framework focuses on systems design and implementation issues in addition to a complete set of evaluation, and analysis tools. The objective of this project is to improve the standards of higher education in Jordan through the implementation of transparent, collaborative, innovative, and modern quality educational programs. The framework highlights the major steps required to plan, design, and implement collaborative learning systems. Several issues are discussed such as unification of courses and program of studies, using appropriate learning management system, software design development using Agile methodology, infrastructure design, access issues, proprietary data storage, and social network analysis (SNA techniques.

GaggleBridge: collaborative data analysis.

Science.gov (United States)

Battke, Florian; Symons, Stephan; Herbig, Alexander; Nieselt, Kay

2011-09-15

Tools aiding in collaborative data analysis are becoming ever more important as researchers work together over long distances. We present an extension to the Gaggle framework, which has been widely adopted as a tool to enable data exchange between different analysis programs on one computer. Our program, GaggleBridge, transparently extends this functionality to allow data exchange between Gaggle users at different geographic locations using network communication. GaggleBridge can automatically set up SSH tunnels to traverse firewalls while adding some security features to the Gaggle communication. GaggleBridge is available as open-source software implemented in the Java language at http://it.inf.uni-tuebingen.de/gb. florian.battke@uni-tuebingen.de Supplementary data are available at Bioinformatics online.

[Analysis of hospital mortality at a regional hospital].

Science.gov (United States)

Sánchez Bisonó, J R; Gómez Rosich, A; Amor Gea, J F; García Sánchez, M J; Campoy Domene, L F; Peña Migallón-Sánchez, P

1997-02-01

The hospital mortality rate in our centre es 2.34% (264 deaths from a total of 11,336 discharges between 1991 and 1993). The most frequent causes are acute myocardial infarction and cerebrovascular accidents, followed in descending order by pneumonia, chronic bronchitis, congestive heart failure, upper GI haemorrhage, GI tumours, liver cirrhosis, lung tumours and arrhythmias. Our analysis reflects a mortality pattern of a rural population with an age pyramid in which 52% of the patients are older than 45 years. The pattern also reflects the little impact of accidents on our mortality. A 87% of the deaths were older than 65 years with a male to female ratio of 1, 6 and a Swaroop index of 93% and 94% for males and females respectively.

Milrinone and mortality in adult cardiac surgery: a meta-analysis.

Science.gov (United States)

Zangrillo, Alberto; Biondi-Zoccai, Giuseppe; Ponschab, Martin; Greco, Massimiliano; Corno, Laura; Covello, Remo Daniel; Cabrini, Luca; Bignami, Elena; Melisurgo, Giulio; Landoni, Giovanni

2012-02-01

The authors conducted a review of randomized studies to show whether there are any increases or decreases in survival when using milrinone in patients undergoing cardiac surgery. A meta-analysis. Hospitals. Five hundred eighteen patients from 13 randomized trials. None. BioMedCentral, PubMed EMBASE, the Cochrane central register of clinical trials, and conference proceedings were searched for randomized trials that compared milrinone versus placebo or any other control in the setting of cardiac surgery that reported data on mortality. Overall analysis showed that milrinone increased perioperative mortality (13/249 [5.2%] in the milrinone group v 6/269 [2.2%] in the control arm, odds ratio [OR] = 2.67 [1.05-6.79], p for effect = 0.04, p for heterogeneity = 0.23, I(2) = 25% with 518 patients and 13 studies included). Subanalyses confirmed increased mortality with milrinone (9/84 deaths [10.7%] v 3/105 deaths [2.9%] with other drugs as control, OR = 4.19 [1.27-13.84], p = 0.02) with 189 patients and 5 studies included) but did not confirm a difference in mortality (4/165 [2.4%] in the milrinone group v 3/164 [1.8%] with placebo or nothing as control, OR = 1.27 [0.28-5.84], p = 0.76 with 329 patients and 8 studies included). This analysis suggests that milrinone might increase mortality in adult patients undergoing cardiac surgery. The effect was seen only in patients having an active inotropic drug for comparison and not in the placebo subgroup. Therefore, the question remains whether milrinone increased mortality or if the control inotropic drugs were more protective. Copyright © 2012 Elsevier Inc. All rights reserved.

Collaborative, Nondestructive Analysis of Contaminated Soil

Energy Technology Data Exchange (ETDEWEB)

Knight, K. B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Dai, Z. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Davidson, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Eppich, G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Lindvall, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Parsons-Davis, T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ramon, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Roberts, S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sharp, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Turin, H. J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); LaMont, S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Zidi, T. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Belamri, M. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Bounatiro, S. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Benbouzid, S. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Fellouh, A. S. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Idir, T. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Larbah, Y. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Moulay, M. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Noureddine, A. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France); Rahal, B. [Commissariat a l' Energie Atomique (COMENA), Gif-sur-Yvette (France)

2017-12-14

This report summarizes a joint nondestructive analysis exercise that LLNL, LANL, and COMENA discussed through a collaborative meeting in July 2017. This work was performed as one part of a collaboration with Algeria under Action Sheet 7: “Technical Cooperation and Assistance in Nuclear Forensics”. The primary intent of this exercise was for US and Algerian participants to jointly share results of nondestructive analyses (NDA) of a contaminated soil sample provided by the Algerians and to discuss key observations and analytical approaches. While the two samples were analyzed blind at LLNL and LANL, the soil samples were revealed after the exercise to have a common origin, and to have originated as an IAEA soil sample (IAEA-326, Bojanowski et al., 2001) provided to COMENA as part of a previous exercise. Comparative analysis revealed common findings between the laboratories, and also emphasized the need for standardized operating procedures to improve inter-comparability and confidence in conclusions. Recommended handling practices in the presence of sample heterogeneities were also discussed. This exercise provided an opportunity to demonstrate nuclear forensics analytical capabilities at COMENA, LANL, and LLNL, and identified areas that could benefit from future technical exchanges. Plans were made for a follow-on joint exercise in 2018, involving destructive analyses of the CUP-2 uranium ore concentrate standard.

Towards a Design Theory for Collaborative Qualitative Data Analysis

DEFF Research Database (Denmark)

Nielsen, Peter Axel

2016-01-01

This position paper addresses how to develop a design theory to support the collaborative practice of qualitative data analysis. Qualitative researchers face several challenges in making sense of their empirical data and IS-support for this practice can be found in software applications...... such as NVivo, Atlas.ti, and DeDoose. While these software tools have utility and are valuable, they are also limiting – and they are particularly limiting researchers in their collaborative efforts with their co-researchers. In this paper, we investigate a design theory to extend it to support collaboration....... We use this as a stepping stone to discuss how to use a design theory to problematize existing applications and how to extend a design theory by abduction....

Collaborative human-machine nuclear non-proliferation analysis

Energy Technology Data Exchange (ETDEWEB)

Greitzer, F.L.; Badalamente, R.V.; Stewart, T.S.

1993-10-01

The purpose of this paper is to report on the results of a project investigating support concepts for the information treatment needs of the International Atomic Energy Agency (IAEA, also referred to as the Agency) and its attempts to strengthen international safeguards. The aim of the research was to define user/computer interface concepts and intelligent support features that will enhance the analyst`s access to voluminous and diverse information, the ability to recognize and evaluate uncertain data, and the capability to make decisions and recommendations. The objective was to explore techniques for enhancing safeguards analysis through application of (1) more effective user-computer interface designs and (2) advanced concepts involving human/system collaboration. The approach was to identify opportunities for human/system collaboration that would capitalize on human strengths and still accommodate human limitations. This paper documents the findings and describes a concept prototype, Proliferation Analysis Support System (PASS), developed for demonstration purposes. The research complements current and future efforts to enhance the information systems used by the IAEA, but has application elsewhere, as well.

Data on cardiac defects, morbidity and mortality in patients affected by RASopathies. CARNET study results.

Science.gov (United States)

Calcagni, Giulio; Limongelli, Giuseppe; D'Ambrosio, Angelo; Gesualdo, Francesco; Digilio, Maria Cristina; Baban, Anwar; Albanese, Sonia B; Versacci, Paolo; De Luca, Enrica; Ferrero, Giovanni B; Baldassarre, Giuseppina; Agnoletti, Gabriella; Banaudi, Elena; Marek, Jan; Kaski, Juan P; Tuo, Giulia; Russo, Maria Giovanna; Pacileo, Giuseppe; Milanesi, Ornella; Messina, Daniela; Marasini, Maurizio; Cairello, Francesca; Formigari, Roberto; Brighenti, Maurizio; Dallapiccola, Bruno; Tartaglia, Marco; Marino, Bruno

2018-02-01

A comprehensive description of morbidity and mortality in patients affected by mutations in genes encoding for signal transducers of the RAS-MAPK cascade (RASopathies) was performed in our study recently published in the International Journal of Cardiology. Seven European cardiac centres participating to the CArdiac Rasopathy NETwork (CARNET), collaborated in this multicentric, observational, retrospective data analysis and collection. In this study, clinical records of 371 patients with confirmed molecular diagnosis of RASopathy were reviewed. Cardiac defects, crude mortality, survival rate of patients with 1) hypertrophic cardiomyopathy (HCM) and age Noonan syndrome and pulmonary stenosis carrying PTPN11 mutations; 3) biventricular obstruction and PTPN11 mutations; 4) Costello syndrome or cardiofaciocutaneous syndrome were analysed. Mortality was described as crude mortality, cumulative survival and restricted estimated mean survival. In particular, with this Data In Brief (DIB) paper, the authors aim to report specific statistic highlights of the multivariable regression analysis that was used to assess the impact of mutated genes on number of interventions and overall prognosis.

Analysis and Assessment of Computer-Supported Collaborative Learning Conversations

NARCIS (Netherlands)

Trausan-Matu, Stefan

2008-01-01

Trausan-Matu, S. (2008). Analysis and Assessment of Computer-Supported Collaborative Learning Conversations. Workshop presentation at the symposium Learning networks for professional. November, 14, 2008, Heerlen, Nederland: Open Universiteit Nederland.

Ciência & Saúde Coletiva: scientific production analysis and collaborative research networks.

Science.gov (United States)

Conner, Norma; Provedel, Attilio; Maciel, Ethel Leonor Noia

2017-03-01

The purpose of this metric and descriptive study was to identify the most productive authors and their collaborative research networks from articles published in Ciência & Saúde Coletiva between, 2005, and 2014. Authors meeting the cutoff criteria of at least 10 articles were considered the most productive authors. VOSviewer and Network Workbench technologies were applied for visual representations of collaborative research networks involving the most productive authors in the period. Initial analysis recovered 2511 distinct articles, with 8920 total authors with an average of 3.55 authors per article. Author analysis revealed 6288 distinct authors, 24 of these authors were identified as the most productive. These 24 authors generated 287 articles with an average of 4.31 authors per article, and represented 8 separate collaborative partnerships, the largest of which had 14 authors, indicating a significant degree of collaboration among these authors. This analysis provides a visual representation of networks of knowledge development in public health and demonstrates the usefulness of VOSviewer and Network Workbench technologies in future research.

Collaboration in sensor network research: an in-depth longitudinal analysis of assortative mixing patterns.

Science.gov (United States)

Pepe, Alberto; Rodriguez, Marko A

2010-09-01

Many investigations of scientific collaboration are based on statistical analyses of large networks constructed from bibliographic repositories. These investigations often rely on a wealth of bibliographic data, but very little or no other information about the individuals in the network, and thus, fail to illustrate the broader social and academic landscape in which collaboration takes place. In this article, we perform an in-depth longitudinal analysis of a relatively small network of scientific collaboration (N = 291) constructed from the bibliographic record of a research centerin the development and application of wireless and sensor network technologies. We perform a preliminary analysis of selected structural properties of the network, computing its range, configuration and topology. We then support our preliminary statistical analysis with an in-depth temporal investigation of the assortative mixing of selected node characteristics, unveiling the researchers' propensity to collaborate preferentially with others with a similar academic profile. Our qualitative analysis of mixing patterns offers clues as to the nature of the scientific community being modeled in relation to its organizational, disciplinary, institutional, and international arrangements of collaboration.

MedRate: a wearable against child mortality

CERN Document Server

CERN. Geneva

2018-01-01

In humanitarian environments, when treating the main causes of child mortality, there are two key vital constants not easily measurable: the heart beat of the foetus and respiration rate of children. During the CERN Medtech:Hack, my team came up with MedRate, an inexpensive wearable able to monitor both. Collaboration is required to make MedRate a reality. Would you join us for a more fair fight against child mortality?

Determinants of traffic accident mortality in The Netherlands: a geographical analysis

NARCIS (Netherlands)

van Beeck, E. F.; Mackenbach, J. P.; Looman, C. W.; Kunst, A. E.

1991-01-01

In the Netherlands, a country with one of the lowest levels of traffic accident mortality in the world, large regional mortality differences can be observed. An analysis was performed of the contribution of regional differences in traffic mobility (kilometers travelled/person-years), injury rate

Meta-analysis of individual registry results enhances international registry collaboration.

Science.gov (United States)

Paxton, Elizabeth W; Mohaddes, Maziar; Laaksonen, Inari; Lorimer, Michelle; Graves, Stephen E; Malchau, Henrik; Namba, Robert S; Kärrholm, John; Rolfson, Ola; Cafri, Guy

2018-03-28

Background and purpose - Although common in medical research, meta-analysis has not been widely adopted in registry collaborations. A meta-analytic approach in which each registry conducts a standardized analysis on its own data followed by a meta-analysis to calculate a weighted average of the estimates allows collaboration without sharing patient-level data. The value of meta-analysis as an alternative to individual patient data analysis is illustrated in this study by comparing the risk of revision of porous tantalum cups versus other uncemented cups in primary total hip arthroplasties from Sweden, Australia, and a US registry (2003-2015). Patients and methods - For both individual patient data analysis and meta-analysis approaches a Cox proportional hazard model was fit for time to revision, comparing porous tantalum (n = 23,201) with other uncemented cups (n = 128,321). Covariates included age, sex, diagnosis, head size, and stem fixation. In the meta-analysis approach, treatment effect size (i.e., Cox model hazard ratio) was calculated within each registry and a weighted average for the individual registries' estimates was calculated. Results - Patient-level data analysis and meta-analytic approaches yielded the same results with the porous tantalum cups having a higher risk of revision than other uncemented cups (HR (95% CI) 1.6 (1.4-1.7) and HR (95% CI) 1.5 (1.4-1.7), respectively). Adding the US cohort to the meta-analysis led to greater generalizability, increased precision of the treatment effect, and similar findings (HR (95% CI) 1.6 (1.4-1.7)) with increased risk of porous tantalum cups. Interpretation - The meta-analytic technique is a viable option to address privacy, security, and data ownership concerns allowing more expansive registry collaboration, greater generalizability, and increased precision of treatment effects.

Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

Science.gov (United States)

1996-11-23

To document the outcome of planned and unplanned births outside hospital. Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. Northern Regional Health Authority area. All 558,691 registered births to women normally resident in the former Northern Regional Health Authority area during 1981-94. Perinatal death. The estimated perinatal mortality during 1981-94 among women booked for a home birth was 14 deaths in 2888 births. This was less than half that among all women in the region. Only three of the 14 women delivered outside hospital. Independent review suggested that two of the 14 deaths might have been averted by different management. Both births occurred in hospital, and in only one was management before admission of the mother judged inappropriate. Perinatal loss to the 64 women who booked for hospital delivery but delivered outside and to the 67 women who delivered outside hospital without ever making arrangements to receive professional care during labour accounted for the high perinatal mortality (134 deaths in 3466 deliveries) among all births outside hospital. The perinatal hazard associated with planned home birth in the few women who exercised this option (unplanned delivery outside hospital.

Scientific collaboration and endorsement: Network analysis of coauthorship and citation networks

Science.gov (United States)

Ding, Ying

2010-01-01

Scientific collaboration and endorsement are well-established research topics which utilize three kinds of methods: survey/questionnaire, bibliometrics, and complex network analysis. This paper combines topic modeling and path-finding algorithms to determine whether productive authors tend to collaborate with or cite researchers with the same or different interests, and whether highly cited authors tend to collaborate with or cite each other. Taking information retrieval as a test field, the results show that productive authors tend to directly coauthor with and closely cite colleagues sharing the same research interests; they do not generally collaborate directly with colleagues having different research topics, but instead directly or indirectly cite them; and highly cited authors do not generally coauthor with each other, but closely cite each other. PMID:21344057

Neighborhood socio-environmental vulnerability and infant mortality in Hermosillo, Sonora.

Science.gov (United States)

Lara-Valencia, Francisco; Álvarez-Hernández, Gerardo; Harlow, Siobán D; Denman, Catalina; García-Pérez, Hilda

2012-01-01

This paper explores the impact of contextual variables at the neighborhood level on a health marker in the city of Hermosillo, Mexico and discusses the importance of collaboration between planners and health professional to minimize the negative effect of contextual factors on urban health. Few studies in Mexico have assessed health outcomes at the intra-urban scale and their interaction with neighborhood-level contextual variables. Using spatial analysis and geographical information systems, the paper explores the association between infant mortality and an index of socio-environmental vulnerability used to measure urban contextual factors. Two high infant mortality clusters were detected within neighborhoods characterized by relatively good environmental conditions and one in a neighborhood with a poor environment. Our results show the clustering of high infant mortality areas and some association with built environment factors in Hermosillo. The results support the need to reconnect public health and urban planning as a way to create healthier environments in Mexican cities.

Coauthorship and institutional collaborations on cost-effectiveness analyses: a systematic network analysis.

Directory of Open Access Journals (Sweden)

Ferrán Catalá-López

Full Text Available BACKGROUND: Cost-Effectiveness Analysis (CEA has been promoted as an important research methodology for determining the efficiency of healthcare technology and guiding medical decision-making. Our aim was to characterize the collaborative patterns of CEA conducted over the past two decades in Spain. METHODS AND FINDINGS: A systematic analysis was carried out with the information obtained through an updated comprehensive literature review and from reports of health technology assessment agencies. We identified CEAs with outcomes expressed as a time-based summary measure of population health (e.g. quality-adjusted life-years or disability-adjusted life-years, conducted in Spain and published between 1989 and 2011. Networks of coauthorship and institutional collaboration were produced using PAJEK software. One-hundred and thirty-one papers were analyzed, in which 526 authors and 230 institutions participated. The overall signatures per paper index was 5.4. Six major groups (one with 14 members, three with 7 members and two with 6 members were identified. The most prolific authors were generally affiliated with the private-for-profit sector (e.g. consulting firms and the pharmaceutical industry. The private-for-profit sector maintains profuse collaborative networks including public hospitals and academia. Collaboration within the public sector (e.g. healthcare administration and primary care was weak and fragmented. CONCLUSIONS: This empirical analysis reflects critical practices among collaborative networks that contributed substantially to the production of CEA, raises challenges for redesigning future policies and provides a framework for similar analyses in other regions.

A SWOT Analysis of Collaborative Strategies between Engineering Universities and Industry in Pakistan

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Zaki Rashidi

2014-10-01

Full Text Available Collaboration among academia and industry is a long aspiring vision of every country to promote innovation and commercialization. A deeper analysis of collaborative efforts among this triad may reveal significant aspects to look for well informed decision making. The purpose of this research is to conduct the SWOT (Strengths, Weaknesses, Opportunities, and Threats analysis of collaboration in engineering education, research and practices in Pakistan. The study attempts to identify strengths and weaknesses of the current collaborative strategies; opportunities for establishing strong and rewarding relationships, and threats that may hinder development of this association. It further provides practical schema to establish productive association between the two partners through creative leadership, effective strategic partnership, and systematic modus operandi to way forward with implications for academics, researchers, and industry. The research is qualitative in nature, based on interpretivist approach. The data is collected by using focus group and semi-structured interviews of experts in industry and academia; primary data obtained by these tools is analyzed by using thematic analysis through open and axial coding. The study identifies the barriers in collaborative efforts, and delineates the roles of industry and academia to overcome these barriers along with SWOT matrix in the context of Pakistan

Analysis of childhood leukemia mortality trends in Brazil, from 1980 to 2010

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Franciane F. Silva

2014-12-01

Full Text Available OBJECTIVE: Leukemias comprise the most common group of cancers in children and adolescents. Studies conducted in other countries and Brazil have observed a decrease in their mortality.This study aimed to evaluate the trend of mortality from leukemia in children under 19 years of age in Brazil, from 1980 to 2010. METHODS: This was an ecological study, using retrospective time series data from the Mortality Information System, from 1980 to 2010. Calculations of mortality rates were performed, including gross, gender-specific, and age-based. For trend analysis, linear and semi-log regression models were used. The significance level was 5%. RESULTS: Mortality rates for lymphoid and myeloid leukemias presented a growth trend, with the exception of lymphoid leukemia among children under 4 years of age (percentage decrease: 1.21% annually, while in the sub-group "Other types of leukemia", a downward trend was observed. Overall, mortality from leukemia tended to increase for boys and girls, especially in the age groups 10-14 years (annual percentage increase of 1.23% for males and 1.28% for females and 15-19 years (annual percentage increase of 1.40% for males and 1.62% for females. CONCLUSIONS: The results for leukemia generally corroborate the results of other similar studies. A detailed analysis by subgroup of leukemia, age, and gender revealed no trends shown in other studies, thus indicating special requirements for each variable in the analysis.

Analysis of childhood leukemia mortality trends in Brazil, from 1980 to 2010.

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Silva, Franciane F; Zandonade, Eliana; Zouain-Figueiredo, Glaucia P

2014-01-01

Leukemias comprise the most common group of cancers in children and adolescents. Studies conducted in other countries and Brazil have observed a decrease in their mortality.This study aimed to evaluate the trend of mortality from leukemia in children under 19 years of age in Brazil, from 1980 to 2010. This was an ecological study, using retrospective time series data from the Mortality Information System, from 1980 to 2010. Calculations of mortality rates were performed, including gross, gender-specific, and age-based. For trend analysis, linear and semi-log regression models were used. The significance level was 5%. Mortality rates for lymphoid and myeloid leukemias presented a growth trend, with the exception of lymphoid leukemia among children under 4 years of age (percentage decrease: 1.21% annually), while in the sub-group "Other types of leukemia", a downward trend was observed. Overall, mortality from leukemia tended to increase for boys and girls, especially in the age groups 10-14 years (annual percentage increase of 1.23% for males and 1.28% for females) and 15-19 years (annual percentage increase of 1.40% for males and 1.62% for females). The results for leukemia generally corroborate the results of other similar studies. A detailed analysis by subgroup of leukemia, age, and gender revealed no trends shown in other studies, thus indicating special requirements for each variable in the analysis. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Change in body size and mortality: results from the Melbourne collaborative cohort study.

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Karahalios, Amalia; Simpson, Julie A; Baglietto, Laura; MacInnis, Robert J; Hodge, Allison M; Giles, Graham G; English, Dallas R

2014-01-01

The association between change in weight or body mass index, and mortality is widely reported, however, both measures fail to account for fat distribution. Change in waist circumference, a measure of central adiposity, in relation to mortality has not been studied extensively. We investigated the association between mortality and changes in directly measured waist circumference, hips circumference and weight from baseline (1990-1994) to wave 2 (2003-2007) in a prospective cohort study of people aged 40-69 years at baseline. Cox regression, with age as the time metric and follow-up starting at wave 2, adjusted for confounding variables, was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for change in body size in relation to mortality from all causes, cardiovascular disease and cancer. There were 1465 deaths (109 cancer, 242 cardiovascular disease) identified during an average 7.7 years of follow-up from 21 298 participants. Compared to minimal increase in body size, loss of waist circumference (HR: 1.26; 95% CI: 1.09-1.47), weight (1.80; 1.54-2.11), or hips circumference (1.35; 1.15-1.57) were associated with an increased risk of all-cause mortality, particularly for older adults. Weight loss was associated with cardiovascular disease mortality (2.40; 1.57-3.65) but change in body size was not associated with obesity-related cancer mortality. This study confirms the association between weight loss and increased mortality from all-causes for older adults. Based on evidence from observational cohort studies, weight stability may be the recommended option for most adults, especially older adults.

Child malnutrition and mortality in Swaziland: Situation analysis of ...

African Journals Online (AJOL)

Child malnutrition and mortality in Swaziland: Situation analysis of the immediate, ... African Journal of Food, Agriculture, Nutrition and Development ... care of children and women, insufficient health services and unhealthy environment), and ...

Modeling and Capturing Users’ Actions in CSCL Systems for Collaboration Analysis Purposes

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Manuel Ortega

2009-03-01

Full Text Available A significant number of CSCL (Computer-Supported Collaborative Learning environments support the learning of groups of students enabling their collaboration in solving problems. These collaborative environments usually need additional computational support to allow the automatic processing of both the actions carried out by the students and the end solution with the aim of studying the learning process and the validity of the solution proposed to the problem. This process, known as Collaboration and Interaction Analysis, is typically carried out in three phases: observation, abstraction and intervention. In this paper, we propose a methodological approach for the design of mechanisms for the observation phase. This approach provides a set of procedures enabling developers to design observation systems in CSCL environments that capture and model all the information required for comprehensive analyses of the collaboration process and the resulting solution to the problem. This methodological approach is put into practice by means of its use in the design of an observation system in the SPACE-DESIGN (SPecification and Automatic Construction of collaborative Environments of DESIGN collaborative environment.

Data on cardiac defects, morbidity and mortality in patients affected by RASopathies. CARNET study results

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Giulio Calcagni

2018-02-01

Full Text Available A comprehensive description of morbidity and mortality in patients affected by mutations in genes encoding for signal transducers of the RAS-MAPK cascade (RASopathies was performed in our study recently published in the International Journal of Cardiology. Seven European cardiac centres participating to the CArdiac Rasopathy NETwork (CARNET, collaborated in this multicentric, observational, retrospective data analysis and collection. In this study, clinical records of 371 patients with confirmed molecular diagnosis of RASopathy were reviewed. Cardiac defects, crude mortality, survival rate of patients with 1 hypertrophic cardiomyopathy (HCM and age <2 years or young adults; 2 individuals with Noonan syndrome and pulmonary stenosis carrying PTPN11 mutations; 3 biventricular obstruction and PTPN11 mutations; 4 Costello syndrome or cardiofaciocutaneous syndrome were analysed. Mortality was described as crude mortality, cumulative survival and restricted estimated mean survival. In particular, with this Data In Brief (DIB paper, the authors aim to report specific statistic highlights of the multivariable regression analysis that was used to assess the impact of mutated genes on number of interventions and overall prognosis.

An exploratory analysis of network characteristics and quality of interactions among public health collaboratives

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Danielle M. Varda

2012-06-01

Full Text Available While the benefits of collaboration have become widely accepted and the practice of collaboration is growing within the public health system, a paucity of research exists that examines factors and mechanisms related to effective collaboration between public health and their partner organizations. The purpose of this paper is to address this gap by exploring the structural and organizational characteristics of public health collaboratives. Design and Methods. Using both social network analysis and traditional statistical methods, we conduct an exploratory secondary data analysis of 11 public health collaboratives chosen from across the United States. All collaboratives are part of the PARTNER (www.partnertool.net database. We analyze data to identify relational patterns by exploring the structure (the way that organizations connect and exchange relationships, in relation to perceptions of value and trust, explanations for varying reports of success, and factors related to outcomes. We describe the characteristics of the collaboratives, types of resource contributions, outcomes of the collaboratives, perceptions of success, and reasons for success. We found high variation and significant differences within and between these collaboratives including perceptions of success. There were significant relationships among various factors such as resource contributions, reasons cited for success, and trust and value perceived by organizations. We find that although the unique structure of each collaborative makes it challenging to identify a specific set of factors to determine when a collaborative will be successful, the organizational characteristics and interorganizational dynamics do appear to impact outcomes. We recommend a quality improvement process that suggests matching assessment to goals and developing action steps for performance improvement.

Beyond Needs Analysis: Soft Systems Methodology for Meaningful Collaboration in EAP Course Design

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Tajino, Akira; James, Robert; Kijima, Kyoichi

2005-01-01

Designing an EAP course requires collaboration among various concerned stakeholders, including students, subject teachers, institutional administrators and EAP teachers themselves. While needs analysis is often considered fundamental to EAP, alternative research methodologies may be required to facilitate meaningful collaboration between these…

Trichloroethylene Is Associated with Kidney Cancer Mortality: A Population-based Analysis.

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Alanee, Shaheen; Clemons, Joseph; Zahnd, Whitney; Sadowski, Daniel; Dynda, Danuta

2015-07-01

To examine the association between the distribution of trichloroethylene (TCE) exposure and mortality from kidney cancer (Kca) across United States counties. Multiple linear regression was used to assess the association of TCE discharges from industrial sites and age-adjusted incidence and mortality rates for Kca during 2005 through 2010, controlling for confounders. A total of 163 counties were included in analysis. We observed an excess risk of Kca mortality associated with higher amounts of environmental TCE releases. A significant dose-response relationship was observed between TCE releases and Kca mortality in females. Smoking, education, income, hypertension, and obesity were significant predictors of incidence and mortality, consistent with previous research on the epidemiology of Kca. TCE exposure may increase the risk of mortality from Kca, an association not highlighted before. There is a need for policy measures to limit TCE discharge to the environment if these results are validated. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Comparison of the effects of albumin and crystalloid on mortality in adult patients with severe sepsis and septic shock: a meta-analysis of randomized clinical trials.

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Xu, Jing-Yuan; Chen, Qi-Hong; Xie, Jian-Feng; Pan, Chun; Liu, Song-Qiao; Huang, Li-Wei; Yang, Cong-Shan; Liu, Ling; Huang, Ying-Zi; Guo, Feng-Mei; Yang, Yi; Qiu, Hai-Bo

2014-12-15

The aim of this study was to examine whether albumin reduced mortality when employed for the resuscitation of adult patients with severe sepsis and septic shock compared with crystalloid by meta-analysis. We searched for and gathered data from MEDLINE, Elsevier, Cochrane Central Register of Controlled Trials and Web of Science databases. Studies were eligible if they compared the effects of albumin versus crystalloid therapy on mortality in adult patients with severe sepsis and septic shock. Two reviewers extracted data independently. Disagreements were resolved by discussion with other two reviewers until a consensus was achieved. Data including mortality, sample size of the patients with severe sepsis, sample size of the patients with septic shock and resuscitation endpoints were extracted. Data were analyzed by the methods recommended by the Cochrane Collaboration Review Manager 4.2 software. A total of 5,534 records were identified through the initial search. Five studies compared albumin with crystalloid. In total, 3,658 severe sepsis and 2,180 septic shock patients were included in the meta-analysis. The heterogeneity was determined to be non-significant (P = 0.86, I(2) = 0%). Compared with crystalloid, a trend toward reduced 90-day mortality was observed in severe sepsis patients resuscitated with albumin (odds ratio (OR) 0.88; 95% CI, 0.76 to 1.01; P = 0.08). However, the use of albumin for resuscitation significantly decreased 90-day mortality in septic shock patients (OR 0.81; 95% CI, 0.67 to 0.97; P = 0.03). Compared with saline, the use of albumin for resuscitation slightly improved outcome in severe sepsis patients (OR 0.81; 95% CI, 0.64 to 1.08; P = 0.09). In this meta-analysis, a trend toward reduced 90-day mortality was observed in severe sepsis patients resuscitated with albumin compared with crystalloid and saline. Moreover, the 90-day mortality of patients with septic shock decreased significantly.

Sensitivity analysis of synergistic collaborative scenarios towards sustainable nuclear energy systems

International Nuclear Information System (INIS)

Fesenko, G.; Kuznetsov, V.; Poplavskaya, E.

2013-01-01

The paper presents results of the study on the role of collaboration among countries towards sustainable global nuclear energy systems. The study explores various market shares for nuclear fuel cycle services, possible scale of collaboration among countries and assesses benefits and issues relevant for collaboration between suppliers and users of nuclear fuel cycle services. The approach used in the study is based on a heterogeneous world model with grouping of the non-personified nuclear energy countries according to different nuclear fuel cycle policies. The methodology applied in the analysis allocates a fraction of future global nuclear energy generation to each of such country-groups as a function of time. The sensitivity studies performed show the impacts of the group shares on the scope of collaboration among countries and on the resulting possible reactor mix and nuclear fuel cycle infrastructure versus time. The study quantitatively demonstrates that the synergistic approach to nuclear fuel cycle has a significant potential for offering a win-win collaborative strategy to both, technology holders and technology users on their joint way to future sustainable nuclear energy systems. The study also highlights possible issues on such a collaborative way. (authors)

Maternal obesity and infant mortality: a meta-analysis.

Science.gov (United States)

Meehan, Sean; Beck, Charles R; Mair-Jenkins, John; Leonardi-Bee, Jo; Puleston, Richard

2014-05-01

Despite numerous studies reporting an elevated risk of infant mortality among women who are obese, the magnitude of the association is unclear. A systematic review and meta-analysis was undertaken to assess the association between maternal overweight or obesity and infant mortality. Four health care databases and gray literature sources were searched and screened against the protocol eligibility criteria. Observational studies reporting on the relationship between maternal overweight and obesity and infant mortality were included. Data extraction and risk of bias assessments were performed. Twenty-four records were included from 783 screened. Obese mothers (BMI ≥30) had greater odds of having an infant death (odds ratio 1.42; 95% confidence interval, 1.24-1.63; P obese (BMI >35) (odds ratio 2.03; 95% confidence interval, 1.61-2.56; P obese mothers and that this risk may increase with greater maternal BMI or weight; however, residual confounding may explain these findings. Given the rising prevalence of maternal obesity, additional high-quality epidemiologic studies to elucidate the actual influence of elevated maternal mass or weight on infant mortality are needed. If a causal link is determined and the biological basis explained, public health strategies to address the issue of maternal obesity will be needed. Copyright © 2014 by the American Academy of Pediatrics.

An in-depth longitudinal analysis of mixing patterns in a small scientific collaboration network

Energy Technology Data Exchange (ETDEWEB)

Rodriguez, Marko A [Los Alamos National Laboratory; Pepe, Alberto [UCLA

2009-01-01

Many investigations of scientific collaboration are based on large-scale statistical analyses of networks constructed from bibliographic repositories. These investigations often rely on a wealth of bibliographic data, but very little or no other information about the individuals in the network, and thus, fail to illustate the broader social and academic landscape in which collaboration takes place. In this article, we perform an in-depth longitudinal analysis of a small-scale network of scientific collaboration (N = 291) constructed from the bibliographic record of a research center involved in the development and application of sensor network technologies. We perform a preliminary analysis of selected structural properties of the network, computing its range, configuration and topology. We then support our preliminary statistical analysis with an in-depth temporal investigation of the assortativity mixing of these node characteristics: academic department, affiliation, position, and country of origin of the individuals in the network. Our qualitative analysis of mixing patterns offers clues as to the nature of the scientific community being modeled in relation to its organizational, disciplinary, institutional, and international arrangements of collaboration.

Multivitamin use and risk of stroke mortality: the Japan collaborative cohort study.

Science.gov (United States)

Dong, Jia-Yi; Iso, Hiroyasu; Kitamura, Akihiko; Tamakoshi, Akiko

2015-05-01

An effect of multivitamin supplement on stroke risk is uncertain. We aimed to examine the association between multivitamin use and risk of death from stroke and its subtypes. A total of 72 180 Japanese men and women free from cardiovascular diseases and cancers at baseline in 1988 to 1990 were followed up until December 31, 2009. Lifestyles including multivitamin use were collected using self-administered questionnaires. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of total stroke and its subtypes in relation to multivitamin use. During a median follow-up of 19.1 years, we identified 2087 deaths from stroke, including 1148 ischemic strokes and 877 hemorrhagic strokes. After adjustment for potential confounders, multivitamin use was associated with lower but borderline significant risk of death from total stroke (HR, 0.87; 95% confidence interval, 0.76-1.01), primarily ischemic stroke (HR, 0.80; 95% confidence interval, 0.63-1.01), but not hemorrhagic stroke (HR, 0.96; 95% confidence interval, 0.78-1.18). In a subgroup analysis, there was a significant association between multivitamin use and lower risk of mortality from total stroke among people with fruit and vegetable intake stroke. Multivitamin use, particularly frequent use, was associated with reduced risk of total and ischemic stroke mortality among Japanese people with lower intake of fruits and vegetables. © 2015 American Heart Association, Inc.

Mortality in former Olympic athletes: retrospective cohort analysis

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Zwiers, R; Zantvoord, F W A; van Bodegom, D; van der Ouderaa, F J G; Westendorp, R G J

2012-01-01

Objective To assess the mortality risk in subsequent years (adjusted for year of birth, nationality, and sex) of former Olympic athletes from disciplines with different levels of exercise intensity. Design Retrospective cohort study. Setting Former Olympic athletes. Participants 9889 athletes (with a known age at death) who participated in the Olympic Games between 1896 and 1936, representing 43 types of disciplines with different levels of cardiovascular, static, and dynamic intensity exercise; high or low risk of bodily collision; and different levels of physical contact. Main outcome measure All cause mortality. Results Hazard ratios for mortality among athletes from disciplines with moderate cardiovascular intensity (1.01, 95% confidence interval 0.96 to 1.07) or high cardiovascular intensity (0.98, 0.92 to 1.04) were similar to those in athletes from disciplines with low cardiovascular intensity. The underlying static and dynamic components in exercise intensity showed similar non-significant results. Increased mortality was seen among athletes from disciplines with a high risk of bodily collision (hazard ratio 1.11, 1.06 to 1.15) and with high levels of physical contact (1.16, 1.11 to 1.22). In a multivariate analysis, the effect of high cardiovascular intensity remained similar (hazard ratio 1.05, 0.89 to 1.25); the increased mortality associated with high physical contact persisted (hazard ratio 1.13, 1.06 to 1.21), but that for bodily collision became non-significant (1.03, 0.98 to 1.09) as a consequence of its close relation with physical contact. Conclusions Among former Olympic athletes, engagement in disciplines with high intensity exercise did not bring a survival benefit compared with disciplines with low intensity exercise. Those who engaged in disciplines with high levels of physical contact had higher mortality than other Olympians later in life. PMID:23241269

Mortality in patients with HIV-1 infection starting antiretroviral therapy in South Africa, Europe, or North America: a collaborative analysis of prospective studies.

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Andrew Boulle

2014-09-01

Full Text Available High early mortality in patients with HIV-1 starting antiretroviral therapy (ART in sub-Saharan Africa, compared to Europe and North America, is well documented. Longer-term comparisons between settings have been limited by poor ascertainment of mortality in high burden African settings. This study aimed to compare mortality up to four years on ART between South Africa, Europe, and North America.Data from four South African cohorts in which patients lost to follow-up (LTF could be linked to the national population register to determine vital status were combined with data from Europe and North America. Cumulative mortality, crude and adjusted (for characteristics at ART initiation mortality rate ratios (relative to South Africa, and predicted mortality rates were described by region at 0-3, 3-6, 6-12, 12-24, and 24-48 months on ART for the period 2001-2010. Of the adults included (30,467 [South Africa], 29,727 [Europe], and 7,160 [North America], 20,306 (67%, 9,961 (34%, and 824 (12% were women. Patients began treatment with markedly more advanced disease in South Africa (median CD4 count 102, 213, and 172 cells/µl in South Africa, Europe, and North America, respectively. High early mortality after starting ART in South Africa occurred mainly in patients starting ART with CD4 count <50 cells/µl. Cumulative mortality at 4 years was 16.6%, 4.7%, and 15.3% in South Africa, Europe, and North America, respectively. Mortality was initially much lower in Europe and North America than South Africa, but the differences were reduced or reversed (North America at longer durations on ART (adjusted rate ratios 0.46, 95% CI 0.37-0.58, and 1.62, 95% CI 1.27-2.05 between 24 and 48 months on ART comparing Europe and North America to South Africa. While bias due to under-ascertainment of mortality was minimised through death registry linkage, residual bias could still be present due to differing approaches to and frequency of linkage.After accounting for under

A Genetic Analysis of Mortality in Pigs

DEFF Research Database (Denmark)

Varona, Luis; Sorensen, Daniel

2010-01-01

to investigate whether there is support for genetic variation for mortality and to study the quality of fit and predictive properties of the various models. In both breeds, the model that provided the best fit to the data was the standard binomial hierarchical model. The model that performed best in terms......An analysis of mortality is undertaken in two breeds of pigs: Danish Landrace and Yorkshire. Zero-inflated and standard versions of hierarchical Poisson, binomial, and negative binomial Bayesian models were fitted using Markov chain Monte Carlo (MCMC). The objectives of the study were...... of the ability to predict the distribution of stillbirths was the hierarchical zero-inflated negative binomial model. The best fit of the binomial hierarchical model and of the zero-inflated hierarchical negative binomial model was obtained when genetic variation was included as a parameter. For the hierarchical...

An Exploratory Analysis of Network Characteristics and Quality of Interactions among Public Health Collaboratives.

Science.gov (United States)

Varda, Danielle M; Retrum, Jessica H

2012-06-15

While the benefits of collaboration have become widely accepted and the practice of collaboration is growing within the public health system, a paucity of research exists that examines factors and mechanisms related to effective collaboration between public health and their partner organizations. The purpose of this paper is to address this gap by exploring the structural and organizational characteristics of public health collaboratives. Design and Methods. Using both social network analysis and traditional statistical methods, we conduct an exploratory secondary data analysis of 11 public health collaboratives chosen from across the United States. All collaboratives are part of the PARTNER (www.partnertool.net) database. We analyze data to identify relational patterns by exploring the structure (the way that organizations connect and exchange relationships), in relation to perceptions of value and trust, explanations for varying reports of success, and factors related to outcomes. We describe the characteristics of the collaboratives, types of resource contributions, outcomes of the collaboratives, perceptions of success, and reasons for success. We found high variation and significant differences within and between these collaboratives including perceptions of success. There were significant relationships among various factors such as resource contributions, reasons cited for success, and trust and value perceived by organizations. We find that although the unique structure of each collaborative makes it challenging to identify a specific set of factors to determine when a collaborative will be successful, the organizational characteristics and interorganizational dynamics do appear to impact outcomes. We recommend a quality improvement process that suggests matching assessment to goals and developing action steps for performance improvement. the authors would like to thank the Robert Wood Johnson Foundation's Public Health Program for funding for this research.

A critical review and meta-analysis of the association between overt hyperthyroidism and mortality.

Science.gov (United States)

Brandt, Frans; Green, Anders; Hegedüs, Laszlo; Brix, Thomas H

2011-10-01

Overt hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in study design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis. Based on an electronic PubMed search, using the Medical Subject Heading words such as hyperthyroidism, thyrotoxicosis, and mortality or survival, case-control and cohort studies were selected and reviewed. Using meta-analysis, an overall relative risk (RR) of mortality was calculated. Eight studies fulfilled the inclusion criteria, six of which showed an increased all-cause mortality; seven studies, including 31,138 patients and 400,000 person years at risk, allowed calculation of mortality in a meta-analysis. Based on this, the RR of overall mortality was 1.21 (95% confidence interval: 1.05-1.38). Analyses including studies considering setting, treatment, and control for co-morbidity did not significantly alter this finding. As the measured heterogeneity (I(2)) ranges from 89.1 to 98.3%, which is much higher than the 50% generally viewed on as a threshold, the statistical heterogeneity is very pronounced in the included studies. In patients diagnosed with hyperthyroidism, mortality is increased by ∼ 20%. Future studies need to address the cause of hyperthyroidism, impact of type of therapy, time dependency, as well as the potential influence of confounding or genetic susceptibility before the question of causality can be answered.

A case-crossover analysis of forest fire haze events and mortality in Malaysia

Science.gov (United States)

Sahani, Mazrura; Zainon, Nurul Ashikin; Wan Mahiyuddin, Wan Rozita; Latif, Mohd Talib; Hod, Rozita; Khan, Md Firoz; Tahir, Norhayati Mohd; Chan, Chang-Chuan

2014-10-01

The Southeast Asian (SEA) haze events due to forest fires are recurrent and affect Malaysia, particularly the Klang Valley region. The aim of this study is to examine the risk of haze days due to biomass burning in Southeast Asia on daily mortality in the Klang Valley region between 2000 and 2007. We used a case-crossover study design to model the effect of haze based on PM10 concentration to the daily mortality. The time-stratified control sampling approach was used, adjusted for particulate matter (PM10) concentrations, time trends and meteorological influences. Based on time series analysis of PM10 and backward trajectory analysis, haze days were defined when daily PM10 concentration exceeded 100 μg/m3. The results showed a total of 88 haze days were identified in the Klang Valley region during the study period. A total of 126,822 cases of death were recorded for natural mortality where respiratory mortality represented 8.56% (N = 10,854). Haze events were found to be significantly associated with natural and respiratory mortality at various lags. For natural mortality, haze events at lagged 2 showed significant association with children less than 14 years old (Odd Ratio (OR) = 1.41; 95% Confidence Interval (CI) = 1.01-1.99). Respiratory mortality was significantly associated with haze events for all ages at lagged 0 (OR = 1.19; 95% CI = 1.02-1.40). Age-and-gender-specific analysis showed an incremental risk of respiratory mortality among all males and elderly males above 60 years old at lagged 0 (OR = 1.34; 95% CI = 1.09-1.64 and OR = 1.41; 95% CI = 1.09-1.84 respectively). Adult females aged 15-59 years old were found to be at highest risk of respiratory mortality at lagged 5 (OR = 1.66; 95% CI = 1.03-1.99). This study clearly indicates that exposure to haze events showed immediate and delayed effects on mortality.

Coherent Forecasts of Mortality with Compositional Data Analysis

DEFF Research Database (Denmark)

Bergeron-Boucher, Marie-Pier; Canudas-Romo, Vladimir; Oeppen, Jim

2017-01-01

Data Analysis (CoDa) of the life table distribution of deaths. We adapt existing coherent and non–coherent forecasting models to CoDa and compare their results. Results We apply our coherent method to the female mortality of 15 Western European countries and show that our proposed strategy would have...

Collaboration: a SWOT analysis of the process of conducting a review of nursing workforce policies in five European countries.

Science.gov (United States)

Uhrenfeldt, Lisbeth; Lakanmaa, Riitta-Liisa; Flinkman, Mervi; Basto, Marta Lima; Attree, Moira

2014-05-01

This paper critically reviews the literature on international collaboration and analyses the collaborative process involved in producing a nursing workforce policy analysis. Collaboration is increasingly promoted as a means of solving shared problems and achieving common goals; however, collaboration creates its own opportunities and challenges. Evidence about the collaboration process, its outcomes and critical success factors is lacking. A literature review and content analysis of data collected from six participants (from five European countries) members of the European Academy of Nursing Science Scholar Collaborative Workforce Workgroup, using a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis template. Two major factors affecting scholarly collaboration were identified: Facilitators, which incorporated personal attributes and enabling contexts/mechanisms, including individual commitment, responsibility and teamwork, facilitative supportive structures and processes. The second, Barriers, incorporated unmet needs for funding; time; communication and impeding contexts/mechanisms, including workload and insufficient support/mentorship. The literature review identified a low level of evidence on collaboration processes, outcomes, opportunities and challenges. The SWOT analysis identified critical success factors, planning strategies and resources of effective international collaboration. Collaboration is an important concept for management. Evidence-based knowledge of the critical success factors facilitating and impeding collaboration could help managers make collaboration more effective. © 2012 John Wiley & Sons Ltd.

Macroeconomic effects on mortality revealed by panel analysis with nonlinear trends.

Science.gov (United States)

Ionides, Edward L; Wang, Zhen; Tapia Granados, José A

2013-10-03

Many investigations have used panel methods to study the relationships between fluctuations in economic activity and mortality. A broad consensus has emerged on the overall procyclical nature of mortality: perhaps counter-intuitively, mortality typically rises above its trend during expansions. This consensus has been tarnished by inconsistent reports on the specific age groups and mortality causes involved. We show that these inconsistencies result, in part, from the trend specifications used in previous panel models. Standard econometric panel analysis involves fitting regression models using ordinary least squares, employing standard errors which are robust to temporal autocorrelation. The model specifications include a fixed effect, and possibly a linear trend, for each time series in the panel. We propose alternative methodology based on nonlinear detrending. Applying our methodology on data for the 50 US states from 1980 to 2006, we obtain more precise and consistent results than previous studies. We find procyclical mortality in all age groups. We find clear procyclical mortality due to respiratory disease and traffic injuries. Predominantly procyclical cardiovascular disease mortality and countercyclical suicide are subject to substantial state-to-state variation. Neither cancer nor homicide have significant macroeconomic association.

Pediatric mortality due to nosocomial infection: a critical approach

Directory of Open Access Journals (Sweden)

Julia Marcia Maluf Lopes

Full Text Available Nosocomial infection is a frequent event with potentially lethal consequences. We reviewed the literature on the predictive factors for mortality related to nosocomial infection in pediatric medicine. Electronic searches in English, Spanish and Portuguese of the PubMed/MEDLINE, LILACS and Cochrane Collaboration Databases was performed, focusing on studies that had been published from 1996 to 2006. The key words were: nosocomial infection and mortality and pediatrics/neonate/ newborn/child/infant/adolescent. The risk factors found to be associated with mortality were: nosocomial infection itself, leukemia, lymphopenia, neutropenia, corticosteroid therapy, multiple organ failure, previous antimicrobial therapy, catheter use duration, candidemia, cancer, bacteremia, age over 60, invasive procedures, mechanical ventilation, transport out of the pediatric intensive care unit, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Burkholderia cepacia infections, acute physiology and chronic health evaluation (APACHE II scores over 15. Among these factors, the only one that can be minimized is inadequate antimicrobial treatment, which has proven to be an important contributor to hospital mortality in critically-ill patients. There is room for further prognosis research on this matter to determine local differences. Such research requires appropriate epidemiological design and statistical analysis so that pediatric death due to nosocomial infection can be reduced and health care quality improved in pediatric hospitals.

Mortality in Patients with HIV-1 Infection Starting Antiretroviral Therapy in South Africa, Europe, or North America: A Collaborative Analysis of Prospective Studies

Science.gov (United States)

Boulle, Andrew; Schomaker, Michael; May, Margaret T.; Hogg, Robert S.; Shepherd, Bryan E.; Monge, Susana; Keiser, Olivia; Lampe, Fiona C.; Giddy, Janet; Ndirangu, James; Garone, Daniela; Fox, Matthew; Ingle, Suzanne M.; Reiss, Peter; Dabis, Francois; Costagliola, Dominique; Castagna, Antonella; Ehren, Kathrin; Campbell, Colin; Gill, M. John; Saag, Michael; Justice, Amy C.; Guest, Jodie; Crane, Heidi M.; Egger, Matthias; Sterne, Jonathan A. C.

2014-01-01

Background High early mortality in patients with HIV-1 starting antiretroviral therapy (ART) in sub-Saharan Africa, compared to Europe and North America, is well documented. Longer-term comparisons between settings have been limited by poor ascertainment of mortality in high burden African settings. This study aimed to compare mortality up to four years on ART between South Africa, Europe, and North America. Methods and Findings Data from four South African cohorts in which patients lost to follow-up (LTF) could be linked to the national population register to determine vital status were combined with data from Europe and North America. Cumulative mortality, crude and adjusted (for characteristics at ART initiation) mortality rate ratios (relative to South Africa), and predicted mortality rates were described by region at 0–3, 3–6, 6–12, 12–24, and 24–48 months on ART for the period 2001–2010. Of the adults included (30,467 [South Africa], 29,727 [Europe], and 7,160 [North America]), 20,306 (67%), 9,961 (34%), and 824 (12%) were women. Patients began treatment with markedly more advanced disease in South Africa (median CD4 count 102, 213, and 172 cells/µl in South Africa, Europe, and North America, respectively). High early mortality after starting ART in South Africa occurred mainly in patients starting ART with CD4 count Africa, Europe, and North America, respectively. Mortality was initially much lower in Europe and North America than South Africa, but the differences were reduced or reversed (North America) at longer durations on ART (adjusted rate ratios 0.46, 95% CI 0.37–0.58, and 1.62, 95% CI 1.27–2.05 between 24 and 48 months on ART comparing Europe and North America to South Africa). While bias due to under-ascertainment of mortality was minimised through death registry linkage, residual bias could still be present due to differing approaches to and frequency of linkage. Conclusions After accounting for under-ascertainment of mortality

Air pollution and tuberculosis disease mortality: a quantitative analysis (a viewpoint)

Energy Technology Data Exchange (ETDEWEB)

Koshal, R K; Koshal, M

1976-01-01

This paper establishes a quantitative relationship between tuberculosis mortality rates and the levels of air pollution and other socio-economic variables by using a macro-model. With the help of regression analysis, it is observed that a hundred percent increase in the air pollution would imply an increase in the mortality rate by about 45--79 percent. An average improvement of 50 percent in the quality of air would reduce the tuberculosis mortality rate by 22.5--39.5 percent. This would imply a social saving of about $139 to $234 million per year in terms of tuberculosis only.

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children Ages 1-5 Years: A Causal Modeling Analysis.

Science.gov (United States)

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N'Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2016-03-01

There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modeling analysis in children ages 1-5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups, and regions. ART-naïve children of ages 12-59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. About one quarter of the 5,826 included children was from West Africa (24.6%).The median (first; third quartile) CD4% at the first visit was 16% (11%; 23%), the median weight-for-age z-scores and height-for-age z-scores were -1.5 (-2.7; -0.6) and -2.5 (-3.5; -1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count <750 cells/mm³ or CD4% <25% was 0.2% (95% CI = -0.2%; 0.3%), and the difference in the mean height-for-age z-scores of those who survived was -0.02 (95% CI = -0.04; 0.01). Younger children ages 1-2 and children in West Africa had worse outcomes. Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, although we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below 750/25%.

Acquisition Path Analysis as a Collaborative Activity

International Nuclear Information System (INIS)

Nakao, A.; Grundule, R.; Gushchyn, K.; El Gebaly, A.; Higgy, R.; Tsvetkov, I.; Mandl, W.

2015-01-01

In the International Atomic Energy Agency, acquisition path analysis (APA) is indispensable to safeguards implementation. It is an integral part of both State evaluation process and the development of State level safeguards approaches, all performed through ongoing collaborative analysis of all available safeguards relevant information by State evaluation groups (SEG) with participation of other contributors, as required. To perform comprehensive State evaluation, to develop and revise State-level safeguards approaches, and to prepare annual implementation plans, the SEG in its collaborative analysis follows accepted safeguards methodology and guidance. In particular, the guide ''Performing Acquisition Path Analysis for the Development of a State-level Safeguards Approach for a State with a CSA'' is used. This guide identifies four major steps of the APA process: 1. Consolidating information about the State's past, present and planned nuclear fuel cycle-related capabilities and infrastructure; 2. Identifying and visually presenting technically plausible acquisition paths for the State; 3. Assessing acquisition path steps (State's technical capabilities and possible actions) along the identified acquisition paths; and 4. Assessing the time needed to accomplish each identified technically plausible acquisition path for the State. The paper reports on SEG members' and other contributors' experience with APA when following the above steps, including the identification of plausible acquisition pathways, estimation of time frames for all identified steps and determination of the time needed to accomplish each acquisition path. The difficulties that the SEG encountered during the process of performing the APA are also addressed. Feedback in the form of practical suggestions for improving the clarity of the acquisition path step assessment forms and a proposal for software support are also included. (author)

Impact of Early Valve Surgery on Outcome of Staphylococcus aureus Prosthetic Valve Infective Endocarditis: Analysis in the International Collaboration of Endocarditis–Prospective Cohort Study

OpenAIRE

Chirouze, Catherine; Alla, François; Fowler, Vance G.; Sexton, Daniel J.; Corey, G. Ralph; Chu, Vivian H.; Wang, Andrew; Erpelding, Marie-Line; Durante-Mangoni, Emanuele; Fernández-Hidalgo, Nuria; Giannitsioti, Efthymia; Hannan, Margaret M.; Lejko-Zupanc, Tatjana; Miró, José M.; Muñoz, Patricia

2014-01-01

Using appropriate analytical methods to examine data from the International Collaboration on Endocarditis–Prospective Cohort Study, we found that early valve surgery was not associated with reduced 1-year mortality in Staphylococcus aureus prosthetic valve infective endocarditis.

Collaborative partnership and the social value of clinical research: a qualitative secondary analysis.

Science.gov (United States)

Nurmi, Sanna-Maria; Halkoaho, Arja; Kangasniemi, Mari; Pietilä, Anna-Maija

2017-10-25

Protecting human subjects from being exploited is one of the main ethical challenges for clinical research. However, there is also a responsibility to protect and respect the communities who are hosting the research. Recently, attention has focused on the most efficient way of carrying out clinical research, so that it benefits society by providing valuable research while simultaneously protecting and respecting the human subjects and the communities where the research is conducted. Collaboration between partners plays an important role and that is why we carried out a study to describe how collaborative partnership and social value are emerging in clinical research. A supra-analysis design for qualitative descriptive secondary analysis was employed to consider a novel research question that pertained to nurse leaders' perceptions of ethical recruitment in clinical research and the ethics-related aspects of clinical research from the perspective of administrative staff. The data consisted of two separate pre-existing datasets, comprising 451 pages from 41 interviews, and we considered the research question by using deductive-inductive content analysis with NVivo software. A deductive analysis matrix was generated on the basis of two requirements, namely collaborative partnership and social value, as presented in An Ethical Framework for Biomedical Research by Emanuel et al. The findings showed that collaborative partnership was a cornerstone for ethical clinical research and ways to foster inter-partner collaboration were indicated, such as supporting mutual respect and equality, shared goals and clearly defined roles and responsibilities. In addition, the social value of clinical research was an important precondition for ethical clinical research and its realisation required the research partners to demonstrate collaboration and shared responsibility during the research process. However, concerns emerged that the multidimensional meaning of clinical research for

Help Seeking in Online Collaborative Groupwork: A Multilevel Analysis

Science.gov (United States)

Du, Jianxia; Xu, Jianzhong; Fan, Xitao

2015-01-01

This study examined predictive models for students' help seeking in the context of online collaborative groupwork. Results from multilevel analysis revealed that most of the variance in help seeking was at the individual student level, and multiple variables at the individual level were predictive of help-seeking behaviour. Help seeking was…

Spatiotemporal analysis of particulate air pollution and ischemic heart disease mortality in Beijing, China.

Science.gov (United States)

Xu, Meimei; Guo, Yuming; Zhang, Yajuan; Westerdahl, Dane; Mo, Yunzheng; Liang, Fengchao; Pan, Xiaochuan

2014-12-12

Few studies have used spatially resolved ambient particulate matter with an aerodynamic diameter of <10 μm (PM10) to examine the impact of PM10 on ischemic heart disease (IHD) mortality in China. The aim of our study is to evaluate the short-term effects of PM10 concentrations on IHD mortality by means of spatiotemporal analysis approach. We collected daily data on air pollution, weather conditions and IHD mortality in Beijing, China during 2008 and 2009. Ordinary kriging (OK) was used to interpolate daily PM10 concentrations at the centroid of 287 township-level areas based on 27 monitoring sites covering the whole city. A generalized additive mixed model was used to estimate quantitatively the impact of spatially resolved PM10 on the IHD mortality. The co-effects of the seasons, gender and age were studied in a stratified analysis. Generalized additive model was used to evaluate the effects of averaged PM10 concentration as well. The averaged spatially resolved PM10 concentration at 287 township-level areas was 120.3 ± 78.1 μg/m3. Ambient PM10 concentration was associated with IHD mortality in spatiotemporal analysis and the strongest effects were identified for the 2-day average. A 10 μg/m3 increase in PM10 was associated with an increase of 0.33% (95% confidence intervals: 0.13%, 0.52%) in daily IHD mortality. The effect estimates using spatially resolved PM10 were larger than that using averaged PM10. The seasonal stratification analysis showed that PM10 had the statistically stronger effects on IHD mortality in summer than that in the other seasons. Males and older people demonstrated the larger response to PM10 exposure. Our results suggest that short-term exposure to particulate air pollution is associated with increased IHD mortality. Spatial variation should be considered for assessing the impacts of particulate air pollution on mortality.

C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Giovanni Leuzzi

2017-02-01

Full Text Available The prognostic role of baseline C-reactive protein (CRP in chronic obstructive pulmonary disease (COPD is controversial. In order to clarify this issue, we performed a systematic review and meta-analysis to assess the predictive effect of baseline CRP level in COPD patients. 15 eligible articles focusing on late mortality in COPD were included in our study. We performed a random-effects meta-analysis, and assessed heterogeneity and publication bias. We pooled hazard ratio (HR estimates and their 95% confidence intervals on mortality for the comparison between the study-specific highest category of CRP level versus the lowest category. In overall analysis, elevated baseline CRP levels were significantly associated with higher mortality (HR 1.53, 95% CI 1.32–1.77, I2=68.7%, p<0.001. Similar results were observed across subgroups. However, higher mortality risk was reported in studies using a cut-off value of 3 mg·L−1 (HR 1.61, 95% CI 1.12–2.30 and in those enrolling an Asiatic population (HR 3.51, 95% CI 1.69–7.31. Our analysis indicates that baseline high CRP level is significantly associated with higher late mortality in patients with COPD. Further prospective controlled studies are needed to confirm these data.

Data on cardiac defects, morbidity and mortality in patients affected by RASopathies. CARNET study results

OpenAIRE

Giulio Calcagni; Giuseppe Limongelli; Angelo D'Ambrosio; Francesco Gesualdo; Maria Cristina Digilio; Anwar Baban; Sonia B. Albanese; Paolo Versacci; Enrica De Luca; Giovanni B. Ferrero; Giuseppina Baldassarre; Gabriella Agnoletti; Elena Banaudi; Jan Marek; Juan P. Kaski

2018-01-01

A comprehensive description of morbidity and mortality in patients affected by mutations in genes encoding for signal transducers of the RAS-MAPK cascade (RASopathies) was performed in our study recently published in the International Journal of Cardiology. Seven European cardiac centres participating to the CArdiac Rasopathy NETwork (CARNET), collaborated in this multicentric, observational, retrospective data analysis and collection. In this study, clinical records of 371 patients with conf...

a comparative analysis of first day neonatal mortality between

African Journals Online (AJOL)

East African Medical Journal Vol. 90 No. 11 November 2013. A COMPARATIVE ANALYSIS OF FIRST DAY NEONATAL MORTALITY BETWEEN ADOLESCENTS AND ADULT. FEMALES GIVING BIRTH AT LIGULA HOSPITAL IN MTWARA, SOUTH EASTERN TANZANIA 2008 – 2009. A. Ramaiya, MSc, Ifakara Health ...

Size matters: a meta-analysis on the impact of hospital size on patient mortality.

Science.gov (United States)

Fareed, Naleef

2012-06-01

This paper seeks to understand the relationship between hospital size and patient mortality. Patient mortality has been used by several studies in the health services research field as a proxy for measuring healthcare quality. A systematic review is conducted to identify studies that investigate the impact of hospital size on patient mortality. Using the findings of 21 effect sizes from 10 eligible studies, a meta-analysis is performed using a random effects model. Subgroup analyses using three factors--the measure used for hospital size, type of mortality measure used and whether mortality was adjusted or unadjusted--were utilised to investigate their moderating influence on the study's primary relationship. Results from this analysis indicate that big hospitals have lower odds of patient mortality versus small hospitals. Specifically, the probability of patient mortality in a big hospital, in reference to a small hospital, is 11% less. Subgroup analyses show that studies with unadjusted mortality rates have an even lower overall odds ratio of mortality versus studies with adjusted mortality rates. Aside from some limitations in data reporting, the findings of this paper support theoretical notions that big hospitals have lower mortality rates than small hospitals. Guidelines for better data reporting and future research are provided to further explore the phenomenon. Policy implications of this paper's findings are underscored and a sense of urgency is called for in an effort to help improve the state of a healthcare system that struggles with advancing healthcare quality. © 2012 The Author. International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute.

Persuading Collaboration: Analysing Persuasion in Online Collaboration Projects

DEFF Research Database (Denmark)

McHugh, Ronan; Larsen, Birger

2010-01-01

In this paper we propose that online collaborative production sites can be fruitfully analysed in terms of the general theoretical framework of Persuasive Design. OpenStreetMap and The Pirate Bay are used as examples of collaborative production sites. Results of a quantitative analysis of persuas...

Gearbox Reliability Collaborative Gearbox 1 Failure Analysis Report: December 2010 - January 2011

Energy Technology Data Exchange (ETDEWEB)

Errichello, R.; Muller, J.

2012-02-01

Unintended gearbox failures have a significant impact on the cost of wind farm operations. In 2007, NREL initiated the Gearbox Reliability Collaborative (GRC). The project combines analysis, field testing, dynamometer testing, condition monitoring, and the development and population of a gearbox failure database in a multi-pronged approach to determine why wind turbine gearboxes do not achieve their expected design life. The collaborative of manufacturers, owners, researchers, and consultants focuses on gearbox testing and modeling and the development of a gearbox failure database. Collaborative members also investigate gearbox condition monitoring techniques. Data gained from the GRC will enable designers, developers, and manufacturers to improve gearbox designs and testing standards and create more robust modeling tools. GRC project essentials include the development of two identical, heavily instrumented representative gearbox designs. Knowledge gained from the field and dynamometer tests conducted on these gearboxes builds an understanding of how the selected loads and events translate into bearing and gear response. This report contains the analysis of the first gearbox design.

Inequality in outcomes for adolescents living with perinatally acquired HIV in sub-Saharan Africa: a Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Cohort Collaboration analysis.

Science.gov (United States)

2018-02-01

Eighty percent of adolescents living with perinatally and behaviourally acquired HIV live in sub-Saharan Africa (SSA), a continent with marked economic inequality. As part of our global project describing adolescents living with perinatally acquired HIV (APH), we aimed to assess whether inequality in outcomes exists by country income group (CIG) for APH within SSA. Through the CIPHER cohort collaboration, individual retrospective data from 7 networks and 25 countries in SSA were included. APH were included if they entered care at age 10 years. World Bank CIG classification for median year of first visit was used. Cumulative incidence of mortality, transfer-out and loss-to-follow-up was calculated by competing risks analysis. Mortality was compared across CIG by Cox proportional hazards models. A total of 30,296 APH were included; 50.9% were female and 75.7% were resident in low-income countries (LIC). Median [interquartile range (IQR)] age at antiretroviral therapy (ART) start was 8.1 [6.3; 9.5], 7.8 [6.2; 9.3] and 7.3 [5.2; 8.9] years in LIC, lower-middle income countries (LMIC) and upper-middle income countries (UMIC) respectively. Median age at last follow-up was 12.1 [10.9; 13.8] years, with no difference between CIG. Cumulative incidence (95% CI) for mortality between age 10 and 15 years was lowest in UMIC (1.1% (0.8; 1.4)) compared to LIC (3.5% (3.1; 3.8)) and LMIC (3.9% (2.7; 5.4)). Loss-to-follow-up was highest in UMIC (14.0% (12.9; 15.3)) compared to LIC (13.1% (12.4; 13.8)) and LMIC (8.3% (6.3; 10.6)). Adjusted mortality hazard ratios (95% CI) for APH in LIC and LMIC in reference to UMIC were 2.50 (1.85; 3.37) and 2.96 (1.90; 4.61) respectively, with little difference when restricted only to APH who ever received ART. In adjusted analyses mortality was similar for male and female APH. Results highlight probable inequality in mortality according to CIG in SSA even when ART was received. These findings highlight that without attention towards SDG 10 (to

Meta-analysis of randomized trials of effect of milrinone on mortality in cardiac surgery: an update.

Science.gov (United States)

Majure, David T; Greco, Teresa; Greco, Massimiliano; Ponschab, Martin; Biondi-Zoccai, Giuseppe; Zangrillo, Alberto; Landoni, Giovanni

2013-04-01

The long-term use of milrinone is associated with increased mortality in chronic heart failure. A recent meta-analysis suggested that it might increase mortality in patients undergoing cardiac surgery. The authors conducted an updated meta-analysis of randomized trials in patients undergoing cardiac surgery to determine if milrinone impacted survival. A meta-analysis. Hospitals. One thousand thirty-seven patients from 20 randomized trials. None. Biomed, Central, PubMed, EMBASE, the Cochrane central register of clinical trials, and conference proceedings were searched for randomized trials that compared milrinone versus placebo or any other control in adult and pediatric patients undergoing cardiac surgery. Authors of trials that did not include mortality data were contacted. Only trials for which mortality data were available were included. Overall analysis showed no difference in mortality between patients receiving milrinone versus control (12/554 [2.2%] in the milrinone group v 10/483 [2.1%] in the control arm; relative risk [RR] = 1.15; 95% confidence interval [CI], 0.55-2.43; p = 0.7) or in analysis restricted to adults (11/364 [3%] in the milrinone group v 9/371 [2.4%] in the control arm; RR = 1.17; 95% CI, 0.54-2.53; p = 0.7). Sensitivity analyses in trials with a low risk of bias showed a trend toward an increase in mortality with milrinone (8/153 [5.2%] in the milrinone arm v 2/152 [1.3%] in the control arm; RR = 2.71; 95% CI, 0.82-9; p for effect = 0.10). Despite theoretic concerns for increased mortality with intravenous milrinone in patients undergoing cardiac surgery, the authors were unable to confirm an adverse effect on survival. However, sensitivity analysis of high-quality trials showed a trend toward increased mortality with milrinone. Copyright © 2013 Elsevier Inc. All rights reserved.

Petroleum R and D collaboration

International Nuclear Information System (INIS)

Kerr, R.

1995-01-01

Conditions for collaboration in research and development (R and D) were developed based on a decision-tree analysis. A key requirement for effective R and D collaboration was stated to be the company's ability to internalize a significant portion of the benefits. This was seen as the principal factor that determined good collaborators and good industries for collaboration. It was noted that collaboration benefits can also be improved through R and D exchanges in collaborative associations. Simple decision-tree analysis tended to understate the advantages of collaboration. Portfolio risk reduction and inter-project synergies were significant additional advantages. Collaborative R and D was said to be the preferred route for the development of a broad base of petroleum-related technologies. 5 tabs., 2 figs

Excess mortality associated with hypopituitarism in adults: a meta-analysis of observational studies.

Science.gov (United States)

Pappachan, Joseph M; Raskauskiene, Diana; Kutty, V Raman; Clayton, Richard N

2015-04-01

Several previous observational studies showed an association between hypopituitarism and excess mortality. Reports on reduction of standard mortality ratio (SMR) with GH replacement have been published recently. This meta-analysis assessed studies reporting SMR to clarify mortality risk in hypopituitary adults and also the potential benefit conferred by GH replacement. A literature search was performed in Medline, Embase, and Cochrane library up to March 31, 2014. Studies with or without GH replacement reporting SMR with 95% confidence intervals (95% CI) were included. Patient characteristics, SMR data, and treatment outcomes were independently assessed by two authors, and with consensus from third author, studies were selected for analysis. Meta-analysis was performed in all studies together, and those without and with GH replacement separately, using the statistical package metafor in R. Six studies reporting a total of 19 153 hypopituiatary adults with a follow-up duration of more than 99,000 person years were analyzed. Hypopituitarism was associated with an overall excess mortality (weighted SMR, 1.99; 95% CI, 1.21-2.76) in adults. Female hypopituitary adults showed higher SMR compared with males (2.53 vs 1.71). Onset of hypopituitarism at a younger age was associated with higher SMR. GH replacement improved the mortality risk in hypopituitary adults that is comparable to the background population (SMR with GH replacement, 1.15; 95% CI, 1.05-1.24 vs SMR without GH, 2.40; 95% CI, 1.46-3.34). GH replacement conferred lower mortality benefit in hypopituitary women compared with men (SMR, 1.57; 95% CI, 1.38-1.77 vs 0.95; 95% CI, 0.85-1.06). There was a potential selection bias of benefit of GH replacement from a post-marketing data necessitating further evidence from long-term randomized controlled trials. Hypopituitarism may increase premature mortality in adults. Mortality benefit from GH replacement in hypopituitarism is less pronounced in women than men.

Scientific Collaboration in Chinese Nursing Research: A Social Network Analysis Study.

Science.gov (United States)

Hou, Xiao-Ni; Hao, Yu-Fang; Cao, Jing; She, Yan-Chao; Duan, Hong-Mei

2016-01-01

Collaboration has become very important in research and in technological progress. Coauthorship networks in different fields have been intensively studied as an important type of collaboration in recent years. Yet there are few published reports about collaboration in the field of nursing. This article aimed to reveal the status and identify the key features of collaboration in the field of nursing in China. Using data from the top 10 nursing journals in China from 2003 to 2013, we constructed a nursing scientific coauthorship network using social network analysis. We found that coauthorship was a common phenomenon in the Chinese nursing field. A coauthorship network with 228 subnetworks formed by 1428 nodes was constructed. The network was relatively loose, and most subnetworks were of small scales. Scholars from Shanghai and from military medical system were at the center of the Chinese nursing scientific coauthorship network. We identified the authors' positions and influences according to the research output and centralities of each author. We also analyzed the microstructure and the evolution over time of the maximum subnetwork.

Distributed analysis with PROOF in ATLAS collaboration

International Nuclear Information System (INIS)

Panitkin, S Y; Ernst, M; Ito, H; Maeno, T; Majewski, S; Rind, O; Tarrade, F; Wenaus, T; Ye, S; Benjamin, D; Montoya, G Carillo; Guan, W; Mellado, B; Xu, N; Cranmer, K; Shibata, A

2010-01-01

The Parallel ROOT Facility - PROOF is a distributed analysis system which allows to exploit inherent event level parallelism of high energy physics data. PROOF can be configured to work with centralized storage systems, but it is especially effective together with distributed local storage systems - like Xrootd, when data are distributed over computing nodes. It works efficiently on different types of hardware and scales well from a multi-core laptop to large computing farms. From that point of view it is well suited for both large central analysis facilities and Tier 3 type analysis farms. PROOF can be used in interactive or batch like regimes. The interactive regime allows the user to work with typically distributed data from the ROOT command prompt and get a real time feedback on analysis progress and intermediate results. We will discuss our experience with PROOF in the context of ATLAS Collaboration distributed analysis. In particular we will discuss PROOF performance in various analysis scenarios and in multi-user, multi-session environments. We will also describe PROOF integration with the ATLAS distributed data management system and prospects of running PROOF on geographically distributed analysis farms.

Distributed analysis with PROOF in ATLAS collaboration

Energy Technology Data Exchange (ETDEWEB)

Panitkin, S Y; Ernst, M; Ito, H; Maeno, T; Majewski, S; Rind, O; Tarrade, F; Wenaus, T; Ye, S [Brookhaven National Laboratory, Upton, NY 11973 (United States); Benjamin, D [Duke University, Durham, NC 27708 (United States); Montoya, G Carillo; Guan, W; Mellado, B; Xu, N [University of Wisconsin-Madison, Madison, WI 53706 (United States); Cranmer, K; Shibata, A [New York University, New York, NY 10003 (United States)

2010-04-01

The Parallel ROOT Facility - PROOF is a distributed analysis system which allows to exploit inherent event level parallelism of high energy physics data. PROOF can be configured to work with centralized storage systems, but it is especially effective together with distributed local storage systems - like Xrootd, when data are distributed over computing nodes. It works efficiently on different types of hardware and scales well from a multi-core laptop to large computing farms. From that point of view it is well suited for both large central analysis facilities and Tier 3 type analysis farms. PROOF can be used in interactive or batch like regimes. The interactive regime allows the user to work with typically distributed data from the ROOT command prompt and get a real time feedback on analysis progress and intermediate results. We will discuss our experience with PROOF in the context of ATLAS Collaboration distributed analysis. In particular we will discuss PROOF performance in various analysis scenarios and in multi-user, multi-session environments. We will also describe PROOF integration with the ATLAS distributed data management system and prospects of running PROOF on geographically distributed analysis farms.

Mortality from idiopathic pulmonary fibrosis: a temporal trend analysis in Brazil, 1979-2014

OpenAIRE

Algranti, Eduardo; Saito, Cézar Akiyoshi; Silva, Diego Rodrigues Mendonça e; Carneiro, Ana Paula Scalia; Bussacos, Marco Antonio

2017-01-01

ABSTRACT Objective: To analyze mortality from idiopathic pulmonary fibrosis (IPF) in Brazil over the period 1979-2014. Methods: Microdata were extracted from the Brazilian National Ministry of Health Mortality Database. Only deaths for which the underlying cause was coded as International Classification of Diseases version 9 (ICD-9) 515 or 516.3 (until 1995) or as ICD version 10 (ICD-10) J84.1 (from 1996 onward) were included in our analysis. Standardized mortality rates were calculated for...

The Effects of Mobile-Computer-Supported Collaborative Learning: Meta-Analysis and Critical Synthesis.

Science.gov (United States)

Sung, Yao-Ting; Yang, Je-Ming; Lee, Han-Yueh

2017-08-01

One of the trends in collaborative learning is using mobile devices for supporting the process and products of collaboration, which has been forming the field of mobile-computer-supported collaborative learning (mCSCL). Although mobile devices have become valuable collaborative learning tools, evaluative evidence for their substantial contributions to collaborative learning is still scarce. The present meta-analysis, which included 48 peer-reviewed journal articles and doctoral dissertations written over a 16-year period (2000-2015) involving 5,294 participants, revealed that mCSCL has produced meaningful improvements for collaborative learning, with an overall mean effect size of 0.516. Moderator variables, such as domain subject, group size, teaching method, intervention duration, and reward method were related to different effect sizes. The results provided implications for future research and practice, such as suggestions on how to appropriately use the functionalities of mobile devices, how to best leverage mCSCL through effective group learning mechanisms, and what outcome variables should be included in future studies to fully elucidate the process and products of mCSCL.

Second analysis of mortality of nuclear industry workers in Japan, 1986-1997

International Nuclear Information System (INIS)

Ohshima, Sumio; Murata, Motoi

2001-01-01

This article is a commentary concerning the second report of the study in the title committed by the Science and Technology Agency (the present Ministry of Education, Culture, Sports, Science and Technology) to Radiation Effects Association. The study is an epidemiological one as for the relationships between long-term low dose radiation and its health effects in workers of nuclear industry like nuclear power plant and uses the cohort methodology for the factor (exposure dose) and diseases (mortality). In about 244,000 personnel, mortality was calculated from obtainable 179,000 resident cards of object males. For those died during the study period, cause of death was checked with the card for the movement of population (Ministry of Health, Labor and Welfare). The exposure dose was checked with the dose records of radiation workers stored in the registration center. Analysis results of standardized mortality ratio (comparison of mortality of the objects and non-object Japanese males) and of correlation of integrated dose and mortality gave no clear evidence that the low dose radiation exposure affects the mortality due to cancer. (K.H.)

Victorian Audit of Surgical Mortality is associated with improved clinical outcomes.

Science.gov (United States)

Beiles, C Barry; Retegan, Claudia; Maddern, Guy J

2015-11-01

Improved outcomes are desirable results of clinical audit. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM) and the Victorian Admitted Episodes Dataset (VAED) to highlight specific areas of clinical improvement and reduction in mortality over the duration of the audit process. This study used retrospective, observational data from VASM and VAED. VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Aggregated VAED data were supplied by the Victorian Department of Health. Assessment of outcomes was performed using chi-squared trend analysis over successive annual audit periods. Because initial collection of data was incomplete in the recruitment phase, statistical analysis was confined to the last 3-year period, 2010-2013. A 20% reduction in surgical mortality over the past 5 years has been identified from the VAED data. Progressive increase in both surgeon and hospital participation, significant reduction in both errors in management as perceived by assessors and increased direct consultant involvement in cases returned to theatre have been documented. The benefits of VASM are reflected in the association with a reduction of mortality and adverse clinical outcomes, which have clinical and financial benefits. It is a purely educational exercise and continued participation in this audit will ensure the highest standards of surgical care in Australia. This also highlights the valuable collaboration between the Victorian Department of Health and the RACS. © 2014 Royal Australasian College of Surgeons.

When to start antiretroviral therapy in children aged 2-5 years: a collaborative causal modelling analysis of cohort studies from southern Africa.

Science.gov (United States)

Schomaker, Michael; Egger, Matthias; Ndirangu, James; Phiri, Sam; Moultrie, Harry; Technau, Karl; Cox, Vivian; Giddy, Janet; Chimbetete, Cleophas; Wood, Robin; Gsponer, Thomas; Bolton Moore, Carolyn; Rabie, Helena; Eley, Brian; Muhe, Lulu; Penazzato, Martina; Essajee, Shaffiq; Keiser, Olivia; Davies, Mary-Ann

2013-11-01

There is limited evidence on the optimal timing of antiretroviral therapy (ART) initiation in children 2-5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaborative dataset to determine the difference in mortality when starting ART in children aged 2-5 y immediately (irrespective of CD4 criteria), as recommended in the World Health Organization (WHO) 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4 percentage (CD4%) <25%. ART-naïve children enrolling in HIV care at IeDEA-SA sites who were between 24 and 59 mo of age at first visit and with ≥1 visit prior to ART initiation and ≥1 follow-up visit were included. We estimated mortality for ART initiation at different CD4 thresholds for up to 3 y using g-computation, adjusting for measured time-dependent confounding of CD4 percent, CD4 count, and weight-for-age z-score. Confidence intervals were constructed using bootstrapping. The median (first; third quartile) age at first visit of 2,934 children (51% male) included in the analysis was 3.3 y (2.6; 4.1), with a median (first; third quartile) CD4 count of 592 cells/mm(3) (356; 895) and median (first; third quartile) CD4% of 16% (10%; 23%). The estimated cumulative mortality after 3 y for ART initiation at different CD4 thresholds ranged from 3.4% (95% CI: 2.1-6.5) (no ART) to 2.1% (95% CI: 1.3%-3.5%) (ART irrespective of CD4 value). Estimated mortality was overall higher when initiating ART at lower CD4 values or not at all. There was no mortality difference between starting ART immediately, irrespective of CD4 value, and ART initiation at the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4% <25%, with mortality estimates of 2.1% (95% CI: 1.3%-3.5%) and 2.2% (95% CI: 1.4%-3.5%) after 3 y, respectively. The analysis was limited by loss to follow

When to start antiretroviral therapy in children aged 2-5 years: a collaborative causal modelling analysis of cohort studies from southern Africa.

Directory of Open Access Journals (Sweden)

Michael Schomaker

2013-11-01

Full Text Available There is limited evidence on the optimal timing of antiretroviral therapy (ART initiation in children 2-5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS-Southern Africa (IeDEA-SA collaborative dataset to determine the difference in mortality when starting ART in children aged 2-5 y immediately (irrespective of CD4 criteria, as recommended in the World Health Organization (WHO 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3 or CD4 percentage (CD4% <25%.ART-naïve children enrolling in HIV care at IeDEA-SA sites who were between 24 and 59 mo of age at first visit and with ≥1 visit prior to ART initiation and ≥1 follow-up visit were included. We estimated mortality for ART initiation at different CD4 thresholds for up to 3 y using g-computation, adjusting for measured time-dependent confounding of CD4 percent, CD4 count, and weight-for-age z-score. Confidence intervals were constructed using bootstrapping. The median (first; third quartile age at first visit of 2,934 children (51% male included in the analysis was 3.3 y (2.6; 4.1, with a median (first; third quartile CD4 count of 592 cells/mm(3 (356; 895 and median (first; third quartile CD4% of 16% (10%; 23%. The estimated cumulative mortality after 3 y for ART initiation at different CD4 thresholds ranged from 3.4% (95% CI: 2.1-6.5 (no ART to 2.1% (95% CI: 1.3%-3.5% (ART irrespective of CD4 value. Estimated mortality was overall higher when initiating ART at lower CD4 values or not at all. There was no mortality difference between starting ART immediately, irrespective of CD4 value, and ART initiation at the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3 or CD4% <25%, with mortality estimates of 2.1% (95% CI: 1.3%-3.5% and 2.2% (95% CI: 1.4%-3.5% after 3 y, respectively. The analysis was limited by loss to follow-up and

A critical review and meta-analysis of the association between overt hyperthyroidism and mortality

DEFF Research Database (Denmark)

Brandt, Frans; Green, Anders; Hegedüs, Laszlo

2011-01-01

Overt hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in stud...... design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis....

[Time-series analysis on effect of air pollution on stroke mortality in Tianjin, China].

Science.gov (United States)

Wang, De-zheng; Gu, Qing; Jiang, Guo-hong; Yang, De-yi; Zhang, Hui; Song, Gui-de; Zhang, Ying

2012-12-01

To investigate the effect of air pollution on stroke mortality in Tianjin, China, and to provide basis for stroke control and prevention. Total data of mortality surveillance were collected by Tianjin Centers for Disease Control and Prevention. Meteorological data and atmospheric pollution data were from Tianjin Meteorological Bureau and Tianjin Environmental Monitoring Center, respectively. Generalized additive Poisson regression model was used in time-series analysis on the relationship between air pollution and stroke mortality in Tianjin. Single-pollutant analysis and multi-pollutant analysis were performed after adjustment for confounding factors such as meteorological factors, long-term trend of death, "days of the week" effect and population. The crude death rates of stroke in Tianjin were from 136.67 in 2001 to 160.01/100000 in 2009, with an escalating trend (P = 0.000), while the standardized mortality ratios of stroke in Tianjin were from 138.36 to 99.14/100000, with a declining trend (P = 0.000). An increase of 10 µg/m³ in daily average concentrations of atmospheric SO₂, NO₂ and PM₁₀ led to 1.0105 (95%CI: 1.0060 ∼ 1.0153), 1.0197 (95%CI: 1.0149 ∼ 1.0246) and 1.0064 (95%CI: 1.0052 ∼ 1.0077), respectively, in relative risks of stroke mortality. SO₂ effect peaked after 1-day exposure, while NO₂ and PM₁₀ effects did within 1 day. Air pollution in Tianjin may increase the risk of stroke mortality in the population and induce acute onset of stroke. It is necessary to carry out air pollution control and allocate health resources rationally to reduce the hazard of stroke mortality.

All-cause mortality in treated HIV-infected adults with CD4 ≥500/mm3 compared with the general population

DEFF Research Database (Denmark)

Lewden, Charlotte; Bouteloup, Vincent; De Wit, Stéphane

2012-01-01

Using data from a large European collaborative study, we aimed to identify the circumstances in which treated HIV-infected individuals will experience similar mortality rates to those of the general population.......Using data from a large European collaborative study, we aimed to identify the circumstances in which treated HIV-infected individuals will experience similar mortality rates to those of the general population....

Collaborating with other developers : the ENMAX/Suncor experience

Energy Technology Data Exchange (ETDEWEB)

Vainstein, K. [Suncor Energy, Calgary, AB (Canada); Lawlor, D. [ENMAX Power Corp., Calgary, AB (Canada)

2006-07-01

Suncor Energy and ENMAX Power Corporation have both made significant investments in wind power energy development. In order to better understand the potential environmental impacts of wind power activities, the 2 companies recently collaborated together to develop the ENMAX/Suncor post construction monitoring program. The program is comprised of sensitive species monitoring; mortality searches; and bat habitat and migration studies. The collaboration was successful as both companies shared the same environmental philosophy, were committed to knowledge sharing, and operated wind farms in the same region. The program also provided significant cost savings for the 2 companies. The program has led to stronger relationships with community stakeholders in the region. While the ENMAX/Suncor collaboration was a success, energy source developers should consider their current commitments and the size of their projects before committing themselves to collaborative programs. A cost-splitting formula was agreed upon by the 2 companies, and a formal collaboration agreement was prepared before the program was established. Both Suncor and ENMAX have agreed to collaborate in future projects involving community engagement; public education on wind projects; and information-sharing. It was concluded that collaboration can lead to tangible benefits. However, projects and company values need to be similar for a collaboration to fully succeed. refs., tabs., figs.

An Analysis of Collaborative Problem-Solving Activities Mediated by Individual-Based and Collaborative Computer Simulations

Science.gov (United States)

Chang, C.-J.; Chang, M.-H.; Liu, C.-C.; Chiu, B.-C.; Fan Chiang, S.-H.; Wen, C.-T.; Hwang, F.-K.; Chao, P.-Y.; Chen, Y.-L.; Chai, C.-S.

2017-01-01

Researchers have indicated that the collaborative problem-solving space afforded by the collaborative systems significantly impact the problem-solving process. However, recent investigations into collaborative simulations, which allow a group of students to jointly manipulate a problem in a shared problem space, have yielded divergent results…

The effect of tuberculosis on mortality in HIV positive people: a meta-analysis.

Directory of Open Access Journals (Sweden)

Masja Straetemans

Full Text Available BACKGROUND: Tuberculosis is a leading cause of death in people living with HIV (PLWH. We conducted a meta analysis to assess the effect of tuberculosis on mortality in people living with HIV. METHODS: Meta-analysis of cohort studies assessing the effect of tuberculosis on mortality in PLWH. To identify eligible studies we systematically searched electronic databases (until December 2008, performed manual searches of citations from relevant articles, and reviewed conference proceedings. Multivariate hazard ratios (HR of mortality in PLWH with and without tuberculosis, estimated in individual cohort studies, were pooled using random effect weighting according to "Der Simonian Laird method" if the p-value of the heterogeneity test was <0.05. RESULTS: Fifteen cohort studies were systematically retrieved. Pooled overall analysis of these 15 studies estimating the effect of tuberculosis on mortality in PLWH showed a Hazard Ratio (HR of 1.8 (95% confidence interval (CI: 1.4-2.3. Subanalysis of 8 studies in which the cohort was not exposed to highly active antiretroviral therapy (HAART showed an HR of 2.6 (95% CI: 1.8-3.6. Subanalysis of 6 studies showed that tuberculosis did not show an effect on mortality in PLWH exposed to HAART: HR 1.1 (95% CI: 0.9-1.3. CONCLUSION: These results provide an indication of the magnitude of benefit to an individual that could have been expected if tuberculosis had been prevented. It emphasizes the need for additional studies assessing the effect of preventing tuberculosis or early diagnosis and treatment of tuberculosis in PLWH on reducing mortality. Furthermore, the results of the subgroup analyses in cohorts largely exposed to HAART provide additional support to WHO's revised guidelines, which include promoting the initiation of HAART for PLWH co-infected with tuberculosis. The causal effect of tuberculosis on mortality in PLWH exposed to HAART needs to be further evaluated once the results of more cohort studies

International Medical Collaboration: Lessons from Cuba

Science.gov (United States)

Castelló González, Mauro; Pons Vásquez, Reinaldo; Rodriguez Bencomo, David; Choonara, Imti

2016-01-01

Over 50,000 Cuban health professionals are currently working overseas in 67 different countries. They work in conjunction with local health professionals. The majority work in primary care in deprived areas. The aim is to reduce morbidity and mortality but also improve health in the long term by training local health professionals, and building both institutions and a structure to deliver health care alongside educating the local population. Cuba is a small, middle-income country. It has, however, made a significant international contribution in relation to medical collaboration. Cuba’s international collaboration is based on the principles of social justice and equity for all. It has set an example for other countries to emulate. PMID:27763571

International Medical Collaboration: Lessons from Cuba

Directory of Open Access Journals (Sweden)

Mauro Castelló González

2016-10-01

Full Text Available Over 50,000 Cuban health professionals are currently working overseas in 67 different countries. They work in conjunction with local health professionals. The majority work in primary care in deprived areas. The aim is to reduce morbidity and mortality but also improve health in the long term by training local health professionals, and building both institutions and a structure to deliver health care alongside educating the local population. Cuba is a small, middle-income country. It has, however, made a significant international contribution in relation to medical collaboration. Cuba’s international collaboration is based on the principles of social justice and equity for all. It has set an example for other countries to emulate.

Space-Time Analysis to Identify Areas at Risk of Mortality from Cardiovascular Disease

Directory of Open Access Journals (Sweden)

Poliany C. O. Rodrigues

2015-01-01

Full Text Available This study aimed at identifying areas that were at risk of mortality due to cardiovascular disease in residents aged 45 years or older of the cities of Cuiabá and Várzea Grande between 2009 and 2011. We conducted an ecological study of mortality rates related to cardiovascular disease. Mortality rates were calculated for each census tract by the Local Empirical Bayes estimator. High- and low-risk clusters were identified by retrospective space-time scans for each year using the Poisson probability model. We defined the year and month as the temporal analysis unit and the census tracts as the spatial analysis units adjusted by age and sex. The Mann-Whitney U test was used to compare the socioeconomic and environmental variables by risk classification. High-risk clusters showed higher income ratios than low-risk clusters, as did temperature range and atmospheric particulate matter. Low-risk clusters showed higher humidity than high-risk clusters. The Eastern region of Várzea Grande and the central region of Cuiabá were identified as areas at risk of mortality due to cardiovascular disease in individuals aged 45 years or older. High mortality risk was associated with socioeconomic and environmental factors. More high-risk clusters were observed at the end of the dry season.

Lost-to-follow-up bias in an occupational mortality analysis: a quantitative consideration

International Nuclear Information System (INIS)

Acquavella, J.F.; Tietjen, G.L.; Wilkinson, G.S.

1982-12-01

A major problem in occupational cohort studies is how to treat study subjects who are lost to follow-up (LTF). The assumptions made concerning their vital status may affect the results of comparative mortality analyses. The problem was considered within the context of an occupational follow-up study of white male employees at a nuclear facility in Colorado. In this analysis, 568 or 8% of cohort members were LTF. Comparative mortality for the entire cohort was estimated by treating LTF workers as lost at employment termination date, as living at the end-of-study date, and with cumulative mortality simulated between 0% and 100%. Results indicate that simulations of cumulative mortality among employees LTF can be useful in assessing the potential bias caused by LTF mortality assumptions. Further, a general method for assessing LTF bias in occupational analyses is proposed

Avoidable mortality among First Nations adults in Canada: A cohort analysis.

Science.gov (United States)

Park, Jungwee; Tjepkema, Michael; Goedhuis, Neil; Pennock, Jennifer

2015-08-01

Avoidable mortality is a measure of deaths that potentially could have been averted through effective prevention practices, public health policies, and/or provision of timely and adequate health care. This longitudinal analysis compares avoidable mortality among First Nations and non-Aboriginal adults. Data are from the 1991-to-2006 Canadian Census Mortality and Cancer Follow-up Study. A 15% sample of 1991 Census respondents aged 25 or older was linked to 16 years of mortality data. This study examines avoidable mortality among 61,220 First Nations and 2,510,285 non-Aboriginal people aged 25 to 74. During the 1991-to-2006 period, First Nations adults had more than twice the risk of dying from avoidable causes compared with non-Aboriginal adults. The age-standardized avoidable mortality rate (ASMR) per 100,000 person-years at risk for First Nations men was 679.2 versus 337.6 for non-Aboriginal men (rate ratio = 2.01). For women, ASMRs were lower, but the gap was wider. The ASMR for First Nations women was 453.2, compared with 183.5 for non-Aboriginal women (rate ratio = 2.47). Disparities were greater at younger ages. Diabetes, alcohol and drug use disorders, and unintentional injuries were the main contributors to excess avoidable deaths among First Nations adults. Education and income accounted for a substantial share of the disparities. The results highlight the gap in avoidable mortality between First Nations and non-Aboriginal adults due to specific causes of death and the association with socioeconomic factors.

When to Start Antiretroviral Therapy in Children Aged 2–5 Years: A Collaborative Causal Modelling Analysis of Cohort Studies from Southern Africa

Science.gov (United States)

Schomaker, Michael; Egger, Matthias; Ndirangu, James; Phiri, Sam; Moultrie, Harry; Technau, Karl; Cox, Vivian; Giddy, Janet; Chimbetete, Cleophas; Wood, Robin; Gsponer, Thomas; Bolton Moore, Carolyn; Rabie, Helena; Eley, Brian; Muhe, Lulu; Penazzato, Martina; Essajee, Shaffiq; Keiser, Olivia; Davies, Mary-Ann

2013-01-01

Background There is limited evidence on the optimal timing of antiretroviral therapy (ART) initiation in children 2–5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS–Southern Africa (IeDEA-SA) collaborative dataset to determine the difference in mortality when starting ART in children aged 2–5 y immediately (irrespective of CD4 criteria), as recommended in the World Health Organization (WHO) 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm3 or CD4 percentage (CD4%) <25%. Methods and Findings ART-naïve children enrolling in HIV care at IeDEA-SA sites who were between 24 and 59 mo of age at first visit and with ≥1 visit prior to ART initiation and ≥1 follow-up visit were included. We estimated mortality for ART initiation at different CD4 thresholds for up to 3 y using g-computation, adjusting for measured time-dependent confounding of CD4 percent, CD4 count, and weight-for-age z-score. Confidence intervals were constructed using bootstrapping. The median (first; third quartile) age at first visit of 2,934 children (51% male) included in the analysis was 3.3 y (2.6; 4.1), with a median (first; third quartile) CD4 count of 592 cells/mm3 (356; 895) and median (first; third quartile) CD4% of 16% (10%; 23%). The estimated cumulative mortality after 3 y for ART initiation at different CD4 thresholds ranged from 3.4% (95% CI: 2.1–6.5) (no ART) to 2.1% (95% CI: 1.3%–3.5%) (ART irrespective of CD4 value). Estimated mortality was overall higher when initiating ART at lower CD4 values or not at all. There was no mortality difference between starting ART immediately, irrespective of CD4 value, and ART initiation at the WHO 2010 recommended threshold of CD4 count <750 cells/mm3 or CD4% <25%, with mortality estimates of 2.1% (95% CI: 1.3%–3.5%) and 2.2% (95% CI: 1.4%–3.5%) after 3 y, respectively. The

[Scientific productivity, collaboration and research areas in Enfermedades Infecciosas y Microbiología Clínica (2003-2007)].

Science.gov (United States)

González-Alcaide, Gregorio; Valderrama-Zurián, Juan Carlos; Ramos-Rincón, José Manuel

2010-10-01

Collaboration is essential for biomedical research. The Carlos III Health Institute (the Spanish national public organization responsible for promoting biomedical research) has encouraged scientific collaboration by promoting Thematic Networks and Cooperative Research Centres. Scientific collaboration in Enfermedades Infecciosas y Microbiología Clinica journal is investigated. Papers published in Enfermedades Infecciosas y Microbiología Clinica in the period 2002-2007 have been identified. Bibliometrics and Social Network Analysis methods have been carried out in order to quantify and characterise scientific collaboration and research areas. A total of 805 papers generated by 2,289 authors and 326 institutions have been analysed. There were 36 research groups involving 138 authors identified. The Collaboration Index for articles was 5.5. Institutional collaboration was determined in 75% of articles. The collaboration between departments or units of the same institution prevails (43%), followed by intra-regional domestic collaboration (41%) and inter-regional domestic collaboration (14%). Hospital centres were the main institutional sector responsible of research (88% of papers), with 68% of articles cited. Sida/VIH (AIDS/HIV) is the main research area (n=114), followed by Staphylococcal Infections (n=33). Notable collaboration and citation rates have been observed. Research is focused on diseases with the highest mortality rates caused by infectious diseases in Spain. Copyright © 2009 Elsevier España, S.L. All rights reserved.

Weight Gain After Breast Cancer Diagnosis and All-Cause Mortality: Systematic Review and Meta-Analysis

Science.gov (United States)

Bracken, Michael B.; Sanft, Tara B.; Ligibel, Jennifer A.; Harrigan, Maura; Irwin, Melinda L.

2015-01-01

Background: Overweight and obesity are associated with breast cancer mortality. However, the relationship between postdiagnosis weight gain and mortality is unclear. We conducted a systematic review and meta-analysis of weight gain after breast cancer diagnosis and breast cancer–specific, all-cause mortality and recurrence outcomes. Methods: Electronic databases identified articles up through December 2014, including: PubMed (1966-present), EMBASE (1974-present), CINAHL (1982-present), and Web of Science. Language and publication status were unrestricted. Cohort studies and clinical trials measuring weight change after diagnosis and all-cause/breast cancer–specific mortality or recurrence were considered. Participants were women age 18 years or older with stage I-IIIC breast cancer. Fixed effects analysis summarized the association between weight gain (≥5.0% body weight) and all-cause mortality; all tests were two-sided. Results: Twelve studies (n = 23 832) were included. Weight gain (≥5.0%) compared with maintenance (breast cancer–specific mortality (HR = 1.17, 95% CI = 1.00 to 1.38, P = .05). Conclusions: Weight gain after diagnosis of breast cancer is associated with higher all-cause mortality rates compared with maintaining body weight. Adverse effects are greater for weight gains of 10.0% or higher. PMID:26424778

Dynamic analysis of interhospital collaboration and competition: empirical evidence from an Italian regional health system.

Science.gov (United States)

Mascia, Daniele; Di Vincenzo, Fausto; Cicchetti, Americo

2012-05-01

Policymakers stimulate competition in universalistic health-care systems while encouraging the formation of service provision networks among hospital organizations. This article addresses a gap in the extant literature by empirically analyzing simultaneous collaboration and competition between hospitals within the Italian National Health Service, where important procompetition reforms have been implemented. To explore how rising competition between hospitals relates to their propensity to collaborate with other local providers. Longitudinal data on interhospital collaboration and competition collected in an Italian region from 2003 to 2007 are analyzed. Social network analysis techniques are applied to study the structure and dynamics of interhospital collaboration. Negative binomial regressions are employed to explore how interhospital competition relates to the collaborative network over time. Competition among providers does not hinder interhospital collaboration. Collaboration is primarily local, with resource complementarity and differentials in the volume of activity and hospital performance explaining the propensity to collaborate. Formation of collaborative networks among hospitals is not hampered by reforms aimed at fostering market forces. Because procompetition reforms elicit peculiar forms of managed competition in universalistic health systems, studies are needed to clarify whether the positive association between interhospital competition and collaboration can be generalized to other health-care settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Mapping the research on scientific collaboration

Institute of Scientific and Technical Information of China (English)

HOU Jianhua; CHEN Chaomei; YAN Jianxin

2010-01-01

The aim of this paper was to identify the trends and hot topics in the study of scientific collaboration via scientometric analysis.Information visualization and knowledge domain visualization techniques were adopted to determine how the study of scientific collaboration has evolved.A total of 1,455 articles on scientific cooperation published between 1993 and 2007 were retrieved from the SCI,SSCI and A&HCI databases with a topic search of scientific collaboration or scientific cooperation for the analysis.By using CiteSpace,the knowledge bases,research foci,and research fronts in the field of scientific collaboration were studied.The results indicated that research fronts and research foci are highly consistent in terms of the concept,origin,measurement,and theory of scientific collaboration.It also revealed that research fronts included scientific collaboration networks,international scientific collaboration,social network analysis and techniques,and applications of bibliometrical indicators,webmetrics,and health care related areas.

Volunteering by older adults and risk of mortality: a meta-analysis.

Science.gov (United States)

Okun, Morris A; Yeung, Ellen WanHeung; Brown, Stephanie

2013-06-01

Organizational volunteering has been touted as an effective strategy for older adults to help themselves while helping others. Extending previous reviews, we carried out a meta-analysis of the relation between organizational volunteering by late-middle-aged and older adults (minimum age = 55 years old) and risk of mortality. We focused on unadjusted effect sizes (i.e., bivariate relations), adjusted effect sizes (i.e., controlling for other variables such as health), and interaction effect sizes (e.g., the joint effect of volunteering and religiosity). For unadjusted effect sizes, on average, volunteering reduced mortality risk by 47%, with a 95% confidence interval ranging from 38% to 55%. For adjusted effect sizes, on average, volunteering reduced mortality risk by 24%, with a 95% confidence interval ranging from 16% to 31%. For interaction effect sizes, we found preliminary support that as public religiosity increases, the inverse relation between volunteering and mortality risk becomes stronger. The discussion identifies several unresolved issues and directions for future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Prostate cancer mortality in Serbia, 1991-2010: a joinpoint regression analysis.

Science.gov (United States)

Ilic, Milena; Ilic, Irena

2016-06-01

The aim of this descriptive epidemiological study was to analyze the mortality trend of prostate cancer in Serbia (excluding the Kosovo and Metohia) from 1991 to 2010. The age-standardized prostate cancer mortality rates (per 100 000) were calculated by direct standardization, using the World Standard Population. Average annual percentage of change (AAPC) and the corresponding 95% confidence interval (CI) was computed for trend using the joinpoint regression analysis. Significantly increased trend in prostate cancer mortality was recorded in Serbia continuously from 1991 to 2010 (AAPC = +2.2, 95% CI = 1.6-2.9). Mortality rates for prostate cancer showed a significant upward trend in all men aged 50 and over: AAPC (95% CI) was +1.9% (0.1-3.8) in aged 50-59 years, +1.7% (0.9-2.6) in aged 60-69 years, +2.0% (1.2-2.9) in aged 70-79 years and +3.5% (2.4-4.6) in aged 80 years and over. According to comparability test, prostate cancer mortality trends in majority of age groups were parallel (final selected model failed to reject parallelism, P > 0.05). The increasing prostate cancer mortality trend implies the need for more effective measures of prevention, screening and early diagnosis, as well as prostate cancer treatment in Serbia. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Fever Is Associated with Reduced, Hypothermia with Increased Mortality in Septic Patients: A Meta-Analysis of Clinical Trials.

Science.gov (United States)

Rumbus, Zoltan; Matics, Robert; Hegyi, Peter; Zsiboras, Csaba; Szabo, Imre; Illes, Anita; Petervari, Erika; Balasko, Marta; Marta, Katalin; Miko, Alexandra; Parniczky, Andrea; Tenk, Judit; Rostas, Ildiko; Solymar, Margit; Garami, Andras

2017-01-01

Sepsis is usually accompanied by changes of body temperature (Tb), but whether fever and hypothermia predict mortality equally or differently is not fully clarified. We aimed to find an association between Tb and mortality in septic patients with meta-analysis of clinical trials. We searched the PubMed, EMBASE, and Cochrane Controlled Trials Registry databases (from inception to February 2016). Human studies reporting Tb and mortality of patients with sepsis were included in the analyses. Average Tb with SEM and mortality rate of septic patient groups were extracted by two authors independently. Forty-two studies reported Tb and mortality ratios in septic patients (n = 10,834). Pearson correlation analysis revealed weak negative linear correlation (R2 = 0.2794) between Tb and mortality. With forest plot analysis, we found a 22.2% (CI, 19.2-25.5) mortality rate in septic patients with fever (Tb > 38.0°C), which was higher, 31.2% (CI, 25.7-37.3), in normothermic patients, and it was the highest, 47.3% (CI, 38.9-55.7), in hypothermic patients (Tb 75%).

Unemployment, public-sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981-2009.

Science.gov (United States)

Maruthappu, Mahiben; Da Zhou, Charlie; Williams, Callum; Zeltner, Thomas; Atun, Rifat

2015-06-01

The global economic downturn has been associated with increased unemployment and reduced public-sector expenditure on health care (PSEH). We determined the association between unemployment, PSEH and HIV mortality. Data were obtained from the World Bank and the World Health Organisation (1981-2009). Multivariate regression analysis was implemented, controlling for country-specific demographics and infrastructure. Time-lag analyses and robustness-checks were performed. Data were available for 74 countries (unemployment analysis) and 75 countries (PSEH analysis), equating to 2.19 billion and 2.22 billion people, respectively, as of 2009. A 1% increase in unemployment was associated with a significant increase in HIV mortality (men: 0.1861, 95% CI: 0.0977 to 0.2744, P = 0.0000, women: 0.0383, 95% CI: 0.0108 to 0.0657, P = 0.0064). A 1% increase in PSEH was associated with a significant decrease in HIV mortality (men: -0.5015, 95% CI: -0.7432 to -0.2598, P = 0.0001; women: -0.1562, 95% CI: -0.2404 to -0.0720, P = 0.0003). Time-lag analysis showed that significant changes in HIV mortality continued for up to 5 years following variations in both unemployment and PSEH. Unemployment increases were associated with significant HIV mortality increases. PSEH increases were associated with reduced HIV mortality. The facilitation of access-to-care for the unemployed and policy interventions which aim to protect PSEH could contribute to improved HIV outcomes.

Collaborative entrepreneurship: On the Influence of Internal and External Collaboration on Corporate Entrepreneurial Innovation

DEFF Research Database (Denmark)

Lassen, Astrid Heidemann; Timenes Laugen, Bjørge; Middel, Rick

2008-01-01

The present paper empirically tests the effect which internal/external collaboration has on innovation height and identifies characteristics of collaboration patterns leading to entrepreneurial innovation in particular. Doing so adds to the understanding of how corporate entrepreneurship best...... unfolds as interfirm activity, which here is termed collaborative entrepreneurship, and provides details on the particular patterns of Open Innovation. The empirical analysis is based on a data set with responses from 512 Danish engineers. The analysis finds that external collaboration has significantly...... different effects on innovation height depending on the type of partners involved, and furthermore suggests that the development of entrepreneurial innovation is not only dependent on high external involvement, but also on involvement and collaboration among internal functional departments and people....

Collaborative Consumption

DEFF Research Database (Denmark)

Gjerdrum Pedersen, Esben Rahbek; Netter, Sarah

2015-01-01

Purpose – The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach – The analysis is based on a multiple-case study of Scandinavian fashion libraries – a new...... to the new phenomenon of fashion libraries and does not cover other types of collaborative consumption within the fashion industry (Swap-parties, etc.). Originality/value – The paper is one of the first attempts to examine new business models of collaborative consumption in general and the fashion library...... concept in particular. The study contributes to the discussions of whether and how fashion sharing and collaboration holds promise as a viable business model and as a means to promote sustainability....

Colorectal cancer mortality trends in Serbia during 1991-2010: an age-period-cohort analysis and a joinpoint regression analysis.

Science.gov (United States)

Ilic, Milena; Ilic, Irena

2016-06-22

For both men and women worldwide, colorectal cancer is among the leading causes of cancer-related death. This study aimed to assess the mortality trends of colorectal cancer in Serbia between 1991 and 2010, prior to the introduction of population-based screening. Joinpoint regression analysis was used to estimate average annual percent change (AAPC) with the corresponding 95% confidence interval (CI). Furthermore, age-period-cohort analysis was performed to examine the effects of birth cohort and calendar period on the observed temporal trends. We observed a significantly increased trend in colorectal cancer mortality in Serbia during the study period (AAPC = 1.6%, 95% CI 1.3%-1.8%). Colorectal cancer showed an increased mortality trend in both men (AAPC = 2.0%, 95% CI 1.7%-2.2%) and women (AAPC = 1.0%, 95% CI 0.6%-1.4%). The temporal trend of colorectal cancer mortality was significantly affected by birth cohort (P < 0.05), whereas the study period did not significantly affect the trend (P = 0.072). Colorectal cancer mortality increased for the first several birth cohorts in Serbia (from 1916 to 1955), followed by downward flexion for people born after the 1960s. According to comparability test, overall mortality trends for colon cancer and rectal and anal cancer were not parallel (the final selected model rejected parallelism, P < 0.05). We found that colorectal cancer mortality in Serbia increased considerably over the past two decades. Mortality increased particularly in men, but the trends were different according to age group and subsite. In Serbia, interventions to reduce colorectal cancer burden, especially the implementation of a national screening program, as well as treatment improvements and measures to encourage the adoption of a healthy lifestyle, are needed.

How social network analysis can be used to monitor online collaborative learning and guide an informed intervention.

Science.gov (United States)

Saqr, Mohammed; Fors, Uno; Tedre, Matti; Nouri, Jalal

2018-01-01

To ensure online collaborative learning meets the intended pedagogical goals (is actually collaborative and stimulates learning), mechanisms are needed for monitoring the efficiency of online collaboration. Various studies have indicated that social network analysis can be particularly effective in studying students' interactions in online collaboration. However, research in education has only focused on the theoretical potential of using SNA, not on the actual benefits they achieved. This study investigated how social network analysis can be used to monitor online collaborative learning, find aspects in need of improvement, guide an informed intervention, and assess the efficacy of intervention using an experimental, observational repeated-measurement design in three courses over a full-term duration. Using a combination of SNA-based visual and quantitative analysis, we monitored three SNA constructs for each participant: the level of interactivity, the role, and position in information exchange, and the role played by each participant in the collaboration. On the group level, we monitored interactivity and group cohesion indicators. Our monitoring uncovered a non-collaborative teacher-centered pattern of interactions in the three studied courses as well as very few interactions among students, limited information exchange or negotiation, and very limited student networks dominated by the teacher. An intervention based on SNA-generated insights was designed. The intervention was structured into five actions: increasing awareness, promoting collaboration, improving the content, preparing teachers, and finally practicing with feedback. Evaluation of the intervention revealed that it has significantly enhanced student-student interactions and teacher-student interactions, as well as produced a collaborative pattern of interactions among most students and teachers. Since efficient and communicative activities are essential prerequisites for successful content

Oesophageal atresia in premature infants: an analysis of morbidity and mortality over a period of 20 years

NARCIS (Netherlands)

Deurloo, J. A.; Smit, B. J.; Ekkelkamp, S.; Aronson, D. C.

2004-01-01

Aim: To determine the morbidity and mortality of premature infants born with oesophageal atresia (OA) and to evaluate historical changes in morbidity and mortality over time. Methods: Retrospective analysis of morbidity and mortality of all patients admitted for OA, with or without

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis

Science.gov (United States)

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N’Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2017-01-01

Background There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions. Methods ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. Results About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes. Conclusions Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%. PMID:26479876

Collaboration in scientific practice

DEFF Research Database (Denmark)

Wagenknecht, Susann

2014-01-01

This monograph investigates the collaborative creation of scientific knowledge in research groups. To do so, I combine philosophical analysis with a first-hand comparative case study of two research groups in experimental science. Qualitative data are gained through observation and interviews......, and I combine empirical insights with existing approaches to knowledge creation in philosophy of science and social epistemology. On the basis of my empirically-grounded analysis I make several conceptual contributions. I study scientific collaboration as the interaction of scientists within research...... to their publication. Specifically, I suggest epistemic difference and the porosity of social structure as two conceptual leitmotifs in the study of group collaboration. With epistemic difference, I emphasize the value of socio-cognitive heterogeneity in group collaboration. With porosity, I underline the fact...

High mortality in the Thule cohort

DEFF Research Database (Denmark)

Juel, K

1994-01-01

The objective was to study mortality in the Thule cohort in order to clarify whether it is a selected population and to ascertain the possibility of misinterpretation when national mortality rates are used as reference in the analysis of occupational mortality.......The objective was to study mortality in the Thule cohort in order to clarify whether it is a selected population and to ascertain the possibility of misinterpretation when national mortality rates are used as reference in the analysis of occupational mortality....

Meta-analysis of surgical safety checklist effects on teamwork, communication, morbidity, mortality, and safety.

Science.gov (United States)

Lyons, Vanessa E; Popejoy, Lori L

2014-02-01

The purpose of this study is to examine the effectiveness of surgical safety checklists on teamwork, communication, morbidity, mortality, and compliance with safety measures through meta-analysis. Four meta-analyses were conducted on 19 studies that met the inclusion criteria. The effect size of checklists on teamwork and communication was 1.180 (p = .003), on morbidity and mortality was 0.123 (p = .003) and 0.088 (p = .001), respectively, and on compliance with safety measures was 0.268 (p teamwork and communication, reduce morbidity and mortality, and improve compliance with safety measures. This meta-analysis is limited in its generalizability based on the limited number of studies and the inclusion of only published research. Future research is needed to examine possible moderating variables for the effects of surgical safety checklists.

Excess under-5 female mortality across India: a spatial analysis using 2011 census data

Directory of Open Access Journals (Sweden)

Christophe Z Guilmoto, PhD

2018-06-01

Full Text Available Summary: Background: Excess female mortality causes half of the missing women (estimated deficit of women in countries with suspiciously low proportion of females in their population today. Globally, most of these avoidable deaths of women occur during childhood in China and India. We aimed to estimate excess female under-5 mortality rate (U5MR for India's 35 states and union territories and 640 districts. Methods: Using the summary birth history method (or Brass method, we derived district-level estimates of U5MR by sex from 2011 census data. We used data from 46 countries with no evidence of gender bias for mortality to estimate the effects and intensity of excess female mortality at district level. We used a detailed spatial and statistical analysis to highlight the correlates of excess mortality at district level. Findings: Excess female U5MR was 18·5 per 1000 livebirths (95% CI 13·1–22·6 in India 2000–2005, which corresponds to an estimated 239 000 excess deaths (169 000–293 000 per year. More than 90% of districts had excess female mortality, but the four largest states in northern India (Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh accounted for two-thirds of India's total number. Low economic development, gender inequity, and high fertility were the main predictors of excess female mortality. Spatial analysis confirmed the strong spatial clustering of postnatal discrimination against girls in India. Interpretation: The considerable effect of gender bias on mortality in India highlights the need for more proactive engagement with the issue of postnatal sex discrimination and a focus on the northern districts. Notably, these regions are not the same as those most affected by skewed sex ratio at birth. Funding: None.

Collaborative Consumption

DEFF Research Database (Denmark)

Gjerdrum Pedersen, Esben Rahbek; Netter, Sarah

Purpose: The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach: The analysis is based on a multiple-­‐‑case study of Scandinavian fashion libraries – a new...... to the new phenomenon of fashion libraries and does not cover other types of collaborative consumption within the fashion industry (Swap-­‐‑parties, etc.). Originality/value: The paper is one of the first attempts to examine new business models of collaborative consumption in general and the fashion library...... concept in particular. The study contributes to the discussions of whether and how fashion sharing and collaboration holds promise as a viable business model and as a means to promote sustainability....

Mortality reduction by post-dilution online-haemodiafiltration : A cause-specific analysis

NARCIS (Netherlands)

Nubé, Menso J.; Peters, Sanne A E; Blankestijn, Peter J.; Canaud, Bernard; Davenport, Andrew; Grooteman, Muriel P C; Asci, Gulay; Locatelli, Francesco; Maduell, Francisco; Morena, Marion; Ok, Ercan; Torres, Ferran; Bots, Michiel L.; Moreso, Francesc; Pons, Mercedes; Ramos, Rosa; Mora-Macià, Josep; Carreras, Jordi; Soler, Jordi; Campistol, Josep M.; Martinez-Castelao, Alberto; Insensé, B.; Perez, C.; Feliz, T.; Barbetta, M.; Soto, C.; Mora, J.; Juan, A.; Ibrik, O.; Foraster, A.; Nin, J.; Fernández, A.; Arruche, M.; Sánchez, C.; Vidiella, J.; Barbosa, F.; Chiné, M.; Hurtado, S.; Llibre, J.; Ruiz, A.; Serra, M.; Salvó, M.; Poyuelo, T.; Maduell, F.; Carrera, M.; Fontseré, N.; Arias, M.; Merín, A.; Ribera, L.; Galceran, J. M.; Mòdol, J.; Moliner, E.; Ramirez, A.; Aguilera, J.; Alvarez, M.; De La Torre, B.; Molera, M.; Casellas, J.; Martín, G.; Andres, E.; Coll, E.; Valles, M.; Martínez, C.; Castellote, E.; Casals, J. M.; Gabàs, J.; Romero, M.; Martinez-Castelao, A.; Fulladosa, X.; Ramirez-Arellano, M.; Fulquet, M.; Pelegrí, A.; El Manouari, M.; Ramos, N.; Bartolomé, J.; Sans, R.; Fernández, E.; Sarró, F.; Compte, T.; Marco, F.; Mauri, R.; Bronsoms, J.; Arnaiz, J. A.; Beleta, H.; Pejenaute, A.; Ríos, J.; Lara, J.; Ter Wee, P. M.; Van Den Dorpel, M. A.; Dorval, M.; Lévesque, R.; Koopman, M. G.; Konings, C. J A M; Haanstra, W. P.; Kooistra, M.; Van Jaarsveld, B.; Noordzij, T.; Feith, G. W.; Peltenburg, H. G.; Van Buren, M.; Offerman, J. J G; Hoogeveen, E. K.; De Heer, F.; Van De Ven, P. J.; Kremer Hovinga, T. K.; Bax, W. A.; Groeneveld, J. O.; Lavrijssen, A. T J; Schrander-Van Der Meer, A. M.; Reichert, L. J M; Huussen, J.; Rensma, P. L.; Schrama, Y.; Van Hamersvelt, H. W.; Boer, W. H.; Van Kuijk, W. H.; Vervloet, M. G.; Wauters, I. M P M J; Sekse, I.; Toz, Huseyin; Ok, Ebru Sevinc; Kircelli, Fatih; Yilmaz, Mumtaz; Hur, Ender; Demirci, Meltem Sezis; Demirci, Cenk; Duman, Soner; Basci, Ali; Adam, Siddig Momin; Isik, Ismet Onder; Zengin, Murat; Suleymanlar, Gultekin; Yilmaz, Mehmet Emin; Ergin, Mehmet Ozkahya Pinar; Sagdic, Alfert; Kayali, Erkan; Boydak, Can; Colak, Taskin; Caliskan, Sihli; Kaplan, Hakan; Ulas, Hasibe; Kirbiyik, Sait; Berktas, Hakan; Dilbaz, Necati; Cristol, Jean Paul; Leray-Moragues, Hélène; Chenine, Leïla; Picot, Marie Christine; Jaussent, Audrey; Belloc, Claire; Lagarrigue, Mélodie; Chalabi, Lotfi; Debure, Alain; Ouziala, Messaoud; Lefevre, Jean Jacques; Thibaudin, Damien; Mohey, Hesham; Broyet, Christian; Afiani, Aida; Serveaux, Marie Odile; Patrier, Laure; Maurice, François; Rivory, Jean Pierre; Nicoud, Philippe; Durand, Claude; Normand, Michel; Seigneuric, Bruno; Magnant, Eric; Azzouz, Lynda; Islam, Mohamed Shariful; Vido, Sandor; Nzeyimana, Hilaire; Simonin, Danièle; Azymah, Yamina; Farah, Ibrahim; Coindre, Jean Philippe; Puyoo, Olivier; Chabannier, Marie Hélène; Ibos, Richard; Rouleau, Fabienne; Vela, Carlos; Joule, Josiane; Combarnous, François; Turc-Baron, Cécile; Ducret, Francis; Pointet, Philippe; Rey, Isabelle; Potier, Jacky; Bendini, Jean Christophe; Perrin, Franck; Kunz, Kristian; Lefrancois, Gaëlle; Colin, Angélique; Parahy, Sophie; Dancea, Irima; Coupel, Stéphanie; Testa, Angelo; Brunet, Philippe; Lebrun, Gaétan; Jaubert, Dominique; Delcroix, Catherine; Lavainne, Frédéric; Lefebvre, Anne; Guillodo, Marie Paule; Le Grignou, Dominique; Djema, Assia; Maaz, Mehadji; Chiron, Sylvie; Hoffmann, Maxime; Depraetre, Pascale; Haddj-Elmrabet, Atman; Joyeux, Véronique; Fleury, Dominique; Vrigneaud, Laurence; Lemaitre, Vincent; Aguilera, Didier; Guerraoui, Abdallah; Cremault, Alain; Laradi, Achour; Babinet, Francois

Background. From an individual participant data (IPD) meta-analysis from four randomized controlled trials comparing haemodialysis (HD) with post-dilution online-haemodiafiltration (ol-HDF), previously it appeared that HDF decreases all-cause mortality by 14% (95% confidence interval 25; 1) and

Visualization analysis of author collaborations in schizophrenia research

OpenAIRE

Wu, Ying; Duan, Zhiguang

2015-01-01

Background Schizophrenia is a serious mental illness that levies a heavy medical toll and cost burden throughout the world. Scientific collaborations are necessary for progress in psychiatric research. However, there have been few publications on scientific collaborations in schizophrenia. The aim of this study was to investigate the extent of author collaborations in schizophrenia research. Methods This study used 58,107 records on schizophrenia from 2003 to 2012 which were downloaded from S...

Hyponatremia improvement is associated with a reduced risk of mortality: evidence from a meta-analysis.

Directory of Open Access Journals (Sweden)

Giovanni Corona

Full Text Available Hyponatremia is the most common electrolyte disorder and it is associated with increased morbidity and mortality. However, there is no clear demonstration that the improvement of serum sodium concentration ([Na(+] counteracts the increased risk of mortality associated with hyponatremia. Thus, we performed a meta-analysis that included the published studies that addressed the effect of hyponatremia improvement on mortality.A Medline, Embase and Cochrane search was performed to retrieve all English-language studies of human subjects published up to June 30th 2014, using the following words: "hyponatremia", "hyponatraemia", "mortality", "morbidity" and "sodium". Fifteen studies satisfied inclusion criteria encompassing a total of 13,816 patients. The identification of relevant abstracts, the selection of studies and the subsequent data extraction were performed independently by two of the authors, and conflicts resolved by a third investigator. Across all fifteen studies, any improvement of hyponatremia was associated with a reduced risk of overall mortality (OR=0.57[0.40-0.81]. The association was even stronger when only those studies (n=8 reporting a threshold for serum [Na(+] improvement to >130 mmol/L were considered (OR=0.51[0.31-0.86]. The reduced mortality rate persisted at follow-up (OR=0.55[0.36-0.84] at 12 months. Meta-regression analyses showed that the reduced mortality associated with hyponatremia improvement was more evident in older subjects and in those with lower serum [Na(+] at enrollment.This meta-analysis documents for the first time that improvement in serum [Na(+] in hyponatremic patients is associated with a reduction of overall mortality.

THE ANALYSIS OF CANCER INCIDENCE AND MORTALITY AMONG THE POPULATION OF THE MOSCOW REGION IN 2014

Directory of Open Access Journals (Sweden)

A. N. Gurov

2015-01-01

Full Text Available Rationale: Analysis of the cancer incidence and mortality in the population is of major importance for planning of measures aimed at improvement of organization of medical care to cancer patients, ensuring high quality and availability of this type of medical care.Aim: To evaluate cancer-related incidence and mortality rates and structure among the population of the Moscow Region depending on patient gender and tumor localization.Materials and methods: The estimation and analysis of incidence and mortality rates was performed based on the Reporting Form of the Federal Statistic Surveillance #7 “Information on disorders related to malignant tumors” in the Moscow Region in 2014. For mortality analysis, including that among pediatric patients, we used data from the State Statistics Service of the Moscow Region.Results: In 2014, there were 25 600 new cases of malignancies diagnosed in the Moscow Region, that corresponded to the incidence rate of 363.2 per 100,000 of the population. The leading types of newly diagnosed tumors in men were prostate cancer, as well as tracheal, bronchial and lung cancers (54.2 and 47.0 per 100,000 of male population, respectively. In women, the highest incidence rates were found for breast and skin cancers (86.0 and 58.9 per 100,000 of female population, respectively. According to the data from Rosstat, in 2014, the overall cancer mortality rate in the Moscow Region was 228.1 per 100,000 of the population. Among the causes of cancer mortality in men, the leading one was tracheal, bronchial and lung cancer (22.2%, followed by stomach cancer (13.3% and prostate cancer (8.1%. In women, the leading cause of cancer mortality was breast cancer (16.6%, followed by ovarian, uterine and cervical cancers (14.1% and stomach cancer (11.4%.Conclusion: Based on the results of medical and statistical analysis of cancer incidence and mortality rates, the main direction of improvement of medical care to cancer patients and the ways

The analysis of competing events like cause-specific mortality--beware of the Kaplan-Meier method

NARCIS (Netherlands)

Verduijn, Marion; Grootendorst, Diana C.; Dekker, Friedo W.; Jager, Kitty J.; le Cessie, Saskia

2011-01-01

Kaplan-Meier analysis is a popular method used for analysing time-to-event data. In case of competing event analyses such as that of cardiovascular and non-cardiovascular mortality, however, the Kaplan-Meier method profoundly overestimates the cumulative mortality probabilities for each of the

Mortality analysis in the French cohort of uranium miners

International Nuclear Information System (INIS)

Vacquier, B.

2008-10-01

The objective of this thesis is to contribute to the estimation of radiation-induced risks at low dose rates. This work is based on the cohort of uranium miners French presenting multiple exposures, contamination by internal (radon and uranium dust) and external exposure (gamma radiation). An analysis of the risk of death and the relationship risk exposure was carried out within the cohort of uranium miners after extension of the monitoring until 1999, for cancers diseases and non-cancers. In addition, an analysis taking into account multiple exposures to ionizing radiation was carried out within the framework of this thesis. This analysis has improved knowledge on the risk of mortality associated with low levels of exposure to radon. (author)

Mortality in Pediatric Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Wong, Judith Ju-Ming; Jit, Mark; Sultana, Rehena; Mok, Yee Hui; Yeo, Joo Guan; Koh, Jia Wen Janine Cynthia; Loh, Tsee Foong; Lee, Jan Hau

2017-01-01

Sparse and conflicting evidence exists regarding mortality risk from pediatric acute respiratory distress syndrome (ARDS). We aimed to determine the pooled mortality in pediatric ARDS and to describe its trend over time. MEDLINE, EMBASE, and Web of Science were searched from 1960 to August 2015. Keywords or medical subject headings (MESH) terms used included "respiratory distress syndrome, adult," "acute lung injury," "acute respiratory insufficiency," "acute hypoxemic respiratory failure," "pediatrics," and "child." Study inclusion criteria were (1) pediatric patients aged 0 days to 18 years, (2) sufficient baseline data described in the pediatric ARDS group, and (3) mortality data. Randomized controlled trials (RCTs) and prospective observational studies were eligible. Data on study characteristics, patient demographics, measures of oxygenation, and mortality were extracted using a standard data extraction form. Independent authors conducted the search, applied the selection criteria, and extracted the data. Methodological quality of studies was assessed. Meta-analysis using a random-effects model was performed to obtain pooled estimates of mortality. Meta-regression was performed to analyze variables contributing to change in mortality over time. Eight RCTs and 21 observational studies (n = 2274 patients) were included. Pooled mortality rate was 24% (95% confidence interval [CI]: 19-31). There was a decrease in mortality rates over 3 epochs (≤2000, 2001-2009, and ≥2010: 40% [95% CI: 24-59], 35% [95% CI: 21-51], and 18% [95% CI: 12-26], respectively, P < .001). Observational studies reported a higher mortality rate than RCTs (27% [95% CI: 24-29] versus 16% [95% CI: 12-20], P < .001). Earlier year of publication was an independent factor associated with mortality. Overall mortality rate in pediatric ARDS is approximately 24%. Studies conducted and published later were associated with better survival.

Using Social Network Analysis to Assess Mentorship and Collaboration in a Public Health Network.

Science.gov (United States)

Petrescu-Prahova, Miruna; Belza, Basia; Leith, Katherine; Allen, Peg; Coe, Norma B; Anderson, Lynda A

2015-08-20

Addressing chronic disease burden requires the creation of collaborative networks to promote systemic changes and engage stakeholders. Although many such networks exist, they are rarely assessed with tools that account for their complexity. This study examined the structure of mentorship and collaboration relationships among members of the Healthy Aging Research Network (HAN) using social network analysis (SNA). We invited 97 HAN members and partners to complete an online social network survey that included closed-ended questions about HAN-specific mentorship and collaboration during the previous 12 months. Collaboration was measured by examining the activity of the network on 6 types of products: published articles, in-progress manuscripts, grant applications, tools, research projects, and presentations. We computed network-level measures such as density, number of components, and centralization to assess the cohesiveness of the network. Sixty-three respondents completed the survey (response rate, 65%). Responses, which included information about collaboration with nonrespondents, suggested that 74% of HAN members were connected through mentorship ties and that all 97 members were connected through at least one form of collaboration. Mentorship and collaboration ties were present both within and across boundaries of HAN member organizations. SNA of public health collaborative networks provides understanding about the structure of relationships that are formed as a result of participation in network activities. This approach may offer members and funders a way to assess the impact of such networks that goes beyond simply measuring products and participation at the individual level.

Personality Predicts Mortality Risk: An Integrative Data Analysis of 15 International Longitudinal Studies.

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Graham, Eileen K; Rutsohn, Joshua P; Turiano, Nicholas A; Bendayan, Rebecca; Batterham, Philip J; Gerstorf, Denis; Katz, Mindy J; Reynolds, Chandra A; Sharp, Emily S; Yoneda, Tomiko B; Bastarache, Emily D; Elleman, Lorien G; Zelinski, Elizabeth M; Johansson, Boo; Kuh, Diana; Barnes, Lisa L; Bennett, David A; Deeg, Dorly J H; Lipton, Richard B; Pedersen, Nancy L; Piccinin, Andrea M; Spiro, Avron; Muniz-Terrera, Graciela; Willis, Sherry L; Schaie, K Warner; Roan, Carol; Herd, Pamela; Hofer, Scott M; Mroczek, Daniel K

2017-10-01

This study examined the Big Five personality traits as predictors of mortality risk, and smoking as a mediator of that association. Replication was built into the fabric of our design: we used a Coordinated Analysis with 15 international datasets, representing 44,094 participants. We found that high neuroticism and low conscientiousness, extraversion, and agreeableness were consistent predictors of mortality across studies. Smoking had a small mediating effect for neuroticism. Country and baseline age explained variation in effects: studies with older baseline age showed a pattern of protective effects (HReffects for extraversion. This study demonstrated coordinated analysis as a powerful approach to enhance replicability and reproducibility, especially for aging-related longitudinal research.

An analysis of the determinants of maternal mortality in sub-Saharan Africa.

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Buor, Daniel; Bream, Kent

2004-10-01

To establish what population characteristics affect the high maternal mortality rate in the sub-Saharan Africa region and to propose possible solutions to reduce this rate. This study is a secondary analysis of existing data sources from the World Bank, the World Health Organization (WHO), as well as direct and indirect sources from UNAIDS, the United Nations, Demographic and Health Surveys (DHS), Macro International, and national statistical offices. Instead of looking at continentwide or individual nation models, it develops a regional model. Sociodemographic population variables are used as independent variables to predict the dependent variable, maternal mortality. Additionally, a new country-specific political stability independent variable is introduced into the model. Data from 28 sub-Saharan African countries are used. Bivariate correlations are used to establish associations among the variables, whereas cross-tabulations, using Kendall's tau-c values, and regression lines are used to establish impacts. In the sub-Saharan Africa region, births attended by skilled health personnel and life expectancy at birth strongly correlate with maternal mortality. Gross national product (GNP) per capita and health expenditure per capita also have strong association with maternal mortality. The availability of skilled delivery personnel, life expectancy, national economic wealth, and health expenditure per capita predict the maternal mortality rate of a country. Based on these findings, it is recommended that structural arrangements be made to train skilled health personnel to take care of maternal health problems. In view of the high cost of training physicians, middle-level health personnel may offer an affordable alternative to handle emergency obstetrical cases to address the shortage of physicians. In addition, the allocation of adequate resources to the health sector could improve maternal mortality. The economic wealth of a country and life expectancy at birth are

Unemployment, public–sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981–2009

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Mahiben Maruthappu

2015-06-01

Full Text Available Background: The global economic downturn has been associated with increased unemployment and reduced public–sector expenditure on health care (PSEH. We determined the association between unemployment, PSEH and HIV mortality. Methods: Data were obtained from the World Bank and the World Health Organisation (1981–2009. Multivariate regression analysis was implemented, controlling for country–specific demographics and infrastructure. Time–lag analyses and robustness–checks were performed. Findings: Data were available for 74 countries (unemployment analysis and 75 countries (PSEH analysis, equating to 2.19 billion and 2.22 billion people, respectively, as of 2009. A 1% increase in unemployment was associated with a significant increase in HIV mortality (men: 0.1861, 95% CI: 0.0977 to 0.2744, P<0.0001, women: 0.0383, 95% CI: 0.0108 to 0.0657, P=0.0064. A 1% increase in PSEH was associated with a significant decrease in HIV mortality (men: –0.5015, 95% CI: –0.7432 to –0.2598, P=0.0001; women: –0.1562, 95% CI: –0.2404 to –0.0720, P=0.0003. Time–lag analysis showed that significant changes in HIV mortality continued for up to 5 years following variations in both unemployment and PSEH. Interpretation: Unemployment increases were associated with significant HIV mortality increases. PSEH increases were associated with reduced HIV mortality. The facilitation of access–to–care for the unemployed and policy interventions which aim to protect PSEH could contribute to improved HIV outcomes.

Association of fine particles with respiratory disease mortality: a meta-analysis.

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Chang, Xuhong; Zhou, Liangjia; Tang, Meng; Wang, Bei

2015-01-01

Short-time exposure to high levels of fine particles (particulate matter with an aerodynamic diameter≤2.5 μm; PM2.5) may trigger respiratory disease, but this association has not been determined. The objective of this study was to evaluate and quantify the short-time exposure to fine particles on respiratory disease mortality. Published articles were obtained from electronic databases and a validity assessment was used. The meta-analysis was conducted with the incorporation of good-quality studies. After applying the inclusion criteria, 9 articles were included in the study. The methodological qualities of the published studies were good, and every study achieved a score of 3. Fine particles were significantly associated with an increase in respiratory mortality risk (for every 10 μg/m3 increment, rate difference [RD]=1.32%, 95% confidence interval [CI]: 0.95%-1.68%; p=.000). These findings indicate that short-time exposure to fine particles could increase the risk of respiratory disease mortality.

Multifunctional Collaborative Modeling and Analysis Methods in Engineering Science

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Ransom, Jonathan B.; Broduer, Steve (Technical Monitor)

2001-01-01

Engineers are challenged to produce better designs in less time and for less cost. Hence, to investigate novel and revolutionary design concepts, accurate, high-fidelity results must be assimilated rapidly into the design, analysis, and simulation process. This assimilation should consider diverse mathematical modeling and multi-discipline interactions necessitated by concepts exploiting advanced materials and structures. Integrated high-fidelity methods with diverse engineering applications provide the enabling technologies to assimilate these high-fidelity, multi-disciplinary results rapidly at an early stage in the design. These integrated methods must be multifunctional, collaborative, and applicable to the general field of engineering science and mechanics. Multifunctional methodologies and analysis procedures are formulated for interfacing diverse subdomain idealizations including multi-fidelity modeling methods and multi-discipline analysis methods. These methods, based on the method of weighted residuals, ensure accurate compatibility of primary and secondary variables across the subdomain interfaces. Methods are developed using diverse mathematical modeling (i.e., finite difference and finite element methods) and multi-fidelity modeling among the subdomains. Several benchmark scalar-field and vector-field problems in engineering science are presented with extensions to multidisciplinary problems. Results for all problems presented are in overall good agreement with the exact analytical solution or the reference numerical solution. Based on the results, the integrated modeling approach using the finite element method for multi-fidelity discretization among the subdomains is identified as most robust. The multiple-method approach is advantageous when interfacing diverse disciplines in which each of the method's strengths are utilized. The multifunctional methodology presented provides an effective mechanism by which domains with diverse idealizations are

Mortality trends among Japanese dialysis patients, 1988-2013: a joinpoint regression analysis.

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Wakasugi, Minako; Kazama, Junichiro James; Narita, Ichiei

2016-09-01

Evaluation of mortality trends in dialysis patients is important for improving their prognoses. The present study aimed to examine temporal trends in deaths (all-cause, cardiovascular, noncardiovascular and the five leading causes) among Japanese dialysis patients. Mortality data were extracted from the Japanese Society of Dialysis Therapy registry. Age-standardized mortality rates were calculated by direct standardization against the 2013 dialysis population. The average annual percentage of change (APC) and the corresponding 95% confidence interval (CI) were computed for trends using joinpoint regression analysis. A total of 469 324 deaths occurred, of which 25.9% were from cardiac failure, 17.5% from infectious disease, 10.2% from cerebrovascular disorders, 8.6% from malignant tumors and 5.6% from cardiac infarction. The joinpoint trend for all-cause mortality decreased significantly, by -3.7% (95% CI -4.2 to -3.2) per year from 1988 through 2000, then decreased more gradually, by -1.4% (95% CI -1.7 to -1.2) per year during 2000-13. The improved mortality rates were mainly due to decreased deaths from cardiovascular disease, with mortality rates due to noncardiovascular disease outnumbering those of cardiovascular disease in the last decade. Among the top five causes of death, cardiac failure has shown a marked decrease in mortality rate. However, the rates due to infectious disease have remained stable during the study period [APC 0.1 (95% CI -0.2-0.3)]. Significant progress has been made, particularly with regard to the decrease in age-standardized mortality rates. The risk of cardiovascular death has decreased, while the risk of death from infection has remained unchanged for 25 years. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

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

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

2013-06-01

Dietary restriction (DR) extends lifespan in multiple species from various taxa. This effect can arise via two distinct but not mutually exclusive ways: a change in aging rate and/or vulnerability to the aging process (i.e. initial mortality rate). When DR affects vulnerability, this lowers mortality instantly, whereas a change in aging rate will gradually lower mortality risk over time. Unraveling how DR extends lifespan is of interest because it may guide toward understanding the mechanism(s) mediating lifespan extension and also has practical implications for the application of DR. We reanalyzed published survival data from 82 pairs of survival curves from DR experiments in rats and mice by fitting Gompertz and also Gompertz-Makeham models. The addition of the Makeham parameter has been reported to improve the estimation of Gompertz parameters. Both models separate initial mortality rate (vulnerability) from an age-dependent increase in mortality (aging rate). We subjected the obtained Gompertz parameters to a meta-analysis. We find that DR reduced aging rate without affecting vulnerability. The latter contrasts with the conclusion of a recent analysis of a largely overlapping data set, and we show how the earlier finding is due to a statistical artifact. Our analysis indicates that the biology underlying the life-extending effect of DR in rodents likely involves attenuated accumulation of damage, which contrasts with the acute effect of DR on mortality reported for Drosophila. Moreover, our findings show that the often-reported correlation between aging rate and vulnerability does not constrain changing aging rate without affecting vulnerability simultaneously. © 2013 John Wiley & Sons Ltd and the Anatomical Society.

Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care

DEFF Research Database (Denmark)

Andersen, Anne Bendix; Frederiksen, Kirsten; Kolbæk, Raymond

2017-01-01

of intersectorial collaboration. The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order...... policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish healthcare. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the ‘Health Agreements’. Using Fairclough’s three......-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a ‘negotiated text’, appearing as an overriding document legitimising one possible discourse regarding the premises...

An empirical analysis of the relationship between the consumption of alcohol and liver cirrhosis mortality

DEFF Research Database (Denmark)

Bentzen, Jan Børsen; Smith, Valdemar

The question whether intake of alcohol is associated with liver cirrhosis mortality is analyzed using aggregate data for alcohol consumption, alcohol related diseases and alcohol policies of 16 European countries. The empirical analysis gives support to a close association between cirrhosis morta...... mortality and intake of alcohol - and the latter also concerns each of the specific beverages, i.e. spirits, wine and beer, where other studies usually only find evidence of spirits and wine related to liver cirrhosis mortality.  ...

Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.

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Arcelus, Jon; Mitchell, Alex J; Wales, Jackie; Nielsen, Søren

2011-07-01

Morbidity and mortality rates in patients with eating disorders are thought to be high, but exact rates remain to be clarified. To systematically compile and analyze the mortality rates in individuals with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS). A systematic literature search, appraisal, and meta-analysis were conducted of the MEDLINE/PubMed, PsycINFO, and Embase databases and 4 full-text collections (ie, ScienceDirect, Ingenta Select, Ovid, and Wiley-Blackwell Interscience). English-language, peer-reviewed articles published between January 1, 1966, and September 30, 2010, that reported mortality rates in patients with eating disorders. Primary data were extracted as raw numbers or confidence intervals and corrected for years of observation and sample size (ie, person-years of observation). Weighted proportion meta-analysis was used to adjust for study size using the DerSimonian-Laird model to allow for heterogeneity inclusion in the analysis. From 143 potentially relevant articles, we found 36 quantitative studies with sufficient data for extraction. The studies reported outcomes of AN during 166 642 person-years, BN during 32 798 person-years, and EDNOS during 22 644 person-years. The weighted mortality rates (ie, deaths per 1000 person-years) were 5.1 for AN, 1.7 for BN, and 3.3 for EDNOS. The standardized mortality ratios were 5.86 for AN, 1.93 for BN, and 1.92 for EDNOS. One in 5 individuals with AN who died had committed suicide. Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN. The mortality rates for BN and EDNOS are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS.

Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies.

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Lee, Jung Eun; McLerran, Dale F; Rolland, Betsy; Chen, Yu; Grant, Eric J; Vedanthan, Rajesh; Inoue, Manami; Tsugane, Shoichiro; Gao, Yu-Tang; Tsuji, Ichiro; Kakizaki, Masako; Ahsan, Habibul; Ahn, Yoon-Ok; Pan, Wen-Harn; Ozasa, Kotaro; Yoo, Keun-Young; Sasazuki, Shizuka; Yang, Gong; Watanabe, Takashi; Sugawara, Yumi; Parvez, Faruque; Kim, Dong-Hyun; Chuang, Shao-Yuan; Ohishi, Waka; Park, Sue K; Feng, Ziding; Thornquist, Mark; Boffetta, Paolo; Zheng, Wei; Kang, Daehee; Potter, John; Sinha, Rashmi

2013-10-01

Total or red meat intake has been shown to be associated with a higher risk of mortality in Western populations, but little is known of the risks in Asian populations. We examined temporal trends in meat consumption and associations between meat intake and all-cause and cause-specific mortality in Asia. We used ecological data from the United Nations to compare country-specific meat consumption. Separately, 8 Asian prospective cohort studies in Bangladesh, China, Japan, Korea, and Taiwan consisting of 112,310 men and 184,411 women were followed for 6.6 to 15.6 y with 24,283 all-cause, 9558 cancer, and 6373 cardiovascular disease (CVD) deaths. We estimated the study-specific HRs and 95% CIs by using a Cox regression model and pooled them by using a random-effects model. Red meat consumption was substantially lower in the Asian countries than in the United States. Fish and seafood consumption was higher in Japan and Korea than in the United States. Our pooled analysis found no association between intake of total meat (red meat, poultry, and fish/seafood) and risks of all-cause, CVD, or cancer mortality among men and women; HRs (95% CIs) for all-cause mortality from a comparison of the highest with the lowest quartile were 1.02 (0.91, 1.15) in men and 0.93 (0.86, 1.01) in women. Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries.

Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis.

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Liu, Ping; Hao, Qiukui; Hai, Shan; Wang, Hui; Cao, Li; Dong, Birong

2017-09-01

The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I 2 =27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the

Excess under-5 female mortality across India: a spatial analysis using 2011 census data.

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Guilmoto, Christophe Z; Saikia, Nandita; Tamrakar, Vandana; Bora, Jayanta Kumar

2018-06-01

Excess female mortality causes half of the missing women (estimated deficit of women in countries with suspiciously low proportion of females in their population) today. Globally, most of these avoidable deaths of women occur during childhood in China and India. We aimed to estimate excess female under-5 mortality rate (U5MR) for India's 35 states and union territories and 640 districts. Using the summary birth history method (or Brass method), we derived district-level estimates of U5MR by sex from 2011 census data. We used data from 46 countries with no evidence of gender bias for mortality to estimate the effects and intensity of excess female mortality at district level. We used a detailed spatial and statistical analysis to highlight the correlates of excess mortality at district level. Excess female U5MR was 18·5 per 1000 livebirths (95% CI 13·1-22·6) in India 2000-2005, which corresponds to an estimated 239 000 excess deaths (169 000-293 000) per year. More than 90% of districts had excess female mortality, but the four largest states in northern India (Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh) accounted for two-thirds of India's total number. Low economic development, gender inequity, and high fertility were the main predictors of excess female mortality. Spatial analysis confirmed the strong spatial clustering of postnatal discrimination against girls in India. The considerable effect of gender bias on mortality in India highlights the need for more proactive engagement with the issue of postnatal sex discrimination and a focus on the northern districts. Notably, these regions are not the same as those most affected by skewed sex ratio at birth. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Collaborative learning for public relations: Frame analysis in training for spokespersons

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Sergio Álvarez Sánchez

2018-05-01

Full Text Available The collaborative model for learning implies students forming teams in order to reach a common goal. The objectives of this research are both exploring the impact of the collaborative model over the performance of those learners who study contents related to the formation of spokespersons for organizations; and evaluating the potential of frame analysis as a content for training in public relations. To delve into those issues, a case study exercise was administered to six groups of students of the “Training for Spokespersons” subject, consisting of analyzing the audiovisual intervention of a spokesperson talking on behalf of a strike commitee, and answering questions about target publics and frames of reference. The exercise succeeded in helping the students understand the role of emotional communication; however, they still got slightly confused about frame analysis and its link with the concept of social norm. For future research, it becomes necessary to focus on moving even more away from the classic master classes, as well as using cases that students can feel closer to their interests. With respect to frame analysis, the results encourage the teaching of more precise classifications in terms of general frames about a certain topic, and specific frames about particular situations.

Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study.

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Kavanagh, Shane A; Shelley, Julia M; Stevenson, Christopher

2017-12-01

A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01-1.09), business ownership (OR 1.04 95% CI 1.01-1.08), earnings (OR 1.04 95% CI 1.01-1.08) and relative poverty (OR 1.07 95% CI 1.03-1.10) measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z -score. Similar effects were seen for working-age men. In older men (65+ years) only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications.

Global mortality estimates for the 2009 Influenza Pandemic from the GLaMOR project: a modeling study.

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Simonsen, Lone; Spreeuwenberg, Peter; Lustig, Roger; Taylor, Robert J; Fleming, Douglas M; Kroneman, Madelon; Van Kerkhove, Maria D; Mounts, Anthony W; Paget, W John

2013-11-01

Assessing the mortality impact of the 2009 influenza A H1N1 virus (H1N1pdm09) is essential for optimizing public health responses to future pandemics. The World Health Organization reported 18,631 laboratory-confirmed pandemic deaths, but the total pandemic mortality burden was substantially higher. We estimated the 2009 pandemic mortality burden through statistical modeling of mortality data from multiple countries. We obtained weekly virology and underlying cause-of-death mortality time series for 2005-2009 for 20 countries covering ∼35% of the world population. We applied a multivariate linear regression model to estimate pandemic respiratory mortality in each collaborating country. We then used these results plus ten country indicators in a multiple imputation model to project the mortality burden in all world countries. Between 123,000 and 203,000 pandemic respiratory deaths were estimated globally for the last 9 mo of 2009. The majority (62%-85%) were attributed to persons under 65 y of age. We observed a striking regional heterogeneity, with almost 20-fold higher mortality in some countries in the Americas than in Europe. The model attributed 148,000-249,000 respiratory deaths to influenza in an average pre-pandemic season, with only 19% in persons representation of low-income countries among single-country estimates and an inability to study subsequent pandemic waves (2010-2012). We estimate that 2009 global pandemic respiratory mortality was ∼10-fold higher than the World Health Organization's laboratory-confirmed mortality count. Although the pandemic mortality estimate was similar in magnitude to that of seasonal influenza, a marked shift toward mortality among persons Europe. A collaborative network to collect and analyze mortality and hospitalization surveillance data is needed to rapidly establish the severity of future pandemics. Please see later in the article for the Editors' Summary.

DISTRIBUTED LEADERSHIP COLLABORATION FACTORS TO SUPPORT IDEA GENERATION IN COMPUTER-SUPPORTED COLLABORATIVE e-LEARNING

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Niki Lambropoulos

2011-01-01

Full Text Available This paper aims to identify, discuss and analyze students’ collaboration factors related to distributed leadership (DL, which correlates with interaction quality evident in idea generation. Scripting computer-supported collaborative e-learning (CSCeL activities based on DL can scaffold students’ interactions that support collaboration and promote idea generation. Furthermore, the associated tools can facilitate collaboration via scripting and shed light on students’ interactions and dialogical sequences. Such detailed planning can result in effective short e-courses. In this case study, 21 MSc students’ teams worked on a DL project within a 2-day e-course at the IT Institute (ITIN, France. The research methods involved a self-reported questionnaire; the Non-Negative Matrix Factorization (NNMF algorithm with qualitative analysis; and outcomes from the Social Network Analysis (SNA tools implemented within the forums. The results indicated that scripting DL based on the identified distributed leadership attributes can support values such as collaboration and can be useful in supporting idea generation in short e-courses.

A Qualitative Descriptive Analysis of Collaboration Technology in the Navy

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Ryan Wark

2015-10-01

Full Text Available Collaboration technologies enable people to communicate and use information to make organizational decisions. The United States Navy refers to this concept as information dominance. Various collaboration technologies are used by the Navy to achieve this mission. This qualitative descriptive study objectively examined how a matrix oriented Navy activity perceived an implemented collaboration technology. These insights were used to determine whether a specific collaboration technology achieved a mission of information dominance. The study used six collaboration themes as a foundation to include: (a Cultural intelligence, (b Communication, (c Capability, (d Coordination, (e Cooperation, and (f Convergence. It was concluded that collaboration technology was mostly perceived well and helped to achieve some levels of information dominance. Collaboration technology improvement areas included bringing greater awareness to the collaboration technology, revamping the look and feel of the user interface, centrally paying for user and storage fees, incorporating more process management tools, strategically considering a Continuity of Operations, and incorporating additional industry best practices for data structures. Emerging themes of collaboration were collected to examine common patterns identified in the collected data. Emerging themes included acceptance, awareness, search, scope, content, value, tools, system performance, implementation, training, support, usage, structure, complexity, approach, governance/configuration management/policy, and resourcing.

Antipsychotic medication and long-term mortality risk in patients with schizophrenia; a systematic review and meta-analysis.

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Vermeulen, J; van Rooijen, G; Doedens, P; Numminen, E; van Tricht, M; de Haan, L

2017-10-01

Patients with schizophrenia have a higher mortality risk than patients suffering from any other psychiatric disorder. Previous research is inconclusive regarding the association of antipsychotic treatment with long-term mortality risk. To this aim, we systematically reviewed the literature and performed a meta-analysis on the relationship between long-term mortality and exposure to antipsychotic medication in patients with schizophrenia. The objectives were to (i) determine long-term mortality rates in patients with schizophrenia using any antipsychotic medication; (ii) compare these with mortality rates of patients using no antipsychotics; (iii) explore the relationship between cumulative exposure and mortality; and (iv) assess causes of death. We systematically searched the EMBASE, MEDLINE and PsycINFO databases for studies that reported on mortality and antipsychotic medication and that included adults with schizophrenia using a follow-up design of more than 1 year. A total of 20 studies fulfilled our inclusion criteria. These studies reported 23,353 deaths during 821,347 patient years in 133,929 unique patients. Mortality rates varied widely per study. Meta-analysis on a subgroup of four studies showed a consistent trend of an increased long-term mortality risk in schizophrenia patients who did not use antipsychotic medication during follow-up. We found a pooled risk ratio of 0.57 (LL:0.46 UL:0.76 p value schizophrenia without antipsychotic medication require further research. Prospective validation studies, uniform measures of antipsychotic exposure and classified causes of death are commendable.

Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis.

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Hyun Jeong Kim

Full Text Available BACKGROUND: Lactic acidosis is a common cause of high anion gap metabolic acidosis. Sodium bicarbonate may be considered for an arterial pH <7.15 but paradoxically depresses cardiac performance and exacerbates acidosis by enhancing lactate production. This study aimed to evaluate the cause and mortality rate of lactic acidosis and to investigate the effect of factors, including sodium bicarbonate use, on death. METHODS: We conducted a single center analysis from May 2011 through April 2012. We retrospectively analyzed 103 patients with lactic acidosis among 207 patients with metabolic acidosis. We used SOFA and APACHE II as severity scores to estimate illness severity. Multivariate logistic regression analysis and Cox regression analysis models were used to identify factors that affect mortality. RESULTS: Of the 103 patients with a mean age of 66.1±11.4 years, eighty-three patients (80.6% died from sepsis (61.4%, hepatic failure, cardiogenic shock and other causes. The percentage of sodium bicarbonate administration (p = 0.006, catecholamine use, ventilator care and male gender were higher in the non-survival group than the survival group. The non-survival group had significantly higher initial and follow-up lactic acid levels, lower initial albumin, higher SOFA scores and APACHE II scores than the survival group. The mortality rate was significantly higher in patients who received sodium bicarbonate. Sodium bicarbonate administration (p = 0.016 was associated with higher mortality. Independent factors that affected mortality were SOFA score (Exp (B = 1.72, 95% CI = 1.12-2.63, p = 0.013 and sodium bicarbonate administration (Exp (B = 6.27, 95% CI = 1.10-35.78, p = 0.039. CONCLUSIONS: Lactic acidosis, which has a high mortality rate, should be evaluated in patients with metabolic acidosis. In addition, sodium bicarbonate should be prescribed with caution in the case of lactic acidosis because sodium bicarbonate

Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis.

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Crippa, Alessio; Discacciati, Andrea; Larsson, Susanna C; Wolk, Alicja; Orsini, Nicola

2014-10-15

Several studies have analyzed the relationship between coffee consumption and mortality, but the shape of the association remains unclear. We conducted a dose-response meta-analysis of prospective studies to examine the dose-response associations between coffee consumption and mortality from all causes, cardiovascular disease (CVD), and all cancers. Pertinent studies, published between 1966 and 2013, were identified by searching PubMed and by reviewing the reference lists of the selected articles. Prospective studies in which investigators reported relative risks of mortality from all causes, CVD, and all cancers for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Twenty-one prospective studies, with 121,915 deaths and 997,464 participants, met the inclusion criteria. There was strong evidence of nonlinear associations between coffee consumption and mortality for all causes and CVD (P for nonlinearity Coffee consumption was not associated with cancer mortality. Findings from this meta-analysis indicate that coffee consumption is inversely associated with all-cause and CVD mortality. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis.

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Smith, Toby; Pelpola, Kelum; Ball, Martin; Ong, Alice; Myint, Phyo Kyaw

2014-07-01

hip fracture is a common and serious condition associated with high mortality. This study aimed to identify pre-operative characteristics which are associated with an increased risk of mortality after hip fracture surgery. systematic search of published and unpublished literature databases, including EMBASE, MEDLINE, AMED, CINAHL, PubMed and the Cochrane Library, was undertaken to identify all clinical studies on pre-operative predictors of mortality after surgery in hip fracture with at least 3-month follow-up. Data pertaining to the study objectives was extracted by two reviewers independently. Where study homogeneity was evidence, a meta-analysis of pooled relative risk and 95% confidence intervals was performed for mortality against pre-admission characteristics. fifty-three studies including 544,733 participants were included. Thirteen characteristics were identified as possible pre-operative indicators for mortality. Following meta-analysis, the four key characteristics associated with the risk of mortality up to 12 months were abnormal ECG (RR: 2.00; 95% CI: 1.45, 2.76), cognitive impairment (RR: 1.91; 95% CI: 1.35, 2.70), age >85 years (RR: 0.42; 95% CI: 0.20, 0.90) and pre-fracture mobility (RR: 0.13; 95% CI: 0.05, 0.34). Other statistically significant pre-fracture predictors of increased mortality were male gender, being resident in a care institution, intra-capsular fracture type, high ASA grade and high Charlson comorbidity score on admission. this review has identified the characteristics of patients with a high risk of mortality after a hip fracture surgery beyond the peri-operative period who may benefit from comprehensive assessment and appropriate management. CRD42012002107. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Statin Treatment and Mortality in Bacterial Infections – A Systematic Review and Meta-Analysis

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Björkhem-Bergman, Linda; Bergman, Peter; Andersson, Jan; Lindh, Jonatan D.

2010-01-01

Background Several studies have reported improved survival in severe bacterial infections among statin treated patients. In addition, statins have been ascribed beneficial anti-inflammatory effects. The aim of this study was to evaluate the effect of statin-treatment on mortality in patients with bacterial infections, by means of a systematic review and a meta-analysis. Methodology and Principal Findings Studies investigating the association between statin use and mortality in patients with bacterial disease were identified in a systematic literature review and a meta-analysis was performed to calculate the overall odds ratio of mortality in statin users. The literature search identified 947 citations from which 40 relevant studies were extracted. In all, 15 studies comprising 113 910 patients were included in the final analysis. Statin use was associated with a significantly (pstatin treatment was no longer significant, with an OR of 0.79 (95% CI 0.58–1.07). Conclusion/Significance According to the meta-analysis of observational studies presented here, patients on statin therapy seem to have a better outcome in bacterial infections. However, the association did not reach statistical significance after adjustment for apparent publication bias. Thus, there is a great need for randomised controlled trials investigating the possible beneficial effect of statins in bacterial infections. PMID:20502712

Estimating global mortality from potentially foodborne diseases: an analysis using vital registration data

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Hanson Laura A

2012-03-01

Full Text Available Abstract Background Foodborne diseases (FBD comprise a large part of the global mortality burden, yet the true extent of their impact remains unknown. The present study utilizes multiple regression with the first attempt to use nonhealth variables to predict potentially FBD mortality at the country level. Methods Vital registration (VR data were used to build a multiple regression model incorporating nonhealth variables in addition to traditionally used health indicators. This model was subsequently used to predict FBD mortality rates for all countries of the World Health Organization classifications AmrA, AmrB, EurA, and EurB. Results Statistical modeling strongly supported the inclusion of nonhealth variables in a multiple regression model as predictors of potentially FBD mortality. Six variables were included in the final model: percent irrigated land, average calorie supply from animal products, meat production in metric tons, adult literacy rate, adult HIV/AIDS prevalence, and percent of deaths under age 5 caused by diarrheal disease. Interestingly, nonhealth variables were not only more robust predictors of mortality than health variables but also remained significant when adding additional health variables into the analysis. Mortality rate predictions from our model ranged from 0.26 deaths per 100,000 (Netherlands to 15.65 deaths per 100,000 (Honduras. Reported mortality rates of potentially FBD from VR data lie within the 95% prediction interval for the majority of countries (37/39 where comparison was possible. Conclusions Nonhealth variables appear to be strong predictors of potentially FBD mortality at the country level and may be a powerful tool in the effort to estimate the global mortality burden of FBD. Disclaimer The views expressed in this document are solely those of the authors and do not represent the views of the World Health Organization.

Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

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Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.

Longitudinal burnout-collaboration patterns in Japanese medical care workers at special needs schools: a latent class growth analysis

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Kanayama M

2016-06-01

Full Text Available Mieko Kanayama,1 Machiko Suzuki,1 Yoshikazu Yuma2 1Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; 2Department of Human Development Education, Graduate School of Education, Hyogo University of Teacher Education, Kato, Hyogo, Japan Abstract: The present study aimed to identify and characterize potential burnout types and the relationship between burnout and collaboration over time. Latent class growth analysis and the growth mixture model were used to identify and characterize heterogeneous patterns of longitudinal stability and change in burnout, and the relationship between burnout and collaboration. We collected longitudinal data at three time points based on Japanese academic terms. The 396 study participants included academic teachers, yogo teachers, and registered nurses in Japanese special needs schools. The best model included four types of both burnout and collaboration in latent class growth analysis with intercept, slope, and quadratic terms. The four types of burnout were as follows: low stable, moderate unstable, high unstable, and high decreasing. They were identified as involving inverse collaboration function. The results indicated that there could be dynamic burnout types, namely moderate unstable, high unstable, and high decreasing, when focusing on growth trajectories in latent class analyses. The finding that collaboration was dynamic for dynamic burnout types and stable for stable burnout types is of great interest. This was probably related to the inverse relationship between the two constructs. Keywords: burnout, collaboration, latent class growth analysis, interprofessional care, special needs schools

Gender inequality, health expenditure and maternal mortality in sub-Saharan Africa: A secondary data analysis

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Frank Chirowa

2013-08-01

Full Text Available Background: This article provided an analysis of gender inequality, health expenditure and its relationship to maternal mortality. Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA. A unique analysis was used to correlate the Gender Inequality Index (GII, Health Expenditure and Maternal Mortality Ratio (MMR. The GII captured inequalities across three dimensions – Reproductive health, Women empowerment and Labour force participation between men and women. The GII is a composite index introduced by the UNDP in 2010 and corrects for the disadavanatges of the other gender indices. Although the GII incorporates MMR in its calculation, it should not be taken as a substitute for, but rather as complementary to, the MMR. Method: An exploratory and descriptive design to a secondary documentary review using quantitative data and qualitative information was used. The article referred to sub-Saharan Africa, but seven countries were purposively selected for an in-depth analysis based on the availability of data. The countries selected were Angola, Botswana, Malawi, Mozambique,South Africa, Zambia and Zimbabwe. Results: Countries with high gender inequality captured by the gender inequality index were associated with high maternal mortality ratios as compared with countries with lower gender inequality, whilst countries that spend less on health were associated with higher maternal deaths than countries that spend more. Conclusion: A potential relationship exists between gender inequality, health expenditure, and maternal mortality. Gender inequalities are systematic and occur at the macro, societal and household levels.

Twelve-year mortality in adults initiating antiretroviral therapy in South Africa.

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Cornell, Morna; Johnson, Leigh F; Wood, Robin; Tanser, Frank; Fox, Matthew P; Prozesky, Hans; Schomaker, Michael; Egger, Matthias; Davies, Mary-Ann; Boulle, Andrew

2017-09-25

South Africa has the largest number of individuals living with HIV and the largest antiretroviral therapy (ART) programme worldwide. In September 2016, ART eligibility was extended to all 7.1 million HIV-positive South Africans. To ensure that further expansion of services does not compromise quality of care, long-term outcomes must be monitored. Few studies have reported long-term mortality in resource-constrained settings, where mortality ascertainment is challenging. Combining site records with data linked to the national vital registration system, sites in the International Epidemiology Databases to Evaluate AIDS Southern Africa collaboration can identify >95% of deaths in patients with civil identification numbers (IDs). This study used linked data to explore long-term mortality and viral suppression among adults starting ART in South Africa. The study was a cohort analysis of routine data on adults with IDs starting ART 2004-2015 in five large ART cohorts. Mortality was estimated overall and by gender using the Kaplan-Meier estimator and Cox's proportional hazards regression. Standardized mortality ratios (SMRs) were calculated by dividing observed numbers of deaths by numbers expected if patients had been HIV-negative. Viral suppression in patients with viral loads (VLs) in their last year of follow-up was the secondary outcome. Among 72,812 adults followed for 350,376 person years (pyrs), the crude mortality rate was 3.08 (95% CI 3.02-3.14)/100 pyrs. Patients were predominantly female (67%) and the percentage of men initiating ART did not increase. Cumulative mortality 12 years after ART initiation was 23.9% (33.4% male and 19.4% female). Mortality peaked in patients enrolling in 2007-2009 and was higher in men than women at all durations. Observed mortality rates were higher than HIV-negative mortality, decreasing with duration. By 48 months, observed mortality was close to that in the HIV-negative population, and SMRs were similar for all baseline CD4

Factors affecting mortality in older trauma patients-A systematic review and meta-analysis.

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Sammy, Ian; Lecky, Fiona; Sutton, Anthea; Leaviss, Joanna; O'Cathain, Alicia

2016-06-01

Major trauma in older people is a significant health burden in the developed world. The aging of the population has resulted in larger numbers of older patients suffering serious injury. Older trauma patients are at greater risk of death from major trauma, but the reasons for this are less well understood. The aim of this review was to identify the factors affecting mortality in older patients suffering major injury. A systematic review of Medline, Cinhal and the Cochrane database, supplemented by a manual search of relevant papers was undertaken, with meta-analysis. Multi-centre cohort studies of existing trauma registries that reported risk-adjusted mortality (adjusted odds ratios, AOR) in their outcomes and which analysed patients aged 65 and older as a separate cohort were included in the review. 3609 papers were identified from the electronic databases, and 28 from manual searches. Of these, 15 papers fulfilled the inclusion criteria. Demographic variables (age and gender), pre-existing conditions (comorbidities and medication), and injury-related factors (injury severity, pattern and mechanism) were found to affect mortality. The 'oldest old', aged 75 and older, had higher mortality rates than younger patients, aged 65-74 years. Older men had a significantly higher mortality rate than women (cumulative odds ratio 1.51, 95% CI 1.37-1.66). Three papers reported a higher risk of death in patients with pre-existing conditions. Two studies reported increased mortality in patients on warfarin (cumulative odds ratio 1.32, 95% CI 1.05-1.66). Higher mortality was seen in patients with lower Glasgow coma scores and systolic blood pressures. Mortality increased with increased injury severity and number of injuries sustained. Low level falls were associated with higher mortality than motor vehicle collisions (cumulative odds ratio 2.88, 95% CI 1.26-6.60). Multiple factors contribute to mortality risk in older trauma patients. The relation between these factors and

A regional multilevel analysis: can skilled birth attendants uniformly decrease neonatal mortality?

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Singh, Kavita; Brodish, Paul; Suchindran, Chirayath

2014-01-01

Globally 40 % of deaths to children under-five occur in the very first month of life with three-quarters of these deaths occurring during the first week of life. The promotion of delivery with a skilled birth attendant (SBA) is being promoted as a strategy to reduce neonatal mortality. This study explored whether SBAs had a protective effect against neonatal mortality in three different regions of the world. The analysis pooled data from nine diverse countries for which recent Demographic and Health Survey data were available. Multilevel logistic regression was used to understand the influence of skilled delivery on two outcomes-neonatal mortality during the first week of life and during the first day of life. Control variables included age, parity, education, wealth, residence (urban/rural), geographic region (Africa, Asia and Latin America/Caribbean), antenatal care and tetanus immunization. The direction of the effect of skilled delivery on neonatal mortality was dependent on geographic region. While having a SBA at delivery was protective against neonatal mortality in Latin America/Caribbean, in Asia there was only a protective effect for births in the first week of life. In Africa SBAs were associated with higher neonatal mortality for both outcomes, and the same was true for deaths on the first day of life in Asia. Many women in Africa and Asia deliver at home unless a complication occurs, and thus skilled birth attendants may be seeing more women with complications than their unskilled counterparts. In addition there are issues with the definition of a SBA with many attendants in both Africa and Asia not actually having the needed training and equipment to prevent neonatal mortality. Considerable investment is needed in terms of training and health infrastructure to enable these providers to save the youngest lives.

COLLABORATIVE TRIAL AND QUALITY CONTROL IN CHEMICAL ANALYSIS

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Narsito Narsito

2010-06-01

Full Text Available Abstract                                                             This paper deals with some practical problems related to the quality of analytical chemical data usually met in practice. Special attention is given to the topic of quality control in analytical chemistry, since analytical data is one of the primary information from which some important scientifically based decision are to be made. The present paper starts with brief description on some fundamental aspects associated with quality of analytical data, such as sources of variation of analytical data, criteria for quality of analytical method, quality assurance in chemical analysis. The assessment of quality parameter for analytical method like the use of standard materials as well as standard methods is given. Concerning with the quality control of analytical data, the use of several techniques, such as control samples and control charts, in monitoring analytical data in quality control program are described qualitatively.  In the final part of this paper, some important remarks for the preparation of collaborative trials, including the evaluation of accuracy and reproducibility of analytical method are also given Keywords: collaborative trials, quality control, analytical data Abstract                                                             This paper deals with some practical problems related to the quality of analytical chemical data usually met in practice. Special attention is given to the topic of quality control in analytical chemistry, since analytical data is one of the primary information from which some important scientifically based decision are to be made. The present paper starts with brief description on some fundamental aspects associated with quality of analytical data, such as sources of variation of analytical data, criteria for quality of

Effect of a telemonitoring-facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study.

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Dendale, Paul; De Keulenaer, Gilles; Troisfontaines, Pierre; Weytjens, Caroline; Mullens, Wilfried; Elegeert, Ivan; Ector, Bavo; Houbrechts, Marita; Willekens, Koen; Hansen, Dominique

2012-03-01

Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow-up of patients through a telemonitoring-facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate. One hunderd and sixty CHF patients [mean age 76 ± 10 years, 104 males, mean left ventricular ejection fraction (LVEF) 35 ± 15%] were block randomized by sealed envelopes and assigned to 6 months of intense follow-up facilitated by telemonitoring (TM) or usual care (UC). The TM group measured body weight, blood pressure, and heart rate on a daily basis with electronic devices that transferred the data automatically to an online database. Email alerts were sent to the GP and heart failure clinic to intervene when pre-defined limits were exceeded. All-cause mortality was significantly lower in the TM group as compared with the UC group (5% vs. 17.5%, P = 0.01). The total number of follow-up days lost to hospitalization, dialysis, or death was significantly lower in the TM group as compared with the UC group (13 vs. 30 days, P = 0.02). The number of hospitalizations for heart failure per patient showed a trend (0.24 vs. 0.42 hospitalizations/patient, P = 0.06) in favour of TM. Telemonitoring-facilitated collaboration between GPs and a heart failure clinic reduces mortality and number of days lost to hospitalization, death, or dialysis in CHF patients. These findings need confirmation in a large trial.

Collaboration across the Arctic

DEFF Research Database (Denmark)

Huppert, Verena Gisela; Chuffart, Romain François R.

2017-01-01

The Arctic is witnessing the rise of a new paradigm caused by an increase in pan-Arctic collaborations which co-exist with the region’s traditional linkages with the South. Using an analysis of concrete examples of regional collaborations in the Arctic today in the fields of education, health...... and infrastructure, this paper questions whether pan-Arctic collaborations in the Arctic are more viable than North-South collaborations, and explores the reasons behind and the foreseeable consequences of such collaborations. It shows that the newly emerging East-West paradigm operates at the same time...... as the traditional North-South paradigm, with no signs of the East-West paradigm being more viable in the foreseeable future. However, pan-Arctic collaboration, both due to pragmatic reasons and an increased awareness of similarities, is likely to increase in the future. The increased regionalization process...

Mortality and Case Fatality Due to Visceral Leishmaniasis in Brazil: A Nationwide Analysis of Epidemiology, Trends and Spatial Patterns

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Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jorg

2014-01-01

Background Visceral leishmaniasis (VL) is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. Methods We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. Results In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03%) deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants), Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change – APC: 9.4%; 95% confidence interval – CI: 5.3 to 13.6), and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9); and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4). Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. Conclusions Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment are fundamental strategies for reducing case fatality of VL in Brazil. PMID:24699517

Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

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Jacobs, Ian J; Menon, Usha; Ryan, Andy; Gentry-Maharaj, Aleksandra; Burnell, Matthew; Kalsi, Jatinderpal K; Amso, Nazar N; Apostolidou, Sophia; Benjamin, Elizabeth; Cruickshank, Derek; Crump, Danielle N; Davies, Susan K; Dawnay, Anne; Dobbs, Stephen; Fletcher, Gwendolen; Ford, Jeremy; Godfrey, Keith; Gunu, Richard; Habib, Mariam; Hallett, Rachel; Herod, Jonathan; Jenkins, Howard; Karpinskyj, Chloe; Leeson, Simon; Lewis, Sara J; Liston, William R; Lopes, Alberto; Mould, Tim; Murdoch, John; Oram, David; Rabideau, Dustin J; Reynolds, Karina; Scott, Ian; Seif, Mourad W; Sharma, Aarti; Singh, Naveena; Taylor, Julie; Warburton, Fiona; Widschwendter, Martin; Williamson, Karin; Woolas, Robert; Fallowfield, Lesley; McGuire, Alistair J; Campbell, Stuart; Parmar, Mahesh; Skates, Steven J

2016-01-01

Summary Background Ovarian cancer has a poor prognosis, with just 40% of patients surviving 5 years. We designed this trial to establish the effect of early detection by screening on ovarian cancer mortality. Methods In this randomised controlled trial, we recruited postmenopausal women aged 50–74 years from 13 centres in National Health Service Trusts in England, Wales, and Northern Ireland. Exclusion criteria were previous bilateral oophorectomy or ovarian malignancy, increased risk of familial ovarian cancer, and active non-ovarian malignancy. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS) with serum CA125 interpreted with use of the risk of ovarian cancer algorithm, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian cancer by Dec 31, 2014, comparing MMS and USS separately with no screening, ascertained by an outcomes committee masked to randomisation group. All analyses were by modified intention to screen, excluding the small number of women we discovered after randomisation to have a bilateral oophorectomy, have ovarian cancer, or had exited the registry before recruitment. Investigators and participants were aware of screening type. This trial is registered with ClinicalTrials.gov, number NCT00058032. Findings Between June 1, 2001, and Oct 21, 2005, we randomly allocated 202 638 women: 50 640 (25·0%) to MMS, 50 639 (25·0%) to USS, and 101 359 (50·0%) to no screening. 202 546 (>99·9%) women were eligible for analysis: 50 624 (>99·9%) women in the MMS group, 50 623 (>99·9%) in the USS group, and 101 299 (>99·9%) in the no screening group. Screening ended on Dec 31, 2011, and included 345 570 MMS and 327 775 USS annual screening episodes. At a median follow-up of 11·1 years (IQR 10·0–12·0), we diagnosed ovarian cancer in

Sources of variation in under-5 mortality across sub-Saharan Africa: a spatial analysis.

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Burke, Marshall; Heft-Neal, Sam; Bendavid, Eran

2016-12-01

Detailed spatial understanding of levels and trends in under-5 mortality is needed to improve the targeting of interventions to the areas of highest need, and to understand the sources of variation in mortality. To improve this understanding, we analysed local-level information on child mortality across sub-Saharan Africa between 1980-2010. We used data from 82 Demographic and Health Surveys in 28 sub-Saharan African countries, including the location and timing of 3·24 million childbirths and 393 685 deaths, to develop high-resolution spatial maps of under-5 mortality in the 1980s, 1990s, and 2000s. These estimates were at a resolution of 0·1 degree latitude by 0·1 degree longitude (roughly 10 km × 10 km). We then analysed this spatial information to distinguish within-country versus between-country sources of variation in mortality, to examine the extent to which declines in mortality have been accompanied by convergence in the distribution of mortality, and to study localised drivers of mortality differences, including temperature, malaria burden, and conflict. In our sample of sub-Saharan African countries from the 1980s to the 2000s, within-country differences in under-5 mortality accounted for 74-78% of overall variation in under-5 mortality across space and over time. Mortality differed significantly across only 8-15% of country borders, supporting the role of local, rather than national, factors in driving mortality patterns. We found that by the end of the study period, 23% of the eligible children in the study countries continue to live in mortality hotspots-areas where, if current trends continue, the Sustainable Developent Goals mortality targets will not be met. In multivariate analysis, within-country mortality levels at each pixel were significantly related to local temperature, malaria burden, and recent history of conflict. Our findings suggest that sub-national determinants explain a greater portion of under-5 mortality than do country

MortalityPredictors.org: a manually-curated database of published biomarkers of human all-cause mortality.

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Peto, Maximus V; De la Guardia, Carlos; Winslow, Ksenia; Ho, Andrew; Fortney, Kristen; Morgen, Eric

2017-08-31

Biomarkers of all-cause mortality are of tremendous clinical and research interest. Because of the long potential duration of prospective human lifespan studies, such biomarkers can play a key role in quantifying human aging and quickly evaluating any potential therapies. Decades of research into mortality biomarkers have resulted in numerous associations documented across hundreds of publications. Here, we present MortalityPredictors.org , a manually-curated, publicly accessible database, housing published, statistically-significant relationships between biomarkers and all-cause mortality in population-based or generally healthy samples. To gather the information for this database, we searched PubMed for appropriate research papers and then manually curated relevant data from each paper. We manually curated 1,576 biomarker associations, involving 471 distinct biomarkers. Biomarkers ranged in type from hematologic (red blood cell distribution width) to molecular (DNA methylation changes) to physical (grip strength). Via the web interface, the resulting data can be easily browsed, searched, and downloaded for further analysis. MortalityPredictors.org provides comprehensive results on published biomarkers of human all-cause mortality that can be used to compare biomarkers, facilitate meta-analysis, assist with the experimental design of aging studies, and serve as a central resource for analysis. We hope that it will facilitate future research into human mortality and aging.

Perceptual Factors Affecting the Tendency to Collaboration in SMEs: Perceived Importance of Collaboration Modes and Partners

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Heeyong Noh

2015-10-01

Full Text Available This research aims to explore key factors of SMEs’ external collaboration and identifies the perceived factors affecting propensity for collaboration. Particularly, we focus on two factors – internal strategic activities geared towards open innovation and external collaboration partners, both of which are essential to establishing an external collaboration. We conducted a survey of Korean SMEs regarding their collaboration project experiences, and used logistic regression analysis to analyze the survey data. The research findings are expected to help understanding the complex open innovation mechanism in SMEs and to have meaningful implications for the development of their collaboration model.

Meta-analysis of self-reported daytime napping and risk of cardiovascular or all-cause mortality.

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Liu, Xiaokun; Zhang, Qi; Shang, Xiaoming

2015-05-04

Whether self-reported daytime napping is an independent predictor of cardiovascular or all-cause mortality remains unclear. The aim of this study was to investigate self-reported daytime napping and risk of cardiovascular or all-cause mortality by conducting a meta-analysis. A computerized literature search of PubMed, Embase, and Cochrane Library was conducted up to May 2014. Only prospective studies reporting risk ratio (RR) and corresponding 95% confidence intervals (CI) of cardiovascular or all-cause mortality with respect to baseline self-reported daytime napping were included. Seven studies with 98,163 subjects were included. Self-reported daytime napping was associated with a greater risk of all-cause mortality (RR 1.15; 95% CI 1.07-1.24) compared with non-nappers. Risk of all-cause mortality appeared to be more pronounced among persons with nap duration >60 min (RR 1.15; 95% CI 1.04-1.27) than persons with nap duration napping is a mild but statistically significant predictor for all-cause mortality, but not for cardiovascular mortality. However, whether the risk is attributable to excessive sleep duration or napping alone remains controversial. More prospective studies stratified by sleep duration, napping periods, or age are needed.

Collaboration and E-collaboration

DEFF Research Database (Denmark)

Razmerita, Liana; Kirchner, Kathrin

2015-01-01

Understanding student’s perception of collaboration and how collaboration is supported by ICT is important for its efficient use in the classroom. This article aims to investigate how students perceive collaboration and how they use new technologies in collaborative group work. Furthermore......, it tries to measure the impact of technology on students’ satisfaction with collaboration outcomes. In particular, the study aims to address the following research questions: Which demographic information (e.g. gender and place of origin) is significant for collaboration and ecollaboration? and Which...... are the perceived factors that influence the students’ group performance? The findings of this study emphasize that there are gender and cultural differences with respect to the perception of e-collaboration. Furthermore, the article summarizes in a model the most significant factors influencing group performance....

Small-area spatiotemporal analysis of heatwave impacts on elderly mortality in Paris: A cluster analysis approach.

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Benmarhnia, Tarik; Kihal-Talantikite, Wahida; Ragettli, Martina S; Deguen, Séverine

2017-08-15

Heat-waves have a substantial public health burden. Understanding spatial heterogeneity at a fine spatial scale in relation to heat and related mortality is central to target interventions towards vulnerable communities. To determine the spatial variability of heat-wave-related mortality risk among elderly in Paris, France at the census block level. We also aimed to assess area-level social and environmental determinants of high mortality risk within Paris. We used daily mortality data from 2004 to 2009 among people aged >65 at the French census block level within Paris. We used two heat wave days' definitions that were compared to non-heat wave days. A Bernoulli cluster analysis method was applied to identify high risk clusters of mortality during heat waves. We performed random effects meta-regression analyses to investigate factors associated with the magnitude of the mortality risk. The spatial approach revealed a spatial aggregation of death cases during heat wave days. We found that small scale chronic PM 10 exposure was associated with a 0.02 (95% CI: 0.001; 0.045) increase of the risk of dying during a heat wave episode. We also found a positive association with the percentage of foreigners and the percentage of labor force, while the proportion of elderly people living in the neighborhood was negatively associated. We also found that green space density had a protective effect and inversely that the density of constructed feature increased the risk of dying during a heat wave episode. We showed that a spatial variation in terms of heat-related vulnerability exists within Paris and that it can be explained by some contextual factors. This study can be useful for designing interventions targeting more vulnerable areas and reduce the burden of heat waves. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment of drought related mortality in pinyon-juniper and ponderosa pine forests using Forest Inventory and Analysis data

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John D. Shaw

2008-01-01

(Please note, this is an abstract only) Widespread mortality in several forest types is associated with several years of drought in the Southwest. Implementation of USDA Forest Service Forest Inventory and Analysis (FIA) annual inventory in several states coincided with the onset of elevated mortality rates. Analysis of data collected 2000-2004 reveals the status and...

Urban sprawl, obesity, and cancer mortality in the United States: cross-sectional analysis and methodological challenges.

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Berrigan, David; Tatalovich, Zaria; Pickle, Linda W; Ewing, Reid; Ballard-Barbash, Rachel

2014-01-06

Urban sprawl has the potential to influence cancer mortality via direct and indirect effects on obesity, access to health services, physical activity, transportation choices and other correlates of sprawl and urbanization. This paper presents a cross-sectional analysis of associations between urban sprawl and cancer mortality in urban and suburban counties of the United States. This ecological analysis was designed to examine whether urban sprawl is associated with total and obesity-related cancer mortality and to what extent these associations differed in different regions of the US. A major focus of our analyses was to adequately account for spatial heterogeneity in mortality. Therefore, we fit a series of regression models, stratified by gender, successively testing for the presence of spatial heterogeneity. Our resulting models included county level variables related to race, smoking, obesity, access to health services, insurance status, socioeconomic position, and broad geographic region as well as a measure of urban sprawl and several interactions. Our most complex models also included random effects to account for any county-level spatial autocorrelation that remained unexplained by these variables. Total cancer mortality rates were higher in less sprawling areas and contrary to our initial hypothesis; this was also true of obesity related cancers in six of seven U.S. regions (census divisions) where there were statistically significant associations between the sprawl index and mortality. We also found significant interactions (p urban sprawl for total and obesity related cancer mortality in both sexes. Thus, the association between urban sprawl and cancer mortality differs in different regions of the US. Despite higher levels of obesity in more sprawling counties in the US, mortality from obesity related cancer was not greater in such counties. Identification of disparities in cancer mortality within and between geographic regions is an ongoing public

Collaborative care for depression in European countries: a systematic review and meta-analysis.

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Sighinolfi, Cecilia; Nespeca, Claudia; Menchetti, Marco; Levantesi, Paolo; Belvederi Murri, Martino; Berardi, Domenico

2014-10-01

This is a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effectiveness of collaborative care compared to Primary Care Physician's (PCP's) usual care in the treatment of depression, focusing on European countries. A systematic review of English and non-English articles, from inception to March 2014, was performed using database PubMed, British Nursing Index and Archive, Ovid Medline (R), PsychINFO, Books@Ovid, PsycARTICLES Full Text, EMBASE Classic+Embase, DARE (Database of Abstract of Reviews of Effectiveness) and the Cochrane Library electronic database. Search term included depression, collaborative care, physician family and allied health professional. RCTs comparing collaborative care to usual care for depression in primary care were included. Titles and abstracts were independently examined by two reviewers, who extracted from the included trials information on participants' characteristics, type of intervention, features of collaborative care and type of outcome measure. The 17 papers included, regarding 15 RCTs, involved 3240 participants. Primary analyses showed that collaborative care models were associated with greater improvement in depression outcomes in the short term, within 3 months (standardized mean difference (SMD) -0.19, 95% CI=-0.33; -0.05; p=0.006), medium term, between 4 and 11 months (SMD -0.24, 95% CI=-0.39; -0.09; p=0.001) and medium-long term, from 12 months and over (SMD -0.21, 95% CI=-0.37; -0.04; p=0.01), compared to usual care. The present review, specifically focusing on European countries, shows that collaborative care is more effective than treatment as usual in improving depression outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies123

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Lee, Jung Eun; McLerran, Dale F; Rolland, Betsy; Chen, Yu; Grant, Eric J; Vedanthan, Rajesh; Inoue, Manami; Tsugane, Shoichiro; Gao, Yu-Tang; Tsuji, Ichiro; Kakizaki, Masako; Ahsan, Habibul; Ahn, Yoon-Ok; Pan, Wen-Harn; Ozasa, Kotaro; Yoo, Keun-Young; Sasazuki, Shizuka; Yang, Gong; Watanabe, Takashi; Sugawara, Yumi; Parvez, Faruque; Kim, Dong-Hyun; Chuang, Shao-Yuan; Ohishi, Waka; Park, Sue K; Feng, Ziding; Thornquist, Mark; Boffetta, Paolo; Zheng, Wei; Kang, Daehee; Potter, John; Sinha, Rashmi

2013-01-01

Background: Total or red meat intake has been shown to be associated with a higher risk of mortality in Western populations, but little is known of the risks in Asian populations. Objective: We examined temporal trends in meat consumption and associations between meat intake and all-cause and cause-specific mortality in Asia. Design: We used ecological data from the United Nations to compare country-specific meat consumption. Separately, 8 Asian prospective cohort studies in Bangladesh, China, Japan, Korea, and Taiwan consisting of 112,310 men and 184,411 women were followed for 6.6 to 15.6 y with 24,283 all-cause, 9558 cancer, and 6373 cardiovascular disease (CVD) deaths. We estimated the study-specific HRs and 95% CIs by using a Cox regression model and pooled them by using a random-effects model. Results: Red meat consumption was substantially lower in the Asian countries than in the United States. Fish and seafood consumption was higher in Japan and Korea than in the United States. Our pooled analysis found no association between intake of total meat (red meat, poultry, and fish/seafood) and risks of all-cause, CVD, or cancer mortality among men and women; HRs (95% CIs) for all-cause mortality from a comparison of the highest with the lowest quartile were 1.02 (0.91, 1.15) in men and 0.93 (0.86, 1.01) in women. Conclusions: Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries. PMID:23902788

The effect of high temperature on cause-specific mortality: A multi-county analysis in China.

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Ban, Jie; Xu, Dandan; He, Mike Z; Sun, Qinghua; Chen, Chen; Wang, Wentao; Zhu, Pengfei; Li, Tiantian

2017-09-01

Although existing studies have linked high temperature to mortality in a small number of regions, less evidence is available on the variation in the associations between high temperature exposure and cause-specific mortality of multiple regions in China. Our study focused on the use of time series analysis to quantify the association between high temperature and different cause-specific mortalities for susceptible populations for 43 counties in China. Two-stage analyses adopting a distributed lag non-linear model (DLNM) and a meta-analysis allowed us to obtain county-specific estimates and national-scale pooled estimates of the nonlinear temperature-mortality relationship. We also considered different populations stratified by age and sex, causes of death, absolute and relative temperature patterns, and potential confounding from air pollutants. All of the observed cause-specific mortalities are significantly associated with higher temperature. The estimated effects of high temperature on mortality varied by spatial distribution and temperature patterns. Compared with the 90th percentile temperature, the overall relative risk (RR) at the 99th percentile temperature for non-accidental mortality is 1.105 (95%CI: 1.089, 1.122), for circulatory disease is 1.107 (95%CI: 1.081, 1.133), for respiratory disease is 1.095 (95%CI: 1.050, 1.142), for coronary heart disease is 1.073 (95%CI: 1.047, 1.099), for acute myocardial infarction is 1.072 (95%CI: 1.042, 1.104), and for stroke is 1.095 (95%CI: 1.052, 1.138). Based on our findings, we believe that heat-related health effect in China is a significant issue that requires more attention and allocation of existing resources. Copyright © 2017 Elsevier Ltd. All rights reserved.

Weight change and all-cause mortality in older adults: A meta-analysis

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This meta-analysis of observational cohort studies examined the association between weight change (weight loss, weight gain, and weight fluctuation) and all-cause mortality among older adults. We used PubMed (MEDLINE), Web of Science, and Cochrane Library to identify prospective studies published in...

Web2.0 paves new ways for collaborative and exploratory analysis of Chemical Compounds in Spectrometry Data

Directory of Open Access Journals (Sweden)

Loyek Christian

2011-06-01

Full Text Available In nowadays life science projects, sharing data and data interpretation is becoming increasingly important. This considerably calls for novel information technology approaches, which enable the integration of expert knowledge from different disciplines in combination with advanced data analysis facilities in a collaborative manner. Since the recent development of web technologies offers scientific communities new ways for cooperation and communication, we propose a fully web-based software approach for the collaborative analysis of bioimage data and demonstrate the applicability of Web2.0 techniques to ion mobility spectrometry image data. Our approach allows collaborating experts to easily share, explore and discuss complex image data without any installation of software packages. Scientists only need a username and a password to get access to our system and can directly start exploring and analyzing their data.

Creatinine Change on Vasoconstrictors as Mortality Surrogate in Hepatorenal Syndrome: Systematic Review & Meta-Analysis.

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Justin M Belcher

Full Text Available Hepatorenal syndrome is a severe complication of cirrhosis and associates with significant mortality. Vasoconstrictor medications improve renal function in patients with hepatorenal syndrome. However, it is unclear to what extent changes in serum creatinine during treatment may act as a surrogate for changes in mortality. We have performed a meta-analysis of randomized trials of vasoconstrictors assessing the association between changes in serum creatinine, taken as a continuous variable, and mortality, both while on treatment and during the follow-up period for survivors.The electronic databases of PubMed, Web of Science and Embase were searched for randomized trials evaluating the efficacy of vasoconstrictor therapy for treatment of HRS type 1 or 2. The relative risk (RR for mortality was calculated against delta creatinine. The proportion of treatment effect explained (PTE was calculated for delta creatinine.Seven trials enrolling 345 patients were included. The correlation between delta creatinine and ln (RR was moderately good (R2 = 0.61. The intercept and parameter estimate indicated a fall in creatinine while on treatment of 1 mg/dL resulted in a 27% reduction in RR for mortality compared to the control arm. In patients surviving the treatment period, a fall in creatinine while on treatment of 1 mg/dL resulted in a 16% reduction in RR for post-treatment mortality during follow-up. The PTE of delta creatinine for overall mortality was 0.91 and 0.26 for post-treatment mortality.Changes in serum creatinine in response to vasoconstrictor therapy appear to be a valid surrogate for mortality, even in the period following the completion of treatment.

Creatinine Change on Vasoconstrictors as Mortality Surrogate in Hepatorenal Syndrome: Systematic Review & Meta-Analysis

Science.gov (United States)

Belcher, Justin M.; Coca, Steven G.; Parikh, Chirag R.

2015-01-01

Background and Aims Hepatorenal syndrome is a severe complication of cirrhosis and associates with significant mortality. Vasoconstrictor medications improve renal function in patients with hepatorenal syndrome. However, it is unclear to what extent changes in serum creatinine during treatment may act as a surrogate for changes in mortality. We have performed a meta-analysis of randomized trials of vasoconstrictors assessing the association between changes in serum creatinine, taken as a continuous variable, and mortality, both while on treatment and during the follow-up period for survivors. Methods The electronic databases of PubMed, Web of Science and Embase were searched for randomized trials evaluating the efficacy of vasoconstrictor therapy for treatment of HRS type 1 or 2. The relative risk (RR) for mortality was calculated against delta creatinine. The proportion of treatment effect explained (PTE) was calculated for delta creatinine. Results Seven trials enrolling 345 patients were included. The correlation between delta creatinine and ln (RR) was moderately good (R2 = 0.61). The intercept and parameter estimate indicated a fall in creatinine while on treatment of 1 mg/dL resulted in a 27% reduction in RR for mortality compared to the control arm. In patients surviving the treatment period, a fall in creatinine while on treatment of 1 mg/dL resulted in a 16% reduction in RR for post-treatment mortality during follow-up. The PTE of delta creatinine for overall mortality was 0.91 and 0.26 for post-treatment mortality. Conclusions Changes in serum creatinine in response to vasoconstrictor therapy appear to be a valid surrogate for mortality, even in the period following the completion of treatment. PMID:26295585

Cytobank: providing an analytics platform for community cytometry data analysis and collaboration.

Science.gov (United States)

Chen, Tiffany J; Kotecha, Nikesh

2014-01-01

Cytometry is used extensively in clinical and laboratory settings to diagnose and track cell subsets in blood and tissue. High-throughput, single-cell approaches leveraging cytometry are developed and applied in the computational and systems biology communities by researchers, who seek to improve the diagnosis of human diseases, map the structures of cell signaling networks, and identify new cell types. Data analysis and management present a bottleneck in the flow of knowledge from bench to clinic. Multi-parameter flow and mass cytometry enable identification of signaling profiles of patient cell samples. Currently, this process is manual, requiring hours of work to summarize multi-dimensional data and translate these data for input into other analysis programs. In addition, the increase in the number and size of collaborative cytometry studies as well as the computational complexity of analytical tools require the ability to assemble sufficient and appropriately configured computing capacity on demand. There is a critical need for platforms that can be used by both clinical and basic researchers who routinely rely on cytometry. Recent advances provide a unique opportunity to facilitate collaboration and analysis and management of cytometry data. Specifically, advances in cloud computing and virtualization are enabling efficient use of large computing resources for analysis and backup. An example is Cytobank, a platform that allows researchers to annotate, analyze, and share results along with the underlying single-cell data.

Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study

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Shane A. Kavanagh

2017-12-01

Full Text Available A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01–1.09, business ownership (OR 1.04 95% CI 1.01–1.08, earnings (OR 1.04 95% CI 1.01–1.08 and relative poverty (OR 1.07 95% CI 1.03–1.10 measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z-score. Similar effects were seen for working-age men. In older men (65+ years only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications.

Milk Consumption and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis.

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Larsson, Susanna C; Crippa, Alessio; Orsini, Nicola; Wolk, Alicja; Michaëlsson, Karl

2015-09-11

Results from epidemiological studies of milk consumption and mortality are inconsistent. We conducted a systematic review and meta-analysis of prospective studies assessing the association of non-fermented and fermented milk consumption with mortality from all causes, cardiovascular disease, and cancer. PubMed was searched until August 2015. A two-stage, random-effects, dose-response meta-analysis was used to combine study-specific results. Heterogeneity among studies was assessed with the I² statistic. During follow-up periods ranging from 4.1 to 25 years, 70,743 deaths occurred among 367,505 participants. The range of non-fermented and fermented milk consumption and the shape of the associations between milk consumption and mortality differed considerably between studies. There was substantial heterogeneity among studies of non-fermented milk consumption in relation to mortality from all causes (12 studies; I² = 94%), cardiovascular disease (five studies; I² = 93%), and cancer (four studies; I² = 75%) as well as among studies of fermented milk consumption and all-cause mortality (seven studies; I² = 88%). Thus, estimating pooled hazard ratios was not appropriate. Heterogeneity among studies was observed in most subgroups defined by sex, country, and study quality. In conclusion, we observed no consistent association between milk consumption and all-cause or cause-specific mortality.

Collaborative Video Sketching

DEFF Research Database (Denmark)

Henningsen, Birgitte; Gundersen, Peter Bukovica; Hautopp, Heidi

2017-01-01

This paper introduces to what we define as a collaborative video sketching process. This process links various sketching techniques with digital storytelling approaches and creative reflection processes in video productions. Traditionally, sketching has been used by designers across various...... findings: 1) They are based on a collaborative approach. 2) The sketches act as a mean to externalizing hypotheses and assumptions among the participants. Based on our analysis we present an overview of factors involved in collaborative video sketching and shows how the factors relate to steps, where...... the participants: shape, record, review and edit their work, leading the participants to new insights about their work....

Assessing Online Collaborative Discourse.

Science.gov (United States)

Breen, Henny

2015-01-01

This qualitative study using transcript analysis was undertaken to clarify the value of Harasim's Online Collaborative Learning Theory as a way to assess the collaborative process within nursing education. The theory incorporated three phases: (a) idea generating; (b) idea organizing; and (c) intellectual convergence. The transcripts of asynchronous discussions from a 2-week module about disaster nursing using a virtual community were analyzed and formed the data for this study. This study supports the use of Online Collaborative Learning Theory as a framework for assessing online collaborative discourse. Individual or group outcomes were required for the students to move through all three phases of the theory. The phases of the Online Collaborative Learning Theory could be used to evaluate the student's ability to collaborate. It is recommended that group process skills, which have more to do with interpersonal skills, be evaluated separately from collaborative learning, which has more to do with cognitive skills. Both are required for practicing nurses. When evaluated separately, the student learning needs are more clearly delineated. © 2014 Wiley Periodicals, Inc.

Collaborative Systems – Finite State Machines

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Ion IVAN

2011-01-01

Full Text Available In this paper the finite state machines are defined and formalized. There are presented the collaborative banking systems and their correspondence is done with finite state machines. It highlights the role of finite state machines in the complexity analysis and performs operations on very large virtual databases as finite state machines. It builds the state diagram and presents the commands and documents transition between the collaborative systems states. The paper analyzes the data sets from Collaborative Multicash Servicedesk application and performs a combined analysis in order to determine certain statistics. Indicators are obtained, such as the number of requests by category and the load degree of an agent in the collaborative system.

Managing Distributed Innovation Processes in Virtual Organizations by Applying the Collaborative Network Relationship Analysis

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Eschenbächer, Jens; Seifert, Marcus; Thoben, Klaus-Dieter

Distributed innovation processes are considered as a new option to handle both the complexity and the speed in which new products and services need to be prepared. Indeed most research on innovation processes was focused on multinational companies with an intra-organisational perspective. The phenomena of innovation processes in networks - with an inter-organisational perspective - have been almost neglected. Collaborative networks present a perfect playground for such distributed innovation processes whereas the authors highlight in specific Virtual Organisation because of their dynamic behaviour. Research activities supporting distributed innovation processes in VO are rather new so that little knowledge about the management of such research is available. With the presentation of the collaborative network relationship analysis this gap will be addressed. It will be shown that a qualitative planning of collaboration intensities can support real business cases by proving knowledge and planning data.

Longitudinal burnout-collaboration patterns in Japanese medical care workers at special needs schools: a latent class growth analysis

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Kanayama, Mieko; Suzuki, Machiko; Yuma, Yoshikazu

2016-01-01

The present study aimed to identify and characterize potential burnout types and the relationship between burnout and collaboration over time. Latent class growth analysis and the growth mixture model were used to identify and characterize heterogeneous patterns of longitudinal stability and change in burnout, and the relationship between burnout and collaboration. We collected longitudinal data at three time points based on Japanese academic terms. The 396 study participants included academic teachers, yogo teachers, and registered nurses in Japanese special needs schools. The best model included four types of both burnout and collaboration in latent class growth analysis with intercept, slope, and quadratic terms. The four types of burnout were as follows: low stable, moderate unstable, high unstable, and high decreasing. They were identified as involving inverse collaboration function. The results indicated that there could be dynamic burnout types, namely moderate unstable, high unstable, and high decreasing, when focusing on growth trajectories in latent class analyses. The finding that collaboration was dynamic for dynamic burnout types and stable for stable burnout types is of great interest. This was probably related to the inverse relationship between the two constructs. PMID:27366107

Temperature extremes and infant mortality in Bangladesh: Hotter months, lower mortality.

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Babalola, Olufemi; Razzaque, Abdur; Bishai, David

2018-01-01

Our study aims to obtain estimates of the size effects of temperature extremes on infant mortality in Bangladesh using monthly time series data. Data on temperature, child and infant mortality were obtained for Matlab district of rural Bangladesh for January 1982 to December 2008 encompassing 49,426 infant deaths. To investigate the relationship between mortality and temperature, we adopted a regression with Autoregressive Integrated Moving Average (ARIMA) errors model of seasonally adjusted temperature and mortality data. The relationship between monthly mean and maximum temperature on infant mortality was tested at 0 and 1 month lags respectively. Furthermore, our analysis was stratified to determine if the results differed by gender (boys versus girls) and by age (neonates (≤ 30 days) versus post neonates (>30days and Bangladesh. Each degree Celsius increase in mean monthly temperature reduced monthly mortality by 3.672 (SE 1.544, pBangladesh. This may reflect a more heightened sensitivity of infants to hypothermia than hyperthermia in this environment.

[Epidemiological analysis on mortality of cancer in China, 2015].

Science.gov (United States)

Lan, L; Zhao, F; Cai, Y; Wu, R X; Meng, Q

2018-01-10

Objective: To understand the distribution of cancer deaths in China in 2015 and provide reference for the prevention and control of cancer. Methods: Based on the results of Global Burden of Disease 2015, the cancer death distributions in different age groups, sex groups, provinces or by different malignant tumor in Chinese were described. Results: The age-standardized mortality rate of cancer was 159.01/100 000 in China in 2015. The mortality rate was highest in age group ≥70 years (1 102.73/100 000), and lowest in age group 5-14 years (5.40/100 000). The mortality rate in males was 2.15 times higher than that in females. The first 5 provinces with high cancer mortality rate were Anhui, Qinghai, Sichuan, Guangxi and Henan. Lung cancer, liver cancer, stomach cancer, esophageal cancer and colorectal cancer ranked 1-5 in term of mortality rate. Conclusion: The cancer mortality differed with age, gender, area and different malignant tumors, suggesting the necessity to develop targeted prevention and control strategies.

Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity? A systematic review with meta-analysis and trial sequential analysis.

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Imberger, G; Orr, A; Thorlund, K; Wetterslev, J; Myles, P; Møller, A M

2014-03-01

The role of nitrous oxide in modern anaesthetic practice is contentious. One concern is that exposure to nitrous oxide may increase the risk of cardiovascular complications. ENIGMA II is a large randomized clinical trial currently underway which is investigating nitrous oxide and cardiovascular complications. Before the completion of this trial, we performed a systematic review and meta-analysis, using Cochrane methodology, on the outcomes that make up the composite primary outcome. We used conventional meta-analysis and trial sequential analysis (TSA). We reviewed 8282 abstracts and selected 138 that fulfilled our criteria for study type, population, and intervention. We attempted to contact the authors of all the selected publications to check for unpublished outcome data. Thirteen trials had outcome data eligible for our outcomes. We assessed three of these trials as having a low risk of bias. Using conventional meta-analysis, the relative risk of short-term mortality in the nitrous oxide group was 1.38 [95% confidence interval (CI) 0.22-8.71] and the relative risk of long-term mortality in the nitrous oxide group was 0.94 (95% CI 0.80-1.10). In both cases, TSA demonstrated that the data were far too sparse to make any conclusions. There were insufficient data to perform meta-analysis for stroke, myocardial infarct, pulmonary embolus, or cardiac arrest. This systematic review demonstrated that we currently do not have robust evidence for how nitrous oxide used as part of general anaesthesia affects mortality and cardiovascular complications.

The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Tura Gurmesa

2013-01-01

Full Text Available Abstract Background Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, health facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of health facility delivery on neonatal mortality. Methods The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg’s test and Egger’s test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Laird's estimator. Results A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final pooled effect size in the form of relative risk was 0.71 (95% CI: 0.54, 0.87 for health facility delivery as compared to home delivery. Conclusion Health facility delivery is found to reduce the risk of neonatal mortality by 29% in low and middle income countries. Expansion of health facilities, fulfilling the enabling environments and promoting their utilization during childbirth are

Formation of a collaborative society

OpenAIRE

Buřita, Ladislav; Ondryhal, Vojtěch

2014-01-01

The MilUNI knowledge portal, based on the knowledge base developed in ATOM software has been created at the authors' workplace with the aim to form a collaborative society of military universities. The analysis of the collaborative society concept is presented. The description of the MilUNI project is included. Some areas for university cooperation are proposed, as well as the measures facilitating the formation and development of the collaborative society.

The collaboration of general practitioners and nurses in primary care: a comparative analysis of concepts and practices in Slovenia and Spain.

Science.gov (United States)

Hämel, Kerstin; Vössing, Carina

2017-09-01

Aim A comparative analysis of concepts and practices of GP-nurse collaborations in primary health centres in Slovenia and Spain. Cross-professional collaboration is considered a key element for providing high-quality comprehensive care by combining the expertise of various professions. In many countries, nurses are also being given new and more extensive responsibilities. Implemented concepts of collaborative care need to be analysed within the context of care concepts, organisational structures, and effective collaboration. Background review of primary care concepts (literature analysis, expert interviews), and evaluation of collaboration in 'best practice' health centres in certain regions of Slovenia and Spain. Qualitative content analysis of expert interviews, presentations, observations, and group discussions with professionals and health centre managers. Findings In Slovenian health centres, the collaboration between GPs and nurses has been strongly shaped by their organisation in separate care units and predominantly case-oriented functions. Conventional power structures between professions hinder effective collaboration. The introduction of a new cross-professional primary care concept has integrated advanced practice nurses into general practice. Conventional hierarchies still exist, but a shared vision of preventive care is gradually strengthening attitudes towards team-oriented care. Formal regulations or incentives for teamwork have yet to be implemented. In Spain, health centres were established along with a team-based care concept that encompasses close physician-nurse collaboration and an autonomous role for nurses in the care process. Nurses collaborate with GPs on more equal terms with conflicts centring on professional disagreements. Team development structures and financial incentives for team achievements have been implemented, encouraging teams to generate their own strategies to improve teamwork. Clearly defined structures, shared visions of

An empirical analysis of the importance of controlling for unobserved heterogeneity when estimating the income-mortality gradient

Directory of Open Access Journals (Sweden)

Adriaan Kalwij

2014-10-01

Full Text Available Background: Statistical theory predicts that failing to control for unobserved heterogeneity in a Gompertz mortality risk model attenuates the estimated income-mortality gradient toward zero. Objective: I assess the empirical importance of controlling for unobserved heterogeneity in a Gompertz mortality risk model when estimating the income-mortality gradient. The analysis is carried out using individual-level administrative data from the Netherlands over the period 1996-2012. Methods: I estimate a Gompertz mortality risk model in which unobserved heterogeneity has a gamma distribution and left-truncation of life durations is explicitly taken into account. Results: I find that, despite a strong and significant presence of unobserved heterogeneity in both the male and female samples, failure to control for unobserved heterogeneity yields only a small and insignificant attenuation bias in the negative income-mortality gradient. Conclusions: The main finding, a small and insignificant attenuation bias in the negative income-mortality gradient when failing to control for unobserved heterogeneity, is positive news for the many empirical studies, whose estimations of the income-mortality gradient ignore unobserved heterogeneity.

Supply chain collaboration in industrial symbiosis networks

DEFF Research Database (Denmark)

Herczeg, Gabor; Akkerman, Renzo; Hauschild, Michael Zwicky

2018-01-01

A strategy supporting the development towards a circular economy is industrial symbiosis (IS). It is a form of collaborative supply chain management aiming to make industry more sustainable and achieve collective benefits based on utilization of waste, by-products, and excess utilities between...... economically independent industries. Based on an extensive analysis of published studies on existing IS collaborations and interviews with central stakeholders of a comprehensive IS, this paper investigates IS from a supply chain collaboration perspective. A theoretical framework is built and used to discuss...... how industrial symbiosis pursues sustainability and to identify the main collaboration aspects and performance impacts. This framework is then used in the analysis of selected published cases. Based on this, we derive propositions on the organizational and operational requirements for collaboration...

Red blood cell transfusion and mortality in trauma patients: risk-stratified analysis of an observational study.

Directory of Open Access Journals (Sweden)

Pablo Perel

2014-06-01

Full Text Available Haemorrhage is a common cause of death in trauma patients. Although transfusions are extensively used in the care of bleeding trauma patients, there is uncertainty about the balance of risks and benefits and how this balance depends on the baseline risk of death. Our objective was to evaluate the association of red blood cell (RBC transfusion with mortality according to the predicted risk of death.A secondary analysis of the CRASH-2 trial (which originally evaluated the effect of tranexamic acid on mortality in trauma patients was conducted. The trial included 20,127 trauma patients with significant bleeding from 274 hospitals in 40 countries. We evaluated the association of RBC transfusion with mortality in four strata of predicted risk of death: 50%. For this analysis the exposure considered was RBC transfusion, and the main outcome was death from all causes at 28 days. A total of 10,227 patients (50.8% received at least one transfusion. We found strong evidence that the association of transfusion with all-cause mortality varied according to the predicted risk of death (p-value for interaction 50% predicted risk of death (OR 0.59, 95% CI 0.47-0.74, p<0.0001. Transfusion was associated with an increase in fatal and non-fatal vascular events (OR 2.58, 95% CI 2.05-3.24, p<0.0001. The risk associated with RBC transfusion was significantly increased for all the predicted risk of death categories, but the relative increase was higher for those with the lowest (<6% predicted risk of death (p-value for interaction <0.0001. As this was an observational study, the results could have been affected by different types of confounding. In addition, we could not consider haemoglobin in our analysis. In sensitivity analyses, excluding patients who died early; conducting propensity score analysis adjusting by use of platelets, fresh frozen plasma, and cryoprecipitate; and adjusting for country produced results that were similar.The association of transfusion

Absolute or relative? A comparative analysis of the relationship between poverty and mortality.

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Fritzell, Johan; Rehnberg, Johan; Bacchus Hertzman, Jennie; Blomgren, Jenni

2015-01-01

We aimed to examine the cross-national and cross-temporal association between poverty and mortality, in particular differentiating the impact of absolute and relative poverty. We employed pooled cross-sectional time series analysis. Our measure of relative poverty was based upon the standard 60% of median income. The measure of absolute, or fixed, poverty was based upon the US poverty threshold. Our analyses were conducted on data for 30 countries between 1978 and 2010, a total of 149 data points. We separately studied infant, child, and adult mortality. Our findings highlight the importance of relative poverty for mortality. Especially for infant and child mortality, we found that our estimates of fixed poverty is close to zero either in the crude models, or when adjusting for gross domestic product. Conversely, the relative poverty estimates increased when adjusting for confounders. Our results seemed robust to a number of sensitivity tests. If we agree that risk of death is important, the public policy implication of our findings is that relative poverty, which has close associations to overall inequality, should be a major concern also among rich countries.

Comparative analysis of old-age mortality estimations in Africa.

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Eran Bendavid

Full Text Available Survival to old ages is increasing in many African countries. While demographic tools for estimating mortality up to age 60 have improved greatly, mortality patterns above age 60 rely on models based on little or no demographic data. These estimates are important for social planning and demographic projections. We provide direct estimations of older-age mortality using survey data.Since 2005, nationally representative household surveys in ten sub-Saharan countries record counts of living and recently deceased household members: Burkina Faso, Côte d'Ivoire, Ethiopia, Namibia, Nigeria, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. After accounting for age heaping using multiple imputation, we use this information to estimate probability of death in 5-year intervals ((5q(x. We then compare our (5q(x estimates to those provided by the World Health Organization (WHO and the United Nations Population Division (UNPD to estimate the differences in mortality estimates, especially among individuals older than 60 years old.We obtained information on 505,827 individuals (18.4% over age 60, 1.64% deceased. WHO and UNPD mortality models match our estimates closely up to age 60 (mean difference in probability of death -1.1%. However, mortality probabilities above age 60 are lower using our estimations than either WHO or UNPD. The mean difference between our sample and the WHO is 5.9% (95% CI 3.8-7.9% and between our sample is UNPD is 13.5% (95% CI 11.6-15.5%. Regardless of the comparator, the difference in mortality estimations rises monotonically above age 60.Mortality estimations above age 60 in ten African countries exhibit large variations depending on the method of estimation. The observed patterns suggest the possibility that survival in some African countries among adults older than age 60 is better than previously thought. Improving the quality and coverage of vital information in developing countries will become increasingly important with

"Ikigai", Subjective Wellbeing, as a Modifier of the Parity-Cardiovascular Mortality Association　- The Japan Collaborative Cohort Study.

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Yasukawa, Sumiyo; Eguchi, Eri; Ogino, Keiki; Tamakoshi, Akiko; Iso, Hiroyasu

2018-04-25

Nulliparity is associated with an excess risk of cardiovascular disease (CVD). "Ikigai", subjective wellbeing in Japan, is associated with reduced risk of CVD. The impact of ikigai on the association between parity and the risk of CVD, however, has not been reported.Methods and Results:A total of 39,870 Japanese women aged 40-79 years without a history of CVD, cancer or insufficient information at baseline in 1988-1990, were enrolled and followed until the end of 2009. They were categorized into 7 groups according to parity number 0-≥6. Using Cox regression hazard modeling, the associations between parity and mortality from stroke, coronary artery disease, and total CVD were investigated. During the follow-up period, 2,121 total CVD deaths were documented. No association was observed between parity and stroke and CVD mortality in women with ikigai, but there was an association in those without ikigai. The multivariable hazard ratios of stroke and total CVD mortality for nulliparous women without ikigai vs. those with 1 child were 1.87 (95% CI: 1.15-3.05) and 1.46 (95% CI: 1.07-2.01), respectively, and that for stroke mortality in high parity women without ikigai was 1.56 (95% CI: 1.00-2.45). Nulliparous or high parity women without ikigai had higher mortality from stroke and/or total CVD, suggesting that ikigai attenuated the association between parity and CVD mortality in Japanese women.

Fournier’s gangrene: our experience with 50 patients and analysis of factors affecting mortality

Science.gov (United States)

2013-01-01

Introduction Fournier’s gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. Case series have shown a mortality rate of 20% to 40% with an incidence of as high as 88% in some reports. In this study we aimed to share our experience in the management of Fournier’s gangrene and to identify risk factors that affect mortality. Methods The medical records of 50 patients with Fournier’s gangrene who presented at the University Hospital Hassan II of Fez from January 2003 to December 2009 were reviewed retrospectively to analyze the outcome and identify the risk factors and prognostic indicators of mortality. Results Ten males and five females were enrolled in the study. The mean age was 54 years (range 23–81). The most common predisposing factor was diabetes mellitus (34%). E. coli was the most frequent bacterial organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. The mortality rate was 24%. The advanced age, renal failure on admission, extension of infection to the abdominal wall, occurrence of septic shock and need for postoperative mechanical ventilation are the main prognostic factors of mortality. In multivariate analysis, none of these variables is an independent predictor of mortality. Conclusions Fournier’s gangrene is still a very severe disease with high mortality rates. Early recognition of infection associated with invasive and aggressive treatment is essential for attempting to reduce these prognostic indices. PMID:23547796

Poisson regression analysis of the mortality among a cohort of World War II nuclear industry workers

International Nuclear Information System (INIS)

Frome, E.L.; Cragle, D.L.; McLain, R.W.

1990-01-01

A historical cohort mortality study was conducted among 28,008 white male employees who had worked for at least 1 month in Oak Ridge, Tennessee, during World War II. The workers were employed at two plants that were producing enriched uranium and a research and development laboratory. Vital status was ascertained through 1980 for 98.1% of the cohort members and death certificates were obtained for 96.8% of the 11,671 decedents. A modified version of the traditional standardized mortality ratio (SMR) analysis was used to compare the cause-specific mortality experience of the World War II workers with the U.S. white male population. An SMR and a trend statistic were computed for each cause-of-death category for the 30-year interval from 1950 to 1980. The SMR for all causes was 1.11, and there was a significant upward trend of 0.74% per year. The excess mortality was primarily due to lung cancer and diseases of the respiratory system. Poisson regression methods were used to evaluate the influence of duration of employment, facility of employment, socioeconomic status, birth year, period of follow-up, and radiation exposure on cause-specific mortality. Maximum likelihood estimates of the parameters in a main-effects model were obtained to describe the joint effects of these six factors on cause-specific mortality of the World War II workers. We show that these multivariate regression techniques provide a useful extension of conventional SMR analysis and illustrate their effective use in a large occupational cohort study

Canonical correlation analysis between collaborative networks and innovation: A case study in information technology companies in province of Tehran, Iran

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Ahmad Jafar Nejad

2013-07-01

Full Text Available The increase competitions as well as technological advancements have created motivation among business owners to look for more innovative ideas from outside their organizations. Many enterprises collaborate with other organizations to empower themselves through innovative ideas. These kinds of collaborations can be observed as a concept called Regional Innovation System. These collaborations include inter-firm collaborations, research organizations, intermediary institutions and governmental agencies. The primary objective of this paper is to evaluate relationships between Collaborative Networks and Innovation in information technology business units located in province of Tehran, Iran. The research method utilized for the present study is descriptive-correlation. To evaluate the relationships between independent and dependent variables, canonical correlation analysis (CCA is used. The results confirm the previous findings regarding the relationship between Collaborative Networks and Innovation. Among various dimensions of Collaboration, Collaboration with governmental agencies had a very small impact on the relationship between collaboration networks and innovation. In addition, the results show that in addition to affecting product innovation and process innovation, collaboration networks also affected management innovation.

International Collaboration on CO2 Sequestration

Energy Technology Data Exchange (ETDEWEB)

Peter H. Israelsson; E. Eric Adams

2007-06-30

On December 4, 1997, the US Department of Energy (USDOE), the New Energy and Industrial Technology Development Organization of Japan (NEDO), and the Norwegian Research Council (NRC) entered into a Project Agreement for International Collaboration on CO{sub 2} Ocean Sequestration. Government organizations from Japan, Canada, and Australia, and a Swiss/Swedish engineering firm later joined the agreement, which outlined a research strategy for ocean carbon sequestration via direct injection. The members agreed to an initial field experiment, with the hope that if the initial experiment was successful, there would be subsequent field evaluations of increasingly larger scale to evaluate environmental impacts of sequestration and the potential for commercialization. The evolution of the collaborative effort, the supporting research, and results for the International Collaboration on CO{sub 2} Ocean Sequestration were documented in almost 100 papers and reports, including 18 peer-reviewed journal articles, 46 papers, 28 reports, and 4 graduate theses. These efforts were summarized in our project report issued January 2005 and covering the period August 23, 1998-October 23, 2004. An accompanying CD contained electronic copies of all the papers and reports. This report focuses on results of a two-year sub-task to update an environmental assessment of acute marine impacts resulting from direct ocean sequestration. The approach is based on the work of Auerbach et al. [6] and Caulfield et al. [20] to assess mortality to zooplankton, but uses updated information concerning bioassays, an updated modeling approach and three modified injection scenarios: a point release of negatively buoyant solid CO{sub 2} hydrate particles from a moving ship; a long, bottom-mounted diffuser discharging buoyant liquid CO{sub 2} droplets; and a stationary point release of hydrate particles forming a sinking plume. Results suggest that in particular the first two discharge modes could be

Meta-analysis Reveals that Hydraulic Traits Explain Cross-Species Patterns of Drought-Induced Tree Mortality across the Globe

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Anderegg, W.

2016-12-01

Drought-induced tree mortality has been observed globally and is expected to increase under climate change scenarios, with large potential consequences for the terrestrial carbon sink. Predicting mortality across species is crucial for assessing the effects of climate extremes on forest community biodiversity, composition, and carbon sequestration. However, the physiological traits associated with elevated risk of mortality in diverse ecosystems remain unknown, though these could greatly improve understanding and prediction of tree mortality in forests. We performed a meta-analysis on species' mortality rates across 475 species from 33 studies around the globe to assess which traits determine a species' mortality risk. We found that species-specific mortality anomalies from community mortality rate in a given drought were associated with plant hydraulic traits. Across all species, mortality was best predicted by a low hydraulic safety margin - the difference between typical minimum xylem water potential and that causing xylem dysfunction - and xylem vulnerability to embolism. Angiosperms and gymnosperms experienced roughly equal mortality risk. Our results provide broad support that hydraulic traits capture key mechanisms determining tree death and highlight that physiological traits can improve vegetation models' prediction of tree mortality during climate extremes. We conclude with thoughts about a revised framework for future tree mortality research.

Remote Collaboration With Mixed Reality Displays

DEFF Research Database (Denmark)

Müller, Jens; Rädle, Roman; Reiterer, Harald

2017-01-01

HCI research has demonstrated Mixed Reality (MR) as being beneficial for co-located collaborative work. For remote collaboration, however, the collaborators' visual contexts do not coincide due to their individual physical environments. The problem becomes apparent when collaborators refer...... to physical landmarks in their individual environments to guide each other's attention. In an experimental study with 16 dyads, we investigated how the provisioning of shared virtual landmarks (SVLs) influences communication behavior and user experience. A quantitative analysis revealed that participants used...

Malignant Lymphatic and Hematopoietic Neoplasms Mortality in Serbia, 1991–2010: A Joinpoint Regression Analysis

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Ilic, Milena; Ilic, Irena

2014-01-01

Background Limited data on mortality from malignant lymphatic and hematopoietic neoplasms have been published for Serbia. Methods The study covered population of Serbia during the 1991–2010 period. Mortality trends were assessed using the joinpoint regression analysis. Results Trend for overall death rates from malignant lymphoid and haematopoietic neoplasms significantly decreased: by −2.16% per year from 1991 through 1998, and then significantly increased by +2.20% per year for the 1998–2010 period. The growth during the entire period was on average +0.8% per year (95% CI 0.3 to 1.3). Mortality was higher among males than among females in all age groups. According to the comparability test, mortality trends from malignant lymphoid and haematopoietic neoplasms in men and women were parallel (final selected model failed to reject parallelism, P = 0.232). Among younger Serbian population (0–44 years old) in both sexes: trends significantly declined in males for the entire period, while in females 15–44 years of age mortality rates significantly declined only from 2003 onwards. Mortality trend significantly increased in elderly in both genders (by +1.7% in males and +1.5% in females in the 60–69 age group, and +3.8% in males and +3.6% in females in the 70+ age group). According to the comparability test, mortality trend for Hodgkin's lymphoma differed significantly from mortality trends for all other types of malignant lymphoid and haematopoietic neoplasms (P<0.05). Conclusion Unfavourable mortality trend in Serbia requires targeted intervention for risk factors control, early diagnosis and modern therapy. PMID:25333862

A comparative analysis of heat waves and associated mortality in St. Louis, Missouri--1980 and 1995.

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Smoyer, K E

1998-08-01

This research investigates heat-related mortality during the 1980 and 1995 heat waves in St. Louis, Missouri. St. Louis has a long history of extreme summer weather, and heat-related mortality is a public health concern. Heat waves are defined as days with apparent temperatures exceeding 40.6 degrees C (105 degrees F). The study uses a multivariate analysis to investigate the relationship between mortality and heat wave intensity, duration, and timing within the summer season. The heat wave of 1980 was more severe and had higher associated mortality than that of 1995. To learn if changing population characteristics, in addition to weather conditions, contributed to this difference, changes in population vulnerability between 1980 and 1995 are evaluated under simulated heat wave conditions. The findings show that St. Louis remains at risk of heat wave mortality. In addition, there is evidence that vulnerability has increased despite increased air-conditioning penetration and public health interventions.

Mortality in Central Java: results from the indonesian mortality registration system strengthening project

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Irianto Joko

2010-12-01

Full Text Available Abstract Background Mortality statistics from death registration systems are essential for health policy and development. Indonesia has recently mandated compulsory death registration across the entire country in December 2006. This article describes the methods and results from activities to ascertain causes of registered deaths in two pilot registration areas in Central Java during 2006-2007. The methods involved several steps, starting with adaptation of international standards for reporting causes of registered deaths for implementation in two sites, Surakarta (urban and Pekalongan (rural. Causes for hospital deaths were certified by attending physicians. Verbal autopsies were used for home deaths. Underlying causes were coded using ICD-10. Completeness of registration was assessed in a sample of villages and urban wards by triangulating data from the health sector, the civil registration system, and an independent household survey. Finally, summary mortality indicators and cause of death rankings were developed for each site. Findings A total of 10,038 deaths were registered in the two sites during 2006-2007; yielding annual crude death rates of 5.9 to 6.8 per 1000. Data completeness was higher in rural areas (72.5% as compared to urban areas (52%. Adjusted life expectancies at birth were higher for both males and females in the urban population as compared to the rural population. Stroke, ischaemic heart disease and chronic respiratory disease are prominent causes in both populations. Other important causes are diabetes and cancer in urban areas; and tuberculosis and diarrhoeal diseases in rural areas. Conclusions Non-communicable diseases cause a significant proportion of premature mortality in Central Java. Implementing cause of death reporting in conjunction with death registration appears feasible in Indonesia. Better collaboration between health and registration sectors is required to improve data quality. These are the first local

Antiretroviral Treatment Scale-Up and Tuberculosis Mortality in High TB/HIV Burden Countries: An Econometric Analysis.

Science.gov (United States)

Yan, Isabel; Bendavid, Eran; Korenromp, Eline L

2016-01-01

Antiretroviral therapy (ART) reduces mortality in patients with active tuberculosis (TB), but the population-level relationship between ART coverage and TB mortality is untested. We estimated the reduction in population-level TB mortality that can be attributed to increasing ART coverage across 41 high HIV-TB burden countries. We compiled TB mortality trends between 1996 and 2011 from two sources: (1) national program-reported TB death notifications, adjusted for annual TB case detection rates, and (2) WHO TB mortality estimates. National coverage with ART, as proportion of HIV-infected people in need, was obtained from UNAIDS. We applied panel linear regressions controlling for HIV prevalence (5-year lagged), coverage of TB interventions (estimated by WHO and UNAIDS), gross domestic product per capita, health spending from domestic sources, urbanization, and country fixed effects. Models suggest that that increasing ART coverage was followed by reduced TB mortality, across multiple specifications. For death notifications at 2 to 5 years following a given ART scale-up, a 1% increase in ART coverage predicted 0.95% faster mortality rate decline (p = 0.002); resulting in 27% fewer TB deaths in 2011 alone than would have occurred without ART. Based on WHO death estimates, a 1% increase in ART predicted a 1.0% reduced TB death rate (peconometric analysis supports a substantial impact of ART on population-level TB mortality realized already within the first decade of ART scale-up, that is apparent despite variable-quality mortality data.

Exploring governance for a One Health collaboration for leptospirosis prevention and control in Fiji: Stakeholder perceptions, evidence, and processes.

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McPherson, Anna; Hill, Peter S; Kama, Mike; Reid, Simon

2018-03-30

Fiji has a high burden of leptospirosis, with endemic infection and epidemic outbreaks with high mortality, often associated with flooding and cyclones. As a zoonosis, leptospirosis control requires interventions in sectors beyond the usual control of health-in Fiji, the dairy and sugar industries, and water and sanitation and rodent control in communities. This paper presents the findings of qualitative research to inform policy around governance for a One Health multisectoral approach to leptospirosis control. Key informants from relevant government agencies and industry organizations were interviewed in late 2014, and the interviews analyzed and triangulated with documentary analysis. The analysis identified 5 themes: perceptions of the impact of leptospirosis, governance processes, models for collaboration, leptospirosis control, and preferred leadership for leptospirosis management. Data were limited, with poor communication between ministries, and limited awareness of leptospirosis outside outbreaks. Collaboration during outbreaks was positive but not sustained in endemic periods. Mechanism for enhanced collaboration was developed for endemic and outbreak situations. The findings informed a One Health governance approach to leptospirosis, framed within a National Strategic Plan, with a specific National Action Plan for Leptospirosis. The process provides a research based One Health template for application to other zoonotic diseases. Copyright © 2018 John Wiley & Sons, Ltd.

[Spatial analysis of neonatal mortality in the state of São Paulo, 2006-2010].

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Almeida, Milena Cristina Silva; Gomes, Camila Moraes Santos; Nascimento, Luiz Fernando Costa

2014-12-01

The aim of this study was to identify spatial patterns of distribution of overall, early, and late neonatal mortality rates in São Paulo state. An ecological and exploratory study was carried in micro-regions of São Paulo sate. Mortality rates per 1,000 live births (LB) were calculated using data on overall, early, and late neonatal mortality in São Paulo between 2006 and 2010; these data were obtained from Information System and Information Technology Department of the Brazilian National Healthcare System (DATASUS). The global Moran's indices (I) were calculated for rates and thematic maps were built with these rates. Micro-regions with a high priority for intervention were identified by the box map. The software TerraView 4.2.1 was used for spatial analysis. The rates of early and late neonatal mortality were 6.2 per thousand LB and 2.5 per thousand LB, respectively. The global Moran's indexes (I) were I=0.13, I=0.15, and I=0.26 for overall, early, and late neonatal mortality rates, respectively; all global Moran's indices showed p-values <0.05. Thematic maps showed clusters of micro-regions with high rates located in the southwest and east of the state. The results presented in this study allow the implementation of policies by health managers, aiming to reduce neonatal mortality. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990-2010: a longitudinal analysis.

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Maruthappu, Mahiben; Watkins, Johnathan; Noor, Aisyah Mohd; Williams, Callum; Ali, Raghib; Sullivan, Richard; Zeltner, Thomas; Atun, Rifat

2016-08-13

The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care (PEH). We estimated the effects of changes in unemployment and PEH on cancer mortality, and identified how universal health coverage (UHC) affected these relationships. For this longitudinal analysis, we obtained data from the World Bank and WHO (1990-2010). We aggregated mortality data for breast cancer in women, prostate cancer in men, and colorectal cancers in men and women, which are associated with survival rates that exceed 50%, into a treatable cancer class. We likewise aggregated data for lung and pancreatic cancers, which have 5 year survival rates of less than 10%, into an untreatable cancer class. We used multivariable regression analysis, controlling for country-specific demographics and infrastructure, with time-lag analyses and robustness checks to investigate the relationship between unemployment, PEH, and cancer mortality, with and without UHC. We used trend analysis to project mortality rates, on the basis of trends before the sharp unemployment rise that occurred in many countries from 2008 to 2010, and compared them with observed rates. Data were available for 75 countries, representing 2.106 billion people, for the unemployment analysis and for 79 countries, representing 2.156 billion people, for the PEH analysis. Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH increased. Time-series analysis provided an estimate of more than

National surgical mortality audit may be associated with reduced mortality after emergency admission.

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Kiermeier, Andreas; Babidge, Wendy J; McCulloch, Glenn A J; Maddern, Guy J; Watters, David A; Aitken, R James

2017-10-01

The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality. Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes. © 2017 Royal Australasian College of Surgeons.

Mortality among immigrants in England and Wales by major causes of death, 1971-2012: A longitudinal analysis of register-based data.

Science.gov (United States)

Wallace, Matthew; Kulu, Hill

2015-12-01

Recent research has found a migrant mortality advantage among immigrants relative to the UK-born population living in England and Wales. However, while all-cause mortality is useful to show differences in mortality between immigrants and the host population, it can mask variation in mortality patterns from specific causes of death. This study analyses differences in the causes of death among immigrants living in England and Wales. We extend previous research by applying competing-risks survival analysis to study a large-scale longitudinal dataset from 1971 to 2012 to directly compare causes of death. We confirm low all-cause mortality among nearly all immigrants, except immigrants from Scotland, Northern Ireland and the Republic of Ireland (who have high mortality). In most cases, low all-cause mortality among immigrants is driven by lower mortality from chronic diseases (in nearly all cases by lower cancer mortality and in some cases by lower mortality from cardiovascular diseases (CVD)). This low all-cause mortality often coexists with low respiratory disease mortality and among non-western immigrants, coexists with high mortality from infectious diseases; however, these two causes of death contribute little to mortality among immigrants. For men, CVD is the leading cause of death (particularly among South Asians). For women, cancer is the leading cause of death (except among South Asians, for whom CVD is also the leading cause). Differences in CVD mortality over time remain constant between immigrants relative to UK-born, but immigrant cancer patterns shows signs of some convergence to the cancer mortality among the UK-born (though cancer mortality is still low among immigrants by age 80). The study provides the most up-to-date, reliable UK-based analysis of immigrant mortality. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prognostic Effect of the Nocturnal Blood Pressure Fall in Hypertensive Patients: The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) Meta-Analysis.

Science.gov (United States)

Salles, Gil F; Reboldi, Gianpaolo; Fagard, Robert H; Cardoso, Claudia R L; Pierdomenico, Sante D; Verdecchia, Paolo; Eguchi, Kazuo; Kario, Kazuomi; Hoshide, Satoshi; Polonia, Jorge; de la Sierra, Alejandro; Hermida, Ramon C; Dolan, Eamon; O'Brien, Eoin; Roush, George C

2016-04-01

The prognostic importance of the nocturnal systolic blood pressure (SBP) fall, adjusted for average 24-hour SBP levels, is unclear. The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) examined this issue in a meta-analysis of 17 312 hypertensives from 3 continents. Risks were computed for the systolic night-to-day ratio and for different dipping patterns (extreme, reduced, and reverse dippers) relative to normal dippers. ABC-H investigators provided multivariate adjusted hazard ratios (HRs), with and without adjustment for 24-hour SBP, for total cardiovascular events (CVEs), coronary events, strokes, cardiovascular mortality, and total mortality. Average 24-hour SBP varied from 131 to 140 mm Hg and systolic night-to-day ratio from 0.88 to 0.93. There were 1769 total CVEs, 916 coronary events, 698 strokes, 450 cardiovascular deaths, and 903 total deaths. After adjustment for 24-hour SBP, the systolic night-to-day ratio predicted all outcomes: from a 1-SD increase, summary HRs were 1.12 to 1.23. Reverse dipping also predicted all end points: HRs were 1.57 to 1.89. Reduced dippers, relative to normal dippers, had a significant 27% higher risk for total CVEs. Risks for extreme dippers were significantly influenced by antihypertensive treatment (Panalysis of hypertensive patients, the nocturnal BP fall provided substantial prognostic information, independent of 24-hour SBP levels. © 2016 American Heart Association, Inc.

Remote Collaboration, Decision Support, and On-Demand Medical Image Analysis for Acute Stroke Care

NARCIS (Netherlands)

Sales Barros, Renan; Borst, Jordi; Kleynenberg, Steven; Badr, Celine; Ganji, Rama-Rao; de Bliek, Hubrecht; Zeng-Eyindanga, Landry-Stephane; van den Brink, Henk; Majoie, Charles; Marquering, Henk; Olabarriaga, Silvia Delgado

2015-01-01

Acute stroke is the leading cause of disabilities and the fourth cause of death worldwide. The treatment of stroke patients often requires fast collaboration between medical experts and fast analysis and sharing of large amounts of medical data, especially image data. In this situation, cloud

Interprofessional collaboration in the ICU: how to define?

Science.gov (United States)

Rose, Louise

2011-01-01

The intensive care unit (ICU) is a dynamic, complex and, at times, highly stressful work environment that involves ongoing exposure to the complexities of interprofessional team functioning. Failures of communication, considered examples of poor collaboration among health care professionals, are the leading cause of inadvertent harm across all health care settings. Evidence suggests effective interprofessional collaboration results in improved outcomes for critically ill patients. One recent study demonstrated a link between low standardized mortality ratios and self-identified levels of collaboration. The aim of this paper is to discuss determinants and complexities of interprofessional collaboration, the evidence supporting its impact on outcomes in the ICU, and interventions designed to foster better interprofessional team functioning. Elements of effective interprofessional collaboration include shared goals and partnerships including explicit, complementary and interdependent roles; mutual respect; and power sharing. In the ICU setting, teams continually alter due to large staff numbers, shift work and staff rotations through the institution. Therefore, the ideal 'unified' team working together to provide better care and improve patient outcomes may be difficult to sustain. Power sharing is one of the most complex aspects of interprofessional collaboration. Ownership of specialized knowledge, technical skills, clinical territory, or even the patient, may produce interprofessional conflict when ownership is not acknowledged. Collaboration by definition implies interdependency as opposed to autonomy. Yet, much nursing literature focuses on achievement of autonomy in clinical decision-making, cited to improve job satisfaction, retention and patient outcomes. Autonomy of health care professionals may be an inappropriate goal when striving to foster interprofessional collaboration. Tools such as checklists, guidelines and protocols are advocated, by some, as ways

Nontraumatic hypotension and shock in the emergency department and the prehospital setting, prevalence, etiology, and mortality: a systematic review.

Directory of Open Access Journals (Sweden)

Jon Gitz Holler

Full Text Available Acute patients presenting with hypotension in the prehospital or emergency department (ED setting are in need of focused management and knowledge of the epidemiology characteristics might help the clinician. The aim of this review was to address prevalence, etiology and mortality of nontraumatic hypotension (SBP ≤ 90 mmHg with or without the presence of shock in the prehospital and ED setting.We performed a systematic literature search up to August 2013, using Medline, Embase, Cinahl, Dare and The Cochrane Library. The analysis and eligibility criteria were documented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-guidelines and The Cochrane Collaboration. No restrictions on language, publication date, or status were imposed. We used the Newcastle-Ottawa quality assessment scale (NOS-scale and the Strengthening the Reporting of Observational studies in Epidemiology (STROBE-statement to assess the quality.Six observational studies were considered eligible for analysis based on the evaluation of 11,880 identified papers. Prehospital prevalence of hypotension was 19.5/1000 emergency medicine service (EMS contacts, and the prevalence of hypotensive shock was 9.5-19/1000 EMS contacts with an inhospital mortality of shock between 33 to 52%. ED prevalence of hypotension was 4-13/1000 contacts with a mortality of 12%. Information on mortality, prevalence and etiology of shock in the ED was limited. A meta-analysis was not feasible due to substantial heterogeneity between studies.There is inadequate evidence to establish concise estimates of the characteristics of nontraumatic hypotension and shock in the ED or in the prehospital setting. The available studies suggest that 2% of EMS contacts present with nontraumatic hypotension while 1-2% present with shock. The inhospital mortality of prehospital shock is 33-52%. Prevalence of hypotension in the ED is 1% with an inhospital mortality of 12%. Prevalence

Infant mortality in South Africa - distribution, associations and policy implications, 2007: an ecological spatial analysis

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Sartorius Benn KD

2011-11-01

antenatal HIV sero-prevalence, previous sibling mortality and maternal mortality were found to be the most attributable respectively. Conclusions This study demonstrates the usefulness of advanced spatial analysis to both quantify excess infant mortality risk at the lowest administrative unit, as well as the use of Bayesian modelling to quantify determinant significance given spatial correlation. The "novel" integration of determinant prevalence at the sub-district and coefficient estimates to estimate attributable fractions further elucidates the "high impact" factors in particular areas and has considerable potential to be applied in other locations. The usefulness of the paper, therefore, not only suggests where to intervene geographically, but also what specific interventions policy makers should prioritize in order to reduce the infant mortality burden in specific administration areas.

The effect of combined antiretroviral therapy on the overall mortality of HIV-infected individuals

NARCIS (Netherlands)

Phillips, A. N.; Gilson, R.; Easterbrook, P.; Fisher, M.; Gazzard, B.; Johnson, M.; Walsh, J.; Leen, C.; Orkin, C.; Anderson, J.; Pillay, D.; Delpech, V.; Schwenk, A.; Dunn, D.; Gompels, M.; Hill, T.; Porter, K.; Babiker, A.; Sabin, C.; Waters, A.; Crates, D.; Mohamed-Saad, S.; Perry, N.; Pullin, A.; Churchill, D.; Harris, W.; Nelson, M.; Asboe, D.; Bulbeck, S.; Mandalia, S.; Clarke, J.; Dodds, J.; Rider, A.; Youle, M.; Lampe, F.; Smith, C.; Gumley, H.; Chaloner, C.; Ismajani, D.; Weber, J.; Cashin, S.; Kemble, C.; Mackie, N.; Thomas, R.; Jones, K.; Gann, S.; Wilson, A.; Ainsworth, J.; de Wolf, F.; Bezemer, D. O.; Gras, L. A. J.; Kesselring, A. M.; van Sighem, A. I.; Smit, C.; Zhang, S.; Zaheri, S.; Prins, J. M.; Bos, J. C.; Eeftinck-Schattenkerk, J. K. M.; Geerlings, S. E.; Godfried, M. H.; Lange, J. M. A.; van der Meer, J. T. M.; Nellen, F. J. B.; Olszyna, D. P.; van der Poll, M.; Reiss, P.; Sankatsing, S. U. C.; Steingrover, R.; van der Valk, M.; Vermeulen, J. N.; Vrouenraets, S. M. E.; van Vugt, M.; Wit, F. W. M. N.; Schreij, G.; van der Geest, S.; Oude Lashof, A.; Lowe, S.; Verbon, A.; Kuijpers, T. W.; Pajkrt, D.; Scherpbier, H. J.; van der Ende, M. E.; Bax, H.; van der Feltz, M.; Gelinck, L. B. S.; Nouwen, J. L.; Rijnders, B. J. A.; de Ruiter, E. D.; Slobbe, L.; Schurink, C. A. M.; de Vries, T. E. M. S.; Driessen, G.; van der Flier, M.; Hartwig, N. G.; Branger, J.; Kauffmann, R. H.; Schippers, E. F.; Groeneveld, P. H. P.; Alleman, M. A.; ten Kate, R. W.; Soetekouw, R.; Kroon, F. P.; Arend, S. M.; de Boer, M. G. J.; van den Broek, P. J.; van Dissel, J. T.; van Nieuwkoop, C.; den Hollander, J. G.; Bronsveld, W.; Vriesendorp, R.; Jeurissen, F. J. F.; Leyten, E. M. S.; van Houte, D.; Polée, M. B.; ten Napel, C. H. H.; Kootstra, G. J.; Brinkman, K.; van den Berk, G. E. L.; Blok, W. L.; Frissen, P. H. J.; Schouten, W. E. M.; van Eeden, A.; Verhagen, D. W. M.; Mulder, J. W.; van Gorp, E. C. M.; Mairuhu, A. T. A.; Wagenaar, J.; Juttmann, J. R.; van Kasteren, M. E. E.; Veenstra, J.; Vasmel, W. L. E.; Koopmans, P. P.; Brouwer, A. M.; Dofferhoff, A. S. M.; de Groot, R.; ter Hofstede, H. J. M.; Keuter, M.; van der Ven, A. J. A. M.; Sprenger, H. G.; van Assen, S.; van Leeuwen, J. T. M.; Stek, C. J.; Doedens, R.; Scholvinck, E. H.; Hoepelman, I. M.; Schneider, M. M. E.; Bonten, M. J. M.; Ellerbroek, P. M.; Jaspers, C. A. J. J.; Maarschalk-Ellerbroek, L. J.; Oosterheert, J. J.; Peters, E. J. G.; Mudrikova, T.; Wassenberg, M. W. M.; Weijer, S.; Geelen, S. P. M.; Wolfs, T. F. W.; Danner, S. A.; van Agtmael, M. A.; Bierman, W. F. W.; Claessen, F. A. P.; Hillebrand, M. E.; de Jong, E. V.; Kortmann, W.; Perenboom, R. M.; bij de Vaate, E. A.; Richter, C.; van der Berg, J.; Gisolf, E. H.; Tanis, A. A.; Duits, A. J.; Winkel, K.; Elisabeth, S. T.; Abgrall, S.; Barin, F.; Bentata, M.; Billaud, E.; Boué, F.; Burty, C.; Cabié, A.; Costagliola, D.; Cotte, L.; de Truchis, P.; Duval, X.; Duvivier, C.; Enel, P.; Fredouille-Heripret, L.; Gasnault, J.; Gaud, C.; Gilquin, J.; Grabar, S.; Katlama, C.; Khuong, M. A.; Lang, J. M.; Lascaux, A. S.; Launay, O.; Mahamat, A.; Mary-Krause, M.; Matheron, S.; Meynard, J. L.; Pavie, J.; Pialoux, G.; Pilorgé, F.; Poizot-Martin, I.; Pradier, C.; Reynes, J.; Rouveix, E.; Simon, A.; Tattevin, P.; Tissot-Dupont, H.; Viard, J. P.; Viget, N.; Salomon, Valérie; Jacquemet, N.; Guiguet, M.; Lanoy, E.; Liévre, L.; Selinger-Leneman, H.; Lacombe, J. M.; Potard, V.; Bricaire, F.; Herson, S.; Desplanque, N.; Girard, P. M.; Meyohas, M. C.; Picard, O.; Cadranel, J.; Mayaud, C.; Clauvel, J. P.; Decazes, J. M.; Gerard, L.; Molina, J. M.; Diemer, M.; Sellier, P.; Honoré, P.; Jeantils, V.; Tassi, S.; Mechali, D.; Taverne, B.; Berthé, H.; Dupont, C.; Chandemerle, C.; Mortier, E.; Tisne-Dessus, D.; Weiss, L.; Salmon, D.; Auperin, I.; Roudière, L.; Fior, R.; Delfraissy, J. F.; Goujard, C.; Jung, C.; Lesprit, P. H.; Vittecoq, D.; Fraisse, P.; Rey, D.; Beck-Wirth, G.; Stahl, J. P.; Lecercq, P.; Gourdon, F.; Laurichesse, H.; Fresard, A.; Lucht, F.; Bazin, C.; Verdon, R.; Chavanet, P.; Arvieux, C.; Michelet, C.; Choutet, P.; Goudeau, A.; Maître, M. F.; Hoen, B.; Eglinger, P.; Faller, J. P.; Borsa-Lebas, F.; Caron, F.; Daures, J. P.; May, T.; Rabaud, C.; Berger, J. L.; Rémy, G.; Arlet-Suau, E.; Cuzin, L.; Massip, P.; Legrand, M. F. Thiercelin; Pontonnier, G.; Yasdanpanah, Y.; Dellamonica, P.; Pugliese, P.; Aleksandrowicz, K.; Quinsat, D.; Ravaux, I.; Delmont, J. P.; Moreau, J.; Gastaut, J. A.; Retornaz, F.; Soubeyrand, J.; Galinier, A.; Ruiz, J. M.; Allegre, T.; Blanc, P. A.; Bonnet-Montchardon, D.; Lepeu, G.; Granet-Brunello, P.; Esterni, J. P.; Pelissier, L.; Cohen-Valensi, R.; Nezri, M.; Chadapaud, S.; Laffeuillade, A.; Raffi, F.; Boibieux, A.; Peyramond, D.; Livrozet, J. M.; Touraine, J. L.; Trepo, C.; Strobel, M.; Bissuel, F.; Pradinaud, R.; Sobesky, M.; Contant, M.; Aebi, C.; Battegay, M.; Bernasconi, E.; Böni, J.; Brazzola, P.; Bucher, H. C.; Bürgisser, P. H.; Calmy, A.; Cattacin, S.; Cavassini, M.; Cheseaux, J.-J.; Drack, G.; Dubs, R.; Egger, M.; Elzi, L.; Fischer, M.; Flepp, M.; Fontana, A.; Francioli, P.; Furrer, H. J.; Fux, C.; Gayet-Ageron, A.; Gerber, S.; Gorgievski, M.; Günthard, H.; Gyr, T. H.; Hirsch, H.; Hirschel, B.; Hösli, I.; Hüsler, M.; Kaiser, L.; Kahlert, C. H.; Karrer, U.; Kind, C.; Klimkait, T. H.; Ledergerber, B.; Martinetti, G.; Martinez, B.; Müller, N.; Nadal, D.; Paccaud, F.; Pantaleo, G.; Raio, L.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schultze, D.; Schüpbach, J.; Speck, R.; Taffé, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Weber, R.; Wyler, C.-A.; Yerly, S.; Casabona, J.; Miró, J. M.; Alquézar, A.; Isern, V.; Esteve, A.; Podzamczer, D.; Murillas, J.; Gatell, J. M.; Agüero, F.; Tural, C.; Clotet, B.; Ferrer, E.; Riera, M.; Segura, F.; Navarro, G.; Force, L.; Vilaró, J.; Masabeu, A.; García, I.; Guadarrama, M.; Romero, A.; Agustí, C.; Montoliu, A.; Ortega, N.; Lazzari, E.; Puchol, E.; Sanchez, M.; Blanco, J. L.; Garcia-Alcaide, F.; Martínez, E.; López-Dieguez, M.; García-Goez, J. F.; Sirera, G.; Romeu, J.; Jou, A.; Negredo, E.; Miranda, C.; Capitan, M. C.; Olmo, M.; Barragan, P.; Saumoy, M.; Bolao, F.; Cabellos, C.; Peña, C.; Sala, M.; Cervantes, M.; Amengual, M. J.; Navarro, M.; Penelo, E.; Berenguer, J.; del Amo, J.; García, F.; Gutiérrez, F.; Labarga, P.; Moreno, S.; Muñoz, M. A.; Caro-Murillo, A. M.; Sobrino, P.; Jarrín, I.; Sirvent, J. L. Gómez; Rodríguez, P.; Alemán, M. R.; Alonso, M. M.; López, A. M.; Hernández, M. I.; Soriano, V.; Barreiro, P.; Medrano, J.; Rivas, P.; Herrero, D.; Blanco, F.; Vispo, M. E.; Martín, L.; Ramírez, G.; de Diego, M.; Rubio, R.; Pulido, F.; Moreno, V.; Cepeda, C.; Hervás, R. I.; Iribarren, J. A.; Arrizabalaga, J.; Aramburu, M. J.; Camino, X.; Rodríguez-Arrondo, F.; von Wichmann, M. A.; Pascual, L.; Goenaga, M. A.; Masiá, M.; Ramos, J. M.; Padilla, S.; Sánchez-Hellín, V.; Bernal, E.; Escolano, C.; Montolio, F.; Peral, Y.; López, J. C.; Miralles, P.; Cosín, J.; Sánchez, M.; Gutiérrez, I.; Ramírez, M.; Padilla, B.; Vidal, F.; Sanjuan, M.; Peraire, J.; Veloso, S.; Viladés, C.; López-Dupla, M.; Olona, M.; Vargas, M.; Aldeguer, J. L.; Blanes, M.; Lacruz, J.; Salavert, M.; Montero, M.; Cuéllar, S.; de los Santos, I.; Sanz, J.; Oteo, J. A.; Blanco, J. R.; Ibarra, V.; Metola, L.; Sanz, M.; Pérez-Martínez, L.; Sola, J.; Uriz, J.; Castiello, J.; Reparaz, J.; Arriaza, M. J.; Irigoyen, C.; Antela, A.; Casado, J. L.; Dronda, F.; Moreno, A.; Pérez, M. J.; López, D.; Gutiérrez, C.; Hernández, B.; Pumares, M.; Martí, P.; García, L.; Page, C.; Hernández, J.; Peña, A.; Muñoz, L.; Parra, J.; Viciana, P.; Leal, M.; López-Cortés, L. F.; Trastoy, M.; Mata, R.; Justice, A. C.; Fiellin, D. A.; Rimland, D.; Jones-Taylor, C.; Oursler, K. A.; Titanji, R.; Brown, S.; Garrison, S.; Rodriguez-Barradas, M.; Masozera, N.; Goetz, M.; Leaf, D.; Simberkoff, M.; Blumenthal, D.; Leung, J.; Butt, A.; Hoffman, E.; Gibert, C.; Peck, R.; Mattocks, K.; Braithwaite, S.; Brandt, C.; Bryant, K.; Cook, R.; Conigliaro, J.; Crothers, K.; Chang, J.; Crystal, S.; Day, N.; Erdos, J.; Freiberg, M.; Kozal, M.; Gandhi, N.; Gaziano, M.; Gerschenson, M.; Good, B.; Gordon, A.; Goulet, J. L.; Hernán, M. A.; Kraemer, K.; Lim, J.; Maisto, S.; Miller, P.; Mole, L.; O'Connor, P.; Papas, R.; Robins, J. M.; Rinaldo, C.; Roberts, M.; Samet, J.; Tierney, B.; Whittle, J.; Phillips, A.; Brettle, R.; Darbyshire, J.; Fidler, S.; Goldberg, D.; Hawkins, D.; Jaffe, H.; McLean, K.; Porter, Kholoud; Cursley, Adam; Ewings, Fiona; Fairbrother, Keith; Gnatiuc, Louisa; Lodi, Sara; Murphy, Brendan; Douglas, G.; Kennedy, N.; Pritchard, J.; Andrady, U.; Gwynedd, Ysbyty; Rajda, N.; Maw, R.; McKernan, S.; Drake, S.; Gilleran, G.; White, D.; Ross, J.; Toomer, S.; Hewart, R.; Wilding, H.; Woodward, R.; Dean, G.; Heald, L.; Horner, P.; Glover, S.; Bansaal, D.; Eduards, S.; Carne, C.; Browing, M.; Das, R.; Stanley, B.; Estreich, S.; Magdy, A.; O'Mahony, C.; Fraser, P.; Hayman, B.; Jebakumar, S. P. R.; Joshi, U.; Ralph, S.; Wade, A.; Mette, R.; Lalik, J.; Summerfield, H.; El-Dalil, A.; France, A. J.; White, C.; Robertson, R.; Gordon, S.; McMillan, S.; Morris, S.; Lean, C.; Vithayathil, K.; McLean, L.; Winter, A.; Gale, D.; Jacobs, S.; Tayal, S.; Short, L.; Green, S.; Williams, G.; Sivakumar, K.; Bhattacharyya, D. N.; Monteiro, E.; Minton, J.; Dhar, J.; Nye, F.; DeSouza, C. B.; Isaksen, A.; McDonald, L.; Franca, A.; William, L.; Jendrulek, I.; Shaunak, S.; El-Gadi, S.; Easterbrook, P. J.; Mazhude, C.; Johnstone, R.; Fakoya, A.; Mchale, J.; Kegg, S.; Mitchell, S.; Byrne, P.; Rice, P.; Mullaney, S. A.; McCormack, S.; David, D.; Melville, R.; Phillip, K.; Balachandran, T.; Mabey-Puttock, S.; Sukthankar, A.; Murphy, C.; Wilkins, E.; Ahmad, S.; Haynes, J.; Evans, E.; Ong, E.; Grey, R.; Meaden, J.; Bignell, C.; Loay, D.; Peacock, K.; Girgis, M. R.; Morgan, B.; Palfreeman, A.; Wilcox, J.; Tobin, J.; Tucker, L.; Saeed, A. M.; Chen, F.; Deheragada, A.; Williams, O.; Lacey, H.; Herman, S.; Kinghorn, D.; Devendra, S. V.; Wither, J.; Dawson, S.; Rowen, D.; Harvey, J.; Bridgwood, A.; Singh, G.; Chauhan, M.; Kellock, D.; Young, S.; Dannino, S.; Kathir, Y.; Rooney, G.; Currie, J.; Fitzgerald, M.; Devendra, S.; Keane, F.; Booth, G.; Green, T.; Arumainayyagam, J.; Chandramani, S.; Rajamanoharan, S.; Robinson, T.; Curless, E.; Gokhale, R.; Tariq, A.; Luzzi, G.; Fairley, I.; Wallis, F.; Smit, E.; Ward, F.; Morlat, P.; Bonarek, M.; Bonnet, F.; Nouts, C.; Louis, J.; Reliquet, V.; Sauser, F.; Biron, C.; Mounoury, O.; Hue, H.; Brosseau, D.; Ghosn, J.; Rannou, M. T.; Bergmann, J. F.; Badsi, E.; Rami, A.; Parrinello, M.; Samanon-Bollens, D.; Campa, P.; Tourneur, M.; Desplanques, N.; Jeanblanc, F.; Chiarello, P.; Makhloufi, D.; Blanc, A. P.; Allègre, T.; Baillat, V.; Lemoing, V.; de Boever, C. Merle; Tramoni, C.; Sobesky, G.; Abel, S.; Beaujolais, V.; Slama, L.; Chakvetadze, C.; Berrebi, V.; Yeni, P.; Bouvet, E.; Fournier, I.; Gerbe, J.; Koffi, K.; Augustin-Normand, C.; Miailhes, P.; Thoirain, V.; Brochier, C.; Souala, F.; Ratajczak, M.; Beytoux, J.; Jacomet, C.; Morelon, S.; Olivier, C.; Lortholary, O.; Dupont, B.; Maignan, A.; Ragnaud, J. M.; Raymond, I.; Leport, C.; Jadand, C.; Jestin, C.; Longuet, P.; Boucherit, S.; Sereni, D.; Lascoux, C.; Prevoteau, F.; Sobel, A.; Levy, Y.; Lelièvre, J. D.; Dominguez, S.; Dumont, C.; Aumaître, H.; Delmas, B.; Saada, M.; Medus, M.; Guillevin, L.; Tahi, T.; Yazdanpanah, Y.; Pavel, S.; Marien, M. C.; Drenou, B.; Beck, C.; Benomar, M.; Tubiana, R.; Mohand, H. Ait; Chermak, A.; Abdallah, S. Ben; Touam, F.; Drobacheff, C.; Folzer, A.; Obadia, M.; Prudhomme, L.; Bonnet, E.; Balzarin, F.; Pichard, E.; Chennebault, J. M.; Fialaire, P.; Loison, J.; Galanaud, P.; Bornarel, D.; Six, M.; Ferret, P.; Batisse, D.; Gonzales-Canali, G.; Devidas, A.; Chevojon, P.; Turpault, I.; Lafeuillade, A.; Cheret, A.; Philip, G.; Morel, P.; Timsit, J.; Amirat, N.; Brancion, C.; Cabane, J.; Tredup, J.; Stein, A.; Ravault, I.; Chavanet, C.; Buisson, M.; Treuvetot, S.; Nau, P.; Bastides, F.; Boyer, L.; Wassoumbou, S.; Oksenhendeler, E.; Gérard, L.; Bernard, L.; Domart, Y.; Merrien, D.; Belan, A. Greder; Gayraud, M.; Bodard, L.; Meudec, A.; Beuscart, C.; Daniel, C.; Pape, E.; Vinceneux, P.; Simonpoli, A. M.; Zeng, A.; Fournier, L.; Fuzibet, J. G.; Sohn, C.; Rosenthal, E.; Quaranta, M.; Chaillou, S.; Sabah, M.; Audhuy, B.; Schieber, A.; Moreau, P.; Niault, M.; Vaillant, O.; Huchon, G.; Compagnucci, A.; Szmania, I. De Lacroix; Richier, L.; Lamaury, I.; Saint-Dizier, F.; Garipuy, D.; Drogoul, M. P.; Martin, I. Poizot; Fabre, G.; de Cursay, G. Lambert; Abraham, B.; Perino, C.; Lagarde, P.; David, F.; Roche-Sicot, J.; Saraux, J. L.; Leprêtre, A.; Fampin, B.; Uludag, A.; Morin, A. S.; Bletry, O.; Zucman, D.; Regnier, A.; Girard, J. J.; Quinsat, D. T.; Heripret, L.; Grihon, F.; Houlbert, D.; Ruel, M.; Chemlal, K.; Debab, Y.; Tremollieres, F.; Perronne, V.; Slama, B.; Perré, P.; Miodovski, C.; Guermonprez, G.; Dulioust, A.; Boudon, P.; Malbec, D.; Patey, O.; Semaille, C.; Deville, J.; Remy, G.; Béguinot, I.; Boue, F.; Chambrin, V.; Pignon, C.; Estocq, G. A.; Levy, A.; Duracinsky, M.; Le Bras, P.; Ngussan, M. S.; Peretti, D.; Medintzeff, N.; Lambert, T.; Segeral, O.; Lezeau, P.; Laurian, Y.; Piketty, C.; Karmochkine, M.; Eliaszewitch, M.; Jayle, D.; Tisne- Dessus, D.; Kazatchkine, M.; Colasante, U.; Nouaouia, W.; Vilde, J. L.; Bollens, D.; Binet, D.; Diallo, B.; Fonquernie, L.; Lagneau, J. L.; Pietrie, M. P.; Sicard, D.; Stieltjes, N.; Michot, J.; Bourdillon, F.; Lelievre, J. D.; Obenga, G.; Escaut, L.; Bolliot, C.; Schneider, L.; Iguertsira, M.; Tomei, C.; Dhiver, C.; Dupont, H. Tissot; Vallon, A.; Gallais, J.; Gallais, H.; Durant, J.; Mondain, V.; Perbost, I.; Cassuto, J. P.; Karsenti, J. M.; Venti, H.; Ceppi, C.; Krivitsky, J. A.; Bouchaud, O.; Honore, P.; Delgado, J.; Rouzioux, C.; Burgard, M.; Boufassa, L.; Peynet, J.; Hoyos, S. Pérez; Ferreros, I.; Hurtado, I.; González, C.; Caro, A. M.; Muga, R.; Sanvicens, A.; Tor, J.; del Romero, J.; Raposo, P.; Rodríguez, C.; García, Soledad; Alastrue, I.; Belda, J.; Trullen, P.; Fernández, E.; Santos, C.; Tasa, T.; Zafra, T.; Guerrero, R.; Marco, A.; Quintana, M.; Ruiz, I.; Nuñez, R.; Pérez, R.; Castilla, J.; Guevara, M.; de Mendoza, C.; Zahonero, N.

2010-01-01

OBJECTIVE: To estimate the effect of combined antiretroviral therapy (cART) on mortality among HIV-infected individuals after appropriate adjustment for time-varying confounding by indication. DESIGN: A collaboration of 12 prospective cohort studies from Europe and the United States (the HIV-CAUSAL

Association between air pollution and cardiovascular mortality in Hefei, China: A time-series analysis.

Science.gov (United States)

Zhang, Chao; Ding, Rui; Xiao, Changchun; Xu, Yachun; Cheng, Han; Zhu, Furong; Lei, Ruoqian; Di, Dongsheng; Zhao, Qihong; Cao, Jiyu

2017-10-01

In recent years, air pollution has become an alarming problem in China. However, evidence on the effects of air pollution on cardiovascular mortality is still not conclusive to date. This research aimed to assess the short-term effects of air pollution on cardiovascular morbidity in Hefei, China. Data of air pollution, cardiovascular mortality, and meteorological characteristics in Hefei between 2010 and 2015 were collected. Time-series analysis in generalized additive model was applied to evaluate the association between air pollution and daily cardiovascular mortality. During the study period, the annual average concentration of PM 10, SO 2 , and NO 2 was 105.91, 20.58, and 30.93 μg/m 3 , respectively. 21,816 people (including 11,876 man, and 14,494 people over 75 years of age) died of cardiovascular diseases. In single pollutant model, the effects of multi-day exposure were greater than single-day exposure of the air pollution. For every increase of 10 μg/m 3 in SO 2 , NO 2 , and PM 10 levels, CVD mortality increased by 5.26% (95%CI: 3.31%-7.23%), 2.71% (95%CI: 1.23%-4.22%), and 0.68% (95%CI: 0.33%-1.04%) at a lag03, respectively. The multi-pollutant models showed that PM 10 and SO 2 remained associated with CVD mortality, although the effect estimates attenuated. However, the effect of NO 2 on CVD mortality decreased to statistically insignificant. Subgroup analyses further showed that women were more vulnerable than man upon air pollution exposure. These findings showed that air pollution could significantly increase the CVD mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in ischemic heart disease mortality in Korea, 1985-2009: an age-period-cohort analysis.

Science.gov (United States)

Lee, Hye Ah; Park, Hyesook

2012-09-01

Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

The problem of fuzzy cause-specific death rates in mortality context analysis: the case of Panama City.

Science.gov (United States)

Bock, S; Gans, P

1993-05-01

In studies of mortality, small and fluctuating numbers of deaths are problems which are caused by infrequent reporting and small spatial unit reporting. To use Panama City as an example, the paper will introduce a Monte Carlo simulation which allows for the analysis of mortality even with small absolute numbers. In addition, Panama City will be used as an example where good medical care is available in every city district, so that social class differences between the districts have a negligible effect on most cause-specific death rates and infant mortality.

An analysis of buyer-supplier collaboration in the South African textile industry

Directory of Open Access Journals (Sweden)

H. Parker

2007-12-01

Full Text Available Purpose: The purpose of this article is to explore perceptions regarding buyer and supplier collaboration around product development. The aim is to gain an understanding of which factors influence buyer-supplier collaboration outcomes in the South African textile industry. Methodology: This study comprised two data collection stages. The first stage comprised the design and administration of a questionnaire survey. The second stage utilised a qualitative interview methodology and entailed interviewing a subset of the questionnaire respondents in order to probe respondents’ own experiences in collaborative product developments and their perception of the factors that determine collaboration outcome. Findings: This study has shed light on the experiences of South African firms in the textile industry engaging in buyer-supplier collaboration around product development. While this study is exploratory, it has provided evidence that there are certain factors which are perceived to have a significant influence on collaboration. Implications: Under the past protective shield of tariffs, South African clothing and textile manufacturers could afford to allow an adversarial mode of operation to perpetuate inefficiencies. However, the increasing external pressures, including the very real threat of overseas competition, heighten the need for collaboration between buyers and suppliers. This relates, in particular, to collaboration aimed at new product development, which can be seen as a new imperative for the survival and growth of this industry. Currently, there are numerous barriers to effective collaboration. The overwhelming power of retailers in the value chain is one such barrier, as it creates an environment which is pressurised, strained and not conducive to buyer-supplier collaboration. Contribution and Value: Studies on collaborative new product development have primarily been done in developed countries, with a focus on technology intensive

Collaborative interactive visualization: exploratory concept

Science.gov (United States)

Mokhtari, Marielle; Lavigne, Valérie; Drolet, Frédéric

2015-05-01

Dealing with an ever increasing amount of data is a challenge that military intelligence analysts or team of analysts face day to day. Increased individual and collective comprehension goes through collaboration between people. Better is the collaboration, better will be the comprehension. Nowadays, various technologies support and enhance collaboration by allowing people to connect and collaborate in settings as varied as across mobile devices, over networked computers, display walls, tabletop surfaces, to name just a few. A powerful collaboration system includes traditional and multimodal visualization features to achieve effective human communication. Interactive visualization strengthens collaboration because this approach is conducive to incrementally building a mental assessment of the data meaning. The purpose of this paper is to present an overview of the envisioned collaboration architecture and the interactive visualization concepts underlying the Sensemaking Support System prototype developed to support analysts in the context of the Joint Intelligence Collection and Analysis Capability project at DRDC Valcartier. It presents the current version of the architecture, discusses future capabilities to help analyst(s) in the accomplishment of their tasks and finally recommends collaboration and visualization technologies allowing to go a step further both as individual and as a team.

[The analysis of general mortality by age and sex: evidence of two types of mortality].

Science.gov (United States)

Damiani, P; Masse, H; Aubenque, M

1984-01-01

The departmental distributions of the probabilities of dying by age group and sex are analyzed for France in 1975. It is found that these distributions are the sum of two lognormal distributions. The authors deduce the existence of two populations that are distinguished by whether mortality was endogenous or exogenous. The relative importance of these two types of mortality is considered according to age. (summary in ENG)

Collaborative human-machine analysis using a controlled natural language

Science.gov (United States)

Mott, David H.; Shemanski, Donald R.; Giammanco, Cheryl; Braines, Dave

2015-05-01

A key aspect of an analyst's task in providing relevant information from data is the reasoning about the implications of that data, in order to build a picture of the real world situation. This requires human cognition, based upon domain knowledge about individuals, events and environmental conditions. For a computer system to collaborate with an analyst, it must be capable of following a similar reasoning process to that of the analyst. We describe ITA Controlled English (CE), a subset of English to represent analyst's domain knowledge and reasoning, in a form that it is understandable by both analyst and machine. CE can be used to express domain rules, background data, assumptions and inferred conclusions, thus supporting human-machine interaction. A CE reasoning and modeling system can perform inferences from the data and provide the user with conclusions together with their rationale. We present a logical problem called the "Analysis Game", used for training analysts, which presents "analytic pitfalls" inherent in many problems. We explore an iterative approach to its representation in CE, where a person can develop an understanding of the problem solution by incremental construction of relevant concepts and rules. We discuss how such interactions might occur, and propose that such techniques could lead to better collaborative tools to assist the analyst and avoid the "pitfalls".

Global mortality estimates for the 2009 Influenza Pandemic from the GLaMOR project: a modeling study.

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Lone Simonsen

2013-11-01

Full Text Available Assessing the mortality impact of the 2009 influenza A H1N1 virus (H1N1pdm09 is essential for optimizing public health responses to future pandemics. The World Health Organization reported 18,631 laboratory-confirmed pandemic deaths, but the total pandemic mortality burden was substantially higher. We estimated the 2009 pandemic mortality burden through statistical modeling of mortality data from multiple countries.We obtained weekly virology and underlying cause-of-death mortality time series for 2005-2009 for 20 countries covering ∼35% of the world population. We applied a multivariate linear regression model to estimate pandemic respiratory mortality in each collaborating country. We then used these results plus ten country indicators in a multiple imputation model to project the mortality burden in all world countries. Between 123,000 and 203,000 pandemic respiratory deaths were estimated globally for the last 9 mo of 2009. The majority (62%-85% were attributed to persons under 65 y of age. We observed a striking regional heterogeneity, with almost 20-fold higher mortality in some countries in the Americas than in Europe. The model attributed 148,000-249,000 respiratory deaths to influenza in an average pre-pandemic season, with only 19% in persons <65 y. Limitations include lack of representation of low-income countries among single-country estimates and an inability to study subsequent pandemic waves (2010-2012.We estimate that 2009 global pandemic respiratory mortality was ∼10-fold higher than the World Health Organization's laboratory-confirmed mortality count. Although the pandemic mortality estimate was similar in magnitude to that of seasonal influenza, a marked shift toward mortality among persons <65 y of age occurred, so that many more life-years were lost. The burden varied greatly among countries, corroborating early reports of far greater pandemic severity in the Americas than in Australia, New Zealand, and Europe. A

Depression and risk of mortality in people with diabetes mellitus: a systematic review and meta-analysis.

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Fleur E P van Dooren

Full Text Available OBJECTIVE: To examine the association between depression and all-cause and cardiovascular mortality in people with diabetes by systematically reviewing the literature and carrying out a meta-analysis of relevant longitudinal studies. RESEARCH DESIGN AND METHODS: PUBMED and PSYCINFO were searched for articles assessing mortality risk associated with depression in diabetes up until August 16, 2012. The pooled hazard ratios were calculated using random-effects models. RESULTS: Sixteen studies met the inclusion criteria, which were pooled in an overall all-cause mortality estimate, and five in a cardiovascular mortality estimate. After adjustment for demographic variables and micro- and macrovascular complications, depression was associated with an increased risk of all-cause mortality (HR = 1.46, 95% CI = 1.29-1.66, and cardiovascular mortality (HR = 1.39, 95% CI = 1.11-1.73. Heterogeneity across studies was high for all-cause mortality and relatively low for cardiovascular mortality, with an I-squared of respectively 78.6% and 39.6%. Subgroup analyses showed that the association between depression and mortality not significantly change when excluding three articles presenting odds ratios, yet this decreased heterogeneity substantially (HR = 1.49, 95% CI = 1.39-1.61, I-squared = 15.1%. A comparison between type 1 and type 2 diabetes could not be undertaken, as only one study reported on type 1 diabetes specifically. CONCLUSIONS: Depression is associated with an almost 1.5-fold increased risk of mortality in people with diabetes. Research should focus on both cardiovascular and non-cardiovascular causes of death associated with depression, and determine the underlying behavioral and physiological mechanisms that may explain this association.

Collaboration space division in collaborative product development based on a genetic algorithm

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Qian, Xueming; Ma, Yanqiao; Feng, Huan

2018-02-01

The advance in the global environment, rapidly changing markets, and information technology has created a new stage for design. In such an environment, one strategy for success is the Collaborative Product Development (CPD). Organizing people effectively is the goal of Collaborative Product Development, and it solves the problem with certain foreseeability. The development group activities are influenced not only by the methods and decisions available, but also by correlation among personnel. Grouping the personnel according to their correlation intensity is defined as collaboration space division (CSD). Upon establishment of a correlation matrix (CM) of personnel and an analysis of the collaboration space, the genetic algorithm (GA) and minimum description length (MDL) principle may be used as tools in optimizing collaboration space. The MDL principle is used in setting up an object function, and the GA is used as a methodology. The algorithm encodes spatial information as a chromosome in binary. After repetitious crossover, mutation, selection and multiplication, a robust chromosome is found, which can be decoded into an optimal collaboration space. This new method can calculate the members in sub-spaces and individual groupings within the staff. Furthermore, the intersection of sub-spaces and public persons belonging to all sub-spaces can be determined simultaneously.

Retention and mortality on antiretroviral therapy in sub-Saharan Africa: collaborative analyses of HIV treatment programmes.

Science.gov (United States)

Haas, Andreas D; Zaniewski, Elizabeth; Anderegg, Nanina; Ford, Nathan; Fox, Matthew P; Vinikoor, Michael; Dabis, François; Nash, Denis; Sinayobye, Jean d'Amour; Niyongabo, Thêodore; Tanon, Aristophane; Poda, Armel; Adedimeji, Adebola A; Edmonds, Andrew; Davies, Mary-Ann; Egger, Matthias

2018-02-01

By 2020, 90% of all people diagnosed with HIV should receive long-term combination antiretroviral therapy (ART). In sub-Saharan Africa, this target is threatened by loss to follow-up in ART programmes. The proportion of people retained on ART long-term cannot be easily determined, because individuals classified as lost to follow-up, may have self-transferred to another HIV treatment programme, or may have died. We describe retention on ART in sub-Saharan Africa, first based on observed data as recorded in the clinic databases, and second adjusted for undocumented deaths and self-transfers. We analysed data from HIV-infected adults and children initiating ART between 2009 and 2014 at a sub-Saharan African HIV treatment programme participating in the International epidemiology Databases to Evaluate AIDS (IeDEA). We used the Kaplan-Meier method to calculate the cumulative incidence of retention on ART and the Aalen-Johansen method to calculate the cumulative incidences of death, loss to follow-up, and stopping ART. We used inverse probability weighting to adjust clinic data for undocumented mortality and self-transfer, based on estimates from a recent systematic review and meta-analysis. We included 505,634 patients: 12,848 (2.5%) from Central Africa, 109,233 (21.6%) from East Africa, 347,343 (68.7%) from Southern Africa and 36,210 (7.2%) from West Africa. In crude analyses of observed clinic data, 52.1% of patients were retained on ART, 41.8% were lost to follow-up and 6.0% had died 5 years after ART initiation. After accounting for undocumented deaths and self-transfers, we estimated that 66.6% of patients were retained on ART, 18.8% had stopped ART and 14.7% had died at 5 years. Improving long-term retention on ART will be crucial to attaining the 90% on ART target. Naïve analyses of HIV cohort studies, which do not account for undocumented mortality and self-transfer of patients, may severely underestimate both mortality and retention on ART. © 2018 The

Contextual determinants of neonatal mortality using two analysis methods, Rio Grande do Sul, Brazil.

Science.gov (United States)

Zanini, Roselaine Ruviaro; Moraes, Anaelena Bragança de; Giugliani, Elsa Regina Justo; Riboldi, João

2011-02-01

To analyze neonatal mortality determinants using multilevel logistic regression and classic hierarchical models. Cohort study including 138,407 live births with birth certificates and 1,134 neonatal deaths recorded in 2003, in the state of Rio Grande do Sul, Southern Brazil. The Information System on Live Births and mortality records were linked for gathering information on individual-level exposures. Sociodemographic data and information on the pregnancy, childbirth care and characteristics of the children at birth were collected. The associated factors were estimated and compared by traditional and multilevel logistic regression analysis. The neonatal mortality rate was 8.19 deaths per 1,000 live births. Low birth weight, 1- and 5-minute Apgar score below eight, congenital malformation, pre-term birth and previous fetal loss were associated with neonatal death in the traditional model. Elective cesarean section had a protective effect. Previous fetal loss did not remain significant in the multilevel model, but the inclusion of a contextual variable (poverty rate) showed that 15% of neonatal mortality variation can be explained by varying poverty rates in the microregions. The use of multilevel models showed a small effect of contextual determinants on the neonatal mortality rate. There was found a positive association with the poverty rate in the general model, and the proportion of households with water supply among preterm newborns.

Network effects on scientific collaborations.

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Shahadat Uddin

Full Text Available BACKGROUND: The analysis of co-authorship network aims at exploring the impact of network structure on the outcome of scientific collaborations and research publications. However, little is known about what network properties are associated with authors who have increased number of joint publications and are being cited highly. METHODOLOGY/PRINCIPAL FINDINGS: Measures of social network analysis, for example network centrality and tie strength, have been utilized extensively in current co-authorship literature to explore different behavioural patterns of co-authorship networks. Using three SNA measures (i.e., degree centrality, closeness centrality and betweenness centrality, we explore scientific collaboration networks to understand factors influencing performance (i.e., citation count and formation (tie strength between authors of such networks. A citation count is the number of times an article is cited by other articles. We use co-authorship dataset of the research field of 'steel structure' for the year 2005 to 2009. To measure the strength of scientific collaboration between two authors, we consider the number of articles co-authored by them. In this study, we examine how citation count of a scientific publication is influenced by different centrality measures of its co-author(s in a co-authorship network. We further analyze the impact of the network positions of authors on the strength of their scientific collaborations. We use both correlation and regression methods for data analysis leading to statistical validation. We identify that citation count of a research article is positively correlated with the degree centrality and betweenness centrality values of its co-author(s. Also, we reveal that degree centrality and betweenness centrality values of authors in a co-authorship network are positively correlated with the strength of their scientific collaborations. CONCLUSIONS/SIGNIFICANCE: Authors' network positions in co

Retrospective Analysis of Communication Events - Understanding the Dynamics of Collaborative Multi-Party Discourse

Energy Technology Data Exchange (ETDEWEB)

Cowell, Andrew J.; Haack, Jereme N.; McColgin, Dave W.

2006-06-08

This research is aimed at understanding the dynamics of collaborative multi-party discourse across multiple communication modalities. Before we can truly make sig-nificant strides in devising collaborative communication systems, there is a need to understand how typical users utilize com-putationally supported communications mechanisms such as email, instant mes-saging, video conferencing, chat rooms, etc., both singularly and in conjunction with traditional means of communication such as face-to-face meetings, telephone calls and postal mail. Attempting to un-derstand an individual’s communications profile with access to only a single modal-ity is challenging at best and often futile. Here, we discuss the development of RACE – Retrospective Analysis of Com-munications Events – a test-bed prototype to investigate issues relating to multi-modal multi-party discourse.

Collaborative Environments. Considerations Concerning Some Collaborative Systems

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Mihaela I. MUNTEAN

2009-01-01

Full Text Available It is obvious, that all collaborative environments (workgroups, communities of practice, collaborative enterprises are based on knowledge and between collaboration and knowledge management there is a strong interdependence. The evolution of information systems in these collaborative environments led to the sudden necessity to adopt, for maintaining the virtual activities and processes, the latest technologies/systems, which are capable to support integrated collaboration in business services. In these environments, portal-based IT platforms will integrate multi-agent collaborative systems, collaborative tools, different enterprise applications and other useful information systems.

Dog Ownership and Mortality in England: A Pooled Analysis of Six Population-based Cohorts.

Science.gov (United States)

Ding, Ding; Bauman, Adrian E; Sherrington, Cathie; McGreevy, Paul D; Edwards, Kate M; Stamatakis, Emmanuel

2018-02-01

Dog ownership may be associated with reduced risk for cardiovascular disease. However, data are scant on the relationship between dog ownership and all-cause and cause-specific mortality risk. Data from six separate cohorts (1995-1997, 2001-2002, 2004) of the Health Survey for England were pooled and analyzed in 2017. Participants were 59,352 adults (mean age 46.5, SD=17.9 years) who consented to be linked to the National Death Registry. Living in a household with a dog was reported at baseline. Outcomes included all-cause and cardiovascular disease mortality (determined using ICD-9 codes 390-459, ICD-10 codes I01-I99). Multilevel Weibull survival analysis was used to examine the associations between dog ownership and mortality, adjusted for various sociodemographic and lifestyle variables. Potential effect modifiers, including age, sex, education, living circumstances, longstanding illness, and prior diagnosis of cardiovascular disease, were also examined. During 679,441 person-years of follow-up (mean 11.5, SD=3.8 years), 8,169 participants died from all causes and 2,451 from cardiovascular disease. In the fully adjusted models, there was no statistically significant association between dog ownership and mortality outcomes (hazard ratio=1.03, 95% CI=0.98, 1.09, for all-cause mortality; and hazard ratio=1.07, 95% CI=0.96, 1.18, for cardiovascular disease mortality) and no significant effect modification. There is no evidence for an association between living in a household with a dog and all-cause or cardiovascular disease mortality in this large sample. These results should be interpreted in light of limitations in the measurement of dog ownership and its complexity in potential long-term health implications. Future studies should measure specific aspects of ownership, such as caring responsibilities and temporality. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Medieval monastic mortality: hazard analysis of mortality differences between monastic and nonmonastic cemeteries in England.

Science.gov (United States)

DeWitte, Sharon N; Boulware, Jessica C; Redfern, Rebecca C

2013-11-01

Scholarship on life in medieval European monasteries has revealed a variety of factors that potentially affected mortality in these communities. Though there is some evidence based on age-at-death distributions from England that monastic males lived longer than members of the general public, what is missing from the literature is an explicit examination of how the risks of mortality within medieval monastic settings differed from those within contemporaneous lay populations. This study examines differences in the hazard of mortality for adult males between monastic cemeteries (n = 528) and non-monastic cemeteries (n = 368) from London, all of which date to between AD 1050 and 1540. Age-at-death data from all cemeteries are pooled to estimate the Gompertz hazard of mortality, and "monastic" (i.e., buried in a monastic cemetery) is modeled as a covariate affecting this baseline hazard. The estimated effect of the monastic covariate is negative, suggesting that individuals in the monastic communities faced reduced risks of dying compared to their peers in the lay communities. These results suggest better diets, the positive health benefits of religious behavior, better living conditions in general in monasteries, or selective recruitment of healthy or higher socioeconomic status individuals. Copyright © 2013 Wiley Periodicals, Inc.

Material consumption and social well-being within the periphery of the world economy: an ecological analysis of maternal mortality.

Science.gov (United States)

Rice, James

2008-12-01

The degree to which social well-being is predicated upon levels of material consumption remains under-examined from a large-N, quantitative perspective. The present study analyzes the factors influencing levels of maternal mortality in 2005 among 92 peripheral countries. We incorporate into regression analysis the ecological footprint, a comprehensive measure of natural resource consumption, and alternative explanatory variables drawn from previous research. Results illustrate ecological footprint consumption has a moderately strong direct influence shaping lower levels of maternal mortality. Path analysis reveals export commodity concentration has a negative effect on level of ecological footprint demand net the strong positive influence of income per capita. This illustrates cross-national trade dependency relations directly influence natural resource consumption opportunities and thereby indirectly contribute to higher maternal mortality levels within the periphery of the world economy. The results confirm material consumption is an important dimension of improvement in maternal mortality.

Studies of the mortality of A-bomb survivors: report 7. Mortality, 1950-1978: part II. Mortality from causes other than cancer and mortality in early entrants

International Nuclear Information System (INIS)

Kato, H.; Brown, C.C.; Hoel, D.G.; Shull, W.J.

1982-01-01

Deaths in the Radiation Effects Research Foundation (REFR) Life Span Study (LSS) sample have been determined for the 4 years 1975-1978, and mortality examined for the 28 years since 1950. An analysis of cancer mortality is presented separately. In this report, we examine whether mortality from causes other than cancer is also increased or whether a nonspecific acceleration of aging occurs. 1. Cumulative mortality from causes other than cancer, estimated by the life table method, does not increase with radiation dose in either city, in either sex, or in any of the five different age-at-the-time-of-bomb groups. 2. No specific cause of death, other than cancer, exhibits a significant relationship with A-bomb exposure. Thus there is still no evidence of a nonspecific acceleration of aging due to radiation in this cohort. 3. Mortality before the LSS sample was established has been reanalyzed using three supplementary mortality surveys to determine the magnitude of the possible bias from the exclusion of deaths prior to 1950. It is unlikely that such a bias seriously affects the interpretation of the radiation effects observed in the cohort after 1950. 4. No excess of deaths from leukemia or other malignant tumors is observed among early entrants into these cities in this cohort

A model and typology of collaboration between professionals in healthcare organizations.

Science.gov (United States)

D'Amour, Danielle; Goulet, Lise; Labadie, Jean-François; Martín-Rodriguez, Leticia San; Pineault, Raynald

2008-09-21

The new forms of organization of healthcare services entail the development of new clinical practices that are grounded in collaboration. Despite recent advances in research on the subject of collaboration, there is still a need for a better understanding of collaborative processes and for conceptual tools to help healthcare professionals develop collaboration amongst themselves in complex systems. This study draws on D'Amour's structuration model of collaboration to analyze healthcare facilities offering perinatal services in four health regions in the province of Quebec. The objectives are to: 1) validate the indicators of the structuration model of collaboration; 2) evaluate interprofessional and interorganizational collaboration in four health regions; and 3) propose a typology of collaboration A multiple-case research strategy was used. The cases were the healthcare facilities that offer perinatal services in four health regions in the province of Quebec (Canada). The data were collected through 33 semi-structured interviews with healthcare managers and professionals working in the four regions. Written material was also analyzed. The data were subjected to a "mixed" inductive-deductive analysis conducted in two main stages: an internal analysis of each case followed by a cross-sectional analysis of all the cases. The collaboration indicators were shown to be valid, although some changes were made to three of them. Analysis of the data showed great variation in the level of collaboration between the cases and on each dimension. The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration. The model and the typology make it possible to analyze collaboration and identify areas for improvement. Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes. Professionals and administrators can use the model to

Risk of Colorectal Cancer and Associated Mortality in HIV: A Systematic Review and Meta-Analysis.

Science.gov (United States)

OʼNeill, Tyler J; Nguemo, Joseph D; Tynan, Anne-Marie; Burchell, Ann N; Antoniou, Tony

2017-08-01

As people with HIV live longer, the numbers of colorectal cancer cases are expected to increase. We sought to compare the colorectal cancer incidence and cause-specific mortality among people living with and without HIV. Systematic review and meta-analysis. We searched 5 electronic databases up to June 28, 2016, for primary studies reporting standardized incidence ratios (SIRs), standardized mortality ratios (SMRs)/hazard ratios or data sufficient for estimating these summary measures. We performed a random effects pooled analysis to estimate SIR and SMR of colorectal cancer in HIV. Of 8110 articles, we included 27 studies from North America (n = 18), Europe (n = 7), the Pacific region (n = 4), and South America (n = 1). Overall, 1660 cases of colorectal cancer and colon cancer (excluding rectal cancer) occurred among 1,696,070 persons with HIV. In pooled analysis, we found no summary risk of malignancy among those with HIV relative to an uninfected population (SIR 1.00; 95% confidence interval 0.82 to 1.22; I = 89.2%). Colorectal cancer-specific mortality was higher among people with HIV but did not reach statistical significance (SMR 2.09; 95% confidence interval: 1.00 to 4.40; I = 85.0%). Rates of colorectal cancer are similar between people with and without HIV. Existing screening guidelines are likely adequate for people with HIV.

RNA/DNA co-analysis from blood stains--Results of a second collaborative EDNAP exercise

DEFF Research Database (Denmark)

Haas, C.; Hanson, E.; Anjos, M.J.

2012-01-01

A second collaborative exercise on RNA/DNA co-analysis for body fluid identification and STR profiling was organized by the European DNA Profiling Group (EDNAP). Six human blood stains, two blood dilution series (5-0.001 [mu]l blood) and, optionally, bona fide or mock casework samples of human or...

Aboriginal premature mortality within South Australia 1999-2006: a cross-sectional analysis of small area results

Directory of Open Access Journals (Sweden)

McDermott Robyn

2011-05-01

Full Text Available Abstract Background This paper initially describes premature mortality by Aboriginality in South Australia during 1999 to 2006. It then examines how these outcomes vary across area level socio-economic disadvantage and geographic remoteness. Methods The retrospective, cross-sectional analysis uses estimated resident population by sex, age and small areas based on the 2006 Census, and Unit Record mortality data. Premature mortality outcomes are measured using years of life lost (YLL. Subsequent intrastate comparisons are based on indirect sex and age adjusted YLL results. A multivariate model uses area level socio-economic disadvantage rank, geographic remoteness, and an interaction between the two variables to predict premature mortality outcomes. Results Aboriginal people experienced 1.1% of total deaths but 2.2% of YLL and Aboriginal premature mortality rates were 2.65 times greater than the South Australian average. Premature mortality for Aboriginal and non-Aboriginal people increased significantly as area disadvantage increased. Among Aboriginal people though, a significant main effect for area remoteness was also observed, together with an interaction between disadvantage and remoteness. The synergistic effect shows the social gradient between area disadvantage and premature mortality increased as remoteness increased. Conclusions While confirming the gap in premature mortality rates between Aboriginal South Australians and the rest of the community, the study also found a heterogeneity of outcomes within the Aboriginal community underlie this difference. The results support the existence of relationship between area level socio-economic deprivation, remoteness and premature mortality in the midst of an affluent society. The study concludes that vertically equitable resourcing according to population need is an important response to the stark mortality gap and its exacerbation by area socio-economic position and remoteness.

South American collaboration in scientific publications on leishmaniasis: bibliometric analysis in SCOPUS (2000-2011).

Science.gov (United States)

Huamaní, Charles; Romaní, Franco; González-Alcaide, Gregorio; Mejia, Miluska O; Ramos, José Manuel; Espinoza, Manuel; Cabezas, César

2014-01-01

Evaluate the production and the research collaborative network on Leishmaniasis in South America. A bibliometric research was carried out using SCOPUS database. The analysis unit was original research articles published from 2000 to 2011, that dealt with leishmaniasis and that included at least one South American author. The following items were obtained for each article: journal name, language, year of publication, number of authors, institutions, countries, and others variables. 3,174 articles were published, 2,272 of them were original articles. 1,160 different institutional signatures, 58 different countries and 398 scientific journals were identified. Brazil was the country with more articles (60.7%) and Oswaldo Cruz Foundation (FIOCRUZ) had 18% of Brazilian production, which is the South American nucleus of the major scientific network in Leishmaniasis. South American scientific production on Leishmaniasis published in journals indexed in SCOPUS is focused on Brazilian research activity. It is necessary to strengthen the collaboration networks. The first step is to identify the institutions with higher production, in order to perform collaborative research according to the priorities of each country.

Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study.

Science.gov (United States)

Sharma, Praveen; Dietrich, Thomas; Ferro, Charles J; Cockwell, Paul; Chapple, Iain L C

2016-02-01

Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased mortality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease-related) in individuals with stage 3-5 CKD, hitherto referred to as "CKD". Survival analysis was carried out using the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality data. Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with CKD. This association was compared with the association between mortality and traditional risk factors in CKD mortality (diabetes, hypertension and smoking). Of the 13,784 participants eligible for analysis in NHANES III, 861 (6%) had CKD. The median follow-up for this cohort was 14.3 years. Adjusting for confounders, the 10-year all-cause mortality rate for individuals with CKD increased from 32% (95% CI: 29-35%) to 41% (36-47%) with the addition of periodontitis. For diabetes, the 10-year all-cause mortality rate increased to 43% (38-49%). There is a strong, association between periodontitis and increased mortality in individuals with CKD. Sources of chronic systemic inflammation (including periodontitis) may be important contributors to mortality in patients with CKD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Study on Collaborative Object Manipulation in Virtual Environment

Science.gov (United States)

Mayangsari, Maria Niken; Yong-Moo, Kwon

This paper presents comparative study on network collaboration performance in different immersion. Especially, the relationship between user collaboration performance and degree of immersion provided by the system is addressed and compared based on several experiments. The user tests on our system include several cases: 1) Comparison between non-haptics and haptics collaborative interaction over LAN, 2) Comparison between non-haptics and haptics collaborative interaction over Internet, and 3) Analysis of collaborative interaction between non-immersive and immersive display environments.

Application of principal component analysis to time series of daily air pollution and mortality

NARCIS (Netherlands)

Quant C; Fischer P; Buringh E; Ameling C; Houthuijs D; Cassee F; MGO

2004-01-01

We investigated whether cause-specific daily mortality can be attributed to specific sources of air pollution. To construct indicators of source-specific air pollution, we applied a principal component analysis (PCA) on routinely collected air pollution data in the Netherlands during the period

Spatiotemporal analysis for the effect of ambient particulate matter on cause-specific respiratory mortality in Beijing, China.

Science.gov (United States)

Wang, Xuying; Guo, Yuming; Li, Guoxing; Zhang, Yajuan; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan; Chen, Liangfu

2016-06-01

This study explored the association between particulate matter with an aerodynamic diameter of less than 10 μm (PM10) and the cause-specific respiratory mortality. We used the ordinary kriging method to estimate the spatial characteristics of ambient PM10 at 1-km × 1-km resolution across Beijing during 2008-2009 and subsequently fit the exposure-response relationship between the estimated PM10 and the mortality due to total respiratory disease, chronic lower respiratory disease, chronic obstructive pulmonary disease (COPD), and pneumonia at the street or township area levels using the generalized additive mixed model (GAMM). We also examined the effects of age, gender, and season in the stratified analysis. The effects of ambient PM10 on the cause-specific respiratory mortality were the strongest at lag0-5 except for pneumonia, and an inter-quantile range increase in PM10 was associated with an 8.04 % (95 % CI 4.00, 12.63) increase in mortality for total respiratory disease, a 6.63 % (95 % CI 1.65, 11.86) increase for chronic lower respiratory disease, and a 5.68 % (95 % CI 0.54, 11.09) increase for COPD, respectively. Higher risks due to the PM10 exposure were observed for females and elderly individuals. Seasonal stratification analysis showed that the effects of PM10 on mortality due to pneumonia were stronger during spring and autumn. While for COPD, the effect of PM10 in winter was statistically significant (15.54 %, 95 % CI 5.64, 26.35) and the greatest among the seasons. The GAMM model evaluated stronger associations between concentration of PM10. There were significant associations between PM10 and mortality due to respiratory disease at the street or township area levels. The GAMM model using high-resolution PM10 could better capture the association between PM10 and respiratory mortality. Gender, age, and season also acted as effect modifiers for the relationship between PM10 and respiratory mortality.

The contribution of spatial analysis to understanding HIV/TB mortality in children: a structural equation modelling approach

Directory of Open Access Journals (Sweden)

Eustasius Musenge

2013-01-01

Full Text Available Background: South Africa accounts for more than a sixth of the global population of people infected with HIV and TB, ranking her highest in HIV/TB co-infection worldwide. Remote areas often bear the greatest burden of morbidity and mortality, yet there are spatial differences within rural settings. Objectives: The primary aim was to investigate HIV/TB mortality determinants and their spatial distribution in the rural Agincourt sub-district for children aged 1–5 years in 2004. Our secondary aim was to model how the associated factors were interrelated as either underlying or proximate factors of child mortality using pathway analysis based on a Mosley-Chen conceptual framework. Methods: We conducted a secondary data analysis based on cross-sectional data collected in 2004 from the Agincourt sub-district in rural northeast South Africa. Child HIV/TB death was the outcome measure derived from physician assessed verbal autopsy. Modelling used multiple logit regression models with and without spatial household random effects. Structural equation models were used in modelling the complex relationships between multiple exposures and the outcome (child HIV/TB mortality as relayed on a conceptual framework. Results: Fifty-four of 6,692 children aged 1–5 years died of HIV/TB, from a total of 5,084 households. Maternal death had the greatest effect on child HIV/TB mortality (adjusted odds ratio=4.00; 95% confidence interval=1.01–15.80. A protective effect was found in households with better socio-economic status and when the child was older. Spatial models disclosed that the areas which experienced the greatest child HIV/TB mortality were those without any health facility. Conclusion: Low socio-economic status and maternal deaths impacted indirectly and directly on child mortality, respectively. These factors are major concerns locally and should be used in formulating interventions to reduce child mortality. Spatial prediction maps can guide policy

Outcomes of interprofessional collaboration for hospitalized cancer patients.

Science.gov (United States)

San Martin-Rodriguez, Leticia; D'Amour, Danielle; Leduc, Nicole

2008-01-01

This study aims to evaluate the effect of the intensity of interprofessional collaboration on hospitalized cancer patients. We conducted a cross-sectional study of 312 patients to examine the effects of intensity of interprofessional collaboration (low vs high intensity collaboration) on patient satisfaction, uncertainty, pain management, and length of stay. Data on the intensity of interprofessional collaboration, patient satisfaction, and uncertainty were collected from professionals and patients using valid and reliable instruments. Administrative and clinical records were used to calculate the index of pain management and length of hospital stay. The analysis revealed the existence of significant differences between patients who are cared for by teams operating with a high intensity of collaboration and those who are cared for by teams operating with a low intensity of collaboration, as measured by the mean satisfaction (P management (P = .047). The analysis also found no significant difference (P = .217) in their length of hospital stay. The findings suggest that intensity of interprofessional collaboration has a positive effect on patient satisfaction, reduces uncertainty, and improves pain management, yet they also suggest that the degree of collaboration does not influence the length of hospital stay.

China-Africa and China-Asia Collaboration on Schistosomiasis Control: A SWOT Analysis.

Science.gov (United States)

Xu, J; Bergquist, R; Qian, Y-J; Wang, Q; Yu, Q; Peeling, R; Croft, S; Guo, J-G; Zhou, X-N

2016-01-01

Schistosomiasis, a disease caused by a trematode, parasitic worm, is a worldwide public health problem. In spite of great progress with regard to morbidity control, even elimination of this infection in recent decades, there are still challenges to overcome in sub-Saharan Africa and endemic areas in Southeast Asia. Regarded as one of the most successful countries with respect to schistosomiasis control, The People's Republic of China has accumulated considerable experience and learnt important lessons in various local settings that could benefit schistosomiasis control in other endemic countries. Based on an analysis of conceived strengths, weaknesses, opportunities and threats (SWOT) of potential collaborative activities with regard to schistosomiasis in Africa and Asia, this article addresses the importance of collaborative efforts and explores the priorities that would be expected to facilitate the transfer of Chinese experience to low- and middle-income countries in Africa and Asia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social integration and mortality in Australia.

Science.gov (United States)

Siahpush, M; Singh, G K

1999-12-01

To investigate the relationship between social integration and mortality at the aggregate level of analysis. The data were compiled from several Australian Bureau of Statistics documents. The unit of analysis was State (Territory)-year. The multivariate regression analysis included data from all States and the Australian Capital Territory for 1990-96. Five indicators of social integration--percentage of people living alone; divorce rate; unemployment rate; proportion of people who are discouraged job seekers; and unionization rate--were used as predictors of nine measures of mortality. Higher levels of social integration, as measured by all indicators except unionization, were associated with lower mortality rates. In the case of unionization, higher levels were associated with increased mortality rates. Studies concerning the relationship between social integration and health should investigate the 'type' and 'level' of social integration that is conducive to better health. To help reduce disparities in health and mortality across communities, public health researchers and policy makers need to closely monitor geographic and temporal trends in social integration measures. Social policies that emphasise investment in social integration or social capital through job creation and training, provision of gainful employment and social services for discouraged and marginalized workers, improved work conditions and social support may lower mortality directly or through their beneficial effects on health-promoting behaviours such as reduced levels of smoking, drinking and physical inactivity.

Socioeconomic status (SES) and childhood acute myeloid leukemia (AML) mortality risk: Analysis of SEER data.

Science.gov (United States)

Knoble, Naomi B; Alderfer, Melissa A; Hossain, Md Jobayer

2016-10-01

Socioeconomic status (SES) is a complex construct of multiple indicators, known to impact cancer outcomes, but has not been adequately examined among pediatric AML patients. This study aimed to identify the patterns of co-occurrence of multiple community-level SES indicators and to explore associations between various patterns of these indicators and pediatric AML mortality risk. A nationally representative US sample of 3651 pediatric AML patients, aged 0-19 years at diagnosis was drawn from 17 Surveillance, Epidemiology, and End Results (SEER) database registries created between 1973 and 2012. Factor analysis, cluster analysis, stratified univariable and multivariable Cox proportional hazards models were used. Four SES factors accounting for 87% of the variance in SES indicators were identified: F1) economic/educational disadvantage, less immigration; F2) immigration-related features (foreign-born, language-isolation, crowding), less mobility; F3) housing instability; and, F4) absence of moving. F1 and F3 showed elevated risk of mortality, adjusted hazards ratios (aHR) (95% CI): 1.07(1.02-1.12) and 1.05(1.00-1.10), respectively. Seven SES-defined cluster groups were identified. Cluster 1 (low economic/educational disadvantage, few immigration-related features, and residential-stability) showed the minimum risk of mortality. Compared to Cluster 1, Cluster 3 (high economic/educational disadvantage, high-mobility) and Cluster 6 (moderately-high economic/educational disadvantages, housing-instability and immigration-related features) exhibited substantially greater risk of mortality, aHR(95% CI)=1.19(1.0-1.4) and 1.23 (1.1-1.5), respectively. Factors of correlated SES-indicators and their pattern-based groups demonstrated differential risks in the pediatric AML mortality indicating the need of special public-health attention in areas with economic-educational disadvantages, housing-instability and immigration-related features. Copyright © 2016 Elsevier Ltd. All

Improved 1-year mortality in elderly patients with a hip fracture following integrated orthogeriatric treatment.

Science.gov (United States)

Folbert, E C; Hegeman, J H; Vermeer, M; Regtuijt, E M; van der Velde, D; Ten Duis, H J; Slaets, J P

2017-01-01

To improve the quality of care and reduce the healthcare costs of elderly patients with a hip fracture, surgeons and geriatricians collaborated intensively due to the special needs of these patients. After treatment at the Centre for Geriatric Traumatology (CvGT), we found a significant decrease in the 1-year mortality rate in frail elderly patients compared to the historical control patients who were treated with standard care. The study aimed to evaluate the effect of an orthogeriatric treatment model on elderly patients with a hip fracture on the 1-year mortality rate and identify associated risk factors. This study included patients, aged 70 years and older, who were admitted with a hip fracture and treated in accordance with the integrated orthogeriatric treatment model of the CvGT at the Hospital Group Twente (ZGT) between April 2008 and October 2013. Data registration was carried out by several disciplines using the clinical pathways of the CvGT database. A multivariate logistic regression analysis was used to identify independent risk factors for 1-year mortality. The outcome measures for the 850 patients were compared with those of 535 historical control patients who were managed under standard care between October 2002 and March 2008. The analysis demonstrated that the 1-year mortality rate was 23.2 % (n = 197) in the CvGT group compared to 35.1 % (n = 188) in the historical control group (p malnutrition (OR 2.01), physical limitations in activities of daily living (OR 2.35), and decreasing Barthel Index (BI) (OR 0.96). After integrated orthogeriatric treatment, a significant decrease was seen in the 1-year mortality rate in the frail elderly patients with a hip fracture compared to the historical control patients who were treated with standard care. The most important risk factors for 1-year mortality were male gender, increasing age, malnutrition, physical limitations, increasing BI, and medical conditions. Awareness of risk factors that

Literacy Education and Interprofessional Collaboration

Directory of Open Access Journals (Sweden)

Joron Pihl

2012-03-01

Full Text Available The aim of this article is to explore inter-professional collaboration in literacy education. It examines factors that facilitate collaboration between teachers and librarians and the contributions to literacy education. The study was designed as a research and development project in multicultural schools in Norway (2007-2011. Its theoretical framework was cultural-historical theory of activity theory, and the theory of expansive learning. The methods were formative intervention, interviews, participant observation, and qualitative and quantitative analysis of student literacy. In the study, interprofessional collaboration made significant contributions to professional development and literacy education. Interprofessional collaboration was developed as a collective learning process. It was facilitated by research interventions, development of a shared object of activity and work with new theoretical concepts and cultural artefacts. The findings indicate that inter-professional collaboration can make important contributions to realization of the mandate of the teaching and library profession.

Heat-Related Mortality in India: Excess All-Cause Mortality Associated with the 2010 Ahmedabad Heat Wave

Science.gov (United States)

Azhar, Gulrez Shah; Mavalankar, Dileep; Nori-Sarma, Amruta; Rajiva, Ajit; Dutta, Priya; Jaiswal, Anjali; Sheffield, Perry; Knowlton, Kim; Hess, Jeremy J.; Azhar, Gulrez Shah; Deol, Bhaskar; Bhaskar, Priya Shekhar; Hess, Jeremy; Jaiswal, Anjali; Khosla, Radhika; Knowlton, Kim; Mavalankar, Mavalankar; Rajiva, Ajit; Sarma, Amruta; Sheffield, Perry

2014-01-01

Introduction In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8°C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. Methods We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1–31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. Results The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths). In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest “summer” months of April (r = 0.69, pheat (May 19–25, 2010), mortality rate ratios were 1.76 [95% CI 1.67–1.83, pheat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June. PMID:24633076

Collaborations in fusion research

International Nuclear Information System (INIS)

Barnes, D.; Davis, S.; Roney, P.

1995-01-01

This paper reviews current experimental collaborative efforts in the fusion community and extrapolates to operational scenarios for the Tokamak Physics Experiment (TPX) and the International Thermonuclear Experimental Reactor (ITER). Current requirements, available technologies and tools, and problems, issues and concerns are discussed. This paper specifically focuses on the issues that apply to experimental operational collaborations. Special requirements for other types of collaborations, such as theoretical or design and construction efforts, will not be addressed. Our current collaborative efforts have been highly successful, even though the tools in use will be viewed as primitive by tomorrow's standards. An overview of the tools and technologies in today's collaborations can be found in the first section of this paper. The next generation of fusion devices will not be primarily institutionally based, but will be national (TPX) and international (ITER) in funding, management, operation and in ownership of scientific results. The TPX will present the initial challenge of real-time remotely distributed experimental data analysis for a steady state device. The ITER will present new challenges with the possibility of several remote control rooms all participating in the real-time operation of the experimental device. A view to the future of remote collaborations is provided in the second section of this paper

Regional collaborations and indigenous innovation capabilities in China: A multivariate method for the analysis of regional innovation systems

OpenAIRE

Zhao, S.L.; Cacciolatti, L.; Lee, Soo Hee; Song, W.

2014-01-01

In this study we analyse the emerging patterns of regional collaboration for innovation projects in China, using official government statistics of 30 Chinese regions. We propose the use of Ordinal Multidimensional Scaling and Cluster analysis as a robust method to study regional innovation systems. Our results show that regional collaborations amongst organisations can be categorised by means of eight dimensions: public versus private organisational mindset; public versus private resources; i...

Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium.

Directory of Open Access Journals (Sweden)

Martin Gaksch

Full Text Available Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D concentrations and used aggregate data instead of individual participant data (IPD. We therefore performed an IPD meta-analysis on the association between standardized serum 25(OHD and mortality.In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP protocols to standardize 25(OHD data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OHD with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488.We analysed 26916 study participants (median age 61.6 years, 58% females with a median 25(OHD concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OHD concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval for mortality in the 25(OHD groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00-1.29, 1.33 (1.16-1.51, and 1.67 (1.44-1.89, respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OHD and cancer mortality. There was also no significantly increased mortality risk at high 25(OHD levels up to 125 nmol/L.In the first IPD meta-analysis using standardized measurements of 25(OHD we observed an association between low 25(OHD and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.

Rise in maternal mortality in the Netherlands

NARCIS (Netherlands)

Schutte, J. M.; Steegers, E. A. P.; Schuitemaker, N. W. E.; Santema, J. G.; de Boer, K.; Pel, M.; Vermeulen, G.; Visser, W.; van Roosmalen, J.

2010-01-01

To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. Nationwide in the Netherlands. 2,557,208 live births. Data analysis of all maternal deaths in the period 1993-2005. Maternal mortality.

Usability Analysis within The DataONE Network of Collaborators

Science.gov (United States)

Budden, A. E.; Frame, M. T.; Tenopir, C.; Volentine, R.

2014-12-01

DataONE was conceived as a 10-year project to enable new science and knowledge creation through universal access to data about life on Earth and the environment that sustains it. In Phase I (2009-2014) more than 300 DataONE participants designed, developed and deployed a robust cyberinfrastructure (CI) with innovative services, and directly engaged and educated a broad stakeholder community. DataONE provides a resilient, scalable infrastructure using Member Nodes (data repositories), Coordinating Nodes, and an Investigator Toolkit to support the data access and data management needs of biological, Earth, and environmental science researchers in the U.S. and across the globe. DataONE collaborators, such as the U.S. Geological Survey, University of New Mexico, and the University of Tennessee, perform research to measure both the current data practices and opinions of DataONE stakeholders and the usability of DataONE for these stakeholders. Stakeholders include scientists, data managers, librarians, and educators among others. The DataONE Usability and Assessment Working Group, which includes members from multiple sectors, does research, development, and implementation projects on DataONE processes, systems, and methods. These projects are essential to insure that DataONE products and services meet network goals, include appropriate community involvement, and demonstrate progress and achievements of DataONE. This poster will provide an overview of DataONE's usability analysis and assessment methodologies, benefits to DataONE and its collaborators, and current tools/techniques being utilized by the participants.

Child Mortality in a Developing Country: A Statistical Analysis

Science.gov (United States)

Uddin, Md. Jamal; Hossain, Md. Zakir; Ullah, Mohammad Ohid

2009-01-01

This study uses data from the "Bangladesh Demographic and Health Survey (BDHS] 1999-2000" to investigate the predictors of child (age 1-4 years) mortality in a developing country like Bangladesh. The cross-tabulation and multiple logistic regression techniques have been used to estimate the predictors of child mortality. The…

Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis

Science.gov (United States)

Diniz, Carmen Simone Grilo; Pellini, Alessandra Cristina Guedes; Ribeiro, Adeylson Guimarães; Tedardi, Marcello Vannucci; de Miranda, Marina Jorge; Touso, Michelle Mosna; Baquero, Oswaldo Santos; dos Santos, Patrícia Carlos

2017-01-01

Objective Identify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012. Design Ecological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis. Settings The female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System). Participants Women 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012. Main outcome measures Mortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard. Results In the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006). Conclusions The findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association. PMID:28838894

Supporting tactical intelligence using collaborative environments and social networking

Science.gov (United States)

Wollocko, Arthur B.; Farry, Michael P.; Stark, Robert F.

2013-05-01

Modern military environments place an increased emphasis on the collection and analysis of intelligence at the tactical level. The deployment of analytical tools at the tactical level helps support the Warfighter's need for rapid collection, analysis, and dissemination of intelligence. However, given the lack of experience and staffing at the tactical level, most of the available intelligence is not exploited. Tactical environments are staffed by a new generation of intelligence analysts who are well-versed in modern collaboration environments and social networking. An opportunity exists to enhance tactical intelligence analysis by exploiting these personnel strengths, but is dependent on appropriately designed information sharing technologies. Existing social information sharing technologies enable users to publish information quickly, but do not unite or organize information in a manner that effectively supports intelligence analysis. In this paper, we present an alternative approach to structuring and supporting tactical intelligence analysis that combines the benefits of existing concepts, and provide detail on a prototype system embodying that approach. Since this approach employs familiar collaboration support concepts from social media, it enables new-generation analysts to identify the decision-relevant data scattered among databases and the mental models of other personnel, increasing the timeliness of collaborative analysis. Also, the approach enables analysts to collaborate visually to associate heterogeneous and uncertain data within the intelligence analysis process, increasing the robustness of collaborative analyses. Utilizing this familiar dynamic collaboration environment, we hope to achieve a significant reduction of time and skill required to glean actionable intelligence in these challenging operational environments.

Mortality from cancer and other causes in commercial airline crews: a joint analysis of cohorts from 10 countries.

Science.gov (United States)

Hammer, Gaël P; Auvinen, Anssi; De Stavola, Bianca L; Grajewski, Barbara; Gundestrup, Maryanne; Haldorsen, Tor; Hammar, Niklas; Lagorio, Susanna; Linnersjö, Anette; Pinkerton, Lynne; Pukkala, Eero; Rafnsson, Vilhjálmur; dos-Santos-Silva, Isabel; Storm, Hans H; Strand, Trond-Eirik; Tzonou, Anastasia; Zeeb, Hajo; Blettner, Maria

2014-05-01

Commercial airline crew is one of the occupational groups with the highest exposures to ionising radiation. Crew members are also exposed to other physical risk factors and subject to potential disruption of circadian rhythms. This study analyses mortality in a pooled cohort of 93 771 crew members from 10 countries. The cohort was followed for a mean of 21.7 years (2.0 million person-years), during which 5508 deaths occurred. The overall mortality was strongly reduced in male cockpit (SMR 0.56) and female cabin crews (SMR 0.73). The mortality from radiation-related cancers was also reduced in male cockpit crew (SMR 0.73), but not in female or male cabin crews (SMR 1.01 and 1.00, respectively). The mortality from female breast cancer (SMR 1.06), leukaemia and brain cancer was similar to that of the general population. The mortality from malignant melanoma was elevated, and significantly so in male cockpit crew (SMR 1.57). The mortality from cardiovascular diseases was strongly reduced (SMR 0.46). On the other hand, the mortality from aircraft accidents was exceedingly high (SMR 33.9), as was that from AIDS in male cabin crew (SMR 14.0). This large study with highly complete follow-up shows a reduced overall mortality in male cockpit and female cabin crews, an increased mortality of aircraft accidents and an increased mortality in malignant skin melanoma in cockpit crew. Further analysis after longer follow-up is recommended.

Occupational radiation exposure and mortality: second analysis of the National Registry for Radiation Workers

International Nuclear Information System (INIS)

Muirhead, C.R.; Goodill, A.A.; Haylock, R.G.E.; Vokes, J.; Little, M.P.; Jackson, D.A.; O'Hagan, J.A.; Thomas, J.M.; Kendall, G.M.; Silk, T.J.; Bingham, D.; Berridge, G.L.C.

1999-01-01

The National Registry for Radiation Workers (NRRW) is the largest epidemiological study of UK radiation workers. Following the first analysis published in 1992, a second analysis has been conducted using an enlarged cohort of 124 743 workers, updated dosimetry and personal data for some workers, and a longer follow-up. Overall levels of mortality were found to be less than those expected from national rates; the standardised mortality ratio for all causes was 82, increasing to 89 after adjusting for social class. This 'healthy worker effect' was particularly strong for lung cancer and for some smoking-related non-malignant diseases. Analysis of potential radiation effects involved testing for any trend in mortality risk with external dose, after adjusting for likely confounding factors. For leukaemia, excluding chronic lymphatic leukaemia (CLL), the central estimate of excess relative risk (ERR) per Sv was similar to that estimated for the Japanese atomic bomb survivors at low doses (without the incorporation of a dose-rate correction factor); the corresponding 90% confidence limits for this trend were tighter than in the first analysis, ranging from just under four times the risk estimated at low doses from the Japanese atomic bomb survivors to about zero. For the grouping of all malignancies other than leukaemia, the central estimate of the trend in risk with dose was closer to zero than in the first analysis; also, the 90% confidence limits were tighter than before and included zero. Since results for lung cancer and non-malignant smoking-related diseases suggested the possibility of confounding by smoking, an examination was made, as in the first analysis, of all malignancies other than leukaemia and lung cancer. In this instance the central estimate of the ERR per Sv was similar to that from the A-bomb data (without the incorporation of a dose-rate correction factor), with a 90% confidence interval ranging from about four times the A-bomb value to less than

Cognitive and collaborative demands of freight conductor activities: results and implications of a cognitive task analysis

Science.gov (United States)

2012-07-31

This report presents the results of a cognitive task analysis (CTA) that examined the cognitive and collaborative demands placed on conductors, as well as the knowledge and skills that experienced conductors have developed that enable them to operate...

Innovation and network collaboration

DEFF Research Database (Denmark)

Kesting, Peter; Müller, Sabine; Jørgensen, Frances

2011-01-01

Research suggests that small and medium-sized enterprises (SMEs) can benefit from network collaboration by enhancing opportunities for innovation. Managing the necessary collaboration to benefit from network participation may however be particularly challenging for SMEs due to their size...... and their inherent shortage of resources. In this paper, we propose that human resource management (HRM) practices may provide a means by which SMEs can increase their innovation capacity through network collaboration. Following a brief presentation of the relevant literature on networks, and innovation in networks...... in particular, and HRM, we analyse and evaluate the potential applicability of existing models for supporting innovation in SMEs participating in networks. Finally, we propose several lines of inquiry arising from our analysis that provide directions for future research....

On hunger and child mortality in India.

Science.gov (United States)

Gaiha, Raghav; Kulkarni, Vani S; Pandey, Manoj K; Imai, Katsushi S

2012-01-01

Despite accelerated growth there is pervasive hunger, child undernutrition and mortality in India. Our analysis focuses on their determinants. Raising living standards alone will not reduce hunger and undernutrition. Reduction of rural/urban disparities, income inequality, consumer price stabilization, and mothers’ literacy all have roles of varying importance in different nutrition indicators. Somewhat surprisingly, public distribution system (PDS) do not have a significant effect on any of them. Generally, child undernutrition and mortality rise with poverty. Our analysis confirms that media exposure triggers public action, and helps avert child undernutrition and mortality. Drastic reduction of economic inequality is in fact key to averting child mortality, conditional upon a drastic reordering of social and economic arrangements.

The Effects of Mobile-Computer-Supported Collaborative Learning: Meta-Analysis and Critical Synthesis

Science.gov (United States)

Sung, Yao-Ting; Yang, Je-Ming; Lee, Han-Yueh

2017-01-01

One of the trends in collaborative learning is using mobile devices for supporting the process and products of collaboration, which has been forming the field of mobile-computer-supported collaborative learning (mCSCL). Although mobile devices have become valuable collaborative learning tools, evaluative evidence for their substantial…

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016 : a systematic analysis for the Global Burden of Disease Study 2016

NARCIS (Netherlands)

Postma, Maarten; Berhe, D. F.; van Boven, J. F. M.

2017-01-01

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify

An analysis of national collaboration with Spanish researchers abroad in the health sciences.

Science.gov (United States)

Aceituno-Aceituno, Pedro; Romero-Martínez, Sonia Janeth; Victor-Ponce, Patricia; García-Núñez, José

2015-11-07

The establishment of scientific collaborations with researchers abroad can be considered a good practice to make appropriate use of their knowledge and to increase the possibilities of them returning to their country. This paper analyses the collaboration between Spanish researchers abroad devoted to health sciences and national science institutions. We used the Fontes' approach to perform a study on this collaboration with Spanish researchers abroad. We measured the level of national and international cooperation, the opportunity provided by the host country to collaborate, the promotion of collaboration by national science institutions, and the types of collaboration. A total of 88 biomedical researchers out of the 268 Spanish scientists who filled up the survey participated in the study. Different data analyses were performed to study the variables selected to measure the scientific collaboration and profile of Spanish researchers abroad. There is a high level of cooperation between Spanish health science researchers abroad and international institutions, which contrasts with the small-scale collaboration with national institutions. Host countries facilitate this collaboration with national and international scientific institutions to a larger extent than the level of collaboration promotion carried out by Spanish institutions. The national collaboration with Spanish researchers abroad in the health sciences is limited. Thus, the practice of making appropriate use of the potential of their expertise should be promoted and the opportunities for Spanish health science researchers to return home should be improved.

Decomposing Educational Inequalities in Child Mortality: A Temporal Trend Analysis of Access to Water and Sanitation in Peru.

Science.gov (United States)

Bohra, Tasneem; Benmarhnia, Tarik; McKinnon, Britt; Kaufman, Jay S

2017-01-11

Previous studies of inequality in health and mortality have largely focused on income-based inequality. Maternal education plays an important role in determining access to water and sanitation, and inequalities in child mortality arising due to differential access, especially in low- and middle-income countries such as Peru. This article aims to explain education-related inequalities in child mortality in Peru using a regression-based decomposition of the concentration index of child mortality. The analysis combines a concentration index created along a cumulative distribution of the Demographic and Health Surveys sample ranked according to maternal education, and decomposition measures the contribution of water and sanitation to educational inequalities in child mortality. We observed a large education-related inequality in child mortality and access to water and sanitation. There is a need for programs and policies in child health to focus on ensuring equity and to consider the educational stratification of the population to target the most disadvantaged segments of the population. © The American Society of Tropical Medicine and Hygiene.

[A Meta analysis on the associations between air pollution and respiratory mortality in China].

Science.gov (United States)

Liu, Changjing; Huang, Fei; Yang, Zhizhou; Sun, Zhaorui; Huang, Changbao; Liu, Hongmei; Shao, Danbing; Zhang, Wei; Ren, Yi; Tang, Wenjie; Han, Xiaoqin; Nie, Shinan

2015-08-01

To analyze the associations between air pollution and adverse health outcomes on respiratory diseases and to estimate the short-term effects of air pollutions [Particulate matter with particle size below 10 microns (PM(10)), PM(10) particulate matter with particle size below 2.5 microns (PM(2.5)), nitrogen dioxide (NO₂), sulphur dioxide (SO₂) and ozone (O₃)] on respiratory mortality in China. Data related to the epidemiological studies on the associations between air pollution and adverse health outcomes of respiratory diseases that published from 1989 through 2014 in China, were collected by systematically searching databases of PubMed, SpringerLink, Embase, Medline, CNKI, CBM and VIP in different provinces of China. Short-term effects between (PM(10), PM(2.5), NO₂, SO₂, O₃) and respiratory mortality were analyzed by Meta-analysis method, and estimations were pooled by random or fixed effect models, using the Stata 12.0 software. A total of 157 papers related to the associations between air pollution and adverse health outcomes of respiratory diseases in China were published, which covered 79.4% of all the provinces in China. Results from the Meta-analysis showed that a 10 µg/m³ increase in PM10, PM(2.5), NO₂, SO₂, and O₃was associated with mortality rates as 0.50% (95% CI: 0-0.90%), 0.50% (95% CI: 0.30%-0.70%), 1.39% (95% CI: 0.90%-1.78%), 1.00% (95% CI: 0.40%-1.59%) and 0.10% (95% CI: -1.21%-1.39%) in respiratory tracts, respectively. No publication bias was found among these studies. There seemed positive associations existed between PM(10)/PM(2.5)/NO₂/SO₂and respiratory mortality in China that the relationship called for further attention on air pollution and adverse health outcomes of the respiratory diseases.

Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China.

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Liu, Cong; Yin, Peng; Chen, Renjie; Meng, Xia; Wang, Lijun; Niu, Yue; Lin, Zhijing; Liu, Yunning; Liu, Jiangmei; Qi, Jinlei; You, Jinling; Kan, Haidong; Zhou, Maigeng

2018-01-01

Evidence of the acute health effects of ambient carbon monoxide air pollution in developing countries is scarce and mixed. We aimed to evaluate short-term associations between carbon monoxide and daily cardiovascular disease mortality in China. We did a nationwide time-series analysis in 272 major cities in China from January, 2013, to December, 2015. We extracted daily cardiovascular disease mortality data from China's Disease Surveillance Points system. Data on daily carbon monoxide concentrations for each city were obtained from the National Urban Air Quality Real-time Publishing Platform. City-specific associations between carbon monoxide concentrations and daily mortality from cardiovascular disease, coronary heart disease, and stroke were estimated with over-dispersed generalised linear models. Bayesian hierarchical models were used to obtain national and regional average associations. Exposure-response association curves and potential effect modifiers were evaluated. Two-pollutant models were fit to evaluate the robustness of the effects of carbon monoxide on cardiovascular mortality. The average annual mean carbon monoxide concentration in these cities from 2013 to 2015 was 1·20 mg/m 3 , ranging from 0·43 mg/m 3 to 2·45 mg/m 3 . For a 1 mg/m 3 increase in average carbon monoxide concentrations on the present day and previous day (lag 0-1), we observed significant increments in mortality of 1·12% (95% posterior interval [PI] 0·42-1·83) from cardiovascular disease, 1·75% (0·85-2·66) from coronary heart disease, and 0·88% (0·07-1·69) from stroke. These associations did not vary substantially by city, region, and demographic characteristics (age, sex, and level of education), and the associations for cardiovascular disease and coronary heart disease were robust to the adjustment of criteria co-pollutants. We did not find a threshold below which carbon monoxide exposure had no effect on cardiovascular disease mortality. This analysis is, to our

Methods for reducing sepsis mortality in emergency departments and inpatient units.

Science.gov (United States)

Doerfler, Martin E; D'Angelo, John; Jacobsen, Diane; Jarrett, Mark P; Kabcenell, Andrea I; Masick, Kevin D; Parmentier, Darlene; Nelson, Karen L; Stier, Lori

2015-05-01

As part of a zero-tolerance approach to preventable deaths, North Shore-LIJ Health System (North Shore-LIJ) leadership prioritized a major patient safety initiative to reduce sepsis mortality in 2009 across 10 acute care hospitals (an 11th joined later). At baseline (2008), approximately 3,500 patients were discharged with a diagnosis of sepsis, which ranked as the top All Patient Refined Diagnosis-Related Group by number of deaths (N = 883). Initially, the focus was sepsis recognition and treatment in the emergency departments (EDs). North Shore-LIJ, the 14th largest health care system in the United States, cares for individuals at every stage of life at 19 acute care and specialty hospitals and more than 400 outpatient physician practice sites throughout New York City and the greater New York metropolitan area. The health system launched a strategic partnership with the Institute for Healthcare Improvement (IHI) in August 2011 to accelerate the pace of sepsis improvement. Throughout the course of the initiative, North Shore-LIJ collaborated with many local, state, national, and international organizations to test innovative ideas, share evidence-based best practices, and, more recently, to raise public awareness. North Shore-LIJ reduced overall sepsis mortality by approximately 50% in a six-year period (2008-2013; sustained through 2014) and increased compliance with sepsis resuscitation bundle elements in the EDs and inpatient units in the 11 acute care hospitals. Improvements were achieved by engaging leadership; fostering interprofessional collaboration, collaborating with other leading health care organizations; and developing meaningful, real-time metrics for all levels of staff.

CM-DataONE: A Framework for collaborative analysis of climate model output

Science.gov (United States)

Xu, Hao; Bai, Yuqi; Li, Sha; Dong, Wenhao; Huang, Wenyu; Xu, Shiming; Lin, Yanluan; Wang, Bin

2015-04-01

CM-DataONE is a distributed collaborative analysis framework for climate model data which aims to break through the data access barriers of increasing file size and to accelerate research process. As data size involved in project such as the fifth Coupled Model Intercomparison Project (CMIP5) has reached petabytes, conventional methods for analysis and diagnosis of model outputs have been rather time-consuming and redundant. CM-DataONE is developed for data publishers and researchers from relevant areas. It can enable easy access to distributed data and provide extensible analysis functions based on tools such as NCAR Command Language, NetCDF Operators (NCO) and Climate Data Operators (CDO). CM-DataONE can be easily installed, configured, and maintained. The main web application has two separate parts which communicate with each other through APIs based on HTTP protocol. The analytic server is designed to be installed in each data node while a data portal can be configured anywhere and connect to a nearest node. Functions such as data query, analytic task submission, status monitoring, visualization and product downloading are provided to end users by data portal. Data conform to CMIP5 Model Output Format in each peer node can be scanned by the server and mapped to a global information database. A scheduler included in the server is responsible for task decomposition, distribution and consolidation. Analysis functions are always executed where data locate. Analysis function package included in the server has provided commonly used functions such as EOF analysis, trend analysis and time series. Functions are coupled with data by XML descriptions and can be easily extended. Various types of results can be obtained by users for further studies. This framework has significantly decreased the amount of data to be transmitted and improved efficiency in model intercomparison jobs by supporting online analysis and multi-node collaboration. To end users, data query is

SibRank: Signed bipartite network analysis for neighbor-based collaborative ranking

Science.gov (United States)

Shams, Bita; Haratizadeh, Saman

2016-09-01

Collaborative ranking is an emerging field of recommender systems that utilizes users' preference data rather than rating values. Unfortunately, neighbor-based collaborative ranking has gained little attention despite its more flexibility and justifiability. This paper proposes a novel framework, called SibRank that seeks to improve the state of the art neighbor-based collaborative ranking methods. SibRank represents users' preferences as a signed bipartite network, and finds similar users, through a novel personalized ranking algorithm in signed networks.

Daytime napping and mortality from all causes, cardiovascular disease, and cancer: a meta-analysis of prospective cohort studies.

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Zhong, Guochao; Wang, Yi; Tao, TieHong; Ying, Jun; Zhao, Yong

2015-07-01

The association between daytime napping and mortality remains controversial. We conducted a meta-analysis to examine the associations between daytime napping and the risks of death from all causes, cardiovascular disease (CVD), and cancer. PubMed and Embase databases were searched through 19 September 2014. Prospective cohort studies that provided risk estimates of daytime napping and mortality were eligible for our meta-analysis. Two investigators independently performed study screening and data extraction. A random-effects model was used to estimate the combined effect size. Subgroup analyses were conducted to identify potential effect modifiers. Twelve studies, involving 130,068 subjects, 49,791 nappers, and 19,059 deaths, were included. Our meta-analysis showed that daytime napping was associated with an increased risk of death from all causes [n = 9 studies; hazard ratio (HR), 1.22; 95% confidence interval (CI), 1.14-1.31; I(2) = 42.5%]. No significant associations between daytime napping and the risks of death from CVD (n = 6 studies; HR, 1.20; 95% CI, 0.96-1.50; I(2) = 75.0%) and cancer (n = 4 studies; HR, 1.07; 95% CI, 0.99-1.15; I(2) = 8.9%) were found. There were no significant differences in risks of all-cause and CVD mortality between subgroups stratified by the prevalence of napping, follow-up duration, outcome assessment, age, and sex. Daytime napping is a predictor of increased all-cause mortality but not of CVD and cancer mortality. However, our findings should be treated with caution because of limited numbers of included studies and potential biases. Copyright © 2015. Published by Elsevier B.V.

Musculoskeletal disorders as underlying cause of death in 58 countries, 1986-2011: trend analysis of WHO mortality database.

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Kiadaliri, Aliasghar A; Woolf, Anthony D; Englund, Martin

2017-02-02

Due to low mortality rate of musculoskeletal disorders (MSK) less attention has been paid to MSK as underlying cause of death in the general population. The aim was to examine trend in MSK as underlying cause of death in 58 countries across globe during 1986-2011. Data on mortality were collected from the WHO mortality database and population data were obtained from the United Nations. Annual sex-specific age-standardized mortality rates (ASMR) were calculated by means of direct standardization using the WHO world standard population. We applied joinpoint regression analysis for trend analysis. Between-country disparities were examined using between-country variance and Gini coefficient. The changes in number of MSK deaths between 1986 and 2011 were decomposed using two counterfactual scenarios. The number of MSK deaths increased by 67% between 1986 and 2011 mainly due to population aging. The mean ASMR changed from 17.2 and 26.6 per million in 1986 to 18.1 and 25.1 in 2011 among men and women, respectively (median: 7.3% increase in men and 9.0% reduction in women). Declines in ASMR of 25% or more were observed for men (women) in 13 (19) countries, while corresponding increases were seen for men (women) in 25 (14) countries. In both sexes, ASMR declined during 1986-1997, then increased during 1997-2001 and again declined over 2001-2011. Despite decline over time, there were substantial between-country disparities in MSK mortality and its temporal trend. We found substantial variations in MSK mortality and its trends between countries, regions and also between sex and age groups. Promoted awareness and better management of MSK might partly explain reduction in MSK mortality, but variations across countries warrant further investigations.

SOUTH AMERICAN COLLABORATION IN SCIENTIFIC PUBLICATIONS ON LEISHMANIASIS: BIBLIOMETRIC ANALYSIS IN SCOPUS (2000-2011

Directory of Open Access Journals (Sweden)

Charles Huamaní

2014-09-01

Full Text Available Objectives: Evaluate the production and the research collaborative network on Leishmaniasis in South America. Methods: A bibliometric research was carried out using SCOPUS database. The analysis unit was original research articles published from 2000 to 2011, that dealt with leishmaniasis and that included at least one South American author. The following items were obtained for each article: journal name, language, year of publication, number of authors, institutions, countries, and others variables. Results: 3,174 articles were published, 2,272 of them were original articles. 1,160 different institutional signatures, 58 different countries and 398 scientific journals were identified. Brazil was the country with more articles (60.7% and Oswaldo Cruz Foundation (FIOCRUZ had 18% of Brazilian production, which is the South American nucleus of the major scientific network in Leishmaniasis. Conclusions: South American scientific production on Leishmaniasis published in journals indexed in SCOPUS is focused on Brazilian research activity. It is necessary to strengthen the collaboration networks. The first step is to identify the institutions with higher production, in order to perform collaborative research according to the priorities of each country.

Mortality after exposure to polychlorinated biphenyls and polychlorinated dibenzofurans: a meta-analysis of two highly exposed cohorts.

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Li, Ming-Chieh; Chen, Pau-Chung; Tsai, Pei-Chien; Furue, Masutaka; Onozuka, Daisuke; Hagihara, Akihito; Uchi, Hiroshi; Yoshimura, Takesumi; Guo, Yue Leon

2015-09-15

Both Yucheng and Yusho were events of accidental exposure to highly doses of polychlorinated biphenyls and dibenzofurans in Asian people. Mortality experiences caused by various diseases were reported in both cohorts with similar and dissimilar findings. We thus conducted a meta-analysis of two cohorts to reevaluate the effects of PCBs and PCDFs on major causes of mortalities. Two recently updated Yucheng and Yusho mortality studies were included. For selected diseases, standardized mortality ratios (SMR) and 95% confidence intervals (95% CI) were extracted. Meta-analyses were conducted using a random-effects model only when heterogeneity (I(2)  > 50% and/or p value <0.10 by the Q test) was not found. A total of 1,803 Yucheng subjects (male, N = 830; female, N = 973) with 48,751 person-years of follow-up and 1,664 Yusho subjects (male, N = 860; female, N = 804) with 50,773 person-years are included. An increase in all-cause mortality (pooled SMR=1.2, 95% CI: 1.1-1.3, I(2)  = 0.0%), all cancers (pooled SMR=1.3, 95% CI: 1.1-1.6, I(2)  = 0.0%), lung cancer (pooled SMR=1.7, 95% CI: 1.2-2.3, I(2) =0.0%), heart disease (pooled SMR=1.3, 95% CI: 1.0-1.7, I(2)  = 43.4%) and hepatic disease (pooled SMR=1.9, 95% CI: 1.3-2.8, I(2)  = 0.0%) were found in pooled males. Significant elevation from liver cancer was found in pooled females (pooled SMR=2.0, 95% CI: 1.1-3.6, I(2)  = 0.0%). This meta-analysis of Yucheng and Yusho cohorts showed similar elevation from all cancer, lung cancer, heart disease and hepatic disease mortalities in exposed men. Furthermore, a new finding of elevated liver cancer mortality in exposed women was identified. © 2015 UICC.

Prognostic factors of early metastasis and mortality in dogs with appendicular osteosarcoma after receiving surgery: an individual patient data meta-analysis.

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Schmidt, A F; Nielen, M; Klungel, O H; Hoes, A W; de Boer, A; Groenwold, R H H; Kirpensteijn, J

2013-11-01

Recently an aggregated data meta-analysis showed that serum alkaline phosphatase (SALP) and proximal humerus location are predictors for shorter survival in canine osteosarcoma. To identify additional prognostic factors of mortality and metastasis an individual patient data meta-analysis (IPDMA) was conducted. Individual patient data from 20 studies, identified via the VSSO society, were pooled. Univariable and multivariable hazard ratios (HR) for metastasis and mortality were assessed, using stratified Cox models. The study included 1405 dogs who received surgical treatment, of which the metastasis status was measured in 1155 dogs and mortality status in 1336 dogs; median survival was 256 days. High versus normal SALP and weight (kg) were associated with an increase in hazard of metastasis [HR 1.34 (95%CI 1.07; 1.68) and HR 1.02 (per kg increase) (95%CI 1.01; 1.03)] and for mortality [HR 1.43 (95%CI 1.16; 1.77) and HR 1.02 (95%CI 1.01; 1.02)]. Distal radius tumor was associated with a lower hazard of metastasis compared to other locations: HR 0.75 (95%CI 0.58; 0.96). Proximal humerus and distal femur or proximal tibia location were related with an increased mortality: HR 1.53 (95%CI 1.26; 1.84) and HR 1.23 (95%CI 1.01; 1.49) compared to other locations. Older age (years) was associated with a higher hazard for mortality [HR 1.06 per year (95%CI 1.03; 1.09)] but not for metastasis: HR 1.03 (95%CI 0.99; 1.06). These results confirm findings from a recent aggregated data meta-analysis and (in addition) showed that tumor location, SALP, weight were prognostic factors for both mortality and metastasis. Age was a prognostic factor for mortality but not for metastasis. Copyright © 2013 Elsevier B.V. All rights reserved.

Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis.

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Diniz, Carmen Simone Grilo; Pellini, Alessandra Cristina Guedes; Ribeiro, Adeylson Guimarães; Tedardi, Marcello Vannucci; Miranda, Marina Jorge de; Touso, Michelle Mosna; Baquero, Oswaldo Santos; Santos, Patrícia Carlos Dos; Chiaravalloti-Neto, Francisco

2017-08-23

Identify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012. Ecological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis. The female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System). Women 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012. Mortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard. In the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006). The findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impact of Early Valve Surgery on Outcome of Staphylococcus aureus Prosthetic Valve Infective Endocarditis: Analysis in the International Collaboration of Endocarditis–Prospective Cohort Study

Science.gov (United States)

Chirouze, Catherine; Alla, François; Fowler, Vance G.; Sexton, Daniel J.; Corey, G. Ralph; Chu, Vivian H.; Wang, Andrew; Erpelding, Marie-Line; Durante-Mangoni, Emanuele; Fernández-Hidalgo, Nuria; Giannitsioti, Efthymia; Hannan, Margaret M.; Lejko-Zupanc, Tatjana; Miró, José M.; Muñoz, Patricia; Murdoch, David R.; Tattevin, Pierre; Tribouilloy, Christophe; Hoen, Bruno; Clara, Liliana; Sanchez, Marisa; Nacinovich, Francisco; Oses, Pablo Fernandez; Ronderos, Ricardo; Sucari, Adriana; Thierer, Jorge; Casabé, José; Cortes, Claudia; Altclas, Javier; Kogan, Silvia; Spelman, Denis; Athan, Eugene; Harris, Owen; Kennedy, Karina; Tan, Ren; Gordon, David; Papanicolas, Lito; Eisen, Damon; Grigg, Leeanne; Street, Alan; Korman, Tony; Kotsanas, Despina; Dever, Robyn; Jones, Phillip; Konecny, Pam; Lawrence, Richard; Rees, David; Ryan, Suzanne; Feneley, Michael P.; Harkness, John; Jones, Phillip; Ryan, Suzanne; Jones, Phillip; Ryan, Suzanne; Jones, Phillip; Post, Jeffrey; Reinbott, Porl; Ryan, Suzanne; Gattringer, Rainer; Wiesbauer, Franz; Andrade, Adriana Ribas; de Brito, Ana Cláudia Passos; Guimarães, Armenio Costa; Grinberg, Max; Mansur, Alfredo José; Siciliano, Rinaldo Focaccia; Strabelli, Tania Mara Varejao; Vieira, Marcelo Luiz Campos; de Medeiros Tranchesi, Regina Aparecida; Paiva, Marcelo Goulart; Fortes, Claudio Querido; de Oliveira Ramos, Auristela; Ferraiuoli, Giovanna; Golebiovski, Wilma; Lamas, Cristiane; Santos, Marisa; Weksler, Clara; Karlowsky, James A.; Keynan, Yoav; Morris, Andrew M.; Rubinstein, Ethan; Jones, Sandra Braun; Garcia, Patricia; Cereceda, M; Fica, Alberto; Mella, Rodrigo Montagna; Barsic, Bruno; Bukovski, Suzana; Krajinovic, Vladimir; Pangercic, Ana; Rudez, Igor; Vincelj, Josip; Freiberger, Tomas; Pol, Jiri; Zaloudikova, Barbora; Ashour, Zainab; El Kholy, Amani; Mishaal, Marwa; Rizk, Hussien; Aissa, Neijla; Alauzet, Corentine; Alla, Francois; Campagnac, Catherine; Doco-Lecompte, Thanh; Selton-Suty, Christine; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Habib, Gilbert; Raoult, Didier; Thuny, Franck; Delahaye, François; Delahaye, Armelle; Vandenesch, Francois; Donal, Erwan; Donnio, Pierre Yves; Michelet, Christian; Revest, Matthieu; Tattevin, Pierre; Violette, Jérémie; Chevalier, Florent; Jeu, Antoine; Sorel, Claire; Tribouilloy, Christophe; Bernard, Yvette; Chirouze, Catherine; Hoen, Bruno; Leroy, Joel; Plesiat, Patrick; Naber, Christoph; Neuerburg, Carl; Mazaheri, Bahram; Naber, Christoph; Neuerburg, Carl; Athanasia, Sofia; Giannitsioti, Efthymia; Mylona, Elena; Paniara, Olga; Papanicolaou, Konstantinos; Pyros, John; Skoutelis, Athanasios; Sharma, Gautam; Francis, Johnson; Nair, Lathi; Thomas, Vinod; Venugopal, Krishnan; Hannan, Margaret; Hurley, John; Gilon, Dan; Israel, Sarah; Korem, Maya; Strahilevitz, Jacob; Rubinstein, Ethan; Strahilevitz, Jacob; Casillo, Roberta; Cuccurullo, Susanna; Dialetto, Giovanni; Durante-Mangoni, Emanuele; Irene, Mattucci; Ragone, Enrico; Tripodi, Marie Françoise; Utili, Riccardo; Cecchi, Enrico; De Rosa, Francesco; Forno, Davide; Imazio, Massimo; Trinchero, Rita; Tebini, Alessandro; Grossi, Paolo; Lattanzio, Mariangela; Toniolo, Antonio; Goglio, Antonio; Raglio, Annibale; Ravasio, Veronica; Rizzi, Marco; Suter, Fredy; Carosi, Giampiero; Magri, Silvia; Signorini, Liana; Baban, Tania; Kanafani, Zeina; Kanj, Souha S.; Yasmine, Mohamad; Abidin, Imran; Tamin, Syahidah Syed; Martínez, Eduardo Rivera; Soto Nieto, Gabriel Israel; van der Meer, Jan T.M.; Chambers, Stephen; Holland, David; Morris, Arthur; Raymond, Nigel; Read, Kerry; Murdoch, David R.; Dragulescu, Stefan; Ionac, Adina; Mornos, Cristian; Butkevich, O.M.; Chipigina, Natalia; Kirill, Ozerecky; Vadim, Kulichenko; Vinogradova, Tatiana; Edathodu, Jameela; Halim, Magid; Lum, Luh-Nah; Tan, Ru-San; Lejko-Zupanc, Tatjana; Logar, Mateja; Mueller-Premru, Manica; Commerford, Patrick; Commerford, Anita; Deetlefs, Eduan; Hansa, Cass; Ntsekhe, Mpiko; Almela, Manuel; Armero, Yolanda; Azqueta, Manuel; Castañeda, Ximena; Cervera, Carlos; del Rio, Ana; Falces, Carlos; Garcia-de-la-Maria, Cristina; Fita, Guillermina; Gatell, Jose M.; Marco, Francesc; Mestres, Carlos A.; Miró, José M.; Moreno, Asuncion; Ninot, Salvador; Paré, Carlos; Pericas, Joan; Ramirez, Jose; Rovira, Irene; Sitges, Marta; Anguera, Ignasi; Font, Bernat; Guma, Joan Raimon; Bermejo, Javier; Bouza, Emilio; Fernández, Miguel Angel Garcia; Gonzalez-Ramallo, Victor; Marín, Mercedes; Muñoz, Patricia; Pedromingo, Miguel; Roda, Jorge; Rodríguez-Créixems, Marta; Solis, Jorge; Almirante, Benito; Fernandez-Hidalgo, Nuria; Tornos, Pilar; de Alarcón, Arístides; Parra, Ricardo; Alestig, Eric; Johansson, Magnus; Olaison, Lars; Snygg-Martin, Ulrika; Pachirat, Orathai; Pachirat, Pimchitra; Pussadhamma, Burabha; Senthong, Vichai; Casey, Anna; Elliott, Tom; Lambert, Peter; Watkin, Richard; Eyton, Christina; Klein, John L.; Bradley, Suzanne; Kauffman, Carol; Bedimo, Roger; Chu, Vivian H.; Corey, G. Ralph; Crowley, Anna Lisa; Douglas, Pamela; Drew, Laura; Fowler, Vance G.; Holland, Thomas; Lalani, Tahaniyat; Mudrick, Daniel; Samad, Zaniab; Sexton, Daniel; Stryjewski, Martin; Wang, Andrew; Woods, Christopher W.; Lerakis, Stamatios; Cantey, Robert; Steed, Lisa; Wray, Dannah; Dickerman, Stuart A.; Bonilla, Hector; DiPersio, Joseph; Salstrom, Sara-Jane; Baddley, John; Patel, Mukesh; Peterson, Gail; Stancoven, Amy; Afonso, Luis; Kulman, Theresa; Levine, Donald; Rybak, Michael; Cabell, Christopher H.; Baloch, Khaula; Chu, Vivian H.; Corey, G. Ralph; Dixon, Christy C.; Fowler, Vance G.; Harding, Tina; Jones-Richmond, Marian; Pappas, Paul; Park, Lawrence P.; Redick, Thomas; Stafford, Judy; Anstrom, Kevin; Athan, Eugene; Bayer, Arnold S.; Cabell, Christopher H.; Chu, Vivian H.; Corey, G. Ralph; Fowler, Vance G.; Hoen, Bruno; Karchmer, A. W.; Miró, José M.; Murdoch, David R.; Sexton, Daniel J.; Wang, Andrew; Bayer, Arnold S.; Cabell, Christopher H.; Chu, Vivian; Corey, G. Ralph; Durack, David T.; Eykyn, Susannah; Fowler, Vance G.; Hoen, Bruno; Miró, José M.; Moreillon, Phillipe; Olaison, Lars; Raoult, Didier; Rubinstein, Ethan; Sexton, Daniel J.

2015-01-01

Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis–Prospective Cohort Study. Methods. Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results. EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non–S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39–1.15]; P = .15). Conclusions. In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE. PMID:25389255

[Interagency collaboration in Spanish scientific production in nursing: social network analysis].

Science.gov (United States)

Almero-Canet, Amparo; López-Ferrer, Mayte; Sales-Orts, Rafael

2013-01-01

The objectives of this paper are to analyze the Spanish scientific production in nursing, define its temporal evolution, its geographical and institutional distribution, and observe the interinstitutional collaboration. We analyze a comprehensive sample of Spanish scientific production in the nursing area extracted from the multidisciplinary database SciVerse Scopus. The nursing scientific production grows along time. The collaboration rate is 3.7 authors per paper and 61% of the authors only publish one paper. Barcelona and Madrid are the provinces with highest number of authors. Most belong to the hospitalary environment, followed closely by authors belonging to the university. The most institutions that collaborate, sharing authorship of articles are: University of Barcelona, Autonomous University of Barcelona and Clinic Hospital of Barcelona. The nursing scientific production has been increasing since her incorporation at the university. The collaboration rate found is higher than found for other papers. It shows a low decrease of occasional authors. It discusses the outlook of scientific collaboration in nursing in Spain, at the level of institutions by co-authorship of papers, through a network graph. It observes their distribution, importance and interactions or lack thereof. There is a strong need to use international databases for research, care and teaching, in addition to the national specialized information resources. Professionals are encouraged to normalization of the paper's signature, both, surnames and institutions to which they belong. It confirms the limited cooperation with foreign institutions, although there is an increasing trend of collaboration between Spanish authors in this discipline. It is observed, clearly defined three interinstitutional collaboration patterns. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Heat-related mortality in India: excess all-cause mortality associated with the 2010 Ahmedabad heat wave.

Directory of Open Access Journals (Sweden)

Gulrez Shah Azhar

Full Text Available In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8 °C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality.We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1-31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations.The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths. In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest "summer" months of April (r = 0.69, p<0.001, May (r = 0.77, p<0.001, and June (r = 0.39, p<0.05. During a period of more intense heat (May 19-25, 2010, mortality rate ratios were 1.76 [95% CI 1.67-1.83, p<0.001] and 2.12 [95% CI 2.03-2.21] applying reference periods (May 12-18, 2010 from various years.The May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June.

Revisiting Sex Equality With Transcatheter Aortic Valve Replacement Outcomes: A Collaborative, Patient-Level Meta-Analysis of 11,310 Patients.

Science.gov (United States)

O'Connor, Stephen A; Morice, Marie-Claude; Gilard, Martine; Leon, Martin B; Webb, John G; Dvir, Danny; Rodés-Cabau, Josep; Tamburino, Corrado; Capodanno, Davide; D'Ascenzo, Fabrizio; Garot, Philippe; Chevalier, Bernard; Mikhail, Ghada W; Ludman, Peter F

2015-07-21

There has been conflicting clinical evidence as to the influence of female sex on outcomes after transcatheter aortic valve replacement. The aim of this study was to evaluate the impact of sex on early and late mortality and safety end points after transcatheter aortic valve replacement using a collaborative meta-analysis of patient-level data. From the MEDLINE, Embase, and the Cochrane Library databases, data were obtained from 5 studies, and a database containing individual patient-level time-to-event data was generated from the registry of each selected study. The primary outcome of interest was all-cause mortality. The safety end point was the combined 30-day safety end points of major vascular complications, bleeding events, and stroke, as defined by the Valve Academic Research Consortium when available. Five studies and their ongoing registry data, comprising 11,310 patients, were included. Women constituted 48.6% of the cohort and had fewer comorbidities than men. Women had a higher rate of major vascular complications (6.3% vs. 3.4%; p women and men (2.6 % vs. 2.2% [p = 0.24] and 6.5% vs. 6.5% [p = 0.93], respectively), but female sex was independently associated with improved survival at median follow-up of 387 days (interquartile range: 192 to 730 days) from the index procedure (adjusted hazard ratio: 0.79; 95% confidence interval: 0.73 to 0.86; p = 0.001). Although women experience more bleeding events, as well as vascular and stroke complications, female sex is an independent predictor of late survival after transcatheter aortic valve replacement. This should be taken into account during patient selection for this procedure. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Patterns in PARTNERing across Public Health Collaboratives

Science.gov (United States)

Bevc, Christine A.; Retrum, Jessica H.; Varda, Danielle M.

2015-01-01

Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships. PMID:26445053

Patterns in PARTNERing across Public Health Collaboratives.

Science.gov (United States)

Bevc, Christine A; Retrum, Jessica H; Varda, Danielle M

2015-10-05

Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

Patterns in PARTNERing across Public Health Collaboratives

Directory of Open Access Journals (Sweden)

Christine A. Bevc

2015-10-01

Full Text Available Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162, to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

Evaluating the Collaborative Ecosystem for an Innovation-Driven Economy: A Systems Analysis and Case Study of Science Parks

Directory of Open Access Journals (Sweden)

Min-Ren Yan

2018-03-01

Full Text Available National policies for science parks and innovation have been identified as one of the major driving forces for the innovation-driven economy, especially for publicly funded science parks. To investigate this collaborative ecosystem (government-academia-industry for growth and sustainable development, this paper proposes a nation-wide economic impact analysis of science parks and innovation policy based on historical data drawn from one of the globally recognized high-technology industrial clusters in Taiwan. Systems thinking with causal loop analysis are adopted to improve our understanding of the collaborative ecosystem with science park policies. First, from a holistic viewpoint, the role of government in a science parks and innovation ecosystem is reviewed. A systems analysis of an innovation-driven economy with a science park policy is presented as a strategy map for policy implementers. Second, the added economic value and employment of the benchmarked science parks is evaluated from a long range perspective. Third, the concepts of government-academia-industry collaboration and policies to innovation ecosystem are introduced while addressing the measures and performance of innovation and applied R&D in the science parks. We conclude with a discussion of lessons learned and the policy implications of science park development and an innovation ecosystem.

Age structure and mortality of walleyes in Kansas reservoirs: Use of mortality caps to establish realistic management objectives

Science.gov (United States)

Quist, M.C.; Stephen, J.L.; Guy, C.S.; Schultz, R.D.

2004-01-01

Age structure, total annual mortality, and mortality caps (maximum mortality thresholds established by managers) were investigated for walleye Sander vitreus (formerly Stizostedion vitreum) populations sampled from eight Kansas reservoirs during 1991-1999. We assessed age structure by examining the relative frequency of different ages in the population; total annual mortality of age-2 and older walleyes was estimated by use of a weighted catch curve. To evaluate the utility of mortality caps, we modeled threshold values of mortality by varying growth rates and management objectives. Estimated mortality thresholds were then compared with observed growth and mortality rates. The maximum age of walleyes varied from 5 to 11 years across reservoirs. Age structure was dominated (???72%) by walleyes age 3 and younger in all reservoirs, corresponding to ages that were not yet vulnerable to harvest. Total annual mortality rates varied from 40.7% to 59.5% across reservoirs and averaged 51.1% overall (SE = 2.3). Analysis of mortality caps indicated that a management objective of 500 mm for the mean length of walleyes harvested by anglers was realistic for all reservoirs with a 457-mm minimum length limit but not for those with a 381-mm minimum length limit. For a 500-mm mean length objective to be realized for reservoirs with a 381-mm length limit, managers must either reduce mortality rates (e.g., through restrictive harvest regulations) or increase growth of walleyes. When the assumed objective was to maintain the mean length of harvested walleyes at current levels, the observed annual mortality rates were below the mortality cap for all reservoirs except one. Mortality caps also provided insight on management objectives expressed in terms of proportional stock density (PSD). Results indicated that a PSD objective of 20-40 was realistic for most reservoirs. This study provides important walleye mortality information that can be used for monitoring or for inclusion into

Exploring the Technological Collaboration Characteristics of the Global Integrated Circuit Manufacturing Industry

Directory of Open Access Journals (Sweden)

Yun Liu

2018-01-01

Full Text Available With the intensification of international competition, there are many international technological collaborations in the integrated circuit manufacturing (ICM industry. The importance of improving the level of international technological collaboration is becoming more and more prominent. Therefore, it is vital for a country, a region, or an institution to understand the international technological collaboration characteristics of the ICM industry and, thus, to know how to enhance its own international technological collaboration. This paper depicts the international technological collaboration characteristics of the ICM industry based on patent analysis. Four aspects, which include collaboration patterns, collaboration networks, collaboration institutions, and collaboration impacts, are analyzed by utilizing patent association analysis and social network analysis. The findings include the following: first, in regard to international technological collaboration, the USA has the highest level, while Germany has great potential for future development; second, Asia and Europe have already formed clusters, respectively, in the cooperative network; last, but not least, research institutions, colleges, and universities should also actively participate in international collaboration. In general, this study provides an objective reference for policy making, competitiveness, and sustainability in the ICM industry. The framework presented in this paper could be applied to examine other industrial international technological collaborations.

Learning Performance Enhancement Using Computer-Assisted Language Learning by Collaborative Learning Groups

Directory of Open Access Journals (Sweden)

Ya-huei Wang

2017-08-01

Full Text Available This study attempted to test whether the use of computer-assisted language learning (CALL and innovative collaborative learning could be more effective than the use of traditional collaborative learning in improving students’ English proficiencies. A true experimental design was used in the study. Four randomly-assigned groups participated in the study: a traditional collaborative learning group (TCLG, 34 students, an innovative collaborative learning group (ICLG, 31 students, a CALL traditional collaborative learning group (CALLTCLG, 32 students, and a CALL innovative collaborative learning group (CALLICLG, 31 students. TOEIC (Test of English for International Communication listening, reading, speaking, and writing pre-test and post-test assessments were given to all students at an interval of sixteen weeks. Multivariate analysis of covariance (MANCOVA, multivariate analysis of variance (MANOVA, and analysis of variance (ANOVA were used to analyze the data. The results revealed that students who used CALL had significantly better learning performance than those who did not. Students in innovative collaborative learning had significantly better learning performances than those in traditional collaborative learning. Additionally, students using CALL innovative collaborative learning had better learning performances than those in CALL collaborative learning, those in innovative collaborative learning, and those in traditional collaborative learning.

Increased non-AIDS mortality among persons with AIDS-defining events after antiretroviral therapy initiation

DEFF Research Database (Denmark)

Pettit, April C; Giganti, Mark J; Ingle, Suzanne M

2018-01-01

) initiation. METHODS: We included HIV treatment-naïve adults from the Antiretroviral Therapy Cohort Collaboration (ART-CC) who initiated ART from 1996 to 2014. Causes of death were assigned using the Coding Causes of Death in HIV (CoDe) protocol. The adjusted hazard ratio (aHR) for overall and cause......-specific non-AIDS mortality among those with an ADE (all ADEs, tuberculosis (TB), Pneumocystis jiroveci pneumonia (PJP), and non-Hodgkin's lymphoma (NHL)) compared to those without an ADE was estimated using a marginal structural model. RESULTS: The adjusted hazard of overall non-AIDS mortality was higher...

Collaborative Economy

DEFF Research Database (Denmark)

collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...... localities of tourism Greg Richards 11.Collaborative economy and destination marketing organizations: A systems approach Jonathan Day 12.Working within the Collaborative Tourist Economy: The complex crafting of work and meaning Jane Widtfeldt Meged and Mathilde Dissing Christensen PART - III Encounters...

Regional differences in Dutch maternal mortality

NARCIS (Netherlands)

de Graaf, J.P.; Schutte, J.M.; Poeran, J.J.; van Roosmalen, J.; Bonsel, G.J.; Steegers, E.A.P.

2012-01-01

Objective To study regional differences in maternal mortality in the Netherlands. Design Confidential inquiry into the causes of maternal mortality. Setting Nationwide. Population A total of 3 108 235 live births and 337 maternal deaths. Methods Data analysis of all maternal deaths in the period

Short-term mortality and prognostic factors related to status epilepticus

Directory of Open Access Journals (Sweden)

Fernando Gustavo Stelzer

2015-08-01

Full Text Available Objective Status epilepticus (SE is associated with significant morbidity and mortality, and there is some controversy concerning predictive indicators of outcome. Our main goal was to determine mortality and to identify factors associated with SE prognosis. Method This prospective study in a tertiary-care university hospital, included 105 patients with epileptic seizures lasting more than 30 minutes. Mortality was defined as death during hospital admission. Results The case-fatality rate was 36.2%, which was higher than in previous studies. In univariate analysis, mortality was associated with age, previous epilepsy, complex focal seizures; etiology, recurrence, and refractoriness of SE; clinical complications, and focal SE. In multivariate analysis, mortality was associated only with presence of clinical complications. Conclusions Mortality associated with SE was higher than reported in previous studies, and was not related to age, specific etiology, or SE duration. In multivariate analysis, mortality was independently related to occurrence of medical complications.

Epistemological development and collaborative learning: a hermeneutic analysis of music therapy students' experience.

Science.gov (United States)

Luce, David W

2008-01-01

Undergraduate education must address student's developmental needs, as well as their learning needs. Yet, there has been little discussion regarding music therapy students' epistemological development, how that influences their education and clinical training, and how that understanding can inform educators and clinical supervisors. As part of an introductory music therapy course that was taught using collaborative learning consensus groups, students provided written and verbal comments about their experience and some students agreed to a series of interviews (Luce, 2002). This hermeneutic analysis of that data was based upon Perry's Scheme and Women's Ways of Knowing suggested that (a) the students' comments reflected the various perspectives or positions within the models, (b) the collaborative learning consensus groups facilitated transitions and movement within the models, and (c) there was a need for more research to understand music therapy students' developmental needs, to enhance teaching methods and pedagogy, and to address students' developmental needs as they prepare to enter the profession.

International Collaboration: the Virtuous Cycle of Low Carbon Innovation and Diffusion. An Analysis of Solar Photovoltaic, Concentrating Solar Power and Carbon Capture and Storage

International Nuclear Information System (INIS)

Dominique, Katheen

2010-01-01

International collaboration can be leveraged to accelerate the innovation and diffusion of low carbon technologies required to realize the shift to a low carbon trajectory. A collaborative approach to innovation has the potential to capture several benefits, including: pooling risks and achieving scale; knowledge sharing that accommodates competition and cooperation; the creation of a global market; facilitation of policy learning and exchange; and the alignment of technology, finance and policy. International Collaboration: the Virtuous Cycle of Low Carbon Innovation and Diffusion An Analysis of Solar Photovoltaic, Concentrating Solar Power and Carbon Capture and Storage A range of obstacles to the diffusion of low carbon technologies provides ample opportunity for international collaboration in global market creation and capacity building, expanding beyond conventional modes of technology transfer. Current collaborative efforts for carbon capture and storage, solar photovoltaic and concentrating solar power technologies are active in all stages of innovation and diffusion and involve a wide range of actors. Yet, current efforts are not sufficient to achieve the necessary level of emission mitigation at the pace required to avoid catastrophic levels of atmospheric destabilization. This analysis sets forth recommendation to scale up current endeavors and create new ones. The analysis begins by describing the fundamental characteristics of innovation and diffusion processes that create opportunities for international collaboration. It then illustrates a broad array of on-going collaborative activities, depicting how these efforts contribute to innovation and diffusion. Finally, highlighting the gap between the current level of collaborative activities and technology targets deemed critical for emission mitigation, the report sets forth several recommendations to build on current efforts and construct new endeavors

Raising Awareness on Heat Related Mortality in Bangladesh

Science.gov (United States)

Arrighi, J.; Burkart, K.; Nissan, H.

2017-12-01

Extreme heat is the leading cause of weather-related deaths in the United States and Europe, and was responsible for four of the ten deadliest natural disasters worldwide in 2015. Near the tropics, where hot weather is considered the norm, perceived heat risk is often low, but recent heat waves in South Asia have caught the attention of the health community, policy-makers and the public. In a recent collaboration between the Red Cross Red Crescent Climate Centre, Columbia University and BBC Media Action the effects of extreme heat in Bangladesh were analyzed and the findings were subsequently used as a basis to raise awareness about the impacts of extreme heat on the most vulnerable, to the general public. Analysis of excess heat in Bangladesh between 2003 and 2007 showed that heatwaves occur between April and June with most extreme heat events occurring in May. Between 2003 and 2007 it is estimated that an average of 1500 people died per year due to heatwaves lasting three days or longer, with an eight-day heatwave in 2005 resulting in a minimum of 3,800 excess deaths. Utilizing these findings BBC Media Action launched an online communications campaign in May 2017 ultimately reaching approximately 3.9 million people with information on reducing the impacts of extreme heat. This presentation will highlight key findings from the study of heat related mortality in Bangladesh as well as highlight the benefit of collaboration between scientists and communicators for increasing awareness about the effects of extreme heat on the most vulnerable.

Mortality of colorectal cancer in Taiwan, 1971-2010: temporal changes and age-period-cohort analysis.

Science.gov (United States)

Su, Shih-Yung; Huang, Jing-Yang; Jian, Zhi-Hong; Ho, Chien-Chang; Lung, Chia-Chi; Liaw, Yung-Po

2012-12-01

Colorectal cancer (CRC) is the second most common cause of cancer death in developed countries among men (after lung cancer) and the third most common among women. This study thus examines the long-term trends of CRC mortality in Taiwan. CRC cases were collective between patients aged 30 years or older and younger than 85 years from the Taiwan death registries during 1971-2010. Standard descriptive techniques such as age-standardized mortality rates (ASMR), aural percent change, and age-period-cohort analyses were used. The increase of percentage change by each age group in men was higher than in women. The ASMR of CRC increased 2-fold for men and almost 1.5-fold for women during the periods 1971-1975 and 2006-2010. For age-period-cohort analysis, the estimated mortality rate increased steadily with age in both sexes, and plateaued at 175.29 per 100,000 people for men and 128.14 per 100,000 for women in the 80- to 84-year-old group. Period effects were weak in both sexes. Cohort effects were strong. Between 30 and 59 years of age, the sex ratio showed that the female CRC mortality rate was higher than that of their male counterparts. Conversely, the mortality risk of CRC in men was higher than that in women when they were between 60 and 84 years old. The current findings showed a consistent increase in mortality from CRC over the years. Changes in the patient sex ratio indicated an important etiological role of sex hormones, especially in women aged 60 years or younger.

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

NARCIS (Netherlands)

Wang, H.; Geleijnse, J.M.

2017-01-01

Background
Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify

Serbia within the European context: An analysis of premature mortality

Directory of Open Access Journals (Sweden)

Marinkovic Jelena

2009-08-01

Full Text Available Abstract Background Based on the global predictions majority of deaths will be collectively caused by cancer, cardiovascular diseases, and traffic accidents over the coming 25 years. In planning future national health policy actions, inter – regional assessments play an important role. The purpose of the study was to analyze similarities and differences in premature mortality between Serbia, EURO A, EURO B, and EURO C regions in 2000. Methods Mortality and premature mortality patterns were analysed according to cause of death, by gender and seven age intervals. The study results are presented in relative (% and absolute terms (age-specific and age-standardized death rates per 100,000 population, and age-standardized rates of years of life lost – YLL per 1,000. Direct standardization of rates was undertaken using the standard population of Europe. The inter-regional comparison was based on a calculation of differences in YLL structures and with a ratio of age-standardized YLL rates per 1,000. A multivariate generalized linear model was used to explore mortality of Serbia and Europe sub-regions with ln age-specific death rates. The dissimilarity was achieved with a p ≤ 0.05. Results According to the mortality pattern, Serbia was similar to EURO B, but with a lower average YLL per death case. YLL patterns indicated similarities between Serbia and EURO A, while SRR YLL had similarities between Serbia and EURO B. Compared to all Europe sub-regions, Serbia had a major excess of premature mortality in neoplasms and diabetes mellitus. Serbia had lost more years of life than EURO A due to cardiovascular, genitourinary diseases, and intentional injuries. Yet, Serbia was not as burdened with communicable diseases and injuries as were EURO B and EURO C. Conclusion With a premature mortality pattern, Serbia is placed in the middle position of the Europe triangle. The main excess of YLL in Serbia was due to cardiovascular, malignant diseases, and

Social Capital and Human Mortality: Explaining the Rural Paradox with County-Level Mortality Data

Science.gov (United States)

Jensen, Leif; Haran, Murali

2014-01-01

The “rural paradox” refers to standardized mortality rates in rural areas that are unexpectedly low in view of well-known economic and infrastructural disadvantages there. We explore this paradox by incorporating social capital, a promising explanatory factor that has seldom been incorporated into residential mortality research. We do so while being attentive to spatial dependence, a statistical problem often ignored in mortality research. Analyzing data for counties in the contiguous United States, we find that: (1) the rural paradox is confirmed with both metro/non-metro and rural-urban continuum codes, (2) social capital significantly reduces the impacts of residence on mortality after controlling for race/ethnicity and socioeconomic covariates, (3) this attenuation is greater when a spatial perspective is imposed on the analysis, (4) social capital is negatively associated with mortality at the county level, and (5) spatial dependence is strongly in evidence. A spatial approach is necessary in county-level analyses such as ours to yield unbiased estimates and optimal model fit. PMID:25392565

Time-series analysis of air pollution and cause-specific mortality

NARCIS (Netherlands)

Zmirou, D; Schwartz, J; Saez, M; Zanobetti, A; Wojtyniak, B; Touloumi, G; Spix, C; de Leon, AP; Le Moullec, Y; Bacharova, L; Schouten, J; Ponka, A; Katsouyanni, K

Ten large European cities provided data on daily air pollution as well as mortality from respiratory and cardiovascular mortality. We used Poisson autoregressive models that controlled for trend, season, influenza epidemics, and meteorologic influences to assess the short-term effects of air

Processes of international collaboration in management research

DEFF Research Database (Denmark)

Jonsen, Karsten; Butler, Christina; Mäkelä, Kristiina

2013-01-01

Scientists and academics increasingly work on collaborative projects and write papers in international research teams. This trend is driven by greater publishing demands in terms of the quality and breadth of data and analysis methods, which tend to be difficult to achieve without collaborating...... across institutional and national boundaries. Yet, our understanding of the collaborative processes in an academic setting and the potential tensions associated with them remains limited. We use a reflexive, autoethnographic approach to explicitly investigate our own experiences of international...... collaborative research. We offer systematic insights into the social and intellectual processes of academic collaborative writing, identifying six lessons and two key tensions that influence the success of international research teams. Our findings may benefit the formation of future coauthor teams...

Red Cell Distribution Width and Mortality in Patients With Acute Coronary Syndrome: A Meta-Analysis on Prognosis.

Science.gov (United States)

Abrahan, Lauro L; Ramos, John Daniel A; Cunanan, Elleen L; Tiongson, Marc Denver A; Punzalan, Felix Eduardo R

2018-06-01

Red cell distribution width (RDW), a routine component of the complete blood count (CBC), measures variation in the size of circulating erythrocytes. It has been associated with several clinical outcomes in cardiovascular disease. We sought to strengthen the association between RDW and mortality in patients admitted for acute coronary syndrome (ACS) by pooling together data from available studies. Studies that fulfilled the following were identified for analysis: 1) observational; 2) included patients admitted for ACS; 3) reported data on all-cause or cardiovascular (CV) mortality in association with a low or high RDW; and 4) used logistic regression analysis to control for confounders. Using MEDLINE, Clinical Key, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials databases, a search for eligible studies was conducted until January 9, 2017. The quality of each study was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Our primary outcome of interest was all-cause or CV mortality. We also investigated the impact of RDW on major adverse cardiovascular events (MACEs) for the studies that reported these outcomes. Review Manager (RevMan) 5.3 was utilized to perform Mantel-Haenzel analysis of random effects and compute for relative risk. We identified 13 trials involving 10,410 patients, showing that in ACS, a low RDW is associated with a statistically significant lower all-cause or CV mortality (RR 0.35, (95% CI 0.30 to 0.40), P < 0.00001, I 2 = 53%), a finding that was consistent both in the short- and long-term. A low RDW is also associated with lower risk for MACEs after an ACS (RR 0.56, (95% CI 0.51 to 0.61), P < 0.00001, I 2 = 91%). A low RDW during an ACS is associated with lower all-cause or CV mortality and lower risk of subsequent MACEs, providing us with a convenient and inexpensive risk stratification tool in ACS patients.

[Efficacy of noninvasive ventilation on in-hospital mortality in patients with acute cardiogenic pulmonary edema: a meta-analysis].

Science.gov (United States)

Sun, Tongwen; Wan, Youdong; Kan, Quancheng; Yang, Fei; Yao, Haimu; Guan, Fangxia; Zhang, Jinying; Li, Ling

2014-02-01

To evaluate the efficacy of noninvasive ventilation on in-hospital mortality in adult patients with acute cardiogenic pulmonary edema (ACPE) . We searched PubMed, Embase, Wanfang, CNKI data to find relevant randomized controlled trials of noninvasive ventilation for ACPE, which were reported from January 1980 to December 2012. Meta-analysis was performed with software of RevMan 5.1. According to inclusive criteria and exclusion criteria, 35 randomized controlled trials with 3 204 patients were enrolled for analyses. Meta-analysis of the trials showed that continuous positive airway pressure (CPAP) reduced in-hospital mortality by 43% (RR = 0.57, 95%CI 0.43-0.75, P management strategies for these patients.

Advanced tools for enhancing control room collaborations

International Nuclear Information System (INIS)

Abla, G.; Flanagan, S.M.; Peng, Q.; Burruss, J.R.; Schissel, D.P.

2006-01-01

The US National Fusion Collaboratory (NFC) project has been exploring a variety of computer and network technologies to develop a persistent, efficient, reliable and convenient collaborative environment for magnetic fusion research. One goal is to enhance remote and collocated team collaboration by integrating collaboration software tools into control room operations as well as with data analysis tools. To achieve this goal, the NFC recently introduced two new collaboration technologies into the DIII-D tokamak control room. The first technology is a high-resolution, large format Shared Display Wall (SDW). By creating a shared public display space and providing real time visual information about the multiple aspects of complex experiment activity, the large SDW plays an important role in increasing the rate of information dissemination and promoting interaction among team members. The second technology being implemented is the 'tokamak control room aware' Instant Messaging (IM) service. In addition to providing text-chat capabilities for research scientists, it enables them to automatically receive information about experiment operations and data analysis processes to remotely monitor the status of ongoing tokamak experiment. As a result, the IM service has become a unified portal interface for team collaboration and remote participation

Advanced tools for enhancing control room collaborations

Energy Technology Data Exchange (ETDEWEB)

Abla, G. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States)]. E-mail: abla@fusion.gat.com; Flanagan, S.M. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States); Peng, Q. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States); Burruss, J.R. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States); Schissel, D.P. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States)

2006-07-15

The US National Fusion Collaboratory (NFC) project has been exploring a variety of computer and network technologies to develop a persistent, efficient, reliable and convenient collaborative environment for magnetic fusion research. One goal is to enhance remote and collocated team collaboration by integrating collaboration software tools into control room operations as well as with data analysis tools. To achieve this goal, the NFC recently introduced two new collaboration technologies into the DIII-D tokamak control room. The first technology is a high-resolution, large format Shared Display Wall (SDW). By creating a shared public display space and providing real time visual information about the multiple aspects of complex experiment activity, the large SDW plays an important role in increasing the rate of information dissemination and promoting interaction among team members. The second technology being implemented is the 'tokamak control room aware' Instant Messaging (IM) service. In addition to providing text-chat capabilities for research scientists, it enables them to automatically receive information about experiment operations and data analysis processes to remotely monitor the status of ongoing tokamak experiment. As a result, the IM service has become a unified portal interface for team collaboration and remote participation.

Strategic governance: Addressing neonatal mortality in situations of political instability and weak governance.

Science.gov (United States)

Wise, Paul H; Darmstadt, Gary L

2015-08-01

Neonatal mortality is increasingly concentrated globally in situations of conflict and political instability. In 1991, countries with high levels of political instability accounted for approximately 10% of all neonatal deaths worldwide; in 2013, this figure had grown to 31%. This has generated a "grand divergence" between those countries showing progress in neonatal mortality reduction compared to those lagging behind. We present new analyses demonstrating associations of neonatal mortality with political instability (r = 0.55) and poor governance (r = 0.70). However, heterogeneity in these relationships suggests that progress is possible in addressing neonatal mortality even in the midst of political instability and poor governance. In order to address neonatal mortality more effectively in such situations, we must better understand how specific elements of "strategic governance"--the minimal conditions of political stability and governance required for health service implementation--can be leveraged for successful introduction of specific health services. Thus, a more strategic approach to policy and program implementation in situations of conflict and political instability could lead to major accelerations in neonatal mortality reduction globally. However, this will require new cross-disciplinary collaborations among public health professionals, political scientists, and country actors. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Socio-economic determinants of mortality in Bangladesh.

Science.gov (United States)

Kabir, M; Howlader, A A

1980-01-01

Infant mortality in Bangladesh is 1 of the highest in Asian countries. There are several reasons why infant mortality is still high in Bangladesh. A large number of births occur prematurely, or there is poor handling by birth attendants leading to injury and infection. In addition, there is a gross shortage of maternity clinics, trained midwives, and other paramedical personnel in the country. The children are generally born in the most unhygienic of conditions. Malnutrition is a common factor. In recent years, the study of socioeconomic differentials of infant and child mortality has occupied an important position in demographic research. Given the limited data available to measure many variables which could have an effect on mortality as measured here by infant mortality, the analysis has been essentially confined to an analysis of differences in infant mortality by various socioeconomic characteristics. The factors and relative contributions of the combined effects of medical services, general socioeconomic and environmental factors need to be examined. Mortality can be seen in this context as a final consequence of the interactions between health, work, and income. Due to lack of data availability, very little work has been done on this. The World Fertility Survey has given a unique opportunity to researchers to explore this field more comprehensively.

A Social Network Analysis of Teaching and Research Collaboration in a Teachers' Virtual Learning Community

Science.gov (United States)

Lin, Xiaofan; Hu, Xiaoyong; Hu, Qintai; Liu, Zhichun

2016-01-01

Analysing the structure of a social network can help us understand the key factors influencing interaction and collaboration in a virtual learning community (VLC). Here, we describe the mechanisms used in social network analysis (SNA) to analyse the social network structure of a VLC for teachers and discuss the relationship between face-to-face…

The contribution of unimproved water and toilet facilities to pregnancy-related mortality in Afghanistan: analysis of the Afghan Mortality Survey.

Science.gov (United States)

Gon, Giorgia; Monzon-Llamas, Laura; Benova, Lenka; Willey, Barbara; Campbell, Oona M R

2014-12-01

To estimate the effect of unimproved household water and toilet facilities on pregnancy-related mortality in Afghanistan. The data source was a population-based cross-sectional study, the Afghan Mortality Survey 2010. Descriptive, univariate and multivariate logistic regression analyses were carried out, comparing 69 pregnancy-related deaths (cases) and 15386 surviving women (non-cases) who had a live birth or stillbirth between 2007 and 2010. After adjusting for confounders, households with unimproved water access had 1.91 the odds of pregnancy-related mortality [95% confidence interval (CI) 1.11-3.30] compared to households with improved water access. We also found an association between unimproved toilet facilities and pregnancy-related mortality (OR = 2.25; 95% CI 0.71-7.19; P-value = 0.169), but it was not statistically significant. Unimproved household water access was an important risk factor for pregnancy-related mortality in Afghanistan. However, we were unable to discern whether unimproved water source is a marker of unhygienic environments or socio-economic position. There was weak evidence for the association between unimproved toilet facilities and pregnancy-related mortality; this association requires confirmation from larger studies. © 2014 John Wiley & Sons Ltd.

Design of Scalable and Effective Earth Science Collaboration Tool

Science.gov (United States)

Maskey, M.; Ramachandran, R.; Kuo, K. S.; Lynnes, C.; Niamsuwan, N.; Chidambaram, C.

2014-12-01

Collaborative research is growing rapidly. Many tools including IDEs are now beginning to incorporate new collaborative features. Software engineering research has shown the effectiveness of collaborative programming and analysis. In particular, drastic reduction in software development time resulting in reduced cost has been highlighted. Recently, we have witnessed the rise of applications that allow users to share their content. Most of these applications scale such collaboration using cloud technologies. Earth science research needs to adopt collaboration technologies to reduce redundancy, cut cost, expand knowledgebase, and scale research experiments. To address these needs, we developed the Earth science collaboration workbench (CWB). CWB provides researchers with various collaboration features by augmenting their existing analysis tools to minimize learning curve. During the development of the CWB, we understood that Earth science collaboration tasks are varied and we concluded that it is not possible to design a tool that serves all collaboration purposes. We adopted a mix of synchronous and asynchronous sharing methods that can be used to perform collaboration across time and location dimensions. We have used cloud technology for scaling the collaboration. Cloud has been highly utilized and valuable tool for Earth science researchers. Among other usages, cloud is used for sharing research results, Earth science data, and virtual machine images; allowing CWB to create and maintain research environments and networks to enhance collaboration between researchers. Furthermore, collaborative versioning tool, Git, is integrated into CWB for versioning of science artifacts. In this paper, we present our experience in designing and implementing the CWB. We will also discuss the integration of collaborative code development use cases for data search and discovery using NASA DAAC and simulation of satellite observations using NASA Earth Observing System Simulation

Air Pollution and Deaths among Elderly Residents of São Paulo, Brazil: An Analysis of Mortality Displacement.

Science.gov (United States)

Costa, Amine Farias; Hoek, Gerard; Brunekreef, Bert; Ponce de Leon, Antônio C M

2017-03-01

Evaluation of short-term mortality displacement is essential to accurately estimate the impact of short-term air pollution exposure on public health. We quantified mortality displacement by estimating single-day lag effects and cumulative effects of air pollutants on mortality using distributed lag models. We performed a daily time series of nonaccidental and cause-specific mortality among elderly residents of São Paulo, Brazil, between 2000 and 2011. Effects of particulate matter smaller than 10 μm (PM 10 ), nitrogen dioxide (NO 2 ) and carbon monoxide (CO) were estimated in Poisson generalized additive models. Single-day lag effects of air pollutant exposure were estimated for 0-, 1- and 2-day lags. Distributed lag models with lags of 0-10, 0-20 and 0-30 days were used to assess mortality displacement and potential cumulative exposure effects. PM 10 , NO 2 and CO were significantly associated with nonaccidental and cause-specific deaths in both single-day lag and cumulative lag models. Cumulative effect estimates for 0-10 days were larger than estimates for single-day lags. Cumulative effect estimates for 0-30 days were essentially zero for nonaccidental and circulatory deaths but remained elevated for respiratory and cancer deaths. We found evidence of mortality displacement within 30 days for nonaccidental and circulatory deaths in elderly residents of São Paulo. We did not find evidence of mortality displacement within 30 days for respiratory or cancer deaths. Citation: Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. 2017. Air pollution and deaths among elderly residents of São Paulo, Brazil: an analysis of mortality displacement. Environ Health Perspect 125:349-354; http://dx.doi.org/10.1289/EHP98.

Analysis of team types based on collaborative relationships among doctors, home-visiting nurses and care managers for effective support of patients in end-of-life home care.

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Fujita, Junko; Fukui, Sakiko; Ikezaki, Sumie; Otoguro, Chizuru; Tsujimura, Mayuko

2017-11-01

To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis. Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice. It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; 17: 1943-1950. © 2017 Japan Geriatrics Society.

Outcome Indicators on Interprofessional Collaboration Interventions for Elderly

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Giannoula Tsakitzidis

2016-05-01

Full Text Available    Background: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. Method: A systematic review is performed in the Cochrane Library, Pubmed (Medline, Embase, Cinahl and Psychinfo with a search until June 2014. Results: Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance. Discussion and conclusion: The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is

Collaboration

Science.gov (United States)

King, Michelle L.

2010-01-01

This article explores collaboration between library media educators and regular classroom teachers. The article focuses on the context of the issue, positions on the issue, the impact of collaboration, and how to implement effective collaboration into the school system. Various books and professional journals are used to support conclusions…

The influence of learning in collaborative improvement

DEFF Research Database (Denmark)

Nielsen, Jacob S.; Boer, Harry; Gertsen, Frank

2008-01-01

Collaborative improvement is a purposeful inter-company interactive process that focuses on continuous incremental innovation aimed at enhancing the partnership's overall performance. Considering that in such an environment the capability to learn jointly and individually is crucial, this paper...... takes a learning perspective on collaborative improvement and addresses the question: How do organisational learning and collaboration interplay and affect improvement performance? Based on an analysis of three dyads of the same Extended Manufacturing Enterprise, this paper concludes that a robust...

A meta-analysis of prospective studies of coffee consumption and mortality for all causes, cancers and cardiovascular diseases.

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Malerba, Stefano; Turati, Federica; Galeone, Carlotta; Pelucchi, Claudio; Verga, Federica; La Vecchia, Carlo; Tavani, Alessandra

2013-07-01

Several prospective studies considered the relation between coffee consumption and mortality. Most studies, however, were underpowered to detect an association, since they included relatively few deaths. To obtain quantitative overall estimates, we combined all published data from prospective studies on the relation of coffee with mortality for all causes, all cancers, cardiovascular disease (CVD), coronary/ischemic heart disease (CHD/IHD) and stroke. A bibliography search, updated to January 2013, was carried out in PubMed and Embase to identify prospective observational studies providing quantitative estimates on mortality from all causes, cancer, CVD, CHD/IHD or stroke in relation to coffee consumption. A systematic review and meta-analysis was conducted to estimate overall relative risks (RR) and 95 % confidence intervals (CI) using random-effects models. The pooled RRs of all cause mortality for the study-specific highest versus low (≤1 cup/day) coffee drinking categories were 0.88 (95 % CI 0.84-0.93) based on all the 23 studies, and 0.87 (95 % CI 0.82-0.93) for the 19 smoking adjusting studies. The combined RRs for CVD mortality were 0.89 (95 % CI 0.77-1.02, 17 smoking adjusting studies) for the highest versus low drinking and 0.98 (95 % CI 0.95-1.00, 16 studies) for the increment of 1 cup/day. Compared with low drinking, the RRs for the highest consumption of coffee were 0.95 (95 % CI 0.78-1.15, 12 smoking adjusting studies) for CHD/IHD, 0.95 (95 % CI 0.70-1.29, 6 studies) for stroke, and 1.03 (95 % CI 0.97-1.10, 10 studies) for all cancers. This meta-analysis provides quantitative evidence that coffee intake is inversely related to all cause and, probably, CVD mortality.

Collaboration 'Engineerability'

NARCIS (Netherlands)

Kolfschoten, Gwendolyn L.; de Vreede, Gert-Jan; Briggs, Robert O.; Sol, Henk G.

Collaboration Engineering is an approach to create sustained collaboration support by designing collaborative work practices for high-value recurring tasks, and transferring those designs to practitioners to execute for themselves without ongoing support from collaboration professionals. A key

Collaborative Economy

DEFF Research Database (Denmark)

that are emerging from them, and how governments are responding to these new challenges. In doing so, the book provides both theoretical and practical insights into the future of tourism in a world that is, paradoxically, becoming both increasingly collaborative and individualized. Table of Contents Preface 1.The...... collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...

Association of Drug Effects on Serum Parathyroid Hormone, Phosphorus, and Calcium Levels With Mortality in CKD: A Meta-analysis.

Science.gov (United States)

Palmer, Suetonia C; Teixeira-Pinto, Armando; Saglimbene, Valeria; Craig, Jonathan C; Macaskill, Petra; Tonelli, Marcello; de Berardis, Giorgia; Ruospo, Marinella; Strippoli, Giovanni F M

2015-12-01

Serum parathyroid hormone (PTH), phosphorus, and calcium levels are surrogate outcomes that are central to the evaluation of drug treatments in chronic kidney disease (CKD). This systematic review evaluates the evidence for the correlation between drug effects on biochemical (PTH, phosphorus, and calcium) and all-cause and cardiovascular mortality end points in adults with CKD. Systematic review and meta-analysis. Adults with CKD. Randomized trials reporting drug effects on biochemical and mortality end points. Drug interventions with effects on serum PTH, phosphorus, and calcium levels, including vitamin D compounds, phosphate binders, cinacalcet, bisphosphonates, and calcitonin. Correlation between drug effects on biochemical and all-cause and cardiovascular mortality. 28 studies (6,999 participants) reported both biochemical and mortality outcomes and were eligible for analysis. Associations between drug effects on surrogate biochemical end points and corresponding effects on mortality were weak and imprecise. All correlation coefficients were less than 0.70, and 95% credible intervals were generally wide and overlapped with zero, consistent with the possibility of no association. The exception was an inverse correlation between drug effects on serum PTH levels and all-cause mortality, which was nominally significant (-0.64; 95% credible interval, -0.85 to -0.15), but the strength of this association was very imprecise. Risk of bias within available trials was generally high, further reducing confidence in the summary correlations. Findings were robust to adjustment for age, baseline serum PTH level, allocation concealment, CKD stage, and drug class. Low power in analyses and combining evidence from many different drug comparisons with incomplete data across studies. Drug effects on serum PTH, phosphorus, and calcium levels are weakly and imprecisely correlated with all-cause and cardiovascular death in the setting of CKD. Risks of mortality (patient

Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis.

Science.gov (United States)

Thota, Anilkrishna B; Sipe, Theresa Ann; Byard, Guthrie J; Zometa, Carlos S; Hahn, Robert A; McKnight-Eily, Lela R; Chapman, Daniel P; Abraido-Lanza, Ana F; Pearson, Jane L; Anderson, Clinton W; Gelenberg, Alan J; Hennessy, Kevin D; Duffy, Farifteh F; Vernon-Smiley, Mary E; Nease, Donald E; Williams, Samantha P

2012-05-01

To improve the quality of depression management, collaborative care models have been developed from the Chronic Care Model over the past 20 years. Collaborative care is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists. In addition to case management support, primary care providers receive consultation and decision support from mental health specialists (i.e., psychiatrists and psychologists). This collaboration is designed to (1) improve routine screening and diagnosis of depressive disorders; (2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and (3) improve clinical and community support for active client/patient engagement in treatment goal-setting and self-management. A team of subject matter experts in mental health, representing various agencies and institutions, conceptualized and conducted a systematic review and meta-analysis on collaborative care for improving the management of depressive disorders. This team worked under the guidance of the Community Preventive Services Task Force, a nonfederal, independent, volunteer body of public health and prevention experts. Community Guide systematic review methods were used to identify, evaluate, and analyze available evidence. An earlier systematic review with 37 RCTs of collaborative care studies published through 2004 found evidence of effectiveness of these models in improving depression outcomes. An additional 32 studies of collaborative care models conducted between 2004 and 2009 were found for this current review and analyzed. The results from the meta-analyses suggest robust evidence of effectiveness of collaborative care in improving depression symptoms (standardized mean difference [SMD]=0.34); adherence to treatment (OR=2.22); response to treatment (OR=1.78); remission of symptoms (OR=1.74); recovery from symptoms (OR=1.75); quality of

Analysis of Research Collaboration between Universities and Private Companies in Spain Based on Joint Scientific Publications

Science.gov (United States)

Olmeda-Gómez, Carlos; Ovalle-Perandones, María Antonia; de Moya-Anegón, Félix

2015-01-01

Introduction: The article presents the results of a study on scientific collaboration between Spanish universities and private enterprise, measured in terms of the co-authorship of papers published in international journals. Method: Bibliometric analysis of papers published in journals listed in Scopus in 2003-2011. Indicators were calculated for…

Mortality in East African shorthorn zebu cattle under one year: predictors of infectious-disease mortality.

Science.gov (United States)

Thumbi, Samuel M; Bronsvoort, Mark B M de C; Kiara, Henry; Toye, P G; Poole, Jane; Ndila, Mary; Conradie, Ilana; Jennings, Amy; Handel, Ian G; Coetzer, J A W; Steyl, Johan; Hanotte, Olivier; Woolhouse, Mark E J

2013-09-08

Infectious livestock diseases remain a major threat to attaining food security and are a source of economic and livelihood losses for people dependent on livestock for their livelihood. Knowledge of the vital infectious diseases that account for the majority of deaths is crucial in determining disease control strategies and in the allocation of limited funds available for disease control. Here we have estimated the mortality rates in zebu cattle raised in a smallholder mixed farming system during their first year of life, identified the periods of increased risk of death and the risk factors for calf mortality, and through analysis of post-mortem data, determined the aetiologies of calf mortality in this population. A longitudinal cohort study of 548 zebu cattle was conducted between 2007 and 2010. Each calf was followed during its first year of life or until lost from the study. Calves were randomly selected from 20 sub-locations and recruited within a week of birth from different farms over a 45 km radius area centered on Busia in the Western part of Kenya. The data comprised of 481.1 calf years of observation. Clinical examinations, sample collection and analysis were carried out at 5 week intervals, from birth until one year old. Cox proportional hazard models with frailty terms were used for the statistical analysis of risk factors. A standardized post-mortem examination was conducted on all animals that died during the study and appropriate samples collected. The all-cause mortality rate was estimated at 16.1 (13.0-19.2; 95% CI) per 100 calf years at risk. The Cox models identified high infection intensity with Theileria spp., the most lethal of which causes East Coast Fever disease, infection with Trypanosome spp., and helminth infections as measured by Strongyle spp. eggs per gram of faeces as the three important infections statistically associated with infectious disease mortality in these calves. Analysis of post-mortem data identified East Coast Fever as

Multisource Images Analysis Using Collaborative Clustering

Directory of Open Access Journals (Sweden)

Pierre Gançarski

2008-04-01

Full Text Available The development of very high-resolution (VHR satellite imagery has produced a huge amount of data. The multiplication of satellites which embed different types of sensors provides a lot of heterogeneous images. Consequently, the image analyst has often many different images available, representing the same area of the Earth surface. These images can be from different dates, produced by different sensors, or even at different resolutions. The lack of machine learning tools using all these representations in an overall process constraints to a sequential analysis of these various images. In order to use all the information available simultaneously, we propose a framework where different algorithms can use different views of the scene. Each one works on a different remotely sensed image and, thus, produces different and useful information. These algorithms work together in a collaborative way through an automatic and mutual refinement of their results, so that all the results have almost the same number of clusters, which are statistically similar. Finally, a unique result is produced, representing a consensus among the information obtained by each clustering method on its own image. The unified result and the complementarity of the single results (i.e., the agreement between the clustering methods as well as the disagreement lead to a better understanding of the scene. The experiments carried out on multispectral remote sensing images have shown that this method is efficient to extract relevant information and to improve the scene understanding.

Negative Control Outcomes and the Analysis of Standardized Mortality Ratios.

Science.gov (United States)

Richardson, David B; Keil, Alexander P; Tchetgen Tchetgen, Eric; Cooper, Glinda

2015-09-01

In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to noncomparability of the occupational cohort and reference population with respect to unmeasured risk factors for the outcome of interest. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for such bias. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR = 1.9; 95% confidence interval [CI] = 1.3, 2.7) but not among monthly-paid males (SMR = 1.0; 95% CI = 0.67, 1.3). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR = 2.2; 95% CI = 1.5, 3.2; and, aSMR = 2.0; 95% CI = 1.4, 2.8, respectively). The proposed adjusted SMR offers a complement to typical SMR analyses.

Air pollution and mortality in the Canary Islands: a time-series analysis

Directory of Open Access Journals (Sweden)

Ballester Ferran

2010-02-01

Full Text Available Abstract Background The island factor of the cities of Las Palmas de Gran Canaria and Santa Cruz de Tenerife, along with their proximity to Africa and their meteorology, create a particular setting that influences the air quality of these cities and provides researchers an opportunity to analyze the acute effects of air-pollutants on daily mortality. Methods From 2000 to 2004, the relationship between daily changes in PM10, PM2.5, SO2, NO2, CO, and ozone levels and daily total mortality and mortality due to respiratory and heart diseases were assessed using Generalized Additive Poisson models controlled for potential confounders. The lag effect (up to five days as well as the concurrent and previous day averages and distributed lag models were all estimated. Single and two pollutant models were also constructed. Results Daily levels of PM10, PM2.5, NO2, and SO2 were found to be associated with an increase in respiratory mortality in Santa Cruz de Tenerife and with increased heart disease mortality in Las Palmas de Gran Canaria, thus indicating an association between daily ozone levels and mortality from heart diseases. The effects spread over five successive days. SO2 was the only air pollutant significantly related with total mortality (lag 0. Conclusions There is a short-term association between current exposure levels to air pollution and mortality (total as well as that due specifically to heart and respiratory diseases in both cities. Risk coefficients were higher for respiratory and cardiovascular mortality, showing a delayed effect over several days.

Spatial-Temporal Analysis of Air Pollution, Climate Change, and Total Mortality in 120 Cities of China, 2012-2013.

Science.gov (United States)

Liu, Longjian; Yang, Xuan; Liu, Hui; Wang, Mingquan; Welles, Seth; Márquez, Shannon; Frank, Arthur; Haas, Charles N

2016-01-01

China has had a rapid increase in its economy over the past three decades. However, the economic boom came at a certain cost of depleting air quality. In the study, we aimed to examine the burden of air pollution and its association with climatic factors and health outcomes using data from Chinese national and city-level air quality and public health surveillance systems. City-level daily air pollution index (API, a sum weighted index of SO2, NO2, PM10, CO, and Ozone) in 120 cities in 2012 and 2013, and its association with climate factors were analyzed using multiple linear regression analysis, spatial autocorrelation analysis, and panel fixed models. City-level ecological association between annual average API and total mortality were examined using univariate and partial correlation analysis. Sensitivity analysis was conducted by taking the consideration of time-lag effect between exposures and outcomes. The results show that among the 120 cities, annual average API significantly increased from 2012 to 2013 (65.05 vs. 75.99, p 100 (defined as "slightly polluted"), however, it increased to 21 cities (18%) that experienced API >100 for ≥60 days in 2013. Furthermore, 16 cities (13%) in 2012 and 35 (29%) in 2013 experienced a maximum API >300 (defined as "severely polluted"). API was negatively and significantly correlated with heat index, precipitation, and sunshine hours, but positively with air pressure. Cities with higher API concentrations had significantly higher total mortality rates than those with lower API. About a 4-7% of the variation in total mortality could be explained by the difference in API across the nation. In conclusion, the study highlights an increased trend of air pollution from 2012 to 2013 in China. The magnitude of air pollution varied by seasons and regions and correlated with climatic factors and total mortality across the country.

Losing Life and Livelihood: A Systematic Review and Meta-Analysis of Unemployment and All-Cause Mortality

Science.gov (United States)

Roelfs, David J.; Shor, Eran; Davidson, Karina W.; Schwartz, Joseph E.

2011-01-01

Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the magnitude of the risk and moderating factors have not been explored. The study is a random-effects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late-career. The risk of death was highest during the first 10 years of follow up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors. PMID:21330027

Global scientific collaboration in COPD research

Directory of Open Access Journals (Sweden)

Su YB

2017-01-01

Full Text Available Yanbing Su,1 Chao Long,2 Qi Yu,1 Juan Zhang,1 Daisy Wu,3 Zhiguang Duan1 1School of Management, Shanxi Medical University, Taiyuan, People’s Republic of China; 2School of Medicine, Stanford University, Palo Alto, CA, 3Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA Purpose: This study aimed to investigate the multiple collaboration types, quantitatively evaluate the publication trends and review the performance of institutions or countries (regions across the world in COPD research.Materials and methods: Scientometric methods and social network analysis were used to survey the development of publication trends and understand current collaboration in the field of COPD research based on the Web of Science publications during the past 18 years.Results: The number of publications developed through different collaboration types has increased. Growth trends indicate that the percentage of papers authored through multinational and domestic multi-institutional collaboration (DMIC have also increased. However, the percentage of intra-institutional collaboration and single-authored (SA studies has reduced. The papers that produced the highest academic impact result from international collaboration. The second highest academic impact papers are produced by DMIC. Out of the three, the papers that are produced by SA studies have the least amount of impact upon the scientific community. A handful of internationally renowned institutions not only take the leading role in the development of the research within their country (region but also play a crucial role in international research collaboration in COPD. Both the amount of papers produced and the amount of cooperation that occurs in each study are disproportionally distributed between high-income countries (regions and low-income countries (regions. Growing attention has been generated toward research on COPD from more and more different

[Co-authorship and Spanish pediatric scientific collaboration networks (2006-2010)].

Science.gov (United States)

Aleixandre Benavent, R; González de Dios, J; Alonso Arroyo, A; Bolaños Pizarro, M; Castelló Cogollos, L; González Alcaide, G; Vidal Infer, A; Navarro Molina, C; Coronado Ferrer, S; González Muñoz, M; Málaga Guerrero, S

2013-06-01

Scientific collaboration is very important, as it is the basis of the scientific development of every discipline. The aim of this paper is to identify the indicators of scientific collaboration and co-authorship networks of Spanish researchers and institutions publishing in national and international paediatric, multidisciplinary or other knowledge areas journals during the period 2006-2010. The papers studied were obtained from the databases including, Science Citation Index Expanded, Scopus, Índice Médico Español and Índice Bibliográfico Español en Ciencias de la Salud, by means of applying different search profiles. All the papers signed by co-authors were quantified in order to identify the authorship and institutional collaboration networks. Furthermore the degree, betweenness index, and closeness index were obtained as a measurement of the structural analysis. Co-authorships were represented graphically by the network analysis and display software Pajek. A total of 7971 articles were published during the period 2006-2010, with 90.55% completed in collaboration. Using a threshold of 10 or more co-authorships, 77 research groups in Pediatrics were identified. Most papers were published in collaboration between institutions of the same Autonomous Community (42.28%), and 14.84% with international collaboration. The analysis of institutional participation enabled a large nucleus or institutional collaboration network to be identified, with 52 linked institutions. International collaboration was led by the USA and European countries, such as United Kingdom, Germany and Italy. Authors, institutions and the most active working groups in Spanish pediatrics were identified, which is very interesting information to establish contacts to increase the existing networks, to prevent redundancies, and to take advantage of the new emerging groups. It is necessary to promote the collaboration of Spanish researchers, especially with their international colleagues, since a

Statistical analysis of child mortality and its determinants | Taiwo | Ife ...

African Journals Online (AJOL)

... residence, birth order and zone. The second factor which seemed to index previous birth had high loadings on child sex, birth sex, birth size (weight of the baby at birth in kilogram)and as well as mother's age. Keywords: Child mortality, Socio-economic and demographic determinants, Mortality rate, Varimax rotation and ...

Urinary cadmium and mortality from all causes, cancer and cardiovascular disease in the general population: systematic review and meta-analysis of cohort studies.

Science.gov (United States)

Larsson, Susanna C; Wolk, Alicja

2016-06-01

Cadmium is a toxic heavy metal distributed in the environment. We conducted a systematic review and meta-analysis to examine the association between urinary cadmium concentration and mortality from all causes, cancer and cardiovascular disease (CVD) in the general population. Studies were identified by searching PubMed and Embase (to 30 March 2015) and the reference lists of retrieved articles. We included prospective studies that reported hazard ratios (HR) with 95% confidence intervals (CI) for the association between urinary cadmium concentration and all-cause, cancer or CVD mortality. A random-effects model was used to combine study-specific results. Nine cohort studies, including 5600 deaths from all causes, 1332 deaths from cancer and 1715 deaths from CVD, were eligible for inclusion in the meta-analysis. The overall HRs for the highest vs lowest category of urinary cadmium were1.44 (95% CI, 1.25-1.64; I(2 )= 40.5%) for all-cause mortality (six studies), 1.39 (95% CI, 0.96-1.99; I(2 )= 75.9%) for cancer mortality (four studies) and 1.57 (95% CI, 1.27-1.95; I(2 )= 34.0%) for CVD mortality (five studies). In an analysis restricted to six cohort studies conducted in populations with a mean urinary cadmium concentration of ≤1 µg/g creatinine, the HRs were 1.38 (95% CI, 1.17-1.63; I(2 )= 48.3%) for all-cause mortality, 1.56 (95% CI, 0.98-2.47; I(2 )= 81.0%) for cancer mortality and 1.50 (95% CI, 1.18-1.91; I(2 )= 38.2%) for CVD mortality. Even at low-level exposure, cadmium appears to be associated with increased mortality. Further large prospective studies of cadmium exposure and mortality are warranted. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

An analysis of anemia and child mortality

NARCIS (Netherlands)

Brabin, B. J.; Premji, Z.; Verhoeff, F.

2001-01-01

The relationship of anemia as a risk factor for child mortality was analyzed by using cross-sectional, longitudinal and case-control studies, and randomized trials. Five methods of estimation were adopted: 1) the proportion of child deaths attributable to anemia; 2) the proportion of anemic children

Cancer mortality

International Nuclear Information System (INIS)

Kato, H.

1986-01-01

The Radiation Effects Research Foundation (RERF) and its predecessor, the Atomic Bomb Casualty Commission (ABCC), have conducted mortality surveillance on a fixed sample, the Life Span Study (LSS), of 82,000 atomic bomb survivors and 27,000 nonexposed residents of Hiroshima and Nagasaki since 1950. The results of the most recent analysis of the LSS are summarized

Dose-response relationship analysis for cancer and circulatory system disease mortality risks among uranium miners

International Nuclear Information System (INIS)

Drubay, Damien

2015-01-01

The relation between lung cancer risk and radon exposure has been clearly established, especially from the studies on uranium miner cohorts. But the association between radon exposure and extrapulmonary cancers and non-cancer diseases remains not well known. Moreover, the health risks associated with the other mining-related ionizing radiation exposures are still under consideration. The aim of this thesis is to contribute to the estimation of the radio-induced health risks at low-doses through the analysis of the kidney cancer and Circulatory System Disease (CSD) mortality risks among uranium miners. Kidney cancer mortality risk analyses were performed from the French cohort of uranium miners (n=5086; follow-up period: 1946-2007), the post-55 cohort (n=3,377; follow-up period: 1957-2007) and the German cohort of the Wismut (n=58,986; follow-up period: 1946-2003) which included 24, 11 and 174 deaths from kidney cancer, respectively. The exposures to radon and its short-lived progeny (expressed in Working Level Month WLM), to uranium ore dust (kBqh.m -3 ) and to external gamma rays (mSv) were estimated for each miners and the equivalent kidney dose was calculated. The dose-response relation was refined considering two responses: the instantaneous risk of kidney cancer mortality (corresponding to the classical analysis, Cause specific Hazard Ratio (CSHR) estimated with the Cox model) and its occurrence probability during the followup (Sub-distribution Hazard Ratio (SHR) estimated with the Fine and Gray model). An excess of kidney cancer mortality was observed only in the French cohort (SMR = 1.62 CI95%[1.04; 2.41]). In the Wismut cohort, a decrease of the kidney cancer mortality was observed (0.89 [0.78; 0.99]). For these three cohorts, the occupational radiological exposures (or the equivalent kidney dose) were significantly associated neither with the risk of kidney cancer mortality (e.g. CSHRWismut-radon/100 WLM=1.023 [0.993; 1.053]), nor with its occurrence

Monitoring Student Activity in Collaborative Software Development

DEFF Research Database (Denmark)

Dietsch, Daniel; Podelski, Andreas; Nam, Jaechang

2013-01-01

year of studies formed 20 groups and worked collaboratively to develop video games. Throughout the lab, students have to use a variety of tools for managing and developing their projects, such as software version control, static analysis tools, wikis, mailing lists, etc. The students are also supported......This paper presents data analysis from a course on Software Engineering in an effort to identify metrics and techniques that would allow instructor to act proactively and identify patterns of low engagement and inefficient peer collaboration. Over the last two terms, 106 students in their second...... by weekly meetings with teaching assistants and instructors regarding group progress, code quality, and management issues. Through these meetings and their interactions with the software tools, students leave a detailed trace of data related to their individual engagement and their collaboration behavior...

Mortality in adults with hypopituitarism: a systematic review and meta-analysis.

Science.gov (United States)

Jasim, Sina; Alahdab, Fares; Ahmed, Ahmed T; Tamhane, Shrikant; Prokop, Larry J; Nippoldt, Todd B; Murad, M Hassan

2017-04-01

Hypopituitarism is a rare disorder with significant morbidity. To study the evidence on the association of premature mortality and hypopituitarism. A comprehensive search of multiple databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was conducted through August, 2015. Eligible studies that evaluated patients with hypopituitarism and reported mortality estimates were selected following a predefined protocol. Reviewers, independently and in duplicate, extracted data and assessed the risk of bias. We included 12 studies (published 1996-2015) that reported on 23,515 patients. Compared to the general population, hypopituitarism was associated with an overall excess mortality (weighted SMR of 1.55; 95 % CI 1.14-2.11), I 2  = 97.8 %, P = 0.000. Risk factors for increased mortality included younger age at diagnosis, female gender, diagnosis of craniopharyngioma, radiation therapy, transcranial surgery, diabetes insipidus and hypogonadism. Hypopituitarism may be associated with premature mortality in adults. Risk is particularly higher in women and those diagnosed at a younger age.

Mind the gap in clinical trials: A participatory action analysis with citizen collaborators.

Science.gov (United States)

Price, Amy; Liew, Su May; Kirkpatrick, Jo; Price, Jazmin; Lopreto, Taylor; Nelken, Yasmin

2017-02-01

What are the strengths, gaps, expectations, and barriers to research engagement in clinical trials as communicated through social media? Clinical trials test treatments to provide reliable information for safety and effectiveness. Trials are building blocks in which what is learned in earlier research can be used to improve treatments, compare alternatives, and improve quality of life. For 20 years, the percentages of clinical trials volunteers have decreased whereas the costs of running clinical trials have multiplied. Participants enroll in trials to access latest treatments, to help others, and to advance science, but there is growing unrest. The priorities of those running the trials differ from those of the participants, and the roles for public research involvement lack clarity. Changes to bridge these gaps in the research culture are proposed through the use of participatory action research (PAR) in which stakeholders collaborate to improve research methodology, galvanize citizen participation, multiply health knowledge, problem-solve barriers to access, and explore the value of research volunteers as collaborators. PAR enabled the inclusion of citizens as full collaborators. Social media data were gathered for 120 days until saturation was reached. De-identified data were organized into a Strengths Weaknesses, Opportunities and Threats framework and coded into themes for analysis. After the analysis, the authors prioritized potential solutions for improving research engagement. Strengths and opportunities remained constant through trial phases, disease burdens, and interventions. Threats included alienation, litigation, disparity, and shaming. Poor management and barriers to inclusion were identified as weaknesses. Opportunities included improving resource management and information quality. Barriers were minimized when relationships between staff and participants were inclusive, respectful, tolerant, and open to change. Participants' communications

Perinatal mortality and socio-spatial inequalities

Directory of Open Access Journals (Sweden)

Eunice Francisca Martins

2013-09-01

Full Text Available OBJECTIVE: to analyze the social inequalities in the distribution of perinatal mortality in Belo Horizonte. MATERIAL AND METHODS: the perinatal deaths of residents in Belo Horizonte in the period 2003 to 2007 were studied on the basis of the Information Systems on Mortality and Newborns. The space analysis and the Health Vulnerability Index were used to identify existing inequalities in the sanitary districts regarding coverage and risk, determined by the Odds Ratio and a value p<0.05. The multivariate analysis was used to describe a model for perinatal mortality. RESULTS: there was a proved variation in the numbers of perinatal mortality per one thousand total births in the sanitary districts (12.5 to 19.4, coverage areas (5.3 to 49.4 and areas of risk (13.2 to 20.7. The mortality rate diminished as the maternal schooling increased. The death rates deriving from asphyxia/hypoxia and non-specified fetal death grew with the increase of risk in the area. CONCLUSION: it was verified that the perinatal deaths are distributed in a differentiated form in relation to the space and the social vulnerabilities. The confrontation of this complex problem requires the establishment of intersecting partnerships.

Open source platform for collaborative construction of wearable sensor datasets for human motion analysis and an application for gait analysis.

Science.gov (United States)

Llamas, César; González, Manuel A; Hernández, Carmen; Vegas, Jesús

2016-10-01

Nearly every practical improvement in modeling human motion is well founded in a properly designed collection of data or datasets. These datasets must be made publicly available for the community could validate and accept them. It is reasonable to concede that a collective, guided enterprise could serve to devise solid and substantial datasets, as a result of a collaborative effort, in the same sense as the open software community does. In this way datasets could be complemented, extended and expanded in size with, for example, more individuals, samples and human actions. For this to be possible some commitments must be made by the collaborators, being one of them sharing the same data acquisition platform. In this paper, we offer an affordable open source hardware and software platform based on inertial wearable sensors in a way that several groups could cooperate in the construction of datasets through common software suitable for collaboration. Some experimental results about the throughput of the overall system are reported showing the feasibility of acquiring data from up to 6 sensors with a sampling frequency no less than 118Hz. Also, a proof-of-concept dataset is provided comprising sampled data from 12 subjects suitable for gait analysis. Copyright © 2016 Elsevier Inc. All rights reserved.

Bibliometric Analysis of Female Authorship Trends and Collaboration Dynamics Over JBMR's 30-Year History.

Science.gov (United States)

Wininger, Austin E; Fischer, James P; Likine, Elive F; Gudeman, Andrew S; Brinker, Alexander R; Ryu, Jonathan; Maupin, Kevin A; Lunsford, Shatoria; Whipple, Elizabeth C; Loder, Randall T; Kacena, Melissa A

2017-12-01

In academia, authorship is considered a currency and is important for career advancement. As the Journal of Bone and Mineral Research (JBMR) is the highest-ranked journal in the field of bone, muscle, and mineral metabolism and is the official publication of the American Society for Bone and Mineral Research, we sought to examine authorship changes over JBMR's 30-year history. Two bibliometric methods were used to collect the data. The "decade method" included all published manuscripts throughout 1 year in each decade over the past 30 years starting with the inaugural year, yielding 746 manuscripts for analysis. The "random method" examined 10% of published manuscripts from each of the 30 years, yielding 652 manuscripts for analysis. Using both methods, the average number of authors per manuscript, numerical location of the corresponding author, number of collaborating institutions, number of collaborating countries, number of printed manuscript pages, and the number of times each manuscript was cited all significantly increased between 1986 and 2015 (p authorship trends over the past 30 years and demonstrate those countries having the most changes and where challenges still exist. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

Human Centered Hardware Modeling and Collaboration

Science.gov (United States)

Stambolian Damon; Lawrence, Brad; Stelges, Katrine; Henderson, Gena

2013-01-01

In order to collaborate engineering designs among NASA Centers and customers, to in clude hardware and human activities from multiple remote locations, live human-centered modeling and collaboration across several sites has been successfully facilitated by Kennedy Space Center. The focus of this paper includes innovative a pproaches to engineering design analyses and training, along with research being conducted to apply new technologies for tracking, immersing, and evaluating humans as well as rocket, vehic le, component, or faci lity hardware utilizing high resolution cameras, motion tracking, ergonomic analysis, biomedical monitoring, wor k instruction integration, head-mounted displays, and other innovative human-system integration modeling, simulation, and collaboration applications.

Bibliometric Analysis of International Collaboration in Wind and Solar Energy

Directory of Open Access Journals (Sweden)

Ichiro Sakata

2013-09-01

Full Text Available Modern technology is increasingly complex and demands an ever-widening range of knowledge and skills. No single country will possess all the knowledge and skills required for addressing global issues such as climate change. Technology collaboration between leading countries is important to promptly and efficiently address the problem. Previous studies have shown that a high level of collaboration is correlated with high paper productivity. This paper first aims to use objective data and create maps that enable us to see both the distribution of worldwide research competency and the relationship of international collaboration in clean energy research. In the international research network of wind power and solar cell, 4,189 institutions located in 121 countries and 6,600 institutions located in 125 countries are included respectively. This paper discusses various factors that would have an impact on research capability and support strong international relationships. With respect to research capability, governmental policies, stability of governmental commitment, natural conditions and historical and institutional differences have a significant impact on it. For research collaborations, factors such as geographical proximity, international science and technology policy, and developmental stage of technology have been brought to attention. This study demonstrates that bibliometrics is a methodology that is capable of providing a knowledge base that is useful in the development of the international science and technology policy and technological management strategy.

Associations of ikigai as a positive psychological factor with all-cause mortality and cause-specific mortality among middle-aged and elderly Japanese people: findings from the Japan Collaborative Cohort Study.

Science.gov (United States)

Tanno, Kozo; Sakata, Kiyomi; Ohsawa, Masaki; Onoda, Toshiyuki; Itai, Kazuyoshi; Yaegashi, Yumi; Tamakoshi, Akiko

2009-07-01

To determine whether presence of ikigai as a positive psychological factor is associated with decreased risks for all-cause and cause-specific mortality among middle-aged and elderly Japanese men and women. From 1988 to 1990, a total of 30,155 men and 43,117 women aged 40 to 79 years completed a lifestyle questionnaire including a question about ikigai. Mortality follow-up was available for a mean of 12.5 years and was classified as having occurred in the first 5 years or the subsequent follow-up period. Associations between ikigai and all-cause and cause-specific mortality were assessed using a Cox's regression model. Multivariate hazard ratios (HRs) were adjusted for age, body mass index, drinking and smoking status, physical activity, sleep duration, education, occupation, marital status, perceived mental stress, and medical history. During the follow-up period, 10,021 deaths were recorded. Men and women with ikigai had decreased risks of mortality from all causes in the long-term follow-up period; multivariate HRs (95% confidence intervals, CIs) were 0.85 (0.80-0.90) for men and 0.93 (0.86-1.00) for women. The risk of cardiovascular mortality was reduced in men with ikigai; the multivariate HR (95% CI) was 0.86 (0.76-0.97). Furthermore, men and women with ikigai had a decreased risk for mortality from external causes; multivariate HRs (95% CIs) were 0.74 (0.59-0.93) for men and 0.67 (0.51-0.88) for women. The findings suggest that a positive psychological factor such as ikigai is associated with longevity among Japanese people.

Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis

Directory of Open Access Journals (Sweden)

Fabiano Timbó Barbosa

2016-04-01

Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Neuraxial anesthesia (NA has been used in association with general anesthesia (GA for coronary artery bypass; however, anticoagulation during surgery makes us question the viability of benefits by the risk of epidural hematoma. The aim of this study was to perform a meta-analyzes examining the efficacy of NA associated with GA compared to GA alone for coronary artery bypass on mortality reduction. METHODS: Mortality, arrhythmias, cerebrovascular accident (CVA, myocardial infarction (MI, length of hospital stay (LHS, length of ICU stay (ICUS, reoperations, blood transfusion (BT, quality of life, satisfaction degree, and postoperative cognitive dysfunction were analyzed. The weighted mean difference (MD was estimated for continuous variables, and relative risk (RR and risk difference (RD for categorical variables. RESULTS: 17 original articles analyzed. Meta-analysis of mortality (RD = -0.01, 95% CI = -0.03 to 0.01, CVA (RR = 0.79, 95% CI = 0.32-1.95, MI (RR = 0.96, 95% CI = 0.52-1.79 and LHS (MD = -1.94, 95% CI = -3.99 to 0.12 were not statistically significant. Arrhythmia was less frequent with NA (RR = 0.68, 95% CI = 0.50-0.93. ICUS was lower in NA (MD = -2.09, 95% CI = -2.92 to -1.26. CONCLUSION: There was no significant difference in mortality. Combined NA and GA showed lower incidence of arrhythmias and lower ICUS.

Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis.

Science.gov (United States)

Ding, Zan; Guo, Pi; Xie, Fang; Chu, Huifang; Li, Kun; Pu, Jingbo; Pang, Shaojie; Dong, Hongli; Liu, Yahui; Pi, Fuhua; Zhang, Qingying

2015-09-01

Diurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007-2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China. Poisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for daily mean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends. The cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 °C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0-21 days was 1.03 (95% confidence interval: 0.95-1.11) and 1.33 (0.94-1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age <75 years than females and age ≥75 years. The effect of DTR on mortality was non-linear, with high DTR associated with increased mortality. A DTR of 16 °C may be a cut-off point for mortality prognosis and has implications for developing intervention strategies to address high DTR exposure. Copyright © 2015 Elsevier B.V. All rights reserved.

Mortality Analysis of Trauma Patients in General Intensive Care Unit of a State Hospital

Directory of Open Access Journals (Sweden)

İskender Kara

2015-08-01

Full Text Available Objective: The aim of this study was to determine the mortality rate and factors affecting the mortality of trauma patients in general intensive care unit (ICU of a state hospital. Material and Method: Data of trauma patients hospitalized between January 2012 and March 2013 in ICU of Konya Numune Hospital were retrospectively analyzed. Demographic characteristics and clinical data of patients were recorded. Patients were divided into two groups as survivors and dead. Mortality rate and factors affectin mortality were examined. Results: A total of 108 trauma patients were included in the study. The mortality rate of overall group was 19.4%. Median age of the patients was 44.5 years and 75.9% of them were males. Median Glasgow Coma Scale of death group was lower (5 (3-8 vs. 15 (13-15, p<0.0001, median APACHE II score was higher (20 (15-26 vs. 10 (8-13, p<0.0001 and median duration of ICU stay was longer (27 (5-62,5 vs. 2 (1-5, p<0.0001 than those in the survival group. The most common etiology of trauma was traffic accidents (47.2% and 52.7% of patients had head trauma. The rate of patients with any fracture was significantly higher in the survival group (66.7% vs. 33.3%, p=0.007. The rate of erythrocyte suspension, fresh frozen plasma, trombocyte suspension and albumin were 38.9%, 27.8%, 0.9% and 8.3%, respectively in all group. The number of patients invasive mechanically ventilated was 27.8% and median length of stay of these patients were 5 (1.75-33.5 days. The rate of operated patients was 42.6%. The rate of tracheostomy, renal replacement therapy, bronchoscopy and percutaneous endoscopic gastrostomy enforcements were higher in the death group. The advanced age (p=0.016, OR: 1.054; 95% CI: 1.010-1100 and low GCS (p<0.0001, OR: 0.583; 95% CI: 0.456-0.745 were found to be independent risk factors the ICU mortality of trauma patients in logistic regression analysis. Conclusion: We believe that the determination of these risk factors affecting

A Web-Based Development Environment for Collaborative Data Analysis

International Nuclear Information System (INIS)

Erdmann, M; Fischer, R; Glaser, C; Klingebiel, D; Müller, G; Rieger, M; Urban, M; Winchen, T; Komm, M; Steggemann, J

2014-01-01

Visual Physics Analysis (VISPA) is a web-based development environment addressing high energy and astroparticle physics. It covers the entire analysis spectrum from the design and validation phase to the execution of analyses and the visualization of results. VISPA provides a graphical steering of the analysis flow, which consists of self-written, re-usable Python and C++ modules for more demanding tasks. All common operating systems are supported since a standard internet browser is the only software requirement for users. Even access via mobile and touch-compatible devices is possible. In this contribution, we present the most recent developments of our web application concerning technical, state-of-the-art approaches as well as practical experiences. One of the key features is the use of workspaces, i.e. user-configurable connections to remote machines supplying resources and local file access. Thereby, workspaces enable the management of data, computing resources (e.g. remote clusters or computing grids), and additional software either centralized or individually. We further report on the results of an application with more than 100 third-year students using VISPA for their regular particle physics exercises during the winter term 2012/13. Besides the ambition to support and simplify the development cycle of physics analyses, new use cases such as fast, location-independent status queries, the validation of results, and the ability to share analyses within worldwide collaborations with a single click become conceivable

A Web-Based Development Environment for Collaborative Data Analysis

Science.gov (United States)

Erdmann, M.; Fischer, R.; Glaser, C.; Klingebiel, D.; Komm, M.; Müller, G.; Rieger, M.; Steggemann, J.; Urban, M.; Winchen, T.

2014-06-01

Visual Physics Analysis (VISPA) is a web-based development environment addressing high energy and astroparticle physics. It covers the entire analysis spectrum from the design and validation phase to the execution of analyses and the visualization of results. VISPA provides a graphical steering of the analysis flow, which consists of self-written, re-usable Python and C++ modules for more demanding tasks. All common operating systems are supported since a standard internet browser is the only software requirement for users. Even access via mobile and touch-compatible devices is possible. In this contribution, we present the most recent developments of our web application concerning technical, state-of-the-art approaches as well as practical experiences. One of the key features is the use of workspaces, i.e. user-configurable connections to remote machines supplying resources and local file access. Thereby, workspaces enable the management of data, computing resources (e.g. remote clusters or computing grids), and additional software either centralized or individually. We further report on the results of an application with more than 100 third-year students using VISPA for their regular particle physics exercises during the winter term 2012/13. Besides the ambition to support and simplify the development cycle of physics analyses, new use cases such as fast, location-independent status queries, the validation of results, and the ability to share analyses within worldwide collaborations with a single click become conceivable.

Collaborative Economy

DEFF Research Database (Denmark)

collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... and similar phenomena are among these collective innovations in tourism that are shaking the very bedrock of an industrial system that has been traditionally sustained along commercial value chains. To date there has been very little investigation of these trends, which have been inspired by, amongst other...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...

Viral infections, neonatal mortality and the mystery of the Athenian Agora: An interview with Professor of Anthropology Maria Liston.

Science.gov (United States)

Mammas, Ioannis N; Spandidos, Demetrios A

2017-10-01

Although excavated almost 80 years ago, the infants' 'bone well' of the Athenian Agora in Athens, Greece and its contents were never thoroughly evaluated and published, until only recently, when a re-analysis of the whole excavation findings was performed. The well dates back to the third quarter of the 2nd century BC and contained at least 449 infants. The project, which explored the causes of neonatal mortality, found that one-third of infants' deaths were attributed to neonatal meningitis, based on the presence of bone disposition on the endocranial surface of the studied skulls. Despite the non-specific differential diagnostic approach of this pathophysiological finding in neonates, the determination of the causes of neonatal mortality in the Athenian Agora is really an impressive scientific attempt and can be a valuable lesson to all neonatal and peadiatric health professionals. According to Professor Maria Liston, Associate Professor of Anthropology at the University of Waterloo in Canada, who was the principal investigator of the skeletons from the infants' 'bone well' of the Athenian Agora, neonatal meningitis was the most frequently detected cause of neonatal mortality. Viral diseases unquestionably contributed to neonatal mortality, she adds and highlights that further research is required in collaboration with physicians for the better understanding and interpretation of various archaeological findings related to neonatal mortality. In the context of the 3rd Workshop on Paediatric Virology, which will be held in October 7th, 2017 in Athens, Greece, Professor Liston will reveal the role of neonatal and paediatric viral infections in the Hellenic antiquity.

International collaboration in medical radiation science.

Science.gov (United States)

Denham, Gary; Allen, Carla; Platt, Jane

2016-06-01

International collaboration is recognised for enhancing the ability to approach complex problems from a variety of perspectives, increasing development of a wider range of research skills and techniques and improving publication and acceptance rates. The aim of this paper is to describe the current status of international collaboration in medical radiation science and compare this to other allied health occupations. This study utilised a content analysis approach where co-authorship of a journal article was used as a proxy for research collaboration and the papers were assigned to countries based on the corporate address given in the by-line of the publication. A convenience sample method was employed and articles published in the professional medical radiation science journals in the countries represented within our research team - Australia, the United Kingdom (UK) and the United States of America (USA) were sampled. Physiotherapy, speech pathology, occupational therapy and nursing were chosen for comparison. Rates of international collaboration in medical radiation science journals from Australia, the UK and the USA have steadily increased over the 3-year period sampled. Medical radiation science demonstrated lower average rates of international collaboration than the other allied health occupations sampled. The average rate of international collaboration in nursing was far below that of the allied health occupations sampled. Overall, the UK had the highest average rate of international collaboration, followed by Australia and the USA, the lowest. Overall, medical radiation science is lagging in international collaboration in comparison to other allied health fields.

Handbook of Collaborative Management Research

CERN Document Server

Shani, A B Rami B; Pasmore, William A A; Stymne, Dr Bengt; Adler, Niclas

2007-01-01

This handbook provides the latest thinking, methodologies and cases in the rapidly growing area of collaborative management research. What makes collaborative management research different is its emphasis on creating a close partnership between scholars and practitioners in the search for knowledge concerning organizations and complex systems. In the ideal situation, scholars and their managerial partners would work together to define the research focus, develop the methods to be used for data collection, participate equally in the analysis of data, and work together in the application and dis

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

Directory of Open Access Journals (Sweden)

Joshua Kembo

2009-10-01

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

Collaborative information seeking

DEFF Research Database (Denmark)

Hertzum, Morten

2008-01-01

Since common ground is pivotal to collaboration, this paper proposes to define collaborative information seeking as the combined activity of information seeking and collaborative grounding. While information-seeking activities are necessary for collaborating actors to acquire new information......, the activities involved in information seeking are often performed by varying subgroups of actors. Consequently, collaborative grounding is necessary to share information among collaborating actors and, thereby, establish and maintain the common ground necessary for their collaborative work. By focusing...... on the collaborative level, collaborative information seeking aims to avoid both individual reductionism and group reductionism, while at the same time recognizing that only some information and understanding need be shared....

Part 5. Public health and air pollution in Asia (PAPA): a combined analysis of four studies of air pollution and mortality.

Science.gov (United States)

Wong, C M; Vichit-Vadakan, N; Vajanapoom, N; Ostro, B; Thach, T Q; Chau, P Y K; Chan, E K P; Chung, R Y N; Ou, C Q; Yang, L; Peiris, J S M; Thomas, G N; Lam, T H; Wong, T W; Hedley, A J; Kan, H; Chen, B; Zhao, N; London, S J; Song, G; Chen, G; Zhang, Y; Jiang, L; Qian, Z; He, Q; Lin, H M; Kong, L; Zhou, D; Liang, S; Zhu, Z; Liao, D; Liu, W; Bentley, C M; Dan, J; Wang, B; Yang, N; Xu, S; Gong, J; Wei, H; Sun, H; Qin, Z

2010-11-01

In recent years, Asia has experienced rapid economic growth and a deteriorating environment caused by the increasing use of fossil fuels. Although the deleterious effects of air pollution from fossil-fuel combustion have been demonstrated in many Western nations, few comparable studies have been conducted in Asia. Time-series studies of daily mortality in Asian cities can contribute important new information to the existing body of knowledge about air pollution and health. Not only can these studies verify important health effects of air pollution in local regions in Asia, they can also help determine the relevance of existing air pollution studies to mortality and morbidity for policymaking and environmental controls. In addition, the studies can help identify factors that might modify associations between air pollution and health effects in various populations and environmental conditions. Collaborative multicity studies in Asia-especially when designed, conducted, and analyzed using a common protocol-will provide more robust air pollution effect estimates for the region as well as relevant, supportable estimates of local adverse health effects needed by environmental and public-health policymakers. The Public Health and Air Pollution in Asia (PAPA*) project, sponsored by the Health Effects Institute, consisted of four studies designed to assess the effects of air pollution on mortality in four large Asian cities, namely Bangkok, in Thailand, and Hong Kong, Shanghai, and Wuhan, in China. In the PAPA project, a Common Protocol was developed based on methods developed and tested in NMMAPS, APHEA, and time-series studies in the literature to help ensure that the four studies could be compared with each other and with previous studies by following an established protocol. The Common Protocol (found at the end of this volume) is a set of prescriptive instructions developed for the studies and used by the investigators in each city. It is flexible enough to allow for

Long-term effects of flooding on mortality in England and Wales, 1994-2005: controlled interrupted time-series analysis

Science.gov (United States)

2011-01-01

Background Limited evidence suggests that being flooded may increase mortality and morbidity among affected householders not just at the time of the flood but for months afterwards. The objective of this study is to explore the methods for quantifying such long-term health effects of flooding by analysis of routine mortality registrations in England and Wales. Methods Mortality data, geo-referenced by postcode of residence, were linked to a national database of flood events for 1994 to 2005. The ratio of mortality in the post-flood year to that in the pre-flood year within flooded postcodes was compared with that in non-flooded boundary areas (within 5 km of a flood). Further analyses compared the observed number of flood-area deaths in the year after flooding with the number expected from analysis of mortality trends stratified by region, age-group, sex, deprivation group and urban-rural status. Results Among the 319 recorded floods, there were 771 deaths in the year before flooding and 693 deaths in the year after (post-/pre-flood ratio of 0.90, 95% CI 0.82, 1.00). This ratio did not vary substantially by age, sex, population density or deprivation. A similar post-flood 'deficit' of deaths was suggested by the analyses based on observed/expected deaths. Conclusions The observed post-flood 'deficit' of deaths is counter-intuitive and difficult to interpret because of the possible influence of population displacement caused by flooding. The bias that might arise from such displacement remains unquantified but has important implications for future studies that use place of residence as a marker of exposure. PMID:21288358

Long-term effects of flooding on mortality in England and Wales, 1994-2005: controlled interrupted time-series analysis

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Leonardi Giovanni

2011-02-01

Full Text Available Abstract Background Limited evidence suggests that being flooded may increase mortality and morbidity among affected householders not just at the time of the flood but for months afterwards. The objective of this study is to explore the methods for quantifying such long-term health effects of flooding by analysis of routine mortality registrations in England and Wales. Methods Mortality data, geo-referenced by postcode of residence, were linked to a national database of flood events for 1994 to 2005. The ratio of mortality in the post-flood year to that in the pre-flood year within flooded postcodes was compared with that in non-flooded boundary areas (within 5 km of a flood. Further analyses compared the observed number of flood-area deaths in the year after flooding with the number expected from analysis of mortality trends stratified by region, age-group, sex, deprivation group and urban-rural status. Results Among the 319 recorded floods, there were 771 deaths in the year before flooding and 693 deaths in the year after (post-/pre-flood ratio of 0.90, 95% CI 0.82, 1.00. This ratio did not vary substantially by age, sex, population density or deprivation. A similar post-flood 'deficit' of deaths was suggested by the analyses based on observed/expected deaths. Conclusions The observed post-flood 'deficit' of deaths is counter-intuitive and difficult to interpret because of the possible influence of population displacement caused by flooding. The bias that might arise from such displacement remains unquantified but has important implications for future studies that use place of residence as a marker of exposure.

[Trends in the mortality of liver cancer in Qidong, China: an analysis of fifty years].

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Chen, Jian-guo; Zhu, Jian; Zhang, Yong-hui; Chen, Yong-sheng; Ding, Lu-lu; Lu, Jian-hua; Zhu, Yuan-rong

2012-07-01

.84%, respectively. The age-specific mortality rates by period showed a decreasing trend for those under age of 44. Moreover, age-birth cohort analysis showed a more rapid lowering mortality in the age groups 35-, 30-, 25-, and 15-, that is, those born after 1950's. Liver cancer remains the leading death cause due to cancers in Qidong, with a continuing higher crude mortality rate. Yet the age-standardized mortality rate has presented a declining posture. The liver cancer mortality in young people in Qidong demonstrates a continuously falling trend. The campaign for the control of liver cancer in Qidong has achieved initial success.

Pioglitazone and cause-specific risk of mortality in patients with type 2 diabetes: extended analysis from a European multidatabase cohort study.

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Strongman, Helen; Christopher, Solomon; Majak, Maila; Williams, Rachael; Bahmanyar, Shahram; Linder, Marie; Heintjes, Edith M; Bennett, Dimitri; Korhonen, Pasi; Hoti, Fabian

2018-01-01

Describe and compare the risk of cardiovascular and non-cardiovascular mortality in patients whose antidiabetic therapy is modified to include pioglitazone compared with an alternative antidiabetic medication at the same stage of disease progression. This exploratory linked database cohort analysis used pooled health and mortality data from three European countries: Finland, Sweden and the UK. Propensity score together with exact matching was used to match 31 133 patients with type 2 diabetes first prescribed pioglitazone from 2000 to 2011, to 31 133 patients never prescribed pioglitazone. Exact matching variables were treatment stage, history of diabetes, diabetes complications and cardiovascular disease, and year of cohort entry. Mean follow-up time was 2.60 (SD 2.00) and 2.69 (SD 2.31) years in the pioglitazone and non-pioglitazone-exposed groups, respectively. Crude cause-specific mortality rates were ascertained. Association with pioglitazone use was estimated using Cox proportional hazards models adjusted a priori for country, age, sex, the propensity score quintile and time-dependent variables representing use of antidiabetic drugs. Stepwise testing identified no additional confounders to include in adjusted models. The crude mortality rate was lower in the pioglitazone-exposed group than the non-exposed group for both cardiovascular and non-cardiovascular mortality. Adjusted HRs comparing pioglitazone to alternative antidiabetic exposure were 0.58 (95% CI 0.52 to 0.63) and 0.63 (95% CI 0.58 to 0.68) for cardiovascular and non-cardiovascular mortality, respectively. A protective effect associated with pioglitazone was also found for all specific cardiovascular causes. This analysis suggests that pioglitazone is associated with a decrease in both cardiovascular and non-cardiovascular mortality. Results should be interpreted with caution due to the potential for residual confounding in this exploratory analysis. Further studies, specifically designed to test

Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis.

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Grosso, Giuseppe; Micek, Agnieszka; Godos, Justyna; Sciacca, Salvatore; Pajak, Andrzej; Martínez-González, Miguel A; Giovannucci, Edward L; Galvano, Fabio

2016-12-01

Coffee consumption has been associated with several benefits toward human health. However, its association with mortality risk has yielded contrasting results, including a non-linear relation to all-cause and cardiovascular disease (CVD) mortality and no association with cancer mortality. As smoking habits may affect the association between coffee and health outcomes, the aim of the present study was to update the latest dose-response meta-analysis of prospective cohort studies on the association between coffee consumption and mortality risk and conduct stratified analyses by smoking status and other potential confounders. A systematic search was conducted in electronic databases to identify relevant studies, risk estimates were retrieved from the studies, and dose-response analysis was modeled by using restricted cubic splines. A total of 31 studies comprising 1610,543 individuals and 183,991 cases of all-cause, 34,574 of CVD, and 40,991 of cancer deaths were selected. Analysis showed decreased all-cause [relative risk (RR) = 0.86, 95 % confidence interval (CI) = 0.82, 0.89)] and CVD mortality risk (RR = 0.85, 95 % CI = 0.77, 0.93) for consumption of up to 4 cups/day of coffee, while higher intakes were associated with no further lower risk. When analyses were restricted only to non-smokers, a linear decreased risk of all-cause (RR = 0.94, 95 % CI = 0.93, 0.96), CVD (RR = 0.94, 95 % CI = 0.91, 0.97), and cancer mortality (RR = 0.98, 95 % CI = 0.96, 1.00) for 1 cup/day increase was found. The search for other potential confounders, including dose-response analyses in subgroups by gender, geographical area, year of publication, and type of coffee, showed no relevant differences between strata. In conclusion, coffee consumption is associated with decreased risk of mortality from all-cause, CVD, and cancer; however, smoking modifies the observed risk when studying the role of coffee on human health.

Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis

International Nuclear Information System (INIS)

Grosso, Giuseppe; Micek, Agnieszka; Godos, Justyna; Sciacca, Salvatore; Pajak, Andrzej; Martínez-González, Miguel A.; Giovannucci, Edward L.; Galvano, Fabio

2016-01-01

Coffee consumption has been associated with several benefits toward human health. However, its association with mortality risk has yielded contrasting results, including a non-linear relation to all-cause and cardiovascular disease (CVD) mortality and no association with cancer mortality. As smoking habits may affect the association between coffee and health outcomes, the aim of the present study was to update the latest dose-response meta-analysis of prospective cohort studies on the association between coffee consumption and mortality risk and conduct stratified analyses by smoking status and other potential confounders. A systematic search was conducted in electronic databases to identify relevant studies, risk estimates were retrieved from the studies, and dose-response analysis was modeled by using restricted cubic splines. A total of 31 studies comprising 1610,543 individuals and 183,991 cases of all-cause, 34,574 of CVD, and 40,991 of cancer deaths were selected. Analysis showed decreased all-cause [relative risk (RR) = 0.86, 95 % confidence interval (CI) = 0.82, 0.89)] and CVD mortality risk (RR = 0.85, 95 % CI = 0.77, 0.93) for consumption of up to 4 cups/day of coffee, while higher intakes were associated with no further lower risk. When analyses were restricted only to non-smokers, a linear decreased risk of all-cause (RR = 0.94, 95 % CI = 0.93, 0.96), CVD (RR = 0.94, 95 % CI = 0.91, 0.97), and cancer mortality (RR = 0.98, 95 % CI = 0.96, 1.00) for 1 cup/day increase was found. The search for other potential confounders, including dose-response analyses in subgroups by gender, geographical area, year of publication, and type of coffee, showed no relevant differences between strata. In conclusion, coffee consumption is associated with decreased risk of mortality from all-cause, CVD, and cancer; however, smoking modifies the observed risk when studying the role of coffee on human health.

KNOWLEDGE MANAGEMENT AND COLLABORATION EFFECTS: SOUTH-SOUTH NGO COLLABORATION: A CASE STUDY ON THE BRAZILIAN INTERDISCIPLINARY AIDS ASSOCIATION

Directory of Open Access Journals (Sweden)

Grace Keeney

2012-06-01

Full Text Available In June 2008, the Brazilian Interdisciplinary AIDS Association (ABIA and the Indian NGO SAHARA submitted a joint pre-grant opposition to the patent application of Tenofovir Disoproxil Fumarate in India. This joint action provides a pertinent case model of the potential effects of South-South cooperation between civil society groups. In this study, the aim sought to determine the practicality of the methodology and propositions developed in Resources, Knowledge and Influence: the Organizational Effects of Interorganizational Collaboration (Hardy et al., 2003 in predicting the types of collaboration effects that would result from the degree of “involvement” and “embeddedness” of a collaboration. Data collection came from archival research, participant observation research and interviews. Research tasks included an investigation on South-South Cooperation in the area of IP rights and AIDS, compiling an SLR on knowledge management and collaboration theories, creating a chronology of the collaboration and application of aforementioned methodology. Application included (1 implementation of codification methodology based on “involvement” and “embeddedness” and (2 identification of types of effects in collaboration - strategic, knowledge creation or political. During data analysis, these effects were compared with the aims of collaboration. Results were then tested against propositions (Hardy et al., 2003 of the relationship between involvement and embeddedness and the collaborative effects. Findings support three propositions: (1 Collaborations with high levels of involvement will be positively associated with the acquisition of distinctive resources, (2 Collaborations with high levels of involvement and high levels of embeddedness will be positively associated with the creation of knowledge, (3 Collaborations that are highly embedded will be positively associated with an increase of influence.

Serbia within the European context: An analysis of premature mortality.

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Santric Milicevic, Milena; Bjegovic, Vesna; Terzic, Zorica; Vukovic, Dejana; Kocev, Nikola; Marinkovic, Jelena; Vasic, Vladimir

2009-08-05

Based on the global predictions majority of deaths will be collectively caused by cancer, cardiovascular diseases, and traffic accidents over the coming 25 years. In planning future national health policy actions, inter - regional assessments play an important role. The purpose of the study was to analyze similarities and differences in premature mortality between Serbia, EURO A, EURO B, and EURO C regions in 2000. Mortality and premature mortality patterns were analysed according to cause of death, by gender and seven age intervals. The study results are presented in relative (%) and absolute terms (age-specific and age-standardized death rates per 100,000 population, and age-standardized rates of years of life lost - YLL per 1,000). Direct standardization of rates was undertaken using the standard population of Europe. The inter-regional comparison was based on a calculation of differences in YLL structures and with a ratio of age-standardized YLL rates per 1,000. A multivariate generalized linear model was used to explore mortality of Serbia and Europe sub-regions with ln age-specific death rates. The dissimilarity was achieved with a p financial and human resources incorporated in the prevention of disease and injury burden.

Technology-mediated collaborative learning: theoretical contributions based on analysis of educational practice

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Sonia CASILLAS MARTÍN

2017-12-01

Full Text Available Collaborative learning has been a subject of great interest in the context of educational research, giving rise to many studies emphasizing the potential of the collaboration process in student learning, knowledge building, the development of diverse abilities and improved academic performance. Based on a conceptual review and thorough reflection on this topic, this article presents the results of a case study carried out in different schools in the Autonomous Community of Castile y Leon (Spain in an attempt to identify patterns of common action through the implementation of collaborative learning methods mediated by information and communication technologies (ICT. Among the many outcomes of this study, we conclude by highlighting the need to plan collaborative work very carefully, taking advantage of the opportunities offered by ICT as communicative environments where it is possible to construct joint and shared learning. 

Collaboratively Constructed Contradictory Accounts

DEFF Research Database (Denmark)

Tunby Gulbrandsen, Ib; Just, Sine Nørholm

2013-01-01

Based on a mixed-method case study of online communication about the Danish pharmaceutical company Novo Nordisk, this article argues that online communication plays out as a centrifugal narration process with centripetal consequences. Through a content analysis of communication about Novo Nordisk...... the theoretical and methodological implications of the empirical findings. It is argued that although the findings are not in themselves surprising, they adequately reflect that online meaning formation is, indeed, a collaborative process in which centrifugal forces have centripetal consequences. Furthermore......, the findings suggest that the chosen mixed-method case study successfully navigates the dilemma of studying online collaborative processes through the traces they leave behind....

The PACA Project : Pro-Am Collaborative Astronomy

Science.gov (United States)

Yanamandra-Fisher, P. A.

2014-04-01

The Pro-Am Collaborative Astronomy (PACA) project is the next stage of evolution of the paradigm developed for the observational campaign of C/2012 S1 or C/ISON. Four different phases of collaboration are identified, and illustrate the integration of scientific investigations with amateur astronomer community via observations, and models; and the rapid dissemination of the results via a multitude of social media for rapid global access. The success of the paradigm shift in scientific research is now implemented in other comet observing campaigns. Both communities (scientific and amateur astronomers) benefit from these collective, collaborative partnerships; while outreach is the instantaneous deliverable that provides both a framework for future data analyses and the dissemination of the results. While PACA identifies a collaborative approach to pro-am collaborations, given the volume of data generated for each campaign, new ways of rapid data analysis, mining access and storage are needed.

Cohort Profile: Antiretroviral Therapy Cohort Collaboration (ART-CC)

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May, Margaret T; Ingle, Suzanne M; Costagliola, Dominique; Justice, Amy C; de Wolf, Frank; Cavassini, Matthias; D’Arminio Monforte, Antonella; Casabona, Jordi; Hogg, Robert S; Mocroft, Amanda; Lampe, Fiona C; Dabis, François; Fätkenheuer, Gerd; Sterling, Timothy R; del Amo, Julia; Gill, M John; Crane, Heidi M; Saag, Michael S; Guest, Jodie; Brodt, Hans-Reinhard; Sterne, Jonathan AC

2014-01-01

The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70 000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org). PMID:23599235

Effects of economic downturns on child mortality: a global economic analysis, 1981-2010.

Science.gov (United States)

Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Zeltner, Thomas; Raine, Rosalind; Atun, Rifat

2017-01-01

To analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels. Retrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation. Global. 204 countries between 1981 and 2010. Child mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors. 197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0-21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1-5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001). Economic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries.

Daily sitting time and all-cause mortality: a meta-analysis.

Directory of Open Access Journals (Sweden)

Josephine Y Chau

Full Text Available To quantify the association between daily total sitting and all-cause mortality risk and to examine dose-response relationships with and without adjustment for moderate-to-vigorous physical activity.Studies published from 1989 to January 2013 were identified via searches of multiple databases, reference lists of systematic reviews on sitting and health, and from authors' personal literature databases. We included prospective cohort studies that had total daily sitting time as a quantitative exposure variable, all-cause mortality as the outcome and reported estimates of relative risk, or odds ratios or hazard ratios with 95% confidence intervals. Two authors independently extracted the data and summary estimates of associations were computed using random effects models.Six studies were included, involving data from 595,086 adults and 29,162 deaths over 3,565,569 person-years of follow-up. Study participants were mainly female, middle-aged or older adults from high-income countries; mean study quality score was 12/15 points. Associations between daily total sitting time and all-cause mortality were not linear. With physical activity adjustment, the spline model of best fit had dose-response HRs of 1.00 (95% CI: 0.98-1.03, 1.02 (95% CI: 0.99-1.05 and 1.05 (95% CI: 1.02-1.08 for every 1-hour increase in sitting time in intervals between 0-3, >3-7 and >7 h/day total sitting, respectively. This model estimated a 34% higher mortality risk for adults sitting 10 h/day, after taking physical activity into account. The overall weighted population attributable fraction for all-cause mortality for total daily sitting time was 5.9%, after adjusting for physical activity.Higher amounts of daily total sitting time are associated with greater risk of all-cause mortality and moderate-to-vigorous physical activity appears to attenuate the hazardous association. These findings provide a starting point for identifying a threshold on which to base clinical and public

Evaluation of effective factors on low birth weight neonates' mortality using path analysis

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Babaee Gh

2008-06-01

Full Text Available Background: This study have conducted in order to determine of direct or indirect effective factors on mortality of neonates with low birth weight by path analysis.Methods: In this cohort study 445 paired mothers and their neonates were participated in Tehran city. The data were gathered through an answer sheet contain mother age, gestational age, apgar score, pregnancy induced hypertension (PIH and birth weight. Sampling was convenience and neonates of women were included in this study who were referred to 15 government and private hospitals in Tehran city. Live being status of neonates was determined until 24 hours after delivery.Results: The most changes in mortality rate is related to birth weight and its negative score means that increasing in weight leads to increase chance of live being. Second score is related to apgar sore and its negative score means that increasing in apgar score leads to decrease chance of neonate death. Third score is gestational age and its negative score means that increasing in weight leads to increase chance of live being. The less changes in mortality rate is due to hypertensive disorders in pregnancy.Conclusion: The methodology has been used could be adopted in other investigations to distinguish and measuring effect of predictive factors on the risk of an outcome.

Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies.

Science.gov (United States)

Johnson, Leigh F; Mossong, Joel; Dorrington, Rob E; Schomaker, Michael; Hoffmann, Christopher J; Keiser, Olivia; Fox, Matthew P; Wood, Robin; Prozesky, Hans; Giddy, Janet; Garone, Daniela Belen; Cornell, Morna; Egger, Matthias; Boulle, Andrew

2013-01-01

Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults. Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2) at age 20 y and 10.1 y (95% CI: 9.3-10.8) at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7) and 14.4 y (95% CI: 13.3-15.3), respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0) if her baseline CD4 count was ≥ 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0) if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥ 200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%-20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations. South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later in the article for the Editors' Summary.

Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies.

Directory of Open Access Journals (Sweden)

Leigh F Johnson

Full Text Available Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults.Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2 at age 20 y and 10.1 y (95% CI: 9.3-10.8 at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7 and 14.4 y (95% CI: 13.3-15.3, respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0 if her baseline CD4 count was ≥ 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0 if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥ 200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%-20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations.South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later in the article for the Editors' Summary.

Effect of rehabilitation on mortality of patients with Guillain-Barre Syndrome: a propensity-matched analysis using nationwide database.

Science.gov (United States)

Inokuchi, H; Yasunaga, H; Nakahara, Y; Horiguchi, H; Ogata, N; Fujitani, J; Matsuda, S; Fushimi, K; Haga, N

2014-08-01

Rehabilitation for patients with Guillain-Barre Syndrome (GBS) is recommended as it improves the outcome of neurological deficits. Few studies focused on the effect of rehabilitation on mortality of the patients. To investigate the effect of rehabilitation on hospital mortality of patients with GBS using the Japanese Diagnosis Procedure Combination (DPC) nationwide administrative claims database. A retrospective observational cohort study. Hospitals adopting the Japanese DPC system. Patients hospitalized with a diagnosis of GBS between July 2007 and October 2011. Data analyzed included sex, age, Barthel index at admission, use of ventilation, immune therapy, and rehabilitation during hospitalization, comorbidity, hospital volume, type of hospital, and in-hospital death. One-to-one propensity score-matching was used to compare hospital mortality rates within 30- and 90-days after admission in rehabilitation and non-rehabilitation groups. The adjusted odds ratios of rehabilitation to hospital mortality were also estimated. A total of 3835 patients were identified and analyzed. Patients with advancing age, lower Barthel index at admission, comorbidities, ventilation, or immune therapy were more likely to receive rehabilitation during hospitalization. Propensity-matched analysis of 926 pairs showed that the rehabilitation group had lower hospital mortality rates within both 30- and 90-days than the non-rehabilitation group. The adjusted odds ratios of rehabilitation to hospital mortality within 30- and 90-days were 0.14 and 0.23, respectively. After matching patients' background, rehabilitation was associated with lower hospital mortality of patients with GBS. Rehabilitation treatment is essential for patients with GBS to improve their survival.

Factors influencing teamwork and collaboration within a tertiary medical center.

Science.gov (United States)

Chien, Shu Feng; Wan, Thomas Th; Chen, Yu-Chih

2012-04-26

To understand how work climate and related factors influence teamwork and collaboration in a large medical center. A survey of 3462 employees was conducted to generate responses to Sexton's Safety Attitudes Questionnaire (SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork (TW) and collaboration (CO) as endogenous variables. The exogenous variables are effective communication (EC), safety culture (SC), job satisfaction (JS), work pressure (PR), and work climate (WC). The measurement instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW (0.81), CO (0.76), EC (0.70), SC (0.83), JS (0.91), WP (0.85), and WC (0.78). Confirmatory factor analysis was performed for each of these constructs. Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork (R(2) = 0.59) and in collaboration (R(2) = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork (β = 0.26) and collaboration (β = 0.88). A relatively weak positive (β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled. Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive

Factors influencing teamwork and collaboration within a tertiary medical center

Science.gov (United States)

Chien, Shu Feng; Wan, Thomas TH; Chen, Yu-Chih

2012-01-01

AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton’s Safety Attitudes Questionnaire (SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork (TW) and collaboration (CO) as endogenous variables. The exogenous variables are effective communication (EC), safety culture (SC), job satisfaction (JS), work pressure (PR), and work climate (WC). The measurement instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW (0.81), CO (0.76), EC (0.70), SC (0.83), JS (0.91), WP (0.85), and WC (0.78). Confirmatory factor analysis was performed for each of these constructs. RESULTS: Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork (R2 = 0.59) and in collaboration (R2 = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork (β = 0.26) and collaboration (β = 0.88). A relatively weak positive (β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled. CONCLUSION: Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are

Analysis of Production, Impact, and Scientific Collaboration on Difficult Airway Through the Web of Science and Scopus (1981-2013).

Science.gov (United States)

García-Aroca, Miguel Ángel; Pandiella-Dominique, Andrés; Navarro-Suay, Ricardo; Alonso-Arroyo, Adolfo; Granda-Orive, José Ignacio; Anguita-Rodríguez, Francisco; López-García, Andrés

2017-06-01

Bibliometrics, the statistical analysis of written publications, is an increasingly popular approach to the assessment of scientific activity. Bibliometrics allows researchers to assess the impact of a field, or research area, and has been used to make decisions regarding research funding. Through bibliometric analysis, we hypothesized that a bibliometric analysis of difficult airway research would demonstrate a growth in authors and articles over time. Using the Web of Science (WoS) and Scopus databases, we conducted a search of published manuscripts on the difficult airway from January 1981 to December 2013. After removal of duplicates, we identified 2412 articles. We then analyzed the articles as a group to assess indicators of productivity, collaboration, and impact over this time period. We found an increase in productivity over the study period, with 37 manuscripts published between 1981 and 1990, and 1268 between 2001 and 2010 (P 9% for both WoS and Scopus, and CAGR for anesthesiology as a whole =0.64% in WoS, and =3.30% in Scopus. Furthermore, we found a positive correlation between the number of papers published per author and the number of coauthored manuscripts (P < .001). We also found an increase in the number of coauthored manuscripts, in international cooperation between institutions, and in the number of citations for each manuscript. For any author, we also identified a positive relationship between the number of citations per manuscript and the number of papers published (P < .001). We found a greater increase over time in the number of difficult airway manuscripts than for anesthesiology research overall. We found that collaboration between authors increases their impact, and that an increase in collaboration increases citation rates. Publishing in English and in certain journals, and collaborating with certain authors and institutions, increases the visibility of manuscripts published on this subject.

Improving collaboration between large and small-medium enterprises in automobile production

Science.gov (United States)

Sung, Soyoung; Kim, Yanghoon; Chang, Hangbae

2018-01-01

Inter-organisational collaboration is important for achieving qualitative and quantitative performance improvement in the global competitive environment. In particular, the extent of collaboration between the mother company and its suppliers is important for the profitability and sustainability of a company in the automobile industry, which is carried out using a customisation and order production system. As a result of the empirical analysis in this study, the collaborative information sharing cycle is shortened and the collaborative information sharing scope is widened. Therefore, the level of collaboration is improved by constructing an IT collaboration system.

Collaborative experience

DEFF Research Database (Denmark)

Mortensen, Thomas Bøtker

-Doerr, 1996) and has been shown to have a positive effect to the outcome of collaborative R&D (Sampson, 2005). Anand & Khanna (2000), furthermore, hypothesized that research joint ventures are more ambiguous than marketing joint ventures and even more the licensing and showed that the effect of collaborative......Literature review: Collaborative experience has been shown to have a positive effect on the collaborative outcome in general (Anand & Khanna, 2000; Kale, Dyer & Singh, 2002). Furthermore, it has been linked to the ability to exploit the network of the firm for learning (Powell, Koput and Smith...... experience was largest the higher the hypothesized ambiguity. Theoretically contribution: This research project aims at contributing to existing literature by arguing, that collaborative experience is a moderating variable which moderates the effects on collaborative outcome from the level of complexity...