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Sample records for nationally representative mortality

  1. Under-five mortality among mothers employed in agriculture: findings from a nationally representative sample.

    Science.gov (United States)

    Singh, Rajvir; Tripathi, Vrijesh

    2015-01-01

    Background. India accounts for 24% to all under-five mortality in the world. Residence in rural area, poverty and low levels of mother's education are known confounders of under-five mortality. Since two-thirds of India's population lives in rural areas, mothers employed in agriculture present a particularly vulnerable population in the Indian context and it is imperative that concerns of this sizeable population are addressed in order to achieve MDG4 targets of reducing U5MR to fewer than 41 per 1,000 by 2015. This study was conducted to examine factors associated with under-five mortality among mothers employed in agriculture. Methods. Data was retrieved from National Family Household Survey-3 in India (2008). The study population is comprised of a national representative sample of single children aged 0 to 59 months and born to mothers aged 15 to 49 years employed in agriculture from all 29 states of India. Univariate and Multivariate Cox PH regression analysis was used to analyse the Hazard Rates of mortality. The predictive power of child mortality among mothers employed in agriculture was assessed by calculating the area under the receiver operating characteristic (ROC) curve. Results. An increase in mothers' ages corresponds with a decrease in child mortality. Breastfeeding reduces child mortality by 70% (HR 0.30, 0.25-0.35, p = 0.001). Standard of Living reduces child mortality by 32% with high standard of living (HR 0.68, 0.52-0.89, 0.001) in comparison to low standard of living. Prenatal care (HR 0.40, 0.34-0.48, p = 0.001) and breastfeeding health nutrition education (HR 0.45, 0.31-0.66, p = 0.001) are associated significant factors for child mortality. Birth Order five is a risk factor for mortality (HR 1.49, 1.05-2.10, p = 0.04) in comparison to Birth Order one among women engaged in agriculture while the household size (6-10 members and ≥ 11 members) is significant in reducing child mortality in comparison to ≤5 members in the house. Under

  2. Under-five mortality among mothers employed in agriculture: findings from a nationally representative sample

    Directory of Open Access Journals (Sweden)

    Rajvir Singh

    2015-01-01

    Full Text Available Background. India accounts for 24% to all under-five mortality in the world. Residence in rural area, poverty and low levels of mother’s education are known confounders of under-five mortality. Since two-thirds of India’s population lives in rural areas, mothers employed in agriculture present a particularly vulnerable population in the Indian context and it is imperative that concerns of this sizeable population are addressed in order to achieve MDG4 targets of reducing U5MR to fewer than 41 per 1,000 by 2015. This study was conducted to examine factors associated with under-five mortality among mothers employed in agriculture.Methods. Data was retrieved from National Family Household Survey-3 in India (2008. The study population is comprised of a national representative sample of single children aged 0 to 59 months and born to mothers aged 15 to 49 years employed in agriculture from all 29 states of India. Univariate and Multivariate Cox PH regression analysis was used to analyse the Hazard Rates of mortality. The predictive power of child mortality among mothers employed in agriculture was assessed by calculating the area under the receiver operating characteristic (ROC curve.Results. An increase in mothers’ ages corresponds with a decrease in child mortality. Breastfeeding reduces child mortality by 70% (HR 0.30, 0.25–0.35, p = 0.001. Standard of Living reduces child mortality by 32% with high standard of living (HR 0.68, 0.52–0.89, 0.001 in comparison to low standard of living. Prenatal care (HR 0.40, 0.34–0.48, p = 0.001 and breastfeeding health nutrition education (HR 0.45, 0.31–0.66, p = 0.001 are associated significant factors for child mortality. Birth Order five is a risk factor for mortality (HR 1.49, 1.05–2.10, p = 0.04 in comparison to Birth Order one among women engaged in agriculture while the household size (6–10 members and ≥ 11 members is significant in reducing child mortality in comparison to ≤5 members

  3. Occupation and lung cancer mortality in a nationally representative U.S. Cohort: The National Health Interview Survey (NHIS).

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    Lee, David J; Fleming, Lora E; Leblanc, William G; Arheart, Kristopher L; Chung-Bridges, Katherine; Christ, Sharon L; Caban, Alberto J; Pitman, Terry

    2006-08-01

    The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation. National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4). Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.

  4. Socioeconomic Inequality in mortality using 12-year follow-up data from nationally representative surveys in South Korea.

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    Khang, Young-Ho; Kim, Hye-Ryun

    2016-03-22

    Investigations into socioeconomic inequalities in mortality have rarely used long-term mortality follow-up data from nationally representative samples in Asian countries. A limited subset of indicators for socioeconomic position was employed in prior studies on socioeconomic inequalities in mortality. We examined socioeconomic inequalities in mortality using follow-up 12-year mortality data from nationally representative samples of South Koreans. A total of 10,137 individuals who took part in the 1998 and 2001 Korea National Health and Nutrition Examination Surveys were linked to mortality data from Statistics Korea. Of those individuals, 1,219 (12.1 %) had died as of December 2012. Cox proportional hazard models were used to estimate the relative risks of mortality according to a wide range of socioeconomic position (SEP) indicators after taking into account primary sampling units, stratification, and sample weights. Our analysis showed strong evidence that individuals with disadvantaged SEP indicators had greater all-cause mortality risks than their counterparts. The magnitude of the association varied according to gender, age group, and specific SEP indicators. Cause-specific analyses using equivalized income quintiles showed that the magnitude of mortality inequalities tended to be greater for cardiovascular disease and external causes than for cancer. Inequalities in mortality exist in every aspect of SEP indicators, both genders, and age groups, and four broad causes of deaths. The South Korean economic development, previously described as effective in both economic growth and relatively equitable income distribution, should be scrutinized regarding its impact on socioeconomic mortality inequalities. Policy measures to reduce inequalities in mortality should be implemented in South Korea.

  5. Child mortality from solid-fuel use in India: a nationally-representative case-control study

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    Bassani Diego G

    2010-08-01

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

  6. Prediction of atherosclerotic cardiovascular disease mortality in a nationally representative cohort using a set of risk factors from pooled cohort risk equations.

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    Zefeng Zhang

    Full Text Available The American College of Cardiology/American Heart Association developed Pooled Cohort equations to estimate atherosclerotic cardiovascular disease (ASCVD risk. It is unclear how well the equations predict ASCVD mortality in a nationally representative cohort. We used the National Health and Nutrition Examination Survey (NHANES 1988-1994 and Linked Mortality through 2006 (n = 6,644. Among participants aged 40-79 years without ASCVD at baseline, we used Cox proportional hazard models to estimate the 10-year probability of ASCVD death by sex and race-ethnicity (non-Hispanic white (NHW, non-Hispanic black (NHB and Mexican American (MA. We estimated the discrimination and calibration for each sex-race-ethnicity model. We documented 288 ASCVD deaths during 62,335 person years. The Pooled Cohort equations demonstrated moderate to good discrimination for ASCVD mortality, with modified C-statistics of 0.716 (95% CI 0.663-0.770, 0.794 (0.734-0.854, and 0.733 (0.654-0.811 for NHW, NHB and MA men, respectively. The corresponding C-statistics for women were 0.781 (0.718-0.844, 0.702 (0.633-0.771, and 0.789 (CI 0.721-0.857. Modified Hosmer-Lemeshow χ2 suggested adequate calibration for NHW, NHB and MA men, and MA women (p-values: 0.128, 0.295, 0.104 and 0.163 respectively. The calibration was inadequate for NHW and NHB women (p<0.05. In this nationally representative cohort, the Pooled Cohort equations performed adequately to predict 10-year ASCVD mortality for NHW and NHB men, and MA population, but not for NHW and NHB women.

  7. Girl-child marriage and its association with morbidity and mortality of children under 5 years of age in a nationally-representative sample of Pakistan.

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    Nasrullah, Muazzam; Zakar, Rubeena; Zakar, Muhammad Zakria; Krämer, Alexander

    2014-03-01

    To determine the relationship between child marriage (before age 18 years) and morbidity and mortality of children under 5 years of age in Pakistan beyond those attributed to social vulnerabilities. Nationally-representative cross-sectional observational survey data from Pakistan Demographic and Health Survey, 2006-2007 was limited to children from the past 5 years, reported by ever-married women aged 15-24 years (n = 2630 births of n = 2138 mothers) to identify differences in infectious diseases in past 2 weeks (diarrhea, acute respiratory infection [ARI], ARI with fever), under 5 years of age and infant mortality, and low birth weight by early (marriage. Associations between child marriage and mortality and morbidity of children under 5 years of age were assessed by calculating adjusted OR using logistic regression models after controlling for maternal and child demographics. Majority (74.5%) of births were from mothers aged Marriage before age 18 years increased the likelihood of recent diarrhea among children born to young mothers (adjusted OR = 1.59; 95% CI: 1.18-2.14). Even though maternal child marriage was associated with infant mortality and mortality of children under 5 years of age in unadjusted models, association was lost in the adjusted models. We did not find a relation between girl-child marriage and low birth weight infants, and ARI. Girl-child marriage increases the likelihood of recent diarrhea among children born to young mothers. Further qualitative and prospective quantitative studies are needed to understand the factors that may drive child morbidity and mortality among those married as children vs adults in Pakistan. Copyright © 2014 Mosby, Inc. All rights reserved.

  8. An integrated national mortality surveillance system for death registration and mortality surveillance, China.

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    Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

    2016-01-01

    In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

  9. National natality and fetal mortality surveys

    International Nuclear Information System (INIS)

    Roney, P.L.

    1980-01-01

    A project is described in which the Epidemiologic Studies Branch, DBE, is cooperating with the National Center for Health Statistics in a National Natality Survey and a National Fetal Mortality Survey of a sample of live births and of late fetal deaths (28 or more weeks gestation) in 1979. Questionnaires will be sent to a sample of mothers who had a live born infant or late fetal death in 1979, to hospitals in which the deliveries took place, to attending physicians, and all other possible sources of health care. The survey will provide quantitative information regarding use of ionizing and nonionizing radiation, including ultrasound, during pregnancy and possible associations between radiation and late fetal mortality. Specifically the study will provide information on the demographic and socioeconomic characteristics of the mothers and complications of pregnancy, labor, and delivery. The physical condition of the infant at birth is also included. This is one of many health surveys conducted routinely by the NCHS under the National Health Survey program

  10. Serum sodium and mortality in a national peritoneal dialysis cohort.

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    Ravel, Vanessa A; Streja, Elani; Mehrotra, Rajnish; Sim, John J; Harley, Kevin; Ayus, Juan Carlos; Amin, Alpesh N; Brunelli, Steven M; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar; Rhee, Connie M

    2017-07-01

    Sodium disarrays are common in peritoneal dialysis (PD) patients, and may be associated with adverse outcomes in this population. However, few studies of limited sample size have examined the association of serum sodium with mortality in PD patients, with inconsistent results. We hypothesized that both hypo- and hypernatremia are associated with higher death risk in a nationally representative cohort of US PD patients. We sought to examine the association of serum sodium over time and mortality among 4687 adult incident PD patients from a large US dialysis organization who underwent one or more serum sodium measurements within the first 3 months of dialysis over January 2007 to December 2011. We examined the association of time-dependent and baseline sodium with all-cause mortality as a proxy of short- and long-term sodium-mortality associations, respectively. Hazard ratios were estimated using Cox models with three adjustment levels: minimally adjusted, case-mix adjusted, and case-mix + laboratory adjusted. In time-dependent analyses, sodium levels mortality remained significant for levels mortality risk across all models (ref: 140 to <142 mEq/L). In PD patients, lower time-dependent and baseline sodium levels were independently associated with higher death risk. Further studies are needed to determine whether correction of dysnatremia improves longevity in this population. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  11. 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

  12. Under-Representation in Nationally Representative Secondary Data

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    Frederick, Karen; Barnard-Brak, Lucy; Sulak, Tracey

    2012-01-01

    There has been a significant increase in the use of secondary data sets. Many such data sets purport to be nationally representative. Secondary data sets include research commissioned by the National Center for Education Statistics, the Centers for Disease Control, and other public entities. Research increasingly utilizes these secondary data in…

  13. Depression and Suicidality among Bisexual Youth: A Nationally Representative Sample

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    Taliaferro, Lindsay A.; Gloppen, Kari M.; Muehlenkamp, Jennifer J.; Eisenberg, Marla E.

    2018-01-01

    To address gaps in the literature on bisexual youth, we used the first nationally representative sample of high school students from the United States to determine profiles of behaviors related to depressive symptoms, a suicide attempt, and a medically-serious attempt. We examined the data from 922 bisexual students in grades 9-12 who completed…

  14. Early menarche and childhood adversities in a nationally representative sample

    OpenAIRE

    Henrichs, Kimberly L; McCauley, Heather L; Miller, Elizabeth; Styne, Dennis M; Saito, Naomi; Breslau, Joshua

    2014-01-01

    Background Epidemiological evidence suggests that early menarche, defined as onset of menses at age 11 or earlier, has increased in prevalence in recent birth cohorts and is associated with multiple poor medical and mental health outcomes in adulthood. There is evidence that childhood adversities occurring prior to menarche contribute to early menarche. Methods Data collected in face-to-face interviews with a nationally representative sample of women age 18 and over (N = 3288), as part of the...

  15. Standardized analysis of German cattle mortality using national register data.

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    Pannwitz, Gunter

    2015-03-01

    In a retrospective cohort study of national register data, 1946 randomly selected holdings, with 286,912 individual cattle accumulating 170,416 animal-years were analyzed. The sample was considered to represent the national herd in Germany 2012. Within each holding, individual cattle records were stratified by current age (≤21 days, 3-6 weeks, 6-12 weeks, 3-6 months, 6-12 months, 1-2, 2-4, 4-8, and >8 years), sex, breed (intensive milk, less intensive milk, and beef), and mean monthly air temperature (rate, slaughter rate, and federal state. 8027 on-site deaths (excluding slaughter for human consumption) were recorded, with cattle aged 2 years contributing 50.0%, 15.4%, and 34.6% of deaths, respectively. Poisson regression and generalized estimating equations (gee) accounting for intra-herd clustering were used to model the number of deaths. In both models, most age bands differed significantly, with highest rates in calves ≤21 days, falling to lowest rates in 1-2 year olds, and rising again thereafter in females. Males exhibited higher mortality than females from birth to 2 years. All breed categories differed significantly with lowest rates in beef and highest in intensive milk breeds. Larger holdings, temperatures ≤10°C, calving rates >0-0.5 per animal year were all associated with higher mortality. Via interaction, intensive and less intensive milk breed cattle aging 6 weeks to 6 months and intensive milk breed females >4 years were associated with higher mortality. There were no significant differences between federal states and slaughter rates. The standardized deviations of modeled dead cattle numbers from occurred deaths per calendar year per holding were calculated and a 95% reference range of deviations constructed. This approach makes a standardized active monitoring and surveillance system regardless of herd size possible, offering a useful, inexpensive and easy implementable aid in the detection of holdings deviant from mortality levels of the

  16. 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.

  17. Changes in the national mortality from leukaemia

    Energy Technology Data Exchange (ETDEWEB)

    Court Brown, W M; Doll, R

    1960-12-01

    In the last 30 years the number of deaths ascribed to leukaemia has increased steadily in all, countries for which adequate statistics are available. Death rates for England and Wales are given show that during this period the rate of mortality has increased threefold-a rate of increase which has been exceeded among the major causes of death only by cancer of the lung and coronary thrombosis. Clearly it is important to discover the reason for this change; more so, perhaps, because ionizing radiations are known to be capable of causing the disease and it is possible that some of the increase may have been due to their more extensive use.

  18. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    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...... with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other...... locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted...

  19. Early menarche and childhood adversities in a nationally representative sample.

    Science.gov (United States)

    Henrichs, Kimberly L; McCauley, Heather L; Miller, Elizabeth; Styne, Dennis M; Saito, Naomi; Breslau, Joshua

    2014-01-01

    Epidemiological evidence suggests that early menarche, defined as onset of menses at age 11 or earlier, has increased in prevalence in recent birth cohorts and is associated with multiple poor medical and mental health outcomes in adulthood. There is evidence that childhood adversities occurring prior to menarche contribute to early menarche. Data collected in face-to-face interviews with a nationally representative sample of women age 18 and over (N = 3288), as part of the National Comorbidity Survey-Replication, were analyzed. Associations between pre-menarchal childhood adversities and menarche at age 11 or earlier were estimated in discrete time survival models with statistical adjustment for age at interview, ethnicity, and body mass index. Adversities investigated included physical abuse, sexual abuse, neglect, biological father absence from the home, other parent loss, parent mental illness, parent substance abuse, parent criminality, inter-parental violence, serious physical illness in childhood, and family economic adversity. Mean age at menarche varied across decadal birth cohorts (χ(2)₍₄₎ = 21.41, p Childhood adversities were also more common in younger than older cohorts. Of the 11 childhood adversities, 5 were associated with menarche at age 11 or earlier, with OR of 1.3 or greater. Each of these five adversities is associated with a 26% increase in the odds of early menarche (OR = 1.26, 95% CI 1.14-1.39). The relationship between childhood sexual abuse and early menarche was sustained after adjustment for co-occurring adversities. (OR = 1.77, 95% CI 1.21-2.6). Evidence from this study is consistent with hypothesized physiological effects of early childhood family environment on endocrine development. Childhood sexual abuse is the adversity most strongly associated with early menarche. However, because of the complex way that childhood adversities cluster within families, the more generalized influence of highly dysfunctional

  20. Major causes of lamb mortality at Ebinat woreda, Amhara National ...

    African Journals Online (AJOL)

    A year-round (from September 2008 to August 2009) study was conducted to investigate causes of lamb mortality at Ebinat woreda, Amhara National Regional State, northwestern Ethiopia. Two hundred and forty one lambs under the age of six months were exploited for analysis of this study. Out of the 241 lambs observed, ...

  1. Japanese practicing physicians' relationships with pharmaceutical representatives: a national survey.

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    Sayaka Saito

    Full Text Available BACKGROUND: Previous surveys on the relationship between physicians and pharmaceutical representatives (PRs have been of limited quality. The purpose of our survey of practicing physicians in Japan was to assess the extent of their involvement in pharmaceutical promotional activities, physician characteristics that predict such involvement, attitudes toward relationships with PRs, correlations between the extent of involvement and attitudes, and differences in the extent of involvement according to self-reported prescribing behaviors. METHODS AND FINDINGS: From January to March 2008, we conducted a national survey of 2621 practicing physicians in seven specialties: internal medicine, general surgery, orthopedic surgery, pediatrics, obstetrics-gynecology, psychiatry, and ophthalmology. The response rate was 54%. Most physicians met with PRs (98%, received drug samples (85% and stationery (96%, and participated in industry-sponsored continuing medical education (CME events at the workplace (80% and outside the workplace (93%. Half accepted meals outside the workplace (49% and financial subsidies to attend CME events (49%. Rules at the workplace banning both meetings with PRs and gifts predicted less involvement of physicians in promotional activities. Physicians valued information from PRs. They believed that they were unlikely to be influenced by promotional activities, but that their colleagues were more susceptible to such influence than themselves. They were divided about the appropriateness of low-value gifts. The extent of physician involvement in promotional activities was positively correlated with the attitudes that PRs are a valuable source of information and that gifts are appropriate. The extent of such involvement was higher among physicians who prefer to ask PRs for information when a new medication becomes available, physicians who are not satisfied with patient encounters ending only with advice, and physicians who prefer to

  2. ICU telemedicine and critical care mortality: a national effectiveness study

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    Kahn, Jeremy M; Le, Tri Q.; Barnato, Amber E.; Hravnak, Marilyn; Kuza, Courtney C.; Pike, Francis; Angus, Derek C.

    2015-01-01

    Background Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. Objectives To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. Research design We performed a multi-center retrospective case-control study using 2001–2010 Medicare claims data linked to a national survey identifying United States hospitals adopting ICU telemedicine. We matched each adopting hospital (cases) to up to 3 non-adopting hospitals (controls) based on size, case-mix and geographic proximity during the year of adoption. Using ICU admissions from 2 years before and after the adoption date, we compared outcomes between case and control hospitals using a difference-in-differences approach. Results 132 adopting case hospitals were matched to 389 similar non-adopting control hospitals. The pre- and post-adoption unadjusted 90-day mortality was similar in both case hospitals (24.0% vs. 24.3%, p=0.07) and control hospitals (23.5% vs. 23.7%, ptelemedicine adoption was associated with a small relative reduction in 90-day mortality (ratio of odds ratios: 0.96, 95% CI = 0.95–0.98, ptelemedicine effect across individual hospitals (median ratio of odds ratios: 1.01; interquartile range 0.85–1.12; range 0.45–2.54). Only 16 case hospitals (12.2%) experienced statistically significant mortality reductions post-adoption. Hospitals with a significant mortality reduction were more likely to have large annual admission volumes (ptelemedicine adoption resulted in a small relative overall mortality reduction, there was heterogeneity in effect across adopting hospitals, with large-volume urban hospitals experiencing the greatest mortality reductions. PMID:26765148

  3. Road traffic related mortality in Vietnam: Evidence for policy from a national sample mortality surveillance system

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    Ngo Anh D

    2012-07-01

    Full Text Available Abstract Background Road traffic injuries (RTIs are among the leading causes of mortality in Vietnam. However, mortality data collection systems in Vietnam in general and for RTIs in particular, remain inconsistent and incomplete. Underlying distributions of external causes and body injuries are not available from routine data collection systems or from studies till date. This paper presents characteristics, user type pattern, seasonal distribution, and causes of 1,061 deaths attributable to road crashes ascertained from a national sample mortality surveillance system in Vietnam over a two-year period (2008 and 2009. Methods A sample mortality surveillance system was designed for Vietnam, comprising 192 communes in 16 provinces, accounting for approximately 3% of the Vietnamese population. Deaths were identified from commune level data sources, and followed up by verbal autopsy (VA based ascertainment of cause of death. Age-standardised mortality rates from RTIs were computed. VA questionnaires were analysed in depth to derive descriptive characteristics of RTI deaths in the sample. Results The age-standardized mortality rates from RTIs were 33.5 and 8.5 per 100,000 for males and females respectively. Majority of deaths were males (79%. Seventy three percent of all deaths were aged from 15 to 49 years and 58% were motorcycle users. As high as 80% of deaths occurred on the day of injury, 42% occurred prior to arrival at hospital, and a further 29% occurred on-site. Direct causes of death were identified for 446 deaths (42% with head injuries being the most common cause attributable to road traffic injuries overall (79% and to motorcycle crashes in particular (78%. Conclusion The VA method can provide a useful data source to analyse RTI mortality. The observed considerable mortality from head injuries among motorcycle users highlights the need to evaluate current practice and effectiveness of motorcycle helmet use in Vietnam. The high number of

  4. Mortality among workers at the Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Checkoway, H.; Mathew, R.M.; Wolf, S.H.; Shy, C.M.; Muller, S.M.; Beck, J.; Watson, J.E. Jr.; Wray, M.; Fry, S.A.

    1983-01-01

    A retrospective cohort mortality study was conducted among employees of the Oak Ridge National Laboratory. Since 1943, this facility has been the site of energy-related research, including uranium and plutonium recovery and radioisotope production. Historical follow-up conducted for the years 1943 to 1977 for 8681 white males who had been employed for at least one month during the period 1943 to 1972. Vital status was ascertained for 90 percent of the cohort. Standardized Mortality Ratios (SMRs) were computed to contrast the workers' mortality experience with that of the US white male population. The observed number of 1017 deaths from all causes was 74 percent of that expected, a finding indicative of the healthy worker effect and the relatively high socioeconomic status of the cohort. The SMR for all cancers was 0.75 (195 observed vs. 261.3 expected). Mortality deficits were seen for non-malignant diseases of all major organ groups and for all site-specific malignancies except prostate cancer (SMR = 1.13), leukemia (SMR = 1.16) and Hodgkin's disease (SMR = 1.28). None of the elevations was statistically significant. There were no consistent trends of cause-specific mortality with either external or internal radiation exposure levels

  5. An affordable proxy of representative national survey on radon concentration in dwellings: Design, organisation and preliminary evaluation of representativeness

    International Nuclear Information System (INIS)

    Antignani, Sara; Carelli, Vinicio; Cordedda, Carlo; Zonno, Fedele; Ampollini, Marco; Carpentieri, Carmela; Venoso, Gennaro; Bochicchio, Francesco

    2013-01-01

    Representative national surveys in dwellings are important to unbiasedly evaluate the exposure of the general population to radon. In Italy, a representative national survey was conducted from 1989 to 1996, which involved about 5600 dwellings in 232 towns. Later on, some Regions carried out more detailed surveys, but a new national survey in dwellings is necessary in order to obtain a more thorough estimate of radon concentration distribution over the Italian territory. The need to make this survey in an affordable way led to implement a new approach based on the collaboration between the Istituto Superiore di Sanità and a national company with workplaces and employees' homes throughout the country. The intent is to carry out a proxy of a population representative survey by measuring radon concentration in the homes of a random sample of the company employees. The realisation of this survey was affordable, thanks to the availability of corporate e-mail for each employee, intranet service, and company internal mail service. A dedicated web procedure and e-questionnaires allowed to automatically manage the contact with employees and to collect their data, which were both cost- and time-saving. Using this e-mail contact approach, 53% of contacted employees consented to participate in the survey. Radon concentration passive measuring devices were distributed to about 7000 dwellings, using about 14000 CR-39 detectors (two measured rooms per dwelling). In order to reduce costs, the devices were exposed for 12 months instead of two consecutive 6-month periods (as with the former national survey). A first checking of the actual representativeness of the sample was done by comparing characteristics of dwellings and occupants in the sample with corresponding data from the latest National Census. This was accomplished thanks to the fact that the questions in the survey questionnaire were tailored to the categories adopted for the Census questionnaire. A preliminary

  6. Income Inequality and Child Mortality in Wealthy Nations.

    Science.gov (United States)

    Collison, David

    2016-01-01

    This chapter presents evidence of a relationship between child mortality data and socio-economic factors in relatively wealthy nations. The original study on child mortality that is reported here, which first appeared in a UK medical journal, was undertaken in a school of business by academics with accounting and finance backgrounds. The rationale explaining why academics from such disciplines were drawn to investigate these issues is given in the first part of the chapter. The findings related to child mortality data were identified as a special case of a wide range of social and health indicators that are systematically related to the different organisational approaches of capitalist societies. In particular, the so-called Anglo-American countries show consistently poor outcomes over a number of indicators, including child mortality. Considerable evidence has been adduced in the literature to show the importance of income inequality as an explanation for such findings. An important part of the chapter is the overview of a relatively recent publication in the epidemiological literature entitled The Spirit Level: Why Equality Is Better for Everyone, which was written by Wilkinson and Pickett. © 2016 S. Karger AG, Basel.

  7. Mortality patterns in Vietnam, 2006: Findings from a national verbal autopsy survey

    Directory of Open Access Journals (Sweden)

    Adair Timothy

    2010-03-01

    Full Text Available Abstract Background Accurate nationally representative statistics on total and cause-specific mortality in Vietnam are lacking due to incomplete capture in government reporting systems. This paper presents total and cause-specific mortality results from a national verbal autopsy survey conducted first time in Vietnam in conjunction with the annual population change survey and discusses methodological and logistical challenges associated with the implementation of a nation-wide assessment of mortality based on surveys. Verbal autopsy interviews, using the WHO standard questionnaire, were conducted with close relatives of the 6798 deaths identified in the 2007 population change survey in Vietnam. Data collectors were health staff recruited from the commune health station who undertook 3-day intensive training on VA interview. The Preston-Coale method assessed the level of completeness of mortality reporting from the population change survey. The number of deaths in each age-sex grouping is inflated according to the estimate of completeness to produce an adjusted number of deaths. Underlying causes of death were aggregated to the International Classification of Diseases Mortality Tabulation List 1. Leading causes of death were tabulated by sex for three broad age groups: 0-14 years; 15-59 years; and 60 years and above. Findings Completeness of mortality reporting was 69% for males and 54% for females with substantial regional variation. The use of VA has resulted in 10% of deaths being classified to ill-defined among males, and 15% among females. More ill-defined deaths were reported among the 60 year or above age group. Incomplete death reporting, wide geographical dispersal of deaths, extensive travel between households, and substantial variation in local responses to VA interviews challenged the implementation of a national mortality and cause of death assessment based on surveys. Conclusions Verbal autopsy can be a viable tool to identify cause

  8. Diet in Saudi Arabia: findings from a nationally representative survey.

    Science.gov (United States)

    Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Afshin, Ashkan; Daoud, Farah; AlMazroa, Mohammad A; Al Saeedi, Mohammad; Basulaiman, Mohammed; Memish, Ziad A; Al Rabeeah, Abdullah A; Mokdad, Ali H

    2017-04-01

    No recent original studies on the pattern of diet are available for Saudi Arabia at the national level. The present study was performed to describe the consumption of foods and beverages by Saudi adults. The Saudi Health Interview Survey (SHIS) was conducted in 2013. Data were collected through interviews and anthropometric measurements were done. A diet history questionnaire was used to determine the amount of consumption for eighteen food or beverage items in a typical week. The study was a household survey in all thirteen administrative regions of Saudi Arabia. Participants were 10 735 individuals aged 15 years or older. Mean daily consumption was 70·9 (se 1·3) g for fruits, 111·1 (se 2·0) g for vegetables, 11·6 (se 0·3) g for dark fish, 13·8 (se 0·3) g for other fish, 44·2 (se 0·7) g for red meat, 4·8 (se 0·2) g for processed meat, 10·9 (se 0·3) g for nuts, 219·4 (se 5·1) ml for milk and 115·5 (se 2·6) ml for sugar-sweetened beverages. Dietary guideline recommendations were met by only 5·2 % of individuals for fruits, 7·5 % for vegetables, 31·4 % for nuts and 44·7 % for fish. The consumption of processed foods and sugar-sweetened beverages was high in young adults. Only a small percentage of the Saudi population met the dietary recommendations. Programmes to improve dietary behaviours are urgently needed to reduce the current and future burden of disease. The promotion of healthy diets should target both the general population and specific high-risk groups. Regular assessments of dietary status are needed to monitor trends and inform interventions.

  9. Cancer incidence and mortality in Mongolia - National Registry Data.

    Science.gov (United States)

    Sandagdorj, Tuvshingerel; Sanjaajamts, Erdenechimeg; Tudev, Undarmaa; Oyunchimeg, Dondov; Ochir, Chimedsuren; Roder, David

    2010-01-01

    The National Cancer Registry of Mongolia began as a hospital-based registry in the early 1960s but then evolved to have a population-wide role. The Registry provides the only cancer data available from Mongolia for international comparison. The descriptive data presented in this report are the first to be submitted on cancer incidence in Mongolia to a peer-reviewed journal. The purpose was to describe cancer incidence and mortality for all invasive cancers collectively, individual primary sites, and particularly leading sites, and consider cancer control opportunities. This study includes data on new cancer cases registered in Mongolia in 2003-2007. Incidence and mortality rates were calculated as mean annual numbers per 100,000 residents. Age-standardized incidence (ASR) and age-standardized mortality (ASMR) rates were calculated from age-specific rates by weighting directly to the World Population standard. Between 2003 and 2007, 17,271 new cases of invasive cancer were recorded (52.2% in males, 47.7% in females). The five leading primary sites in males were liver, stomach, lung, esophagus, and colon/rectum; whereas in females they were liver, cervix, stomach, esophagus and breast. ASRs were lower in females than males for cancers of the liver at 63.0 and 99.1 per 100,000 respectively; cancers of the stomach at 19.1 and 42.1 per 100,000 respectively; and cancers of the lung at 8.3 and 33.2 per 100,000 respectively. Liver cancer was the most common cause of death in each gender, the ASMR being lower for females than males at 60.6 compared with 94.8 per 100,000. In females the next most common sites of cancer death were the stomach and esophagus, whereas in males, they were the stomach and lung. Available data indicate that ASRs of all cancers collectively have increased over the last 20 years. Rates are highest for liver cancer, at about four times the world average. The most common cancers are those with a primary site of liver, stomach and esophagus, for which

  10. Wildlife Mortality on National Highway 72 and 74 Across Rajaji National Park, North India

    Directory of Open Access Journals (Sweden)

    Ritesh JOSHI

    2012-06-01

    Full Text Available Evaluating the road impact on resident wildlife is one of the important aspects of future conservation planning and of management related actions. Expanding a motor road network in and around protected habitats is considered to be a major threat that can cause the extinction of endangered species. We assessed vertebrate fauna mortality on two inter–state national highways: No. 72 (Haridwar–Dehradun and 74 (Haridwar–Bijnor and an ancillary road running across the Rajaji National Park and Haridwar Conservation area, North India. Field data on wildlife mortality was collected from June 2009 to May 2011. A total of 352 individuals of 39 species (3 amphibians, 9 reptiles, 18 mammals and 9 avian species were found dead on the national highways 72 & 74 and Haridwar–Chilla–Rishikesh motor road, which is running in between Rajaji National Park. Among all the mortalities, avian species were the most affected accounting for 38%, followed by mammals (27%. During Maha–Kumbh 2010, road accidents increased. It was an event that caused tremendous disturbance in animal migratory corridors and in drinking sites. The evaluation of vehicle traffic pressure on national highways revealed that ±14100 and ±9900 vehicles had been moving across these highways every day. In addition to that, expanding the motor roads network and increasing vehicle traffic pressure is disrupting ecological connectivity and impeding the movement of wild animals. In addition, wildlife mortality rate was observed to be increasing. Further studies are needed to understand the ecological impacts of increasing vehicle traffic on various national highways and roads and on animal behavioral responses, in order to take proper conservation actions

  11. Clinical and economic outcomes among hospitalized patients with acute coronary syndrome: an analysis of a national representative Medicare population.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeffrey

    2013-01-01

    To evaluate the clinical and economic burden of acute coronary syndrome (ACS), a common cardiovascular illness, in the Medicare population. Data from the Medicare Current Beneficiary Survey were analyzed. Patients with incident hospitalization for ACS without similar events during the 6 months prior were included. Outcomes evaluated included inpatient mortality, 30-day mortality and readmission, subsequent hospitalization events, and total direct health care costs. Sample population weights were applied, accounting for multistage sampling design to obtain nationally representative estimates for the US Medicare population. Between March 1, 2002 and December 31, 2006, we identified 795 incident ACS patients (mean age 76 years; 49% male) representing 2,542,211 Medicare beneficiaries. The inpatient mortality rate was 9.71% and the 30-day mortality ranged from 10.96% to 13.93%. The 30-day readmission rate for surviving patients was 18.56% for all causes and 17.90% for cardiovascular disease (CVD)-related diagnoses. The incidence of death since admission was 309 cases per 1000 person-years. Among patients discharged alive, the incidence was 197 for death, 847 for CVD-related admission, and 906 for all-cause admission. During the year when the ACS event occurred, mean annual total direct health care costs per person were US$50,458, with more than half attributable to inpatient hospitalization ($27,609). In this national representative Medicare population, we found a substantial clinical and economic burden for ACS. These findings suggest a continuing unmet medical need for more effective management of patients with ACS. The continuous burden underscores the importance of development of new interventions and/or strategies to improve long-term outcomes.

  12. Clinical and economic outcomes among hospitalized patients with acute coronary syndrome: an analysis of a national representative Medicare population

    Directory of Open Access Journals (Sweden)

    Chen SY

    2013-05-01

    Full Text Available Shih-Yin Chen,1 Concetta Crivera,2 Michael Stokes,1 Luke Boulanger,1 Jeffrey Schein2 1United BioSource Corporation, Lexington, MA, USA; 2Janssen Scientific Affairs, LLC, Raritan, NJ, USA Objective: To evaluate the clinical and economic burden of acute coronary syndrome (ACS, a common cardiovascular illness, in the Medicare population. Methods: Data from the Medicare Current Beneficiary Survey were analyzed. Patients with incident hospitalization for ACS without similar events during the 6 months prior were included. Outcomes evaluated included inpatient mortality, 30-day mortality and readmission, subsequent hospitalization events, and total direct health care costs. Sample population weights were applied, accounting for multistage sampling design to obtain nationally representative estimates for the US Medicare population. Results: Between March 1, 2002 and December 31, 2006, we identified 795 incident ACS patients (mean age 76 years; 49% male representing 2,542,211 Medicare beneficiaries. The inpatient mortality rate was 9.71% and the 30-day mortality ranged from 10.96% to 13.93%. The 30-day readmission rate for surviving patients was 18.56% for all causes and 17.90% for cardiovascular disease (CVD-related diagnoses. The incidence of death since admission was 309 cases per 1000 person–years. Among patients discharged alive, the incidence was 197 for death, 847 for CVD-related admission, and 906 for all-cause admission. During the year when the ACS event occurred, mean annual total direct health care costs per person were US$50,458, with more than half attributable to inpatient hospitalization ($27,609. Conclusion: In this national representative Medicare population, we found a substantial clinical and economic burden for ACS. These findings suggest a continuing unmet medical need for more effective management of patients with ACS. The continuous burden underscores the importance of development of new interventions and/or strategies to

  13. Alcohol use in the first three years of bereavement: a national representative survey

    Directory of Open Access Journals (Sweden)

    Pilling János

    2012-01-01

    Full Text Available Abstract Background Earlier results concerning alcohol consumption of bereaved persons are contradictory. The aim of the present study was to analyze the relationship between bereavement and alcohol consumption accounting for time and gender differences on a nationally representative sample from Hungary ("Hungarostudy Epidemiological Panel Survey", N = 4457 Methods Drinking characteristics of mourning persons (alcohol consumption, dependence symptoms, and harmful consequences of alcohol use in the first three years of grief were examined among persons between 18-75 years using the Alcohol Use Disorders Identification Test (AUDIT. Results Men bereaved for one year scored higher on two dimensions of AUDIT (dependence symptoms and harmful alcohol use, while men bereaved for two years scored higher on all three dimensions of AUDIT compared to the non-bereaved. The rate of men clinically at-risk concerning alcohol consumption among the non-bereaved is 12.9%, and among men bereaved for one year is 18.4% (a non-significant difference, while 29.8% (p Conclusion Among bereaved men, the risk of alcohol related problems tends to be higher, which can be shown both among men bereaved for one year as well as men bereaved for two years. Considering the higher morbidity and mortality rates of bereaved men, alcohol consumption might play a mediator role. These facts draw attention to the importance of prevention, early recognition, and effective therapy of hazardous drinking in bereaved men.

  14. Exclusive Breastfeeding Rate and Complementary Feeding Indicators in China: A National Representative Survey in 2013

    Directory of Open Access Journals (Sweden)

    Yifan Duan

    2018-02-01

    Full Text Available Appropriate infant and young child feeding could reduce morbidity and mortality and could improve cognitive development of children. However, nationwide data on exclusive breastfeeding and complementary feeding status in China are scarce. The aim of this study was to assess current exclusive breastfeeding and complementary feeding status in China. A national representative survey (Chinese National Nutrition and Health Survey of children aged under 6 years was done in 2013. Stratified multistage cluster sampling was used to select study participants. World Health Organization (WHO infant and young child feeding indicators were firstly used to assess exclusive breastfeeding and complementary feeding practice nationwide. In total, 14,458 children aged under two years (0 to <730 days were studied from 55 counties in 30 provinces in China. The crude exclusive breastfeeding rate under 6 months was 20.7% (908/4381 and the weighted exclusive breastfeeding rate was 18.6%. The crude prevalence of minimum dietary diversity, minimum meal frequency and minimum acceptable diet were 52.5% (5286/10,071, 69.8% (7027/10,071, and 27.4% (2764/10,071 among children aged 6–23 months, respectively. The weighted rate was 53.7%, 69.1%, and 25.1%, respectively. Residential area, household income and maternal education were positively associated with the three complementary feeding indicators. The exclusive breastfeeding rate under 6 months was low and complementary feeding practice was not optimal in China. Residential area, household income and maternal education might be used to target infants and young children to improve complementary feeding practice.

  15. Identifying probable suicide clusters in wales using national mortality data.

    Directory of Open Access Journals (Sweden)

    Phillip Jones

    Full Text Available Up to 2% of suicides in young people may occur in clusters i.e., close together in time and space. In early 2008 unprecedented attention was given by national and international news media to a suspected suicide cluster among young people living in Bridgend, Wales. This paper investigates the strength of statistical evidence for this apparent cluster, its size, and temporal and geographical limits.The analysis is based on official mortality statistics for Wales for 2000-2009 provided by the UK's Office for National Statistics (ONS. Temporo-spatial analysis was performed using Space Time Permutation Scan Statistics with SaTScan v9.1 for suicide deaths aged 15 and over, with a sub-group analysis focussing on cases aged 15-34 years. These analyses were conducted for deaths coded by ONS as: (i suicide or of undetermined intent (probable suicides and (ii for a combination of suicide, undetermined, and accidental poisoning and hanging (possible suicides. The temporo-spatial analysis did not identify any clusters of suicide or undetermined intent deaths (probable suicides. However, analysis of all deaths by suicide, undetermined intent, accidental poisoning and accidental hanging (possible suicides identified a temporo-spatial cluster (p = 0.029 involving 10 deaths amongst 15-34 year olds centred on the County Borough of Bridgend for the period 27(th December 2007 to 19(th February 2008. Less than 1% of possible suicides in younger people in Wales in the ten year period were identified as being cluster-related.There was a possible suicide cluster in young people in Bridgend between December 2007 and February 2008. This cluster was smaller, shorter in duration, and predominantly later than the phenomenon that was reported in national and international print media. Further investigation of factors leading to the onset and termination of this series of deaths, in particular the role of the media, is required.

  16. National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions.

    Science.gov (United States)

    Huicho, Luis; Trelles, Miguel; Gonzales, Fernando

    2006-07-04

    Information on profiles for under-five causes of death is important to guide choice of child-survival interventions. Global level data have been published, but information at country level is scarce. We aimed at defining national and departmental trends and profiles of under-five mortality in Peru from 1996 through 2000. We used the Ministry of Health registered under-five mortality data. For correction of under-registration, a model life-table that fitted the age distribution of the population and of registered deaths was identified for each year. The mortality rates corresponding to these model life-tables were then assigned to each department in each particular year. Cumulative reduction in under-five mortality rate in the 1996-2000 period was estimated calculating the annual reduction slope for each department. Departmental level mortality profiles were constructed. Differences in mortality profiles and in mortality reduction between coastal, andean and jungle regions were also assessed. At country level, only 4 causes (pneumonia, diarrhoea, neonatal diseases and injuries) accounted for 68% of all deaths in 1996, and for 62% in 2000. There was 32.7% of under-five death reduction from 1996 to 2000. Diarrhoea and pneumonia deaths decreased by 84.5% and 41.8%, respectively, mainly in the andean region, whereas deaths due to neonatal causes and injuries decreased by 37.2% and 21.7%. For 1996-2000 period, the andean, coast and jungle regions accounted for 52.4%, 33.1% and 14.4% of deaths, respectively. These regions represent 41.0%, 46.4% and 12.6% of under-five population. Both diarrhoea and pneumonia constitute 30.6% of under-five deaths in the andean region. As a proportion, neonatal deaths remained stable in the country from 1996 to 2000, accounting for about 30% of under-five deaths, whereas injuries and "other" causes, including congenital anomalies, increased by about 5%. Under-five mortality declined substantially in all departments from 1996 to 2000, which

  17. National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions

    Directory of Open Access Journals (Sweden)

    Trelles Miguel

    2006-07-01

    Full Text Available Abstract Background Information on profiles for under-five causes of death is important to guide choice of child-survival interventions. Global level data have been published, but information at country level is scarce. We aimed at defining national and departmental trends and profiles of under-five mortality in Peru from 1996 through 2000. Methods We used the Ministry of Health registered under-five mortality data. For correction of under-registration, a model life-table that fitted the age distribution of the population and of registered deaths was identified for each year. The mortality rates corresponding to these model life-tables were then assigned to each department in each particular year. Cumulative reduction in under-five mortality rate in the 1996–2000 period was estimated calculating the annual reduction slope for each department. Departmental level mortality profiles were constructed. Differences in mortality profiles and in mortality reduction between coastal, andean and jungle regions were also assessed. Results At country level, only 4 causes (pneumonia, diarrhoea, neonatal diseases and injuries accounted for 68% of all deaths in 1996, and for 62% in 2000. There was 32.7% of under-five death reduction from 1996 to 2000. Diarrhoea and pneumonia deaths decreased by 84.5% and 41.8%, respectively, mainly in the andean region, whereas deaths due to neonatal causes and injuries decreased by 37.2% and 21.7%. For 1996–2000 period, the andean, coast and jungle regions accounted for 52.4%, 33.1% and 14.4% of deaths, respectively. These regions represent 41.0%, 46.4% and 12.6% of under-five population. Both diarrhoea and pneumonia constitute 30.6% of under-five deaths in the andean region. As a proportion, neonatal deaths remained stable in the country from 1996 to 2000, accounting for about 30% of under-five deaths, whereas injuries and "other" causes, including congenital anomalies, increased by about 5%. Conclusion Under

  18. National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions

    Science.gov (United States)

    Huicho, Luis; Trelles, Miguel; Gonzales, Fernando

    2006-01-01

    Background Information on profiles for under-five causes of death is important to guide choice of child-survival interventions. Global level data have been published, but information at country level is scarce. We aimed at defining national and departmental trends and profiles of under-five mortality in Peru from 1996 through 2000. Methods We used the Ministry of Health registered under-five mortality data. For correction of under-registration, a model life-table that fitted the age distribution of the population and of registered deaths was identified for each year. The mortality rates corresponding to these model life-tables were then assigned to each department in each particular year. Cumulative reduction in under-five mortality rate in the 1996–2000 period was estimated calculating the annual reduction slope for each department. Departmental level mortality profiles were constructed. Differences in mortality profiles and in mortality reduction between coastal, andean and jungle regions were also assessed. Results At country level, only 4 causes (pneumonia, diarrhoea, neonatal diseases and injuries) accounted for 68% of all deaths in 1996, and for 62% in 2000. There was 32.7% of under-five death reduction from 1996 to 2000. Diarrhoea and pneumonia deaths decreased by 84.5% and 41.8%, respectively, mainly in the andean region, whereas deaths due to neonatal causes and injuries decreased by 37.2% and 21.7%. For 1996–2000 period, the andean, coast and jungle regions accounted for 52.4%, 33.1% and 14.4% of deaths, respectively. These regions represent 41.0%, 46.4% and 12.6% of under-five population. Both diarrhoea and pneumonia constitute 30.6% of under-five deaths in the andean region. As a proportion, neonatal deaths remained stable in the country from 1996 to 2000, accounting for about 30% of under-five deaths, whereas injuries and "other" causes, including congenital anomalies, increased by about 5%. Conclusion Under-five mortality declined substantially in

  19. Risk factors of suicide mortality among multiple attempters: A national registry study in Taiwan.

    Science.gov (United States)

    Chen, I-Ming; Liao, Shih-Cheng; Lee, Ming-Been; Wu, Chia-Yi; Lin, Po-Hsien; Chen, Wei J

    2016-05-01

    Little is known about the risk factors of suicide mortality among multiple attempters. This study aims to investigate the predictors of suicidal mortality in a prospective cohort of attempters in Taiwan, focusing on the time interval and suicide method change between the last two nonfatal attempts. The representative data retrieved from the National Suicide Surveillance System (NSSS) was linked with National Mortality Database to identify the causes of death in multiple attempters during 2006-2008. Cox-proportional hazard models were applied to calculate the hazard ratios for the predictors of suicide. Among the 55,560 attempters, 6485 (11.7%) had survived attempts ranging from one to 11 times; 861 (1.5%) eventually died by suicide. Multiple attempters were characterized by female (OR = 1.56, p suicidal death were identified as male, older age (≥ 45 years), shorter interval and not maintaining methods of low lethality in the last two nonfatal attempts. Receipt of nationwide aftercare was associated with lower risk of suicide but the effect was insignificant. The time interval of the last two nonfatal attempts and alteration in the lethality of suicide method were significant factors for completed suicide. Risk assessment involving these two factors may be necessary for multiple attempters in different clinical settings. Effective strategies for suicide prevention emphasizing this high risk population should be developed in the future. Copyright © 2015. Published by Elsevier B.V.

  20. 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

  1. Association between history of tuberculosis and vegetarianism from a nationally representative survey in India

    NARCIS (Netherlands)

    P. Arora (Paul); P. Jha (Prabhat); N.J.D. Nagelkerke (Nico)

    2011-01-01

    textabstractA vegetarian diet has been implicated as a risk factor for tuberculosis (TB) among South Asians in the United Kingdom. To explore whether this is also the case in India, we analysed data from the nationally representative National Family Health Survey-3 (2006) which collected information

  2. Worry as a Predictor of Nutrition Behaviors: Results from a Nationally Representative Survey

    Science.gov (United States)

    Ferrer, Rebecca A.; Bergman, Hannah E.; Klein, William M. P.

    2013-01-01

    Worry has been shown to predict a variety of health behaviors, such as cancer screening, yet there are few studies linking worry and nutrition. This study used nationally representative data from National Cancer Institute's Food Attitudes and Behavior Survey ("n" = 3,397) to examine the association between health-related worry and a variety of…

  3. New representative of the Director-General of the IAEA to the United Nations

    International Nuclear Information System (INIS)

    2000-01-01

    The document gives information about Mr. Kwaku Aning (Ghana) who was nominated as the Representative of the Director-General of the IAEA to the United Nations and as Director of its Office at the United Nations Headquarters in New York, USA, as of 1 February 2000

  4. Disentangling the Relationship between Child Maltreatment and Violent Delinquency: Using a Nationally Representative Sample

    Science.gov (United States)

    Yun, Ilhong; Ball, Jeremy D.; Lim, Hyeyoung

    2011-01-01

    This study uses the National Longitudinal Study of Adolescents (Add Health) data, a nationally representative sample of adolescents, to disentangle the relationship between child maltreatment and violent delinquency. Also examined are potential moderating effects of gender, socioeconomic status (SES), and religiosity on the association between…

  5. a review of maternal mortality at the kenyatta national hospital ...

    African Journals Online (AJOL)

    hi-tech

    2006-01-01

    Jan 1, 2006 ... Main outcome measures: Determination of maternal mortality rates of all patients admitted to the ... complications of pregnancy and childbirth, majority of who come from ... Yearly distribution of maternal deaths. Year. Deaths.

  6. Gender imbalance in infant mortality: a cross-national study of social structure and female infanticide.

    Science.gov (United States)

    Fuse, Kana; Crenshaw, Edward M

    2006-01-01

    Sex differentials in infant mortality vary widely across nations. Because newborn girls are biologically advantaged in surviving to their first birthday, sex differentials in infant mortality typically arise from genetic factors that result in higher male infant mortality rates. Nonetheless, there are cases where mortality differentials arise from social or behavioral factors reflecting deliberate discrimination by adults in favor of boys over girls, resulting in atypical male to female infant mortality ratios. This cross-national study of 93 developed and developing countries uses such macro-social theories as modernization theory, gender perspectives, human ecology, and sociobiology/evolutionary psychology to predict gender differentials in infant mortality. We find strong evidence for modernization theory, human ecology, and the evolutionary psychology of group process, but mixed evidence for gender perspectives.

  7. Associations among School Characteristics and Foodservice Practices in a Nationally Representative Sample of United States Schools

    Science.gov (United States)

    Thomson, Jessica L.; Tussing-Humphreys, Lisa M.; Martin, Corby K.; LeBlanc, Monique M.; Onufrak, Stephen J.

    2012-01-01

    Objective: Determine school characteristics associated with healthy/unhealthy food service offerings or healthy food preparation practices. Design: Secondary analysis of cross-sectional data. Setting: Nationally representative sample of public and private elementary, middle, and high schools. Participants: Data from the 2006 School Health Policies…

  8. Age Differences in Personality: Evidence from a Nationally Representative Australian Sample

    Science.gov (United States)

    Lucas, Richard E.; Donnellan, M. Brent

    2009-01-01

    Cross-sectional age differences in the Big Five personality traits were examined in a nationally representative sample of Australians (N = 12,618; age range = 15-84). Extraversion, Neuroticism, and Openness were negatively associated with age, whereas Agreeableness and Conscientiousness were positively associated with age. Effect sizes comparing…

  9. Ethnic Variations of Pathways Linking Socioeconomic Status, Parenting, and Preacademic Skills in a Nationally Representative Sample

    Science.gov (United States)

    Iruka, Iheoma U.; Dotterer, Aryn M.; Pungello, Elizabeth P.

    2014-01-01

    Research Findings: Grounded in the investment model and informed by the integrative theory of the study of minority children, this study used the Early Childhood Longitudinal Study-Birth Cohort data set, a nationally representative sample of young children, to investigate whether the association between socioeconomic status (family income and…

  10. Prescription Pain Reliever Abuse and Dependence among Adolescents: A Nationally Representative Study

    Science.gov (United States)

    Wu, Li-Tzy; Ringwalt, Christopher L.; Mannelli, Paolo; Patkar, Ashwin A.

    2008-01-01

    The study investigates the prevalence, patterns, and correlates of adolescents' abuse, sub-threshold dependence, and dependence on prescription pain relievers (PPRs) in a nationally representative sample. Results show dependence on PPRs can take place without abuse and that sub-threshold dependence could have implications for major diagnostic…

  11. Serum phosphorus and mortality in the Third National Health and Nutrition Examination Survey (NHANES III): effect modification by fasting.

    Science.gov (United States)

    Chang, Alex R; Grams, Morgan E

    2014-10-01

    Serum phosphorus levels have been associated with mortality in some but not all studies. Because dietary intake prior to measurement can affect serum phosphorus levels, we hypothesized that the association between serum phosphorus level and mortality is strongest in those who have fasted longer. Prospective cohort study. Nationally representative sample of 12,984 participants 20 years or older in the Third National Health and Nutrition Examination Survey (1988-1994). Serum phosphorus level, fasting duration (dichotomized as ≥ 12 or fasting duration recorded as time since food or drink other than water was consumed. Individuals fasting 12 or more hours had lower serum phosphorus levels than those fasting less than 12 hours (3.34 vs 3.55 mg/dL; P fasting 12 or more hours (adjusted HR, 1.74; 95% CI, 1.38-2.20; reference, lowest quartile) but not in participants fasting less than 12 hours (adjusted HR, 1.08; 95% CI, 0.89-1.32; P for interaction = 0.002). Relationships were consistent using 8 hours as the fasting cutoff point or cardiovascular mortality as the outcome. Observational study, lack of fibroblast growth factor 23 or intact parathyroid hormone measurements. Fasting but not nonfasting serum phosphorus levels were associated with increased mortality. Risk prognostication based on serum phosphorus may be improved using fasting levels. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  12. Correlation between national income, HIV/AIDS and political status and mortalities in African countries.

    Science.gov (United States)

    Andoh, S Y; Umezaki, M; Nakamura, K; Kizuki, M; Takano, T

    2006-07-01

    To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education. We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants. Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR. National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

  13. Visit of H.E. Mr. S. Marchi, Ambassador and Permanent Representative for Canada to the Office of the United Nations at Geneva and H.E. Mr. Ch. Westdal, Alternate Permanent Representative, Ambassador to the Office of the United Nations Permanent Representative and Ambassador to the United Nations for Disarmament for Canada

    CERN Multimedia

    Patrice Loiez

    2000-01-01

    Visit of H.E. Mr. S. Marchi, Ambassador and Permanent Representative for Canada to the Office of the United Nations at Geneva and H.E. Mr. Ch. Westdal, Alternate Permanent Representative, Ambassador to the Office of the United Nations Permanent Representative and Ambassador to the United Nations for Disarmament for Canada

  14. National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

    Science.gov (United States)

    Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

    2016-01-01

    Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

  15. Renal failure deaths and their risk factors in India 2001-13: nationally representative estimates from the Million Death Study.

    Science.gov (United States)

    Dare, Anna J; Fu, Sze Hang; Patra, Jayadeep; Rodriguez, Peter S; Thakur, J S; Jha, Prabhat

    2017-01-01

    Renal failure represents a growing but mostly undocumented cause of premature mortality in low-income and middle-income countries. We investigated changes in adult renal failure mortality and its key risk factors in India using the nationally representative Million Death Study. In this cross-sectional analysis of population-based data, two trained physicians independently assigned underlying causes to 150 018 deaths at ages 15-69 years from a nationally-representative mortality survey in India for 2001-03 and 2010-13, using the International Classification of Diseases, 10th version (ICD-10). We applied the age-specific proportion of renal failure deaths for the 2010-13 period to the 2015 UN estimates of total deaths in India and calculated age-standardised death rates for renal failure by rural or urban residence, state, and age group. We used proportional mortality of renal deaths (cases) to injuries (controls) to calculate the odds of renal death in the presence of different comorbidities and stratified risks by decade of birth. In 2001-03, 2·1% of total deaths among 15-69 year olds were from renal failure (1266 [2·2%] of 58 871; unweighted). By 2010-13, the proportion of deaths from renal failure had risen to 2·9% (2943 [3·2%] of 91 147; unweighted) of total deaths and corresponding to 136 000 renal failure deaths (range 108 000-150 000) of 4 688 000 total deaths nationally in 2015. Age-standardised renal death rates were highest in the southern and eastern states, particularly among adults aged 45-69 years in 2010-13. Diabetes, hypertension, and cardiovascular disease were all significantly associated with increased renal failure deaths, with diabetes the strongest predictor-odds ratio (OR) vs control 9·2 (95% CI 6·7-12·7) in 2001-03, rising to 15·1 (12·6-18·1) in 2010-13. In the 2010-13 study population, the diabetes to non-diabetes OR was twice as large in adults born in the 1970s (25·5, 95% CI 17·6-37·1) as in those individuals

  16. Symptoms and problems in a nationally representative sample of advanced cancer patients

    DEFF Research Database (Denmark)

    Johnsen, Anna Thit; Petersen, Morten Aagaard; Pedersen, Lise

    2009-01-01

    Little is known about the need for palliative care among advanced cancer patients who are not in specialist palliative care. The purpose was to identify prevalence and predictors of symptoms and problems in a nationally representative sample of Danish advanced cancer patients. Patients with cancer...... or not were associated with several symptoms and problems. This is probably the first nationally representative study of its kind. It shows that advanced cancer patients in Denmark have symptoms and problems that deserve attention and that some patient groups are especially at risk....... predictors. In total, 977 (60%) patients participated. The most frequent symptoms/problems were fatigue (57%; severe 22%) followed by reduced role function, insomnia and pain. Age, cancer stage, primary tumour, type of department, marital status and whether the patient had recently been hospitalized...

  17. A review of sugar consumption from nationally representative dietary surveys across the world

    OpenAIRE

    Newens, K. J.; Walton, J.

    2015-01-01

    Abstract Background Government and health organisations worldwide have recently reviewed the evidence on the role of dietary sugars in relation to health outcomes. Hence, it is timely to review current intakes of dietary sugars with respect to this guidance and as a benchmark for future surveillance. Methods This review collates data from nationally representative dietary surveys across the world and reports estimates of intakes of total and added sugars, and sucrose in different population s...

  18. Socioeconomic Determinants of Bullying in the Workplace: A National Representative Sample in Japan

    OpenAIRE

    Tsuno, Kanami; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Odagiri, Yuko; Yoshikawa, Toru; Haratani, Takashi; Shimomitsu, Teruichi; Kawachi, Ichiro

    2015-01-01

    Bullying in the workplace is an increasingly recognized threat to employee health. We sought to test three hypotheses related to the determinants of workplace bullying: power distance at work; safety climate; and frustration related to perceived social inequality. A questionnaire survey was administered to a nationally representative community-based sample of 5,000 residents in Japan aged 20-60 years. The questionnaire included questions about employment, occupation, company size, education, ...

  19. Predictors of type 2 diabetes in a nationally representative sample of adults with psychosis

    OpenAIRE

    Foley, Debra L; Mackinnon, Andrew; Morgan, Vera A; Watts, Gerald F; McGrath, John J; Castle, David J; Waterreus, Anna; Galletly, Cherrie A

    2014-01-01

    Antipsychotic drugs such as clozapine and olanzapine are associated with an increased risk for type 2 diabetes, but relatively little is known about the relationship between risk factors for type 2 diabetes established in the general population and type 2 diabetes in people with psychosis. We estimated the prevalence of established risk factors and their association with type 2 diabetes in a nationally representative sample of people with an ICD-10 psychosis (N=1642) who gave a fasting blood ...

  20. Calculating a Continuous Metabolic Syndrome Score Using Nationally Representative Reference Values.

    Science.gov (United States)

    Guseman, Emily Hill; Eisenmann, Joey C; Laurson, Kelly R; Cook, Stephen R; Stratbucker, William

    2018-02-26

    The prevalence of metabolic syndrome in youth varies on the basis of the classification system used, prompting implementation of continuous scores; however, the use of these scores is limited to the sample from which they were derived. We sought to describe the derivation of the continuous metabolic syndrome score using nationally representative reference values in a sample of obese adolescents and a national sample obtained from National Health and Nutrition Examination Survey (NHANES) 2011-2012. Clinical data were collected from 50 adolescents seeking obesity treatment at a stage 3 weight management center. A second analysis relied on data from adolescents included in NHANES 2011-2012, performed for illustrative purposes. The continuous metabolic syndrome score was calculated by regressing individual values onto nationally representative age- and sex-specific standards (NHANES III). Resultant z scores were summed to create a total score. The final sample included 42 obese adolescents (15 male and 35 female subjects; mean age, 14.8 ± 1.9 years) and an additional 445 participants from NHANES 2011-2012. Among the clinical sample, the mean continuous metabolic syndrome score was 4.16 ± 4.30, while the NHANES sample mean was quite a bit lower, at -0.24 ± 2.8. We provide a method to calculate the continuous metabolic syndrome by comparing individual risk factor values to age- and sex-specific percentiles from a nationally representative sample. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  1. 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.

  2. What characterizes persons with high levels of perceived stress in Denmark? A national representative study.

    Science.gov (United States)

    Nielsen, Line; Curtis, Tine; Kristensen, Tage S; Rod Nielsen, Naja

    2008-06-01

    Stress is a growing public health problem, but there are only a few studies with national representative samples on the occurrence of stress. The aim of this study was to assess the level of stress, measured by the Perceived Stress Scale, in Denmark, and to identify and characterize the group with high levels of stress by factors measured at both the individual and neighbourhood levels in a national representative sample of the Danish population. The 10,022 participants in the National Health Interview Survey 2005 were asked about perceived stress and individual factors in a cross-sectional design. Information on neighbourhood factors was derived from a national registry. Data were analysed by means of logistic regression models. Low education, heavy smoking, physical inactivity, lack of social network and poor working conditions were associated with perceived stress. For women, living in a neighbourhood with low average education, and for men, living in a neighbourhood with a high rate of crime and a low degree of ethnic diversity, were associated with higher perceived stress. Perceived stress was also related to indicators of morbidity. The group with high perceived stress is characterized by individual and neighbourhood factors with negative impacts on quality of life and risk of illness. This knowledge can guide future stress prevention efforts. Additionally, the results suggest a negative social component where perceived stress, unhealthy lifestyle and low social status are accumulated, and perceived stress might be used as a measure to identify groups characterized by accumulation of risk factors.

  3. Operationalization and Validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Fall Risk Algorithm in a Nationally Representative Sample

    Science.gov (United States)

    Lohman, Matthew C.; Crow, Rebecca S.; DiMilia, Peter R.; Nicklett, Emily J.; Bruce, Martha L.; Batsis, John A.

    2017-01-01

    Background Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool’s predictive validity or adaptability to survey data. Methods Data from five annual rounds (2011–2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 and older in the US. Analytic sample respondents (n=7,392) were categorized at baseline as having low, moderate, or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. Results Participants classified as having moderate and high fall risk had 2.62 (95% CI: 2.29, 2.99) and 4.76 (95% CI: 3.51, 6.47) times greater odds of falling during follow-up compared to those with low risk, respectively, controlling for sociodemographic and health related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. Conclusion The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardize screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted. PMID:28947669

  4. Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample.

    Science.gov (United States)

    Lohman, Matthew C; Crow, Rebecca S; DiMilia, Peter R; Nicklett, Emily J; Bruce, Martha L; Batsis, John A

    2017-12-01

    Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool's predictive validity or adaptability to survey data. Data from five annual rounds (2011-2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 years and older in the USA. Analytic sample respondents (n=7392) were categorised at baseline as having low, moderate or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. Participants classified as having moderate and high fall risk had 2.62 (95% CI 2.29 to 2.99) and 4.76 (95% CI 3.51 to 6.47) times greater odds of falling during follow-up compared with those with low risk, respectively, controlling for sociodemographic and health-related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardise screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted. © 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.

  5. National Trends in Patients Hospitalized for Stroke and Stroke Mortality in France, 2008 to 2014.

    Science.gov (United States)

    Lecoffre, Camille; de Peretti, Christine; Gabet, Amélie; Grimaud, Olivier; Woimant, France; Giroud, Maurice; Béjot, Yannick; Olié, Valérie

    2017-11-01

    Stroke is the leading cause of death in women and the third leading cause in men in France. In young adults (ie, stroke was observed at a local scale between 1985 and 2011. After the implementation of the 2010 to 2014 National Stroke Action Plan, this study investigates national trends in patients hospitalized by stroke subtypes, in-hospital mortality, and stroke mortality between 2008 and 2014. Hospitalization data were extracted from the French national hospital discharge databases and mortality data from the French national medical causes of death database. Time trends were tested using a Poisson regression model. From 2008 to 2014, the age-standardized rates of patients hospitalized for ischemic stroke increased by 14.3% in patients hemorrhagic stroke was stable (+2.0%), irrespective of age and sex. The proportion of patients hospitalized in stroke units substantially increased. In-hospital mortality decreased by 17.1% in patients with ischemic stroke. From 2008 to 2013, stroke mortality decreased, except for women between 45 and 64 years old and for people aged ≥85 years. An increase in cardiovascular risk factors and improved stroke management may explain the increase in the rates of patients hospitalized for ischemic stroke. The decrease observed for in-hospital stroke mortality may be because of recent improvements in acute-phase management. © 2017 American Heart Association, Inc.

  6. Pneumonectomy for lung cancer: contemporary national early morbidity and mortality outcomes.

    Science.gov (United States)

    Thomas, Pascal A; Berbis, Julie; Baste, Jean-Marc; Le Pimpec-Barthes, Françoise; Tronc, François; Falcoz, Pierre-Emmanuel; Dahan, Marcel; Loundou, Anderson

    2015-01-01

    The study objective was to determine contemporary early outcomes associated with pneumonectomy for lung cancer and to identify their predictors using a nationally representative general thoracic surgery database (EPITHOR). After discarding inconsistent files, a group of 4498 patients who underwent elective pneumonectomy for primary lung cancer between 2003 and 2013 was selected. Logistic regression analysis was performed on variables for mortality and major adverse events. Then, a propensity score analysis was adjusted for imbalances in baseline characteristics between patients with or without neoadjuvant treatment. Operative mortality was 7.8%. Surgical, cardiovascular, pulmonary, and infectious complications rates were 14.9%, 14.1%, 11.5%, and 2.7%, respectively. None of these complications were predicted by the performance of a neoadjuvant therapy. Operative mortality analysis, adjusted for the propensity scores, identified age greater than 65 years (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5-2.9; P < .001), underweight body mass index category (OR, 2.2; 95% CI, 1.2-4.0; P = .009), American Society of Anesthesiologists score of 3 or greater (OR, 2.310; 95% CI, 1.615-3.304; P < .001), right laterality of the procedure (OR, 1.8; 95% CI, 1.1-2.4; P = .011), performance of an extended pneumonectomy (OR, 1.5; 95% CI, 1.1-2.1; P = .018), and absence of systematic lymphadenectomy (OR, 2.9; 95% CI, 1.1-7.8; P = .027) as risk predictors. Induction therapy (OR, 0.63; 95% CI, 0.5-0.9; P = .005) and overweight body mass index category (OR, 0.60; 95% CI, 0.4-0.9; P = .033) were protective factors. Several risk factors for major adverse early outcomes after pneumonectomy for cancer were identified. Overweight patients and those who received induction therapy had paradoxically lower adjusted risks of mortality. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  7. The Impact of climate change on heat-related mortality in six major cities, South Korea, under representative concentration pathways (RCPs

    Directory of Open Access Journals (Sweden)

    Youngmin eKim

    2014-02-01

    Full Text Available Background: We aimed to quantify the excess mortality associated with increased temperature due to climate change in six major Korean cities under Representative Concentration Pathways (RCPs which are new emission scenarios designed for the fifth assessment report of the Intergovernmental Panel on Climate Change (IPCC. Methods: We first examined the association between daily mean temperature and mortality in each during the summertime (June to September from 2001 to 2008. This was done using a generalized linear Poisson model with adjustment for a long-term time trend, relative humidity, air pollutants, and day of the week. We then computed heat-related mortality attributable to future climate change using estimated mortality risks, projected future populations, and temperature increments for both future years 2041-2070 and 2071-2100 under RCP 4.5 and 8.5. We considered effects from added days with high temperatures over thresholds and shifted effects from high to higher temperature.Results: Estimated excess all-cause mortalities for six cities in Korea ranged from 500 (95% CI: 313-703 for 2041-2070 to 2,320 (95% CI: 1,430-3,281 deaths per year for 2071-2100 under two RCPs. Excess cardiovascular mortality was estimated to range from 192 (95% CI: 41-351 to 896 (95% CI: 185-1,694 deaths per year, covering about 38.5% of all-cause excess mortality. Increased rates of heat-related mortality were higher in cities located at relatively lower latitude than cities with higher latitude. Estimated excess mortality under RCP 8.5, a fossil fuel-intensive emission scenario, was more than twice as high compared with RCP 4.5, low to medium emission scenario.Conclusions: Excess mortality due to climate change is expected to be profound in the future showing spatial variation. Efforts to mitigate climate change can cause substantial health benefits via reducing heat-related mortality.

  8. 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

  9. Sexual orientation and future parenthood in a 2011-2013 nationally representative United States sample.

    Science.gov (United States)

    Riskind, Rachel G; Tornello, Samantha L

    2017-09-01

    Previous researchers have found evidence for differences in parenting goals between lesbian and gay people and their heterosexual peers. However, no previous research has quantified the parenting goals of bisexual people or evaluated parenting goals as a function of sexual partner gender. In addition, political and social climates for sexual minority people had improved rapidly since the last representative data on lesbian and gay peoples' plans for parenthood were collected. We analyzed data from 3,941 childless lesbian, gay, bisexual, and heterosexual participants from the 2011-2013 National Survey of Family Growth (NSFG; United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2014), a nationally representative sample of United States residents aged 15 to 44 years. We found that statistically significant, within-gender sexual orientation differences in parenting plans persist, despite social and legal changes. Consistent with hypotheses, bisexual men's parenting desires and intentions were similar to those of their heterosexual male peers and different from those of their gay male peers, while bisexual women's reports were more mixed. Also consistent with hypotheses, the gender of the most recent sexual partner was a strong predictor of parenting goals. We discuss implications for mental and reproductive health-care providers, attorneys, social workers, and others who interact with sexual minority adults. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Neighborhoods and mortality in Sweden: Is deprivation best assessed nationally or regionally?

    Directory of Open Access Journals (Sweden)

    Daniel Oudin Åström

    2018-01-01

    Full Text Available Background: The association between neighborhood deprivation and mortality is well established, but knowledge about whether deprivation is best assessed regionally or nationally is scarce. Objective: The present study aims to examine whether there is a difference in results when using national and county-specific neighborhood deprivation indices and whether the level of urbanization modifies the association between neighborhood deprivation and mortality. Methods: We collected data on the entire population aged above 50 residing in the 21 Swedish counties on January 1, 1990, and followed them for mortality due to all causes and for coronary heart disease. The association between neighborhood deprivation and mortality was assessed using Cox regression, assuming proportional hazards with attained age as an underlying variable, comparing the 25Š most deprived neighborhoods with the 25Š most affluent ones within each region, and using both the national and the county-specific indices. The potential interactions were also assessed. Results: The choice of a national or a county-specific index did not affect the estimates to a large extent. The effect of neighborhood deprivation on mortality in metropolitan regions (hazard ratio: 1.21 [1.20-1.22] was somewhat higher than that in the more rural southern (HR: 1.16 [1.15-1.17] and northern regions (HR: 1.11 [1.09-1.12]. Conclusions: Our data indicates that the choice of a national or a county-specific deprivation index does not influence the results to a significant extent, but may be of importance in large metropolitan regions. Furthermore, the strength of the association between neighborhood deprivation and mortality is somewhat greater in metropolitan areas than in more rural southern and northern areas. Contribution: The study contributes to a better understanding of the complex association between neighborhood and mortality.

  11. The prevalence of workaholism: a survey study in a nationally representative sample of Norwegian employees.

    Directory of Open Access Journals (Sweden)

    Cecilie Schou Andreassen

    Full Text Available Workaholism has become an increasingly popular area for empirical study. However, most studies examining the prevalence of workaholism have used non-representative samples and measures with poorly defined cut-off scores. To overcome these methodological limitations, a nationally representative survey among employees in Norway (N = 1,124 was conducted. Questions relating to gender, age, marital status, caretaker responsibility for children, percentage of full-time equivalent, and educational level were asked. Workaholism was assessed by the use of a psychometrically validated instrument (i.e., Bergen Work Addiction Scale. Personality was assessed using the Mini-International Personality Item Pool. Results showed that the prevalence of workaholism was 8.3% (95% CI  = 6.7-9.9%. An adjusted logistic regression analysis showed that workaholism was negatively related to age and positively related to the personality dimensions agreeableness, neuroticism, and intellect/imagination. Implications for these findings are discussed.

  12. Intergenerational Transmission of Marital Violence: Results From a Nationally Representative Sample of Men.

    Science.gov (United States)

    Murshid, Nadine Shaanta; Murshid, Navine

    2015-09-16

    The present study assesses the association between childhood exposure to parental violence and perpetration of marital violence as adults among a representative sample of 3,396 men in Bangladesh. We used secondary analysis of survey data from the nationally representative Bangladesh Demographic and Health Survey 2007 to examine factors associated with perpetration of martial violence among 3,396 ever-married men between the ages of 16 and 50 years. Outcome measure, marital violence perpetration, was measured using a modified Conflict Tactics Scale, and predictor variables included childhood exposure to parental violence, justification of marital violence, marital duration, religion, and demographic variables. Results indicate that marital violence perpetration is significantly associated with childhood exposure to marital violence, suggesting a cycle of violence that is maintained across generations. Implications for policy and practice are discussed. © The Author(s) 2015.

  13. Income is a stronger predictor of mortality than education in a national sample of US adults.

    Science.gov (United States)

    Sabanayagam, Charumathi; Shankar, Anoop

    2012-03-01

    Low socioeconomic status (SES) is associated with mortality in several populations. SES measures, such as education and income, may operate through different pathways. However, the independent effect of each measure mutually adjusting for the effect of other SES measures is not clear. The association between poverty-income ratio (PIR) and education and all-cause mortality among 15,646 adults, aged >20 years, who participated in the Third National Health and Nutrition Examination Survey in the USA, was examined. The lower PIR quartiles and less than high school education were positively associated with all-cause mortality in initial models adjusting for the demographic, lifestyle and clinical risk factors. After additional adjustment for education, the lower PIR quartiles were still significantly associated with all-cause mortality. The multivariable odds ratio (OR) [95% confidence interval (CI)] of all-cause mortality comparing the lowest to the highest quartile of PIR was 2.11 (1.52-2.95, p trend education was no longer associated with all-cause mortality [multivariable OR (95% CI) of all-cause mortality comparing less than high school to more than high school education was 1.05 (0.85-1.31, p trend=0.57)]. The results suggest that income may be a stronger predictor of mortality than education, and narrowing the income differentials may reduce the health disparities.

  14. Timing of mortality in pediatric trauma patients: A National Trauma Data Bank analysis.

    Science.gov (United States)

    McLaughlin, Cory; Zagory, Jessica A; Fenlon, Michael; Park, Caron; Lane, Christianne J; Meeker, Daniella; Burd, Randall S; Ford, Henri R; Upperman, Jeffrey S; Jensen, Aaron R

    2018-02-01

    The classic "trimodal" distribution of death has been described in adult patients, but the timing of mortality in injured children is not well understood. The purpose of this study was to define the temporal distribution of mortality in pediatric trauma patients. A retrospective cohort of patients with mortality from the National Trauma Data Bank (2007-2014) was analyzed. Categorical comparison of 'dead on arrival', 'death in the emergency department', and early (≤24h) or late (>24h) inpatient death was performed. Secondary analyses included mortality by pediatric age, predictors of early mortality, and late complication rates. Children (N=5463 deaths) had earlier temporal distribution of death compared to adults (n=104,225 deaths), with 51% of children dead on arrival or in ED compared to 44% of adults (p<0.001). For patients surviving ED resuscitation, children and adolescents had a shorter median time to death than adults (1.2 d and 0.8 days versus 1.6 days, p<0.001). Older age, penetrating mechanism, bradycardia, hypotension, tube thoracostomy, and thoracotomy were associated with early mortality in children. Injured children have higher incidence of early mortality compared to adults. This suggests that injury prevention efforts and strategies for improving early resuscitation have potential to improve mortality after pediatric injury. Level III: Retrospective cohort study. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Religious Influence on Older Americans' Sexual Lives: A Nationally-Representative Profile.

    Science.gov (United States)

    Iveniuk, James; O'Muircheartaigh, Colm; Cagney, Kathleen A

    2016-01-01

    This study investigated the relationship between religious influence and sexual expression in older Americans, with specific attention to gender. Using the National Social Life, Health, and Aging Project, a nationally-representative survey of older adults, we created a composite measure of religious influence on sexual expression using Latent Class Analysis. We found more variability within denominations than between in terms of membership in the high-influence class; this indicated that religious influence on sexual expression was diverse within faiths. We show that religious influence was associated with higher self-reported satisfaction with frequency of sex, as well as higher physical and emotional satisfaction with sex, but only for men. Men were also significantly more likely than women to report that they would only have sex with a person they love. These results persisted in the presence of controls for demographic characteristics, religious affiliation, church attendance, intrinsic religiosity, political ideology, and functional health.

  16. Religious influence on older Americans’ sexual lives: A nationally-representative profile

    Science.gov (United States)

    Iveniuk, James; O’Muircheartaigh, Colm

    2017-01-01

    This study investigates the relationship between religious influence and sexual expression in older Americans, with specific attention to gender. Using the National Social Life, Health and Aging Project, a nationally-representative survey of older adults, we create a composite measure of religious influence on sexual expression using Latent Class Analysis. We find more variability within denominations than between in terms of membership in the high-influence class; this indicates that religious influence on sexual expression is diverse within faiths. We show that religious influence is associated with higher self-reported satisfaction with frequency of sex, as well as higher physical and emotional satisfaction with sex, but only for men. Men are also significantly more likely than women to report that they would only have sex with a person they love. These results persisted in the presence of controls for demographic characteristics, religious affiliation, church attendance, intrinsic religiosity, political ideology, and functional health. PMID:26063533

  17. One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey.

    Science.gov (United States)

    Shah, Rupal; Nahar, Quamrun; Gurley, Emily S

    2016-03-01

    We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh. © The American Society of Tropical Medicine and Hygiene.

  18. Ordinary or peculiar men? Comparing the customers of prostitutes with a nationally representative sample of men.

    Science.gov (United States)

    Monto, Martin A; Milrod, Christine

    2014-07-01

    Recent media attention implies that prostitution seeking is widespread, an "ordinary" aspect of masculine sexual behavior. Other accounts suggest that customers are "peculiar," characterized by distinct qualities, perversions, or psychological impairments. Using the nationally representative General Social Survey (GSS), this study demonstrates that prostitution seeking is relatively uncommon. Only about 14% of men in the United States report having ever paid for sex, and only 1% report having done so during the previous year. Furthermore, this study dissects whether customers are ordinary or peculiar by comparing a new sample of active customers who solicit sex on the Internet with an older sample of arrested customers, a sample of customers from the GSS, and a nationally representative sample of noncustomers. The customers of Internet sexual service providers differed greatly from men in general and also from other customers. The remaining samples of customers differed slightly from noncustomers in general. We argue for a balanced perspective that recognizes the significant variety among customers. There is no evidence of a peculiar quality that differentiates customers in general from men who have not paid for sex. © The Author(s) 2013.

  19. The influence of community well-being on mortality among Registered First Nations people.

    Science.gov (United States)

    Oliver, Lisa N; Penney, Chris; Peters, Paul A

    2016-07-20

    Living in a community with lower socioeconomic status is associated with higher mortality. However, few studies have examined associations between community socioeconomic characteristics and mortality among the First Nations population. The 1991-to-2006 Census Mortality and Cancer Cohort follow-up, which tracked a 15% sample of Canadians aged 25 or older, included 57,300 respondents who self-identified as Registered First Nations people or Indian band members. The Community Well-Being Index (CWB), a measure of the social and economic well-being of communities, consists of income, education, labour force participation, and housing components. A dichotomous variable was used to indicate residence in a community with a CWB score above or below the average for First Nations communities. Age-standardized mortality rates (ASMRs) were calculated for First Nations cohort members in communities with CWB scores above and below the First Nations average. Cox proportional hazards models examined the impact of CWB when controlling for individual characteristics. The ASMR for First Nations cohort members in communities with a below-average CWB was 1,057 per 100,000 person-years at risk, compared with 912 for those in communities with an above-average CWB score. For men, living in a community with below-average income and labour force participation CWB scores was associated with an increased hazard of death, even when individual socioeconomic characteristics were taken into account. Women in communities with below-average income scores had an increased hazard of death. First Nations people in communities with below-average CWB scores tended to have higher mortality rates. For some components of the CWB, effects remained even when individual socioeconomic characteristics were taken into account.

  20. Mortality among foreign nationals in Chiang Mai City, Thailand, 2010 to 2011.

    Science.gov (United States)

    Pawun, Vichan; Visrutaratna, Surasing; Ungchusak, Kumnuan; Mahasing, Suteerat; Khumtalord, Chosita; Tipsriraj, Siriying; Chenwittaya, Chalermpol; Guadamuz, Thomas E; Wisniewski, Stephen R

    2012-12-01

    Up to 65% of travelers to less developed countries report health problems while traveling. International travel is an increasing concern for health practitioners. To date, there have not been any published analyses of mortality amongst foreign nationals visiting Thailand. Our objectives are to examine the magnitude and characterize the deaths among foreign nationals in Chiang Mai, a popular tourist province in Thailand. The study commenced with a review of the Thai death registration. Death certificates were retrieved, reviewed, and classified by the causes of death. Basic statistics and proportionate mortality ratio (PMR) were used to describe the pattern of deaths. Standardized mortality ratio (SMR) was used to assess the excess mortality risk among foreign nationals. Between January 1, 2010 and May 31, 2011, there were 1,295 registered deaths in Chiang Mai City, of which 102 records (7.9%) were foreign nationals. Median age of decedents was 64 years (range 14-102 y). Female-to-male ratio was 1 : 5.4. The highest mortality was among Europeans (45.1%). Most of the deaths were natural causes (89.2%) including 36 cardiac diseases (PMR = 35.3) and 20 malignancy diseases (PMR = 19.6). Deaths due to external causes were low. The SMRs range between 0.15 and 0.30. Communicable diseases and injuries were not the leading causes of death among foreign nationals visiting Chiang Mai, Thailand. It is essential that travelers are aware of mortality risk associated with their underlying diseases and that they are properly prepared to handle them while traveling. © 2012 International Society of Travel Medicine.

  1. The mental health impact of AIDS-related mortality in South Africa: a national study

    Science.gov (United States)

    Myer, L; Seedat, S; Stein, D J; Moomal, H; Williams, D R

    2011-01-01

    Background Few data exist on how the HIV/AIDS epidemic may influence population mental health. The associations were examined between knowing someone who died of HIV/AIDS and common mental disorders among South African adults. Methods Between 2002 and 2004, a nationally representative sample of 4351 adults were interviewed about personally knowing someone who died of HIV/AIDS, and the World Health Organization Composite International Diagnostic Interview was used to generate psychiatric diagnoses for depression, anxiety and substance abuse disorders during the preceding 12 months based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). Results Overall, 42.2% of the sample knew someone who died of HIV/AIDS, and 16.5% met the criteria for at least one DSM-IV diagnosis. Individuals who knew someone who died of HIV/AIDS were significantly more likely to have any DSM-IV defined disorder, including any depressive, anxiety or substance-related disorder (pdrug dependence or abuse. Based on these results, it is estimated that up to 15% of 12-month DSM-IV disorders in the South African adult population may be related to knowing someone who died of HIV/AIDS. Conclusion These novel data suggest that AIDS-related mortality may contribute substantially to the burden of mental disorders in settings of high HIV prevalence. While this finding requires further investigation, these data suggest the need to strengthen mental health services in communities where HIV/AIDS is prevalent. PMID:19074926

  2. Association of post-traumatic stress disorder and obesity in a nationally representative sample.

    Science.gov (United States)

    Pagoto, Sherry L; Schneider, Kristin L; Bodenlos, Jamie S; Appelhans, Bradley M; Whited, Matthew C; Ma, Yunsheng; Lemon, Stephenie C

    2012-01-01

    Recent studies suggest a possible link between post-traumatic stress disorder (PTSD) and obesity risk, which would have implications for the development of obesity-related diseases in this population. The present study examined the association between PTSD and obesity and whether this association differed by sex in a representative sample of the US population. A secondary objective was to determine whether the association between PTSD and obesity was mediated by binge eating disorder (BED). Data were from the Collaborative Psychiatric Epidemiology Surveys (CPES), which comprises three nationally representative cross-sectional surveys that were conducted between 2001 and 2003. Logistic regression analyses weighted to represent the general US adult population were performed. In the total sample of 20,013 participants, rates of obesity were 24.1% for persons without a lifetime history of PTSD and 32.6% among persons with PTSD in the past year. Adjusting for socio-demographic characteristics, depression, substance and alcohol abuse/dependence, and psychotropic medication status, past year PTSD was associated with greater likelihood of obesity (odds ratio (OR) = 1.51; 95% confidence interval (CI) = 1.18, 1.95), with no differences by gender. BED did not statistically mediate the relationship between PTSD and obesity. The present study provides support for a link between PTSD and obesity. Findings further existing literature by indicating that the association is consistent across sexes and is not statistically mediated by BED.

  3. Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample.

    Science.gov (United States)

    Skodol, Andrew E; Grilo, Carlos M; Keyes, Katherine M; Geier, Timothy; Grant, Bridget F; Hasin, Deborah S

    2011-03-01

    The purpose of this study was to examine the effects of specific personality disorder comorbidity on the course of major depressive disorder in a nationally representative sample. Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (in 2001-2002) were reinterviewed 3 years later (in 2004-2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. A total of 15.1% of participants had persistent major depressive disorder, and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With axis I comorbidity controlled, all personality disorders except histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal disorders remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, the number of previous episodes, duration of the current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. In this nationally representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment.

  4. Relationship of Personality Disorders to the Course of Major Depressive Disorder in a Nationally Representative Sample

    Science.gov (United States)

    Skodol, Andrew E.; Grilo, Carlos M.; Keyes, Katherine; Geier, Timothy; Grant, Bridget F.; Hasin, Deborah S.

    2011-01-01

    Objective The purpose of this study was to examine the effects of specific personality disorder co-morbidity on the course of major depressive disorder in a nationally-representative sample. Method Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (2001–2002) were re-interviewed three years later (2004–2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other Axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. Results 15.1% of participants had persistent major depressive disorder and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With Axis I co-morbidity controlled, all but histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, number of previous episodes, duration of current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. Conclusions In this nationally-representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment. PMID:21245088

  5. Applying an Occupational Classification to a National Representative Sample of Work Histories of Young Men and Women.

    Science.gov (United States)

    Nafziger, Dean H.; And Others

    Holland's occupational classification was used to analyze the work histories of a national representative sample of young men and women age 14-24. This study extended previous tests of the classification in three ways: (1) It was applied for the first time to a national, representative sample of women, (2) For the sample of men, 3-year…

  6. Health Correlates of Insomnia Symptoms and Comorbid Mental Disorders in a Nationally Representative Sample of US Adolescents

    NARCIS (Netherlands)

    Blank, M.; Zhang, J.H.; Lamers, F.; Taylor, A.D.; Hickie, I.B.; Merikangas, K.R.

    2015-01-01

    Study Objectives: To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. Design: National representative cross-sectional study. Setting: Population-based

  7. Pathological narcissism and maladaptive self-regulatory behaviours in a nationally representative sample of Canadian men.

    Science.gov (United States)

    Kealy, David; Ogrodniczuk, John S; Rice, Simon M; Oliffe, John L

    2017-10-01

    Clinical observation has linked externalizing coping strategies such as substance overuse and aggressive behaviours with narcissistic personality dysfunction. This study examined the relationship between pathological narcissism and maladaptive self-regulatory behaviours among Canadian men. An online survey was distributed among a stratified, nationally representative sample of 1000 men from across Canada. The survey included brief self-report measures of pathological narcissism, maladaptive externalizing coping behaviours, and general psychological distress. After controlling for the effects of age and general psychological distress, pathological narcissism was found to be significantly associated with alcohol overuse and aggressive behaviour. Significant though modest interaction effects were found between pathological narcissism and age - with regards to drug use - and distress - with regards to risk-taking behaviour. The findings point to the need for attention to narcissistic dysfunction as a clinical and public health issue among men. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample.

    Directory of Open Access Journals (Sweden)

    Fanni Bányai

    Full Text Available Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD. Using the Bergen Social Media Addiction Scale (BSMAS and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs.

  9. Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample.

    Science.gov (United States)

    Bányai, Fanni; Zsila, Ágnes; Király, Orsolya; Maraz, Aniko; Elekes, Zsuzsanna; Griffiths, Mark D; Andreassen, Cecilie Schou; Demetrovics, Zsolt

    2017-01-01

    Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs.

  10. Neighborhood age structure and cognitive function in a nationally-representative sample of older adults in the U.S.

    Science.gov (United States)

    Friedman, Esther M; Shih, Regina A; Slaughter, Mary E; Weden, Margaret M; Cagney, Kathleen A

    2017-02-01

    Recent evidence suggests that living in a neighborhood with a greater percentage of older adults is associated with better individual health, including lower depression, better self-rated health, and a decreased risk of overall mortality. However, much of the work to date suffers from four limitations. First, none of the U.S.-based studies examine the association at the national level. Second, no studies have examined three important hypothesized mechanisms - neighborhood socioeconomic status and neighborhood social and physical characteristics - which are significantly correlated with both neighborhood age structure and health. Third, no U.S. study has longitudinally examined cognitive health trajectories. We build on this literature by examining nine years of nationally-representative data from the Health and Retirement Study (2002-2010) on men and women aged 51 and over linked with Census data to examine the relationship between the percentage of adults 65 and older in a neighborhood and individual cognitive health trajectories. Our results indicate that living in a neighborhood with a greater percentage of older adults is related to better individual cognition at baseline but we did not find any significant association with cognitive decline. We also explored potential mediators including neighborhood socioeconomic status, perceived neighborhood cohesion and perceived neighborhood physical disorder. We did not find evidence that neighborhood socioeconomic status explains this relationship; however, there is suggestive evidence that perceived cohesion and disorder may explain some of the association between age structure and cognition. Although more work is needed to identify the precise mechanisms, this work may suggest a potential contextual target for public health interventions to prevent cognitive impairment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Global Volcano Mortality Risks and Distribution

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Volcano Mortality Risks and Distribution is a 2.5 minute grid representing global volcano mortality risks. The data set was constructed using historical...

  12. Nutritional status and its correlates in Equatorial Guinean preschool children: results from a nationally representative survey.

    Science.gov (United States)

    Custodio, Estefanía; Descalzo, Miguel Angel; Roche, Jesús; Sánchez, Ignacio; Molina, Laura; Lwanga, Magdalena; Bernis, Cristina; Villamor, Eduardo; Baylin, Ana

    2008-03-01

    In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it. To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected. The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed. The overall prevalence of stunting (hemoglobin hemoglobin education, should be undertaken.

  13. Sex differences in the association between perceived stress and adiposity in a nationally representative sample.

    Science.gov (United States)

    Suglia, Shakira F; Pamplin, John R; Forde, Allana T; Shelton, Rachel C

    2017-10-01

    Prior studies examining the association between perceived stress and adiposity have reported mixed findings, and sex differences have largely not been examined. We examined the relationship between perceived stress and body mass index (BMI) and waist circumference in young adults in the National Longitudinal Study of Adolescent to Adult Health. Participants (mean age 29 years; N = 14,044) completed the short form of Cohen's Perceived Stress Scale during a home visit. Height, weight, and waist circumference were assessed during the same visit. BMI was calculated based on measured height and weight. In the sample, 52% were male and 65% were identified as white. In adjusted linear regression analyses, a sex by Perceived Stress Scale interaction was noted (P stress was statistically significantly associated with lower BMI (β: -0.09; standard error [SE]: 0.05) and was associated with lower waist circumference, although not statistically significant (β: -0.18; SE: 0.10) among men. No associations were noted among women. In this nationally representative sample of young adults, perceived stress was associated with lower levels of adiposity among men. Noted differences could be attributed to different behavioral and coping strategies in response to stress between men and women as well as biological mechanisms which should be explored further. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Maternal depression in the United States: nationally representative rates and risks.

    Science.gov (United States)

    Ertel, Karen A; Rich-Edwards, Janet W; Koenen, Karestan C

    2011-11-01

    To examine the public health burden of major depressive disorder (MDD) among mothers: its prevalence and sociodemographic patterns; associated functioning, comorbidities, and adversities; and racial/ethnic disparities. This was a cross-sectional analysis of 8916 mothers in the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative survey of the civilian U.S. population in 2001?2002. Past-year MDD was assessed with a structured interview protocol. Ten percent of mothers experienced depression in the past year. White and Native American women, those with low education or income, and those not married had high rates of depression. Depression was not strongly patterned by number of or age of children. Depressed mothers experienced more adversities (poverty, separation or divorce, unemployment, financial difficulties) and had worse functioning. Half of depressed mothers received services for their depression. Black and Hispanic depressed mothers were more likely to experience multiple adversities and less likely to receive services than white depressed mothers. Maternal depression is a major public health problem in the United States, with an estimated 1 in 10 children experiencing a depressed mother in any given year. Professionals who work with mothers and children should be aware of its prevalence and its detrimental effects.

  15. Less healthy dietary pattern is associated with smoking in Korean men according to nationally representative data.

    Science.gov (United States)

    Suh, Sang-Yeon; Lee, Ju Hyun; Park, Sang Shin; Seo, Ah-Ram; Ahn, Hong-Yup; Bae, Woo Kyung; Lee, Yong Joo; Yim, Eunji

    2013-06-01

    The relationship between smoking and nutrient intake has been widely investigated in several countries. However, Korea presents a population with a smoking rate of approximately 50% and dietary consumption of unique foods. Thus, the aim of this study was to evaluate the association of dietary patterns with smoking in Korean men using a nationally representative sample. The study subjects were comprised of 4,851 Korean men over 19 yr of age who participated in the fourth Korean National Health and Nutrition Examination Survey. Dietary data were assessed by the 24-hr recall method. The smoking group comprised 2,136 men (46.6%). Five dietary patterns were derived using factor analysis: 'sugar & fat', 'vegetables & seafood', 'meat & drinks', 'grains & eggs', and 'potatoes, fruits and dairy products.' Current smokers showed a more significant 'sugar & fat' pattern (P = 0.001) while significantly less of the 'vegetables & seafood' and 'potatoes, fruits and dairy products' patterns (P = 0.011, P Korean male smokers showed less healthy dietary patterns than nonsmokers. Thus, the result of this study underlines the need for health professionals to also provide advice on dietary patterns when counseling patients on smoking cessation.

  16. Prevalence and Predictors of Bullying Behavior among Overweight and Obese Youth in a Nationally Representative Sample.

    Science.gov (United States)

    Odar Stough, Cathleen; Merianos, Ashley; Nabors, Laura; Peugh, James

    2016-08-01

    Child and adolescent overweight and obesity are independent risk factors for poor social outcomes. Whether children who are overweight display greater bullying behaviors than normal weight peers, controlling for demographic and other social-ecological factors, was examined. The influence of child (e.g., mental health), family (e.g., income, parent mental health, and exposure to domestic violence), and community (e.g., exposure to neighborhood violence, unfair treatment based on race or ethnic group) factors on bullying risk in the subset of children who are overweight and obese was explored. We conducted a secondary data analysis of the 2011-2012 National Survey of Children's Health, a cross-sectional study providing a nationally representative sample of participants, using a series of multinomial logistic regressions in Mplus software (Muthén & Muthén, Los Angeles, CA). Participants were 41,361 youth ages 10-17 years. Despite statistically significant differences in unadjusted analyses, no differences were found in bullying behavior by weight status once controlling for other factors. Child, family, and neighborhood factors predicted bullying behavior in both the overall sample and the subset of overweight and obese youth. However, some risk factors were unique to children who were overweight or obese. Children who are overweight or obese are not at greater risk for engaging in bullying behavior than normal weight peers. Health professionals targeting bullying behavior should be aware of the impact child, family, and neighborhood factors have on bullying by overweight and obese children and adolescents.

  17. Genital burns in the national burn repository: incidence, etiology, and impact on morbidity and mortality.

    Science.gov (United States)

    Harpole, Bethany G; Wibbenmeyer, Lucy A; Erickson, Bradley A

    2014-02-01

    To better characterize national genital burns (GBs) characteristics using a large burn registry. We hypothesized that mortality and morbidity will be higher in patients with GBs. The National Burn Repository, a large North American registry of hospitalized burn patients, was queried for patients with GB. Burn characteristics and mechanism, demographics, mortality, and surgical interventions were retrieved. Outcomes of interest were mortality, hospital-acquired infection (HAI), and surgical intervention on the genitalia. Adjusted odds ratios (aOR) for outcomes were determined with binomial logistic regression controlling for age, total burn surface area, race, length of stay, gender, and inhalation injury presence. GBs were present in 1245 cases of 71,895 burns (1.7%). Patients with GB had significantly greater average total burn surface area, length of stay, and mortality. In patients with GB, surgery of the genitalia was infrequent (10.4%), with the aOR of receiving surgery higher among men (aOR 2.7, P burns (aOR 3.1, P <.002). Presence of a GB increased the odds of HAI (aOR 3.0, P <.0001) and urinary tract infections (aOR 3.4, P <.0001). GB was also an independent predictor of mortality (aOR 1.54) even after adjusting for the increased HAI risk. GBs are rare but associated with higher HAI rates and higher mortality after adjusting for well-established mortality risk factors. Although a cause and effect relationship cannot be established using these registry data, we believe this study suggests the need for special management considerations in GB cases to improve overall outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Properties of body composition of female representatives of the Polish national fencing team - the sabre event.

    Science.gov (United States)

    Jagiełło, Władysław; Marina, Jagiełło; Maciej, Kalina Roman; Jan, Barczyński Bartłomiej; Artur, Litwiniuk; Jarosław, Klimczak

    2017-12-01

    Fencing is a combat sport whose form of direct confrontation involves hitting the opponent with a weapon. The purpose of the study was to determine the properties of body composition of female representatives of the Polish national fencing team. The study involved 11 female athletes of the Polish national fencing team. Their age was 16-22 years (19±2.32), body weight 52-78 kg (59.7±7.4), body height 158-183 cm (167.46±6.10) and the training experience 7.64±3.47 years. The reference group consisted of 153 students of Warsaw University of Technology (Poland). Twenty basic somatic characteristics were measured. The following indices were calculated: slenderness, Rohrer's, BMI, Manouvrier's, and pelvic-shoulder indices. Density of the body, total body fat, active tissue, the overall profile of body composition and internal proportions of the body were determined. Analysis of internal proportions of factors of the athletes' body composition revealed significant differences in particular groups of features. The total size of the athletes' bodies is due to less-than-average magnitude of the length and stoutness characteristics and a high magnitude of adiposity (M = 0.63) in the Polish female national team of fencers (sabre) calculated from the normalized values for the control group. The proportions of features within the analysed factors revealed a significant advantage of the length of the upper extremity over the lower one and a distinct advantage of forearm musculature. The specific profile of body composition of female athletes practising sabre fencing is most likely due to long-term effects of training as well as the system of selection of persons with specific somatic prerequisites developed in the course of many years of training practice.

  19. Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth.

    Science.gov (United States)

    Thomas, Hannah J; Connor, Jason P; Lawrence, David M; Hafekost, Jennifer M; Zubrick, Stephen R; Scott, James G

    2017-09-01

    Bullying prevalence studies are limited by varied measurement methods and a lack of representative samples. This study estimated the national prevalence of bullying victimisation, perpetration and combined victim-perpetration experiences in a representative population-based sample of Australian youth. The relationships between the three types of bullying involvement with a range of mental health symptoms and diagnoses were also examined. A randomly selected nationally representative sample aged 11-17 years ( N = 2967, M age = 14.6 years; 51.6% male) completed the youth component of the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing (Young Minds Matter). Parents or carers also completed a structured face-to-face interview that asked questions about a single randomly selected child in the household. The youth survey comprised self-reported bullying victimisation and perpetration (Olweus Bully-Victim Questionnaire-adapted), psychological distress (K10), emotional and behavioural problems (Strengths and Difficulties Questionnaire), as well as self-harm, suicide attempts and substance use. Modules from the Diagnostic Interview Schedule for Children Version IV were administered to all youth and parents to assess for mental disorder diagnoses (major depressive disorder, any anxiety disorder and any externalising disorder [attention-deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder]). The 12-month prevalence of bullying victimisation was 13.3%, perpetration 1.6% and victim-perpetration 1.9%. Logistic regression models showed all forms of involvement in bullying were associated with increased risk of psychological distress, emotional and behavioural problems, substance use, self-harm and attempted suicide. Victimisation and victim-perpetration were associated with youth-reported major depressive disorder. There were also significant associations between bullying involvement and parent-reported diagnoses of major

  20. Smoking and Its Determinants in Chinese Internal Migrants: Nationally Representative Cross-Sectional Data Analyses.

    Science.gov (United States)

    Ji, Ying; Liu, Shenglan; Zhao, Xiaoping; Jiang, Ying; Zeng, Qingqi; Chang, Chun

    2016-08-01

    Migrants often face multiple risk factors for smoking initiation. Former studies that have explored the smoking habits of Chinese migrants have provided inconsistent findings and lacked nationally representative samples. Using data from the 2012 Migrant Dynamics Monitoring Survey in China published by the National Population and Family Planning Commission, this study explored current smoking rates and its determinants among migrants in China. The smoking rates of men (46.9%, 46.3%-47.3%) and women (1.8%, 1.7%-1.9%) differed significantly. Although the overall smoking rates in migrants was slightly lower than in the general population, the rates in certain subgroups were much higher. Among men, the three leading associated factors were the following: higher smoking rates among the divorced or widowed (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.34-1.74); lower smoking rates among those with an educational level of senior high school or above (OR = 0.73, 95% CI: 0.71-0.76), and higher smoking rates in the migrant-receiving area (OR = 1.29, 95% CI: 1.18-1.42). Among women, smoking rates were also higher in the migrant-receiving area (OR = 1.78, 95% CI: 1.34-2.34), when monthly income was more than 3000 Renminbi (OR = 1.65, 95% CI: 1.43-1.90), and among those with an educational level of senior high school or above (OR = 0.65, 95% CI: 0.56-0.75). The social integration of migrants, the duration of stay, and working hours had weaker associations with smoking risk. The sociodemographic features, work pressure, and migration-related features were sex-dependent determinants of smoking rates. These factors need to be considered when planning tobacco control interventions among migrants. Our study was the first to analyze a nationally representative Chinese migrant sample with respect to smoking, its differential rates across various subgroups, and its determinants. Our results provided overall levels of migrant smoking rates. The findings also demonstrated the

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

    Science.gov (United States)

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

    2013-01-04

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

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

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    Schmidlin Kurt

    2013-01-01

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

  3. Determinants of anemia among 6-59 months aged children in Bangladesh: evidence from nationally representative data.

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    Khan, Jahidur Rahman; Awan, Nabil; Misu, Farjana

    2016-01-11

    Anemia is a global public health problem but the burden of anemia is disproportionately borne among children in developing countries. Anemia in early stages of life has serious consequences on the growth and development of the children. We examine the prevalence of anemia, possible association between anemia and different socio-economic, demographic, health and other factors among children with ages from 6 to 59 months from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). Data on hemoglobin (Hb) concentration among the children aged 6-59 months from the most recent BDHS (2011) were used. This nationally representative survey allowed a multistage stratified cluster sampling design and provided data on a wide range of indicators such as fertility, mortality, women and child health, nutrition and other background characteristics. Anemia status was determined using hemoglobin level (<11.0 g/dl), and weighted prevalence of childhood anemia along with 95 % confidence intervals were provided. We also examined the distribution of weighted anemia prevalence across different groups and performed logistic regression to assess the association of anemia with different factors. A total of 2171 children aged 6-59 months were identified for this analysis, with weighted prevalence of anemia being 51.9 % overall- 47.4 % in urban and 53.1 % in rural regions. Results of a multivariable logistic regression analysis showed that, children below 24 months of age (odds ratio, [OR] 3.01; 95 % confidence interval [CI] 2.38-3.81), and those from an anemic mother (OR 1.80; 95 % CI 1.49-2.18) were at higher risk of anemia. Childhood anemia was significantly associated with chronic malnutrition of child, source of drinking water, household wealth and geographical location (defined by division). A high prevalence of anemia among 6-59 months aged children was observed in Bangladesh. Given the negative impact of anemia on the development of children in

  4. Alcohol Use and Transactional Sex among Women in South Africa: Results from a Nationally Representative Survey.

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    Sarah Magni

    Full Text Available Transactional sex is a risk factor for HIV infection. Alcohol use may increase the risk of transactional sex. No nationally-representative studies have examined the relationship between multiple dimensions of alcohol use and transactional sex in women in South Africa. The aim of the study was to examine the relationship between alcohol dependence, binge drinking and frequency of drinking in the past month and transactional sex in adult women in South Africa.A cross-sectional study using multi-stage, cluster sampling collected data from a nationally representative sample of 5,969 women aged 16-55 years in 2012. The analysis conducted for this paper was restricted to women reporting sexual activity in the past 12 months (n = 3,594. Transactional sex was defined as having received money/gifts in exchange for sex with any sex partner in the past year. Alcohol use measures included: alcohol dependence (≥2 positive responses to the CAGE questionnaire; binge drinking (≥4 drinks for women on one occasion; and drinking frequency in the previous month. Logistic regression models were built to test the hypotheses that each dimension of alcohol use was associated with transactional sex.About 6.3% (n = 225 of sexually active women reported transactional sex. Almost a third (30.6% of sexually active women had ever drunk alcohol, and 19.2% were current (past month drinkers. Among lifetime drinkers, 28.0% were alcohol dependent and 56.6% were binge drinkers. Alcohol dependent women were twice as likely to report transactional sex (AOR 2.0, 95% CI 1.1-4.3, p<0.05 than those not alcohol dependent. Binge drinkers were 3.1 times more likely to have had transactional sex (95% CI 1.5-6.6, p<0.01 than non-binge drinkers. There was no significant relationship between frequency of drinking in the past month and transactional sex.Alcohol dependency and binge drinking are significantly associated with transactional sex in South African women. HIV prevention programmes

  5. Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey

    Science.gov (United States)

    Arora, Paul; Vasa, Priya; Brenner, Darren; Iglar, Karl; McFarlane, Phil; Morrison, Howard; Badawi, Alaa

    2013-01-01

    Background: Chronic kidney disease is an important risk factor for death and cardiovascular-related morbidity, but estimates to date of its prevalence in Canada have generally been extrapolated from the prevalence of end-stage renal disease. We used direct measures of kidney function collected from a nationally representative survey population to estimate the prevalence of chronic kidney disease among Canadian adults. Methods: We examined data for 3689 adult participants of cycle 1 of the Canadian Health Measures Survey (2007–2009) for the presence of chronic kidney disease. We also calculated the age-standardized prevalence of cardiovascular risk factors by chronic kidney disease group. We cross-tabulated the estimated glomerular filtration rate (eGFR) with albuminuria status. Results: The prevalence of chronic kidney disease during the period 2007–2009 was 12.5%, representing about 3 million Canadian adults. The estimated prevalence of stage 3–5 disease was 3.1% (0.73 million adults) and albuminuria 10.3% (2.4 million adults). The prevalence of diabetes, hypertension and hypertriglyceridemia were all significantly higher among adults with chronic kidney disease than among those without it. The prevalence of albuminuria was high, even among those whose eGFR was 90 mL/min per 1.73 m2 or greater (10.1%) and those without diabetes or hypertension (9.3%). Awareness of kidney dysfunction among adults with stage 3–5 chronic kidney disease was low (12.0%). Interpretation: The prevalence of kidney dysfunction was substantial in the survey population, including individuals without hypertension or diabetes, conditions most likely to prompt screening for kidney dysfunction. These findings highlight the potential for missed opportunities for early intervention and secondary prevention of chronic kidney disease. PMID:23649413

  6. Illicit drug use among rave attendees in a nationally representative sample of US high school seniors.

    Science.gov (United States)

    Palamar, Joseph J; Griffin-Tomas, Marybec; Ompad, Danielle C

    2015-07-01

    The popularity of electronic dance music and rave parties such as dance festivals has increased in recent years. Targeted samples of party-goers suggest high rates of drug use among attendees, but few nationally representative studies have examined these associations. We examined sociodemographic correlates of rave attendance and relationships between rave attendance and recent (12-month) use of various drugs in a representative sample of US high school seniors (modal age: 18) from the Monitoring the Future study (2011-2013; Weighted N=7373). One out of five students (19.8%) reported ever attending a rave, and 7.7% reported attending at least monthly. Females and highly religious students were less likely to attend raves, and Hispanics, students residing in cities, students with higher income and those who go out for fun multiple times per week were more likely to attend. Rave attendees were more likely than non-attendees to report use of an illicit drug other than marijuana (35.5% vs. 15.6%, p<0.0001). Attendees were more likely to report use of each of the 18 drugs assessed, and attendees were more likely to report more frequent use (≥6 times) of each drug (ps<0.0001). Controlling for sociodemographic covariates, frequent attendance (monthly or more often) was associated with higher odds of use of each drug (ps<0.0001). Frequent attendees were at highest risk for use of "club drugs." Findings from this study can help inform prevention and harm reduction among rave attendees at greatest risk for drug use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Psychological resilience in U.S. military veterans: A 2-year, nationally representative prospective cohort study.

    Science.gov (United States)

    Isaacs, Kayla; Mota, Natalie P; Tsai, Jack; Harpaz-Rotem, Ilan; Cook, Joan M; Kirwin, Paul D; Krystal, John H; Southwick, Steven M; Pietrzak, Robert H

    2017-01-01

    Although many cross-sectional studies have examined the correlates of psychological resilience in U.S. military veterans, few longitudinal studies have identified long-term predictors of resilience in this population. The current prospective cohort study utilized data from a nationally representative sample of 2157 U.S. military veterans who completed web-based surveys in two waves (2011 and 2013) as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of cumulative lifetime exposure to potentially traumatic events and Wave 2 measures of current symptoms of posttraumatic stress, major depressive, and generalized anxiety disorders was performed to characterize different profiles of current trauma-related psychological symptoms. Different profiles were compared with respect to sociodemographic, clinical, and psychosocial characteristics. A three-group cluster analysis revealed a Control group with low lifetime trauma exposure and low current psychological distress (59.5%), a Resilient group with high lifetime trauma and low current distress (27.4%), and a Distressed group with both high trauma exposure and current distress symptoms (13.1%). These results suggest that the majority of trauma-exposed veterans (67.7%) are psychologically resilient. Compared with the Distressed group, the Resilient group was younger, more likely to be Caucasian, and scored lower on measures of physical health difficulties, past psychiatric history, and substance abuse. Higher levels of emotional stability, extraversion, dispositional gratitude, purpose in life, and altruism, and lower levels of openness to experiences predicted resilient status. Prevention and treatment efforts designed to enhance modifiable factors such as gratitude, sense of purpose, and altruism may help promote resilience in highly trauma-exposed veterans. Published by Elsevier Ltd.

  8. Internet Addiction Among Elementary and Middle School Students in China: A Nationally Representative Sample Study

    Science.gov (United States)

    Li, Yajun; Zhang, Xinghui; Lu, Furong; Zhang, Qin

    2014-01-01

    Abstract The purpose of this study was to examine the prevalence of Internet addiction in a nationally representative sample of Chinese elementary and middle school students and to investigate Internet addiction among Internet users with different usages. The data were from the National Children's Study of China (NCSC) in which 24,013 fourth- to ninth-grade students were recruited from 100 counties in 31 provinces in China. Only 54.2% of the students had accessed the Internet. According to the criteria of Young's Diagnostic Questionnaire (YDQ), an eight-item instrument, the prevalence of Internet addiction in the total sample was 6.3%, and among Internet users was 11.7%. Among the Internet users, males (14.8%) and rural students (12.1%) reported Internet addiction more than females (7.0%) and urban students (10.6%). The percentage of Internet addicts in elementary school students (11.5%) was not significantly lower than the percentage of middle school students (11.9%). There was no statistically significant difference between the four geographical regions (9.6%, 11.5%, 12.3%, 11.1%) characterized by different levels of economy, health, education, and social environment. As the frequency of Internet use and time spent online per week increased, the percentage of Internet addicts increased. When considering the location and purpose of Internet use, the percentage of Internet addicts was highest in adolescents typically surfing in Internet cafes (18.1%) and playing Internet games (22.5%). PMID:23971432

  9. The influence of stress, depression, and anxiety on PSA screening rates in a nationally representative sample.

    Science.gov (United States)

    Kotwal, Ashwin A; Schumm, Phil; Mohile, Supriya G; Dale, William

    2012-12-01

    Prostate-specific antigen (PSA) testing for prostate cancer is controversial, with concerning rates of both overscreening and underscreening. The reasons for the observed rates of screening are unknown, and few studies have examined the relationship of psychological health to PSA screening rates. Understanding this relationship can help guide interventions to improve informed decision-making for screening. A nationally representative sample of men 57-85 years old without prostate cancer (N = 1169) from the National Social life, Health and Aging Project was analyzed. The independent relationship of validated psychological health scales measuring stress, anxiety, and depression to PSA testing rates was assessed using multivariable logistic regression analyses. PSA screening rates were significantly lower for men with higher perceived stress [odds ratio (OR) = 0.76, P = 0.006], but not for higher depressive symptoms (OR = 0.89, P = 0.22) when accounting for stress. Anxiety influences PSA screening through an interaction with number of doctor visits (P = 0.02). Among the men who visited the doctor once those with higher anxiety were less likely to be screened (OR = 0.65, P = 0.04). Conversely, those who visited the doctor 10+ times with higher anxiety were more likely to be screened (OR = 1.71, P = 0.04). Perceived stress significantly lowers PSA screening likelihood, and it seems to partly mediate the negative relationship of depression with screening likelihood. Anxiety affects PSA screening rates differently for men with different numbers of doctor visits. Interventions to influence PSA screening rates should recognize the role of the patients' psychological state to improve their likelihood of making informed decisions and improve screening appropriateness.

  10. Strengthening the role of Community Health Representatives in the Navajo Nation

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    Caroline King

    2017-04-01

    Full Text Available Abstract Background Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. Methods The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015 about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. Results CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. Conclusions These findings suggest that CHRs have experienced

  11. Comparison of teen and adult driver crash scenarios in a nationally representative sample of serious crashes.

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    McDonald, Catherine C; Curry, Allison E; Kandadai, Venk; Sommers, Marilyn S; Winston, Flaura K

    2014-11-01

    Motor vehicle crashes are the leading cause of death and acquired disability during the first four decades of life. While teen drivers have the highest crash risk, few studies examine the similarities and differences in teen and adult driver crashes. We aimed to: (1) identify and compare the most frequent crash scenarios-integrated information on a vehicle's movement prior to crash, immediate pre-crash event, and crash configuration-for teen and adult drivers involved in serious crashes, and (2) for the most frequent scenarios, explore whether the distribution of driver critical errors differed for teens and adult drivers. We analyzed data from the National Motor Vehicle Crash Causation Survey, a nationally representative study of serious crashes conducted by the U.S. National Highway Traffic Safety Administration from 2005 to 2007. Our sample included 642 16- to 19-year-old and 1167 35- to 54-year-old crash-involved drivers (weighted n=296,482 and 439,356, respectively) who made a critical error that led to their crash's critical pre-crash event (i.e., event that made the crash inevitable). We estimated prevalence ratios (PR) and 95% confidence intervals (CI) to compare the relative frequency of crash scenarios and driver critical errors. The top five crash scenarios among teen drivers, accounting for 37.3% of their crashes, included: (1) going straight, other vehicle stopped, rear end; (2) stopped in traffic lane, turning left at intersection, turn into path of other vehicle; (3) negotiating curve, off right edge of road, right roadside departure; (4) going straight, off right edge of road, right roadside departure; and (5) stopped in lane, turning left at intersection, turn across path of other vehicle. The top five crash scenarios among adult drivers, accounting for 33.9% of their crashes, included the same scenarios as the teen drivers with the exception of scenario (3) and the addition of going straight, crossing over an intersection, and continuing on a

  12. 30-days mortality in patients with perforated peptic ulcer: A national audit

    Science.gov (United States)

    Nakano, Anne; Bendix, Jørgen; Adamsen, Sven; Buck, Daniel; Mainz, Jan; Bartels, Paul; Nørgård, Bente

    2008-01-01

    Background In 2005, The Danish National Indicator Project (DNIP) reported findings on patients hospitalized with perforated ulcer. The indicator “30-days mortality” showed major discrepancy between the observed mortality of 28% and the chosen standard (10%). Rationale An audit committee was appointed to examine quality problems linked to the high mortality. The purpose was to (i) examine patient characteristics, (ii) evaluate the appropriateness of the standard, and (iii) audit all cases of deaths within 30 days after surgery. Methods Four hundred and twelve consecutive patients were included and used for the analyses of patient characteristics. The evaluation of the standard was based on a literature review, and a structured audit was performed according to the 115 deaths that occurred. Results The mean age was 69.1 years, 42.0% had one co-morbid disease and 17.7% had two co-morbid diseases. 45.9% had an American Association of Anaesthetists score of 3–4. We found no results on mortality in studies similar to ours. The audit process indicated that the postoperative observation of patients was insufficient. Discussion As a result of this study, the standard for mortality was increased to 20%, and the new indicators for postoperative monitoring were developed. The DNIP continues to evaluate if these initiatives will improve the results on mortality. PMID:22312201

  13. A Layer Cake—From the Dish from Prekmurje to the Representative National Specialty

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    Damir Josipovič

    2014-03-01

    Full Text Available The layer cake from Prekmurje—gibanica—is not merely a culinary specialty. It is an immaterial culturological content moving through its physical space. The phenomenon of gibanica marks modern Slovenes at least from the 1980s onwards and was deployed as an important medium of the Slovene ethno-national emancipation and the prospect of independence. Apart of other implications, we established a working hypothesis wherein the gibanica personifies severe problems of nativeness as one of crucial implications of contemporary mono-layered societal stratification in Slovenia. Applying comparative analysis of various regional and ethno-linguistic indicators, we confirmed the initial hypothesis and, furthermore, ascertained that gibanica managed to operate not only as a regional predictor but as a social-status predictor as well. From a local class-related dessert, it evolved into a pastry of the entire population of Prekmurje only after WWII. Whereas the emergence of the recipe of the cake is not known precisely, it may be placed somewhere into the 19th century and put together with the Jewish settlement in the Prekmurje region. Today, gibanica, so much different from the layer cake of Prlekija, represents the non-negotiable boundary of the Sloveneness towards the Croatianness despite the common geographical and cultural origin.

  14. Personality Traits Are Associated with Academic Achievement in Medical School: A Nationally Representative Study.

    Science.gov (United States)

    Sobowale, Kunmi; Ham, Sandra A; Curlin, Farr A; Yoon, John D

    2018-06-01

    This nationally representative study sought to identify personality traits that are associated with academic achievement in medical school. Third-year medical students, who completed an initial questionnaire in January 2011, were mailed a second questionnaire several months later during their fourth year. Controlling for sociodemographic characteristics and burnout, the authors used multivariate logistic regressions to determine whether Big Five personality traits were associated with receiving honors/highest grade in clinical clerkships, failing a course or rotation, and being selected for the Alpha Omega Alpha or Gold Humanism Honor Society. The adjusted response rates for the two surveys were 61 (n = 564/919) and 84% (n = 474/564). The personality trait conscientiousness predicted obtaining honors/highest grade in all clinical clerkships. In contrast, students high in neuroticism were less likely to do well in most specialties. Students with higher conscientiousness were more likely to be inducted into the Alpha Omega Alpha Honor Society, while students high in openness or agreeableness traits were more likely to be inducted into the Gold Humanism Honor Society. Burnout was not associated with any clinical performance measures. This study suggests the importance of personality traits, particularly conscientiousness, in predicting success during the clinical years of medical school. Medical educators should consider a nuanced examination of personality traits and other non-cognitive factors, particularly for psychiatry.

  15. Caffeine intake and its sources: A review of national representative studies.

    Science.gov (United States)

    Verster, Joris C; Koenig, Juergen

    2018-05-24

    Aim of this review is to summarize current daily caffeine intake of children, adolescents, and adults, and trends in caffeine intake over the past decade. A literature search was conducted (1997-2015) which yielded 18 reports on nationally representative studies, describing caffeine consumption of over 275,000 children, adolescents and adults. The data revealed that mean total daily caffeine intake in children, adolescents, and adults is below caffeine intake recommendations such as those stated by Health Canada (2.5 mg/kg bw/day for children and adolescents, and 400 mg/day for adults) and the European Food Safety Authority, EFSA (3 mg/kg bw/day for children and adolescents, and 400 mg/day for adults). Total daily caffeine intake has remained stable in the last 10-15 years, and coffee, tea and soft drinks are the most important caffeine sources. Across all age groups, energy drinks contribute little to total caffeine intake. The highest potential for reducing daily caffeine intake is by limiting coffee consumption, and in some countries and age groups, by reducing tea and soft drink consumption.

  16. Empowerment and Intimate Partner Violence in Pakistan: Results From a Nationally Representative Survey.

    Science.gov (United States)

    Murshid, Nadine Shaanta; Critelli, Filomena M

    2017-02-01

    Using empowerment theory, the current study examines antecedents of lifetime experience of intimate partner violence, intimate partner violence experienced in the last 12 months, emotional violence, and husbands' controlling behaviors toward their wives in Pakistan. Using data from a subsample of 658 women from the nationally representative Pakistan Demographic and Health Survey 2012-2013, this study examined whether empowerment variables, such as household decision-making power, economic decision-making power, and adherence to patriarchy, operationalized as justification of wife beating, contribute to intimate partner violence using logistic regression analyses. Results indicate that adherence to patriarchal norms, household decision-making power, and higher education was found to be associated with lifetime prevalence of intimate partner violence. Adherence to patriarchal norms, economic decision-making power, and higher education was found significantly associated with intimate partner violence in the past 12 months. Adherence to patriarchal norms was significantly associated with experiencing emotional violence as well as controlling behaviors by husbands. In conclusion, women's adherence to patriarchal norms is a reflection of the patriarchal society in which they live; indeed, this was found to be the most important predictor of women's experience of intimate partner violence, when different types of violence were assessed. Implications for social work practice are discussed.

  17. Physical activity, sedentary behavior, and body mass index in the Czech Republic: a nationally representative survey.

    Science.gov (United States)

    Mitáš, Josef; Ding, Ding; Frömel, Karel; Kerr, Jacqueline

    2014-07-01

    Post-communist countries have experienced rapid economic development and social changes, which have been accompanied by changes in health-related lifestyle behaviors, such as physical activity. The purpose of this study was to examine the associations of domain-specific physical activity and total sedentary time with BMI among adults in the Czech Republic. We surveyed a nationally representative sample (n = 4097) of the Czech Republic in fall 2007 using the International Physical Activity Questionnaire (long form). Multiple linear regression analyses were used to examine associations of physical activity, sedentary time and sociodemographic characteristics with BMI. Older age, lower educational attainment, and lower levels of leisure-time physical activity were associated with higher BMI. Compared with those living in large cities, men living in small towns and women living in small villages had higher BMI. This study has identified correlates of BMI in the Czech Republic. Although more evidence from longitudinal studies is needed, findings from the current study can inform interventions to prevent the rising obesity epidemic.

  18. Microfinance Participation and Domestic Violence in Bangladesh: Results From a Nationally Representative Survey.

    Science.gov (United States)

    Murshid, Nadine Shaanta; Akincigil, Ayse; Zippay, Allison

    2016-05-01

    This article examines domestic violence among women who participate in microfinance in Bangladesh. Secondary analysis of survey data from nationally representative Bangladesh Demographic and Health Survey was used to investigate the association between microfinance participation and domestic violence of 4,163 ever-married women between the ages of 18 and 49 years. Outcome measure is experience of domestic violence as measured by a modified Conflict Tactics Scale (CTS) and predictor variables include microfinance, binary indicator of relatively better economic status, autonomy, decision-making power, and demographic variables. The likelihood of experiencing domestic violence was not found to vary with microfinance participation. However, the interaction effect of microfinance and better economic status was found to be significantly associated with domestic violence (9% increased probability). Experience of domestic violence was negatively associated with older age, higher education of the husband, and autonomy. In Bangladesh, microfinance participation may be associated with a higher probability of experiencing domestic violence for women with relatively better economic status, but not for the poorest of the poor. © The Author(s) 2015.

  19. Temperatures and heating energy in New Zealand houses from a nationally representative study - HEEP

    Energy Technology Data Exchange (ETDEWEB)

    French, L.J.; Camilleri, M.J.; Isaacs, N.P.; Pollard, A.R. [BRANZ Ltd., Private Bag 50 908, Porirua City (New Zealand)

    2007-07-15

    The household energy end-use project (HEEP) has collected energy and temperature data from a randomly selected, nationally representative sample of about 400 houses throughout New Zealand. This database has been used to explore the drivers of indoor temperatures and heating energy. Initial analysis of the winter living room temperatures shows that heating type, climate and house age are the key drivers. On average, houses heated by solid fuel are the warmest, with houses heated by portable LPG and electric heaters the coldest. Over the three winter months, living rooms are below 20 {sup o}C for 83% of the time - and the living room is typically the warmest room. Central heating is in only 5% of houses. Solid fuel is the dominant heating fuel in houses. The lack of air conditioning means that summer temperatures are affected by passive influences (e.g. house design, construction). Summer temperatures are strongly influenced by the house age and the local climate - together these variables explain 69% of the variation in daytime (9 a.m. to 5 p.m.) living room temperatures. In both summer and winter newer (post-1978) houses are warmer - this is beneficial in winter, but the high temperatures in summer are potentially uncomfortable. (author)

  20. 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.

    Science.gov (United States)

    2017-09-16

    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 exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age

  1. European Lifelong Guidance Policy Network Representatives' Conceptions of the Role of Information and Communication Technologies Related to National Guidance Policies

    Science.gov (United States)

    Kettunen, Jaana; Vuorinen, Raimo; Ruusuvirta, Outi

    2016-01-01

    This article reports findings from a phenomenographic investigation into European Lifelong Guidance Policy Network representatives' conceptions of the role of information and communication technologies (ICT) related to national lifelong guidance policies. The role of ICT in relation to national lifelong guidance policies was conceived as (1)…

  2. The Relationship between Child Abuse, Parental Divorce, and Lifetime Mental Disorders and Suicidality in a Nationally Representative Adult Sample

    Science.gov (United States)

    Afifi, Tracie O.; Boman, Jonathan; Fleisher, William; Sareen, Jitender

    2009-01-01

    Objectives: To determine how the experiences of child abuse and parental divorce are related to long-term mental health outcomes using a nationally representative adult sample after adjusting for sociodemographic variables and parental psychopathology. Methods: Data were drawn from the National Comorbidity Survey (NCS, n=5,877; age 15-54 years;…

  3. The Association Between Neighborhood Environment and Mortality: Results from a National Study of Veterans.

    Science.gov (United States)

    Nelson, Karin; Schwartz, Greg; Hernandez, Susan; Simonetti, Joseph; Curtis, Idamay; Fihn, Stephan D

    2017-04-01

    As the largest integrated US health system, the Veterans Health Administration (VHA) provides unique national data to expand knowledge about the association between neighborhood socioeconomic status (NSES) and health. Although living in areas of lower NSES has been associated with higher mortality, previous studies have been limited to higher-income, less diverse populations than those who receive VHA care. To describe the association between NSES and all-cause mortality in a national sample of veterans enrolled in VHA primary care. One-year observational cohort of veterans who were alive on December 31, 2011. Data on individual veterans (vital status, and clinical and demographic characteristics) were abstracted from the VHA Corporate Data Warehouse. Census tract information was obtained from the US Census Bureau American Community Survey. Logistic regression was used to model the association between NSES deciles and all-cause mortality during 2012, adjusting for individual-level income and demographics, and accounting for spatial autocorrelation. Veterans who had vital status, demographic, and NSES data, and who were both assigned a primary care physician and alive on December 31, 2011 (n = 4,814,631). Census tracts were used as proxies for neighborhoods. A summary score based on census tract data characterized NSES. Veteran addresses were geocoded and linked to census tract NSES scores. Census tracts were divided into NSES deciles. In adjusted analysis, veterans living in the lowest-decile NSES tract were 10 % (OR 1.10, 95 % CI 1.07, 1.14) more likely to die than those living in the highest-decile NSES tract. Lower neighborhood SES is associated with all-cause mortality among veterans after adjusting for individual-level socioeconomic characteristics. NSES should be considered in risk adjustment models for veteran mortality, and may need to be incorporated into strategies aimed at improving veteran health.

  4. Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults.

    Science.gov (United States)

    Geldsetzer, Pascal; Manne-Goehler, Jennifer; Theilmann, Michaela; Davies, Justine I; Awasthi, Ashish; Vollmer, Sebastian; Jaacks, Lindsay M; Bärnighausen, Till; Atun, Rifat

    2018-03-01

    Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services. However, to our knowledge there has been no prior nationally representative study of these conditions to guide the design of effective policies. To determine the prevalence of diabetes and hypertension in India, and its variation by state, rural vs urban location, and individual-level sociodemographic characteristics. This was a cross-sectional, nationally representative, population-based study carried out between 2012 and 2014. A total of 1 320 555 adults 18 years or older with plasma glucose (PG) and blood pressure (BP) measurements were included in the analysis. State, rural vs urban location, age, sex, household wealth quintile, education, and marital status. Diabetes (PG level ≥126 mg/dL if the participant had fasted or ≥200 mg/dL if the participant had not fasted) and hypertension (systolic BP≥140 mm Hg or diastolic BP≥90 mm Hg). Of the 1 320 555 adults, 701 408 (53.1%) were women. The crude prevalence of diabetes and hypertension was 7.5% (95% CI, 7.3%-7.7%) and 25.3% (95% CI, 25.0%-25.6%), respectively. Notably, hypertension was common even among younger age groups (eg, 18-25 years: 12.1%; 95% CI, 11.8%-12.5%). Being in the richest household wealth quintile compared with being in the poorest quintile was associated with only a modestly higher probability of diabetes (rural: 2.81 percentage points; 95% CI, 2.53-3.08 and urban: 3.47 percentage points; 95% CI, 3.03-3.91) and hypertension (rural: 4.15 percentage points; 95% CI, 3.68-4.61 and urban: 3.01 percentage points; 95% CI, 2.38-3.65). The differences in the probability of both conditions by educational category were generally small (≤2 percentage points). Among states, the crude prevalence of diabetes and hypertension varied from 3.2% (95% CI, 2.7%-3.7%) to 19.9% (95% CI, 17.6%-22.3%), and 18.0% (95% CI, 16

  5. Associations between the timing of childhood adversity and adulthood suicidal behavior: A nationally-representative cohort.

    Science.gov (United States)

    Chang, Hyoung Yoon; Chung, Yeonseung; Keyes, Katherine M; Jung, Sun Jae; Kim, Seung-Sup

    2015-11-01

    Although childhood adversities (CAs) are known to be associated with later suicidal behavior, it is uncertain whether the timing of specific CAs may influence this association. We analyzed nationally representative data for 9205 participants from the Korean Welfare Panel Study. Four different CAs (parental death, parental divorce, suspension of school education and being raised in a relative's house due to financial strain) were assessed and were categorized as early childhood and adolescent onset. Lifetime experiences of suicidal behaviors along with the age of the first time experience were recorded. Cox regression was used. After adjusting for age, sex, and childhood socioeconomic status, parental death before the age of 12 was associated with adulthood suicidal behavior (ideation HR 1.35, 95% CI 1.13, 1.61; attempt HR 1.60, 95% CI 1.02, 2.52), while suspension of school due to financial strain was associated with suicidal behavior when it occurred at adolescence (ideation HR 1.48, 95% CI 1.22, 1.79; plan HR 1.69, 95% CI 1.16, 2.48). When we also adjusted for adulthood SES, which is a potential mediator, there was no significant change except that the association between early parental death and suicidal attempt became non-significant (HR: 1.43, 95% CI: 0.92, 2.26). Experience of CA was assessed retrospectively, and the assessment of suicidal attempt was not specifically defined. There could be selection bias due to loss to the follow-up. There may be a critical period for the effect of CA on later suicidal behavior depending on the characteristics of CA. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Iron status and its determinants in a nationally representative sample of pregnant women.

    Science.gov (United States)

    Vandevijvere, Stefanie; Amsalkhir, Sihame; Van Oyen, Herman; Egli, Ines; Ines, Egli; Moreno-Reyes, Rodrigo

    2013-05-01

    Iron-deficiency anemia is associated with adverse neonatal health outcomes. Iron status and its determinants were assessed in a representative sample of Belgian pregnant women. Blood samples were collected and a questionnaire was completed face-to-face. Hemoglobin (Hb) and mean cell volume were measured using a Beckman Coulter Hematology Analyzer and serum ferritin (SF) and transferrin receptor (sTfr) concentrations by immunoassay. In total, 55 obstetric clinics and 1,311 pregnant women were included. Approximately 40% of third-trimester and 6% of first-trimester women had SF levels less than 15 μg/L. Approximately 21% of third-trimester and 4% of first-trimester women had anemia (Hb 8.5 mg/L). The median body iron stores were 8.1 mg/kg among first-trimester women, but only 3.6 mg/kg among third-trimester women. SF levels were significantly positively associated with age and education level, and were higher among nulliparous women and lower among North-African women. sTfr concentrations were significantly negatively associated with age and were lower among smokers, nulliparous women, and women who planned their pregnancy. Despite the fact that two thirds of Belgian pregnant women took iron-containing supplements, iron deficiency and iron-deficiency anemia were frequent in third-trimester women. The World Health Organization regards this as a moderate public health problem. National iron supplementation guidelines are needed in Belgium to optimize iron status during pregnancy. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. Internal migration and the health of the returned population: a nationally representative study of China.

    Science.gov (United States)

    Zhang, Luwen; Liu, Shuaishuai; Zhang, Guoying; Wu, Shaolong

    2015-07-28

    China had 236 million internal migrants in 2012 and the majority of them migrated from rural to urban areas. The research based on medical and epidemical records found that the migrants had worse health than the urban residents, but the household and working place investigations reported better health status. The sick or unhealthy migrants are likely to return to their hometowns, which in turn may cause a report bias or over-estimation of the health status of rural-to-urban migrants in China. This paper explores the association of migration status and the physical and psychological health of Chinese internal migrants. Nationally representative household survey data from the China Labor-force Dynamics Survey 2012 (CLDS) were used to analyze the association between the migration status and the health status of internal migrants in China. Migration status of the respondents was measured by hukou status and migration experience and all respondents were divided into four groups: returned population, migrant population, urban residents, and rural residents. Health status of respondents was measured by self-reported physical and psychological health. Migration experience was associated with the physical health of the returned population. The physical health of the returned population was worse than the migrant population and was distinguished by age and sex. The physical health status of migrant population was significantly better than rural residents, but not significantly better than urban residents. However, the association between migration status and psychological health was not statistically significant. Besides migration status, the socioeconomic status (SES) had a positive correlation with both physical and psychological health status, while occupational hazards exerted negative influence. The results indicate a tight association between migration experience and health status. The internal unhealthy migrants were more likely to return to their hometown and the

  8. Socioeconomic determinants of bullying in the workplace: a national representative sample in Japan.

    Science.gov (United States)

    Tsuno, Kanami; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Odagiri, Yuko; Yoshikawa, Toru; Haratani, Takashi; Shimomitsu, Teruichi; Kawachi, Ichiro

    2015-01-01

    Bullying in the workplace is an increasingly recognized threat to employee health. We sought to test three hypotheses related to the determinants of workplace bullying: power distance at work; safety climate; and frustration related to perceived social inequality. A questionnaire survey was administered to a nationally representative community-based sample of 5,000 residents in Japan aged 20-60 years. The questionnaire included questions about employment, occupation, company size, education, household income, and subjective social status (SSS). We inquired about both the witnessing and personal experience of workplace bullying during the past 30 days. Among 2,384 respondents, data were analyzed from 1,546 workers. Multiple logistic regression analyses were used to examine the social determinants of workplace bullying. Six percent and 15 percent of the total sample reported experiencing or witnessing workplace bullying, respectively. After adjusting for gender and age, temporary employees (Odds Ratio [OR]: 2.45 [95% Confidence Interval (CI) = 1.03-5.85]), junior high school graduates (OR: 2.62 [95%CI: 1.01-6.79]), workers with lowest household income (OR: 4.13 [95%CI:1.58-10.8]), and workers in the lowest SSS stratum (OR: 4.21 [95%CI:1.66-10.7]) were at increased risk of experiencing workplace bullying. When all variables were entered simultaneously in the model, a significant inverse association was observed between higher SSS and experiencing bullying (p = 0.002). Similarly in terms of witnessing bullying; SSS was significantly inversely associated (p = 0.017) while temporary employees reported a significantly higher risk of witnessing bullying compared to permanent workers (OR: 2.25 [95%CI:1.04 to 4.87]). The significant association between SSS and experiencing/witnessing workplace bullying supports the frustration hypothesis. The power distance hypothesis was also partly supported by the finding that temporary employees experienced a higher prevalence of

  9. Socioeconomic determinants of bullying in the workplace: a national representative sample in Japan.

    Directory of Open Access Journals (Sweden)

    Kanami Tsuno

    Full Text Available Bullying in the workplace is an increasingly recognized threat to employee health. We sought to test three hypotheses related to the determinants of workplace bullying: power distance at work; safety climate; and frustration related to perceived social inequality. A questionnaire survey was administered to a nationally representative community-based sample of 5,000 residents in Japan aged 20-60 years. The questionnaire included questions about employment, occupation, company size, education, household income, and subjective social status (SSS. We inquired about both the witnessing and personal experience of workplace bullying during the past 30 days. Among 2,384 respondents, data were analyzed from 1,546 workers. Multiple logistic regression analyses were used to examine the social determinants of workplace bullying. Six percent and 15 percent of the total sample reported experiencing or witnessing workplace bullying, respectively. After adjusting for gender and age, temporary employees (Odds Ratio [OR]: 2.45 [95% Confidence Interval (CI = 1.03-5.85], junior high school graduates (OR: 2.62 [95%CI: 1.01-6.79], workers with lowest household income (OR: 4.13 [95%CI:1.58-10.8], and workers in the lowest SSS stratum (OR: 4.21 [95%CI:1.66-10.7] were at increased risk of experiencing workplace bullying. When all variables were entered simultaneously in the model, a significant inverse association was observed between higher SSS and experiencing bullying (p = 0.002. Similarly in terms of witnessing bullying; SSS was significantly inversely associated (p = 0.017 while temporary employees reported a significantly higher risk of witnessing bullying compared to permanent workers (OR: 2.25 [95%CI:1.04 to 4.87]. The significant association between SSS and experiencing/witnessing workplace bullying supports the frustration hypothesis. The power distance hypothesis was also partly supported by the finding that temporary employees experienced a higher prevalence

  10. Internet Gaming Disorder Among Slovenian Primary Schoolchildren: Findings From a Nationally Representative Sample of Adolescents

    Science.gov (United States)

    Pontes, Halley M.; Macur, Mirna; Griffiths, Mark D.

    2016-01-01

    Background and aims Since the inclusion of Internet Gaming Disorder (IGD) in the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a tentative disorder, a few psychometric screening instruments have been developed to assess IGD, including the 9-item Internet Gaming Disorder Scale – Short-Form (IGDS9-SF) – a short, valid, and reliable instrument. Methods Due to the lack of research on IGD in Slovenia, this study aimed to examine the psychometric properties of the IGDS9-SF in addition to investigating the prevalence rates of IGD in a nationally representative sample of eighth graders from Slovenia (N = 1,071). Results The IGDS9-SF underwent rigorous psychometric scrutiny in terms of validity and reliability. Construct validation was investigated with confirmatory factor analysis to examine the factorial structure of the IGDS9-SF and a unidimensional structure appeared to fit the data well. Concurrent and criterion validation were also investigated by examining the association between IGD and relevant psychosocial and game-related measures, which warranted these forms of validity. In terms of reliability, the Slovenian version IGDS9-SF obtained excellent results regarding its internal consistency at different levels, and the test appears to be a valid and reliable instrument to assess IGD among Slovenian youth. Finally, the prevalence rates of IGD were found to be around 2.5% in the whole sample and 3.1% among gamers. Discussion and conclusion Taken together, these results illustrate the suitability of the IGDS9-SF and warrants further research on IGD in Slovenia. PMID:27363464

  11. Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample☆

    Science.gov (United States)

    Grandner, Michael A.; Jackson, Nicholas; Gerstner, Jason R.; Knutson, Kristen L.

    2013-01-01

    Short sleep duration is associated with weight gain and obesity, diabetes, cardiovascular disease, psychiatric illness, and performance deficits. Likewise, long sleep duration is also associated with poor physical and mental health. The role of a healthy diet in habitual sleep duration represents a largely unexplored pathway linking sleep and health. This study evaluated associations between habitual sleep parameters and dietary/nutritional variables obtained via the National Health and Nutrition Examination Survey (NHANES), 2007–2008. We hypothesized that habitual very short (theobromine (long sleep RR = 0.910, p < 0.05), vitamin C (short sleep RR = 0.890, p < 0.05), tap water (short sleep RR = 0.952, p < 0.001; very short (<5 h) sleep RR = 0.941, p < 0.05), lutein + zeaxanthin (short sleep RR = 1.123, p < 0.05), dodecanoic acid (long sleep RR = 0.812, p < 0.05), choline (long sleep RR = 0.450, p = 0.001), lycopene (very short (<5 h) sleep RR = 0.950, p <0.05), total carbohydrate (very short (<5 h) sleep RR = 0.494, p <0.05; long sleep RR = 0.509, p <0.05), selenium (short sleep RR = 0.670, p <0.01) and alcohol (long sleep RR = 1.172, p < 0.01). Overall, many nutrient variables were associated with short and/or long sleep duration, which may be explained by differences in food variety. Future studies should assess whether these associations are due to appetite dysregulation, due to short/long sleep and/or whether these nutrients have physiologic effects on sleep regulation. In addition, these data may help us better understand the complex relationship between diet and sleep and the potential role of diet in the relationship between sleep and obesity and other cardiometabolic risks. PMID:23339991

  12. Parenting style and mental disorders in a nationally representative sample of US adolescents.

    Science.gov (United States)

    Eun, John David; Paksarian, Diana; He, Jian-Ping; Merikangas, Kathleen Ries

    2018-01-01

    We examined associations between parenting style and past-year mental disorders in a nationally representative cross-sectional survey of US adolescents and whether the associations differed by adolescent demographic characteristics. The sample included 6483 adolescents aged 13-18 years who were interviewed for a full range of DSM-IV mental disorders. Parenting style was assessed by adolescent-reported maternal and paternal care and control using items from the Parental Bonding Instrument. We controlled for socio-demographics, parental history of mental disorders, stressful life events, sexual violence, inter-parental conflict, and household composition. We also tested for two-way interactions between parental care and control and adolescent age, sex, and race/ethnicity. In adjusted models, high maternal care was associated with lower odds of depressive, eating, and behavioral disorders, and high maternal control was associated with greater odds of depressive, anxiety, eating, and behavioral disorders. High paternal care was associated with lower odds of social phobia and alcohol abuse/dependence. High paternal control was associated with greater odds of agoraphobia and alcohol abuse/dependence but with lower odds of attention-deficit/hyperactivity disorder. Associations of maternal and paternal control with anxiety disorders and substance abuse/dependence differed by sex. High paternal care was associated with lower odds of anxiety disorders only among Hispanics and non-Hispanic blacks. Perceived parental care and control were associated with adolescent mental disorders after controlling for multiple potential confounders. Differential patterns of association were found according to adolescent sex and race/ethnicity. Findings have implications for prevention and intervention programs that incorporate familial contextual factors.

  13. Socioeconomic Determinants of Bullying in the Workplace: A National Representative Sample in Japan

    Science.gov (United States)

    Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Odagiri, Yuko; Yoshikawa, Toru; Haratani, Takashi; Shimomitsu, Teruichi

    2015-01-01

    Bullying in the workplace is an increasingly recognized threat to employee health. We sought to test three hypotheses related to the determinants of workplace bullying: power distance at work; safety climate; and frustration related to perceived social inequality. A questionnaire survey was administered to a nationally representative community-based sample of 5,000 residents in Japan aged 20–60 years. The questionnaire included questions about employment, occupation, company size, education, household income, and subjective social status (SSS). We inquired about both the witnessing and personal experience of workplace bullying during the past 30 days. Among 2,384 respondents, data were analyzed from 1,546 workers. Multiple logistic regression analyses were used to examine the social determinants of workplace bullying. Six percent and 15 percent of the total sample reported experiencing or witnessing workplace bullying, respectively. After adjusting for gender and age, temporary employees (Odds Ratio [OR]: 2.45 [95% Confidence Interval (CI) = 1.03–5.85]), junior high school graduates (OR: 2.62 [95%CI: 1.01–6.79]), workers with lowest household income (OR: 4.13 [95%CI:1.58–10.8]), and workers in the lowest SSS stratum (OR: 4.21 [95%CI:1.66–10.7]) were at increased risk of experiencing workplace bullying. When all variables were entered simultaneously in the model, a significant inverse association was observed between higher SSS and experiencing bullying (p = 0.002). Similarly in terms of witnessing bullying; SSS was significantly inversely associated (p = 0.017) while temporary employees reported a significantly higher risk of witnessing bullying compared to permanent workers (OR: 2.25 [95%CI:1.04 to 4.87]). The significant association between SSS and experiencing/witnessing workplace bullying supports the frustration hypothesis. The power distance hypothesis was also partly supported by the finding that temporary employees experienced a higher prevalence

  14. Effectiveness of National Weather Service heat alerts in preventing mortality in 20 US cities.

    Science.gov (United States)

    Weinberger, Kate R; Zanobetti, Antonella; Schwartz, Joel; Wellenius, Gregory A

    2018-04-09

    Extreme heat is a well-documented public health threat. The US National Weather Service (NWS) issues heat advisories and warnings (collectively, "heat alerts") in advance of forecast extreme heat events. The effectiveness of these alerts in preventing deaths remains largely unknown. To quantify the change in mortality rates associated with heat alerts in 20 US cities between 2001 and 2006. Because NWS heat alerts are issued based on forecast weather and these forecasts are imperfect, in any given location there exists a set of days of similar observed heat index in which heat alerts have been issued for some days but not others. We used a case-crossover design and conditional logistic regression to compare mortality rates on days with versus without heat alerts among such eligible days, adjusting for maximum daily heat index and temporal factors. We combined city-specific estimates into a summary measure using standard random-effects meta-analytic techniques. Overall, NWS heat alerts were not associated with lower mortality rates (percent change in rate: -0.5% [95% CI: -2.8, 1.9]). In Philadelphia, heat alerts were associated with a 4.4% (95% CI: -8.3, -0.3) lower mortality rate or an estimated 45.1 (95% empirical CI: 3.1, 84.1) deaths averted per year if this association is assumed to be causal. No statistically significant beneficial association was observed in other individual cities. Our results suggest that between 2001 and 2006, NWS heat alerts were not associated with lower mortality in most cities studied, potentially missing a valuable opportunity to avert a substantial number of heat-related deaths. These results highlight the need to better link alerts to effective communication and intervention strategies to reduce heat-related mortality. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. National HIV/AIDS mortality, prevalence, and incidence rates are associated with the Human Development Index.

    Science.gov (United States)

    Lou, Li-Xia; Chen, Yi; Yu, Chao-Hui; Li, You-Ming; Ye, Juan

    2014-10-01

    HIV/AIDS is a worldwide threat to human health with mortality, prevalence, and incidence rates varying widely. We evaluated the association between the global HIV/AIDS epidemic and national socioeconomic development. We obtained global age-standardized HIV/AIDS mortality, prevalence, and incidence rates from World Health Statistics Report of the World Health Organization. The human development indexes (HDIs) of 141 countries were obtained from a Human Development Report. Countries were divided into 4 groups according to the HDI distribution. We explored the association between HIV/AIDS epidemic and HDI information using Spearman correlation analysis, regression analysis, and the Kruskal-Wallis test. HIV/AIDS mortality, prevalence, and incidence rates were inversely correlated with national HDI (r = -0.675, -0.519, and -0.398, respectively; P birth, mean years of schooling, expected years of schooling, and gross national income per capita). Low HDI countries had higher HIV/AIDS mortality, prevalence, and incidence rates than that of medium, high, and very high HDI countries. Quantile regression results indicated that HDI had a greater negative effect on the HIV/AIDS epidemic in countries with more severe HIV/AIDS epidemic. Less-developed countries are likely to have more severe HIV/AIDS epidemic. There is a need to pay more attention to HIV/AIDS control in less-developed countries, where lower socioeconomic status might have accelerated the HIV/AIDS epidemic more rapidly. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. 30-days mortality in patients with perforated peptic ulcer: A national audit

    Directory of Open Access Journals (Sweden)

    Anne Nakano

    2008-11-01

    Full Text Available Anne Nakano1,4, Jørgen Bendix2, Sven Adamsen3, Daniel Buck4, Jan Mainz5, Paul Bartels1, Bente Nørgård4,61The Danish National Indicator Project, Regionshuset Aarhus, Aarhus, Denmark; 2Department of Gastrointestinal Surgery L, Aarhus University Hospital, Denmark; 3Digestive Disease Center, Section for Gastrointestinal Surgery, Copenhagen, Denmark; University Hospital Herlev, Denmark; 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 5Department of Psychiatry Region North, Denmark and Institute of Public Health, University of Southern Denmark, Odense, Denmark; 6Center for National Clinical Databases, South, Odense University Hospital, and Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, DenmarkBackground: In 2005, The Danish National Indicator Project (DNIP reported findings on patients hospitalized with perforated ulcer. The indicator “30-days mortality” showed major discrepancy between the observed mortality of 28% and the chosen standard (10%.Rationale: An audit committee was appointed to examine quality problems linked to the high mortality. The purpose was to (i examine patient characteristics, (ii evaluate the appropriateness of the standard, and (iii audit all cases of deaths within 30 days after surgery.Methods: Four hundred and twelve consecutive patients were included and used for the analyses of patient characteristics. The evaluation of the standard was based on a literature review, and a structured audit was performed according to the 115 deaths that occurred.Results: The mean age was 69.1 years, 42.0% had one co-morbid disease and 17.7% had two co-morbid diseases. 45.9% had an American Association of Anaesthetists score of 3–4. We found no results on mortality in studies similar to ours. The audit process indicated that the postoperative observation of patients was insufficient.Discussion: As a result of this study, the standard for mortality was increased to

  17. National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

    Directory of Open Access Journals (Sweden)

    Farzadfar Farshad

    2011-10-01

    Full Text Available Abstract Background Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP, fasting plasma glucose (FPG, total cholesterol (TC, and high body mass index (BMI on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods. Methods We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework. Results In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000 deaths in men and 39,000 (36,000, 42,000 deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9 and 4.1 years (3.2, 4.9 in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions. Discussion Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran

  18. Factors Associated With Mortality of Thyroid Storm: Analysis Using a National Inpatient Database in Japan.

    Science.gov (United States)

    Ono, Yosuke; Ono, Sachiko; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Tanaka, Yuji

    2016-02-01

    Thyroid storm is a life-threatening and emergent manifestation of thyrotoxicosis. However, predictive features associated with fatal outcomes in this crisis have not been clearly defined because of its rarity. The objective of this study was to investigate the associations of patient characteristics, treatments, and comorbidities with in-hospital mortality. We conducted a retrospective observational study of patients diagnosed with thyroid storm using a national inpatient database in Japan from April 1, 2011 to March 31, 2014. Of approximately 21 million inpatients in the database, we identified 1324 patients diagnosed with thyroid storm. The mean (standard deviation) age was 47 (18) years, and 943 (71.3%) patients were female. The overall in-hospital mortality was 10.1%. The number of patients was highest in the summer season. The most common comorbidity at admission was cardiovascular diseases (46.6%). Multivariable logistic regression analyses showed that higher mortality was significantly associated with older age (≥60 years), central nervous system dysfunction at admission, nonuse of antithyroid drugs and β-blockade, and requirement for mechanical ventilation and therapeutic plasma exchange combined with hemodialysis. The present study identified clinical features associated with mortality of thyroid storm using large-scale data. Physicians should pay special attention to older patients with thyrotoxicosis and coexisting central nervous system dysfunction. Future prospective studies are needed to clarify treatment options that could improve the survival outcomes of thyroid storm.

  19. Oral cancer: the association between nation-based alcohol-drinking profiles and oral cancer mortality.

    Science.gov (United States)

    Petti, Stefano; Scully, Crispian

    2005-09-01

    The unclear association between different nation-based alcohol-drinking profiles and oral cancer mortality was investigated using, as observational units, 20 countries from Europe, Northern America, Far Eastern Asia, with cross-nationally comparable data. Stepwise multiple regression analyses were run with male age-standardised, mortality rate (ASMR) as explanatory variable and annual adult alcohol consumption, adult smoking prevalence, life expectancy, as explanatory. Large between-country differences in ASMR (range, 0.88-6.87 per 100,000) were found, but the mean value was similar to the global estimate (3.31 vs. 3.09 per 100,000). Differences in alcohol consumption (2.06-21.03 annual litres per capita) and in distribution between beverages were reported. Wine was the most prevalent alcoholic beverage in 45% of cases. Significant increases in ASMR for every litre of pure ethanol (0.15 per 100,000; 95 CI, 0.01-0.29) and spirits (0.26 per 100,000; 95 CI, 0.03-0.49), non-significant effects for beer and wine were estimated. The impact of alcohol on oral cancer deaths would be higher than expected and the drinking profile could affect cancer mortality, probably because of the different drinking pattern of spirit drinkers, usually consuming huge alcohol quantities on single occasions, and the different concentrations of ethanol and cancer-preventing compounds such as polyphenols, in the various beverages.

  20. Measurement of sexual health in the U.S.: an inventory of nationally representative surveys and surveillance systems.

    Science.gov (United States)

    Ivankovich, Megan B; Leichliter, Jami S; Douglas, John M

    2013-01-01

    To identify opportunities within nationally representative surveys and surveillance systems to measure indicators of sexual health, we reviewed and inventoried existing data systems that include variables relevant to sexual health. We searched for U.S. nationally representative surveys and surveillance systems that provided individual-level sexual health data. We assessed the methods of each data system and catalogued them by their measurement of the following domains of sexual health: knowledge, communication, attitudes, service access and utilization, sexual behaviors, relationships, and adverse health outcomes. We identified 18 U.S.-focused, nationally representative data systems: six assessing the general population, seven focused on special populations, and five addressing health outcomes. While these data systems provide a rich repository of information from which to assess national measures of sexual health, they present several limitations. Most importantly, apart from data on service utilization, routinely gathered, national data are currently focused primarily on negative aspects of sexual health (e.g., risk behaviors and adverse health outcomes) rather than more positive attributes (e.g., healthy communication and attitudes, and relationship quality). Nationally representative data systems provide opportunities to measure a broad array of domains of sexual health. However, current measurement gaps indicate the need to modify existing surveys, where feasible and appropriate, and develop new tools to include additional indicators that address positive domains of sexual health of the U.S. population across the life span. Such data can inform the development of effective policy actions, services, prevention programs, and resource allocation to advance sexual health.

  1. Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.

    Science.gov (United States)

    Yankey, Barbara A; Rothenberg, Richard; Strasser, Sheryl; Ramsey-White, Kim; Okosun, Ike S

    2017-11-01

    Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.

  2. The prevalence of couple infertility in the United States from a male perspective: evidence from a nationally representative sample

    OpenAIRE

    Louis, Jean Fredo; Thoma, Marie E.; Sørensen, Ditte Nørbo; McLain, Alexander C.; King, Rosalind B.; Sundaram, Rajeshwari; Keiding, Niels; Buck Louis, Germaine M.

    2013-01-01

    Infertility is a couple based fecundity impairment, though population level research is largely based upon information reported by female partners. Of the few studies focusing on male partners, most focus on the utilization of infertility services rather than efforts to estimate the prevalence and determinants of infertility as reported by male partners. Data from a nationally-representative sample of men aged 15–44 years who participated in the 2002 National Survey of Family Growth (NSFG) we...

  3. Generalised and abdominal adiposity are important risk factors for chronic disease in older people: results from a nationally representative survey.

    Science.gov (United States)

    Hirani, V

    2011-06-01

    To look at the trends in prevalence of generalised (body mass index (BMI) ≥ 25 kg/m2) and abdominal obesity (waist circumference (WC) >102 cm, men; > 88 cm, women) among older people from 1993 to 2008, prevalence of chronic disease by overweight/obesity and WC categories in England 2005 and evaluate the association of these measures with chronic diseases. Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE). Non-institutionalised men and women aged ≥ 65 years (in HSE 2005, 1512 men and 1747 women). Height, weight, waist circumference, blood pressure measurements were taken according to standardised HSE protocols. Information collected on socio-demographic, health behaviour and doctor diagnosed health conditions. Generalised obesity and abdominal obesity increased among men and women from 1993 to 2008. In 2005, the HSE 2005 focussed on older people. 72% of men and 68% of women aged over 65 were either overweight or obese. Prevalence of raised WC was higher in women (58%) than in men (46%). The prevalence of diabetes and arthritis was higher in people with generalised obesity in both sexes. Men were more likely to have had a joint replacement and had a higher prevalence of stroke if they were overweight only but women were more likely to have had a joint replacement only if they were obese (13%) and had a higher risk of falls with generalised obesity. The pattern was similar for the prevalence of chronic diseases by raised WC. Multivariate analysis showed that generalised and abdominal obesity was independently associated with risk of hypertension, diabetes and arthritis in both men and women. In women only, there was an association between generalised obesity and having a fall in the last year (OR: 1.5), and between abdominal obesity and having a joint replacement (OR: 1.9, p=0.01). Complications of obesity such as diabetes, hypertension and arthritis, are more common in men and women aged over 65 who are

  4. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys.

    Science.gov (United States)

    Giovino, Gary A; Mirza, Sara A; Samet, Jonathan M; Gupta, Prakash C; Jarvis, Martin J; Bhala, Neeraj; Peto, Richard; Zatonski, Witold; Hsia, Jason; Morton, Jeremy; Palipudi, Krishna M; Asma, Samira

    2012-08-18

    Despite the high global burden of diseases caused by tobacco, valid and comparable prevalence data for patterns of adult tobacco use and factors influencing use are absent for many low-income and middle-income countries. We assess these patterns through analysis of data from the Global Adult Tobacco Survey (GATS). Between Oct 1, 2008, and March 15, 2010, GATS used nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam). We compared weighted point estimates and 95% CIs of tobacco use between these 14 countries and with data from the 2008 UK General Lifestyle Survey and the 2006-07 US Tobacco Use Supplement to the Current Population Survey. All these surveys had cross-sectional study designs. In countries participating in GATS, 48·6% (95% CI 47·6-49·6) of men and 11·3% (10·7-12·0) of women were tobacco users. 40·7% of men (ranging from 21·6% in Brazil to 60·2% in Russia) and 5·0% of women (0·5% in Egypt to 24·4% in Poland) in GATS countries smoked a tobacco product. Manufactured cigarettes were favoured by most smokers (82%) overall, but smokeless tobacco and bidis were commonly used in India and Bangladesh. For individuals who had ever smoked daily, women aged 55-64 years at the time of the survey began smoking at an older age than did equivalently aged men in most GATS countries. However, those individuals who had ever smoked daily and were aged 25-34-years when surveyed started to do so at much the same age in both sexes. Quit ratios were very low (<20% overall) in China, India, Russia, Egypt, and Bangladesh. The first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote

  5. Impact of social integration on metabolic functions: evidence from a nationally representative longitudinal study of US older adults.

    Science.gov (United States)

    Yang, Yang Claire; Li, Ting; Ji, Yinchun

    2013-12-20

    Metabolic functions may operate as important biophysiological mechanisms through which social relationships affect health. It is unclear how social embeddedness or the lack thereof is related to risk of metabolic dysregulation. To fill this gap we tested the effects of social integration on metabolic functions over time in a nationally representative sample of older adults in the United States and examined population heterogeneity in the effects. Using longitudinal data from 4,323 adults aged over 50 years in the Health and Retirement Study and latent growth curve models, we estimated the trajectories of social integration spanning five waves, 1998-2006, in relation to biomarkers of energy metabolism in 2006. We assessed social integration using a summary index of the number of social ties across five domains. We examined six biomarkers, including total cholesterol, high-density lipoprotein cholesterol, glycosylated hemoglobin, waist circumference, and systolic and diastolic blood pressure, and the summary index of the overall burden of metabolic dysregulation. High social integration predicted significantly lower risks of both individual and overall metabolic dysregulation. Specifically, adjusting for age, sex, race, and body mass index, having four to five social ties reduced the risks of abdominal obesity by 61% (odds ratio [OR] [95% confidence interval {CI}] = 0.39 [0.23, 0.67], p = .007), hypertension by 41% (OR [95% CI] = 0.59 [0.42, 0.84], p = .021), and the overall metabolic dysregulation by 46% (OR [95% CI] = 0.54 [0.40, 0.72], p < .001). The OR for the overall burden remained significant when adjusting for social, behavioral, and illness factors. In addition, stably high social integration had more potent metabolic impacts over time than changes therein. Such effects were consistent across subpopulations and more salient for the younger old (those under age 65), males, whites, and the socioeconomically disadvantaged. This study

  6. Suicide Mortality Among Retired National Football League Players Who Played 5 or More Seasons.

    Science.gov (United States)

    Lehman, Everett J; Hein, Misty J; Gersic, Christine M

    2016-10-01

    There is current disagreement in the scientific literature about the relationship between playing football and suicide risk, particularly among professional players in the National Football League (NFL). While some research indicates players are at high risk of football-related concussions, which may lead to chronic traumatic encephalopathy and suicide, other research finds such a connection to be speculative and unsupported by methodologically sound research. To compare the suicide mortality of a cohort of NFL players to what would be expected in the general population of the United States. Cohort study; Level of evidence, 3. A cohort of 3439 NFL players with at least 5 credited playing seasons between 1959 and 1988 was assembled for statistical analysis. The vital status for this cohort was updated through 2013. Standardized mortality ratios (SMRs), the ratio of observed deaths to expected deaths, and 95% CIs were computed for the cohort; 95% CIs that excluded unity were considered statistically significant. For internal comparison purposes, standardized rate ratios were calculated to compare mortality results between players stratified into speed and nonspeed position types. Suicide among this cohort of professional football players was significantly less than would be expected in comparison with the United States population (SMR = 0.47; 95% CI, 0.24-0.82). There were no significant differences in suicide mortality between speed and nonspeed position players. There is no indication of elevated suicide risk in this cohort of professional football players with 5 or more credited seasons of play. Because of the unique nature of this cohort, these study results may not be applicable to professional football players who played fewer than 5 years or to college or high school players. © 2016 The Author(s).

  7. Pulmonary function levels as predictors of mortality in a national sample of US adults.

    Science.gov (United States)

    Neas, L M; Schwartz, J

    1998-06-01

    Single breath pulmonary diffusing capacity for carbon monoxide (DL(CO)) was examined as a predictor of all-cause mortality among 4,333 subjects who were aged 25-74 years at baseline in the First National Health and Nutrition Examination Survey (NHANES I) conducted from 1971 to 1975. The relation of the percentage of predicted DL(CO) to all-cause mortality was examined in a Cox proportional hazard model that included age, sex, race, current smoking status, systolic blood pressure, serum cholesterol, alcohol consumption, body mass index, percentage of predicted forced vital capacity (FVC), and the ratio of forced expiratory volume at 1 second (FEV1) to FVC. Mortality had a linear association with the percentage of predicted FVC (rate ratio (RR) = 1.12, 95% confidence interval (CI) 1.08-1.17, for a 10% decrement) and a significantly nonlinear association with the percentage of predicted DL(CO) with an adverse effect that was clearly evident for levels below 85% of those predicted (RR = 1.24, 95% CI 1.12-1.37 for a 10% decrement). The relative hazard for the percentage of predicted DL(CO) below 85% was not modified by sex, smoking status, or exclusion of subjects with clinical respiratory disease on the initial examination. This association with the percentage of predicted DL(CO) was present among 3,005 subjects with FEV1 levels above 90% of those predicted. Thus, pulmonary diffusing capacity below 85% of predicted levels is a significant predictor of the all-cause mortality rate within the general US population independent of standard spirometry measures and even in the absence of apparent clinical respiratory disease.

  8. Sex Education, First Sex and Sexual Health Outcomes in Adulthood: Findings from a Nationally Representative Sexual Health Survey

    Science.gov (United States)

    Bourke, Ashling; Boduszek, Daniel; Kelleher, Caroline; McBride, Orla; Morgan, Karen

    2014-01-01

    This study investigated the relationship between school sex education and sexual health behaviours at first sex and later in adulthood, using nationally representative data. Respondents were adults from the 2010 Irish Contraception and Crisis Pregnancy Survey, a cross-sectional survey designed to assess knowledge, attitudes and behaviours relating…

  9. 31 july 2014 - H. WU Ambassador Permanent Representative of the People's Republic of China to the United Nations

    CERN Multimedia

    Egli, Laurent

    2014-01-01

    His Excellency Mr Hailong WU Ambassador Permanent Representative of the People's Republic of China to the United Nations Office at Geneva and other international organizations in Switzerland visiting the ATLAS cavern with ATLAS Spokesperson D. Charlton and the LHC tunnel at Point 1 with Technology Department, Vacuum, Surfaces and Coatings Group P. Cruikshank.

  10. What Puts Women at Risk of Violence from Their Husbands? Findings from a Large, Nationally Representative Survey in Turkey

    Science.gov (United States)

    Yuksel-Kaptanoglu, Ilknur; Turkyilmaz, Ahmet Sinan; Heise, Lori

    2012-01-01

    A large, nationally representative, cross-sectional survey was conducted in Turkey in 2008. In this survey, which used the WHO (World Health Organization) study module on violence, information about lifetime and current violence (past 12 months) was obtained using weighted, stratified, and multistage cluster sampling. This article describes…

  11. The impact of income inequality and national wealth on child and adolescent mortality in low and middle-income countries.

    Science.gov (United States)

    Ward, Joseph L; Viner, Russell M

    2017-05-11

    Income inequality and national wealth are strong determinants for health, but few studies have systematically investigated their influence on mortality across the early life-course, particularly outside the high-income world. We performed cross-sectional regression analyses of the relationship between income inequality (national Gini coefficient) and national wealth (Gross Domestic Product (GDP) averaged over previous decade), and all-cause and grouped cause national mortality rate amongst infants, 1-4, 5-9, 10-14, 15-19 and 20-24 year olds in low and middle-income countries (LMIC) in 2012. Gini models were adjusted for GDP. Data were available for 103 (79%) countries. Gini was positively associated with increased all-cause and communicable disease mortality in both sexes across all age groups, after adjusting for national wealth. Gini was only positively associated with increased injury mortality amongst infants and 20-24 year olds, and increased non-communicable disease mortality amongst 20-24 year old females. The strength of these associations tended to increase during adolescence. Increasing GDP was negatively associated with all-cause, communicable and non-communicable disease mortality in males and females across all age groups. GDP was also associated with decreased injury mortality in all age groups except 15-19 year old females, and 15-24 year old males. GDP became a weaker predictor of mortality during adolescence. Policies to reduce income inequality, rather than prioritising economic growth at all costs, may be needed to improve adolescent mortality in low and middle-income countries, a key development priority.

  12. Associations between Delinquency and Suicidal Behaviors in a Nationally Representative Sample of Adolescents

    Science.gov (United States)

    Thompson, Martie P.; Kingree, J. B.; Ho, Ching-hua

    2006-01-01

    Suicide was the second leading cause of death for 14-17 years olds in 2002. Prior studies indicate that suicidal behaviors are especially common among juvenile delinquents, yet this association has not been examined in a national sample. The 2003 Youth Risk Behavior Surveillance System was used to examine associations between suicidal behaviors…

  13. Personality correlates of type 1 diabetes in a national representative sample

    OpenAIRE

    Čukić, Iva; Weiss, Alexander

    2016-01-01

    We examined cross-sectional relationships between personality traits and type 1 diabetes. The sample (N=8490) was taken from the 1982-84 wave of the National Health and Nutrition Examination Survey Epidemiological Follow-up Study. We fit three logistic regression models to test whether neuroticism, extraversion, openness, or the Type A behavior pattern were associated with type 1 diabetes. Model 1 included sex, age, race/ethnicity and all four personality traits. Model 2 added depressive symp...

  14. Intuitive intellectual property law: A nationally-representative test of the plagiarism fallacy.

    Science.gov (United States)

    Fast, Anne A; Olson, Kristina R; Mandel, Gregory N

    2017-01-01

    Studies with convenience samples have suggested that the lay public's conception of intellectual property laws, including how the laws should regulate and why they should exist, are largely incommensurate with the actual intended purpose of intellectual property laws and their history in the United States. In this paper, we test whether these findings generalize to a more diverse and representative sample. The major findings from past work were replicated in the current study. When presented with several potential reasons for IP protection, the lay public endorsed plagiarism and felt that acknowledging the original source of a creative work should make copying that work permissible-viewpoints strongly divergent from lawmakers' intent and the law itself. In addition, we replicate the finding that lay people know remarkably little about intellectual property laws more generally and report little experience as users or creators of creative works.

  15. Religiousness and suicide in a nationally representative sample of Trinidad and Tobago adolescents and young adults.

    Science.gov (United States)

    Toussaint, Loren; Wilson, Colwick M; Wilson, Leon C; Williams, David R

    2015-09-01

    The present study examines religiousness and its connection to suicidal thoughts, plans, and attempts among Trinidad and Tobago adolescents and young adults. Data are from Trend Research Empowering National Development on adolescents and young adults in Trinidad and Tobago (N = 4448). Religious affiliation, self-perceived religiousness, attendance at religious services, prayer frequency, socio-demographic variables, and suicidal thoughts, plans, and attempts were assessed. Compared to nonreligious, Catholics (OR 0.63, p religious services was related to lower likelihood of thinking about suicide (OR 0.94, p Religiousness may offer benefits for adolescents and young adults in Trinidad and Tobago by reducing the likelihood that they engage in suicide thoughts and behaviors. Results may hold implications for counselors, clergy, teachers, and others working with adolescents and young adults in Trinidad and Tobago.

  16. The Big Five Personality Traits and Intimate Partner Violence: Findings From a Large, Nationally Representative Sample.

    Science.gov (United States)

    Ulloa, Emilio C; Hammett, Julia F; O'Neal, Danielle N; Lydston, Emily E; Leon Aramburo, Leslie F

    2016-12-01

    Intimate partner violence (IPV) is a major public health concern. Thus, it is vital to identify factors, such as individuals' personality traits, that may place men and women at risk for experiencing IPV. This study used data from Wave 4 of the National Longitudinal Study of Adolescent Health (N = 7,187), to examine the association between the Big Five personality traits and IPV perpetration and victimization among men and women. High openness, extraversion, and neuroticism emerged as the three most important risk factors associated with IPV. Although risk factors were found to be relatively similar for IPV perpetration and IPV victimization, some gender differences emerged, showing that extraversion was only connected to IPV for women but not for men. The present findings may bear important considerations for researchers and practitioners working with individuals and couples affected by IPV.

  17. Understanding the value of imperfect science from national estimates of bird mortality from window collisions

    Science.gov (United States)

    Machtans, Craig S.; Thogmartin, Wayne E.

    2014-01-01

    The publication of a U.S. estimate of bird–window collisions by Loss et al. is an example of the somewhat contentious approach of using extrapolations to obtain large-scale estimates from small-scale studies. We review the approach by Loss et al. and other authors who have published papers on human-induced avian mortality and describe the drawbacks and advantages to publishing what could be considered imperfect science. The main drawback is the inherent and somewhat unquantifiable bias of using small-scale studies to scale up to a national estimate. The direct benefits include development of new methodologies for creating the estimates, an explicit treatment of known biases with acknowledged uncertainty in the final estimate, and the novel results. Other overarching benefits are that these types of papers are catalysts for improving all aspects of the science of estimates and for policies that must respond to the new information.

  18. Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort

    OpenAIRE

    Surkan, Pamela J; Ettinger, Anna K; Hock, Rebecca S; Ahmed, Saifuddin; Strobino, Donna M; Minkovitz, Cynthia S

    2014-01-01

    Background: Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods: Using data from 6,550 singleton births from the E...

  19. The Longitudinal Relation Between Peer Violent Victimization and Delinquency: Results From a National Representative Sample of U.S. Adolescents

    OpenAIRE

    Jackson, Corrie L.; Hanson, Rochelle F.; Amstadter, Ananda B.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2012-01-01

    Using a nationally representative sample of adolescents from the United States aged 12 to 17 years (Wave 1, n = 3,614; Wave 2, n = 2,511), this study examined (a) demographic and descriptive information about peer violent victimization (PVV); and (b) the longitudinal relation between a history of PVV and delinquency. Results indicated that 12.4% of adolescents reported lifetime exposure to PVV, and many of these adolescents with a previous history of PVV also reported exposure to other forms ...

  20. Nonmelanoma skin cancer visits and procedure patterns in a nationally representative sample: national ambulatory medical care survey 1995-2007.

    Science.gov (United States)

    Wysong, Ashley; Linos, Eleni; Hernandez-Boussard, Tina; Arron, Sarah T; Gladstone, Hayes; Tang, Jean Y

    2013-04-01

    The rising incidence of nonmelanoma skin cancer (NMSC) is well documented, but data are limited on the number of visits and treatment patterns of NMSC in the outpatient setting. To evaluate practice and treatment patterns of NMSC in the United States over the last decade and to characterize differences according to sex, age, race, insurance type, and physician specialty. Adults with an International Classification of Diseases, Ninth Revision, diagnosis of NMSC were included in this cross-sectional survey study of the National Ambulatory Medical Care Survey between 1995 and 2007. Primary outcomes included population-adjusted NMSC visit rates and odds ratios of receiving a procedure for NMSC using logistic regression. Rates of NMSC visits increased between 1995 and 2007. The number of visits was significantly higher in men, particularly those aged 65 and older. Fifty-nine percent of NMSC visits were associated with a procedure, and the individuals associated with that visit were more likely to be male, to be seen by a dermatologist, and to have private-pay insurance. Nonmelanoma skin cancer visit rates increased from 1995 to 2007 and were higher in men than women. Visits to a dermatologist are more likely to be associated with a procedure for NMSC, and there may be discrepancies in treatment patterns based on insurance type and sex. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  1. Recent illicit drug use among psychiatric patients in Brazil: a national representative study

    Science.gov (United States)

    Nahas, Miriam Almeida; Melo, Ana Paula Souto; Cournos, Francine; Mckinnon, Karen; Wainberg, Milton; Guimarães, Mark Drew Crosland

    2017-01-01

    ABSTRACT OBJECTIVE To estimate factors associated to illicit drug use among patients with mental illness in Brazil according to gender. METHODS A cross-sectional representative sample of psychiatric patients (2,475 individuals) was randomly selected from 11 hospitals and 15 public mental health outpatient clinics. Data on self-reported illicit drug use and sociodemographic, clinical and behavioral characteristics were obtained from face-to-face interviews. Logistic regression was used to estimate associations with recent illicit drug use. RESULTS The prevalence of any recent illicit drug use was 11.4%. Men had higher prevalence than women for all substances (17.5% and 5.6%, respectively). Lower education, history of physical violence, and history of homelessness were associated with drug use among men only; not professing a religion was associated with drug use in women only. For both men and women, younger age, current hospitalization, alcohol and tobacco use, history of incarceration, younger age at sexual debut, and more than one sexual partner were statistically associated with illicit drug use. CONCLUSIONS Recent illicit drug use among psychiatric patients is higher than among the general Brazilian population and it is associated with multiple factors including markers of psychiatric severity. Our data indicate the need for the development of gender-based drug-use interventions among psychiatric patients in Brazil. Integration of substance use treatment strategies with mental health treatment should be a priority. PMID:28832753

  2. Predictors of utilisation of dental care services in a nationally representative sample of adults.

    Science.gov (United States)

    Guiney, H; Woods, N; Whelton, H; Morgan, K

    2011-12-01

    The objective of this study was to identify the predictors of utilisation of dental care services in Ireland. The 2007 Irish Survey of Lifestyle, Attitudes and Nutrition is a cross-sectional study, conducted in 2006/2007 (n = 10,364), by interviews at home to a representative sample of adults aged 18 years or over. Multivariate logistic regression was used to investigate the influence of socioeconomic, predisposing and enabling factors on the odds of males and females having a dental visit in the past year. The significant predictors of visiting the dentist in the past year were for males: having 3rd level education, employment status, earning 50,000 euros or more, location of residence, use of a car, brushing frequently, and dentition status. For females, the predictors were being between 25-34 or 55-64 years-old, education level, earning 50,000 euros or more, location of residence, use of a car, brushing frequently and dentition status. Predictors of the use of dental services vary by gender. Predictors common to both genders were education level, higher income, location of residence, use of a car, brushing frequently and dentition status. Many of the predictors of dental visiting in the past year are also related to social inequalities in health. These predictors may be useful markers of impact for policies designed to address inequalities in access to oral health services.

  3. Recent illicit drug use among psychiatric patients in Brazil: a national representative study

    Directory of Open Access Journals (Sweden)

    Miriam Almeida Nahas

    2017-08-01

    Full Text Available ABSTRACT OBJECTIVE To estimate factors associated to illicit drug use among patients with mental illness in Brazil according to gender. METHODS A cross-sectional representative sample of psychiatric patients (2,475 individuals was randomly selected from 11 hospitals and 15 public mental health outpatient clinics. Data on self-reported illicit drug use and sociodemographic, clinical and behavioral characteristics were obtained from face-to-face interviews. Logistic regression was used to estimate associations with recent illicit drug use. RESULTS The prevalence of any recent illicit drug use was 11.4%. Men had higher prevalence than women for all substances (17.5% and 5.6%, respectively. Lower education, history of physical violence, and history of homelessness were associated with drug use among men only; not professing a religion was associated with drug use in women only. For both men and women, younger age, current hospitalization, alcohol and tobacco use, history of incarceration, younger age at sexual debut, and more than one sexual partner were statistically associated with illicit drug use. CONCLUSIONS Recent illicit drug use among psychiatric patients is higher than among the general Brazilian population and it is associated with multiple factors including markers of psychiatric severity. Our data indicate the need for the development of gender-based drug-use interventions among psychiatric patients in Brazil. Integration of substance use treatment strategies with mental health treatment should be a priority.

  4. Parental supply of alcohol and adolescent drinking: a multilevel analysis of nationally representative data.

    Science.gov (United States)

    Chan, Gary C K; Leung, Janni; Connor, Jason; Hall, Wayne; Kelly, Adrian B

    2017-06-09

    Existing research on parental supply of alcohol analyses the effects of self-reported parental supply on adolescent drinking using individual level data. This study examined the contextual effect of parental supply of alcohol on adolescent alcohol use by examining the association between the prevalence of parental supply in each Australian state and adolescent alcohol use using a multilevel analytic framework. Adolescent samples (Age: 12-17) were drawn from the four National Drug Strategy Household Surveys (2004, 2007, 2010 and 2013; N = 6803). The prevalence of parental supply of alcohol, defined as the weighted percentage of sample who reported obtaining alcohol from their parents, was estimated in each state and territory across the four surveys. Three multilevel logistic regressions were used to examine the contextual effects of parental supply prevalence on adolescents' alcohol use in the past 12 months, weekly drinking and heavy drinking. Overall, adolescents' rates of past 12 months alcohol use, heavy drinking and weekly drinking between 2004 and 2013 were 40.1, 14.4 and 6.4% respectively. The prevalence of parental supply was significantly associated with past 12 months alcohol use (OR = 1.06, p supply. A high prevalence of parental supply in a region was associated with heavier adolescent drinking, regardless of whether adolescents primarily obtained their alcohol from their own parents.

  5. Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample.

    Science.gov (United States)

    Allen, Junior Lloyd; Mowbray, Orion

    2016-04-01

    Gay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. Using data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. Findings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. These findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Rate and Predictors of Persistent Major Depressive Disorder in a Nationally Representative Sample.

    Science.gov (United States)

    Walker, Elizabeth Reisinger; Druss, Benjamin G

    2015-08-01

    This study examined predictors of persistent major depressive disorder over 10 years, focusing on the effects of clinical variables, physical health, and social support. Data from the National Survey of Midlife Development in the United States in 1995-1996 and 2004-2006 were analyzed. Logistic regression was used to predict non-recovery from major depression among individuals who met clinical-based criteria for major depressive disorder at baseline. Fifteen percent of the total sample was classified as having major depression in 1995-1996; of these individuals, 37 % had major depression in 2004-2006. Baseline variables that were significantly associated with persistent major depression at follow-up were being female, having never married, having two or more chronic medical conditions, experiencing activity limitation, and less contact with family. Therefore, treatment strategies focused on physical health, social support, and mental health needs are necessary to comprehensively address the factors that contribute to persistent major depressive disorder.

  7. Social networks and alcohol use disorders: findings from a nationally representative sample

    Science.gov (United States)

    Mowbray, Orion; Quinn, Adam; Cranford, James A.

    2014-01-01

    Background While some argue that social network ties of individuals with alcohol use disorders (AUD) are robust, there is evidence to suggest that individuals with AUDs have few social network ties, which are a known risk factor for health and wellness. Objectives Social network ties to friends, family, co-workers and communities of individuals are compared among individuals with a past-year diagnosis of alcohol dependence or alcohol abuse to individuals with no lifetime diagnosis of AUD. Method Respondents from Wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC) were assessed for the presence of past-year alcohol dependence or past-year alcohol abuse, social network ties, sociodemographics and clinical characteristics. Results Bivariate analyses showed that both social network size and social network diversity was significantly smaller among individuals with alcohol dependence, compared to individuals with alcohol abuse or no AUD. When social and clinical factors related to AUD status were controlled, multinomial logistic models showed that social network diversity remained a significant predictor of AUD status, while social network size did not differ among AUD groups. Conclusion Social networks of individuals with AUD may be different than individuals with no AUD, but this claim is dependent on specific AUD diagnosis and how social networks are measured. PMID:24405256

  8. Predictors of parent-child communication among a nationally representative sample in Nigeria.

    Science.gov (United States)

    Berg, Katrina; Sun, Christina J; Babalola, Stella

    2012-01-01

    This study explores what constructs are associated with parent-adolescent communication about AIDS/sexually transmitted infections (STIs) and sexual relationships in Nigeria. The analyses use data from the 2007 National HIV/AIDS and Reproductive Health Survey on 2593 men and women who had at least one child over the age of 12 years. The respondents were classified as low, medium, or high communicators. Low communicators were parents who did not talk to their child about either AIDS/STIs or sexual relationships. Medium communicators were parents who discussed only one topic with at least one child. High communicators were parents who discussed both topics with at least one child. Logistic regression was used to compare high communicators with low/medium communicators. There are commonalities and differences among men and women in the factors associated with parent-adolescent communication. Age, religion, and knowing where to obtain information about HIV/AIDS were associated with the extent of communication, regardless of the parent's gender. Perceived social support was an important correlate for fathers, while knowledge of female STI symptoms showed a significant association only for mothers. Programmatic and communication implications of the findings include addressing men and women differently, developing strategies to specifically reach younger parents and Muslims, and increasing general awareness of HIV/AIDS information resources. Further research is needed to understand the context, content, and timing of parent-adolescent conversations about AIDS/STIs and sexual relationships and how these factors affect the sexual behaviors of adolescents.

  9. Association Between Playing American Football in the National Football League and Long-term Mortality.

    Science.gov (United States)

    Venkataramani, Atheendar S; Gandhavadi, Maheer; Jena, Anupam B

    2018-02-27

    Studies of the longevity of professional American football players have demonstrated lower mortality relative to the general population but they may have been susceptible to selection bias. To examine the association between career participation in professional American football and mortality risk in retirement. Retrospective cohort study involving 3812 retired US National Football League (NFL) players who debuted in the NFL between 1982 and 1992, including regular NFL players (n = 2933) and NFL "replacement players" (n = 879) who were temporarily hired to play during a 3-game league-wide player strike in 1987. Follow-up ended on December 31, 2016. NFL participation as a career player or as a replacement player. The primary outcome was all-cause mortality by December 31, 2016. Cox proportional hazards models were estimated to compare the observed number of years from age 22 years until death (or censoring), adjusted for birth year, body mass index, height, and position played. Information on player death and cause of death was ascertained from a search of the National Death Index and web-based sources. Of the 3812 men included in this study (mean [SD] age at first NFL activity, 23.4 [1.5] years), there were 2933 career NFL players (median NFL tenure, 5 seasons [interquartile range {IQR}, 2-8]; median follow-up, 30 years [IQR, 27-33]) and 879 replacement players (median NFL tenure, 1 season [IQR, 1-1]; median follow-up, 31 years [IQR, 30-33]). At the end of follow-up, 144 NFL players (4.9%) and 37 replacement players (4.2%) were deceased (adjusted absolute risk difference, 1.0% [95% CI, -0.7% to 2.7%]; P = .25). The adjusted mortality hazard ratio for NFL players relative to replacements was 1.38 (95% CI, 0.95 to 1.99; P = .09). Among career NFL players, the most common causes of death were cardiometabolic disease (n = 51; 35.4%), transportation injuries (n = 20; 13.9%), unintentional injuries (n = 15; 10.4%), and neoplasms (n = 15

  10. Assessing the Risk Factors of Cyber and Mobile Phone Bullying Victimization in a Nationally Representative Sample of Singapore Youth.

    Science.gov (United States)

    Holt, Thomas J; Fitzgerald, Sarah; Bossler, Adam M; Chee, Grace; Ng, Esther

    2016-04-01

    This study utilized routine activity theory to examine the relationships between online behaviors, target suitability, and cyber and mobile phone-based bullying victimization in a nationally representative sample of youth from nine schools across Singapore. Key measures in all three categories-access to technology, online routine behaviors, and target suitability-were significant predictors of both forms of bullying victimization. In particular, females and victims of physical bullying were more likely to experience both forms of victimization. Access to technology and online routine behaviors predicted cyber and mobile phone-based bullying victimization differently. These findings demonstrate that routine activity theory is a viable framework to understand online bullying in non-Western nations, consistent with the existing literature on Western nations. © The Author(s) 2014.

  11. Gambling and violence in a nationally representative sample of UK men.

    Science.gov (United States)

    Roberts, Amanda; Coid, Jeremy; King, Robert; Murphy, Raegan; Turner, John; Bowden-Jones, Henrietta; Du Preez, Katie Palmer; Landon, Jason

    2016-12-01

    The relationship between violence and problem gambling in general population samples is under-researched and requires further attention to inform treatment and prevention efforts. We investigated the relationship between gambling problems and violence among men and sought to determine if the link can be accounted for by mental disorders, alcohol and drug dependence and impulsivity. A cross-sectional survey. A UK representative general population survey conducted in 2009. A total of 3025 UK men aged 18-64 years. Binary logistic regression was used to examine relationships. Outcome measures included gambling behaviour and self-reports of violence. Covariates included alcohol and drug dependence, mental illness, impulsivity and socio-demography. Problem gambling and probable pathological gambling were associated with increased odds of the perpetration of violence [adjusted odd ratios (AOR) = 3.09, confidence interval (CI) = 1.90-5.00 and 4.09, CI = 2.76-6.30, respectively] and a range of other behaviours, such as using a weapon (AORs = 4.93, CI = 2.52-9.63 and 6.33, CI = 3.52-11.38) and the perpetration of intimate partner violence (AOR = 9.80, CI =2.45-39.04). The results were attenuated when adjusted for comorbid mental illness and impulsivity, but remained statistically significant. Alcohol and drug dependence had the most impact; relationships were most attenuated when they added into the models, with the latter having the largest effect. Among men in the United Kingdom, self-reports of problem/pathological gambling remain predictive of a range of measures of violent behaviour after adjusting for alcohol and drug dependence, comorbid mental disorder and impulsivity; of the covariates, alcohol and drug dependence have the greatest effect in attenuating the gambling-violence association. © 2016 Society for the Study of Addiction.

  12. Polydrug use typologies and childhood maltreatment in a nationally representative survey of Danish young adults.

    Science.gov (United States)

    Armour, Cherie; Shorter, Gillian W; Elhai, Jon D; Elklit, Ask; Christoffersen, Mogens N

    2014-01-01

    Substance use and childhood maltreatment experience are linked, but little is known about the association with polydrug use patterns. Latent class analyses (LCA) were performed on eight illicit drugs in a random population sample of young Danes separated by sex (males: n = 1,555; females: n = 1,425). Logistic regressions explored associations of polydrug use patterns and childhood maltreatment. A three-class solution best described patterns of polydrug use in both the male and female samples. Across all LCA models, Class 1 was characterized by individuals who represented wide-range polydrug users, endorsing many of the drug types (males = 8%; females = 2%). Class 2 was characterized by amphetamine, cannabis, cocaine, and amyl nitrate users (males = 18%; females = 7%). Class 3 was characterized by individuals who endorsed either low-level use of cannabis only or no drug use (males = 74%; females = 91 %). For males, having been a child-protection case was associated with Classes 1 and 2 and for females with Class 2, compared with Class 3. Alcohol problems were associated with Classes 1 and 2 for both sexes. Sexual abuse was associated with Classes 1 and 2 for females but not males, whereas physical abuse was associated with Classes 1 and 2 for males but not females, as compared with Class 3. Separate sex analyses are important; although patterns of polydrug use are broadly similar, females are less frequently polydrug users. In addition, different relationships exist for the sexes, such that polydrug use patterns are associated with sexual abuse in females, whereas such patterns are associated with physical abuse in young males.

  13. Gambling and negative life events in a nationally representative sample of UK men.

    Science.gov (United States)

    Roberts, Amanda; Sharman, Stephen; Coid, Jeremy; Murphy, Raegan; Bowden-Jones, Henrietta; Cowlishaw, Sean; Landon, Jason

    2017-12-01

    The links between gambling problems, trauma and life stressors are known to exist but understanding the extent of these relationships will allow for greater efficacy in early intervention and treatment. We investigated these relationships among men and sought to determine whether links were attenuated by alcohol and drug use problems. A cross-sectional UK representative general population survey was conducted in 2009 with 3025 men aged 18-64years. Measurements included self-reported gambling behaviours, as measured by the South Oaks Gambling Scale (SOGS) and traumatic or stressful life events. Covariates included alcohol and drug dependence and socio-demographics. Binary logistic regression models were used to examine associations. Problem gambling (SOGS 3-4) and probable pathological gambling (SOGS 5+) were associated with increased odds of trauma in childhood (e.g. violence in the home (Adjusted Odd Ratios (AOR) 3.0 (CI=1.8-5.0) and 2.6 (CI=1.7-4.1) respectively), and life stressors in adulthood (e.g. intimate partner violence (AORs 4.5 (CI=2.0-10.3) and 4.7 (CI=2.3-9.7) and homelessness (AORs 2.2 (CI=1.1-4.6) and 3.2 (CI=1.9-5.5)). Results were attenuated when adjusted for probable alcohol and drug dependence with the latter having largest effects. Among men in the United Kingdom, disordered gambling remains uniquely associated with trauma and life stressors in childhood and adulthood after adjusting for alcohol and drug dependence. The results support a need for disordered gambling treatment services to undertake routine screening for alcohol, drugs, IPV and traumatic life events and to tailor treatment that specifically targets the effects of stress for clients who present with such a cluster of issues. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  14. Impact of Tourette Syndrome on School Measures in a Nationally Representative Sample

    Science.gov (United States)

    Claussen, Angelika H.; Bitsko, Rebecca H.; Holbrook, Joseph R.; Bloomfield, Jeanette; Giordano, Kathy

    2018-01-01

    Objective Children with Tourette syndrome (TS) are at risk for a variety of co-occurring conditions and learning and school problems. The purpose of this study was to determine the impact of TS and co-occurring conditions on school measures. Methods Parent-reported data from the 2007–2008 and 2011–2012 National Survey of Children’s Health were combined (n = 129,353 children aged 6–17 yrs). Parent report of health care provider diagnosis of TS; co-occurring mental, emotional, and behavioral conditions; learning and language conditions; and school measures were assessed. School measures included type of school, individual education plan (IEP), number of school days missed, school problems, doing well in school, doing homework, and repeating a grade. Children with TS were compared with those who never had TS on school measures accounting for co-occurring conditions. Results After adjusting for demographics, compared with children without TS, children currently with TS were more likely to have an IEP, have a parent contacted about school problems, and not complete homework. After further adjusting for co-occurring conditions, only IEP status remained statistically significant. Compared with children with mild TS, children with moderate or severe TS were more likely to have an IEP, repeat a grade, encounter school problems, and not care about doing well in school. Conclusion Tourette syndrome severity and co-occurring conditions are associated with school challenges and educational service needs. Awareness among health care providers, teachers and parents of the potential challenges related to both TS and co-occurring conditions would help to best support the child’s education. PMID:29432328

  15. Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

    Science.gov (United States)

    Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-01-01

    Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have

  16. Impact of Tourette Syndrome on School Measures in a Nationally Representative Sample.

    Science.gov (United States)

    Claussen, Angelika H; Bitsko, Rebecca H; Holbrook, Joseph R; Bloomfield, Jeanette; Giordano, Kathy

    2018-05-01

    Children with Tourette syndrome (TS) are at risk for a variety of co-occurring conditions and learning and school problems. The purpose of this study was to determine the impact of TS and co-occurring conditions on school measures. Parent-reported data from the 2007-2008 and 2011-2012 National Survey of Children's Health were combined (n = 129,353 children aged 6-17 yrs). Parent report of health care provider diagnosis of TS; co-occurring mental, emotional, and behavioral conditions; learning and language conditions; and school measures were assessed. School measures included type of school, individual education plan (IEP), number of school days missed, school problems, doing well in school, doing homework, and repeating a grade. Children with TS were compared with those who never had TS on school measures accounting for co-occurring conditions. After adjusting for demographics, compared with children without TS, children currently with TS were more likely to have an IEP, have a parent contacted about school problems, and not complete homework. After further adjusting for co-occurring conditions, only IEP status remained statistically significant. Compared with children with mild TS, children with moderate or severe TS were more likely to have an IEP, repeat a grade, encounter school problems, and not care about doing well in school. Tourette syndrome severity and co-occurring conditions are associated with school challenges and educational service needs. Awareness among health care providers, teachers and parents of the potential challenges related to both TS and co-occurring conditions would help to best support the child's education.

  17. Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample.

    Science.gov (United States)

    Chaudhary, Ninad S; Grandner, Michael A; Jackson, Nicholas J; Chakravorty, Subhajit

    2016-01-01

    Insomnia symptoms have been individually associated with both caffeine consumption and sleep duration abnormalities in prior studies. The goal of this study was to determine whether caffeine consumption was associated with insomnia symptoms from a population perspective and whether this relationship depended on habitual sleep duration. Data were extracted from the 2007-2008 National Health and Nutritional Examination Survey (N = 4730). Caffeine consumption was quantified as mg/d from 2 typical days of use, 7 to 10 d apart. Insomnia symptoms were evaluated using frequencies of difficulty falling asleep (DFA), difficulty staying asleep (DSA), non-restorative sleep (NRS), and daytime sleepiness (DS). Habitual sleep duration was assessed as the hours of sleep obtained on a typical night. Binomial logistic regression analysis evaluated the relationships of individual insomnia and sleepiness symptoms (DFA, DSA, NRS, and DS) with caffeine consumption and sleep duration variables, after adjusting for covariates. The mean ± SD caffeine consumption was 176.6 ± 201 mg/d. Mean habitual sleep duration was 6.8 ± 1.4 h. Insomnia symptoms were prevalent in 19.1% to 28.4% of the respondents. Although caffeine consumption was associated with all insomnia symptoms in the unadjusted models, the adjusted models demonstrated a trend toward significance with DSA. Sleep duration was inversely associated with the insomnia symptoms in unadjusted and adjusted analysis. Finally, NRS was associated with an interaction between increased caffeine consumption and sleep duration. The association between caffeine use and insomnia symptoms depends on habitual sleep duration at a population level. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. E-cigarette awareness, use, and harm perceptions in Italy: a national representative survey.

    Science.gov (United States)

    Gallus, Silvano; Lugo, Alessandra; Pacifici, Roberta; Pichini, Simona; Colombo, Paolo; Garattini, Silvio; La Vecchia, Carlo

    2014-12-01

    Only a few studies have provided information on awareness, use, and harm perceptions of e-cigarettes in Europe. We fill the knowledge gap in Italy. We used data from a face-to-face survey conducted in 2013 of a sample of 3,000 individuals, representative of the Italian population aged ≥15 years (51.1 million inhabitants). Awareness of e-cigarettes was 91.1%; it was lowest among women (87.8%), the elderly (78.4%), those with less education (84.1%), and never-smokers (89.0%). Ever e-cigarette use was 6.8% overall and was inversely related to age, whereas no significant difference was observed according to sex. With regard to smoking status, 2.6% of never-smokers, 7.0% of ex-smokers, and 20.4% of current smokers tried the e-cigarette at least once. Regular e-cigarette use was 1.2% overall, 1.5% among men, and 0.9% among women, and it was highest among young (2.4%) and current smokers (3.7%). Among 36 e-cigarette regular users, 22.0% did not change their smoking habit, 67.7% reduced traditional cigarette consumption, and 10.4% quit smoking. After fewer than 3 years from the opening of the first Italian e-cigarette shop, more than 45 million Italians have heard about e-cigarettes, 3.5 million have tried e-cigaretts, and more than 600,000 Italians regularly use e-cigarettes. Three out of 4 e-cigarette users reported to have favorably modified their smoking habit; however, 90% of users did not quit smoking as a consequence of starting vaping e-cigarettes. Almost 900,000 Italian never-smokers, particularly young never-smokers, have tried this new and potentially addictive product at least once. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Derivation of Nationally Consistent Indices Representing Urban Intensity Within and Across Nine Metropolitan Areas of the Conterminous United States

    Science.gov (United States)

    Cuffney, Thomas F.; Falcone, James A.

    2009-01-01

    Two nationally consistent multimetric indices of urban intensity were developed to support studies of the effects of urbanization on streams in nine metropolitan areas of the conterminous United States: Atlanta, Georgia; Birmingham, Alabama; Boston, Massachusetts; Dallas-Fort Worth, Texas; Denver, Colorado; Milwaukee-Green Bay, Wisconsin; Portland, Oregon; Raleigh, North Carolina; and Salt Lake City, Utah. These studies were conducted as a part of the U.S. Geological Survey's National Water-Quality Assessment Program. These urban intensity indices were used to define gradients of urbanization and to interpret biological, physical, and chemical changes along these gradients. Ninety census, land-cover, and infrastructure variables obtained from nationally available databases were evaluated. Only variables that exhibited a strong and consistent linear relation with 2000 population density were considered for use in the indices. Housing-unit density (HUDEN), percentage of basin area in developed land (P_NLCD1_2), and road density (ROADDEN) were selected as the best representatives of census, land-cover, and infrastructure variables. The metropolitan area national urban intensity index (MA-NUII) was scaled to represent urban intensity within each metropolitan area and ranged from 0 (little or no urban) to 100 (maximum urban) for sites within each metropolitan area. The national urban intensity index (NUII) was scaled to represent urban intensity across all nine metropolitan areas and ranged from 0 to 100 for all sites. The rates at which HUDEN, P_NLCD1_2, and ROADDEN changed with changes in population density varied among metropolitan areas. Therefore, these variables were adjusted to obtain a more uniform rate of response across metropolitan areas in the derivation of the NUII. The NUII indicated that maximum levels of urban intensity occurred in the West and Midwest rather than in the East primarily because small inner-city streams in eastern metropolitan areas are

  20. 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

  1. Concurrent and simultaneous polydrug use: latent class analysis of an Australian nationally representative sample of young adults.

    Directory of Open Access Journals (Sweden)

    Lake-Hui eQuek

    2013-11-01

    Full Text Available Background: Alcohol use and illicit drug use peak during young adulthood (around 18-29 years of age, but comparatively little is known about polydrug use in nationally representative samples of young adults. Drawing on a nationally representative cross-sectional survey (Australian National Drug Strategy Household Survey, this study examines polydrug use patterns and associated psychosocial risk factors among young adults (n = 3,333; age 19-29. Method: The use of a broad range of licit and illicit drugs were examined, including alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers and tranquillizers/sleeping pills. Latent class analysis was employed to identify patterns of polydrug use. Results: Polydrug use in this sample was best described using a 5-class solution. The majority of young adults predominantly used alcohol only (52.3%, alcohol and tobacco (34.18%. The other classes were cannabis, ecstasy, and licit drug use (9.4%, cannabis, amphetamine derivative, and licit drug use (2.8%, and sedative and alcohol use (1.3%. Young adult males with low education and/or high income were most at risk of polydrug use. Conclusion: Almost half of young adults reported polydrug use, highlighting the importance of post-high school screening for key risk factors and polydrug use profiles, and the delivery of early intervention strategies targeting illicit drugs.

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

    Science.gov (United States)

    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.

  3. His Excellency Mr Ali Naci Koru Ambassador extraordinary and plenipotentiary Permanent Representative of Turkey to the United Nations Office at Geneva and other international organisations in Switzerland

    CERN Multimedia

    Bennett, Sophia Elizabeth

    2017-01-01

    His Excellency Mr Ali Naci Koru Ambassador extraordinary and plenipotentiary Permanent Representative of Turkey to the United Nations Office at Geneva and other international organisations in Switzerland

  4. His Excellency Mr Juraj Podhorsky Ambassador Extraordinary and Plenipotentiary Permanent Representative of the Slovak Republic to the United Nations Office and other international organisations in Geneva

    CERN Multimedia

    Ordan, Julien Marius

    2017-01-01

    His Excellency Mr Juraj Podhorsky Ambassador Extraordinary and Plenipotentiary Permanent Representative of the Slovak Republic to the United Nations Office and other international organisations in Geneva

  5. Performance of hospitals according to the ESC ACCA quality indicators and 30-day mortality for acute myocardial infarction: national cohort study using the United Kingdom Myocardial Ischaemia National Audit Project (MINAP) register.

    Science.gov (United States)

    Bebb, Owen; Hall, Marlous; Fox, Keith A A; Dondo, Tatendashe B; Timmis, Adam; Bueno, Hector; Schiele, François; Gale, Chris P

    2017-04-01

    To investigate the application of the European Society of Cardiology Acute Cardiovascular Care Association quality indicators (QI) for acute myocardial infarction for the study of hospital performance and 30-day mortality. National cohort study (n = 118,075 patients, n = 211 hospitals, MINAP registry), 2012-13. Overall, 16 of the 20 QIs could be calculated. Eleven QIs had a significant inverse association with GRACE risk adjusted 30-day mortality (all P < 0.005). The association with the greatest magnitude was high attainment of the composite opportunity-based QI (80-100%) vs. zero attainment (odds ratio 0.04, 95% confidence interval 0.04-0.05, P < 0.001), increasing attainment from low (0.42, 0.37- 0.49, P < 0.001) to intermediate (0.15, 0.13-0.16, P < 0.001) was significantly associated with a reduced risk of 30-day mortality. A 1% increase in attainment of this QI was associated with a 3% reduction in 30-day mortality (0.97, 0.97-0.97, P < 0.001). The QI with the widest hospital variation was 'fondaparinux received among NSTEMI' (interquartile range 84.7%) and least variation 'centre organisation' (0.0%), with seven QIs depicting minimal variation (<11%). GRACE risk score adjusted 30-day mortality varied by hospital (median 6.7%, interquartile range 5.4-7.9%). Eleven QIs were significantly inversely associated with 30-day mortality. Increasing patient attainment of the composite quality indicator was the most powerful predictor; a 1% increase in attainment represented a 3% decrease in 30-day standardised mortality. The ESC QIs for acute myocardial infarction are applicable in a large health system and have the potential to improve care and reduce unwarranted variation in death from acute myocardial infarction. © The Author 2017. Published on behalf of the European Society of Cardiology

  6. Past-Year Treatment Utilization Among Individuals Meeting DSM-5 PTSD Criteria: Results From a Nationally Representative Sample.

    Science.gov (United States)

    Hale, Andrew C; Sripada, Rebecca K; Bohnert, Kipling M

    2018-03-01

    Little is known regarding treatment utilization among individuals meeting DSM-5 criteria for posttraumatic stress disorder (PTSD). Data were analyzed from the third wave of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample using DSM-5 criteria. Factors related to increased odds of PTSD treatment utilization for individuals meeting lifetime criteria included some college education versus less than a high school degree (odds ratio [OR]=3.17), having health insurance versus no insurance (OR=2.86), having a comorbid phobia disorder versus not having a phobia disorder (OR=1.36), and greater PTSD symptom count (OR=1.11). Older age (OR=.40), identifying as black or Asian versus white non-Hispanic (OR=.70 and OR=.28, respectively), and greater social functioning (OR=.98) were associated with decreased odds of PTSD treatment utilization. Results highlight factors that may be useful in identifying population subgroups with PTSD that are at risk for underutilization of services.

  7. Change in the structures, dynamics and disease-related mortality rates of the population of Qatari nationals: 2007-2011.

    Science.gov (United States)

    Al-Thani, Mohamed H; Sadoun, Eman; Al-Thani, Al-Anoud; Khalifa, Shamseldin A; Sayegh, Suzan; Badawi, Alaa

    2014-12-01

    Developing effective public health policies and strategies for interventions necessitates an assessment of the structure, dynamics, disease rates and causes of death in a population. Lately, Qatar has undertaken development resurgence in health and economy that resulted in improving the standard of health services and health status of the entire Qatari population (i.e., Qatari nationals and non-Qatari residents). No study has attempted to evaluate the population structure/dynamics and recent changes in disease-related mortality rates among Qatari nationals. The present study examines the population structure/dynamics and the related changes in the cause-specific mortality rates and disease prevalence in the Qatari nationals. This is a retrospective, analytic descriptive analysis covering a period of 5years (2007-2011) and utilizes a range of data sources from the State of Qatar including the population structure, disease-related mortality rates, and the prevalence of a range of chronic and infectious diseases. Factors reflecting population dynamics such as crude death (CDR), crude birth (CBR), total fertility (TFR) and infant mortality (IMR) rates were also calculated. The Qatari nationals is an expansive population with an annual growth rate of ∼4% and a stable male:female ratio. The CDR declined by 15% within the study period, whereas the CBR was almost stable. The total disease-specific death rate, however, was decreased among the Qatari nationals by 23% due to the decline in mortality rates attributed to diseases of the blood and immune system (43%), nervous system (44%) and cardiovascular system (41%). There was a high prevalence of a range of chronic diseases, whereas very low frequencies of the infectious diseases within the study population. Public health strategies, approaches and programs developed to reduce disease burden and the related death, should be tailored to target the population of Qatari nationals which exhibits characteristics that vary from

  8. Modelling the incidence and mortality of psychotic disorders: data from the second Australian national survey of psychosis.

    Science.gov (United States)

    Saha, Sukanta; Whiteford, Harvey; McGrath, John

    2014-04-01

    The aim of this study was to model estimates related to (a) the incidence of psychotic disorders and (b) the mortality associated with these disorders based on a large, population-based prevalence study. Data were drawn from the second national survey of adults with psychotic disorders conducted in seven Australian catchment areas during March to December 2010. To generate incidence rate estimates, we identified recent onset cases recruited as part of the prevalence study and then imputed population-based incidence rates using a set of conservative assumptions. Similarly, for mortality rates, we identified individuals who had died after being identified as 'screen-positive' for psychosis, but prior to full clinical assessment. Using a set of conservative assumptions, we then used these estimates to infer population-based mortality rates. Based on our models, we estimated that the incidence rate for psychotic disorders was 28 cases per 100,000 population. The rate estimates were significantly higher in males than females, with an overall male:female ratio of 1.57:1. Incidence rate estimates peaked in the youngest age group (18-24 years). The adjusted mortality rate estimated during the whole period of observation was 12.5 per 1000 persons, with a standardised mortality ratio of 5.5. Using treated prevalence data and observed deaths with appropriate algorithms, we were able to impute incidence and mortality rates for psychotic disorders consistent with the published literature. While the second national survey of psychotic disorders was not designed to identify mortality, our estimates provide a stark reminder of the increased mortality associated with these disorders.

  9. The prevalence of discrimination across racial groups in contemporary America: Results from a nationally representative sample of adults.

    Directory of Open Access Journals (Sweden)

    Brian B Boutwell

    Full Text Available A large body of social science research is devoted to understanding the causes and correlates of discrimination. Comparatively less effort has been aimed at providing a general prevalence estimate of discrimination using a nationally representative sample. The current study is intended to offer such an estimate using a large sample of American respondents (N = 14,793 while also exploring perceptions regarding why respondents felt they were discriminated against. The results provide a broad estimate of self-reported discrimination experiences-an event that was only reported by about one-quarter of all sample members-across racial and ethnic categories.

  10. The prevalence of discrimination across racial groups in contemporary America: Results from a nationally representative sample of adults

    Science.gov (United States)

    Nedelec, Joseph L.; Winegard, Bo; Shackelford, Todd; Beaver, Kevin M.; Vaughn, Michael; Barnes, J. C.; Wright, John P.

    2017-01-01

    A large body of social science research is devoted to understanding the causes and correlates of discrimination. Comparatively less effort has been aimed at providing a general prevalence estimate of discrimination using a nationally representative sample. The current study is intended to offer such an estimate using a large sample of American respondents (N = 14,793) while also exploring perceptions regarding why respondents felt they were discriminated against. The results provide a broad estimate of self-reported discrimination experiences—an event that was only reported by about one-quarter of all sample members—across racial and ethnic categories. PMID:28837680

  11. Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample

    Science.gov (United States)

    Nahin, Richard L.; Stussman, Barbara J.; Herman, Patricia M.

    2015-01-01

    National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia. PMID:26320946

  12. Deriving causes of child mortality by re–analyzing national verbal autopsy data applying a standardized computer algorithm in Uganda, Rwanda and Ghana

    Directory of Open Access Journals (Sweden)

    Li Liu

    2015-06-01

    Full Text Available Background To accelerate progress toward the Millennium Development Goal 4, reliable information on causes of child mortality is critical. With more national verbal autopsy (VA studies becoming available, how to improve consistency of national VA derived child causes of death should be considered for the purpose of global comparison. We aimed to adapt a standardized computer algorithm to re–analyze national child VA studies conducted in Uganda, Rwanda and Ghana recently, and compare our results with those derived from physician review to explore issues surrounding the application of the standardized algorithm in place of physician review. Methods and Findings We adapted the standardized computer algorithm considering the disease profile in Uganda, Rwanda and Ghana. We then derived cause–specific mortality fractions applying the adapted algorithm and compared the results with those ascertained by physician review by examining the individual– and population–level agreement. Our results showed that the leading causes of child mortality in Uganda, Rwanda and Ghana were pneumonia (16.5–21.1% and malaria (16.8–25.6% among children below five years and intrapartum–related complications (6.4–10.7% and preterm birth complications (4.5–6.3% among neonates. The individual level agreement was poor to substantial across causes (kappa statistics: –0.03 to 0.83, with moderate to substantial agreement observed for injury, congenital malformation, preterm birth complications, malaria and measles. At the population level, despite fairly different cause–specific mortality fractions, the ranking of the leading causes was largely similar. Conclusions The standardized computer algorithm produced internally consistent distribution of causes of child mortality. The results were also qualitatively comparable to those based on physician review from the perspective of public health policy. The standardized computer algorithm has the advantage of

  13. Investigating the link between liking versus wanting self-esteem and depression in a nationally representative sample of American adults.

    Science.gov (United States)

    Bushman, Brad J; Moeller, Scott J; Konrath, Sara; Crocker, Jennifer

    2012-10-01

    The self-esteem movement has been around since the 1970s, and may have influenced how much value people place on self-esteem. We predicted a negative relationship between age and the amount of value placed on self-esteem boosts. We also investigated the correlates of liking versus wanting self-esteem boosts (and other pleasant rewards) on depression. A nationally representative sample of American adults (N = 867) indicated how much they liked and wanted several pleasant rewards (i.e., sex, food, alcohol, money, friendship, self-esteem boost). They also completed a standardized measure of depressive symptoms. As expected, there was a negative relationship between age and valuing self-esteem boosts, sex, and alcohol. People with depressive symptoms wanted self-esteem boosts, even though they did not like them very much. Similar effects were obtained for depressive symptoms and alcohol and friendship. This is the first research to show that self-esteem boosts are more valued among a nationally representative sample of younger American adults. It also is the first research to explore the association between depression and the motivation to boost self-esteem. People with depressive symptoms want self-esteem, and may pursue it, but this pursuit may feel unrewarding because they do not derive pleasure from it. © 2012 The Authors. Journal of Personality © 2012, Wiley Periodicals, Inc.

  14. Life course persistent and adolescence limited conduct disorder in a nationally representative US sample: prevalence, predictors, and outcomes.

    Science.gov (United States)

    Moore, Ashlee A; Silberg, Judy L; Roberson-Nay, Roxann; Mezuk, Briana

    2017-04-01

    The course of conduct disorder (CD) is heterogeneous. Moffitt proposed the heuristic of life course persistent (LCP) and adolescence limited (AL) to differentiate etiologically distinct forms of antisocial behavior (AB), each with distinct predictors and consequences, although a few studies have assessed this demarcation within the context of CD. The objective of this study was to apply Moffitt's taxonomy in a nationally representative US sample to investigate the prevalence, predictors, and outcomes of LCP and AL CD. Data come from the Collaborative Psychiatric Epidemiology Studies, a set of population-based nationally representative cross-sectional surveys (N = 20,130). Predictors included harsh discipline, maternal and paternal closeness, poverty in childhood, history of learning disability, parental deviance, and nativity. Outcomes included substance use, employment status, education attainment, marital status, income level, and self-rated mental and physical health. The prevalence of LCP and AL CD was 0.5 and 4.6%, respectively, for females, and 1.9 and 5.1%, respectively, for males. Low childhood SES [Odds Ratio (OR) = 3.49], lack of maternal closeness (OR = 2.50), and history of harsh discipline (OR = 2.17) increased odds of LCP group membership. The LCP group had higher odds of developing substance use disorders (OR = 2.00) relative to AL. LCP CD is more strongly influenced by childhood environment and confers increased odds for substance use problems in adulthood relative to AL CD.

  15. Victimization and adversity among children experiencing war-related parental absence or deployment in a nationally representative US sample.

    Science.gov (United States)

    Turner, Heather A; Finkelhor, David; Hamby, Sherry; Henly, Megan

    2017-05-01

    This study compares children and youth who have experienced lifetime war-related parental absence or deployment with those having no such history on a variety of victimization types, non-victimization adversity, trauma symptoms, and delinquency; and assesses whether cumulative adversity and victimization help to explain elevated emotional and behavioral problems among children of parents who have experienced war-related absence or deployment. The National Surveys of Children's Exposure to Violence (NatSCEV) are comprised of three cross-sectional telephone surveys conducted in 2008, 2011, and 2014. Data were collected on the experiences of children aged one month to seventeen years. In each survey, interviews were conducted with youth 10-17 years old and with caregivers of children 0-9 years old. The analyses use pooled data from all three U.S. nationally-representative samples (total sample size of 13,052). Lifetime parental war-related absence or deployment was a marker for elevated childhood exposure to a wide array of victimization and adversity types. Cumulative past year exposure to multiple forms of victimization and adversity fully explained elevated trauma symptoms and delinquency in this population of children. Given the breadth of victimization and adversity risk, children with histories of parental war-related absence or deployment, as well as their families, represent important target groups for broad-based prevention and interventions to reduce exposure and ameliorate consequences when it does occur. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. National and subnational all-cause and cause-specific child mortality in China, 1996-2015: a systematic analysis with implications for the Sustainable Development Goals.

    Science.gov (United States)

    He, Chunhua; Liu, Li; Chu, Yue; Perin, Jamie; Dai, Li; Li, Xiaohong; Miao, Lei; Kang, Leni; Li, Qi; Scherpbier, Robert; Guo, Sufang; Rudan, Igor; Song, Peige; Chan, Kit Yee; Guo, Yan; Black, Robert E; Wang, Yanping; Zhu, Jun

    2017-02-01

    China has achieved Millennium Development Goal 4 to reduce under-5 mortality rate by two-thirds between 1990 and 2015. In this study, we estimated the national and subnational levels and causes of child mortality in China annually from 1996 to 2015 to draw implications for achievement of the SDGs for China and other low-income and middle-income countries. In this systematic analysis, we adjusted empirical data on levels and causes of child mortality collected in the China Maternal and Child Health Surveillance System to generate representative estimates at the national and subnational levels. In adjusting the data, we considered the sampling design and probability, applied smoothing techniques to produce stable trends, fitted livebirth and age-specific death estimates to natvional estimates produced by the UN for international comparison, and partitioned national estimates of infrequent causes produced by independent sources to the subnational level. Between 1996 and 2015, the under-5 mortality rate in China declined from 50·8 per 1000 livebirths to 10·7 per 1000 livebirths, at an average annual rate of reduction of 8·2%. However, 181 600 children still died before their fifth birthday, with 93 400 (51·5%) deaths occurring in neonates. Great inequity exists in child mortality across regions and in urban versus rural areas. The leading causes of under-5 mortality in 2015 were congenital abnormalities (35 700 deaths, 95% uncertainty range [UR] 28 400-45 200), preterm birth complications (30 900 deaths, 24 200-40 800), and injuries (26 600 deaths, 21 000-33 400). Pneumonia contributed to a higher proportion of deaths in the western region of China than in the eastern and central regions, and injury was a main cause of death in rural areas. Variations in cause-of-death composition by age were also examined. The contribution of preterm birth complications to mortality decreased after the neonatal period; congenital abnormalities remained an

  17. Health Correlates of Insomnia Symptoms and Comorbid Mental Disorders in a Nationally Representative Sample of US Adolescents

    Science.gov (United States)

    Blank, Madeleine; Zhang, Jihui; Lamers, Femke; Taylor, Adrienne D.; Hickie, Ian B.; Merikangas, Kathleen R.

    2015-01-01

    Study Objectives: To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. Design: National representative cross-sectional study. Setting: Population-based sample from the US adolescents. Measurements and Results: A total of 6,483 individuals aged between 13–18 y in the National Comorbidity Survey-Adolescent Supplement (NCS-A) with both individual and parental reports of mental health were included in this study. Participants were classified with insomnia symptoms if they reported difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakening, nearly every day for at least 2 w in the past year. Nearly one-third of adolescents reported insomnia symptoms for at least 2 w during the previous year. Hispanic and black youth were significantly more likely to report insomnia symptoms (42.0% and 41.3%, respectively) than non-Hispanic white youth (30.4%). Adolescents with insomnia symptoms were at a higher risk for all classes of mental disorders {odds ratio [OR] (95% confidence interval [CI]: 3.4 (2.9–4.0)} including mood, anxiety, behavioral, substance use, and eating disorders, suicidality [OR (95% CI): 2.63 (1.34–5.16)], poor perceived mental health [OR (95% CI): 2.01 (1.02–3.96)], chronic medical conditions [OR (95% CI): 1.94 (1.55–2.43)], smoking [OR (95% CI: 2.60 (1.00–6.72)], and obesity [OR (95% CI: 1.46 (1.10–1.93)] than those without insomnia symptoms. Adolescents with insomnia symptoms and comorbid mental disorders manifested even greater rates of these indicators of negative health behaviors and disorders than those with mental disorders alone (P Insomnia symptoms are reported by one-third of adolescents in the general population. Insomnia symptoms, even in the absence of concomitant depression or other mental disorders, are associated with serious health conditions, risk factors

  18. Trends in Iron, Zinc, and Vitamin A Status Biomarkers Among Colombian Children: Results From 2 Nationally Representative Surveys.

    Science.gov (United States)

    Li, Wenchao; Herrán, Oscar F; Villamor, Eduardo

    2017-06-01

    Micronutrient deficiencies are still highly prevalent in countries undergoing the nutrition transition, but nationally representative data documenting their burden in children are exceedingly rare. To examine the distribution and recent trends in micronutrient status biomarkers of Colombian children. We compared the distributions of plasma ferritin, serum zinc, and vitamin A in Colombian children between 2005 and 2010 using 2 cross-sectional, nationally representative surveys overall and by categories of sociodemographic variables. Analysis for ferritin included boys and nonpregnant girls aged 1 to 17 years. Analyses for zinc and vitamin A included children aged 1 to 4 years. The mean 2010 to 2005 differences in ferritin, zinc, and vitamin A were 2.5 µg/L (95% confidence interval [CI]: 1.3 to 3.7), -34.9 µg/dL (95% CI: -39.6 to -30.2), and -11.5 µg/dL (95% CI: -12.3 to -10.7), respectively, after adjusting for sociodemographic characteristics. These differences varied significantly by region of residence. In 2010, region of residence was a significant correlate for all 3 micronutrients. Other important correlates included age and maternal education for ferritin and body mass index-for-age Z score, maternal education, wealth index, food insecurity, and urbanicity for vitamin A. Plasma ferritin was slightly higher in 2010 than in 2005, whereas serum zinc and vitamin A were substantially lower in 2010. In the absence of obvious causal explanations, it is uncertain whether this decline represents a worsening of micronutrient status in Colombian children or an artifact due to systematic laboratory or data management errors incurred in the surveys.

  19. Accelerometer-determined physical activity and all-cause mortality in a national prospective cohort study of hypertensive adults.

    Science.gov (United States)

    Loprinzi, Paul D

    2016-05-01

    Research in the general population suggests an inverse association between physical activity and all-cause mortality. Less research on this topic has been conducted among hypertensive adults, but the limited studies also suggest an inverse association between physical activity and all-cause mortality among hypertensive adults. At this point, sex-specific differences are not well understood, and all of the physical activity-mortality studies among hypertensive adults have employed a self-report measure of physical activity. Therefore, the purpose of this study was to examine the sex-specific association between objectively measured physical activity and all-cause mortality among a national sample of hypertensive adults. Data from the 2003 to 2006 National Health and Nutrition Examination Survey, with follow-up through 2011, were employed. Hypertension status was defined using measured blood pressure and use of blood pressure-lowering medication. Physical activity was assessed via accelerometry. After adjustments, for every 60-min increase in physical activity, hypertensive adults had a 19% (hazard rate = 0.81; 95% confidence interval: 0.72-0.91) reduced risk of all-cause mortality. There was also evidence of a dose-response relationship. Compared with those in the lowest tertile, those in the middle and upper tertiles had a 31 and 42% reduced all-cause mortality risk, respectively. There was no evidence of a sex-specific interaction effect. Among hypertensive adults, objectively measured physical activity is associated with all-cause mortality risk in a dose-response manner.

  20. Association Between Objectively Measured Physical Activity and Erectile Dysfunction among a Nationally Representative Sample of American Men.

    Science.gov (United States)

    Loprinzi, Paul D; Edwards, Meghan

    2015-09-01

    Emerging work suggests an inverse association between physical activity and erectile dysfunction (ED). The majority of this cross-sectional research comes from convenience samples and all studies on this topic have employed self-report physical activity methodology. Therefore, the purpose of this brief-report, confirmatory research study was to examine the association between objectively measured physical activity and ED in a national sample of Americans. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Six hundred ninety-two adults between the ages of 50 and 85 years (representing 33.2 million adults) constituted the analytic sample. Participants wore an ActiGraph 7164 accelerometer (ActiGraph, Pensacola, FL, USA) for up to 7 days with ED assessed via self-report. The main outcome measure used was ED assessed via self-report. After adjustments, for every 30 min/day increase in moderate-to-vigorous physical activity, participants had a 43% reduced odds of having ED (odds ratioadjusted  = 0.57; 95% confidence interval: 0.40-0.81; P = 0.004). This confirmatory study employing an objective measure of physical activity in a national sample suggests an inverse association between physical activity and ED. © 2015 International Society for Sexual Medicine.

  1. Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.

    Science.gov (United States)

    Jena, Anupam B; Prasad, Vinay; Goldman, Dana P; Romley, John

    2015-02-01

    Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57,471 during 492 nonmeeting days; heart failure, 19,282 during meeting days and 11,4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low- and high-risk patients. Differences in treatment utilization were assessed. Hospitalization during cardiology meeting dates. Thirty-day mortality, procedure rates, charges, length of stay. Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%-21.2%] vs 24.8% [95% CI, 22.9%-26.6%]; P cardiology meetings. High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive PCI, without any mortality effect.

  2. Development and Validation of a National System for Routine Monitoring of Mortality in People Recently Released from Prison.

    Directory of Open Access Journals (Sweden)

    Stuart A Kinner

    Full Text Available People released from prison are at increased risk of death. However, no country has established a system for routine monitoring of mortality in this population. The aims of this study were to (a evaluate a system for routine monitoring of deaths after release from prison in Australia and (b estimate the number of deaths annually within 28 and 365 days of prison release from 2000 to 2013.Persons released from prison and deaths were identified in records held by Centrelink, Australia's national provider of unemployment benefits. Estimates generated in this manner were compared with those from a study that probabilistically linked correctional records with the National Death Index (NDI, for each calendar year 2000 to 2007. Using Centrelink data, national estimates of mortality within 28 and 365 days of release were produced for each calendar year 2000 to 2013.Compared with estimates based on linkage with the NDI, the estimated crude mortality rate based on Centrelink records was on average 52% lower for deaths within 28 days of release and 24% lower for deaths within 365 days of release. Nationally, over the period 2000 to 2013, we identified an average of 32 deaths per year within 28 days of release and 188 deaths per year within 365 days of release. The crude mortality rate for deaths within both 28 and 365 days of release increased over this time.Using routinely collected unemployment benefits data we detected the majority of deaths in people recently released from prison in Australia. These data may be sufficient for routine monitoring purposes and it may be possible to adopt a similar approach in other countries. Routine surveillance of mortality in ex-prisoners serves to highlight their extreme vulnerability and provides a basis for evaluating policy reforms designed to reduce preventable deaths.

  3. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013

    DEFF Research Database (Denmark)

    Wang, Haidong; Liddell, Chelsea A; Coates, Matthew M

    2014-01-01

    BACKGROUND: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of redu...

  4. High mortality rates after nonelective colon cancer resection : results of a national audit

    NARCIS (Netherlands)

    Bakker, I. S.; Snijders, H. S.; Grossmann, I.; Karsten, T. M.; Havenga, K.; Wiggers, T.

    AimColon cancer resection in a nonelective setting is associated with high rates of morbidity and mortality. The aim of this retrospective study is to identify risk factors for overall mortality after colon cancer resection with a special focus on nonelective resection. MethodData were obtained from

  5. Effect of prescribed burning on mortality of resettlement ponderosa pines in Grand Canyon National Park

    Science.gov (United States)

    G. Alan Kaufmann; W. Wallace Covington

    2001-01-01

    Ponderosa pine (Pinus ponderosa) trees established before Euro-American settlement are becoming rare on the landscape. Prescribed fire is the prime tool used to restore ponderosa pine ecosystems, but can cause high mortality in presettlement ponderosa pines. This study uses retrospective techniques to estimate mortality from prescribed burns within Grand Canyon...

  6. Global, regional, and national levels and causes of maternal mortality during 1990-2013

    DEFF Research Database (Denmark)

    Kassebaum, Nicholas J; Bertozzi-Villa, Amelia; Coggeshall, Megan S

    2014-01-01

    BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contri...

  7. Cross-National Systematic Review of Neonatal Mortality and Postnatal Newborn Care: Special Focus on Pakistan

    Directory of Open Access Journals (Sweden)

    Mansoor Ahmed

    2017-11-01

    Full Text Available The latest nationwide survey of Pakistan showed that considerable progress has been made toward reducing all child mortality indicators except neonatal mortality. The aim of this study is to compare Pakistan’s under-five mortality, neonatal mortality, and postnatal newborn care rates with those of other countries. Neonatal mortality rates and postnatal newborn care rates from the Demographic and Health Surveys (DHSs of nine low- and middle-income countries (LMIC from Asia and Africa were analyzed. Pakistan’s maternal, newborn, and child health (MNCH policies and programs, which have been implemented in the country since 1990, were also analyzed. The results highlighted that postnatal newborn care in Pakistan was higher compared with the rest of countries, yet its neonatal mortality remained the worst. In Zimbabwe, both mortality rates have been increasing, whereas the neonatal mortality rates in Nepal and Afghanistan remained unchanged. An analysis of Pakistan’s MNCH programs showed that there is no nationwide policy on neonatal health. There were only a few programs concerning the health of newborns, and those were limited in scale. Pakistan’s example shows that increased coverage of neonatal care without ensuring quality is unlikely to improve neonatal survival rates. It is suggested that Pakistan needs a comprehensive policy on neonatal health similar to other countries, and its effective programs need to be scaled up, in order to obtain better neonatal health outcomes.

  8. Cross-National Systematic Review of Neonatal Mortality and Postnatal Newborn Care: Special Focus on Pakistan.

    Science.gov (United States)

    Ahmed, Mansoor; Won, Youngjoon

    2017-11-23

    The latest nationwide survey of Pakistan showed that considerable progress has been made toward reducing all child mortality indicators except neonatal mortality. The aim of this study is to compare Pakistan's under-five mortality, neonatal mortality, and postnatal newborn care rates with those of other countries. Neonatal mortality rates and postnatal newborn care rates from the Demographic and Health Surveys (DHSs) of nine low- and middle-income countries (LMIC) from Asia and Africa were analyzed. Pakistan's maternal, newborn, and child health (MNCH) policies and programs, which have been implemented in the country since 1990, were also analyzed. The results highlighted that postnatal newborn care in Pakistan was higher compared with the rest of countries, yet its neonatal mortality remained the worst. In Zimbabwe, both mortality rates have been increasing, whereas the neonatal mortality rates in Nepal and Afghanistan remained unchanged. An analysis of Pakistan's MNCH programs showed that there is no nationwide policy on neonatal health. There were only a few programs concerning the health of newborns, and those were limited in scale. Pakistan's example shows that increased coverage of neonatal care without ensuring quality is unlikely to improve neonatal survival rates. It is suggested that Pakistan needs a comprehensive policy on neonatal health similar to other countries, and its effective programs need to be scaled up, in order to obtain better neonatal health outcomes.

  9. In-home firearm access among US adolescents and the role of religious subculture: Results from a nationally representative study.

    Science.gov (United States)

    Stroope, Samuel; Tom, Joshua C

    2017-09-01

    Religious participation is linked to numerous positive safety outcomes for adolescents. Scant attention, however, has been paid to associations between religious participation and safety risks among adolescents. Using data from Add Health (N = 18,449), a nationally representative school-based sample of US adolescents, this study examines the relationship between adolescents' religious affiliation and easy access to firearms at home. Regression analyses adjust for complex sampling design and compare easy firearm access at home among conservative Protestant adolescents to adolescent firearm access in other religious traditions. Conservative Protestant adolescents have a substantially greater likelihood of easy access to a gun at home compared to adolescents of all other major religious traditions in the United States. Recognizing differences in adolescent firearm access between subcultural groups can help public health interventions more effectively identify and address the needs of vulnerable populations. The paper's conclusion considers suggestions for effective policy and programmatic initiatives. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The longitudinal relation between peer violent victimization and delinquency: results from a national representative sample of u.s. Adolescents.

    Science.gov (United States)

    Jackson, Corrie L; Hanson, Rochelle F; Amstadter, Ananda B; Saunders, Benjamin E; Kilpatrick, Dean G

    2013-05-01

    Using a nationally representative sample of adolescents from the United States aged 12 to 17 years (Wave 1, n = 3,614; Wave 2, n = 2,511), this study examined (a) demographic and descriptive information about peer violent victimization (PVV); and (b) the longitudinal relation between a history of PVV and delinquency. Results indicated that 12.4% of adolescents reported lifetime exposure to PVV, and many of these adolescents with a previous history of PVV also reported exposure to other forms of interpersonal violence, with witnessing community/school violence being the most commonly endorsed exposure category. Males, older adolescents, African American adolescents, and adolescents from low-income households were significantly more likely to endorse PVV. Regardless of the victim's gender, the majority of the perpetrators were male. After controlling for exposure to other forms of interpersonal violence and a history of delinquency, PVV was related to subsequent delinquency. Implications for policy, practice, and future research are discussed.

  11. Parental Migration and Left-Behind Children’s Depressive Symptoms: Estimation Based on a Nationally-Representative Panel Dataset

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    Mi Zhou

    2018-05-01

    Full Text Available China’s rapid urbanization in the past several decades have been accompanied by rural labor migration. An important question that has emerged is whether rural labor migration has a positive or negative impact on the depressive symptoms of children left behind in the countryside by their migrating parents. This paper uses a nationally representative panel dataset to investigate whether parental migration impacts the prevalence of depressive symptoms among left-behind children in China. Using DID and PSM-DID methods, our results show that parental migration significantly increases the depression scores of 10 and 11-year-old children by 2 points using the CES-D depression scale. Furthermore, we also find that the negative effect of decreased parental care is stronger than the positive effect of increased income in terms of determining the depressive symptoms status of children in rural China.

  12. Sexual diversity in the United States: Results from a nationally representative probability sample of adult women and men.

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    Debby Herbenick

    Full Text Available In 2015, we conducted a cross-sectional, Internet-based, U.S. nationally representative probability survey of 2,021 adults (975 men, 1,046 women focused on a broad range of sexual behaviors. Individuals invited to participate were from the GfK KnowledgePanel®. The survey was titled the 2015 Sexual Exploration in America Study and survey completion took about 12 to 15 minutes. The survey was confidential and the researchers never had access to respondents' identifiers. Respondents reported on demographic items, lifetime and recent sexual behaviors, and the appeal of 50+ sexual behaviors. Most (>80% reported lifetime masturbation, vaginal sex, and oral sex. Lifetime anal sex was reported by 43% of men (insertive and 37% of women (receptive. Common lifetime sexual behaviors included wearing sexy lingerie/underwear (75% women, 26% men, sending/receiving digital nude/semi-nude photos (54% women, 65% men, reading erotic stories (57% of participants, public sex (≥43%, role-playing (≥22%, tying/being tied up (≥20%, spanking (≥30%, and watching sexually explicit videos/DVDs (60% women, 82% men. Having engaged in threesomes (10% women, 18% men and playful whipping (≥13% were less common. Lifetime group sex, sex parties, taking a sexuality class/workshop, and going to BDSM parties were uncommon (each <8%. More Americans identified behaviors as "appealing" than had engaged in them. Romantic/affectionate behaviors were among those most commonly identified as appealing for both men and women. The appeal of particular behaviors was associated with greater odds that the individual had ever engaged in the behavior. This study contributes to our understanding of more diverse adult sexual behaviors than has previously been captured in U.S. nationally representative probability surveys. Implications for sexuality educators, clinicians, and individuals in the general population are discussed.

  13. Sexual diversity in the United States: Results from a nationally representative probability sample of adult women and men

    Science.gov (United States)

    Herbenick, Debby; Bowling, Jessamyn; Fu, Tsung-Chieh (Jane); Guerra-Reyes, Lucia; Sanders, Stephanie

    2017-01-01

    In 2015, we conducted a cross-sectional, Internet-based, U.S. nationally representative probability survey of 2,021 adults (975 men, 1,046 women) focused on a broad range of sexual behaviors. Individuals invited to participate were from the GfK KnowledgePanel®. The survey was titled the 2015 Sexual Exploration in America Study and survey completion took about 12 to 15 minutes. The survey was confidential and the researchers never had access to respondents’ identifiers. Respondents reported on demographic items, lifetime and recent sexual behaviors, and the appeal of 50+ sexual behaviors. Most (>80%) reported lifetime masturbation, vaginal sex, and oral sex. Lifetime anal sex was reported by 43% of men (insertive) and 37% of women (receptive). Common lifetime sexual behaviors included wearing sexy lingerie/underwear (75% women, 26% men), sending/receiving digital nude/semi-nude photos (54% women, 65% men), reading erotic stories (57% of participants), public sex (≥43%), role-playing (≥22%), tying/being tied up (≥20%), spanking (≥30%), and watching sexually explicit videos/DVDs (60% women, 82% men). Having engaged in threesomes (10% women, 18% men) and playful whipping (≥13%) were less common. Lifetime group sex, sex parties, taking a sexuality class/workshop, and going to BDSM parties were uncommon (each <8%). More Americans identified behaviors as “appealing” than had engaged in them. Romantic/affectionate behaviors were among those most commonly identified as appealing for both men and women. The appeal of particular behaviors was associated with greater odds that the individual had ever engaged in the behavior. This study contributes to our understanding of more diverse adult sexual behaviors than has previously been captured in U.S. nationally representative probability surveys. Implications for sexuality educators, clinicians, and individuals in the general population are discussed. PMID:28727762

  14. 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.

  15. Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector--Results from a Nationally Representative Outlet Survey.

    Science.gov (United States)

    Act Consortium Drug Quality Project Team And The Impact Study Team

    2015-06-01

    Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85-115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. © The American Society of Tropical Medicine and Hygiene.

  16. Risk Perception of Pregnancy Promotes Disapproval of Gestational Surrogacy: Analysis of a Nationally Representative Opinion Survey in Japan

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    Suzuki, Kohta; Sawa, Rintaro; Muto, Kaori; Kusuda, Satoshi; Banno, Kouji; Yamagata, Zentaro

    2011-01-01

    Background To clarify the relationship between the general attitude towards gestational surrogacy and risk perception about pregnancy and infertility treatment. Materials and Methods This study analysed the data of nationally representative cross-sectional surveys from 2007 concerning assisted reproductive technologies. The participants represented the general Japanese population. We used this data to carry out multivariate analysis. The main outcome measures were adjusted odds ratios and 95% confidence intervals from logistic regression models for factors including the effect of pregnancy risk perception on the attitude toward gestational surrogacy. Results In this survey, 3412 participants responded (response rate of 68.2%). With regard to the attitude towards gestational surrogacy, 54.0% of the respondents approved of it, and 29.7% stated that they were undecided. The perception of a high level of risk concerning ectopic pregnancy, threatened miscarriage or premature birth, and pregnancy-induced hypertension influenced the participants’ attitudes towards gestational surrogacy. Moreover, this perception of risk also contributed to a disapproval of the technique. Conclusion Our findings suggest that a person who understands the risks associated with pregnancy might clearly express their disapproval of gestational surrogacy. PMID:24963363

  17. Risk Perception of Pregnancy Promotes Disapproval of Gestational Surrogacy: Analysis of a Nationally Representative Opinion Survey in Japan

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    Kohta Suzuki

    2011-01-01

    Full Text Available Background: To clarify the relationship between the general attitude towards gestational surrogacyand risk perception about pregnancy and infertility treatment.Materials and Methods: This study analysed the data of nationally representative cross-sectionalsurveys from 2007 concerning assisted reproductive technologies. The participants represented thegeneral Japanese population. We used this data to carry out multivariate analysis. The main outcomemeasures were adjusted odds ratios and 95% confidence intervals from logistic regression modelsfor factors including the effect of pregnancy risk perception on the attitude toward gestationalsurrogacy.Results: In this survey, 3412 participants responded (response rate of 68.2%. With regard to theattitude towards gestational surrogacy, 54.0% of the respondents approved of it, and 29.7% statedthat they were undecided. The perception of a high level of risk concerning ectopic pregnancy,threatened miscarriage or premature birth, and pregnancy-induced hypertension influencedthe participants’ attitudes towards gestational surrogacy. Moreover, this perception of risk alsocontributed to a disapproval of the technique.Conclusion: Our findings suggest that a person who understands the risks associated with pregnancymight clearly express their disapproval of gestational surrogacy.

  18. Parent-adolescent sexual communication and its association with adolescent sexual behaviors: a nationally representative analysis in the Netherlands.

    Science.gov (United States)

    de Looze, Margaretha; Constantine, Norman A; Jerman, Petra; Vermeulen-Smit, Evelien; ter Bogt, Tom

    2015-01-01

    Sexual communication is a principal means of transmitting sexual values, beliefs, expectations, and knowledge from parents to children. Although this area has received considerable research attention, more studies with representative samples are needed to assure that findings are reflective of populations of interest. A nationally representative sample of parent-adolescent dyads (N = 2,965; mean adolescent age = 13.8 years) in the Netherlands was employed to examine the frequency of parent-adolescent sexual communication and its association with adolescent sexual behaviors (defined as sexual initiation, condom use, and contraceptive pill use). Nine communication topics in the areas of anatomy, relationships and rights, and protection and contraception were examined. In all, 75%of parents reported having discussed at least one topic multiple times with their adolescents. Romantic relationships were discussed most frequently. Hierarchical logistic regression analyses indicated that parent-adolescent sexual communication on protection and contraception was positively associated with adolescent sexual initiation and contraceptive pill use but not condom use. This may reflect that adolescents, when they become sexually active, are more likely to discuss sexuality with their parents. Findings are interpreted within the context of Dutch culture, which is generally accepting of adolescent sexuality and characterized by open sexual communication.

  19. Gambling Type, Substance Abuse, Health and Psychosocial Correlates of Male and Female Problem Gamblers in a Nationally Representative French Sample.

    Science.gov (United States)

    Bonnaire, C; Kovess-Masfety, V; Guignard, R; Richard, J B; du Roscoät, E; Beck, F

    2017-06-01

    Many studies carried out on treatment-seeking problem gamblers (PG) have reported high levels of comorbid substance use disorders, and mental and physical health problems. Nevertheless, general population studies are still sparse, most of them have been carried out in the United States or Canada, and gender differences have not always been considered. Thus, the aim of this study was to describe the type of games, and psychological and physical correlates in male and female PG in a nationally representative French sample. The total sample studied involved 25,647 subjects aged 15-85 years, including 333 PG and 25,314 non-problem gamblers (NPG). Data were extracted from a large survey of a representative sample of the French general population. They were evaluated for sociodemographic variables, gambling behavior, type of gambling activity, substance use, psychological distress, body mass index, chronic disease, and lack of sleep. Overall, there were significant differences between PG and NPG in gender, age, education, employment and marital status, substance use disorders (alcohol, tobacco, cannabis, cocaine and heroin), psychological distress, obesity, lack of sleep and type of gambling activity. Although male and female PG had different profiles, the gambling type, especially strategic games, appeared as an important variable in the relationship between gender and problem gambling. This research underlines the importance of considering gender differences and gambling type in the study of gambling disorders. Identifying specific factors in the relationship between gender, gambling type and gambling problems may help improve clinical interventions and health promotion strategies.

  20. Parent-Child Connectedness and Long-Term Risk for Suicidal Ideation in a Nationally Representative Sample of US Adolescents.

    Science.gov (United States)

    Kuramoto-Crawford, S Janet; Ali, Mir M; Wilcox, Holly C

    2017-09-01

    Few studies have addressed on the role of parent-child connectedness (PCC) on adolescents' risk for suicidal ideation from a longitudinal, developmental perspective. This study examined PCC during adolescence and risk of suicidal ideation into adulthood among a nationally representative sample of American adolescents. The study includes 13,234 adolescents aged 11-18 from the National Longitudinal Study of Adolescent to Adult Health (Add Health) who were surveyed during adolescence (1994-1995) and then again in early adulthood (2008-2009). Multinomial logistic regression estimated the association between PCC during adolescence and having ideation during the adolescence period only, in adulthood only, and in both adolescence and adulthood as compared with those without suicidal ideation. After adjusting for depressive symptoms and other parent and adolescent characteristics, adolescents in two-parent households who reported higher PCC during adolescence had lower relative risk of having ideation during adolescence alone and in both adolescence and adulthood. In mother-only households, higher mother connectedness was also associated with decreased risk of having adolescent ideation. PCC is an important modifiable target for the prevention of suicidal ideation from adolescence into adulthood.

  1. Age, sex, and racial differences in harsh physical punishment: results from a nationally representative United States sample.

    Science.gov (United States)

    Taillieu, Tamara L; Afifi, Tracie O; Mota, Natalie; Keyes, Katherine M; Sareen, Jitender

    2014-12-01

    The purpose of this research was to examine age, sex, and racial differences in the prevalence of harsh physical punishment in childhood in a nationally representative sample of the United States. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) collected in 2004 and 2005 (n=34,653). Logistic regression analyses were conducted to examine age, sex, and racial differences in the prevalence of harsh physical punishment. Results suggest that the prevalence of harsh physical punishment has been decreasing among more recently born age groups; however, there appear to be sex and racial differences in this trend over time. The magnitude of the decrease appears to be stronger for males than for females. By race, the decrease in harsh physical punishment over time is only apparent among Whites; Black participants demonstrate little change over time, and harsh physical punishment seems to be increasing over time among Hispanics. Prevention and intervention efforts that educate about the links of physical punishment to negative outcomes and alternative non-physical discipline strategies may be particularly useful in reducing the prevalence of harsh physical punishment over time. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Educational Attainment by Life Course Sexual Attraction: Prevalence and Correlates in a Nationally Representative Sample of Young Adults

    Science.gov (United States)

    Walsemann, Katrina M.; Lindley, Lisa L.; Gentile, Danielle; Welihindha, Shehan V.

    2014-01-01

    Researchers know relatively little about the educational attainment of sexual minorities, despite the fact that educational attainment is consistently associated with a range of social, economic, and health outcomes. We examined whether sexual attraction in adolescence and early adulthood was associated with educational attainment in early adulthood among a nationally representative sample of US young adults. We analyzed Waves I and IV restricted data from the National Longitudinal Study of Adolescent Health (n=14,111). Sexual orientation was assessed using self-reports of romantic attraction in Waves I (adolescence) and IV (adulthood). Multinomial regression models were estimated and all analyses were stratified by gender. Women attracted to the same-sex in adulthood only had lower educational attainment compared to women attracted only to the opposite-sex in adolescence and adulthood. Men attracted to the same-sex in adolescence only had lower educational attainment compared to men attracted only to the opposite-sex in adolescence and adulthood. Adolescent experiences and academic performance attenuated educational disparities among men and women. Adjustment for adolescent experiences also revealed a suppression effect; women attracted to the same-sex in adolescence and adulthood had lower predicted probabilities of having a high school diploma or less compared to women attracted only to the opposite-sex in adolescence and adulthood. Our findings challenge previous research documenting higher educational attainment among sexual minorities in the US. Additional population-based studies documenting the educational attainment of sexual minority adults are needed. PMID:25382888

  3. Variation in lumbar punctures for early onset neonatal sepsis: a nationally representative serial cross-sectional analysis, 2003-2009

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    Patrick Stephen W

    2012-08-01

    Full Text Available Abstract Background Whether lumbar punctures (LPs should be performed routinely for term newborns suspected of having early onset neonatal sepsis (EONS is subject to debate. It is unclear whether variations in performance of LPs for EONS may be associated with patient, hospital, insurance or regional factors. Our objective was to identify characteristics associated with the practice of performing LPs for suspected EONS in a nationally representative sample. Methods Utilizing data from the 2003, 2006 and 2009 Kids’ Inpatient Database (KID compiled by the Agency for Healthcare Research and Quality, we examined the frequency and characteristics of term, normal-birth weight newborns receiving an LP for EONS. Survey-weighting was applied for national estimates and used in chi squared and multivariable regression analysis. Results In 2009, there were 13,694 discharges for term newborns that underwent LPs for apparent EONS. Newborns having LPs performed were more likely to be covered by Medicaid vs. private insurance (51.9 vs. 45.1 percent; p Conclusions We found pronounced variation in LPs performed for EONS, even when adjusting for clinical conditions that would prompt LPs. These findings indicate practice variations in newborn care that merit further examination and explanation.

  4. Social relationships and hypertension in late life: evidence from a nationally representative longitudinal study of older adults.

    Science.gov (United States)

    Yang, Yang Claire; Boen, Courtney; Mullan Harris, Kathleen

    2015-04-01

    Social relationships are widely understood to be important for sustaining and improving health and longevity, but it remains unclear how different dimensions of social relationships operate through similar or distinct mechanisms to affect biophysiological markers of aging-related disease over time. This study utilized longitudinal data on a nationally representative sample of older adults from the National Social Life, Health, and Aging Project (2005-2011) to examine the prospective associations between social integration and social support and change in systolic blood pressure (SBP) and hypertension risk over time. Although both social relationship dimensions have significant physiological impacts, their relative importance differs by outcome. Low social support was predictive of increase in SBP, whereas low social integration was predictive of increase in risk of hypertension. The different roles of relationship characteristics in predicting change in physiological outcomes suggest specific biophysiological stress response and behavioral mechanisms that have important implications for both scientific understandings and effective prevention and control of a leading chronic condition in late life. © The Author(s) 2014.

  5. Dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine.

    Science.gov (United States)

    Evans, E Whitney; Lipton, Richard B; Peterlin, B Lee; Raynor, Hollie A; Thomas, J Graham; O'Leary, Kevin C; Pavlovic, Jelena; Wing, Rena R; Bond, Dale S

    2015-04-01

    The role of diet in migraine is not well understood. We sought to characterize usual dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine. We also examined whether the relationship between migraine and diet differs by weight status. In this analysis, women with migraine or severe headache status was determined by questionnaire for 3069 women, ages 20-50 years, who participated in the National Health and Nutrition Examination Study, 1999-2004. Women who experienced severe headaches or migraines were classified as migraine for the purposes of this analysis. Dietary intake patterns (micro- and macronutrient intake and eating frequency) and diet quality, measured by the Healthy Eating Index, 2005, were determined using one 24-hour dietary recall. Dietary intake patterns did not significantly differ between women with and without migraine. Normal weight women with migraine had significantly lower diet quality (Healthy Eating Index, 2005 total scores) than women without migraine (52.5 ± 0.9 vs. 45.9 ± 1.0; P quality differs by migraine status in normal weight women. Prospective analyses are needed to establish how diet relates to migraine onset, characteristics, and clinical features in individuals of varying weight status. © 2015 American Headache Society.

  6. Adverse childhood experiences among children placed in and adopted from foster care: Evidence from a nationally representative survey.

    Science.gov (United States)

    Turney, Kristin; Wildeman, Christopher

    2017-02-01

    Despite good reason to believe that children in foster care are disproportionately exposed to adverse childhood experiences (ACEs), relatively little research considers exposure to ACEs among this group of vulnerable children. In this article, we use data from the 2011-2012 National Survey of Children's Health (NSCH), a nationally representative sample of non-institutionalized children ages 0-17 in the United States, to estimate the association between foster care placement and exposure to an array of ACEs. In adjusted logistic regression models, we find that children placed in foster care or adopted from foster care, compared to their counterparts, were more likely to experience parental divorce or separation, parental death, parental incarceration, parental abuse, violence exposure, household member mental illness, and household member substance abuse. These children were also more likely to experience ACEs than children across different thresholds of socioeconomic disadvantage (e.g., children in households with incomes below the poverty line) and across different family structures (e.g., children in single-mother families). These results advance our understanding of how children in foster care, an already vulnerable population, are disproportionately exposed to ACEs. This exposure, given the link between ACEs and health, may have implications for children's health and wellbeing throughout the life course. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Contributing Factors and Mental Health Outcomes of First Suicide Attempt During Childhood and Adolescence: Results From a Nationally Representative Study.

    Science.gov (United States)

    Peyre, Hugo; Hoertel, Nicolas; Stordeur, Coline; Lebeau, Gaële; Blanco, Carlos; McMahon, Kibby; Basmaci, Romain; Lemogne, Cédric; Limosin, Frédéric; Delorme, Richard

    2017-06-01

    To investigate whether risk factors for suicide attempts differ in children and adolescents and to categorize adulthood mental health outcomes of child and adolescent suicide attempters in the general population. Using a large (N = 34,653), nationally representative US adult sample, the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, we examined whether individuals who first attempted suicide during childhood (under the age of 13 years) differ from those who first attempted suicide during adolescence (13 through 17 years) in (1) contributing factors for first suicide attempt, including mental disorders and traumatic experiences that occurred before the first suicide attempt, parental history of mental disorders, and family poverty and (2) adulthood mental health outcomes, including lifetime and current prevalence of DSM-IV psychiatric disorders and quality of life measures. Suicide attempts during childhood (n = 104) were more strongly related to childhood maltreatment, while suicide attempts during adolescence (n = 415) were more strongly associated with major depressive episode. Compared to first suicide attempts during adolescence, first attempts during childhood were associated with increased risk for multiple suicide attempts (61.3% vs 32.6%), several psychiatric disorders (mania, hypomania, and panic disorder), and poorer social functioning during adulthood (all P values childhood maltreatment and early intervention for psychiatric disorders may have broad benefits to reduce not only the suffering of these children and adolescents, but also the burden of suicide. © Copyright 2017 Physicians Postgraduate Press, Inc.

  8. The Supplemental Nutrition Assistance Program and dietary quality among US adults: findings from a nationally representative survey.

    Science.gov (United States)

    Nguyen, Binh T; Shuval, Kerem; Njike, Valentine Y; Katz, David L

    2014-09-01

    To examine the association of the Supplemental Nutrition Assistance Program (SNAP) and diet quality among low-income adults. We examined US nationally representative data from the National Health and Nutrition Examination Surveys 2003-2004, 2005-2006, 2007-2008, and 2009-2010. The data were analyzed from October 7, 2013, to March 1, 2014. The analytic sample consisted of 4211 low-income adults aged 20 to 64 years, of whom 1830 participate in SNAP. We adhered to the National Cancer Institute method in calculating the Healthy Eating Index 2010 and other dietary indicators, such as empty calorie intake. Bivariate and multivariable regression was used to compare SNAP participants and income-eligible nonparticipants among the full sample and subsamples of age, sex, race/ethnicity, and food insecurity. Compared with low-income nonparticipants, adjusted analyses reveal that SNAP participants had lower dietary quality scores overall (42.58 vs 44.36, P≤.0001) and lower scores for fruits and vegetables, seafood and plant proteins (1.55 vs 1.77, P≤.0022), and empty calories (9.03 vs 9.90, P≤.0001), but they exhibited comparable scores on whole grain, refined grain, total dairy, total protein, fatty acid, and sodium intakes. The association between SNAP participation and lower dietary quality was statistically significant among women, Hispanics, young adults, and individuals who were food secure. Our analyses suggest that SNAP participants have lower dietary quality than their income-eligible nonparticipant counterparts. Although SNAP has an important role in providing nutrition assistance to eligible low-income individuals, interventions are warranted to improve the dietary quality of participants. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  9. National economic and development indicators and international variation in prostate cancer incidence and mortality: an ecological analysis.

    Science.gov (United States)

    Neupane, Subas; Bray, Freddie; Auvinen, Anssi

    2017-06-01

    Macroeconomic indicators are likely associated with prostate cancer (PCa) incidence and mortality globally, but have rarely been assessed. Data on PCa incidence in 2003-2007 for 49 countries with either nationwide cancer registry or at least two regional registries were obtained from Cancer Incidence in Five Continents Vol X and national PCa mortality for 2012 from GLOBOCAN 2012. We compared PCa incidence and mortality rates with various population-level indicators of health, economy and development in 2000. Poisson and linear regression methods were used to quantify the associations. PCa incidence varied more than 15-fold, being highest in high-income countries. PCa mortality exhibited less variation, with higher rates in many low- and middle-income countries. Healthcare expenditure (rate ratio, RR 1.46, 95 % CI 1.45-1.47) and population growth (RR 1.15, 95 % CI 1.14-1.16), as well as computer and mobile phone density, were associated with a higher PCa incidence, while gross domestic product, GDP (RR 0.94, 95 % CI 0.93-0.95) and overall mortality (RR 0.72, 95 % CI 0.71-0.73) were associated with a low incidence. GDP (RR 0.55, 95 % CI 0.46-0.66) was also associated with a low PCa mortality, while life expectancy (RR 3.93, 95 % CI 3.22-4.79) and healthcare expenditure (RR 1.20, 95 % CI 1.09-1.32) were associated with an elevated mortality. Our results show that healthcare expenditure and, thus, the availability of medical resources are an important contributor to the patterns of international variation in PCa incidence. This suggests that there is an iatrogenic component in the current global epidemic of PCa. On the other hand, higher healthcare expenditure is associated with lower PCa death rates.

  10. High mortality associated with tapeworm parasitism in geladas (Theropithecus gelada) in the Simien Mountains National Park, Ethiopia.

    Science.gov (United States)

    Schneider-Crease, India; Griffin, Randi H; Gomery, Megan A; Bergman, Thore J; Beehner, Jacinta C

    2017-09-01

    Despite increasing appreciation for parasitism as an important component of primate ecology and evolution, surprisingly few studies have demonstrated the costs of helminth parasitism in primates. Detecting parasite-related costs in primates is particularly difficult because it requires detailed, long-term data on individual host reproductive success, survival, and parasitism. The identification of the larval tapeworm Taenia serialis in geladas under intensive long-term study in the Ethiopian Highlands (Nguyen et al. [2015] American Journal of Primatology, 77:579-594; Schneider-Crease et al. [2013] Veterinary Parasitology 198:240-243) provides an opportunity to examine how an endemic parasite impacts host reproductive success and survival. We used survival analyses to assess the mortality risk associated with protuberant larval cysts characteristic of T. serialis using a decade of data from a gelada population in the Simien Mountains National Park (SMNP), Ethiopia. We demonstrated strikingly high mortality associated with T. serialis cysts in adult females, particularly for younger adults. The estimated effect of cysts on male mortality was similar, although the effect was not statistically significant, likely owing to the smaller sample size. Additionally, the offspring of mothers with cysts experienced increased mortality, which was driven almost entirely by maternal death. Mothers with cysts had such high mortality that they rarely completed an interbirth interval. Comparison with a study of this parasite in another gelada population on the Guassa Plateau (Nguyen et al. [2015] American Journal of Primatology, 77:579-594) revealed lower cyst prevalence in the SMNP and similar cyst-associated mortality. However, many more females with cysts completed interbirth intervals at Guassa than in the SMNP, suggesting that T. serialis cysts may kill hosts more rapidly in the SMNP. Our results point toward the underlying causes of individual and population

  11. Attitudes toward Bisexual Men and Women among a Nationally Representative Probability Sample of Adults in the United States

    Science.gov (United States)

    Herbenick, Debby; Friedman, M. Reuel; Schick, Vanessa; Fu, Tsung-Chieh (Jane); Bostwick, Wendy; Bartelt, Elizabeth; Muñoz-Laboy, Miguel; Pletta, David; Reece, Michael; Sandfort, Theo G. M.

    2016-01-01

    As bisexual individuals in the United States (U.S.) face significant health disparities, researchers have posited that these differences may be fueled, at least in part, by negative attitudes, prejudice, stigma, and discrimination toward bisexual individuals from heterosexual and gay/lesbian individuals. Previous studies of individual and social attitudes toward bisexual men and women have been conducted almost exclusively with convenience samples, with limited generalizability to the broader U.S. population. Our study provides an assessment of attitudes toward bisexual men and women among a nationally representative probability sample of heterosexual, gay, lesbian, and other-identified adults in the U.S. Data were collected from the 2015 National Survey of Sexual Health and Behavior (NSSHB), via an online questionnaire with a probability sample of adults (18 years and over) from throughout the U.S. We included two modified 5-item versions of the Bisexualities: Indiana Attitudes Scale (BIAS), validated sub-scales that were developed to measure attitudes toward bisexual men and women. Data were analyzed using descriptive statistics, gamma regression, and paired t-tests. Gender, sexual identity, age, race/ethnicity, income, and educational attainment were all significantly associated with participants' attitudes toward bisexual individuals. In terms of responses to individual scale items, participants were most likely to “neither agree nor disagree” with all attitudinal statements. Across sexual identities, self-identified other participants reported the most positive attitudes, while heterosexual male participants reported the least positive attitudes. As in previous research on convenience samples, we found a wide range of demographic characteristics were related with attitudes toward bisexual individuals in our nationally-representative study of heterosexual, gay/lesbian, and other-identified adults in the U.S. In particular, gender emerged as a significant

  12. Attitudes toward Bisexual Men and Women among a Nationally Representative Probability Sample of Adults in the United States.

    Science.gov (United States)

    Dodge, Brian; Herbenick, Debby; Friedman, M Reuel; Schick, Vanessa; Fu, Tsung-Chieh Jane; Bostwick, Wendy; Bartelt, Elizabeth; Muñoz-Laboy, Miguel; Pletta, David; Reece, Michael; Sandfort, Theo G M

    2016-01-01

    As bisexual individuals in the United States (U.S.) face significant health disparities, researchers have posited that these differences may be fueled, at least in part, by negative attitudes, prejudice, stigma, and discrimination toward bisexual individuals from heterosexual and gay/lesbian individuals. Previous studies of individual and social attitudes toward bisexual men and women have been conducted almost exclusively with convenience samples, with limited generalizability to the broader U.S. Our study provides an assessment of attitudes toward bisexual men and women among a nationally representative probability sample of heterosexual, gay, lesbian, and other-identified adults in the U.S. Data were collected from the 2015 National Survey of Sexual Health and Behavior (NSSHB), via an online questionnaire with a probability sample of adults (18 years and over) from throughout the U.S. We included two modified 5-item versions of the Bisexualities: Indiana Attitudes Scale (BIAS), validated sub-scales that were developed to measure attitudes toward bisexual men and women. Data were analyzed using descriptive statistics, gamma regression, and paired t-tests. Gender, sexual identity, age, race/ethnicity, income, and educational attainment were all significantly associated with participants' attitudes toward bisexual individuals. In terms of responses to individual scale items, participants were most likely to "neither agree nor disagree" with all attitudinal statements. Across sexual identities, self-identified other participants reported the most positive attitudes, while heterosexual male participants reported the least positive attitudes. As in previous research on convenience samples, we found a wide range of demographic characteristics were related with attitudes toward bisexual individuals in our nationally-representative study of heterosexual, gay/lesbian, and other-identified adults in the U.S. In particular, gender emerged as a significant characteristic

  13. Health correlates of insomnia symptoms and comorbid mental disorders in a nationally representative sample of US adolescents.

    Science.gov (United States)

    Blank, Madeleine; Zhang, Jihui; Lamers, Femke; Taylor, Adrienne D; Hickie, Ian B; Merikangas, Kathleen R

    2015-01-01

    To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. National representative cross-sectional study. Population-based sample from the US adolescents. A total of 6,483 individuals aged between 13–18 y in the National Comorbidity Survey-Adolescent Supplement (NCS-A) with both individual and parental reports of mental health were included in this study. Participants were classified with insomnia symptoms if they reported difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakening, nearly every day for at least 2 w in the past year. Nearly one-third of adolescents reported insomnia symptoms for at least 2 w during the previous year. Hispanic and black youth were significantly more likely to report insomnia symptoms (42.0% and 41.3%, respectively) than non-Hispanic white youth (30.4%). Adolescents with insomnia symptoms were at a higher risk for all classes of mental disorders {odds ratio [OR] (95% confidence interval [CI]: 3.4 (2.9–4.0)} including mood, anxiety, behavioral, substance use, and eating disorders, suicidality [OR (95% CI): 2.63 (1.34–5.16)], poor perceived mental health [OR (95% CI): 2.01 (1.02–3.96)], chronic medical conditions [OR (95% CI): 1.94 (1.55–2.43)], smoking [OR (95% CI: 2.60 (1.00–6.72)], and obesity [OR (95% CI: 1.46 (1.10–1.93)] than those without insomnia symptoms. Adolescents with insomnia symptoms and comorbid mental disorders manifested even greater rates of these indicators of negative health behaviors and disorders than those with mental disorders alone (P Insomnia symptoms are reported by one-third of adolescents in the general population. Insomnia symptoms, even in the absence of concomitant depression or other mental disorders, are associated with serious health conditions, risk factors, and suicidality. Comorbid mental disorders potentiate the

  14. Association between gender inequality index and child mortality rates: a cross-national study of 138 countries

    OpenAIRE

    Brinda, Ethel Mary; Rajkumar, Anto P; Enemark, Ulrika

    2015-01-01

    BACKGROUND: Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain.METHODS: We employed an...

  15. In-hospital mortality and treatment patterns in acute myocardial infarction patients admitted during national cardiology meeting dates.

    Science.gov (United States)

    Mizuno, Seiko; Kunisawa, Susumu; Sasaki, Noriko; Fushimi, Kiyohide; Imanaka, Yuichi

    2016-10-01

    Many hospitals experience a reduction in the number of available physicians on days when national scientific meetings are conducted. This study investigates the relationship between in-hospital mortality in acute myocardial infarction (AMI) patients and admission during national cardiology meeting dates. Using an administrative database, we analyzed patients with AMI admitted to acute care hospitals in Japan from 2011 to 2013. There were 3 major national cardiology meetings held each year. A hierarchical logistic regression model was used to compare in-hospital mortality and treatment patterns between patients admitted on meeting dates and those admitted on identical days during the week before and after the meeting dates. We identified 6,332 eligible patients, with 1,985 patients admitted during 26 meeting days and 4,347 patients admitted during 52 non-meeting days. No significant differences between meeting and non-meeting dates were observed for in-hospital mortality (7.4% vs. 8.5%, respectively; p=0.151, unadjusted odds ratio: 0.861, 95% confidence interval: 0.704-1.054) and the proportion of percutaneous coronary intervention (PCI) performed on the day of admission (75.9% vs. 76.2%, respectively; p=0.824). We also found that some low-staffed hospitals did not treat AMI patients during meeting dates. Little or no "national meeting effect" was observed on in-hospital mortality in AMI patients, and PCI rates were similar for both meeting and non-meeting dates. Our findings also indicated that during meeting dates, AMI patients may have been consolidated to high-performance and sufficiently staffed hospitals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis.

    Science.gov (United States)

    Thakrar, Ashish P; Forrest, Alexandra D; Maltenfort, Mitchell G; Forrest, Christopher B

    2018-01-01

    The United States has poorer child health outcomes than other wealthy nations despite greater per capita spending on health care for children. To better understand this phenomenon, we examined mortality trends for the US and nineteen comparator nations in the Organization for Economic Cooperation and Development for children ages 0-19 from 1961 to 2010 using publicly available data. While child mortality progressively declined across all countries, mortality in the US has been higher than in peer nations since the 1980s. From 2001 to 2010 the risk of death in the US was 76 percent greater for infants and 57 percent greater for children ages 1-19. During this decade, children ages 15-19 were eighty-two times more likely to die from gun homicide in the US. Over the fifty-year study period, the lagging US performance amounted to over 600,000 excess deaths. Policy interventions should focus on infants and on children ages 15-19, the two age groups with the greatest disparities, by addressing perinatal causes of death, automobile accidents, and assaults by firearm.

  17. National and sub-national analysis of the health benefits and cost-effectiveness of strategies to reduce maternal mortality in Afghanistan.

    Science.gov (United States)

    Carvalho, Natalie; Salehi, Ahmad Shah; Goldie, Sue J

    2013-01-01

    Afghanistan has one of the highest rates of maternal mortality in the world. We assess the health outcomes and cost-effectiveness of strategies to improve the safety of pregnancy and childbirth in Afghanistan. Using national and sub-national data, we adapted a previously validated model that simulates the natural history of pregnancy and pregnancy-related complications. We incorporated data on antenatal care, family planning, skilled birth attendance and information about access to transport, referral facilities and quality of care. We evaluated single interventions (e.g. family planning) and strategies that combined several interventions packaged as integrated services (transport, intrapartum care). Outcomes included pregnancy-related complications, maternal deaths, maternal mortality ratios, costs and cost-effectiveness ratios. Model-projected reduction in maternal deaths between 1999-2002 and 2007-08 approximated 20%. Increasing family planning was the most effective individual intervention to further reduce maternal mortality; up to 1 in 3 pregnancy-related deaths could be prevented if contraception use approached 60%. Nevertheless, reductions in maternal mortality reached a threshold (∼30% to 40%) without strategies that assured women access to emergency obstetrical care. A stepwise approach that coupled improved family planning with incremental improvements in skilled attendance, transport, referral and appropriate intrapartum care and high-quality facilities prevented 3 of 4 maternal deaths. Such an approach would cost less than US$200 per year of life saved at the national level, well below Afghanistan's per capita gross domestic product (GDP), a common benchmark for cost-effectiveness. Similar results were noted sub-nationally. Our findings reinforce the importance of early intensive efforts to increase family planning for spacing and limiting births and to provide control of fertility choices. While significant improvements in health delivery

  18. Understanding drug-related mortality in released prisoners: a review of national coronial records

    Directory of Open Access Journals (Sweden)

    Andrews Jessica Y

    2012-04-01

    Full Text Available Abstract Background The prisoner population is characterised by a high burden of disease and social disadvantage, and ex-prisoners are at increased risk of death following release. Much of the excess mortality can be attributed to an increased risk of unnatural death, particularly from drug overdose; however, relatively few studies have investigated the circumstances surrounding drug-related deaths among released prisoners. This study aimed to explore and compare the circumstances of death for those who died from accidental drug-related causes to those who died from all other reportable causes. Methods A nationwide search of the Australian National Coroners Information System (NCIS was conducted to identify reportable deaths among ex-prisoners from 2000 to 2007. Using a structured coding form, NCIS records for these cases were interrogated to explore causes and circumstances of death. Results Coronial records for 388 deceased ex-prisoners were identified. Almost half of these deaths were a result of accidental drug-related causes (45%. The majority of accidental drug-related deaths occurred in a home environment, and poly-substance use at or around the time of death was common, recorded in 72% of drug-related deaths. Ex-prisoners who died of accidental drug-related causes were on average younger and less likely to be Indigenous, born in Australia, married, or living alone at or around the time of death, compared with those who died from all other reportable causes. Evidence of mental illness or self-harm was less common among accidental drug-related deaths, whereas evidence of previous drug overdose, injecting drug use, history of heroin use and history of drug withdrawal in the previous six months were more common. Conclusions Drug-related deaths are common among ex-prisoners and often occur in a home (vs. public setting. They are often associated with use of multiple substances at or around the time of death, risky drug-use patterns, and even

  19. Actinic skin damage and mortality--the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.

    Directory of Open Access Journals (Sweden)

    Wei He

    Full Text Available BACKGROUND: Exposure to sunlight may decrease the risk of several diseases through the synthesis of vitamin D, whereas solar radiation is the main cause of some skin and eye diseases. However, to the best of our knowledge, the association of sun-induced skin damage with mortality remains unknown. METHODOLOGY/PRINCIPAL FINDINGS: Subjects were 8472 white participants aged 25-74 years in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cardiovascular disease mortality, cancer mortality, and all-cause mortality were obtained by either a death certificate or a proxy interview, or both. Actinic skin damage was examined and recorded by the presence and severity (absent, minimal, moderate, or severe of overall actinic skin damage and its components (i.e., fine telangiectasia, solar elastosis, and actinic keratoses. Cox regression and Kaplan-Meier methods were applied to explore the associations. A total of 672 cancer deaths, 1500 cardiovascular disease deaths, and 2969 deaths from all causes were documented through the follow-up between 1971 and 1992. After controlling for potential confounding variables, severe overall actinic skin damage was associated with a 45% higher risk for all-cause mortality (95% CI: 1.22, 1.72; P<0.001, moderate overall skin damage with a 20% higher risk (95% CI: 1.08., 1.32; P<0.001, and minimal overall skin damage with no significant mortality difference, when compared to those with no skin damage. Similar results were obtained for all-cause mortality with fine telangiectasia, solar elastosis, and actinic keratoses. The results were similar for cancer and cardiovascular disease mortality. CONCLUSIONS: The present study gives an indication of an association of actinic skin damage with cardiovascular disease, cancer and all-cause mortality in white subjects. Given the lack of support in the scientific literature and potential unmeasured confounding factors, this finding should be

  20. Sexual violence against children in South Africa: a nationally representative cross-sectional study of prevalence and correlates

    Directory of Open Access Journals (Sweden)

    Catherine L Ward, ProfPhD

    2018-04-01

    Full Text Available Summary: Background: We aimed to complete a nationally representative study of sexual violence against children in South Africa, and its correlates, since we could identify no other such study. Methods: For this nationally representative, cross-sectional study in South Africa, households were selected by use of a multistage sampling frame, stratified by province, urban or rural setting, and race group, and schools were selected on the basis that they were closest to the area in which households were selected. Interviews and self-administered questionnaires in each location inquired into lifetime and last-year prevalence of sexual abuse, and its correlates among children aged 15–17 years, whose parents gave informed consent and they themselves gave informed assent. Findings: The final household sample was 5631 (94·6% participation rate. 9·99% (95% CI 8·65–11·47 of boys and 14·61% (95% CI 12·83–16·56 of girls reported some lifetime sexual victimisation. Physical abuse, emotional abuse, neglect, family violence, and other victimisations were all strongly associated with sexual victimisation. The following were associated with greater risk of sexual abuse (adjusted odds ratio [OR]; school enrolment (OR 2·12, 95% CI 1·29–3·48; rural dwelling (0·59; 0·43–0·80; having a flush toilet (1·43, 1·04–1·96; parental substance misuse (2·37, 1·67–3·36; being disabled (1·42, 1·10–1·82; female (but not male caregivers' poor knowledge of the child's whereabouts, friends, and activities (1·07, 0·75–1·53 and poor quality of the relationship with the child (ie, poor acceptance; 1·20, 0·55–2·60. The child's own substance misuse (4·72, 3·73–5·98 and high-risk sexual behaviour (3·71, 2·99–4·61 were the behaviours most frequently associated with sexual abuse, with mental health conditions found to be less prevalent than these factors but still strongly associated with sexual victimisation (post-traumatic stress

  1. Trends of VOC exposures among a nationally representative sample: Analysis of the NHANES 1988 through 2004 data sets

    Science.gov (United States)

    Su, Feng-Chiao; Mukherjee, Bhramar; Batterman, Stuart

    2011-09-01

    Exposures to volatile organic compounds (VOCs) are ubiquitous due to emissions from personal, commercial and industrial products, but quantitative and representative information regarding long term exposure trends is lacking. This study characterizes trends from 1988 to 2004 for the 15 VOCs measured in blood in five cohorts of the National Health and Nutrition Examination Survey (NHANES), a large and representative sample of U.S. adults. Trends were evaluated at various percentiles using linear quantile regression (QR) models, which were adjusted for solvent-related occupations and cotinine levels. Most VOCs showed decreasing trends at all quantiles, e.g., median exposures declined by 2.5 (m,p-xylene) to 6.4 (tetrachloroethene) percent per year over the 15 year period. Trends varied by VOC and quantile, and were grouped into three patterns: similar decreases at all quantiles (including benzene, toluene); most rapid decreases at upper quantiles (ethylbenzene, m,p-xylene, o-xylene, styrene, chloroform, tetrachloroethene); and fastest declines at central quantiles (1,4-dichlorobenzene). These patterns reflect changes in exposure sources, e.g., upper-percentile exposures may result mostly from occupational exposure, while lower percentile exposures arise from general environmental sources. Both VOC emissions aggregated at the national level and VOC concentrations measured in ambient air also have declined substantially over the study period and are supportive of the exposure trends, although the NHANES data suggest the importance of indoor sources and personal activities on VOC exposures. While piecewise QR models suggest that exposures of several VOCs decreased little or any during the 1990's, followed by more rapid decreases from 1999 to 2004, questions are raised concerning the reliability of VOC data in several of the NHANES cohorts and its applicability as an exposure indicator, as demonstrated by the modest correlation between VOC levels in blood and personal air

  2. Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey.

    Science.gov (United States)

    Waweru, Evelyn; Opwora, Antony; Toda, Mitsuru; Fegan, Greg; Edwards, Tansy; Goodman, Catherine; Molyneux, Sassy

    2013-10-10

    Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to

  3. The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample.

    Science.gov (United States)

    Afifi, Tracie O; Boman, Jonathan; Fleisher, William; Sareen, Jitender

    2009-03-01

    To determine how the experiences of child abuse and parental divorce are related to long-term mental health outcomes using a nationally representative adult sample after adjusting for sociodemographic variables and parental psychopathology. Data were drawn from the National Comorbidity Survey (NCS, n=5,877; age 15-54 years; response rate 82.4%). Logistic regression models were used to determine the odds of experiencing lifetime psychiatric disorders and suicidal ideation and attempts. Parental divorce alone was associated with some psychiatric disorders after adjusting for sociodemographic variables (AOR ranging from 1.30 to 2.37), while child abuse alone was associated with psychiatric disorders (AOR ranging from 1.39 to 6.07) and suicidal ideation (AOR=2.08; 95% CI=1.57-2.77) and attempts (AOR=1.54; 95% CI=1.02-2.31) after adjusting for sociodemographic variables. However, having experienced both parental divorce and child abuse together resulted in significantly increased odds for lifetime PTSD (AOR=9.87; 95% CI=6.69-14.55), conduct disorder (AOR=4.01; 95% CI=2.92-5.51) and suicide attempts (AOR=2.74; 95% CI=1.84-4.08) compared to having experienced either parental divorce or child abuse alone. These results were attenuated when further adjusting for parental psychopathology. When the experience of parental divorce is accompanied with child abuse, the associations with some poor mental health outcomes are significantly greater compared to the impact of either parental divorce or child abuse on its own. Therefore, parental divorce is an additional childhood adversity that significantly contributes to poor mental health outcomes especially when in combination with child abuse. Parental psychopathology attenuated these relationships suggesting that it may be one possible mechanism to explain the relationships between child abuse, parental divorce, and psychiatric disorders and suicide attempts.

  4. The prevalence of couple infertility in the United States from a male perspective: evidence from a nationally representative sample.

    Science.gov (United States)

    Louis, J F; Thoma, M E; Sørensen, D N; McLain, A C; King, R B; Sundaram, R; Keiding, N; Buck Louis, G M

    2013-09-01

    Infertility is a couple-based fecundity impairment, although population level research is largely based upon information reported by female partners. Of the few studies focusing on male partners, most focus on the utilization of infertility services rather than efforts to estimate the prevalence and determinants of infertility as reported by male partners. Data from a nationally representative sample of men aged 15-44 years who participated in the 2002 National Survey of Family Growth (NSFG) were used to estimate the prevalence of infertility and determinants of longer time-to-pregnancy (TTP) using the novel current duration (CD) approach. Using backward recurrence time parametric survival methods, we estimated infertility prevalence (TTP > 12 months) and time ratios (TR) associated with TTP as derived from males' reported CD of their pregnancy attempt. The estimated prevalence of infertility was 12.0% (95% CI: 7.0, 23.2). Longer TTP was associated with older male age (35-45 vs. 17-24 years) (TR: 2.49; 95% CI: 1.03, 6.03), biological childlessness (TR: 1.53; 95% CI: 1.07, 2.19) and lack of health insurance (TR: 1.73; 95% CI: 1.02, 2.94) after controlling for the differences in couples' age and other socioeconomic factors. The prevalence of infertility based on male reporting is consistent with estimates of infertility in the US found in prospective cohort studies and CD studies based on female reporting. Our findings suggest that male partners can reliably inform about couple infertility. Interventions and services aimed at reducing couple infertility should include attention to male factors associated with longer TTP identified in this study. © 2013 American Society of Andrology and European Academy of Andrology.

  5. Can Nonurgent Emergency Department Care Costs be Reduced? Empirical Evidence from a U.S. Nationally Representative Sample.

    Science.gov (United States)

    Xin, Haichang; Kilgore, Meredith L; Sen, Bisakha Pia; Blackburn, Justin

    2015-09-01

    A well-functioning primary care system has the capacity to provide effective care for patients to avoid nonurgent emergency department (ED) use and related costs. This study examined how patients' perceived deficiency in ambulatory care is associated with nonurgent ED care costs nationwide. This retrospective cohort study used data from the 2010-2011 Medical Expenditure Panel Survey. This study chose usual source of care, convenience of needed medical care, and patient evaluation of care quality as the main independent variables. The marginal effect following a multivariate logit model was employed to analyze the urgent vs. nonurgent ED care costs in 2011, after controlling for covariates in 2010. The endogeneity was accounted for by the time lag effect and controlling for education levels. Sample weights and variance were adjusted with the survey procedures to make results nationally representative. Patient-perceived poor and intermediate levels of primary care quality had higher odds of nonurgent ED care costs (odds ratio [OR] = 2.22, p = 0.035, and OR = 2.05, p = 0.011, respectively) compared to high-quality care, with a marginal effect (at means) of 13.0% and 11.5% higher predicted probability of nonurgent ED care costs. Costs related to these ambulatory care quality deficiencies amounted to $229 million for private plans (95% confidence interval [CI] $100 million-$358 million), $58.5 million for public plans (95% CI $33.9 million-$83.1 million), and an overall of $379 million (95% CI $229 million-$529 million) nationally. These findings highlight the improvement in ambulatory care quality as the potential target area to effectively reduce nonurgent ED care costs. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Intellectual disability is associated with increased risk for obesity in a nationally representative sample of U.S. children.

    Science.gov (United States)

    Segal, Mary; Eliasziw, Misha; Phillips, Sarah; Bandini, Linda; Curtin, Carol; Kral, Tanja V E; Sherwood, Nancy E; Sikich, Lin; Stanish, Heidi; Must, Aviva

    2016-07-01

    Data on obesity prevalence in children with intellectual disability (ID) are scarce. We estimated rates of obesity among children aged 10-17 years with and without ID in a nationally representative dataset that included measures of child weight and ID status, as well as family meal frequency, physical activity, and sedentary behavior. Chi-square tests compared prevalence of obesity, demographic and behavioral characteristics between children with and without ID as reported in the 2011 National Survey of Children's Health. Tests for interaction in logistic regression models determined whether associations between obesity and behavioral characteristics were different between children with/without ID. Obesity prevalence for children with ID was 28.9% and 15.5% for children without ID. After adjusting for age, sex, race/ethnicity and poverty level, the odds ratio was significantly 1.89 times greater among children with ID than among those without ID (95% CI: 1.14 to 3.12). Among children with ID, 49.8% ate at least one meal with family members every day compared to 35.0% without ID (p obesity was higher among all children who ate family meals every day compared to fewer days per week, and the effect was significantly more pronounced among those with ID (p = 0.05). Prevalence of obesity among youth with ID was almost double that of the general population. Prospective studies are needed in this population to examine the impact of consistent family mealtimes and infrequent physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Child maltreatment and eating disorders among men and women in adulthood: Results from a nationally representative United States sample.

    Science.gov (United States)

    Afifi, Tracie O; Sareen, Jitender; Fortier, Janique; Taillieu, Tamara; Turner, Sarah; Cheung, Kristene; Henriksen, Christine A

    2017-11-01

    Child maltreatment is associated with an increased likelihood of having mood disorders, anxiety disorders, post-traumatic stress disorder, substance use disorders, and personality disorders, but far less is known about eating disorders. The objective of the current study was to examine the associations between child maltreatment, including harsh physical punishment, physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, and exposure to intimate partner violence, and eating disorders in adulthood among men and women. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions wave 3 (NESARC-III) collected in 2012-2013. The sample was nationally representative of the United States adult population (N = 36,309). Lifetime eating disorders (anorexia nervosa [AN], bulimia nervosa [BN], and binge-eating disorder [BED]) were assessed using diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria and the alcohol use disorder and associated disabilities interview schedule-5 (AUDADIS-5). The prevalence of any lifetime eating disorder was 1.7% (0.8% among men and 2.7% among women). All child maltreatment types were associated with AN, BN, and BED with notable differences among men and women. Overall, the types of child maltreatment with the strongest relationships with any eating disorder were sexual abuse and physical neglect among men and sexual abuse and emotional abuse among women. Clinicians should be mindful that child maltreatment experiences are associated with increased odds of eating disorders including AN, BED, and BN. Such relationships are significant among men and women although notable gender differences in these relationships exist. Abstract word count = 248. © 2017 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

  8. The Association between Mental Health and Violence among a Nationally Representative Sample of College Students from the United States.

    Science.gov (United States)

    Schwartz, Joseph A; Beaver, Kevin M; Barnes, J C

    2015-01-01

    Recent violent attacks on college campuses in the United States have sparked discussions regarding the prevalence of psychiatric disorders and the perpetration of violence among college students. While previous studies have examined the potential association between mental health problems and violent behavior, the overall pattern of findings flowing from this literature remain mixed and no previous studies have examined such associations among college students. The current study makes use of a nationally representative sample of 3,929 college students from the National Epidemiologic Study on Alcohol and Related Conditions (NESARC) to examine the prevalence of seven violent behaviors and 19 psychiatric disorder diagnoses tapping mood, anxiety, personality, and substance use disorders. Associations between individual and composite psychiatric disorder diagnoses and violent behaviors were also examined. Additional analyses were adjusted for the comorbidity of multiple psychiatric diagnoses. The results revealed that college students were less likely to have engaged in violent behavior relative to the non-student sample, but a substantial portion of college students had engaged in violent behavior. Age- and sex-standardized prevalence rates indicated that more than 21% of college students reported at least one violent act. In addition, more than 36% of college students had at least one diagnosable psychiatric disorder. Finally, the prevalence of one or more psychiatric disorders significantly increased the odds of violent behavior within the college student sample. These findings indicate that violence and psychiatric disorders are prevalent on college campuses in the United States, though perhaps less so than in the general population. In addition, college students who have diagnosable psychiatric disorders are significantly more likely to engage in various forms of violent behavior.

  9. Men's use and perceptions of commercial lubricants: prevalence and characteristics in a nationally representative sample of American adults.

    Science.gov (United States)

    Reece, Michael; Herbenick, Debby; Schick, Vanessa; Sanders, Stephanie A; Fortenberry, J Dennis

    2014-05-01

    Most research on men's use of commercial lubricants during sexual activities is in the context of condom use and often specifically among men who have sex with men. Less is known about men's use of lubricants associated with a broader range of sexual experiences. The aims of this study are to document the prevalence of commercial lubricant use among adult U.S. men (age 18+), to document men's use of lubricants across solo and partnered sexual behaviors, and to assess men's perceptions of the contributions lubricants have to the sexual experience. Data are from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of U.S. adults ages 18 and older. Sociodemographic characteristics, recent and lifetime commercial lubricant use, lubricant use during specific sexual behaviors, frequency of lubricant use, and reasons for lubricant use. Most men in the United States (70%, N = 1,014) reported having used a commercial lubricant, with men older than 24 and those in a relationship more likely to report lubricant use. About one in four men had used a lubricant in the past 30 days. Intercourse was the most common behavior during which men used lubricant, though solo masturbation and partnered sexual play were also frequently linked to lubricant use. The most common reasons for lubricant use included "to make sex more comfortable," "for fun," "curiosity," and "my partner wanted to." Most American men have used a lubricant; lubricant use is common across all age groups, and some of the most common reasons why men report using lubricants have to do with sexual enhancement, comfort, and pleasure. Clinicians may find these data helpful to their efforts to educate patients about lubricant use, comfort during sex, and sexual enhancement. © 2014 International Society for Sexual Medicine.

  10. Smoking and its risk factors in Chinese elementary and middle school students: a nationally representative sample study.

    Science.gov (United States)

    Zhang, Xinghui; Li, Yajun; Zhang, Qin; Lu, Furong; Wang, Yun

    2014-05-01

    The purpose of this study was to examine the prevalence of smoking in a nationally representative sample of Chinese elementary and middle school students and to investigate its risk factors from families and schools. The data were from the National Children's Study of China (NCSC), in which 24,013 fourth- to ninth-grade students were recruited from 100 counties in 31 provinces in China. Chi-square tests and one-way ANOVAs were used to analyze the relationships between smoking and the risk factors. Logistic regressions were used to calculate odds ratios. The prevalence of ever smokers and current smokers were 19.0% and 5.4%. Focusing on current smokers, boys, middle school students, rural students, boarding students, non-only children and those owning parents with low educational levels reported smoking significantly more than girls, elementary school students, urban students, non-boarding students, only children and those owning parents with high educational levels. Lower trust and support from teachers and higher parent-child conflict positively predicted both smoking and smoking frequency. Lower trust and support from classmates was associated with higher possibility of smoking. However, higher trust and support from classmates was associated with higher smoking frequency. Teacher smoking and friend smoking were only predictive of smoking, but not of smoking frequency. Boys, middle school students, rural students, boarding students, non-only children and those owning parents with low educational levels need special attention. The most risk factors for smoking and smoking frequency were lower trust and support from teachers and higher parent-child conflict. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Blood pressure and its influencing factors in a national representative sample of Iranian children and adolescents: the CASPIAN Study.

    Science.gov (United States)

    Kelishadi, Roya; Ardalan, Gelayol; Gheiratmand, Riaz; Majdzadeh, Reza; Delavari, Alireza; Heshmat, Ramin; Gouya, Mohammad Mehdi; Razaghi, Emran Mohammad; Motaghian, Molouk; Mokhtari, Mohammad Reza; Barekati, Hamed; Arabi, Minoo Sadat Mahmoud

    2006-12-01

    This study was performed to determine the blood pressure (BP) percentile curves by height, as well as to assess the prevalence of high BP and its influencing factors among children in the first national survey in this field in Iran. A multicentre national cross-sectional survey. This study was performed in 23 provinces among a representative sample of 21,111 students aged 6-18 years. Age and sex-specific percentile curves of systolic and diastolic BP were obtained by height. A comparison of the values obtained corresponding to the 90th percentiles with the Second Task Force cut-offs showed that the BP values and trends were relatively similar in both studies. The overall prevalence of systolic, diastolic as well as systolic or diastolic hypertension according to the Second Task Force study 95th percentile cut-off points were 4.2, 5.4 and 7.7%, respectively, without a significant sex difference. A history of low birthweight, overweight, taller height, the consumption of solid hydrogenated fat, as well as the frequency of fast food consumption increased the risk of both systolic and diastolic hypertension. Male sex, large waist, and low education of the mother were the risks for systolic hypertension, whereas the risk of diastolic hypertension rose with living in an urban area, attending public school, low physical activity level, having a housewife mother, and a positive family history of obesity, especially in the parents. Considering the effect of modifiable environmental factors on the childrens' BP, encouraging breast feeding and a healthy lifestyle may have an important effect on public health.

  12. Slow progress in changing the school food environment: nationally representative results from public and private elementary schools.

    Science.gov (United States)

    Turner, Lindsey; Chaloupka, Frank J

    2012-09-01

    Children spend much of their day in school, and authorities have called for improvements in the school food environment. However, it is not known whether changes have occurred since the federal wellness policy mandate took effect in 2006-2007. We examined whether the school food environment in public and private elementary schools changed over time and examined variations by school type and geographic division. Survey data were gathered from respondents at nationally representative samples of elementary schools during the 2006-2007 and 2009-2010 school years (respectively, 578 and 680 public schools, and 259 and 313 private schools). Topics assessed included competitive foods, school meals, and other food-related practices (eg, school gardens and nutrition education). A 16-item food environment summary score was computed, with possible scores ranging from 0 (least healthy) to 100 (healthiest). Multivariate regression models were used to examine changes over time in the total school food environment score and component items, and variations by US census division. Many practices improved, such as participation in school gardens or farm-to-school programs, and availability of whole grains and only lower-fat milks in lunches. Although the school food environment score increased significantly, the magnitude of change was small; as of 2009-2010 the average score was 53.5 for public schools (vs 50.1 in 2006-2007) and 42.2 for private schools (vs 37.2 in 2006-2007). Scores were higher in public schools than in private schools (Pschool size. For public schools, scores were higher in the Pacific and West South Central divisions compared with the national average. Changes in the school food environment have been minimal, with much room remaining for improvement. Additional policy changes may be needed to speed the pace of improvement. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  13. Association of Physical Activity with Alcohol Abuse and Dependence in a Nationally-Representative U.S. Sample.

    Science.gov (United States)

    Damian, April Joy; Mendelson, Tamar

    2017-11-10

    Alcohol use is a pervasive and costly public health problem in the United States. Relapse rates from alcohol use disorders are high. Although exercise has been proposed as a strategy to prevent relapse, lifestyle modification is the least studied aspect of relapse prevention programs, especially among racial/ethnic minority populations. The current study assessed whether being physically active was associated with remission from alcohol abuse or dependence among Black (African American and Afro Caribbean) adults in the U.S. We utilized data on Black adult participants (n = 4,828) from the nationally representative National Survey of American Life (NSAL) conducted in 2001-2003. Logistic regression models were estimated to assess the odds of being in 12-month remission or currently meeting DSM-IV criteria for alcohol abuse or dependence based on level of physical activity, adjusting for socio-demographic and neighborhood characteristics. People who endorsed being physically active had higher odds of being in 12-month remission from alcohol use problems (OR: 1.67, 95% CI: 1.28, 2.17) than people who were physically inactive, adjusting for individual- and neighborhood-level characteristics. People who were physically active did not differ significantly from those who were inactive with respect to odds of currently meeting DSM-IV criteria for alcohol abuse or dependence. Conclusions/Importance: Physical activity was positively associated with being in 12-month remission from alcohol use problems. Longitudinal studies are needed to establish temporal ordering and to explore exercise as a potential relapse prevention strategy for alcohol use problems.

  14. Association between gender inequality index and child mortality rates: a cross-national study of 138 countries.

    Science.gov (United States)

    Brinda, Ethel Mary; Rajkumar, Anto P; Enemark, Ulrika

    2015-03-09

    Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain. We employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables. Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of children of both genders.

  15. Child mortality in the Democratic Republic of Congo: cross-sectional evidence of the effect of geographic location and prolonged conflict from a national household survey.

    Science.gov (United States)

    Kandala, Ngianga-Bakwin; Mandungu, Tumwaka P; Mbela, Kisumbula; Nzita, Kikhela P D; Kalambayi, Banza B; Kayembe, Kalambayi P; Emina, Jacques B O

    2014-03-20

    The child mortality rate is a good indicator of development. High levels of infectious diseases and high child mortality make the Democratic Republic of Congo (DRC) one of the most challenging environments for health development in Sub-Saharan Africa (SSA). Recent conflicts in the eastern part of the country and bad governance have compounded the problem. This study aimed to examine province-level geographic variation in under-five mortality (U5M), accounting for individual- and household-level risk factors including environmental factors such as conflict. Our analysis used the nationally representative cross-sectional household sample of 8,992 children under five in the 2007 DRC Demographic and Health Survey. In the survey year, 1,005 deaths among this group were observed. Information on U5M was aggregated to the 11 provinces, and a Bayesian geo-additive discrete-time survival mixed model was used to map the geographic distribution of under-five mortality rates (U5MRs) at the province level, accounting for observable and unobservable risk factors. The overall U5MR was 159 per 1,000 live births. Significant associations with risk of U5M were found for conflict area of the DRC, and the lowest in the conflict area of North Kivu. This study reveals clear geographic patterns in rates of U5M in the DRC and shows the potential role of individual child, household and environmental factors, which are unexplained by the ongoing conflict. The displacement of mothers to safer areas may explain the lower U5MR observed at the epicentre of the conflict in North Kivu, compared with rates in conflict-free areas. Overall, the U5M maps point to a lack of progress towards the Millennium Development Goal of reducing U5M by half by 2015.

  16. Report from the Society of Thoracic Surgeons National Database Workforce: clarifying the definition of operative mortality.

    Science.gov (United States)

    Overman, David M; Jacobs, Jeffrey P; Prager, Richard L; Wright, Cameron D; Clarke, David R; Pasquali, Sara K; O'Brien, Sean M; Dokholyan, Rachel S; Meehan, Paul; McDonald, Donna E; Jacobs, Marshall L; Mavroudis, Constantine; Shahian, David M

    2013-01-01

    Several distinct definitions of postoperative death have been used in various quality reporting programs. Some have defined postoperative mortality as the occurrence of death after a surgical procedure when the patient dies while still in the hospital, while others have considered all deaths occurring within a predetermined, standardized time interval after surgery to be postoperative mortality. While mortality data are still collected and reported using both these individual definitions, the Society of Thoracic Surgeons (STS) believes that either approach alone may be inadequate. Accordingly, the STS prefers a more encompassing metric, Operative Mortality. Operative Mortality is defined in all STS databases as (1) all deaths, regardless of cause, occurring during the hospitalization in which the operation was performed, even if after 30 days (including patients transferred to other acute care facilities); and (2) all deaths, regardless of cause, occurring after discharge from the hospital, but before the end of the 30th postoperative day. This article provides clarification for some uncommon but important scenarios in which the correct application of this definition may be challenging.

  17. Cross-national injury mortality differentials by income level: the possible role of age and ageing.

    Science.gov (United States)

    Moniruzzaman, S; Andersson, R

    2008-11-01

    To examine age- and cause-specific injury mortality differentials between low-income (LICs), middle-income (MICs) and high-income countries (HICs), and to discuss their implications in explaining changing injury mortality patterns with economic development against the background of general health transition theory. Cross-sectional study. The World Health Organization's mortality database was used as the source of injury mortality data. The grouping into LICs, MICs and HICs was based on data from World Development Indicator. Unintentional injury mortality (UIM) rates in children and adults are highest in LICs and MICs, respectively. UIM rates in the elderly population, however, increase with higher economic conditions and are highest in HICs. Based on these findings, it is hypothesized that ageing and injury interplay mutually with regard to health transition; declining rates in child UIM with economic development contributes to the ageing process, while increasing UIM among the elderly, in combination with ageing populations, boosts the absolute number of injury deaths in this segment.

  18. Effect of Governance Indicators on Under-Five Mortality in OECD Nations: Generalized Method of Moments.

    Science.gov (United States)

    Emamgholipour, Sara; Asemane, Zahra

    2016-01-01

    Today, it is recognized that factors other than health services are involved in health improvement and decreased inequality so identifying them is the main concern of policy makers and health authorities. The aim of this study was to investigate the effect of governance indicators on health outcomes. A panel data study was conducted to investigate the effect of governance indicators on child mortality rate in 27 OECD countries from 1996 to 2012 using the Generalized Method of Moments (GMM) model and EVIEWS.8 software. According to the results obtained, under-five mortality rate was significantly related to all of the research variables (p corruption and rule of law indicators decreased child mortality rate by 0.05 and 0.08%, respectively. Furthermore, 1% increase in public health expenditure per capita resulted in a 0.03% decrease in under-five mortality rate. The results of the study suggest that considering control variables, including GDP per capita, public health expenditure per capita, total fertility rate, and improvement of governance indicators (control of corruption and rule of law) would decrease the child mortality rate.

  19. The associations between nationality, fertility history and diabetes-related mortality: a retrospective cohort study in the Brussels-Capital Region (2001-2005).

    Science.gov (United States)

    Vandenheede, Hadewijch; Deboosere, Patrick; Gadeyne, Sylvie; De Spiegelaere, Myriam

    2012-03-01

    The relationship between women's parity and diabetes mortality has been investigated in several studies, with mixed results. This study aims to establish if parity and age at first birth are associated with diabetes-related mortality and if these factors contribute to variations in diabetes-related mortality among women with different nationalities. Data of the 2001 census are linked to registration records of all deaths and emigrations (period 2001-2005). The study population comprises all female inhabitants of the Brussels-Capital Region aged 45-74 of either Belgian or North African nationality (n = 108 296). Age-standardized mortality rates (direct standardization) and mortality rate ratios (Poisson's regression) are computed. Both parity and age at first birth are associated with diabetes-related mortality. Highest risks of dying from diabetes are observed among grandmultiparous women and teenage mothers. Differences in diabetes-related mortality according to nationality are observed. Age-standardized diabetes mortality rates are higher in North African [ASMR = 417.4/100,000; 95% confidence interval (CI) 227.2-607.7] than in Belgian women (ASMR = 184.0/100,000; 95% CI 157.3-210.8). Taking parity, age at first birth and education into account, these differences largely disappear. Reproductive factors are associated with diabetes-related mortality and play an important part in the higher diabetes-related mortality of North African compared with Belgian women.

  20. 27 October 2014 - H.E. Mr Ney Samol Ambassador Permanent Representative of the Kingdom of Cambodia to the United Nations Office and other international organizations in Geneva

    CERN Multimedia

    Brice, Maximilien

    2014-01-01

    His Excellency Mr Ney Samol Ambassador Permanent Representative of the Kingdom of Cambodia to the United Nations Office and other international organizations in Geneva signing the Guest Book with Deputy Head of International Relations E. Tsesmelis

  1. His Excellency Mr Yusuf Abdulkarim Bucheeri Ambassador Extraordinary and Plenipotentiary Permanent Representative of the Kingdom of Bahrain to the United Nations Office and other international organisations in Geneva

    CERN Multimedia

    Ordan, Julien Marius

    2018-01-01

    Visit of His Excellency Mr Yusuf Abdulkarim Bucheeri Ambassador Extraordinary and Plenipotentiary Permanent Representative of the Kingdom of Bahrain to the United Nations Office and other international organisations in Geneva

  2. His Excellency Mr Zbigniew Czech, Ambassador Extraordinary and Plenipotentiary Permanent Representative of the Republic of Poland to the United Nations Office and other international organisations in Geneva

    CERN Multimedia

    Ordan, Julien Marius

    2018-01-01

    Visit of His Excellency Mr Zbigniew Czech, Ambassador Extraordinary and Plenipotentiary Permanent Representative of the Republic of Poland to the United Nations Office and other international organisations in Geneva

  3. Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

    OpenAIRE

    Kumar, Mohan B.; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

    2012-01-01

    Objective: To determine the prevalence of suicidal ideation among Métis men and women (20-59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006).Study design: Secondary analysis of previously collected data from a nationally representative cross-sectional survey.Results: Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total populati...

  4. The Impact of Nutrition and Health Claims on Consumer Perceptions and Portion Size Selection: Results from a Nationally Representative Survey

    Science.gov (United States)

    Benson, Tony; Lavelle, Fiona; McCloat, Amanda; Mooney, Elaine; Egan, Bernadette; Collins, Clare E.; Dean, Moira

    2018-01-01

    Nutrition and health claims on foods can help consumers make healthier food choices. However, claims may have a ‘halo’ effect, influencing consumer perceptions of foods and increasing consumption. Evidence for these effects are typically demonstrated in experiments with small samples, limiting generalisability. The current study aimed to overcome this limitation through the use of a nationally representative survey. In a cross-sectional survey of 1039 adults across the island of Ireland, respondents were presented with three different claims (nutrition claim = “Low in fat”; health claim = “With plant sterols. Proven to lower cholesterol”; satiety claim = “Fuller for longer”) on four different foods (cereal, soup, lasagne, and yoghurt). Participants answered questions on perceived healthiness, tastiness, and fillingness of the products with different claims and also selected a portion size they would consume. Claims influenced fillingness perceptions of some of the foods. However, there was little influence of claims on tastiness or healthiness perceptions or the portion size selected. Psychological factors such as consumers’ familiarity with foods carrying claims and belief in the claims were the most consistent predictors of perceptions and portion size selection. Future research should identify additional consumer factors that may moderate the relationships between claims, perceptions, and consumption. PMID:29789472

  5. 'At-risk' individuals' responses to direct to consumer advertising of prescription drugs: a nationally representative cross-sectional study.

    Science.gov (United States)

    Khalil Zadeh, Neda; Robertson, Kirsten; Green, James A

    2017-12-06

    The factors determining individuals' self-reported behavioural responses to direct to consumer advertising of prescription drugs were explored with an emphasis on 'at-risk' individuals' responses. Nationally representative cross-sectional survey. Community living adults in New Zealand. 2057 adults (51% women). Self-reported behavioural responses to drug advertising (asking a physician for a prescription, asking a physician for more information about an illness, searching the internet for more information regarding an illness and asking a pharmacist for more information about a drug). Multivariate logistic regressions determined whether participants' self-reported behavioural responses to drug advertising were predicted by attitudes towards advertising and drug advertising, judgements about safety and effectiveness of advertised drugs, self-reported health status, materialism, online search behaviour as well as demographic variables. Identifying as Indian and to a less extent Chinese, Māori and 'other' ethnicities were the strongest predictors of one or more self-reported responses (ORs 1.76-5.00, Ps advertising (ORs 1.34-1.61, all Psadvertising and may make uninformed decisions accordingly. The outcomes raise significant concerns relating to the ethicality of drug advertising and suggest a need for stricter guidelines to ensure that drug advertisements provided by pharmaceutical companies are ethical. © 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.

  6. Association of occupation, employment contract, and company size with mental health in a national representative sample of employees in Japan.

    Science.gov (United States)

    Inoue, Akiomi; Kawakami, Norito; Tsuchiya, Masao; Sakurai, Keiko; Hashimoto, Hideki

    2010-01-01

    The purpose of this study was to investigate the cross-sectional association of employment contract, company size, and occupation with psychological distress using a nationally representative sample of the Japanese population. From June through July 2007, a total of 9,461 male and 7,717 female employees living in the community were randomly selected and surveyed using a self-administered questionnaire and interview including questions about occupational class variables, psychological distress (K6 scale), treatment for mental disorders, and other covariates. Among males, part-time workers had a significantly higher prevalence of psychological distress than permanent workers. Among females, temporary/contract workers had a significantly higher prevalence of psychological distress than permanent workers. Among males, those who worked at companies with 300-999 employees had a significantly higher prevalence of psychological distress than those who worked at the smallest companies (with 1-29 employees). Company size was not significantly associated with psychological distress among females. Additionally, occupation was not significantly associated with psychological distress among males or females. Similar patterns were observed when the analyses were conducted for those who had psychological distress and/or received treatment for mental disorders. Working as part-time workers, for males, and as temporary/contract workers, for females, may be associated with poor mental health in Japan. No clear gradient in mental health along company size or occupation was observed in Japan.

  7. Learning in later life: participation in formal, non-formal and informal activities in a nationally representative Spanish sample.

    Science.gov (United States)

    Villar, Feliciano; Celdrán, Montserrat

    2013-06-01

    This article examines the participation of Spanish older people in formal, non-formal and informal learning activities and presents a profile of participants in each kind of learning activity. We used data from a nationally representative sample of Spanish people between 60 and 75 years old ( n  = 4,703). The data were extracted from the 2007 Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje (EADA, Survey on Adult Population Involvement in Learning Activities). Overall, only 22.8 % of the sample participated in a learning activity. However, there was wide variation in the participation rates for the different types of activity. Informal activities were far more common than formal ones. Multivariate logistic regression indicated that education level and involvement in social and cultural activities were associated with likelihood of participating, regardless of the type of learning activity. When these variables were taken into account, age did not predict decreasing participation, at least in non-formal and informal activities. Implications for further research, future trends and policies to promote older adult education are discussed.

  8. Problematic internet use and problematic online gaming are not the same: findings from a large nationally representative adolescent sample.

    Science.gov (United States)

    Király, Orsolya; Griffiths, Mark D; Urbán, Róbert; Farkas, Judit; Kökönyei, Gyöngyi; Elekes, Zsuzsanna; Tamás, Domokos; Demetrovics, Zsolt

    2014-12-01

    There is an ongoing debate in the literature whether problematic Internet use (PIU) and problematic online gaming (POG) are two distinct conceptual and nosological entities or whether they are the same. The present study contributes to this question by examining the interrelationship and the overlap between PIU and POG in terms of sex, school achievement, time spent using the Internet and/or online gaming, psychological well-being, and preferred online activities. Questionnaires assessing these variables were administered to a nationally representative sample of adolescent gamers (N=2,073; Mage=16.4 years, SD=0.87; 68.4% male). Data showed that Internet use was a common activity among adolescents, while online gaming was engaged in by a considerably smaller group. Similarly, more adolescents met the criteria for PIU than for POG, and a small group of adolescents showed symptoms of both problem behaviors. The most notable difference between the two problem behaviors was in terms of sex. POG was much more strongly associated with being male. Self-esteem had low effect sizes on both behaviors, while depressive symptoms were associated with both PIU and POG, affecting PIU slightly more. In terms of preferred online activities, PIU was positively associated with online gaming, online chatting, and social networking, while POG was only associated with online gaming. Based on our findings, POG appears to be a conceptually different behavior from PIU, and therefore the data support the notion that Internet Addiction Disorder and Internet Gaming Disorder are separate nosological entities.

  9. Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey.

    Science.gov (United States)

    Zhang, Jingya; Lin, Senlin; Liang, Di; Qian, Yi; Zhang, Donglan; Hou, Zhiyuan

    2017-09-01

    There have been obstacles for internal migrants in China in accessing local public health services for some time. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, and demographic characteristics and public health services utilization. Our results showed that internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The years of living in the city of residence were positively associated with the utilization of public health services. Compared to migration within the city, migration across provinces significantly reduced the probability of using health records (OR = 0.88, 95% CI: 0.86-0.90), health education (OR = 0.97, 95% CI: 0.94-1.00), and health education on non-communicable diseases (OR = 0.92, 95% CI: 0.89-0.95) or through the Internet (OR = 0.96, 95% CI: 0.94-0.99). This study concludes that public health services coverage for internal migrants has seen great improvement due to government subsidies. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

  10. Microfinance Participation, Control Over Resources, and Justification of IPV: Results From a Nationally Representative Sample of Women.

    Science.gov (United States)

    Murshid, Nadine Shaanta

    2016-04-13

    A high percentage of men and women are purported to justify intimate partner violence (IPV) in countries that are steeped in patriarchy even in the presence of programs such as microfinance that aim to address gender equity. This article examines two assertions that emerge from the literature on microfinance and its potential for positive outcomes for women who participate in it: (a) Microfinance participation is associated with reduced justification of IPV, and (b) microfinance participants with control over their own resources are less likely to justify IPV when compared with microfinance participants who do not have control over their resources. Couples data from a nationally representative survey, the Bangladesh Demographic and Health Survey, were used in the present study. Propensity score matching and logistic regression analyses were conducted to reveal that (a) microfinance participation was not associated with justification of IPV and that (b) women who participated in microfinance were less likely to justify IPV when they had no control over their resources. Implications for practitioners and policymakers are discussed. © The Author(s) 2016.

  11. Problematic social media use and depressive symptoms among U.S. young adults: A nationally-representative study.

    Science.gov (United States)

    Shensa, Ariel; Escobar-Viera, César G; Sidani, Jaime E; Bowman, Nicholas D; Marshal, Michael P; Primack, Brian A

    2017-06-01

    Depression is the leading cause of disability worldwide. The suggested association between social media use (SMU) and depression may be explained by the emerging maladaptive use pattern known as problematic social media use (PSMU), characterized by addictive components. We aimed to assess the association between PSMU and depressive symptoms-controlling for overall time and frequency of SMU-among a large sample of U.S. young adults. In October 2014, participants aged 19-32 (N = 1749) were randomly selected from a nationally-representative U.S. probability-based panel and subsequently invited to participate in an online survey. We assessed depressive symptoms using the validated Patient-Reported Outcomes Measurement Information System (PROMIS) brief depression scale. We measured PSMU using an adapted version of the Bergen Facebook Addiction Scale to encompass broader SMU. Using logistic regression models, we tested the association between PSMU and depressive symptoms, controlling for time and frequency of SMU as well as a comprehensive set of socio-demographic covariates. In the multivariable model, PSMU was significantly associated with a 9% increase in odds of depressive symptoms (AOR [adjusted odds ratio] = 1.09; 95% CI [confidence interval]: 1.05, 1.13; p addictive components and frequency-rather than time-of SMU. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Prevalence and characteristics of vibrator use by women in the United States: results from a nationally representative study.

    Science.gov (United States)

    Herbenick, Debra; Reece, Michael; Sanders, Stephanie; Dodge, Brian; Ghassemi, Annahita; Fortenberry, J Dennis

    2009-07-01

    Although vibrators are commonly recommended by clinicians as adjunct to treatment for female sexual dysfunction, and for sexual enhancement, little is known about their prevalence or correlates of use. The aim of this study was to determine the lifetime and recent prevalence of women's vibrator use during masturbation and partnered sex, and the correlates of use related to sociodemographic variables, health behaviors, and sexual function. A nationally representative sample of 3,800 women aged 18-60 years were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated. The prevalence of vibrator use, the relationship between vibrator use and physical and psychological well-being (as assessed by the Centers for Disease Control and Prevention [CDC] Healthy Days measure) and health-promoting behaviors, the relationship between vibrator use and women's scores on the Female Sexual Function Index, and an assessment of the frequency and severity of side effects potentially associated with vibrator use. The prevalence of women's vibrator use was found to be 52.5% (95% CI 50.3-54.7%). Vibrator users were significantly more likely to have had a gynecologic exam during the past year (P health-promoting behaviors and positive sexual function, and rarely associated with side effects. Clinicians may find these data useful in responding to patients' sexual issues and recommending vibrator use to improve sexual function. Further research on the relationships between vibrator use and sexual health is warranted.

  13. The Impact of Nutrition and Health Claims on Consumer Perceptions and Portion Size Selection: Results from a Nationally Representative Survey

    Directory of Open Access Journals (Sweden)

    Tony Benson

    2018-05-01

    Full Text Available Nutrition and health claims on foods can help consumers make healthier food choices. However, claims may have a ‘halo’ effect, influencing consumer perceptions of foods and increasing consumption. Evidence for these effects are typically demonstrated in experiments with small samples, limiting generalisability. The current study aimed to overcome this limitation through the use of a nationally representative survey. In a cross-sectional survey of 1039 adults across the island of Ireland, respondents were presented with three different claims (nutrition claim = “Low in fat”; health claim = “With plant sterols. Proven to lower cholesterol”; satiety claim = “Fuller for longer” on four different foods (cereal, soup, lasagne, and yoghurt. Participants answered questions on perceived healthiness, tastiness, and fillingness of the products with different claims and also selected a portion size they would consume. Claims influenced fillingness perceptions of some of the foods. However, there was little influence of claims on tastiness or healthiness perceptions or the portion size selected. Psychological factors such as consumers’ familiarity with foods carrying claims and belief in the claims were the most consistent predictors of perceptions and portion size selection. Future research should identify additional consumer factors that may moderate the relationships between claims, perceptions, and consumption.

  14. Gender differences in the associations of gambling activities and suicidal behaviors with problem gambling in a nationally representative French sample.

    Science.gov (United States)

    Husky, Mathilde M; Michel, Grégory; Richard, Jean-Baptiste; Guignard, Romain; Beck, François

    2015-06-01

    The objectives of the present study are to describe gender differences in factors associated with moderate risk and problem gambling. Data were extracted from the 2010 Health Barometer, a large survey on a representative sample of the general population aged 15-85 years living in France (n=27,653), carried out by the National Institute for Health Promotion and Health Education. Data were collected between October 2009 and July 2010. A computer-assisted telephone interview system was used. The findings indicate that men are three times more likely to experience problems with gambling. Men and women have different patterns of gambling activities. Men were more involved with Rapido, internet gambling, sports and racetrack betting, poker, and casino tables, whereas women gambled more often on scratch games. Both men and women engaging in immediate reward games were significantly more likely to experience difficulties with gambling. This association, however, was stronger in women. Furthermore, suicidal ideation and behaviors were more likely to be associated with gambling problems in women as compared to men. The study underscores the importance of considering gender-related differences in the study of gambling behaviors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Frequency of Aggressive Behaviors in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study.

    Science.gov (United States)

    Sadinejad, Morteza; Bahreynian, Maryam; Motlagh, Mohammad-Esmaeil; Qorbani, Mostafa; Movahhed, Mohsen; Ardalan, Gelayol; Heshmat, Ramin; Kelishadi, Roya

    2015-01-01

    This study aims to explore the frequency of aggressive behaviors among a nationally representative sample of Iranian children and adolescents. This nationwide study was performed on a multi-stage sample of 6-18 years students, living in 30 provinces in Iran. Students were asked to confidentially report the frequency of aggressive behaviors including physical fighting, bullying and being bullied in the previous 12 months, using the questionnaire of the World Health Organization Global School Health Survey. In this cross-sectional study, 13,486 students completed the study (90.6% participation rate); they consisted of 49.2% girls and 75.6% urban residents. The mean age of participants was 12.47 years (95% confidence interval: 12.29, 12.65). In total, physical fight was more prevalent among boys than girls (48% vs. 31%, P bulling to other classmates had a higher frequency among boys compared to girls (29% vs. 25%, P bulling to others). Physical fighting was more prevalent among rural residents (40% vs. 39%, respectively, P = 0.61), while being bullied was more common among urban students (27% vs. 26%, respectively, P = 0.69). Although in this study the frequency of aggressive behaviors was lower than many other populations, still these findings emphasize on the importance of designing preventive interventions that target the students, especially in early adolescence, and to increase their awareness toward aggressive behaviors. Implications for future research and aggression prevention programming are recommended.

  16. Social inequalities and mortality in Europe--results from a large multi-national cohort.

    Directory of Open Access Journals (Sweden)

    Valentina Gallo

    Full Text Available Socio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans.A total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES. Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII was calculated as measure of relative inequality.Total mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52-0.61; among women by 29% (HR 0.71, 95% C.I. 0.64-0.78. The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake (3% in men and 5% in women. Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries.In this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported.

  17. National, regional and global mortality due to alcoholic cardiomyopathy in 2015.

    Science.gov (United States)

    Manthey, Jakob; Probst, Charlotte; Rylett, Margaret; Rehm, Jürgen

    2018-03-13

    (1) A comprehensive mortality assessment of alcoholic cardiomyopathy (ACM) and (2) examination of under-reporting using vital statistics data. A modelling study estimated sex-specific mortality rates for each country, which were subsequently aggregated by region and globally. Input data on ACM mortality were obtained from death registries for n=91 countries. For n=99 countries, mortality estimates were predicted using aggregate alcohol data from WHO publications. Descriptive additional analyses illustrated the scope of under-reporting. In 2015, there were an estimated 25 997 (95% CI 17 385 to 49 096) global deaths from ACM. This translates into 6.3% (95% CI 4.2% to 11.9%) of all global deaths from cardiomyopathy being caused by alcohol. There were large regional variations with regard to mortality burden. While the majority of ACM deaths were found in Russia (19 749 deaths, 76.0% of all ACM deaths), for about one-third of countries (n=57) less than one ACM death was found. Under-reporting was identified for nearly every second country with civil registration data. Overall, two out of three global ACM deaths might be misclassified. The variation of ACM mortality burden is greater than for other alcohol-attributable diseases, and partly may be the result of stigma and lack of detection. Misclassification of ACM fatalities is a systematic phenomenon, which may be caused by low resources, lacking standards and stigma associated with alcohol-use disorders. Clinical management may be improved by including routine alcohol assessments. This could contribute to decrease misclassifications and to provide the best available treatment for affected patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. One-Year Readmission Risk and Mortality after Hip Fracture Surgery: A National Population-Based Study in Taiwan.

    Science.gov (United States)

    Lee, Tien-Ching; Ho, Pei-Shan; Lin, Hui-Tzu; Ho, Mei-Ling; Huang, Hsuan-Ti; Chang, Je-Ken

    2017-07-01

    Early readmission following hip fracture (HFx) is associated with high morbidity and mortality. We conducted a survival analysis of patients with readmission within 1 year after HFx to elucidate the trend and predictors for readmission. We used Taiwan National Health Insurance Database to recruit HFx patients who underwent operations between 2000 and 2009. Patients readmission. 5,442 subjects (61.2% female) met the criteria with mean age of 78.8 years. Approximately 15% and 43% HFx patients were readmitted within 30 days (early) and between 30 days and 1 year (late) after discharge, respectively. Highest readmission incidence was observed within the first 30 days. Most common causes of readmission in early and late groups were respiratory system diseases and injuries, respectively. Cox model showed male, old age, hospital stay > 9 days, Charlson Comorbidity Index ≥ 1, index admission during 2000-2003, and internal fixation of HFx were independent predictors of readmission. One-year mortality of the early and the late readmission groups was 44.9% and 32.3%, much higher than overall mortality which was 16.8%. Predictive factors for readmission within 1 year included male, old age, comorbidities, and longer hospital stay. One-year mortality in readmitted patients was significantly higher. HFx patients with these factors need careful follow-up, especially within 30 days after discharge.

  19. Diametric and status structure, mortality and recruitment of Juglans jamaicensis C. DC., in the Turquino National Park

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    José Luis Rodríguez Sosa

    2015-06-01

    Full Text Available The work was done in the Turquino National Park in order to analyze the diametric structure, mortality and recruitment of Juglans jamaicensis C. DC., for the diagnosis of its condition. The diametric structure from 5 cm width classes and the taxon state structure was characterized. Dynamics of the species through the registration of all individuals for three consecutive years (2011-2013 was evaluated, and parameters determining the average annual death rate, annual rate of change and the finite rate of natural increase. In addition, the relationship between seedling abundance and exposure to light through a correspondence analysis was determined. It was found that Juglans jamaicensis presents an irregular diametric structure denoting a good reproduction and recruitment failure of its groups of trees in the forest, suggesting some imbalance between mortality and recruitment. The growth and retention of individuals are the parameters that have the greatest influence in maintaining Juglans jamaicensis in the forest since the rate indicators mean annual mortality rate of population change and finite natural growth rate reflect high mortality seedling stage as more vulnerable life cycle of the species phase, indicating a recruitment and population stability is not favorable. Tolerance of seedlings of Juglans jamaicensis in the first two years of life was confirmed.

  20. The relationship of walking intensity to total and cause-specific mortality. Results from the National Walkers' Health Study.

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    Paul T Williams

    Full Text Available PURPOSE: Test whether: 1 walking intensity predicts mortality when adjusted for walking energy expenditure, and 2 slow walking pace (≥24-minute mile identifies subjects at substantially elevated risk for mortality. METHODS: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. RESULTS: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10(-5, cardiovascular diseases (2.4% increase, P=0.001, 637 deaths, ischemic heart disease (2.8% increase, P=0.003, 336 deaths, heart failure (6.5% increase, P=0.001, 36 deaths, hypertensive heart disease (6.2% increase, P=0.01, 31 deaths, diabetes (6.3% increase, P=0.004, 32 deaths, and dementia (6.6% increase, P=0.0004, 44 deaths. Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001, cardiovascular diseases (43.9% increased risk, P=0.03, and dementia (5.0-fold increased risk, P=0.0002 even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET-hours per week. CONCLUSIONS: The risk for mortality: 1 decreases in association with walking intensity, and 2 increases substantially in association for walking pace ≥24 minute mile (equivalent to <400 m during a six-minute walk test even among subjects who exercise regularly.

  1. Linking social capital and mortality in the elderly: a Swedish national cohort study.

    Science.gov (United States)

    Sundquist, Kristina; Hamano, Tsuyoshi; Li, Xinjun; Kawakami, Naomi; Shiwaku, Kuninori; Sundquist, Jan

    2014-07-01

    Our objective was to examine the association between neighborhood linking social capital (a concept describing the amount of trust between individuals and societal institutions) and all-cause and cause-specific mortality in the elderly. The entire Swedish population aged 65+, a total of 1,517,336 men and women, was followed from 1 January 2002 until death, emigration, or the end of the study on 31 December 2010. Small geographic units were used to define neighborhoods. The definition of linking social capital was based on neighborhood voting participation rates, categorized into three groups. Multilevel logistic regression was used to estimate odds ratios (ORs) and between-neighborhood variance in three different models. The results showed an overall association between linking social capital and all-cause mortality. The significant OR of 1.53 in the group with low linking social capital decreased, but remained significant (OR=1.27), after accounting for age, sex, family income, marital status, country of birth, education level, and region of residence. There were also significant associations between linking social capital and cause-specific mortality in coronary heart disease, psychiatric disorders, cancer, stroke, chronic lower respiratory diseases, type 2 diabetes, and suicide. There are associations between low linking social capital and mortality from chronic disorders and suicide in the elderly population. Community support for elderly people living in neighborhoods with low levels of linking social capital may need to be strengthened. Copyright © 2014 Elsevier Inc. All rights reserved.

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

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    Johan Fritzell

    2013-01-01

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

  3. LBA-ECO TG-07 Soil Trace Gas Flux and Root Mortality, Tapajos National Forest

    Science.gov (United States)

    R.K. Varner; M.M. Keller

    2009-01-01

    This data set reports the results of an experiment that tested the short-term effects of root mortality on the soil-atmosphere fluxes of nitrous oxide, nitric oxide, methane, and carbon dioxide in a tropical evergreen forest. Weekly trace gas fluxes are provided for treatment and control plots on sand and clay tropical forest soils in two comma separated ASCII files....

  4. Maternal mortality at muhimbili national hospital in Dar-es-Salaam, Tanzania in the year 2011

    NARCIS (Netherlands)

    Pembe, A.B.; Paulo, C.; D'mello, B.S.; van Roosmalen, J.

    2014-01-01

    Background: Improving maternal health is one of the eight millennium development goals adopted at the millennium summit in the year 2000. Within this frame work, the international community is committed to reduce the maternal mortality ratio by 75% between 1990 and 2015. The objective of this study

  5. US National Trends in Mortality From Acute Myocardial Infarction and Heart Failure: Policy Success or Failure?

    Science.gov (United States)

    Chatterjee, Paula; Joynt Maddox, Karen E

    2018-03-14

    Hospitals in the United States have been subject to mandatory public reporting of mortality rates for acute myocardial infarction (AMI) and heart failure (HF) since 2007 and to value-based payment programs for these conditions since 2011. However, whether hospitals with initially poor baseline performance have improved relative to other hospitals under these programs, and whether patterns of improvement differ by condition, is unknown. Understanding trends within public reporting and value-based payment can inform future efforts in these areas. To examine patterns in 30-day mortality from AMI and HF and determine whether they differ for baseline poor performers (worst quartile in 2009 and 2010 in public reporting, prior to value-based payment) compared with other hospitals. Retrospective cross-sectional study at US acute care hospitals from 2009 to 2015 that included 2751 and 3796 hospitals with publicly reported mortality data for AMI and HF, respectively. Public reporting and value-based purchasing. Hospital-level risk-adjusted 30-day mortality rates. We identified 422 and 600 baseline poor-performing hospitals for AMI and HF, respectively. Baseline poor performers for AMI were more often public and for-profit and less often teaching hospitals. Baseline poor performers for HF were less often large hospitals. For AMI, 30-day mortality among baseline poor performers was higher at baseline but improved more over time compared with other hospitals (18.6% in 2009 to 14.6% in 2015; -0.74% per year; P < .001 vs 15.7% in 2009 to 14.0% in 2015; -0.26% per year; P < .001; P for interaction <.001). In contrast, for HF, baseline poor performers improved over time (13.5%-13.0%; -0.12% per year; P < .001), but mean mortality among all other HF hospitals increased during the study period (10.9%-12.0%; 0.17% per year; P < .001; P for interaction, <.001). Despite being subject to identical policy pressures, mortality trends for AMI and HF differed markedly between

  6. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

    OpenAIRE

    GBD Maternal Mortality Collaborators

    2016-01-01

    BACKGROUND: In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. METHODS: We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages ...

  7. The associations between US state and local social spending, income inequality, and individual all-cause and cause-specific mortality: The National Longitudinal Mortality Study.

    Science.gov (United States)

    Kim, Daniel

    2016-03-01

    To investigate government state and local spending on public goods and income inequality as predictors of the risks of dying. Data on 431,637 adults aged 30-74 and 375,354 adults aged 20-44 in the 48 contiguous US states were used from the National Longitudinal Mortality Study to estimate the impacts of state and local spending and income inequality on individual risks of all-cause and cause-specific mortality for leading causes of death in younger and middle-aged adults and older adults. To reduce bias, models incorporated state fixed effects and instrumental variables. Each additional $250 per capita per year spent on welfare predicted a 3-percentage point (-0.031, 95% CI: -0.059, -0.0027) lower probability of dying from any cause. Each additional $250 per capita spent on welfare and education predicted 1.6-percentage point (-0.016, 95% CI: -0.031, -0.0011) and 0.8-percentage point (-0.008, 95% CI: -0.0156, -0.00024) lower probabilities of dying from coronary heart disease (CHD), respectively. No associations were found for colon cancer or chronic obstructive pulmonary disease; for diabetes, external injury, and suicide, estimates were inverse but modest in magnitude. A 0.1 higher Gini coefficient (higher income inequality) predicted 1-percentage point (0.010, 95% CI: 0.0026, 0.0180) and 0.2-percentage point (0.002, 95% CI: 0.001, 0.002) higher probabilities of dying from CHD and suicide, respectively. Empirical linkages were identified between state-level spending on welfare and education and lower individual risks of dying, particularly from CHD and all causes combined. State-level income inequality predicted higher risks of dying from CHD and suicide. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

  8. Morbidity and mortality in children with obstructive sleep apnoea: a controlled national study.

    Science.gov (United States)

    Jennum, Poul; Ibsen, Rikke; Kjellberg, Jakob

    2013-10-01

    Little is known about the diagnostic patterns of obstructive sleep apnoea (OSA) in children. A study was undertaken to evaluate morbidity and mortality in childhood OSA. 2998 patients aged 0-19 years with a diagnosis of OSA were identified from the Danish National Patient Registry. For each patient we randomly selected four citizens matched for age, sex and socioeconomic status, thus providing 11 974 controls. Patients with OSA had greater morbidity at least 3 years before their diagnosis. The most common contacts with the health system arose from infections (OR 1.19, 95% CI 1.01 to 1.40); endocrine, nutritional and metabolic diseases (OR 1.30, 95% CI 0.94 to 1.80); nervous conditions (OR 2.12, 95% CI 1.65 to 2.73); eye conditions (OR 1.43, 95% CI 1.07 to 1.90); ear, nose and throat (ENT) diseases (OR 1.61, 95% CI 1.33 to 1.94); respiratory system diseases (OR 1.78, 95% CI 1.60 to 1.98); gastrointestinal diseases (OR 1.34, 95% CI 1.09 to 1.66); skin conditions (OR 1.32, 95% CI 1.02 to 1.71); congenital malformations (OR 1.56, 95% CI 1.31 to 1.85); abnormal clinical or laboratory findings (OR 1.21, 95% CI 1.06 to 1.39); and other factors influencing health status (OR 1.29, 95% CI 1.16 to 1.43). After diagnosis, OSA was associated with incidences of endocrine, nutritional and metabolic diseases (OR 1.78, 95% CI 1.29 to 2.45), nervous conditions (OR 3.16, 95% CI 2.58 to 3.89), ENT diseases (OR 1.45, 95% CI 1.14 to 1.84), respiratory system diseases (OR 1.94, 95% CI 1.70 to 2.22), skin conditions (OR 1.42, 95% CI 1.06 to 1.89), musculoskeletal diseases (OR 1.29, 95% CI 1.01 to 1.64), congenital malformations (OR 1.83, 95% CI 1.51 to 2.22), abnormal clinical or laboratory findings (OR 1.16, 95% CI 1.06 to 1.27) and other factors influencing health status (OR 1.35, 95% CI 1.20 to 1.51). The 5-year death rate was 70 per 10 000 for patients and 11 per 10 000 for controls. The HR for cases compared with controls was 6.58 (95% CI 3.39 to 12.79; p<0.001). Children with OSA

  9. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece.

    Science.gov (United States)

    Skapinakis, Petros; Bellos, Stefanos; Koupidis, Sotirios; Grammatikopoulos, Ilias; Theodorakis, Pavlos N; Mavreas, Venetsanos

    2013-06-04

    No study in Greece has assessed so far the full range of common mental disorders using a representative sample of the population from both mainland and insular regions of the country. The aim of the present paper was to present the results of the first such study. The study was carried out between 2009-2010 in a nationally representative sample of 4894 individuals living in private households in Greece. Common mental disorders in the past week were assessed with the revised Clinical Interview Schedule (CIS-R). We also assessed alcohol use disorders (using AUDIT), smoking and cannabis use. 14% of the population (Male: 11%, Female: 17%) was found to have clinically significant psychiatric morbidity according to the scores on the CIS-R. The prevalence (past seven days) of specific common mental disorders was as follows: Generalized Anxiety Disorder: 4.10% (95% CI: 3.54, 4.65); Depression: 2.90% (2.43, 3.37); Panic Disorder: 1.88% (1.50, 2.26); Obsessive-Compulsive Disorder: 1.69% (1.33, 2.05); All Phobias: 2.79% (2.33, 3.26); Mixed anxiety-depression: 2.67% (2.22, 3.12). Harmful alcohol use was reported by 12.69% of the population (11.75, 13.62). Regular smoking was reported by 39.60% of the population (38.22, 40.97) while cannabis use (at least once during the past month) by 2.06% (1.66, 2.46). Clinically significant psychiatric morbidity was positively associated with the following variables: female gender, divorced or widowed family status, low educational status and unemployment. Use of all substances was more common in men compared to women. Common mental disorders were often comorbid, undertreated, and associated with a lower quality of life. The findings of the present study can help in the better planning and development of mental health services in Greece, especially in a time of mental health budget restrictions.

  10. Sexual violence against children in South Africa: a nationally representative cross-sectional study of prevalence and correlates.

    Science.gov (United States)

    Ward, Catherine L; Artz, Lillian; Leoschut, Lezanne; Kassanjee, Reshma; Burton, Patrick

    2018-04-01

    We aimed to complete a nationally representative study of sexual violence against children in South Africa, and its correlates, since we could identify no other such study. For this nationally representative, cross-sectional study in South Africa, households were selected by use of a multistage sampling frame, stratified by province, urban or rural setting, and race group, and schools were selected on the basis that they were closest to the area in which households were selected. Interviews and self-administered questionnaires in each location inquired into lifetime and last-year prevalence of sexual abuse, and its correlates among children aged 15-17 years, whose parents gave informed consent and they themselves gave informed assent. The final household sample was 5631 (94·6% participation rate). 9·99% (95% CI 8·65-11·47) of boys and 14·61% (95% CI 12·83-16·56) of girls reported some lifetime sexual victimisation. Physical abuse, emotional abuse, neglect, family violence, and other victimisations were all strongly associated with sexual victimisation. The following were associated with greater risk of sexual abuse (adjusted odds ratio [OR]); school enrolment (OR 2·12, 95% CI 1·29-3·48); rural dwelling (0·59; 0·43-0·80); having a flush toilet (1·43, 1·04-1·96); parental substance misuse (2·37, 1·67-3·36); being disabled (1·42, 1·10-1·82); female (but not male) caregivers' poor knowledge of the child's whereabouts, friends, and activities (1·07, 0·75-1·53) and poor quality of the relationship with the child (ie, poor acceptance; 1·20, 0·55-2·60). The child's own substance misuse (4·72, 3·73-5·98) and high-risk sexual behaviour (3·71, 2·99-4·61) were the behaviours most frequently associated with sexual abuse, with mental health conditions found to be less prevalent than these factors but still strongly associated with sexual victimisation (post-traumatic stress disorder 2·81, 1·65-4·78; depression 3·43, 2·26-5·19; anxiety 2

  11. Predictors of all-cause mortality among 514,866 participants from the Korean National Health Screening Cohort.

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    Choonghyun Ahn

    Full Text Available There is not enough evidence regarding how information obtained from general health check-ups can predict individual mortality based on long-term follow-ups and large sample sizes. This study evaluated the applicability of various health information and measurements, consisting of self-reported data, anthropometric measurements and laboratory test results, in predicting individual mortality.The National Health Screening Cohort included 514,866 participants (aged 40-79 years who were randomly selected from the overall database of the national health screening program in 2002-2003. Death was determined from causes of death statistics provided by Statistics Korea. We assessed variables that were collected at baseline and repeatedly measured for two consecutive years using traditional and time-variant Cox proportional hazards models in addition to random forest and boosting algorithms to identify predictors of 10-year all-cause mortality. Participants' age at enrollment, lifestyle factors, anthropometric measurements and laboratory test results were included in the prediction models. We used c-statistics to assess the discriminatory ability of the models, their external validity and the ratio of expected to observed numbers to evaluate model calibration. Eligibility of Medicaid and household income levels were used as inequality indexes.After the follow-up by 2013, 38,031 deaths were identified. The risk score based on the selected health information and measurements achieved a higher discriminatory ability for mortality prediction (c-statistics = 0.832, 0.841, 0.893, and 0.712 for Cox model, time-variant Cox model, random forest and boosting, respectively than that of the previous studies. The results were externally validated using the community-based cohort data (c-statistics = 0.814.Individuals' health information and measurements based on health screening can provide early indicators of their 10-year death risk, which can be useful for health

  12. Mortality and causes of death in a national sample of type 2 diabetic patients in Korea from 2002 to 2013.

    Science.gov (United States)

    Kang, Yu Mi; Kim, Ye-Jee; Park, Joong-Yeol; Lee, Woo Je; Jung, Chang Hee

    2016-09-13

    We aimed to investigate the mortality rate (MR), causes of death and standardized mortality ratio (SMR) in Korean type 2 diabetic patients from 2002 to 2013 using data from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC). From this NHIS-NSC, we identified 29,807 type 2 diabetic subjects from 2002 to 2004. Type 2 diabetes was defined as a current medication history of anti-diabetic drugs and the presence of International Classification of Diseases (ICD)-10 codes (E11-E14) as diagnosis. Specific causes of death were recorded according to ICD-10 codes as the following: diabetes, malignant neoplasm, disease of the circulatory system, and other causes. A total of 7103 (23.8 %) deaths were recorded. The MR tended to increase with age. In particular, the ratio of MR for men versus women was the highest in their 40s-50s. The overall SMR was 2.32 and the SMRs attenuated with increasing age. The causes of death ascribed to diabetes, malignant neoplasm, ischemic heart disease, cerebrovascular disease, and other causes were 22.0, 24.8, 6.2, 11.2 and 31.3 %, respectively. The SMRs according to each cause of death were 9.73, 1.76, 2.60, 2.04 and 1.89, respectively. The MRs among type 2 diabetic subjects increased with age, and diabetic men exhibited a higher mortality risk than diabetic women in Korea. Subjects with type 2 diabetes exhibited an excess mortality when compared with the general population. Approximately 78.0 % of the diabetes-related deaths was not ascribed to diabetes, and malignant neoplasm was the most common cause of death among those not recorded as diabetes.

  13. Determinants of child stunting in the Royal Kingdom of Bhutan: an in-depth analysis of nationally representative data

    Science.gov (United States)

    Aguayo, Victor M; Badgaiyan, Nina; Paintal, Kajali

    2015-01-01

    Stunting is associated with poor survival and development in children. Our analysis identifies the factors most significantly associated with child stunting in Bhutan using a nationally representative sample of 2085 children 0–23 months old. We find that 27.5% of children were stunted and almost half (42.6%) of the stunted children were severely stunted. Children's mean height-for-age z-score deteriorated significantly with age (from −0.23 in infants 0–5 months old to −1.60 in children 18–23 months old) and levels of severe stunting were significantly higher among boys. Multivariate regression analysis indicates that children from the Eastern/Western regions had a 64% higher odds of being stunted than children from the Central region (OR 1.64; 95% CI 1.29–2.07); similarly, children from the two lower wealth quintiles had 37% higher odds of being stunted than children from the two upper wealth quintiles (OR 1.37; 95% CI 1.00–1.87). Children whose mothers received three or fewer antenatal care visits during the last pregnancy had a 31% higher odds of being stunted (OR 1.31; 95% CI 1.01–1.69) while children whose mothers did not receive antenatal care from a doctor, nurse or midwife had a 51% higher odds of being stunted (OR 1.51; 95% CI 1.18–1.92). Recommended complementary feeding practices tended to be associated with lower odds of stunting, particularly in the first year of life. Specifically, children who were not fed complementary foods at 6–8 months had about threefold higher odds of being severely stunted than children who were fed complementary foods (OR 2.73; 95% CI 1.06–7.02). PMID:25536283

  14. Association between childhood adversities and adulthood depressive symptoms in South Korea: results from a nationally representative longitudinal study.

    Science.gov (United States)

    Kim, Seung-Sup; Jang, Hyobum; Chang, Hyoung Yoon; Park, Young Su; Lee, Dong-Woo

    2013-01-01

    To examine how childhood adversity (ie, parental death, parental divorce, suspension of school education due to financial strain or being raised in a relative's house due to financial strain) is associated with prevalence and incidence of adulthood depressive symptoms and whether this association differs by gender and by age in South Korea. Prospective cohort design. Nationally representative longitudinal survey in South Korea. 11 526 participants in South Korea. Prevalence and incidence of adulthood depressive symptoms were assessed as a dichotomous variable using the Centers for Epidemiologic Studies Depression (CES-D) Scale in 2006 and 2007. In the prevalence analysis, each of the four childhood adversities was significantly associated with a higher prevalence of adulthood depressive symptoms. The higher incidence of depressive symptoms was associated with suspension of school education (OR 1.55, 95% CI 1.32 to 1.82) and parental divorce (OR 1.65, 95% CI 1.00 to 2.71). In the age-stratified analyses, prevalence of depressive symptoms was associated with all CAs across different adulthoods, except for parental divorce and late adulthood depressive symptoms. After being stratified by gender, the association was significant for parental divorce (OR 3.76, 95% CI 2.34 to 6.03) in the prevalence analysis and for being raised in a relative's house (OR 1.89, 95% CI 1.21 to 2.94) in the incidence analysis only among women. This study suggests that childhood adversity may increase prevalence and incidence of adulthood depressive symptoms, and the impact of parental divorce or being raised in a relative's house due to financial strain on adulthood depressive symptoms may differ by gender.

  15. Educational inequalities in smoking among Japanese adults aged 25–94 years: Nationally representative sex- and age-specific statistics

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    Takahiro Tabuchi

    2017-04-01

    Full Text Available Background: Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25–94 years. Methods: Using a large nationally representative sample (167,925 men and 186,588 women in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Results: Among men aged 25–34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%–70.6%, and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%–21.9%. High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%–56.8% in men aged 25–34 years. Among men aged 75–94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25–34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%–52.3%, and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%–7.4%. Compared with older age groups, such as 65–94 years, younger age groups, such as 25–54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Conclusions: Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults.

  16. Subjective measures of household resilience to climate variability and change: insights from a nationally representative survey of Tanzania

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    Lindsey Jones

    2018-03-01

    Full Text Available Promoting household resilience to climate extremes has emerged as a key development priority. Yet tracking and evaluating resilience at this level remains a critical challenge. Most quantitative approaches rely on objective indicators and assessment frameworks, but these are not fully satisfactory. Much of the difficulty arises from a combination of conceptual ambiguities, challenges in selecting appropriate indicators, and in measuring the many intangible aspects that contribute to household resilience. More recently, subjective measures of resilience have been advocated in helping to overcome some of the limitations of traditional objective characterizations. However, few large-scale studies of quantitative subjective approaches to resilience measurement have been conducted. In this study, we address this gap by exploring perceived levels of household resilience to climate extremes in Tanzania and the utility of standardized subjective methods for its assessment. A nationally representative cross-sectional survey involving 1294 individuals was carried out by mobile phone in June 2015 among randomly selected adult respondents aged 18 and above. Factors that are most associated with resilience-related capacities are having had advance knowledge of a previous flood, and to a lesser extent, believing flooding to be a serious community problem. Somewhat surprisingly, though a small number of weak relationships are apparent, most socio-demographic variables do not exhibit statistically significant differences with regards to perceived resilience-related capacities. These findings may challenge traditional assumptions about what factors characterize household resilience, offering a motivation for studying both subjective and objective perspectives, and understanding better their relationship to one another. If further validated, subjective measures may offer potential as both a complement and alternative to traditional objective methods of resilience

  17. Premenstrual dysphoric disorder as a correlate of suicidal ideation, plans, and attempts among a nationally representative sample.

    Science.gov (United States)

    Pilver, Corey E; Libby, Daniel J; Hoff, Rani A

    2013-03-01

    Suicide is a major public health concern and a leading cause of death in the United States. Psychopathology is an established risk factor for non-fatal suicidal behavior; however, it is unclear whether premenstrual dysphoric disorder (PMDD), a psychiatric disorder specific to women, is correlated with these outcomes. The objective of this study was to determine if PMDD status was associated with suicidal ideation, plans, and attempts, independent of socio-demographic factors and psychiatric comorbidity. We conducted a secondary data analysis of 3,965 American women aged 18-40 who participated in the Collaborative Psychiatric Epidemiology Survey. Descriptive statistics and forward stepwise logistic regression modeling were performed using SUDAAN software. The prevalence of non-fatal suicidal behaviors increased in a graded fashion according to PMDD status. Although the control for demographic characteristics and psychiatric comorbidity greatly attenuated the unadjusted association between PMDD and suicidal behaviors, women with PMDD remained significantly more likely than women with no premenstrual symptoms to report suicidal ideation (OR 2.22; 95% CI 1.40-3.53), plans (OR 2.27; 95% CI 1.20-4.28), and attempts (OR 2.10; 95% CI 1.08-4.08). Only the likelihood of suicidal ideation was significantly elevated among women with moderate/severe premenstrual syndrome (PMS; OR 1.49; 95% CI 1.17-1.88), compared to women with no premenstrual symptoms. PMDD was strongly and independently associated with non-fatal suicidal behaviors among a nationally representative sample. These findings suggest that clinicians treating women with PMDD should assess and be vigilant for signs of non-fatal suicidal behavior, and that clinicians should evaluate and treat the premenstrual symptoms of women who express these behaviors.

  18. The association between hypertension and depression and anxiety disorders: results from a nationally-representative sample of South African adults.

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    Anna Grimsrud

    Full Text Available Growing evidence suggests high levels of comorbidity between hypertension and mental illness but there are few data from low- and middle-income countries. We examined the association between hypertension and depression and anxiety in South Africa.Data come from a nationally-representative survey of adults (n = 4351. The Composite International Diagnostic Interview was used to measure DSM-IV mental disorders during the previous 12-months. The relationships between self-reported hypertension and anxiety disorders, depressive disorders and comorbid anxiety-depression were assessed after adjustment for participant characteristics including experience of trauma and other chronic physical conditions.Overall 16.7% reported a previous medical diagnosis of hypertension, and 8.1% and 4.9% were found to have a 12-month anxiety or depressive disorder, respectively. In adjusted analyses, hypertension diagnosis was associated with 12-month anxiety disorders [Odds ratio (OR = 1.55, 95% Confidence interval (CI = 1.10-2.18] but not 12-month depressive disorders or 12-month comorbid anxiety-depression. Hypertension in the absence of other chronic physical conditions was not associated with any of the 12-month mental health outcomes (p-values all <0.05, while being diagnosed with both hypertension and another chronic physical condition were associated with 12-month anxiety disorders (OR = 2.25, 95% CI = 1.46-3.45, but not 12-month depressive disorders or comorbid anxiety-depression.These are the first population-based estimates to demonstrate an association between hypertension and mental disorders in sub-Saharan Africa. Further investigation is needed into role of traumatic life events in the aetiology of hypertension as well as the temporality of the association between hypertension and mental disorders.

  19. Mental health problems and their association to violence and maltreatment in a nationally representative sample of Tanzanian secondary school students.

    Science.gov (United States)

    Nkuba, Mabula; Hermenau, Katharin; Goessmann, Katharina; Hecker, Tobias

    2018-04-12

    Little is known about the prevalence of mental health problems among adolescents in Sub-Saharan Africa. Research consistently determined violence and maltreatment to be important risk factors. In this study, we examined the prevalence of mental health problems among adolescents in Tanzania, as well as the association with exposure to violence and maltreatment. We administered a set of questionnaires (e.g., strength and difficulties questionnaire; conflict tactic scale) to a nationally representative sample of 700 Tanzanian secondary school children (52% girls; age 14.92 years, SD = 1.02) and 333 parents or primary caregivers (53% females; age 43.47 years, SD = 9.02). 41% of the students reported an elevated level of mental health problems (emotional problems 40%, peer problems 63%, conduct problems 45%, hyperactivity 17%) in the past 6 months. Concordantly, 31% of parents reported observing an elevated level of mental health problems in their children (emotional problems 37%, peer problems 54%, conduct problems 35%, hyperactivity 17%). After controlling for other risk factors, we found significant associations between physical violence by parents and adolescent's mental health problems reported by students (β = 0.15) and their parents (β = 0.33). Our findings suggest a high prevalence of mental health problems using screening tools among secondary school students in Tanzania as well as an association between physical violence by parents and adolescents' mental health problems. Our findings emphasize the need to inform the population at large about the potentially adverse consequences associated with violence against children and adolescents.

  20. Livestock ownership and microbial contamination of drinking-water: Evidence from nationally representative household surveys in Ghana, Nepal and Bangladesh.

    Science.gov (United States)

    Wardrop, Nicola A; Hill, Allan G; Dzodzomenyo, Mawuli; Aryeetey, Genevieve; Wright, Jim A

    2018-01-01

    Current priorities for diarrhoeal disease prevention include use of sanitation and safe water. There have been few attempts to quantify the importance of animal faeces in drinking-water contamination, despite the presence of potentially water-borne zoonotic pathogens in animal faeces. This study aimed to quantify the relationship between livestock ownership and point-of-consumption drinking-water contamination. Data from nationally representative household surveys in Nepal, Bangladesh, and Ghana, each with associated water quality assessments, were used. Multinomial regression adjusting for confounders was applied to assess the relationship between livestock ownership and the level of drinking-water contamination with E. coli. Ownership of five or more large livestock (e.g. cattle) was significantly associated with drinking-water contamination in Ghana (RRR=7.9, 95% CI=1.6 to 38.9 for medium levels of contamination with 1-31cfu/100ml; RRR=5.2, 95% CI=1.1-24.5 for high levels of contamination with >31cfu/100ml) and Bangladesh (RRR=2.4, 95% CI=1.3-4.5 for medium levels of contamination; non-significant for high levels of contamination). Ownership of eight or more poultry (chickens, guinea fowl, ducks or turkeys) was associated with drinking-water contamination in Bangladesh (RRR=1.5, 95% CI=1.1-2.0 for medium levels of contamination, non-significant for high levels of contamination). These results suggest that livestock ownership is a significant risk factor for the contamination of drinking-water at the point of consumption. This indicates that addressing human sanitation without consideration of faecal contamination from livestock sources will not be sufficient to prevent drinking-water contamination. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

  1. Social Media Use Before Bed and Sleep Disturbance Among Young Adults in the United States: A Nationally Representative Study.

    Science.gov (United States)

    Levenson, Jessica C; Shensa, Ariel; Sidani, Jaime E; Colditz, Jason B; Primack, Brian A

    2017-09-01

    Social media (SM) use has been positively associated with disturbed sleep among young adults. However, previous studies have not elucidated the specific importance of SM use immediately before bed. We aimed to determine the independent association of SM use during the 30 minutes before bed and disturbed sleep while controlling for covariates including total SM use throughout the day. We assessed a nationally representative sample of 1763 US young adults aged 19-32. Participants estimated to what extent they used SM in the 30 minutes before bed. We assessed sleep disturbance using the brief Patient-Reported Outcomes Measurement Information System (PROMIS®) Sleep Disturbance measure. After testing the proportional odds assumption, we used ordered logistic regression to compute the independent association between SM use before bed and sleep disturbance controlling for covariates, including total SM use. Compared with those who rarely or very rarely check SM in the 30 minutes before bed, those who often or very often check SM at that time had an adjusted odds ratio of 1.62 (95% confidence interval = 1.31-2.34) for increased sleep disturbance. Additionally, we found a significant linear trend in the odds ratios between the frequency of checking SM in the 30 minutes before bed and increased sleep disturbance (p = .007). Results were consistent in all sensitivity analyses. SM use in the 30 minutes before bed is independently associated with disturbed sleep among young adults. Future work should use qualitative and experimental methods to further elucidate the directionality of-and mechanisms underlying-this association. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  2. Relationship between sleep characteristics and measures of body size and composition in a nationally-representative sample.

    Science.gov (United States)

    Xiao, Qian; Gu, Fangyi; Caporaso, Neil; Matthews, Charles E

    2016-01-01

    Short sleep has been linked to obesity. However, sleep is a multidimensional behavior that cannot be characterized solely by sleep duration. There is limited study that comprehensively examined different sleep characteristics in relation to obesity. We examined various aspects of sleep in relation to adiposity in 2005-2006 NHANES participants who were 18 or older and free of cardiovascular disease, cancer, emphysema, chronic bronchitis and depression ( N  = 3995). Sleep characteristics were self-reported, and included duration, overall quality, onset latency, fragmentation, daytime sleepiness, snoring, and sleep disorders. Body measurements included weight, height, waist circumference, and dual-energy X-ray absorptiometry measured fat mass. Snoring was associated with higher BMI (adjusted difference in kg/m 2 comparing snoring for 5+ nights/week with no snoring (95 % confidence interval), 1.85 (0.88, 2.83)), larger waist circumference (cm, 4.52 (2.29, 6.75)), higher percentage of body fat (%, 1.61 (0.84, 2.38)), and higher android/gynoid ratio (0.03 (0.01, 0.06)). The associations were independent of sleep duration and sleep quality, and cannot be explained by the existence of sleep disorders such as sleep apnea. Poor sleep quality (two or more problematic sleep conditions) and short sleep duration (body size and fat composition, although the effects were attenuated after snoring was adjusted. In a nationally representative sample of healthy US adults, snoring, short sleep, and poor sleep quality were associated with higher adiposity.

  3. Problematic Internet Use and Problematic Online Gaming Are Not the Same: Findings from a Large Nationally Representative Adolescent Sample

    Science.gov (United States)

    Griffiths, Mark D.; Urbán, Róbert; Farkas, Judit; Kökönyei, Gyöngyi; Elekes, Zsuzsanna; Tamás, Domokos; Demetrovics, Zsolt

    2014-01-01

    Abstract There is an ongoing debate in the literature whether problematic Internet use (PIU) and problematic online gaming (POG) are two distinct conceptual and nosological entities or whether they are the same. The present study contributes to this question by examining the interrelationship and the overlap between PIU and POG in terms of sex, school achievement, time spent using the Internet and/or online gaming, psychological well-being, and preferred online activities. Questionnaires assessing these variables were administered to a nationally representative sample of adolescent gamers (N=2,073; Mage=16.4 years, SD=0.87; 68.4% male). Data showed that Internet use was a common activity among adolescents, while online gaming was engaged in by a considerably smaller group. Similarly, more adolescents met the criteria for PIU than for POG, and a small group of adolescents showed symptoms of both problem behaviors. The most notable difference between the two problem behaviors was in terms of sex. POG was much more strongly associated with being male. Self-esteem had low effect sizes on both behaviors, while depressive symptoms were associated with both PIU and POG, affecting PIU slightly more. In terms of preferred online activities, PIU was positively associated with online gaming, online chatting, and social networking, while POG was only associated with online gaming. Based on our findings, POG appears to be a conceptually different behavior from PIU, and therefore the data support the notion that Internet Addiction Disorder and Internet Gaming Disorder are separate nosological entities. PMID:25415659

  4. Educational inequalities in smoking among Japanese adults aged 25-94 years: Nationally representative sex- and age-specific statistics.

    Science.gov (United States)

    Tabuchi, Takahiro; Kondo, Naoki

    2017-04-01

    Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years. Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  5. Frequency of aggressive behaviors in a nationally representative sample of Iranian children and adolescents: The CASPIAN-IV study

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    Morteza Sadinejad

    2015-01-01

    Full Text Available Background: This study aims to explore the frequency of aggressive behaviors among a nationally representative sample of Iranian children and adolescents. Methods: This nationwide study was performed on a multi-stage sample of 6-18 years students, living in 30 provinces in Iran. Students were asked to confidentially report the frequency of aggressive behaviors including physical fighting, bullying and being bullied in the previous 12 months, using the questionnaire of the World Health Organization Global School Health Survey. Results: In this cross-sectional study, 13,486 students completed the study (90.6% participation rate; they consisted of 49.2% girls and 75.6% urban residents. The mean age of participants was 12.47 years (95% confidence interval: 12.29, 12.65. In total, physical fight was more prevalent among boys than girls (48% vs. 31%, P < 0.001. Higher rates of involvement in two other behaviors namely being bullied and bulling to other classmates had a higher frequency among boys compared to girls (29% vs. 25%, P < 0.001 for being bullied and (20% vs. 14%, P < 0.001 for bulling to others. Physical fighting was more prevalent among rural residents (40% vs. 39%, respectively, P = 0.61, while being bullied was more common among urban students (27% vs. 26%, respectively, P = 0.69. Conclusions: Although in this study the frequency of aggressive behaviors was lower than many other populations, still these findings emphasize on the importance of designing preventive interventions that target the students, especially in early adolescence, and to increase their awareness toward aggressive behaviors. Implications for future research and aggression prevention programming are recommended.

  6. The effects of raking on sugar pine mortality following prescribed fire in Sequoia and Kings Canyon National Parks, California, USA

    Science.gov (United States)

    Nesmith, Jonathan C. B.; O'Hara, Kevin L.; van Mantgem, Phillip J.; de Valpine, Perry

    2010-01-01

    Prescribed fire is an important tool for fuel reduction, the control of competing vegetation, and forest restoration. The accumulated fuels associated with historical fire exclusion can cause undesirably high tree mortality rates following prescribed fires and wildfires. This is especially true for sugar pine (Pinus lambertiana Douglas), which is already negatively affected by the introduced pathogen white pine blister rust (Cronartium ribicola J.C. Fisch. ex Rabenh). We tested the efficacy of raking away fuels around the base of sugar pine to reduce mortality following prescribed fire in Sequoia and Kings Canyon national parks, California, USA. This study was conducted in three prescribed fires and included 457 trees, half of which had the fuels around their bases raked away to mineral soil to 0.5 m away from the stem. Fire effects were assessed and tree mortality was recorded for three years after prescribed fires. Overall, raking had no detectable effect on mortality: raked trees averaged 30% mortality compared to 36% for unraked trees. There was a significant effect, however, between the interaction of raking and average pre-treatment forest floor fuel depth: the predicted probability of survival of a 50 cm dbh tree was 0.94 vs. 0.96 when average pre-treatment fuel depth was 0 cm for a raked and unraked tree, respectively. When average pre-treatment forest floor fuel depth was 30 cm, the predicted probability of survival for a raked 50 cm dbh tree was 0.60 compared to only 0.07 for an unraked tree. Raking did not affect mortality when fire intensity, measured as percent crown volume scorched, was very low (0% scorch) or very high (>80% scorch), but the raking treatment significantly increased the proportion of trees that survived by 9.6% for trees that burned under moderate fire intensity (1% to 80% scorch). Raking significantly reduced the likelihood of bole charring and bark beetle activity three years post fire. Fuel depth and anticipated fire intensity need

  7. Effectiveness of Chain Link Turtle Fence and Culverts in Reducing Turtle Mortality and Providing Connectivity along U.S. Hwy 83, Valentine National Wildlife Refuge, Nebraska, USA

    Science.gov (United States)

    2017-12-01

    We evaluated the effectiveness of existing turtle fences through collecting and analyzing turtle mortality data along U.S. Hwy 83, in and around Valentine National Wildlife Refuge, Nebraska, USA. We also investigated the level of connectivity for tur...

  8. Completeness and reliability of mortality data in Viet Nam: Implications for the national routine health management information system.

    Science.gov (United States)

    Hong, Tran Thi; Phuong Hoa, Nguyen; Walker, Sue M; Hill, Peter S; Rao, Chalapati

    2018-01-01

    Mortality statistics form a crucial component of national Health Management Information Systems (HMIS). However, there are limitations in the availability and quality of mortality data at national level in Viet Nam. This study assessed the completeness of recorded deaths and the reliability of recorded causes of death (COD) in the A6 death registers in the national routine HMIS in Viet Nam. 1477 identified deaths in 2014 were reviewed in two provinces. A capture-recapture method was applied to assess the completeness of the A6 death registers. 1365 household verbal autopsy (VA) interviews were successfully conducted, and these were reviewed by physicians who assigned multiple and underlying cause of death (UCOD). These UCODs from VA were then compared with the CODs recorded in the A6 death registers, using kappa scores to assess the reliability of the A6 death register diagnoses. The overall completeness of the A6 death registers in the two provinces was 89.3% (95%CI: 87.8-90.8). No COD recorded in the A6 death registers demonstrated good reliability. There is very low reliability in recording of cardiovascular deaths (kappa for stroke = 0.47 and kappa for ischaemic heart diseases = 0.42) and diabetes (kappa = 0.33). The reporting of deaths due to road traffic accidents, HIV and some cancers are at a moderate level of reliability with kappa scores ranging between 0.57-0.69 (pViet Nam.

  9. Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality.

    Science.gov (United States)

    Condon, John R; Zhang, Xiaohua; Baade, Peter; Griffiths, Kalinda; Cunningham, Joan; Roder, David M; Coory, Michael; Jelfs, Paul L; Threlfall, Tim

    2014-01-31

    National cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting. We used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005. Survival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents. Cancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people.

  10. Survival of HIV-infected adolescents on antiretroviral therapy in Uganda: findings from a nationally representative cohort in Uganda.

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    Celestin Bakanda

    2011-04-01

    Full Text Available Adolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART care. However, data on outcomes for adolescents on cART in resource-limited settings remain scarce.We developed an observational study of patients who started cART at The AIDS Service Organization (TASO in Uganda between 2004 and 2009. Age was stratified into three groups: children (≤10 years, adolescents (11-19 years, and adults (≥20 years. Kaplan-Meier survival curves were generated to describe time to mortality and loss to follow-up, and Cox regression used to model associations between age and mortality and loss to follow-up. To address loss to follow up, we applied a weighted analysis that assumes 50% of lost patients had died.A total of 23,367 patients were included in this analysis, including 810 (3.5% children, 575 (2.5% adolescents, and 21 982 (94.0% adults. A lower percentage of children (5.4% died during their cART treatment compared to adolescents (8.5% and adults (10%. After adjusting for confounding, other features predicted mortality than age alone. Mortality was higher among males (p<0.001, patients with a low initial CD4 cell count (p<0.001, patients with advanced WHO clinical disease stage (p<0.001, and shorter duration of time receiving cART (p<0.001. The crude mortality rate was lower for children (22.8 per 1000 person-years; 95% CI: 16.1, 29.5, than adolescents (36.5 per 1000 person-years; 95% CI: 26.3, 46.8 and adults (37.5 per 1000 person-years; 95% CI: 35.9, 39.1.This study is the largest assessment of adolescents receiving cART in Africa. Adolescents did not have cART mortality outcomes different from adults or children.

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

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    Chantal Babb

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  13. Prevalence and Correlates of Elopement in a Nationally Representative Sample of Children with Developmental Disabilities in the United States.

    Directory of Open Access Journals (Sweden)

    Bridget Kiely

    Full Text Available Despite increased awareness and concern about children with developmental disabilities wandering away from adult supervision, there is a paucity of research about elopement. This is the first study to examine and report the prevalence and correlates of elopement in a nationally representative sample of school-age children in the United States with an autism spectrum disorder (ASD and/or cognitive impairment. Data were obtained from the CDC's "Pathways" Survey, a follow-up telephone survey of the parents of 4,032 children with a developmental condition. 3,518 children that had ASD, intellectual disability (ID, and/or developmental delay (DD at the time of survey administration were included for analysis. Children were divided into three condition groups: ASD-only; ID/DD-only; ASD+ID/DD. Logistic regression analyses were used to compare the prevalence of elopement and rates of preventive measure use (barriers and/or electronic devices across condition groups, and to examine the clinical and demographic correlates of elopement. T-tests were also performed to compare scores on the Children's Social Behavior Questionnaire (CSBQ between wanderers and non-wanderers. Overall, 26.7% of children had reportedly eloped within the previous year, most commonly from public places. Children with ASD-only and ASD+ID/DD were more likely to have eloped than those with ID/DD-only. Across all groups, wanderers scored higher than non-wanderers on five out of six CSBQ subscales; they were more likely not to realize when there is danger, to have difficulty distinguishing between strangers and familiar people, to show sudden mood changes, to over-react to everything/everyone, to get angry quickly, to get lost easily, and to panic in new situations or if change occurs. Even after controlling for elopement history, parents of children in the ASD+ID/DD group were more likely than those in the other condition groups to report using physical or electronic measures to prevent

  14. Trust in the internet as a health resource among older adults: analysis of data from a nationally representative survey.

    Science.gov (United States)

    Zulman, Donna M; Kirch, Matthias; Zheng, Kai; An, Lawrence C

    2011-02-16

    Distrust in the Internet as a source of health information remains common among older adults. The influence of this distrust on Internet use for health-related purposes, however, is unclear. The objective of our study was to explore how older adults' trust in the Internet influences their online health-related activities, and to identify potential targets for improving health-related Internet resources for older adults. Data were obtained from a nationally representative, random digit-dial telephone survey of 1450 adults 50 years of age and older in the United States. A model was developed to conceptualize the hypothesized relationships among individual characteristics, distrust, and avoidance of the Internet as a health resource. Multivariate logistic regression analyses were conducted to examine the association between trust in online health information and use of the Internet for health-related purposes. Additional multivariate logistic regression analyses were conducted to identify the key characteristics associated with trust in online health information, adding sequentially the variables hypothesized to account for distrust among older adults: sociodemographic and health characteristics, inexperience and technical difficulties with the Internet, negative feelings toward the Internet, and lack of awareness about the sources providing the health information found online. The mean (SD) age of the study population was 63.7 (10.6) years. Of the 823 (56.8%) Internet users, 628 (76.3%) reported using the Internet as a health resource. Trust in the Internet as a source of health information was associated with using the Internet for a number of health activities, including searching for information about a specific health condition (adjusted OR 4.43, P Internet as a source of health information (OR 0.63, P = .04), even after adjusting for other sociodemographic characteristics and health and function. This age effect was only slightly attenuated (adjusted OR 0.69, P

  15. Trust in the Internet as a Health Resource Among Older Adults: Analysis of Data from a Nationally Representative Survey

    Science.gov (United States)

    Kirch, Matthias; Zheng, Kai; An, Lawrence C

    2011-01-01

    Background Distrust in the Internet as a source of health information remains common among older adults. The influence of this distrust on Internet use for health-related purposes, however, is unclear. Objective The objective of our study was to explore how older adults’ trust in the Internet influences their online health-related activities, and to identify potential targets for improving health-related Internet resources for older adults. Methods Data were obtained from a nationally representative, random digit-dial telephone survey of 1450 adults 50 years of age and older in the United States. A model was developed to conceptualize the hypothesized relationships among individual characteristics, distrust, and avoidance of the Internet as a health resource. Multivariate logistic regression analyses were conducted to examine the association between trust in online health information and use of the Internet for health-related purposes. Additional multivariate logistic regression analyses were conducted to identify the key characteristics associated with trust in online health information, adding sequentially the variables hypothesized to account for distrust among older adults: sociodemographic and health characteristics, inexperience and technical difficulties with the Internet, negative feelings toward the Internet, and lack of awareness about the sources providing the health information found online. Results The mean (SD) age of the study population was 63.7 (10.6) years. Of the 823 (56.8%) Internet users, 628 (76.3%) reported using the Internet as a health resource. Trust in the Internet as a source of health information was associated with using the Internet for a number of health activities, including searching for information about a specific health condition (adjusted OR 4.43, P purchasing prescription drugs (adjusted OR 2.61, P = .03), and talking with a health care provider about information found online (adjusted OR 2.54, P = .002). Older adults (age

  16. Association of Some Vitamins and Minerals with Periodontitis in a Nationally Representative Sample of Korean Young Adults.

    Science.gov (United States)

    Park, Ji-A; Lee, Jung-Hwa; Lee, Hyo-Jin; Jin, Bo-Hyoung; Bae, Kwang-Hak

    2017-08-01

    The purpose of this study was to investigate whether the intakes of some kinds of vitamins and minerals are associated with periodontitis in a nationally representative sample of young adults. This study comprised 2049 young adults aged 19-39 years who took both periodontal examination and nutrition survey. The vitamin and mineral intakes were calculated from dietary intake data gained by complete one-day 24-h recall interviews, and the intake levels for each nutrient were classified by the Recommended Nutrient Intake (RNI) in Dietary Reference Intakes for Koreans and median values. Periodontitis was assessed using Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed in a whole sample and subgroups with the strata of gender or smoking, following a complex sampling design. In analyses according to RNI, a lower intake of niacin was significantly associated with periodontitis in young adults (odd ratio [OR] 1.47, 95% confidential interval [CI] 1.09-2.00) and in its subgroup of women (OR 1.70; 95% CI 1.10-2.64) and current non-smokers (OR 1.75; 95% CI 1.22-2.51). Whereas, in analyses according to median intake values, there were significant associations of periodontitis with a lower intake of niacin in women (OR 1.58; 95% CI 1.02-2.46) and current non-smokers (OR 1.50; 95% CI 1.01-2.22), with lower intake of vitamin C in women (OR 1.66; 95% CI 1.04-2.64) and in current non-smokers (OR 1.49; 95% CI 1.04-2.14), with lower intake of iron in women (OR 1.85; 95% CI 1.11-3.07), and with lower intake of vitamin A marginally in women (OR 1.56; 95% CI 1.00-2.44). In young adults, periodonitis is significantly associated with the lower intakes of niacin, vitamin C, and iron, especially in women and current non-smokers.

  17. Race, ethnicity, language, social class, and health communication inequalities: a nationally-representative cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Kasisomayajula Viswanath

    2011-01-01

    Full Text Available While mass media communications can be an important source of health information, there are substantial social disparities in health knowledge that may be related to media use. The purpose of this study is to investigate how the use of cancer-related health communications is patterned by race, ethnicity, language, and social class.In a nationally-representative cross-sectional telephone survey, 5,187 U.S. adults provided information about demographic characteristics, cancer information seeking, and attention to and trust in health information from television, radio, newspaper, magazines, and the Internet. Cancer information seeking was lowest among Spanish-speaking Hispanics (odds ratio: 0.42; 95% confidence interval: 0.28-0.63 compared to non-Hispanic whites. Spanish-speaking Hispanics were more likely than non-Hispanic whites to pay attention to (odds ratio: 3.10; 95% confidence interval: 2.07-4.66 and trust (odds ratio: 2.61; 95% confidence interval: 1.53-4.47 health messages from the radio. Non-Hispanic blacks were more likely than non-Hispanic whites to pay attention to (odds ratio: 2.39; 95% confidence interval: 1.88-3.04 and trust (odds ratio: 2.16; 95% confidence interval: 1.61-2.90 health messages on television. Those who were college graduates tended to pay more attention to health information from newspapers (odds ratio: 1.98; 95% confidence interval: 1.42-2.75, magazines (odds ratio: 1.86; 95% confidence interval: 1.32-2.60, and the Internet (odds ratio: 4.74; 95% confidence interval: 2.70-8.31 and had less trust in cancer-related health information from television (odds ratio: 0.44; 95% confidence interval: 0.32-0.62 and radio (odds ratio: 0.54; 95% confidence interval: 0.34-0.86 compared to those who were not high school graduates.Health media use is patterned by race, ethnicity, language and social class. Providing greater access to and enhancing the quality of health media by taking into account factors associated with social

  18. Who is more likely to be obese or overweight among siblings? A nationally representative study in rural China.

    Directory of Open Access Journals (Sweden)

    Jiajin Hu

    Full Text Available The aims of this study were to determine the association between sibling rank and childhood obesity among children ≤ 5 years of age in rural China, and to investigate the effect of child gender and the obesity status of other siblings on this association.Data from the China Family Panel Studies, a nationally representative survey, was used for the analysis. Sibling rank was defined as the birth order of all children with the same biological mother. A total of 1116 children ≤ 5 years of age were divided into four groups: children without siblings, first-born children, second-born children, and third-born or younger children. For each child, the body mass index and standard deviation (BMI z score was calculated according to WHO standards; children with BMI z scores > 2 were classified as obese or overweight (ObOw. Logistic regression models were used to estimate the association between sibling rank and ObOw status, and the possible influence of gender and ObOw status among other siblings.The second and third-born or younger children had a significantly higher risk of becoming ObOw than children without siblings (odds ratio [OR]: 1.32, 95% confidence interval [CI]: 1.07-1.63 and OR:1.38, 95% CI: 1.17-1.63, respectively. Specifically, female second-born children and male third-born or younger children had a significantly higher risk of ObOw (OR: 1.50, 95% CI: 1.11-2.01 and OR: 1.57, 95% CI: 1.07-2.32, respectively. Having an ObOw sibling increased the probability of being ObOw and the magnitude of the effect was larger if siblings were younger.Sibling rank was shown to be associated with ObOw status among children 0-5 years of age in rural China. Our findings can help healthcare practitioners and authorities to identify children at risk of obesity. Future studies should focus on the mechanisms of this association.

  19. Association of a television in the bedroom with increased adiposity gain in a nationally representative sample of children and adolescents.

    Science.gov (United States)

    Gilbert-Diamond, Diane; Li, Zhigang; Adachi-Mejia, Anna M; McClure, Auden C; Sargent, James D

    2014-05-01

    Obesity affects health in children and adolescents. Television viewing is an established risk factor for obesity in youth. No prospective study has assessed whether a bedroom television confers an additional risk for obesity in youth. To assess the prospective association between the presence of a bedroom television and change in body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), independent of television viewing, in a nationally representative sample of US children and adolescents. We conducted a random-digit prospective telephone survey that captured children and adolescents from across the United States. Participants included 6522 boys and girls aged 10 to 14 years at baseline who were surveyed via telephone about media risk factors for obesity.Weighted regressions assessed adiposity at 2- and 4-year follow-up, controlling for television and movie viewing, video-game playing, parenting, age, sex, race or ethnicity, household income, and parental educational level. Report of having a television in the bedroom at baseline. Age- and sex-adjusted BMI based on self-report and parent report of weight and height at 2- and 4-year follow-up. Distributions for age, sex, race or ethnicity, and socioeconomic status were similar to census estimates for the US population. Sample weighting methods accounted for higher dropout rates among ethnic minorities and those with lower socioeconomic status. Bedroom televisions were reported by 59.1%of participants at baseline, with boys, ethnic minorities, and those of lower socioeconomic status having significantly higher rates. In multivariate analyses, having a bedroom television was associated with an excess BMI of 0.57 (95%CI, 0.31-0.82) and 0.75 (0.38-1.12) at years 2 and 4, respectively, and a BMI gain of 0.24 (0.02-0.45) from years 2 to 4. Having a bedroom television is associated with weight gain beyond the effect of television viewing time. This association could be the result of

  20. Prevalence of cardio-metabolic risk factors in a nationally representative sample of Iranian adolescents: The CASPIAN-III Study

    Directory of Open Access Journals (Sweden)

    Roya Kelishadi

    2017-03-01

    Conclusion: This study proposes that in addition to national health policies on preventing cardiometabolic risk factors, specific interventions should be considered according to the regional SES level.

  1. Physical Activity Attenuates Total and Cardiovascular Mortality Associated With Physical Disability: A National Cohort of Older Adults.

    Science.gov (United States)

    Martinez-Gomez, David; Guallar-Castillon, Pilar; Higueras-Fresnillo, Sara; Garcia-Esquinas, Esther; Lopez-Garcia, Esther; Bandinelli, Stefania; Rodríguez-Artalejo, Fernando

    2018-01-16

    Regular physical activity (PA) has been shown to protect against disability onset but, once the disability is present, it is unclear if PA might attenuate its harmful health consequences. Thus, we examined if mortality risk associated with physical disability can be offset by PA among older adults. We used data from a cohort of 3,752 individuals representative of the noninstitutionalized population aged 60 years and older in Spain. In 2000-2001, participants self-reported both PA levels (inactive, occasionally, monthly, weekly) and five physical disabilities (agility, mobility, global daily activities, instrumental activities of daily living, and self-care). Individuals were prospectively followed through 2014 to assess incident deaths. The mean follow-up was 10.8 years, with a total of 1,727 deaths, 638 of them due to cardiovascular disease (CVD). All disability types were associated with higher total and CVD mortality. Being physically active (ie, doing any PA) was associated with a statistically significant 26%-37% and 35%-50% lower risk of total and CVD death, respectively, across types of disability. As compared with those being physically active and without disability, those who were inactive and had a disability showed the highest mortality risk from total (hazard ratios from 1.52 to 1.90 across disabilities, all p disability. In older adults, PA could attenuate the increased risk of mortality associated with physical disability. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Mortality patterns and risk among older men and women with intellectual disability: a Swedish national retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Nawi Ng

    2017-11-01

    Full Text Available Abstract Background Sweden has closed all institutions and imposed legislation to ensure service and support for individuals with intellectual disability (ID. Understanding mortality among older individuals with ID is essential to inform development of health promotion and disease control strategies. We investigated patterns and risk of mortality among older adults with ID in Sweden. Methods This retrospective cohort study compared older adults aged 55 years and older with ID with a control population. Participants were followed during 2002–2015 or death, and censored if they moved out of Sweden. Individuals with ID were identified from two national registers: one covering all specialist health-care visits (out-patient visits and hospitalisation and the other covering people accessing social/support services. Individuals with ID (n = 15,289 were matched with a control population by sex, birth year, and year of first hospitalisation/out-patient visit/access to LSS services. Cause-of-death data were recorded using International Classification of Diseases, Tenth Revision. Cox proportional hazards regression were conducted to assess if overall and cause-specific mortality rate among individuals with ID was higher than in the Swedish population. Results The overall mortality rate among individuals with ID was 2483 per 100,000 people compared with 810 in the control population. Among those who died, more individuals with ID were younger than 75 years and unmarried. Leading causes of death among individuals with ID were circulatory diseases (34%, respiratory diseases (17% and neoplasms (15%. Leading causes of death in a sub-sample with Down syndrome (DS were respiratory diseases (37%, circulatory diseases (26% and mental/behavioural disorders (11%. Epilepsy and pneumonitis were more common among individuals with ID than controls. Alzheimer’s disease was common in the control population and individuals with DS, but not among those with ID when

  3. Low dose ionizing radiation exposure and cardiovascular disease mortality: cohort study based on Canadian national dose registry of radiation workers

    International Nuclear Information System (INIS)

    Zielinski, J. M.; Band, P. R.; Ashmore, P. J.; Jiang, H.; Shilnikova, N. S.; Tait, V. K.; Krewski, D.

    2009-01-01

    The purpose of our study was to assess the risk of cardiovascular disease (CVD) mortality in a Canadian cohort of 337 397 individuals (169 256 men and 168 141 women) occupationally exposed to ionizing radiation and included in the National Dose Registry (NDR) of Canada. Material and Methods: Exposure to high doses of ionizing radiation, such as those received during radiotherapy, leads to increased risk of cardiovascular diseases. The emerging evidence of excess risk of CVDs after exposure to doses well below those previously considered as safe warrants epidemiological studies of populations exposed to low levels of ionizing radiation. In the present study, the cohort consisted of employees at nuclear power stations (nuclear workers) as well as medical, dental and industrial workers. The mean whole body radiation dose was 8.6 mSv for men and 1.2 mSv for women. Results: During the study period (1951 - 1995), as many as 3 533 deaths from cardiovascular diseases have been identified (3 018 among men and 515 among women). In the cohort, CVD mortality was significantly lower than in the general population of Canada. The cohort showed a significant dose response both among men and women. Risk estimates of CVD mortality in the NDR cohort, when expressed as excess relative risk per unit dose, were higher than those in most other occupational cohorts and higher than in the studies of Japanese atomic bomb survivors. Conclusions: The study has demonstrated a strong positive association between radiation dose and the risk of CVD mortality. Caution needs to be exercised when interpreting these results, due to the potential bias introduced by dosimetry uncertainties, the possible record linkage errors, and especially by the lack of adjustment for non-radiation risk factors. (authors)

  4. Excess mortality in women of reproductive age from low-income countries: a Swedish national register study.

    Science.gov (United States)

    Esscher, Annika; Haglund, Bengt; Högberg, Ulf; Essén, Birgitta

    2013-04-01

    Cause-of-death statistics is widely used to monitor the health of a population. African immigrants have, in several European studies, shown to be at an increased risk of maternal death, but few studies have investigated cause-specific mortality rates in female immigrants. In this national study, based on the Swedish Cause of Death Register, we studied 27,957 women of reproductive age (aged 15-49 years) who died between 1988 and 2007. Age-standardized mortality rates per 100,000 person years and relative risks for death and underlying causes of death, grouped according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, were calculated and compared between women born in Sweden and in low-, middle- and high-income countries. The total age-standardized mortality rate per 100,000 person years was significantly higher for women born in low-income (84.4) and high-income countries (83.7), but lower for women born in middle-income countries (57.5), as compared with Swedish-born women (68.1). The relative risk of dying from infectious disease was 15.0 (95% confidence interval 10.8-20.7) and diseases related to pregnancy was 6.6 (95% confidence interval 2.6-16.5) for women born in low-income countries, as compared to Swedish-born women. Women born in low-income countries are at the highest risk of dying during reproductive age in Sweden, with the largest discrepancy in mortality rates seen for infectious diseases and diseases related to pregnancy, a cause of death pattern similar to the one in their countries of birth. The World Bank classification of economies may be a useful tool in migration research.

  5. Mortality among workers at Oak Ridge National Laboratory. Evidence of radiation effects in follow-up through 1984

    International Nuclear Information System (INIS)

    Wing, S.; Shy, C.M.; Wood, J.L.; Wolf, S.; Cragle, D.L.; Frome, E.L.

    1991-01-01

    White men hired at the Oak Ridge (Tenn) National Laboratory between 1943 and 1972 were followed up for vital status through 1984 (N = 8318, 1524 deaths). Relatively low mortality compared with that in US white men was observed for most causes of death, but leukemia mortality was elevated in the total cohort (63% higher, 28 deaths) and in workers who had at some time been monitored for internal radionuclide contamination (123% higher, 16 deaths). Median cumulative dose of external penetrating radiation was 1.4 mSv; 638 workers had cumulative doses above 50 mSv (5 rem). After accounting for age, birth cohort, a measure of socioeconomic status, and active worker status, external radiation with a 20-year exposure lag was related to all causes of death (2.68% increase per 10 mSv) primarily due to an association with cancer mortality (4.94% per 10 mSv). Studies of this population through 1977 did not find radiation-cancer mortality associations, and identical analyses using the shorter follow-up showed that associations with radiation did not appear until after 1977. The radiation-cancer dose response is 10 times higher than estimates from the follow-up of survivors of the bombings of Hiroshima and Nagasaki, Japan, but similar to one previous occupational study. Dose-response estimates are subject to uncertainties due to potential problems, including measurement of radiation doses and cancer outcomes. Longer-term follow-up of this and other populations with good measurement of protracted low-level exposures will be critical to evaluating the generalizability of the results reported herein

  6. Childhood leukemia mortality and farming exposure in South Korea: A national population-based birth cohort study.

    Science.gov (United States)

    Cha, Eun Shil; Hwang, Seung-sik; Lee, Won Jin

    2014-08-01

    The aim of this study was to evaluate the relationship between leukemia mortality and exposure to farming among children in South Korea. A retrospective cohort study of South Korean children was conducted using data collected by the national birth register between 1995 and 2006; these data were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until either their death or until December 31, 2006. For surrogate measures of pesticide exposure, we used residence at birth, paternal occupation, and month of conception from the birth certificate. Farming and pesticide exposure indexes by county were calculated using information derived from the 2000 agricultural census. Poisson regression analyses were used to calculate rate ratios (RRs) of childhood leukemia deaths according to indices of exposure to agricultural pesticides after adjustment for potential confounders. In total 585 leukemia deaths were observed during the study period. Childhood leukemia mortality was significantly elevated in children born in rural areas (RR=1.43, 95%CI 1.09-1.86) compared to those in metropolises, and in counties with both the highest farming index (RR=1.33, 95%CI 1.04-1.69) and pesticide exposure index (RR=1.30, 95%CI 1.02-1.66) compared to those in the reference group. However, exposure-response associations were significant only in relation to the farming index. When the analyses were limited to rural areas, the risk of death from leukemia among boys conceived between spring and fall increased over those conceived in winter. Our results show an increase in mortality from childhood leukemia in rural areas; however, further studies are warranted to investigate the environmental factors contributing to the excess mortality from childhood leukemia in rural areas. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi.

    Science.gov (United States)

    Uwemedimo, Omolara T; Lewis, Todd P; Essien, Elsie A; Chan, Grace J; Nsona, Humphreys; Kruk, Margaret E; Leslie, Hannah H

    2018-01-01

    Pneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi. Data were obtained from the 2013-2014 Service Provision Assessment survey, a census of health facilities in Malawi that included direct observation of care and re-examination of children by trained observers. We calculated sensitivity of pneumonia diagnosis and used multilevel log-binomial regression to assess factors associated with diagnostic sensitivity. 3136 clinical visits for children 2-59 months old were observed at 742 health facilities. Healthcare workers completed an average of 30% (SD 13%) of IMCI guidelines in each encounter. 573 children met the IMCI criteria for pneumonia; 118 (21%) were correctly diagnosed. Advanced practice clinicians were more likely than other providers to diagnose pneumonia correctly (adjusted relative risk 2.00, 95% CI 1.21 to 3.29). Clinical quality was strongly associated with correct diagnosis: sensitivity was 23% in providers at the 75th percentile for guideline adherence compared with 14% for those at the 25th percentile. Contextual factors, facility structural readiness, and training or supervision were not associated with sensitivity. Care quality for Malawian children is poor, with low guideline adherence and missed diagnosis for four of five children with pneumonia. Better sensitivity is associated with provider type and higher adherence to IMCI. Existing interventions such as training and supportive supervision are associated with higher guideline adherence, but are insufficient to meaningfully improve sensitivity

  8. His Excellency Dr. Hans Brattskar, Ambassador and Permanent Representative of Norway to the United Nations Office, visiting CERN

    CERN Multimedia

    AUTHOR|(CDS)2099575

    2016-01-01

    Ambassador Hans Brattskar signing the guest book with Director for international relations Charlotte Warakaulle and Director-General Fabiola Gianotti; Deputy Permanent Representative and Minister Kjersti Sommerset and CERN Advisers Pippa Wells and Jens Vigen are also present.

  9. A nationally representative study of maternal obesity in England, UK : trends in incidence and demographic inequalities in 619323 births, 1989-2007.

    OpenAIRE

    Heslehurst, N.; Rankin, J.; Wilkinson, J.R.; Summerbell, C.D.

    2010-01-01

    Background: There is an absence of national statistics for maternal obesity in the UK. This study is the first to describe a nationally representative maternal obesity research data set in England. Design: Retrospective epidemiological study of first trimester obesity. Methods: Data from 34 maternity units were analysed, including 619 323 births between 1989 and 2007. Data analysis included trends in first trimester maternal body bass index status over time, and geographical distribut...

  10. Use of the Internet as a Health Information Resource Among French Young Adults: Results From a Nationally Representative Survey

    Science.gov (United States)

    Richard, Jean-Baptiste; Nguyen-Thanh, Viet; Montagni, Ilaria; Parizot, Isabelle; Renahy, Emilie

    2014-01-01

    Background The Internet is one of the main resources of health information especially for young adults, but website content is not always trustworthy or validated. Little is known about this specific population and the importance of online health searches for use and impact. It is fundamental to assess behaviors and attitudes of young people looking for online health-related information and their level of trust in such information. Objective The objective is to describe the characteristics of Internet users aged 15-30 years who use the Web as a health information resource and their trust in it, and to define the context and the effect of such use on French young adults’ behavior in relation to their medical consultations. Methods We used the French Health Barometer 2010, a nationally representative survey of 27,653 individuals that investigates population health behaviors and concerns. Multivariate logistic regressions were performed using a subsample of 1052 young adults aged 15-30 years to estimate associations between demographics, socioeconomic, and health status and (1) the use of the Internet to search for health information, and (2) its impact on health behaviors and the physician-patient relationship. Results In 2010, 48.5% (474/977) of Web users aged 15-30 years used the Internet for health purposes. Those who did not use the Internet for health purposes reported being informed enough by other sources (75.0%, 377/503), stated they preferred seeing a doctor (74.1%, 373/503) or did not trust the information on the Internet (67.2%, 338/503). However, approximately 80% (371/474) of young online health seekers considered the information found online reliable. Women (PInternet for health purposes. For a subsample of women only, online health seeking was more likely among those having a child (OR 1.8, 95% CI 1.1-2.7) and experiencing psychological distress (OR 2.0, 95% CI 1.0-4.0). Finally, for online health seekers aged 15-30 years, one-third (33.3%, 157

  11. Tree mortality based fire severity classification for forest inventories: A Pacific Northwest national forests example

    Science.gov (United States)

    Thomas R. Whittier; Andrew N. Gray

    2016-01-01

    Determining how the frequency, severity, and extent of forest fires are changing in response to changes in management and climate is a key concern in many regions where fire is an important natural disturbance. In the USA the only national-scale fire severity classification uses satellite image changedetection to produce maps for large (>400 ha) fires, and is...

  12. Participatory democracy, representative democracy, and the nature of diffuse and concentrated interests: A case study of public involvement on a national gorest district

    Science.gov (United States)

    Christine Overdevest

    2000-01-01

    To evaluate whether public involvement on a national forest district fairly represents the public's values, this article proposes four hypothesis tests. First, it is hypothesized that public-involvement programs operute according to a participatory democracy logic, in which broad cross sections of the public participate in public involvement opportunities. A...

  13. Representing Value as Digital Object: A Discussion of Transferability and Anonymity; Digital Library Initiatives of the Deutsche Forschungsgemeinschaft; CrossRef Turns One; Fermi National Accelerator Laboratory (Fermilab).

    Science.gov (United States)

    Kahn, Robert E.; Lyons, Patrice A.; Brahms, Ewald; Brand, Amy; van den Bergen, Mieke

    2001-01-01

    Includes four articles that discuss the use of digital objects to represent value in a network environment; digital library initiatives at the central public funding organization for academic research in Germany; an application of the Digital Object Identifier System; and the Web site of the Fermi National Accelerator Laboratory. (LRW)

  14. A Religious Experience? Personal, Parental, and Peer Religiosity and the Academic Success of Sexual-Minority Youth Using Nationally Representative Samples

    Science.gov (United States)

    Gottfried, Michael A.; Polikoff, Morgan S.

    2012-01-01

    Using nationally representative transcript data, this study is the first to include a discussion of religiosity in the context of sexual-minority students' academic achievement. This study examines the issue in three capacities: first, by comparing school success of sexual-minority youth to a non-sexual-minority reference group; second, by…

  15. Predictors of Suicidal Ideation in Late Childhood and Adolescence: A 5-Year Follow-Up of Two Nationally Representative Cohorts in the Republic of Korea

    Science.gov (United States)

    Park, Sunhee

    2013-01-01

    This study explores the trajectory of suicidal ideation in childhood and adolescence and identifies its strong predictors. Secondary data obtained from two nationally representative cohorts of South Korean youth were longitudinally analyzed using frequencies, percentages, and discrete time survival analysis. This study revealed an increase in the…

  16. Using data from a nationally representative nutrition surveillance system to assess trends and influence nutrition programs and policy

    Directory of Open Access Journals (Sweden)

    Nasima Akhter

    2010-02-01

    Full Text Available The Nutritional Surveillance Project (NSP* of Helen Keller International (HKI, Bangladesh, implemented in partnership with the Government of Bangladesh’s (GOB Institute of Public Health Nutrition (IPHN from 1990 until 2006, is among the longest running surveillance systems; and was implemented with an overall goal to monitor nutrition and health status of children and mothers in Bangladesh. From 1990-1997, NSP data collection included rural and urban poor populations of disaster prone areas of Bangladesh. Since 1998, it evolved into a nationally representative nutrition surveillance system in rural Bangladesh and also continued assessing trends of malnutrition in urban poor areas. Over the 16 year period, the NSP produced plethora of information that was packaged and shared as bulletins, in peer reviewed journal articles, as presentations at conferences, seminars, workshops. The NSP had a flexible framework that allowed it to assess trends and underlying factors of malnutrition, monitor and evaluate selected programs and conduct special studies related to current and emerging issues. NSP findings were available to contribute to program development and supported policy discussions in-country and internationally. The NSP continuously highlighted the importance of monitoring, which is not only an indispensible element for a successful program, but also helps prioritization and decision making to maximize utilization of limited resources for developing countries burdened with numerous problems to address. The NSP provides an example of a technically sound surveillance system with rapid turnover of data and findings, which is imperative to successful program planning, policy formulation and tracking progress toward developmental goals.Le projet Nutritional Surveillance Project (NSP* de l’association Helen Keller International (HKI, mis en œuvre au Bangladesh en partenariat avec l’Institute of Public Health Nutrition (IPHN,

  17. Long-term soil gas flux and root mortality, Tapajos National Forest

    Science.gov (United States)

    W. L. Silver; A. W. Thompson; M. E. McGroddy; R. K. Varner; J. R. Robertson; J. D. Dias; H. Silva; P. Crill; M. Keller

    2012-01-01

    This data set reports measurements of trace gas fluxes of methane (CH4), nitric oxide (N2O), nitrous oxide (NO), carbon dioxide (CO2) from soils at a study site in the Tapajos National Forest (TNF), near the km 83 on the Santarem-Cuiaba Highway south of Santarem, Para, Brazil. Data for root mass and carbon content, soil nitrogen (N), nitrification, and moisture content...

  18. Assessing the Life Science Knowledge of Students and Teachers Represented by the K-8 National Science Standards

    Science.gov (United States)

    Sadler, Philip M.; Coyle, Harold; Cook Smith, Nancy; Miller, Jaimie; Mintzes, Joel; Tanner, Kimberly; Murray, John

    2013-01-01

    We report on the development of an item test bank and associated instruments based on the National Research Council (NRC) K-8 life sciences content standards. Utilizing hundreds of studies in the science education research literature on student misconceptions, we constructed 476 unique multiple-choice items that measure the degree to which test…

  19. Drawing a representative sample from the NCSS soil database: Building blocks for the national wind erosion network

    Science.gov (United States)

    Developing national wind erosion models for the continental United States requires a comprehensive spatial representation of continuous soil particle size distributions (PSD) for model input. While the current coverage of soil survey is nearly complete, the most detailed particle size classes have c...

  20. Proximal risk factors and suicide methods among suicide completers from national suicide mortality data 2004-2006 in Korea.

    Science.gov (United States)

    Im, Jeong-Soo; Choi, Soon Ho; Hong, Duho; Seo, Hwa Jeong; Park, Subin; Hong, Jin Pyo

    2011-01-01

    This study was conducted to examine differences in proximal risk factors and suicide methods by sex and age in the national suicide mortality data in Korea. Data were collected from the National Police Agency and the National Statistical Office of Korea on suicide completers from 2004 to 2006. The 31,711 suicide case records were used to analyze suicide rates, methods, and proximal risk factors by sex and age. Suicide rate increased with age, especially in men. The most common proximal risk factor for suicide was medical illness in both sexes. The most common proximal risk factor for subjects younger than 30 years was found to be a conflict in relationships with family members, partner, or friends. Medical illness was found to increase in prevalence as a risk factor with age. Hanging/Suffocation was the most common suicide method used by both sexes. The use of drug/pesticide poisoning to suicide increased with age. A fall from height or hanging/suffocation was more popular in the younger age groups. Because proximal risk factors and suicide methods varied with sex and age, different suicide prevention measures are required after consideration of both of these parameters. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Green tree frog (Hyla cinerea) and ground squirrel (Xerospermophilus spilosoma) mortality attributed to inland brevetoxin transportation at Padre Island National Seashore, Texas, 2015

    Science.gov (United States)

    Buttke, Danielle E.; Walker, Alicia; Huang, I-Shuo; Flewelling, Leanne; Lankton, Julia S.; Ballmann, Anne E.; Clapp, Travis; Lindsay, James; Zimba, Paul V.

    2018-01-01

    On 16 September 2015, a red tide (Karenia brevis) bloom impacted coastal areas of Padre Island National Seashore Park. Two days later and about 0.9 km inland, 30–40 adult green tree frogs (Hyla cinerea) were found dead after displaying tremors, weakness, labored breathing, and other signs of neurologic impairment. A rainstorm, accompanied by high winds, rough surf, and high tides, which could have aerosolized brevetoxin, occurred on the morning of the mortality event. Frog carcasses were healthy but contained significant brevetoxin in tissues. Tissue brevetoxin was also found in two dead or dying spotted ground squirrels (Xerospermophilus spilosoma) and a coyote (Canis latrans). Rainwater collected from the location of the mortality event contained brevetoxin. Mortality of green tree frog and ground squirrel mortality has not been previously attributed to brevetoxin exposure and such mortality suggested that inland toxin transport, possibly through aerosols, rainfall, or insects, may have important implications for coastal species.

  2. How Often Are Parents Counseled About Family Planning During Pediatric Visits? Results of a Nationally Representative Sample.

    Science.gov (United States)

    Venkataramani, Maya; Cheng, Tina L; Solomon, Barry S; Pollack, Craig Evan

    2017-07-01

    Maternal family planning plays an important role in child, maternal, and family health; children's health care providers are in a unique position to counsel adult caregivers regarding contraception and appropriate birth spacing. We sought to determine the prevalence of caregiver family planning counseling by children's health care providers during preventive care visits for infants and young children. Data from the National Ambulatory Medical Care Survey from 2009 to 2012 as well as National Hospital Ambulatory Medical Care Survey from 2009 to 2011 were analyzed to determine the weighted frequency of family planning/contraception counseling provided during preventive, primary care visits for children younger than the age of 2 years. Family planning/contraception counseling or education was documented in only 16 of 4261 preventive care visits in primary care settings for children younger than the age of 2 years, corresponding to 0.30% (95% confidence interval, -0.08% to 0.68%) of visits nationally. Similar frequencies were calculated for preventive visits with children younger than 1 year and with infants younger than 60 days of age. Despite Bright Futures' recommendations for children's health care providers to address caregiver family planning during well infant visits, documented counseling is rare. The results indicate that there are missed opportunities to promote family health in the pediatric setting. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  3. Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

    Science.gov (United States)

    Bassani, Diego G; Corsi, Daniel J; Gaffey, Michelle F; Barros, Aluisio J D

    2014-01-01

    Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at

  4. The contribution of smoking to inequalities in mortality by education varies over time and by sex: two national cohort studies, 1981-84 and 1996-99.

    Science.gov (United States)

    Blakely, Tony; Wilson, Nick

    2005-10-01

    The contributions of tobacco smoking to overall mortality and socioeconomic inequalities in mortality vary between populations and over time. We determined how these contributions varied by sex and over time in two national New Zealand cohort studies. Poisson regression and modelling were conducted on linked census-mortality cohorts for people aged 45-74 years in 1981-84 and 1996-99 (2.0 and 2.7 million person-years, respectively). Contribution to socioeconomic inequalities in mortality. Adjusting for current and former smoking reduced the all-cause mortality rate ratios for men with nil educational qualifications compared with men with post-school qualifications from 1.34 to 1.29 in 1981-84 and from 1.31 to 1.25 in 1996-99, or 16 and 21% reductions in relative inequalities. Equivalent results for women were 1.42-1.41 in 1981-84 and 1.42-1.37 in 1996-99, or 3 and 11% reductions in relative inequalities. Contribution to overall mortality. Using 1996-99 data, we estimated that if all current smokers quit and became ex-smokers, mortality rates would reduce by 11% for men and 5% for women. If everyone was a never smoker (i.e. a historically smoke-free society), mortality rates would have been 26% lower for men and 25% lower for women. The contribution of smoking to educational inequalities in mortality was greater for males, and increased over time for both males and females, reflecting the historically differential phasing of the tobacco epidemic by sex and socioeconomic position. Complete cessation of smoking in contemporary New Zealand would reduce both overall mortality and educational inequalities in mortality.

  5. Obesity and motor skills among 4 to 6-year-old children in the united states: nationally-representative surveys

    OpenAIRE

    Castetbon Katia; Andreyeva Tatiana

    2012-01-01

    Abstract Background Few population-based studies have assessed relationships between body weight and motor skills in young children. Our objective was to estimate the association between obesity and motor skills at 4 years and 5-6 years of age in the United States. We used repeated cross-sectional assessments of the national sample from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) of preschool 4-year-old children (2005-2006; n = 5 100) and 5-6-year-old kindergarteners (2006-2...

  6. Assessing the Life Science Knowledge of Students and Teachers Represented by the K–8 National Science Standards

    Science.gov (United States)

    Sadler, Philip M.; Coyle, Harold; Smith, Nancy Cook; Miller, Jaimie; Mintzes, Joel; Tanner, Kimberly; Murray, John

    2013-01-01

    We report on the development of an item test bank and associated instruments based on the National Research Council (NRC) K–8 life sciences content standards. Utilizing hundreds of studies in the science education research literature on student misconceptions, we constructed 476 unique multiple-choice items that measure the degree to which test takers hold either a misconception or an accepted scientific view. Tested nationally with 30,594 students, following their study of life science, and their 353 teachers, these items reveal a range of interesting results, particularly student difficulties in mastering the NRC standards. Teachers also answered test items and demonstrated a high level of subject matter knowledge reflecting the standards of the grade level at which they teach, but exhibiting few misconceptions of their own. In addition, teachers predicted the difficulty of each item for their students and which of the wrong answers would be the most popular. Teachers were found to generally overestimate their own students’ performance and to have a high level of awareness of the particular misconceptions that their students hold on the K–4 standards, but a low level of awareness of misconceptions related to the 5–8 standards. PMID:24006402

  7. Assessing the life science knowledge of students and teachers represented by the K-8 national science standards.

    Science.gov (United States)

    Sadler, Philip M; Coyle, Harold; Smith, Nancy Cook; Miller, Jaimie; Mintzes, Joel; Tanner, Kimberly; Murray, John

    2013-01-01

    We report on the development of an item test bank and associated instruments based on the National Research Council (NRC) K-8 life sciences content standards. Utilizing hundreds of studies in the science education research literature on student misconceptions, we constructed 476 unique multiple-choice items that measure the degree to which test takers hold either a misconception or an accepted scientific view. Tested nationally with 30,594 students, following their study of life science, and their 353 teachers, these items reveal a range of interesting results, particularly student difficulties in mastering the NRC standards. Teachers also answered test items and demonstrated a high level of subject matter knowledge reflecting the standards of the grade level at which they teach, but exhibiting few misconceptions of their own. In addition, teachers predicted the difficulty of each item for their students and which of the wrong answers would be the most popular. Teachers were found to generally overestimate their own students' performance and to have a high level of awareness of the particular misconceptions that their students hold on the K-4 standards, but a low level of awareness of misconceptions related to the 5-8 standards.

  8. A new multidimensional population health indicator for policy makers: absolute level, inequality and spatial clustering - an empirical application using global sub-national infant mortality data

    Directory of Open Access Journals (Sweden)

    Benn K.D. Sartorius

    2014-11-01

    Full Text Available The need for a multidimensional measure of population health that accounts for its distribution remains a central problem to guide the allocation of limited resources. Absolute proxy measures, like the infant mortality rate (IMR, are limi- ted because they ignore inequality and spatial clustering. We propose a novel, three-part, multidimensional mortality indi- cator that can be used as the first step to differentiate interventions in a region or country. The three-part indicator (MortalityABC index combines absolute mortality rate, the Theil Index to calculate mortality inequality and the Getis-Ord G statistic to determine the degree of spatial clustering. The analysis utilises global sub-national IMR data to empirically illu- strate the proposed indicator. The three-part indicator is mapped globally to display regional/country variation and further highlight its potential application. Developing countries (e.g. in sub-Saharan Africa display high levels of absolute mortality as well as variable mortality inequality with evidence of spatial clustering within certain sub-national units (“hotspots”. Although greater inequality is observed outside developed regions, high mortality inequality and spatial clustering are com- mon in both developed and developing countries. Significant positive correlation was observed between the degree of spatial clustering and absolute mortality. The proposed multidimensional indicator should prove useful for spatial allocation of healthcare resources within a country, because it can prompt a wide range of policy options and prioritise high-risk areas. The new indicator demonstrates the inadequacy of IMR as a single measure of population health, and it can also be adapted to lower administrative levels within a country and other population health measures.

  9. Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers.

    Science.gov (United States)

    Park, Jae Bum; Nakata, Akinori; Swanson, Naomi G; Chun, Heekyoung

    2013-02-01

    The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers. The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039). The overall prevalence of WRSP was 5.1% (95% confidence interval (CI) 4.7-5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95% CI 1.77-6.81), discrimination due to sex (aOR 2.44: 95% CI 1.36-4.36) or age (aOR 2.22: 95% CI 1.52-3.23), violence at work (aOR 1.98: 95% CI 1.06-3.68), threat of violence (aOR 1.96: 95% CI 1.05-3.66), poor work-life balance (aOR 1.78: 95% CI 1.44-2.20), low job satisfaction (aOR 1.69: 95% CI 1.37-2.09), high cognitive (OR 1.64: 95% CI 1.32-2.03) and emotional (aOR 1.53: 95% CI 1.22-1.91) demands, job insecurity (aOR 1.32: 95% CI 1.07-1.63), and high work intensity (aOR 1.55: 95% CI: 95% CI 1.25-1.92) had an increased risk of WRSP compared to their respective counterparts (p social support was not significantly associated with WRSP (aOR 0.88: 95% CI 0.67-1.15). The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.

  10. Parental supply of alcohol to Australian minors: an analysis of six nationally representative surveys spanning 15 years.

    Science.gov (United States)

    Kelly, Adrian B; Chan, Gary C K; Weier, Megan; Quinn, Catherine; Gullo, Matthew J; Connor, Jason P; Hall, Wayne D

    2016-04-14

    Most adolescents begin alcohol consumption during adolescence, heavy alcohol use by adolescents is common, and alcohol-related harm amongst adolescents is a major public health burden. Parents are a common source of alcohol amongst adolescents, but little is known about how parental supply of alcohol has changed over recent years. This study examines national trends in parental supply of alcohol to adolescent children in Australia since 1998. Six Australian National Drug Strategy Household Surveys (1998-2013) yielded rates of parental supply of current and first ever alcohol consumed. Lifetime and current alcohol use were also estimated. The surveys were conducted for households across all Australian states and territories. Surveyed adolescents were aged 14-17 years (N = 7357, 47.6 % male). Measures included the reported source of currently consumed alcohol and first ever alcoholic beverage (parents/friends/others), lifetime alcohol use, number of standard alcohol units consumed on drinking days, and frequency of alcohol use. Corrected Pearson chi-squared tests were used to compare survey years. There was a significant drop in parental supply of current alcohol use from 21.3 % in 2004 to 11.79 % in 2013 (p supply coincided with legislative changes on parental supply of alcohol to adolescents, but causality cannot be established because of the variation in the timing and reach of parental supply legislation, and small samples in some states. There were downward trends in adolescent experimentation, quantity and frequency of alcohol use across years, with the largest drop in alcohol use in 2010 and 2013. In Australia, there has been a substantial reduction in parental supply of alcohol to adolescents from 2010, and this factor may partially account for reductions in adolescent alcohol use.

  11. Assessing sample representativeness in randomized controlled trials: application to the National Institute of Drug Abuse Clinical Trials Network.

    Science.gov (United States)

    Susukida, Ryoko; Crum, Rosa M; Stuart, Elizabeth A; Ebnesajjad, Cyrus; Mojtabai, Ramin

    2016-07-01

    To compare the characteristics of individuals participating in randomized controlled trials (RCTs) of treatments of substance use disorder (SUD) with individuals receiving treatment in usual care settings, and to provide a summary quantitative measure of differences between characteristics of these two groups of individuals using propensity score methods. Design Analyses using data from RCT samples from the National Institute of Drug Abuse Clinical Trials Network (CTN) and target populations of patients drawn from the Treatment Episodes Data Set-Admissions (TEDS-A). Settings Multiple clinical trial sites and nation-wide usual SUD treatment settings in the United States. A total of 3592 individuals from 10 CTN samples and 1 602 226 individuals selected from TEDS-A between 2001 and 2009. Measurements The propensity scores for enrolling in the RCTs were computed based on the following nine observable characteristics: sex, race/ethnicity, age, education, employment status, marital status, admission to treatment through criminal justice, intravenous drug use and the number of prior treatments. Findings The proportion of those with ≥ 12 years of education and the proportion of those who had full-time jobs were significantly higher among RCT samples than among target populations (in seven and nine trials, respectively, at P difference in the mean propensity scores between the RCTs and the target population was 1.54 standard deviations and was statistically significant at P different from individuals receiving treatment in usual care settings. Notably, RCT participants tend to have more years of education and a greater likelihood of full-time work compared with people receiving care in usual care settings. © 2016 Society for the Study of Addiction.

  12. Prevalence of prehypertension and hypertension in a nationally representative sample of iranian children and adolescents: The CASPIAN-IV study

    Directory of Open Access Journals (Sweden)

    Zahra Fallah

    2014-01-01

    Full Text Available Background: The global health burden has faced toward non-communicable diseases (NCDs. It is suggested that adulthood blood pressure (BP is tracked from childhood. This study aims to evaluate the mean BP and the prevalence of prehypertension and hypertension in the Iranian pediatric population. Methods: In a national survey as the 4 th phase of Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable diseases study and through random multistage cluster sampling, a national sample of Iranian school students, aged 6-18 years, were recruited. Data gathered by means of modified World Health Organization Global school-based student health survey questionnaire, a weight disorders determinants questionnaire and anthropometric and BP measurements. Prehypertension (HTN was defined as BP equal or greater than 90 th age and sex specific percentile or ≥120/80 mmHg and HTN was defined as BP ≥95 th percentile. Results: A total of 13486 students entered the study (49.2% girls, 75.6% urban. Mean age of participants was 11.47 ΁ 3.36 years. A total rate of 4.17% (3.84-4.52 95% CI for high systolic BP (SBP, 4.33% (3.99-4.68 for high diastolic BP (DBP and 6.88% (6.45-7.32 for high SBP and/or DBP was depicted. Conclusions: The prevalence rate of high BP (pre-HTN together with HTN is substantially high in this population. It is needed to study the causative situations and implement relevant interventions.

  13. Visit of His Excellency Mr Juan Martabit, Ambassador, Permanent Representative of Chile to the United Nations Office in Geneva and other international organisations in Switzerland.

    CERN Multimedia

    Maximilien Brice

    2005-01-01

    Secretary-General; Mrs Juan Martabit. 0502017_07.jpg His Excellency Mr Juan Martabit, Ambassador,Permanent Representative of Chile to the United Nations Office in Geneva and other international organisations in Switzerland visiting the ATLAS building site. From left to right: Prof. Giora Mikenberg, ATLAS Collaboration; Mr Maximilian Metzger, Secretary-General and His Excellency Mr Juan Martabit. 0502017_08.jpg His Excellency Mr Juan Martabit, Ambassador,Permanent Representative of Chile to the United Nations Office in Geneva and other international organisations in Switzerland visiting the ATLAS cavern. From left to right: From left to right: Prof. Giora Mikenberg, ATLAS Collaboration; Mr Maximilian Metzger, Secretary-General; His Excellency Mr Juan Martabit and Mrs Juan Martabit.

  14. His Excellency Mr Ian de Jong, Ambassador, Permanent Representative of the Kingdom of the Netherlands to the United Nations Office in Geneva

    CERN Multimedia

    Maximilien Brice

    2003-01-01

    Visit of His Excellency Mr Ian de Jong, Ambassador, Permanent Representative of the Kingdom of the Netherlands to the United Nations Office in Geneva, June 2003. From left to right: Dr Albert Ijspeert, Deputy Leader, Magnet and electrical systems Group, Accelerator Technology Division; Mr Maarten Wilbers, Legal Service; Prof. Cecilia Jarlskog, Adviser to the Director-General for Member State Relations; Mr Jan van der Boon, Director of Administration; His Excellency Mr Ian de Jong, Ambassador, Permanent Representative of the Kingdom of the Netherlands to the United Nations Office in Geneva; Prof. Frank Linde, NIKHEF; Dr Lucie Linssen Experimental Physics Division, Technical Assistance Group and Mr C. J. van Riel, Ministry of Education, Culture and Science, Netherlands, Dutch Delegate to Council and Finance Committee.

  15. Social determinants of rest deprivation amongst Ghanaian women: national and urban-rural comparisons with data from a cross-sectional nationally representative survey

    Directory of Open Access Journals (Sweden)

    Bull Torill

    2010-09-01

    Full Text Available Abstract Background Rest deprivation (rest/napping/sleep 6 or less hours daily is a clinically recognised risk factor for poor health, but its epidemiology is little studied. This study reports prevalence's and social correlates of rest deprivation in Ghana. Methods Data are from the 2008 Ghana Demographic and Health Survey. Women ages 15-49 were recruited in a national sampling design. Respondents were 4,916 women in the national sample, a sub-sample of 530 women in the three northernmost rural regions and a sub-sample of 853 women in urban Greater Accra. Results Prevalence's of rest deprivation were 0.13% nationally, 14.5% in Greater Accra and 16.8% in the North. The significant correlates nationally were age, education, wealth index, Christian religion and literacy. In Accra, they were age, wealth index, having household electricity, and possession of a refrigerator, a stove and a mobile phone. In the North, they were education, occupation, drinking water source, possession of motorcycle/scooter, Christian religion, literacy, and possession of a clock and a cupboard. In logistic regression analyses controlling for age in the national sample, the significant odds ratios were 1.40 for no education compared to secondary and higher education, 0.78-0.43 for the four poorer wealth quintiles compared to the richest wealth index quintile, and 0.55 for Christian religion compared to all others. Also controlling for age, the significant odds ratios in Accra were 2.15 for the second richest wealth quintile compared to the richest quintile and 0.16 for possession of a mobile phone. In the North they were 0.49 for Christian religion compared to all others, 1.87 for having a protected compared to an unprotected water source, and 0.41 for having a cupboard in the home. Conclusions Education, wealth and religion were related to rest deprivation nationally but not in the urban and rural regions (except for religion in the North. This suggests caution in

  16. Telomere Length and Mortality

    DEFF Research Database (Denmark)

    Kimura, Masayuki; Hjelmborg, Jacob V B; Gardner, Jeffrey P

    2008-01-01

    Leukocyte telomere length, representing the mean length of all telomeres in leukocytes, is ostensibly a bioindicator of human aging. The authors hypothesized that shorter telomeres might forecast imminent mortality in elderly people better than leukocyte telomere length. They performed mortality...

  17. Attitudes towards intimate partner violence and the association with condom use among men in Haiti: An analysis of the nationally representative Demographic Health Survey

    OpenAIRE

    Conserve, Donaldson F.; Whembolua, Guy-Lucien; Surkan, Pamela J.

    2014-01-01

    Although men have substantial decision-making power regarding condom use, the majority of HIV knowledge and prevention studies in the general Haitian population have been conducted among youth and women. We investigated attitudes towards intimate partner violence, knowledge of and use of condoms among 9,493 men in Haiti using data from the 2012 nationally representative Demographic and Health Survey. Only 36% of HIV-negative and 44% of HIV-positive men reported using a condom the last time th...

  18. The subjective content of historical memory in autobiographical narratives of representatives of titular ethnic group and national diaspora (based on the example of the Volga Germans

    Directory of Open Access Journals (Sweden)

    Rakhmatulina D.V.

    2017-07-01

    Full Text Available the article contains a justification of the research approach to the detection of subjective content of historical memory among groups of respondents from different ethnic background; presents the results of a study of two groups of respondents, who are descendants of the Volga Germans and the representatives of the titular nation (Russian; establishes the main cultural and historical events of life of the peoples that make up the historical memory.

  19. Diabetes, Frequency of Exercise, and Mortality Over 12 Years: Analysis of the National Health Insurance Service-Health Screening (NHIS-HEALS) Database.

    Science.gov (United States)

    Shin, Woo Young; Lee, Taehee; Jeon, Da Hye; Kim, Hyeon Chang

    2018-02-19

    The goal of this study was to analyze the relationship between exercise frequency and all-cause mortality for individuals diagnosed with and without diabetes mellitus (DM). We analyzed data for 505,677 participants (53.9% men) in the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort. The study endpoint variable was all-cause mortality. Frequency of exercise and covariates including age, sex, smoking status, household income, blood pressure, fasting glucose, body mass index, total cholesterol, and Charlson comorbidity index were determined at baseline. Cox proportional hazard regression models were developed to assess the effects of exercise frequency (0, 1-2, 3-4, 5-6, and 7 days per week) on mortality, separately in individuals with and without DM. We found a U-shaped association between exercise frequency and mortality in individuals with and without DM. However, the frequency of exercise associated with the lowest risk of all-cause mortality was 3-4 times per week (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.65-0.73) in individuals without DM, and 5-6 times per week in those with DM (HR, 0.93; 95% CI, 0.78-1.10). A moderate frequency of exercise may reduce mortality regardless of the presence or absence of DM; however, when compared to those without the condition, people with DM may need to exercise more often. © 2018 The Korean Academy of Medical Sciences.

  20. Cross-national comparison of sex differences in health and mortality in Denmark, Japan and the US

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Crimmins, Eileen; Saito, Yasuhiko

    2010-01-01

    The present study aims to compare the direction and magnitude of sex differences in mortality and major health dimensions across Denmark, Japan and the US. The Human Mortality Database was used to examine sex differences in age-specific mortality rates. The Danish twin surveys, the Danish 1905-Co...

  1. Assessing childhood maltreatment and mental health correlates of disordered eating profiles in a nationally representative sample of English females.

    Science.gov (United States)

    Armour, Cherie; Műllerová, Jana; Fletcher, Shelley; Lagdon, Susan; Burns, Carol Rhonda; Robinson, Martin; Robinson, Jake

    2016-03-01

    Previous research suggests that childhood maltreatment is associated with the onset of eating disorders (ED). In turn, EDs are associated with alternative psychopathologies such as depression and posttraumatic stress disorder (PTSD), and with suicidality. Moreover, it has been reported that various ED profiles may exist. The aim of the current study was to examine the profiles of disordered eating and the associations of these with childhood maltreatment and with mental health psychopathology. The current study utilised a representative sample of English females (N = 4206) and assessed for the presence of disordered eating profiles using Latent Class Analysis. Multinomial logistic regression was implemented to examine the associations of childhood sexual and physical abuse with the disordered eating profiles and the associations of these with PTSD, depression and suicidality. Results supported those of previous findings in that we found five latent classes of which three were regarded as disordered eating classes. Significant relationships were found between these and measures of childhood trauma and mental health outcomes. Childhood sexual and physical abuse increased the likelihood of membership in disordered eating classes and these in turn increased the likelihood of adverse mental health and suicidal outcomes.

  2. Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study

    Science.gov (United States)

    2014-01-01

    Background The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. Methods We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N = 12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. Results Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p’s social relationship domains except marital status were independently associated with depressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. Conclusions Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being. PMID:24656048

  3. Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study.

    Science.gov (United States)

    Barger, Steven D; Messerli-Bürgy, Nadine; Barth, Jürgen

    2014-03-24

    The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N=12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p'sdepressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being.

  4. Prevalence and Predictors of Video Game Addiction: A Study Based on a National Representative Sample of Gamers.

    Science.gov (United States)

    Wittek, Charlotte Thoresen; Finserås, Turi Reiten; Pallesen, Ståle; Mentzoni, Rune Aune; Hanss, Daniel; Griffiths, Mark D; Molde, Helge

    Video gaming has become a popular leisure activity in many parts of the world, and an increasing number of empirical studies examine the small minority that appears to develop problems as a result of excessive gaming. This study investigated prevalence rates and predictors of video game addiction in a sample of gamers, randomly selected from the National Population Registry of Norway ( N  = 3389). Results showed there were 1.4 % addicted gamers, 7.3 % problem gamers, 3.9 % engaged gamers, and 87.4 % normal gamers. Gender (being male) and age group (being young) were positively associated with addicted-, problem-, and engaged gamers. Place of birth (Africa, Asia, South- and Middle America) were positively associated with addicted- and problem gamers. Video game addiction was negatively associated with conscientiousness and positively associated with neuroticism. Poor psychosomatic health was positively associated with problem- and engaged gaming. These factors provide insight into the field of video game addiction, and may help to provide guidance as to how individuals that are at risk of becoming addicted gamers can be identified.

  5. Mental health problems and overweight in a nationally representative sample of adolescents: effects of race and ethnicity.

    Science.gov (United States)

    BeLue, Rhonda; Francis, Lori Ann; Colaco, Brendon

    2009-02-01

    In this study we examined the relation between mental health problems and weight in a population-based study of youth aged 12 to 17 years and whether the association between mental health problems and weight is moderated by race and ethnicity. We used 2003 National Survey on Children's Health data. Logistic regression was used to arrive at adjusted odds ratios showing the relation between BMI and mental health problems. Compared with their nonoverweight counterparts, both white and Hispanic youth who were overweight were significantly more likely to report depression or anxiety, feelings of worthlessness or inferiority, behavior problems, and bullying of others. Odds ratios relating mental health problems and BMI in black subjects were not statistically significant except for physician diagnosis of depression. Our results suggest that, when addressing youth overweight status, mental health problems also need to be addressed. Given that the relationship between mental health problems and youth overweight differs according to race/ethnic group, public health programs that target overweight youth should be cognizant of potential comorbid mental health problems and that race/ethnicity may play a role in the relationship between mental health and overweight status.

  6. ADHD and the externalizing spectrum: direct comparison of categorical, continuous, and hybrid models of liability in a nationally representative sample.

    Science.gov (United States)

    Carragher, Natacha; Krueger, Robert F; Eaton, Nicholas R; Markon, Kristian E; Keyes, Katherine M; Blanco, Carlos; Saha, Tulshi D; Hasin, Deborah S

    2014-08-01

    Alcohol use disorders, substance use disorders, and antisocial personality disorder share a common externalizing liability, which may also include attention-deficit hyperactivity disorder (ADHD). However, few studies have compared formal quantitative models of externalizing liability, with the aim of delineating the categorical and/or continuous nature of this liability in the community. This study compares categorical, continuous, and hybrid models of externalizing liability. Data were derived from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (N = 34,653). Seven disorders were modeled: childhood ADHD and lifetime diagnoses of antisocial personality disorder (ASPD), nicotine dependence, alcohol dependence, marijuana dependence, cocaine dependence, and other substance dependence. The continuous latent trait model provided the best fit to the data. Measurement invariance analyses supported the fit of the model across genders, with females displaying a significantly lower probability of experiencing externalizing disorders. Cocaine dependence, marijuana dependence, other substance dependence, alcohol dependence, ASPD, nicotine dependence, and ADHD provided the greatest information, respectively, about the underlying externalizing continuum. Liability to externalizing disorders is continuous and dimensional in severity. The findings have important implications for the organizational structure of externalizing psychopathology in psychiatric nomenclatures.

  7. Can Early Rehabilitation after Total Hip Arthroplasty Reduce Its Major Complications and Medical Expenses? Report from a Nationally Representative Cohort

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    Daniel Chiung-Jui Su

    2015-01-01

    Full Text Available Objective. To investigate whether early rehabilitation reduces the occurrence of posttotal hip arthroplasty (THA complications, adverse events, and medical expenses within one postoperative year. Method. We retrospectively retrieve data from Taiwan’s National Health Insurance Research Database. Patients who had undergone THA during the period from 1998 to 2010 were recruited, matched for propensity scores, and divided into 2 groups: early rehabilitation (Early Rehab and delayed rehabilitation (Delayed Rehab. Results. Eight hundred twenty of 999 THA patients given early rehabilitation treatments were matched to 205 of 233 THA patients given delayed rehabilitation treatments. The Delayed Rehab group had significantly (all p<0.001 higher medical and rehabilitation expenses and more outpatient department (OPD visits than the Early Rehab group. In addition, the Delayed Rehab group was associated with more prosthetic infection (odds ratio (OR: 3.152; 95% confidence interval (CI: 1.211–8.203; p<0.05 than the Early Rehab group. Conclusions. Early rehabilitation can significantly reduce the incidence of prosthetic infection, total rehabilitation expense, total medical expenses, and number of OPD visits within the first year after THA.

  8. Assessing the fit of the Dysphoric Arousal model across two nationally representative epidemiological surveys: The Australian NSMHWB and the United States NESARC.

    Science.gov (United States)

    Armour, Cherie; Carragher, Natacha; Elhai, Jon D

    2013-01-01

    Since the initial inclusion of PTSD in the DSM nomenclature, PTSD symptomatology has been distributed across three symptom clusters. However, a wealth of empirical research has concluded that PTSD's latent structure is best represented by one of two four-factor models: Numbing or Dysphoria. Recently, a newly proposed five-factor Dysphoric Arousal model, which separates the DSM-IV's Arousal cluster into two factors of Anxious Arousal and Dysphoric Arousal, has gathered support across a variety of trauma samples. To date, the Dysphoric Arousal model has not been assessed using nationally representative epidemiological data. We employed confirmatory factor analysis to examine PTSD's latent structure in two independent population based surveys from American (NESARC) and Australia (NSWHWB). We specified and estimated the Numbing model, the Dysphoria model, and the Dysphoric Arousal model in both samples. Results revealed that the Dysphoric Arousal model provided superior fit to the data compared to the alternative models. In conclusion, these findings suggest that items D1-D3 (sleeping difficulties; irritability; concentration difficulties) represent a separate, fifth factor within PTSD's latent structure using nationally representative epidemiological data in addition to single trauma specific samples. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Longitudinal Associations of Leisure-Time Physical Activity and Cancer Mortality in the Third National Health and Nutrition Examination Survey (1986–2006

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    Niyati Parekh

    2012-01-01

    Full Text Available Longitudinal associations between leisure-time physical activity (LTPA and overall cancer mortality were evaluated within the Third National Health and Nutrition Examination Survey (NHANES III; 1988–2006; n=15,535. Mortality status was ascertained using the National Death Index. Self-reported LTPA was divided into inactive, regular low-to-moderate and vigorous activity. A frequency-weighted metabolic equivalents (METS/week variable was also computed. Hazard ratios (HRs and 95% confidence intervals (CI were calculated for overall cancer mortality in the whole sample, by body mass index categories and insulin resistance (IR status. Nonsignificant protective associations were observed for regular low-to-moderate and vigorous activity, and for the highest quartile of METS/week (HRs range: 0.66–0.95. Individuals without IR engaging in regular vigorous activity had a 48% decreased risk of cancer mortality (HR: 0.52; 95% CI: 0.28–0.98 in multivariate analyses. Conversely, nonsignificant positive associations were observed in people with IR. In conclusion, regular vigorous activity may reduce risk of cancer mortality among persons with normal insulin-glucose metabolism in this national sample.

  10. Workplace psychosocial factors associated with work-related injury absence: a study from a nationally representative sample of Korean workers.

    Science.gov (United States)

    Lu, Ming-Lun; Nakata, Akinori; Park, Jae Bum; Swanson, Naomi G

    2014-02-01

    Little is known about the association between psychosocial factors and injury absence in the workplace. This study aims to assess the association of comprehensive workplace psychosocial factors with work-related injury absence among Korean workers. The data (n = 7,856) were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample (n = 10,043) of the Korean working population. The survey instrument contained questions about hours of work, physical risk factors, work organization, and the effect of work on health/injury. Work-related injury absence was indicated by a dichotomous variable with at least 1 day absence during the preceding 12 months. Logistic regression models were used to calculate odds ratio and confidence interval (CI). Incremental adjustments for sociodemographic, health behavior, and occupational confounding variables were employed in the models. The overall 1-year prevalence of work-related injury absence in this study was 1.37 % (95 % CI, 1.11-1.63 %). Those who experienced violence at work (adjusted odds ratio (aOR), 7.05 (95 % CI, 2.69-18.5)), threat of violence at work (aOR, 4.25 (95 % CI, 1.32-13.64)), low job autonomy (aOR, 1.79 (95 % CI, 1.17-2.74)), and high job strain (aOR, 2.38 (95 % CI, 1.29-4.42) had an increased risk of injury absence, compared with their respective counterparts (p workers in Korea were at a near fourfold risk of work absence due to occupational injuries, compared with managers in low-risk jobs. Workplace violence and increased job strain were two key workplace psychosocial factors associated with work-related injury absence.

  11. Association of Dietary Behaviors with Physical Activity in a Nationally Representative Sample of Children and Adolescents: the CASPIAN- IV Study

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    Saeid Safiri

    2016-03-01

    Full Text Available Background: Nutritional health and adequate physical activity (PA, especially in childhood and grow periods, have a substantial role in health. This study assessed the association of dietary behaviors (main courses and snacks intake with PA in children and adolescents. Materials and Methods: Using multistage random cluster sampling method, a representative sample of 14,880 school students were selected from urban and rural areas of 30 provinces of Iran. Through a validated questionnaire, daily consumption of main course ( breakfast, lunch, and dinner as well as daily consumption of different snacks and health foods ( fast foods, milk, vegetables, dry fruits, fresh fruits, sweetened beverages, salty snacks and sweets were recorded for every participants. Information of past week weekly frequency of leisure time PA was collected. Results: Overall, 13,486 out of 14,880 students (response rate: 90.6% participated in this survey. Participants consisted of 6,640 (49.2% girls and 75.6% urban residents; their mean and standard deviation (SD age was 12.47 (3.36 years. Daily consumption of fresh fruits (odds ratio [OR]: 1.35, 95%confidence interval [CI]: 1.20-1.52, dried fruits (OR: 1.21; 95%CI: 1.06-1.40, vegetable (OR: 1.39; 95% CI: 1.24-1.56, and milk (OR: 1.35; 95% CI: 1.21-1.52 increased the odds of high PA compare to low PA in adjusted model.  Skipping the breakfast, lunch and dinner decreased the odds of moderate and high PA compare to low PA (P

  12. Terror Management in a Multicultural Society: Effects of Mortality Salience on Attitudes to Multiculturalism Are Moderated by National Identification and Self-Esteem Among Native Dutch People.

    Science.gov (United States)

    Tjew-A-Sin, Mandy; Koole, Sander Leon

    2018-01-01

    Terror Management Theory (TMT; Greenberg et al., 1997) proposes that mortality concerns may lead people to reject other cultures than their own. Although highly relevant to multiculturalism, TMT has been rarely tested in a European multicultural society. To fill this void, two studies examined the effects of mortality salience (MS) among native Dutch people with varying levels of national identification and self-esteem. Consistent with TMT, MS led to less favorable attitudes about Muslims and multiculturalism among participants with high (rather than low) national identification and low (rather than high) self-esteem (Study 1). Likewise, MS led participants with high national identification and low self-esteem to increase their support of Sinterklaas, a traditional Dutch festivity with purported racist elements (Study 2). Together, these findings indicate that existential concerns may fuel resistance against multiculturalism, especially among people with low self-esteem who strongly identify with their nationality.

  13. Obesity and motor skills among 4 to 6-year-old children in the united states: nationally-representative surveys

    Science.gov (United States)

    2012-01-01

    Background Few population-based studies have assessed relationships between body weight and motor skills in young children. Our objective was to estimate the association between obesity and motor skills at 4 years and 5-6 years of age in the United States. We used repeated cross-sectional assessments of the national sample from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) of preschool 4-year-old children (2005-2006; n = 5 100) and 5-6-year-old kindergarteners (2006-2007; n = 4 700). Height, weight, and fine and gross motor skills were assessed objectively via direct standardized procedures. We used categorical and continuous measures of body weight status, including obesity (Body Mass Index (BMI) ≥ 95th percentile) and BMI z-scores. Multivariate logistic and linear models estimated the association between obesity and gross and fine motor skills in very young children adjusting for individual, social, and economic characteristics and parental involvement. Results The prevalence of obesity was about 15%. The relationship between motor skills and obesity varied across types of skills. For hopping, obese boys and girls had significantly lower scores, 20% lower in obese preschoolers and 10% lower in obese kindergarteners than normal weight counterparts, p motor skills and fine motor skills of young children were not consistently related to BMI z-scores and obesity. Conclusions Based on objective assessment of children's motor skills and body weight and a full adjustment for confounding covariates, we find no reduction in overall coordination and fine motor skills in obese young children. Motor skills are adversely associated with childhood obesity only for skills most directly related to body weight. PMID:22420636

  14. Obesity and motor skills among 4 to 6-year-old children in the united states: nationally-representative surveys

    Directory of Open Access Journals (Sweden)

    Castetbon Katia

    2012-03-01

    Full Text Available Abstract Background Few population-based studies have assessed relationships between body weight and motor skills in young children. Our objective was to estimate the association between obesity and motor skills at 4 years and 5-6 years of age in the United States. We used repeated cross-sectional assessments of the national sample from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B of preschool 4-year-old children (2005-2006; n = 5 100 and 5-6-year-old kindergarteners (2006-2007; n = 4 700. Height, weight, and fine and gross motor skills were assessed objectively via direct standardized procedures. We used categorical and continuous measures of body weight status, including obesity (Body Mass Index (BMI ≥ 95th percentile and BMI z-scores. Multivariate logistic and linear models estimated the association between obesity and gross and fine motor skills in very young children adjusting for individual, social, and economic characteristics and parental involvement. Results The prevalence of obesity was about 15%. The relationship between motor skills and obesity varied across types of skills. For hopping, obese boys and girls had significantly lower scores, 20% lower in obese preschoolers and 10% lower in obese kindergarteners than normal weight counterparts, p p Conclusions Based on objective assessment of children's motor skills and body weight and a full adjustment for confounding covariates, we find no reduction in overall coordination and fine motor skills in obese young children. Motor skills are adversely associated with childhood obesity only for skills most directly related to body weight.

  15. Racial/ethnic differences in 30-year trajectories of heavy drinking in a nationally representative U.S. sample.

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    Mulia, Nina; Karriker-Jaffe, Katherine J; Witbrodt, Jane; Bond, Jason; Williams, Edwina; Zemore, Sarah E

    2017-01-01

    Racial/ethnic minorities bear a disproportionate burden of alcohol-related problems in the U.S. It is unknown whether this reflects harmful patterns of lifecourse heavy drinking. Prior research shows little support for the latter but has been limited to young samples. We examine racial/ethnic differences in heavy drinking trajectories from ages 21 to 51. Data on heavy drinking (6+ drinks/occasion) are from the 1979 National Longitudinal Survey of Youth (N=9468), collected between 1982 and 2012. Sex-stratified, generalized estimating equations (GEE) were used to model heavy drinking frequency trajectories as a function of age with a cubic curve, and interactions of race with age terms were tested to assess racial/ethnic differences. Models adjusted for time-varying socioeconomic status and marital and parenting status; predictors of trajectories were examined in race- and sex-specific models. White men and women had similarly steep declines in heavy drinking frequency throughout the 20s, contrasting with slower declines (and lower peaks) in Black and Hispanic men and women. During the 30s there was a Hispanic-White crossover in men's heavy drinking curves, and a Black-White female crossover among lifetime heavy drinkers; by age 51, racial/ethnic group trajectories converged in both sexes. Greater education was protective for all groups. Observed racial/ethnic crossovers in heavy drinking frequency following young adulthood might contribute to disparities in alcohol-related problems in middle adulthood, and suggest a need for targeted interventions during this period. Additionally, interventions that increase educational attainment may constitute an important strategy for reducing heavy drinking in all groups. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Blood spot-based measures of glucose homeostasis and diabetes prevalence in a nationally representative population of young US adults.

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    Nguyen, Quynh C; Whitsel, Eric A; Tabor, Joyce W; Cuthbertson, Carmen C; Wener, Mark H; Potter, Alan J; Halpern, Carolyn T; Killeya-Jones, Ley A; Hussey, Jon M; Suchindran, Chirayath; Harris, Kathleen Mullan

    2014-12-01

    We investigated understudied biomarker-based diabetes among young US adults, traditionally characterized by low cardiovascular disease risk. We examined 15,701 participants aged 24 to 32 years at Wave IV of the National Longitudinal Study of Adolescent Health (Add Health, 2008). The study used innovative and relatively noninvasive methods to collect capillary whole blood via finger prick at in-home examinations in all 50 states. Assays of dried blood spots produced reliable and accurate values of HbA1c. Reliability was lower for fasting glucose and lowest for random glucose. Mean (SD) HbA1c was 5.6% (0.8%). More than a quarter (27.4%) had HbA1c-defined prediabetes. HbA1c was highest in the black, non-Hispanic race/ethnic group, inversely associated with education, and more common among the overweight/obese and physically inactive. The prevalence of diabetes defined by previous diagnosis or use of antidiabetic medication was 2.9%. Further incorporating HbA1c and glucose values, the prevalence increased to 6.8%, and among these participants, 38.9% had a previous diagnosis of diabetes (i.e., aware). Among those aware, 37.6% were treated and 64.0% were controlled (i.e., HbA1c young adults faces a historically high risk of diabetes but there is ample opportunity for early detection and intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States.

    Science.gov (United States)

    Taillieu, Tamara L; Brownridge, Douglas A; Sareen, Jitender; Afifi, Tracie O

    2016-09-01

    Child maltreatment is a public health concern with well-established sequelae. However, compared to research on physical and sexual abuse, far less is known about the long-term impact of emotional maltreatment on mental health. The overall purpose of this study was to examine the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Data were from the National Epidemiological Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n=34,653). The most prevalent form of emotional maltreatment was emotional neglect only (6.2%), followed by emotional abuse only (4.8%), and then both emotional abuse and neglect (3.1%). All categories of emotional maltreatment were strongly related to other forms of child maltreatment (odds ratios [ORs] ranged from 2.1 to 68.0) and a history of family dysfunction (ORs ranged from 2.2 to 8.3). In models adjusting for sociodemographic characteristics, all categories of emotional maltreatment were associated with increased odds of almost every mental disorder assessed in this study (adjusted ORs ranged from 1.2 to 7.4). Many relationships remained significant independent of experiencing other forms of child maltreatment and a family history of dysfunction (adjusted ORs ranged from 1.2 to 3.0). The effects appeared to be greater for active (i.e., emotional abuse) relative to passive (i.e., emotional neglect) forms of emotional maltreatment. Childhood emotional maltreatment, particularly emotionally abusive acts, is associated with increased odds of lifetime diagnoses of several Axis I and Axis II mental disorders. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. Circulating Prostate-Specific Antigen and Telomere Length in a Nationally Representative Sample of Men Without History of Prostate Cancer.

    Science.gov (United States)

    Wulaningsih, Wahyu; Astuti, Yuliana; Matsuguchi, Tetsuya; Anggrandariyanny, Putri; Watkins, Johnathan

    2017-01-01

    We investigated the association of prostate-specific antigen (PSA) with leukocyte telomere length, which may be altered in preclinical prostate malignancies. This study was based on the 2001-2002 U.S. National Health and Nutrition Examination Survey (NHANES). A subsample of 1,127 men aged 40-85 years without prior history of prostate cancer who provided informed consent and blood samples were selected. Leukocyte telomere length (LTL) relative to standard DNA reference (T/S ratio) was quantified by polymerase chain reaction (PCR). Survey-weighted multivariable linear regression was performed to examine T/S ratio across quintiles of total and free PSA and free-to-total PSA ratio (%fPSA). A sensitivity analysis was performed by excluding men dying from prostate cancer during follow-up through to December 31, 2006. Stratification analyses were carried out to assess any effect modification by age group, race, body mass index (BMI), and levels of C-reactive protein (CRP), a marker of inflammation. Higher total PSA levels were associated to longer LTL, with approximately 8% increase in log-transformed T/S ratio (95% confidence interval [CI]: 2-13%) among men in the highest quintile of total PSA compared to the lowest in the fully adjusted model (P trend  = 0.01). No significant association was found for free PSA or %fPSA, although nonlinearity between all PSA measures and T/S ratio was indicated. Similar results were found after excluding men who died from prostate cancer during follow-up. We also found the associations between total PSA and T/S ratio to be strongest among non-Hispanic blacks, non-obese men (BMI specific mechanisms contributing to prostate cancer development. Prostate 77:22-32, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample.

    Science.gov (United States)

    Newman-Toker, David E; Hsieh, Yu-Hsiang; Camargo, Carlos A; Pelletier, Andrea J; Butchy, Gregary T; Edlow, Jonathan A

    2008-07-01

    To describe the spectrum of visits to US emergency departments (EDs) for acute dizziness and determine whether ED patients with dizziness are diagnosed as having a range of benign and dangerous medical disorders, rather than predominantly vestibular ones. A cross-sectional study of ED visits from the National Hospital Ambulatory Medical Care Survey (NHAMCS) used a weighted sample of US ED visits (1993-2005) to measure patient and hospital demographics, ED diagnoses, and resource use in cases vs controls without dizziness. Dizziness in patients 16 years or older was defined as an NHAMCS reason-for-visit code of dizziness/vertigo (1225.0) or a final International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis of dizziness/vertigo (780.4) or of a vestibular disorder (386.x). A total of 9472 dizziness cases (3.3% of visits) were sampled over 13 years (weighted 33.6 million). Top diagnostic groups were otologic/vestibular (32.9%), cardiovascular (21.1%), respiratory (11.5%), neurologic (11.2%, including 4% cerebrovascular), metabolic (11.0%), injury/poisoning (10.6%), psychiatric (7.2%), digestive (7.0%), genitourinary (5.1%), and infectious (2.9%). Nearly half of the cases (49.2%) were given a medical diagnosis, and 22.1% were given only a symptom diagnosis. Predefined dangerous disorders were diagnosed in 15%, especially among those older than 50 years (20.9% vs 9.3%; Pdisorder in most ED cases and often is associated with cardiovascular or other medical causes, including dangerous ones. Resource use is substantial, yet many patients remain undiagnosed.

  20. Obesity and motor skills among 4 to 6-year-old children in the United States: nationally-representative surveys.

    Science.gov (United States)

    Castetbon, Katia; Andreyeva, Tatiana

    2012-03-15

    Few population-based studies have assessed relationships between body weight and motor skills in young children. Our objective was to estimate the association between obesity and motor skills at 4 years and 5-6 years of age in the United States. We used repeated cross-sectional assessments of the national sample from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) of preschool 4-year-old children (2005-2006; n = 5 100) and 5-6-year-old kindergarteners (2006-2007; n = 4 700). Height, weight, and fine and gross motor skills were assessed objectively via direct standardized procedures. We used categorical and continuous measures of body weight status, including obesity (Body Mass Index (BMI) ≥ 95th percentile) and BMI z-scores. Multivariate logistic and linear models estimated the association between obesity and gross and fine motor skills in very young children adjusting for individual, social, and economic characteristics and parental involvement. The prevalence of obesity was about 15%. The relationship between motor skills and obesity varied across types of skills. For hopping, obese boys and girls had significantly lower scores, 20% lower in obese preschoolers and 10% lower in obese kindergarteners than normal weight counterparts, p Obese girls could jump 1.6-1.7 inches shorter than normal weight peers (p motor skills and fine motor skills of young children were not consistently related to BMI z-scores and obesity. Based on objective assessment of children's motor skills and body weight and a full adjustment for confounding covariates, we find no reduction in overall coordination and fine motor skills in obese young children. Motor skills are adversely associated with childhood obesity only for skills most directly related to body weight.

  1. Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study.

    Science.gov (United States)

    Evans-Lacko, S; Takizawa, R; Brimblecombe, N; King, D; Knapp, M; Maughan, B; Arseneault, L

    2017-01-01

    Research supports robust associations between childhood bullying victimization and mental health problems in childhood/adolescence and emerging evidence shows that the impact can persist into adulthood. We examined the impact of bullying victimization on mental health service use from childhood to midlife. We performed secondary analysis using the National Child Development Study, the 1958 British Birth Cohort Study. We conducted analyses on 9242 participants with complete data on childhood bullying victimization and service use at midlife. We used multivariable logistic regression models to examine associations between childhood bullying victimization and mental health service use at the ages of 16, 23, 33, 42 and 50 years. We estimated incidence and persistence of mental health service use over time to the age of 50 years. Compared with participants who were not bullied in childhood, those who were frequently bullied were more likely to use mental health services in childhood and adolescence [odds ratio (OR) 2.53, 95% confidence interval (CI) 1.88-3.40] and also in midlife (OR 1.30, 95% CI 1.10-1.55). Disparity in service use associated with childhood bullying victimization was accounted for by both incident service use through to age 33 years by a subgroup of participants, and by persistent use up to midlife. Childhood bullying victimization adds to the pressure on an already stretched health care system. Policy and practice efforts providing support for victims of bullying could help contain public sector costs. Given constrained budgets and the long-term mental health impact on victims of bullying, early prevention strategies could be effective at limiting both individual distress and later costs.

  2. Health care utilisation and out-of-pocket expenditure associated with back pain: a nationally representative survey of Australian women.

    Directory of Open Access Journals (Sweden)

    Emma R Kirby

    Full Text Available BACKGROUND: Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. OBJECTIVE: To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. METHODS: Survey of 1,310 women (response rate 80.9% who reported seeking help for back pain from the '1946-51 cohort' of the Australian Longitudinal Study on Women's Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. RESULTS: In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0 different health care practitioners, and had, on average, 12.2 (SD = 9.7 discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. CONCLUSIONS: Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women's access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in

  3. Mental health and resiliency following 44 months of terrorism: a survey of an Israeli national representative sample

    Science.gov (United States)

    Bleich, Avi; Gelkopf, Marc; Melamed, Yuval; Solomon, Zahava

    2006-01-01

    Background Israeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the psychological sequelae of 44 months of terrorism in Israel, and sought to identify factors that may contribute to vulnerability and resilience. Methods This was a telephone survey using strata sampling of 828 households, which reached a representative sample of 702 adult Israeli residents (84.8% contact rate). In total, 501 people (60.5%) agreed to participate. The methodology was similar to that of our previous study. Exposure to terrorism and other traumatic events, number of traumatic stress-related symptoms (TSRS), percentage of respondents with symptom criteria for post-traumatic stress disorder (PTSD), traumatic stress (TS) resiliency and feelings of depression, anxiety, optimism, sense of safety, and help-seeking were the main outcome measures. Results In total, 56 participants (11.2%) were directly exposed to a terrorist incident, and 101 (20.2%) had family members or friends exposed. Respondents reported a mean ± SD of 5.0 ± 4.5 TSRS; 45 (9%) met symptom criteria for PTSD; and 72 (14.4%) were TS-resilient. There were 147 participants (29.5%) who felt depressed, 50 (10.4%) felt anxious, and almost half (235; 47%) felt life-threatening danger; 48 (9.7%) felt the need for professional help. Women and people of Arab ethnicity had more TSRS, more PTSD, and less TS resiliency. Injury following a life-threatening experience, a major stressful life event, and a major loss of income were associated with PTSD. Immigrant status, lower education, low sense of safety, low sense of social support, high societal distress, and injury following life-threatening experiences were associated with TSRS. TSRS did not increase with exposure severity. This study

  4. Impact of weight change after quitting cigarettes on all-cause and cause-specific mortality in middle-aged male smokers: national health screening cohort study

    OpenAIRE

    Kyuwoong Kim; Seulggie Choi; Mi Hee Cho; Ji Hye Jun; Jooyoung Chang; Sung Min Kim; Kiheon Lee; Sang Min Park

    2018-01-01

    Background We aimed to investigate the association between weight change after smoking cessation and the risk of all-cause and cause-specific mortality among middle-aged male smokers. Methods We conducted a prospective cohort study using the National Health Insurance Service National Health Screening Cohort (NHIS-HealS) database. Male Participants (n=102,403) without critical conditions aged between 40 and 79 at baseline who underwent biennial health examination ...

  5. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study

    Science.gov (United States)

    Martínez Steele, Eurídice; Baraldi, Larissa Galastri; Louzada, Maria Laura da Costa; Moubarac, Jean-Claude; Mozaffarian, Dariush; Monteiro, Carlos Augusto

    2016-01-01

    Objectives To investigate the contribution of ultra-processed foods to the intake of added sugars in the USA. Ultra-processed foods were defined as industrial formulations which, besides salt, sugar, oils and fats, include substances not used in culinary preparations, in particular additives used to imitate sensorial qualities of minimally processed foods and their culinary preparations. Design Cross-sectional study. Setting National Health and Nutrition Examination Survey 2009–2010. Participants We evaluated 9317 participants aged 1+ years with at least one 24 h dietary recall. Main outcome measures Average dietary content of added sugars and proportion of individuals consuming more than 10% of total energy from added sugars. Data analysis Gaussian and Poisson regressions estimated the association between consumption of ultra-processed foods and intake of added sugars. All models incorporated survey sample weights and adjusted for age, sex, race/ethnicity, family income and educational attainment. Results Ultra-processed foods comprised 57.9% of energy intake, and contributed 89.7% of the energy intake from added sugars. The content of added sugars in ultra-processed foods (21.1% of calories) was eightfold higher than in processed foods (2.4%) and fivefold higher than in unprocessed or minimally processed foods and processed culinary ingredients grouped together (3.7%). Both in unadjusted and adjusted models, each increase of 5 percentage points in proportional energy intake from ultra-processed foods increased the proportional energy intake from added sugars by 1 percentage point. Consumption of added sugars increased linearly across quintiles of ultra-processed food consumption: from 7.5% of total energy in the lowest quintile to 19.5% in the highest. A total of 82.1% of Americans in the highest quintile exceeded the recommended limit of 10% energy from added sugars, compared with 26.4% in the lowest. Conclusions Decreasing the consumption of ultra

  6. Risk factors and immunity in a nationally representative population following the 2009 influenza A(H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Don Bandaranayake

    Full Text Available BACKGROUND: Understanding immunity, incidence and risk factors of the 2009 influenza A(H1N1 pandemic (2009 H1N1 through a national seroprevalence study is necessary for informing public health interventions and disease modelling. METHODS AND FINDINGS: We collected 1687 serum samples and individual risk factor data between November-2009 to March-2010, three months after the end of the 2009 H1N1 wave in New Zealand. Participants were randomly sampled from selected general practices countrywide and hospitals in the Auckland region. Baseline immunity was measured from 521 sera collected during 2004 to April-2009. Haemagglutination inhibition (HI antibody titres of ≥1:40 against 2009 H1N1 were considered seroprotective as well as seropositive. The overall community seroprevalence was 26.7% (CI:22.6-29.4. The seroprevalence varied across age and ethnicity. Children aged 5-19 years had the highest seroprevalence (46.7%;CI:38.3-55.0, a significant increase from the baseline (14%;CI:7.2-20.8. Older adults aged ≥60 had no significant difference in seroprevalence between the serosurvey (24.8%;CI:18.7-30.9 and baseline (22.6%;CI:15.3-30.0. Pacific peoples had the highest seroprevalence (49.5%;CI:35.1-64.0. There was no significant difference in seroprevalence between both primary (29.6%;CI:22.6-36.5 and secondary healthcare workers (25.3%;CI:20.8-29.8 and community participants. No significant regional variation was observed. Multivariate analysis indicated age as the most important risk factor followed by ethnicity. Previous seasonal influenza vaccination was associated with higher HI titres. Approximately 45.2% of seropositive individuals reported no symptoms. CONCLUSIONS: Based on age and ethnicity standardisation to the New Zealand Population, about 29.5% of New Zealanders had antibody titers at a level consistent with immunity to 2009 H1N1. Around 18.3% of New Zealanders were infected with the virus during the first wave including about one child

  7. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study.

    Science.gov (United States)

    Martínez Steele, Eurídice; Baraldi, Larissa Galastri; Louzada, Maria Laura da Costa; Moubarac, Jean-Claude; Mozaffarian, Dariush; Monteiro, Carlos Augusto

    2016-03-09

    To investigate the contribution of ultra-processed foods to the intake of added sugars in the USA. Ultra-processed foods were defined as industrial formulations which, besides salt, sugar, oils and fats, include substances not used in culinary preparations, in particular additives used to imitate sensorial qualities of minimally processed foods and their culinary preparations. Cross-sectional study. National Health and Nutrition Examination Survey 2009-2010. We evaluated 9317 participants aged 1+ years with at least one 24 h dietary recall. Average dietary content of added sugars and proportion of individuals consuming more than 10% of total energy from added sugars. Gaussian and Poisson regressions estimated the association between consumption of ultra-processed foods and intake of added sugars. All models incorporated survey sample weights and adjusted for age, sex, race/ethnicity, family income and educational attainment. Ultra-processed foods comprised 57.9% of energy intake, and contributed 89.7% of the energy intake from added sugars. The content of added sugars in ultra-processed foods (21.1% of calories) was eightfold higher than in processed foods (2.4%) and fivefold higher than in unprocessed or minimally processed foods and processed culinary ingredients grouped together (3.7%). Both in unadjusted and adjusted models, each increase of 5 percentage points in proportional energy intake from ultra-processed foods increased the proportional energy intake from added sugars by 1 percentage point. Consumption of added sugars increased linearly across quintiles of ultra-processed food consumption: from 7.5% of total energy in the lowest quintile to 19.5% in the highest. A total of 82.1% of Americans in the highest quintile exceeded the recommended limit of 10% energy from added sugars, compared with 26.4% in the lowest. Decreasing the consumption of ultra-processed foods could be an effective way of reducing the excessive intake of added sugars in the USA

  8. Alcohol use and sickness absence due to all causes and mental- or musculoskeletal disorders: a nationally representative study.

    Science.gov (United States)

    Kaila-Kangas, Leena; Koskinen, Aki; Leino-Arjas, Päivi; Virtanen, Marianna; Härkänen, Tommi; Lallukka, Tea

    2018-01-17

    Previous studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels of alcohol use, as well as in lifelong abstainers, former drinkers, and people with clinical alcohol use disorders. The data of the population-based Health 2000 Survey (BRIF8901) of 3666 Finns aged 30-55 were linked with national registers on medically certified sickness absences lasting for > 10 working days (long-term) for all causes (2000 - 2010) and for mental or musculoskeletal disorders (2004-2010), as well as with registers on pensions and death (2000-2010). Alcohol use was assessed by questionnaire. Chronic somatic diseases were evaluated at baseline in a clinical examination, and common mental and alcohol use disorders using the Composite International Diagnostic Interview (CIDI). Cox regression analyses were conducted with censoring for death and retirement from work. During an average 10-year follow-up, 56.0% of the participants had at least one long-term sickness absence period. Compared with light drinkers, those having an alcohol use disorder had increased risk of all-cause sickness absence (HR = 1.27; 95% CI = 1.04 - 1.54) and sickness absence due to mental disorders (HR = 2.16; 95% CI = 1.39 - 3.35), when somatic and mental disorders as well as demographic, lifestyle-related and occupational factors at baseline were accounted for. Lifelong abstainers did not differ from light drinkers. Also high-volume drinking (HR = 1.52; 95% CI 1.03 - 2.25) and former drinking (HR = 1.57; 95% CI = 1.15 - 2.15) were associated with long-term sickness absence due to mental disorders. Alcohol use was not predictive of sickness absence due to musculoskeletal disorders. These results

  9. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    NARCIS (Netherlands)

    Geleijnse, J.M.

    2015-01-01

    Background

    Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188

  10. Cross-country comparison of waterpipe use: nationally representative data from 13 low and middle-income countries from the Global Adult Tobacco Survey (GATS).

    Science.gov (United States)

    Morton, Jeremy; Song, Yang; Fouad, Heba; Awa, Fatimah El; Abou El Naga, Randa; Zhao, Luhua; Palipudi, Krishna; Asma, Samira

    2014-09-01

    Evidence shows that smoking tobacco using a waterpipe is significantly associated with diseases. Despite this, waterpipe use seems to be increasing worldwide, though nationally representative data are not widely available. The Global Adult Tobacco Survey (GATS) provides an opportunity to measure various indicators of waterpipe use from nationally representative surveys. Data were obtained for adults 15 years of age or older from 13 countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam) who completed GATS from 2008-2010. The GATS questionnaire collected data on current waterpipe use, including daily/less than daily prevalence and number of sessions per day/week. An optional waterpipe module measured former use, age of initiation, and level of consumption during a session. GATS was successful in producing nationally representative data on waterpipe use from 13 countries, many of which for the first time. The prevalence of waterpipe use among men was highest in Vietnam (13.0%) and Egypt (6.2%); among women, waterpipe use was highest in Russia (3.2%) and Ukraine (1.1%). While over 90% of adults in Ukraine thought smoking tobacco causes serious illness, only 31.4% thought smoking tobacco using a waterpipe causes serious illness. GATS data provide the ability to analyse waterpipe use within a country and across countries. Monitoring of waterpipe use at a national level will better enable countries to target tobacco control interventions such as education campaigns about the negative health effects of waterpipe use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Disability, caregiver's dependency and patterns of access to rehabilitation care: results from a national representative study in Peru.

    Science.gov (United States)

    Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vásquez, Alberto; Miranda, J Jaime

    2016-01-01

    To determine the prevalence of disability in Peru, explore dependency on caregiver's assistance and assess access to rehabilitation care. Data from Disability National Survey (ENEDIS), including urban and rural areas, were analyzed. Disability was defined as a permanent limitation on movement, vision, communication, hearing, learning/remembering or social relationships. Dependency was defined as the self-reported need for a caregiver to help with daily activities; and access to rehabilitation care was defined as the self-report of any therapy for disabilities. Estimates and projections were calculated using sample strata, primary sampling units and population weights, and prevalence ratios (PRs) and 95%CI were reported. From 798,308 people screened, 37,524 (5.1%; 95%CI 4.9--5.2%) had at least one disability. A total of 37,117 were included in further analysis, mean age 57.8 (SD ± 24.1) years, 52.1% women. Dependency was self-reported by 14,980 (40.5%; 95%CI: 39.2-41.9%) individuals with disabilities. A family member, usually female, was identified as a caregiver in 94.3% (95%CI: 93.3-95.3%) of dependent participants. Only 2881 (10.7%; 95%CI: 9.7-11.9%) of people with disabilities reported access to rehabilitation care. Major inequality patterns of disability burden versus access to rehabilitation care were observed by age and education level. Older age groups had higher disability burden yet lower chances of access to rehabilitation care. Conversely, the higher the education level, the lesser the overall disability burden but also the higher chances of reporting receiving care. Private healthcare insurance doubled the probability of having access to rehabilitation compared with those without insurance. Approximately 1.6 million Peruvians have at least one disability, and 40% of them require assistance with daily activities. Informal caregiving, likely female and relative-provided, is highly common. Rehabilitation care access is low and inequitable. Our results

  12. Local Distributions of Wealth to Describe Health Inequalities in India: A New Approach for Analyzing Nationally Representative Household Survey Data, 1992–2008

    Science.gov (United States)

    Bassani, Diego G.; Corsi, Daniel J.; Gaffey, Michelle F.; Barros, Aluisio J. D.

    2014-01-01

    Background Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992–3 and 2007–8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Methods Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. Results For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. Conclusions The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health

  13. Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

    Directory of Open Access Journals (Sweden)

    Diego G Bassani

    Full Text Available Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India.Indices were derived through principal components analysis (PCA performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states.For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas.The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth

  14. Prevalence of Low-Cost Generic Program Use in a Nationally Representative Cohort of Privately Insured Adults.

    Science.gov (United States)

    Pauly, Nathan James; Brown, Joshua David

    2015-12-01

    statistical area (MSA), prescription drug coverage, geographic region, comorbidities, and number of unique medications and medication fills. Comparisons were made between users and nonusers using chi-square and t-tests. Multivariable logistic regression was used to identify factors associated with LCGP use. Out of the entire study cohort (N = 19,037), 6,921 (36.4%) individuals were identified as LCGP users, representing 34 million LCGP users annually. Users tended to be older, had higher Charlson Comorbidity Index scores, filled more prescriptions per person, and used more unique medications. Proportions of LCGP users and uses nearly doubled from 2007-2011, while total prescription utilization per person remained relatively stable. Over 10% of all prescription fills were filled through LCGPs. Of all LCGP fills, approximately 42% were for cardiovascular medications, 12% for antidiabetics, and 14% for levothyroxine. Greater than 30% of fills for antigout, metronidazole, angiotensin-converting enzyme inhibitors, levothyroxine, metformin, and diuretics were obtained through LCGPs, as were 18.9% of all warfarin fills. Compared with the reference category aged 18-34, adults aged 35-54 had an adjusted odds ratio (AOR) of being an LCGP user of 1.39 (95% CI = 1.29-1.50) and adults aged 55-64 had an AOR of 1.86 (95% CI = 1.70-2.04). Additionally, those with prescription drug coverage were nearly twice as likely to be LCGP users (AOR = 1.96; 95% CI = 1.64-2.35) compared with those without. Gender, income, comorbidity burden, region, year of panel entry, and number of unique medications also significantly predicted LCGP use. There is a high rate of LCGP use in the privately insured adult population. Users of LCGPs tend to be older, have more chronic comorbidities, and use more medications than nonusers. Claims-based research and quality assurance programs focusing on the benefits and harms of medications available through these programs are at risk of greatly

  15. The development and validation of the Male Genital Self-Image Scale: results from a nationally representative probability sample of men in the United States.

    Science.gov (United States)

    Herbenick, Debby; Schick, Vanessa; Reece, Michael; Sanders, Stephanie A; Fortenberry, J Dennis

    2013-06-01

    Numerous factors may affect men's sexual experiences, including their health status, past trauma or abuse, medication use, relationships, mood, anxiety, and body image. Little research has assessed the influence of men's genital self-image on their sexual function or behaviors and none has done so in a nationally representative sample. The purpose of this study was to, in a nationally representative probability sample of men ages 18 to 60, assess the reliability and validity of the Male Genital Self-Image Scale (MGSIS), and to examine the relationship between scores on the MGSIS and men's scores on the International Index of Erectile Function (IIEF). The MGSIS was developed in two stages. Phase One involved a review of the literature and an analysis of cross-sectional survey data. Phase Two involved an administration of the scale items to a nationally representative sample of men in the United States ages 18 to 60. Measures include demographic items, the IIEF, and the MGSIS. Overall, most men felt positively about their genitals. However, 24.6% of men expressed some discomfort letting a healthcare provider examine their genitals and about 20% reported dissatisfaction with their genital size. The MGSIS was found to be reliable and valid, with the MGSIS-5 (consisting of five items) being the best fit to the data. The MGSIS was found to be a reliable and valid measure. In addition, men's scores on the MGSIS-5 were found to be positively related to men's scores on the IIEF. © 2013 International Society for Sexual Medicine.

  16. Improvement of the Work Environment and Work-Related Stress: A Cross-Sectional Multilevel Study of a Nationally Representative Sample of Japanese Workers.

    Science.gov (United States)

    Watanabe, Kazuhiro; Tabuchi, Takahiro; Kawakami, Norito

    2017-03-01

    This cross-sectional multilevel study aimed to investigate the relationship between improvement of the work environment and work-related stress in a nationally representative sample in Japan. The study was based on a national survey that randomly sampled 1745 worksites and 17,500 nested employees. The survey asked the worksites whether improvements of the work environment were conducted; and it asked the employees to report the number of work-related stresses they experienced. Multilevel multinominal logistic and linear regression analyses were conducted. Improvement of the work environment was not significantly associated with any level of work-related stress. Among men, it was significantly and negatively associated with the severe level of work-related stress. The association was not significant among women. Improvements to work environments may be associated with reduced work-related stress among men nationwide in Japan.

  17. Progress in Reversing the HIV Epidemic through Intensified Access to Antiretroviral Therapy: Results from a Nationally Representative Population-Based Survey in Kenya, 2012

    Science.gov (United States)

    Kim, Andrea A.; Mukui, Irene; N’gan’ga, Lucy; Katana, Abraham; Koros, Dan; Wamicwe, Joyce; De Cock, Kevin M.

    2016-01-01

    Background In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) called for 90% of persons living with HIV (PLHIV) to know their status, 90% of these to be on antiretroviral therapy (ART), and 90% of these to be virally suppressed by 2020 (90-90-90). It is not clear whether planned ART scale-up in countries whose eligibility criteria for ART initiation are based on recommendations from the 2013 World Health Organization treatment guidelines will be sufficient to meet UNAIDS' new global targets. Materials and Methods Using data from a nationally representative population-based household survey of persons in Kenya we compared coverage and unmet need associated with HIV diagnosis, ART, and viral suppression among PLHIV aged 15–64 years in 2012 based on criteria outlined in the 2014 national ART guidelines and UNAIDS’ 90-90-90 goals. Estimates were weighted to account for sampling probability and nonresponse. Results Eight in ten PLHIV aged 15–64 years needed ART based on treatment eligibility. Need for treatment based on the national treatment policy was 97.4% of treatment need based on UNAIDS’ 90-90-90 goals, requiring an excess of 24,000 PLHIV to access treatment beyond those eligible for ART to achieve UNAIDS’ 90-90-90 treatment target. The gap in treatment coverage was high, ranging from 43.1% nationally to 52.3% in Nyanza among treatment-eligible PLHIV and 44.6% nationally to 52.4% in Nyanza among all PLHIV. Conclusion Maintaining the current pace of ART scale-up in Kenya will result in thousands of PLHIV unreached, many with high viral load and at-risk of transmitting infection to others. Careful strategies for reaching 90-90-90 will be instrumental in determining whether intensified access to treatment can be achieved to reach all who require ART. PMID:26930291

  18. Self-reported use of novel psychoactive substances in a US nationally representative survey: Prevalence, correlates, and a call for new survey methods to prevent underreporting.

    Science.gov (United States)

    Palamar, Joseph J; Martins, Silvia S; Su, Mark K; Ompad, Danielle C

    2015-11-01

    In recent years, there has been an increase in emergence and use of novel psychoactive substances (NPS) in the US and worldwide. However, there is little published epidemiological survey data estimating the prevalence of use in the US. Data on self-reported NPS use came from the National Survey of Drug Use and Health (2009-2013), a national representative sample of non-institutionalized individuals in the US. Subjects were asked to provide names of (non-traditional) drugs they used that they were not specifically asked about. We examined lifetime prevalence and sociodemographic correlates of self-reported use of new and uncommon synthetic drugs (NPS) among subjects ages 12-34-years-old. 1.2% of subjects self-reported any use of the 57 NPS we examined. Use of psychedelic tryptamines (primarily DMT) was most common, followed by psychedelic phenethylamines (e.g., 2C series) and synthetic cannabinoids. Prevalence of self-reported use of NPS increased from 2009 to 2013 and use was most common among males, whites, older subjects, those of lower income, and among those residing in cities. Lifetime use of various other illicit drugs (e.g., LSD, cocaine, ecstasy/MDMA) was highly prevalent among NPS users. This the first study reporting on use of a variety of NPS in a nationally representative US sample; however, use appears to be underreported as other national data suggest higher rates of NPS (e.g., synthetic cannabinoid) use. Developing more adaptable survey tools and systematically assessing NPS use would allow researchers to ask about hundreds of NPS and improve reporting as new drugs continue to rapidly emerge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations.

    Science.gov (United States)

    Finegold, Judith A; Asaria, Perviz; Francis, Darrel P

    2013-09-30

    Ischaemic heart disease (IHD) is the leading cause of death worldwide. The World Health Organisation (WHO) collects mortality data coded using the International Statistical Classification of Diseases (ICD) code. We analysed IHD deaths world-wide between 1995 and 2009 and used the UN population database to calculate age-specific and directly and indirectly age-standardised IHD mortality rates by country and region. IHD is the single largest cause of death worldwide, causing 7,249,000 deaths in 2008, 12.7% of total global mortality. There is more than 20-fold variation in IHD mortality rates between countries. Highest IHD mortality rates are in Eastern Europe and Central Asian countries; lowest rates in high income countries. For the working-age population, IHD mortality rates are markedly higher in low-and-middle income countries than in high income countries. Over the last 25 years, age-standardised IHD mortality has fallen by more than half in high income countries, but the trend is flat or increasing in some low-and-middle income countries. Low-and-middle income countries now account for more than 80% of global IHD deaths. The global burden of IHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. In high income countries, population ageing maintains IHD as the leading cause of death. Nevertheless, the progressive decline in age-standardised IHD mortality in high income countries shows that increasing IHD mortality is not inevitable. The 20-fold mortality difference between countries, and the temporal trends, may hold vital clues for handling IHD epidemic which is migratory, and still burgeoning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Mortality among men and women in same-sex marriage: a national cohort study of 8333 Danes.

    Science.gov (United States)

    Frisch, Morten; Brønnum-Hansen, Henrik

    2009-01-01

    We studied overall mortality in a demographically defined, complete cohort of gay men and lesbians to address recent claims of markedly shorter life spans among homosexual persons. We calculated standardized mortality ratios (SMRs) starting 1 year after the date of same-sex marriage for 4914 men and 3419 women in Denmark who married a same-sex partner between 1989 and 2004. Mortality was markedly increased in the first decade after same-sex marriage for men who married between 1989 and 1995 (SMR=2.25; 95% confidence interval [CI]=2.01, 2.50), but much less so for men who married after 1995, when efficient HIV/AIDS therapies were available (SMR=1.33; 95% CI=1.04, 1.68). For women who married their same-sex partner between 1989 and 2004, mortality was 34% higher than was mortality in the general female population (SMR=1.34; 95% CI=1.09, 1.63). For women, and for men marrying after 1995, the significant excess mortality was limited to the period 1 to 3 years after the marriage. Despite recent marked reduction in mortality among gay men, Danish men and women in same-sex marriages still have mortality rates that exceed those of the general population. The excess mortality is restricted to the first few years after a marriage, presumably reflecting preexisting illness at the time of marriage. Although further study is needed, the claims of drastically increased overall mortality in gay men and lesbians appear unjustified.

  1. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2016-01-01

    and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all......Summary Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage......-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software...

  2. Replacing sedentary time with physical activity: a 15-year follow-up of mortality in a national cohort

    Directory of Open Access Journals (Sweden)

    Dohrn IM

    2018-01-01

    Full Text Available Ing-Mari Dohrn,1 Lydia Kwak,2 Pekka Oja,3 Michael Sjöström,4 Maria Hagströmer1,5 1Department of Neurobiology, Care Sciences and Society (NVS, 2Institute of Environmental Medicine (IMM, Karolinska Institutet, Stockholm, Sweden; 3UKK Institute, Tampere, Finland; 4Department of Biosciences and Nutrition (BioNut, Karolinska Institutet, 5Functional Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden Background: Sedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA behavior. Objective: To investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA on all-cause mortality, cardiovascular disease (CVD mortality or cancer mortality in a cohort with 15 years follow-up time.Methods: In total, 851 women and men from the population-based Sweden Attitude Behaviour and Change study were included. Time spent sedentary, in light-intensity PA and in MVPA were assessed using an Actigraph 7164 accelerometer. Mortality data were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR of mortality with 95% confidence intervals (CI and isotemporal substitution models were used to estimate the effect of replacing sedentary behavior with PA for the same amount of time.Results: Over a follow-up of 14.2 years (SD 1.9 with 12,117 person-years at risk, 79 deaths occurred, 24 deaths from CVD, 27 from cancer, and 28 from other causes. Replacing 30 minutes/day of sedentary time with light-intensity PA was associated with significant reduction in all-cause mortality risk (HR: 0.89, 95% CI: 0.81-0.98 and CVD mortality risk (HR

  3. Representing Development

    DEFF Research Database (Denmark)

    Representing Development presents the different social representations that have formed the idea of development in Western thinking over the past three centuries. Offering an acute perspective on the current state of developmental science and providing constructive insights into future pathways, ...

  4. National, regional, and global sex ratios of infant, child, and under-5 mortality and identification of countries with outlying ratios: a systematic assessment.

    Science.gov (United States)

    Alkema, Leontine; Chao, Fengqing; You, Danzhen; Pedersen, Jon; Sawyer, Cheryl C

    2014-09-01

    mortality has decreased since 1990 for the vast majority of countries with outlying sex ratios, the ratios of estimated to expected female mortality did not change substantially for most countries, and worsened for India. Important differences exist between boys and girls with respect to survival up to the age of 5 years. Survival chances tend to improve more rapidly for girls compared with boys as total mortality decreases, with a reversal of this trend at very low infant mortality. For many countries, sex ratios follow this pattern but important exceptions exist. An explanation needs to be sought for selected countries with outlying sex ratios and action should be undertaken if sex discrimination is present. The National University of Singapore and the United Nations Children's Fund (UNICEF). Copyright © 2014 Alkema et al. Open Access article distributed under the terms of CC BY-NC-SA. Published by .. All rights reserved.

  5. Decreased early mortality associated with the treatment of acute myeloid leukemia at National Cancer Institute-designated cancer centers in California.

    Science.gov (United States)

    Ho, Gwendolyn; Wun, Ted; Muffly, Lori; Li, Qian; Brunson, Ann; Rosenberg, Aaron S; Jonas, Brian A; Keegan, Theresa H M

    2018-05-01

    To the authors' knowledge, few population-based studies to date have evaluated the association between location of care, complications with induction therapy, and early mortality in patients with acute myeloid leukemia (AML). Using linked data from the California Cancer Registry and Patient Discharge Dataset (1999-2014), the authors identified adult (aged ≥18 years) patients with AML who received inpatient treatment within 30 days of diagnosis. A propensity score was created for treatment at a National Cancer Institute-designated cancer center (NCI-CC). Inverse probability-weighted, multivariable logistic regression models were used to determine associations between location of care, complications, and early mortality (death ≤60 days from diagnosis). Of the 7007 patients with AML, 1762 (25%) were treated at an NCI-CC. Patients with AML who were treated at NCI-CCs were more likely to be aged ≤65 years, live in higher socioeconomic status neighborhoods, have fewer comorbidities, and have public health insurance. Patients treated at NCI-CCs had higher rates of renal failure (23% vs 20%; P = .010) and lower rates of respiratory failure (11% vs 14%; P = .003) and cardiac arrest (1% vs 2%; P = .014). After adjustment for baseline characteristics, treatment at an NCI-CC was associated with lower early mortality (odds ratio, 0.46; 95% confidence interval, 0.38-0.57). The impact of complications on early mortality did not differ by location of care except for higher early mortality noted among patients with respiratory failure treated at non-NCI-CCs. The initial treatment of adult patients with AML at NCI-CCs is associated with a 53% reduction in the odds of early mortality compared with treatment at non-NCI-CCs. Lower early mortality may result from differences in hospital or provider experience and supportive care. Cancer 2018;124:1938-45. © 2018 American Cancer Society. © 2018 American Cancer Society.

  6. Impacts on quality of life related to dental caries in a national representative sample of Thai 12- and 15-year-olds.

    Science.gov (United States)

    Krisdapong, S; Prasertsom, P; Rattanarangsima, K; Sheiham, A

    2013-01-01

    Dental caries is generally given the highest priority in national oral health services for school-aged populations. Yet, there is no study exploring the impacts on quality of life specifically related to dental caries in national samples of school-aged children. This study assessed prevalence and characteristics of oral impacts attributed to dental caries on quality of life and compared them with overall oral health impacts. In addition, associations of oral impacts attributed to dental caries and dental caries status were investigated. A national representative sample of 1,063 12- and 811 15-year-olds completed a sociodemographic and behavioural questionnaire, and were orally examined and interviewed about oral health-related quality of life using the Child-OIDP or OIDP indexes, respectively. Associations of condition-specific impacts (CS impacts) attributed to dental caries with components of DMF were investigated using χ(2) tests and multivariate logistic regressions. CS impacts attributed to dental caries were reported by nearly half the children and such impacts accounted for half of overall oral impacts from all oral conditions. The majority of impacts were of little intensity and affected only 1-2 daily performances, particularly performances on Eating, Emotional stability and Cleaning teeth. CS impacts were significantly positively associated with number of decayed teeth, and strongly associated with severe decay. Copyright © 2012 S. Karger AG, Basel.

  7. Does uneven geographic distribution of urologists effect bladder and prostate cancers mortality? National health insurance data in Korea from 2007-2011.

    Science.gov (United States)

    Kim, Jae Heon; Sun, Hwa Yeon; Kim, Hyun Jung; Ko, Young Myoung; Chun, Dong-Il; Park, Jae Young

    2017-09-12

    The relationship between distribution of urologists and mortality of bladder and prostate cancers has not been clearly established. The aim of this study was to investigate the relationship between uneven distribution of urologists and urologic cancer specific mortality at country level. Data from the National Health Insurance Service and National Statistical Office in Korea from 2007 to 2011 were analyzed in this ecological study. Univariate and multivariable regression analyses were performed to determine risk factors for age standardized mortality rates (ASMR) of bladder and prostate cancers. Linear regression analysis showed a markedly ( p ASMRs for either bladder cancer or prostate cancer. Univariate analysis after adjusting for time showed that country area, urologist density, and income were significant factors affecting bladder cancer incidence ( p ASMR of bladder cancer, urologist density was not related to ASMR of bladder cancer or prostate cancer. Although there was a marked difference in urologist density between metropolitan and non-metropolitan areas for these years analyzed, mortality rates of bladder and prostate cancers were not significantly affected by country area or urologist density.

  8. Does uneven geographic distribution of urologists effect bladder and prostate cancers mortality? National health insurance data in Korea from 2007–2011

    Science.gov (United States)

    Kim, Jae Heon; Sun, Hwa Yeon; Kim, Hyun Jung; Ko, Young Myoung; Chun, Dong-Il; Park, Jae Young

    2017-01-01

    The relationship between distribution of urologists and mortality of bladder and prostate cancers has not been clearly established. The aim of this study was to investigate the relationship between uneven distribution of urologists and urologic cancer specific mortality at country level. Data from the National Health Insurance Service and National Statistical Office in Korea from 2007 to 2011 were analyzed in this ecological study. Univariate and multivariable regression analyses were performed to determine risk factors for age standardized mortality rates (ASMR) of bladder and prostate cancers. Linear regression analysis showed a markedly (p ASMRs for either bladder cancer or prostate cancer. Univariate analysis after adjusting for time showed that country area, urologist density, and income were significant factors affecting bladder cancer incidence (p ASMR of bladder cancer, urologist density was not related to ASMR of bladder cancer or prostate cancer. Although there was a marked difference in urologist density between metropolitan and non-metropolitan areas for these years analyzed, mortality rates of bladder and prostate cancers were not significantly affected by country area or urologist density. PMID:29029431

  9. Pre-resuscitation factors associated with mortality in 49,130 cases of in-hospital cardiac arrest: a report from the National Registry for Cardiopulmonary Resuscitation.

    Science.gov (United States)

    Larkin, Gregory Luke; Copes, Wayne S; Nathanson, Brian H; Kaye, William

    2010-03-01

    To evaluate key pre-arrest factors and their collective ability to predict post-cardiopulmonary arrest mortality. CPR is often initiated indiscriminately after in-hospital cardiopulmonary arrest. Improved understanding of pre-arrest factors associated with mortality may inform advance care planning. A cohort of 49,130 adults who experienced pulseless cardiopulmonary arrest from January 2000 to September 2004 was obtained from 366 US hospitals participating in the National Registry for Cardiopulmonary Resuscitation (NRCPR). Logistic regression with bootstrapping was used to model in-hospital mortality, which included those discharged in unfavorable and severely worsened neurologic state (Cerebral Performance Category >/=3). Overall in-hospital mortality was 84.1%. Advanced age, black race, non-cardiac, non-surgical illness category, pre-existing malignancy, acute stroke, trauma, septicemia, hepatic insufficiency, general floor or Emergency Department location, and pre-arrest use of vasopressors or assisted/mechanical ventilation were independently predictive of in-hospital mortality. Retained peri-arrest factors including cardiac monitoring, and shockable initial pulseless rhythms, were strongly associated with survival. The validation model's AUROC curve (0.77) revealed fair performance. Predictive pre-resuscitation factors may supplement patient-specific information available at bedside to assist in revising resuscitation plans during the patient's hospitalization. Copyright 2009. Published by Elsevier Ireland Ltd.

  10. Measuring Iran's success in achieving Millennium Development Goal 4: a systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015

    Directory of Open Access Journals (Sweden)

    Younes Mohammadi, PhD

    2017-05-01

    Full Text Available Summary: Background: Child mortality as one of the key Millennium Development Goals (MDG 4—to reduce child mortality by two-thirds from 1990 to 2015, is included in the Sustainable Development Goals (SDG 3, target 2—to reduce child mortality to fewer than 25 deaths per 1000 livebirths for all countries by 2030, and is a key indicator of the health system in every country. In this study, we aimed to estimate the level and trend of child mortality from 1990 to 2015 in Iran, to assess the progress of the country and its provinces toward these goals. Methods: We used three different data sources: three censuses, a Demographic and Health Survey (DHS, and 5-year data from the death registration system. We used the summary birth history data from four data sources (the three censuses and DHS and used maternal age cohort and maternal age period methods to estimate the trends in child mortality rates, combining the estimates of these two indirect methods using Loess regression. We also used the complete birth history method to estimate child mortality rate directly from DHS data. Finally, to synthesise different trends into a single trend and calculate uncertainty intervals (UI, we used Gaussian process regression. Findings: Under-5 mortality rates (deaths per 1000 livebirths at the national level in Iran in 1990, 2000, 2010, and 2015 were 63·6 (95% UI 63·1–64·0, 38·8 (38·5–39·2, 24·9 (24·3–25·4, and 19·4 (18·6–20·2, respectively. Between 1990 and 2015, the median annual reduction and total overall reduction in these rates were 4·9% and 70%, respectively. At the provincial level, the difference between the highest and lowest child mortality rates in 1990, 2000, and 2015 were 65·6, 40·4, and 38·1 per 1000 livebirths, respectively. Based on the MDG 4 goal, five provinces had not decreased child mortality by two-thirds by 2015. Furthermore, six provinces had not reached SDG 3 (target 2. Interpretation: Iran and most of its

  11. Predictors of in-hospital mortality in surgically treated valvular infective endocarditis cases at National Heart Institute, Egypt

    Directory of Open Access Journals (Sweden)

    Ahmed Elmasry

    2017-03-01

    Conclusions: Surgery for IE continues to be challenging. EuroSCORE II has a good discrimination ability to predict in-hospital mortality in IE surgery. Satisfactory results can be obtained with valve repair in IE.

  12. Unmasking inequalities: Sub-national maternal and child mortality data from two urban slums in Lagos, Nigeria tells the story.

    Directory of Open Access Journals (Sweden)

    Erin Anastasi

    Full Text Available Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos.The study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected.Data was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894-1215, and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4% associated with delivery at the health facility.The maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard

  13. Unmasking inequalities: Sub-national maternal and child mortality data from two urban slums in Lagos, Nigeria tells the story.

    Science.gov (United States)

    Anastasi, Erin; Ekanem, Ekanem; Hill, Olivia; Adebayo Oluwakemi, Agnes; Abayomi, Oluwatosin; Bernasconi, Andrea

    2017-01-01

    Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos. The study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected. Data was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894-1215), and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4%) associated with delivery at the health facility. The maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard-to-reach populations in

  14. Pattern analysis of total item score and item response of the Kessler Screening Scale for Psychological Distress (K6 in a nationally representative sample of US adults

    Directory of Open Access Journals (Sweden)

    Shinichiro Tomitaka

    2017-02-01

    Full Text Available Background Several recent studies have shown that total scores on depressive symptom measures in a general population approximate an exponential pattern except for the lower end of the distribution. Furthermore, we confirmed that the exponential pattern is present for the individual item responses on the Center for Epidemiologic Studies Depression Scale (CES-D. To confirm the reproducibility of such findings, we investigated the total score distribution and item responses of the Kessler Screening Scale for Psychological Distress (K6 in a nationally representative study. Methods Data were drawn from the National Survey of Midlife Development in the United States (MIDUS, which comprises four subsamples: (1 a national random digit dialing (RDD sample, (2 oversamples from five metropolitan areas, (3 siblings of individuals from the RDD sample, and (4 a national RDD sample of twin pairs. K6 items are scored using a 5-point scale: “none of the time,” “a little of the time,” “some of the time,” “most of the time,” and “all of the time.” The pattern of total score distribution and item responses were analyzed using graphical analysis and exponential regression model. Results The total score distributions of the four subsamples exhibited an exponential pattern with similar rate parameters. The item responses of the K6 approximated a linear pattern from “a little of the time” to “all of the time” on log-normal scales, while “none of the time” response was not related to this exponential pattern. Discussion The total score distribution and item responses of the K6 showed exponential patterns, consistent with other depressive symptom scales.

  15. Prescription pain reliever misuse and levels of pain impairment: 3-year course in a nationally representative outpatient sample of US adults

    Directory of Open Access Journals (Sweden)

    Novak SP

    2016-06-01

    Full Text Available Scott P Novak,1 Cristie Glasheen,1 Carl L Roland,2 1Behavioral Health Epidemiology, RTI International, 2Clinical Sciences and Outcomes Evidence, Pfizer Inc., Durham, NC, USA Background: The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, a representative 3-year longitudinal survey (ages 18+ years that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods: We used a two-wave, nationally representative sample of adults (aged 18+ years in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves. Results: Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion: This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of

  16. CDC National Health Report: leading causes of morbidity and mortality and associated behavioral risk and protective factors--United States, 2005-2013.

    Science.gov (United States)

    Johnson, Nicole Blair; Hayes, Locola D; Brown, Kathryn; Hoo, Elizabeth C; Ethier, Kathleen A

    2014-10-31

    Although substantial progress has been made in improving the health of persons in the United States, serious problems remain to be solved. Life expectancy is increasing, and the rates of the leading causes of death are improving in many cases; however, numerous indicators (i.e., measures of observed or calculated data on the status of a condition) of the health and safety of the U.S. population remain poor. This report reviews population health in the United States and provides an assessment of recent progress in meeting high-priority health objectives. The health status indicators described in this report were selected because of their direct relation to the leading causes of death and other substantial sources of morbidity and mortality and should be the focus of prevention efforts. Data are reported starting in 2005 (or the earliest available year since 2005) through the current data year. Because data sources and specific indicators vary regarding when data are available, the most recent year for which data are available might range from 2010 to 2013. Data were obtained from 17 CDC surveys or surveillance systems and three non-CDC sources to provide a view of this particular point of time in the nation's health and trends in recent years. Data from the following CDC surveillance systems and surveys were used: Behavioral Risk Factor Surveillance System (BRFSS); Emerging Infections Program/Active Bacterial Core surveillance (EIP/ABCs); Foodborne Diseases Active Surveillance Network (FoodNet); Internet Panel Surveys: Influenza Vaccination Coverage Among Health-Care Personnel and Influenza Vaccination Coverage Among Pregnant Women; National Ambulatory Medical Care Survey (NAMCS); National Health and Nutrition Examination Survey (NHANES); National Health Interview Survey (NHIS); National Healthcare Safety Network (NHSN); National HIV Surveillance System; National Hospital Discharge Survey (NHDS); National Immunization Survey (NIS); National Immunization Survey

  17. Performance of hospitals according to the ESC ACCA quality indicators and 30-day mortality for acute myocardial infarction:national cohort study using the United Kingdom Myocardial Ischaemia National Audit Project (MINAP) register

    OpenAIRE

    Bebb, Owen; Hall, Marlous; Fox, Keith A A; Dondo, Tatendashe B; Timmis, Adam; Bueno, Hector; Schiele, François; Gale, Chris P

    2017-01-01

    Aims: To investigate the application of the European Society of Cardiology Acute Cardiovascular Care Association quality indicators (QI) for acute myocardial infarction for the study of hospital performance and 30-day mortality.Methods and results: National cohort study (n = 118,075 patients, n = 211 hospitals, MINAP registry), 2012-13. Overall, 16 of the 20 QIs could be calculated. Eleven QIs had a significant inverse association with GRACE risk adjusted 30-day mortality (all P < 0.005). ...

  18. Surgical care for the aged: a retrospective cross-sectional study of a national surgical mortality audit

    Science.gov (United States)

    Allen, Jennifer; North, John B; Ware, Robert S

    2015-01-01

    Objectives It is assumed that increased age signifies increased surgical care. Few surgical studies describe the differences in care provided to older patients compared with younger patients. We aimed to examine the relationships between increasing age, preoperative factors and markers of postoperative care in adults who died in-hospital after surgery in Australia. Design This retrospective cross-sectional study extracted data from a national surgical mortality audit—an independent, peer-reviewed process. Setting From January 2009 to December 2012, 111 public and 61 private Australian hospitals notified the audit of in-hospital deaths after general anaesthetic surgery or if the patient was admitted under a surgeon. Participants Notified deaths totalled 19 723. We excluded deaths if patients were brain dead, younger than 17 years or never had an operation (n=11 376). From this baseline population, we divided 11 201 deaths into three patient age groups: youngest (17–64 years), medium (65–79 years) and oldest (≥80 years). Outcome measures Univariable and multivariable logistic regression analyses determined the relationships between increasing age and the measured preoperative factors and postoperative variables. Results The baseline population's median age was 78 years (IQR 66–85), 43.7% (4892/11 201) were 80 years or older and 83.4% (9319/11 173) had emergency admissions. The oldest group had increased trauma and emergency admissions than the medium and youngest age groups. Seven of the eight measured markers of postoperative care demonstrate strong and significant relationships with increasing age. The oldest group compared with the medium group had decreased rates of: unplanned returns to theatre (11.2% (526/4709) vs 20.2% (726/3586)), unplanned intensive care admissions (16.3% (545/3350) vs 24.0% (601/2504)) and treatment in intensive care units (59.7% (2689/4507) vs 76.7% (2754/3590)). Conclusions The oldest patients received

  19. National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment.

    Science.gov (United States)

    Chao, Fengqing; You, Danzhen; Pedersen, Jon; Hug, Lucia; Alkema, Leontine

    2018-05-01

    The progress to achieve the fourth Millennium Development Goal in reducing mortality rate in children younger than 5 years since 1990 has been remarkable. However, work remains to be done in the Sustainable Development Goal era. Estimates of under-5 mortality rates at the national level can hide disparities within countries. We assessed disparities in under-5 mortality rates by household economic status in low-income and middle-income countries (LMICs). We estimated country-year-specific under-5 mortality rates by wealth quintile on the basis of household wealth indices for 137 LMICs from 1990 to 2016, using a Bayesian statistical model. We estimated the association between quintile-specific and national-level under-5 mortality rates. We assessed the levels and trends of absolute and relative disparity in under-5 mortality rate between the poorest and richest quintiles, and among all quintiles. In 2016, for all LMICs (excluding China), the aggregated under-5 mortality rate was 64·6 (90% uncertainty interval [UI] 61·1-70·1) deaths per 1000 livebirths in the poorest households (first quintile), 31·3 (29·5-34·2) deaths per 1000 livebirths in the richest households (fifth quintile), and in between those outcomes for the middle quintiles. Between 1990 and 2016, the largest absolute decline in under-5 mortality rate occurred in the two poorest quintiles: 77·6 (90% UI 71·2-82·6) deaths per 1000 livebirths in the poorest quintile and 77·9 (72·0-82·2) deaths per 1000 livebirths in the second poorest quintile. The difference in under-5 mortality rate between the poorest and richest quintiles decreased significantly by 38·8 (90% UI 32·9-43·8) deaths per 1000 livebirths between 1990 and 2016. The poorest to richest under-5 mortality rate ratio, however, remained similar (2·03 [90% UI 1·94-2·11] in 1990, 1·99 [1·91-2·08] in 2000, and 2·06 [1·92-2·20] in 2016). During 1990-2016, around half of the total under-5 deaths occurred in the poorest two quintiles

  20. High prevalence of thiamine (vitamin B1) deficiency in early childhood among a nationally representative sample of Cambodian women of childbearing age and their children

    DEFF Research Database (Denmark)

    Whitfield, Kyly C; Smith, Geoffry; Chamnan, Chhoun

    2017-01-01

    the thiamine status (measured as erythrocyte thiamine diphosphate concentrations; eThDP) among a representative sample of Cambodian women of childbearing age (15-49 y) and their young children (6-69 mo). METHODOLOGY/PRINCIPLE FINDINGS: Samples for this cross-sectional analysis were collected as part...... of a national micronutrient survey linked to the Cambodian Demographic and Health Survey (CDHS) 2014. One-sixth of households taking part in the CDHS were randomly selected and re-visited for additional blood sampling for eThDP analysis (719 women and 761 children). Thiamine status was assessed using different...... cut-offs from literature. Women were mean (SD) 30 (6) y, and children (46% girls) were 41 (17) mo. Women had lower mean (95% CI) eThDP of 150 nmol/L (146-153) compared to children, 174 nmol/L (171-179; P

  1. Increased obesity risks for being an only child in China: findings from a nationally representative study of 19,487 children.

    Science.gov (United States)

    Li, M; Xue, H; Wang, W; Wen, M; Wang, Y

    2017-12-01

    Given the rapid demographic transition and obesity growth in China, it is important to study how the large only-child population (≈100 million) might contribute to the obesity epidemic. This study evaluated associations of only-child status with weight and energy expenditure-related behaviors in China and examined how the associations may vary by sex and urbanicity. Secondary analyses of nationally representative cross-sectional data from China Education Panel Survey: Junior Cohorts 2013-14, which included 19,487 students from 112 middle schools in 28 regions across China. We used propensity-score-weighted multilevel models to test associations between only-child status and weight outcomes. Compared with sibling-sons, only-sons had higher body mass index (BMI) (Beta = 0.32, P child population in China. Copyright © 2017 The Royal Society for Public Health. All rights reserved.

  2. Modeling of in hospital mortality determinants in myocardial infarction patients, with and without stroke: A national study in Iran

    Directory of Open Access Journals (Sweden)

    Ali Ahmadi

    2016-01-01

    Full Text Available Background: The data and determinants of mortality due to stroke in myocardial infarction (MI patients are unknown. This study was conducted to evaluate the differences in risk factors for hospital mortality among MI patients with and without stroke history. Materials and Methods: This study was a retrospective, cohort study; 20,750 new patients with MI from April, 2012 to March, 2013 were followed up and their data were analyzed according to having or not having the stroke history. Stroke and MI were defined based on the World Health Organization′s definition. The data were analyzed by logistic regression in STATA software. Results: Of the 20,750 studied patients, 4293 had stroke history. The prevalence of stroke in the studied population was derived 20.96% (confidence interval [CI] 95%: 20.13-21.24. Of the patients, 2537 (59.1% had ST-elevation MI (STEMI. Mortality ratio in patients with and without stroke was obtained 18.8% and 10.3%, respectively. The prevalence of risk factors in MI patients with and without a stroke is various. The adjusted odds ratio of mortality in patients with stroke history was derived 7.02 (95% CI: 5.42-9 for chest pain resistant to treatment, 2.39 (95% CI: 1.97-2.9 for STEMI, 3.02 (95% CI: 2.5-3.64 for lack of thrombolytic therapy, 2.2 (95% CI: 1.66-2.91 for heart failure, and 2.17 (95% CI: 1.6-2.9 for ventricular tachycardia. Conclusion: With regards to the factors associated with mortality in this study, it is particularly necessary to control the mortality in MI patients with stroke history. More emphasis should be placed on the MI patients with the previous stroke over those without in the interventions developed for prevention and treatment, and for the prevention of avoidable mortalities.

  3. Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

    Science.gov (United States)

    Kumar, Mohan B.; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

    2012-01-01

    Objective To determine the prevalence of suicidal ideation among Métis men and women (20–59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Study design Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation. PMID:22901287

  4. Suicidal ideation among Métis adult men and women--associated risk and protective factors: findings from a nationally representative survey.

    Science.gov (United States)

    Kumar, Mohan B; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

    2012-08-06

    To determine the prevalence of suicidal ideation among Métis men and women (20-59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

  5. Suicidal ideation among Métis adult men and women - associated risk and protective factors: findings from a nationally representative survey.

    Science.gov (United States)

    Kumar, Mohan B; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

    2012-01-01

    To determine the prevalence of suicidal ideation among Métis men and women (20-59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

  6. Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

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    Mohan B. Kumar

    2012-08-01

    Full Text Available Objective. To determine the prevalence of suicidal ideation among Métis men and women (20–59 years and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006. Study design. Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively. Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

  7. Body Mass Index Percentile Curves for 7 To 18 Year Old Children and Adolescents; are the Sample Populations from Tehran Nationally Representative?

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    Mostafa Hosseini

    2016-06-01

    Full Text Available Background: The children’s body composition status is an important indicator of health condition evaluated through their body mass index (BMI. We aimed to provide standardized percentile curves of BMI in a population of Iranian children and adolescents. We assessed the nationally representative of sample populations from Tehran. Materials and Methods: A total sample of 14,865 children aged 7-18 years was gathered. The Lambda-Mu-Sigma method was used to derive sex-specific smoothed centiles for age via the Lambda-Mu-Sigma Chart Maker Program. Finally, the prevalence of overweight and obesity with 95% confidence interval (CI was calculated. Results: BMI percentiles obtained from Tehran’s population, except for the 10th percentile, seem to be very slightly greater than the urban boys from all over Iran. BMI percentiles have an increasing trend by age that is S-shaped with a slight slope. Only in the 90th and 97th percentiles of BMI for girls, this rising trend seems to stop. Boys generally have higher BMIs than girls. The exceptions are younger ages of 90th and 97th percentiles and older ages of 3rd and 10th percentiles. A total number of 1,008 (13.20%; 95% CI: 12.46-13.98 boys and 603 (8.34%; 95% CI: 7.72-9.00 girls were categorized as overweight and obese. Obesity were observed in 402 (5.27%; 95% CI: 4.79-5.79 boys and 274 (3.76%; 95% CI: 3.35-4.22 girls. Conclusion: We construct BMI percentile curves by age and gender for 7 to 18 years Iranian children and adolescents. It can be concluded that sample populations from Tehran are nationally representative.

  8. Representing dispositions

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    Röhl Johannes

    2011-08-01

    Full Text Available Abstract Dispositions and tendencies feature significantly in the biomedical domain and therefore in representations of knowledge of that domain. They are not only important for specific applications like an infectious disease ontology, but also as part of a general strategy for modelling knowledge about molecular interactions. But the task of representing dispositions in some formal ontological systems is fraught with several problems, which are partly due to the fact that Description Logics can only deal well with binary relations. The paper will discuss some of the results of the philosophical debate about dispositions, in order to see whether the formal relations needed to represent dispositions can be broken down to binary relations. Finally, we will discuss problems arising from the possibility of the absence of realizations, of multi-track or multi-trigger dispositions and offer suggestions on how to deal with them.

  9. Representing time

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    Luca Poncellini

    2010-06-01

    Full Text Available The analysis of natural phenomena applied to architectural planning and design is facing the most fascinating and elusive of the four dimensions through which man attempts to define life within the universe: time. We all know what time is, said St. Augustine, but nobody knows how to describe it. Within architectural projects and representations, time rarely appears in explicit form. This paper presents the results of a research conducted by students of NABA and of the Polytechnic of Milan with the purpose of representing time considered as a key element within architectural projects. Student investigated new approaches and methodologies to represent time using the two-dimensional support of a sheet of paper.

  10. The influence of prefire tree growth and crown condition on postfire mortality of sugar pine following prescribed fire in Sequoia National Park

    Science.gov (United States)

    Nesmith, Jonathan C. B.; Das, Adrian J.; O'Hara, Kevin L.; van Mantgem, Phillip J.

    2015-01-01

    Tree mortality is a vital component of forest management in the context of prescribed fires; however, few studies have examined the effect of prefire tree health on postfire mortality. This is especially relevant for sugar pine (Pinus lambertiana Douglas), a species experiencing population declines due to a suite of anthropogenic factors. Using data from an old-growth mixed-conifer forest in Sequoia National Park, we evaluated the effects of fire, tree size, prefire radial growth, and crown condition on postfire mortality. Models based only on tree size and measures of fire damage were compared with models that included tree size, fire damage, and prefire tree health (e.g., measures of prefire tree radial growth or crown condition). Immediately following the fire, the inclusion of different metrics of prefire tree health produced variable improvements over the models that included only tree size and measures of fire damage, as models that included measures of crown condition performed better than fire-only models, but models that included measures of prefire radial growth did not perform better. However, 5 years following the fire, sugar pine mortality was best predicted by models that included measures of both fire damage and prefire tree health, specifically, diameter at breast height (DBH, 1.37 m), crown scorch, 30-year mean growth, and the number of sharp declines in growth over a 30-year period. This suggests that factors that influence prefire tree health (e.g., drought, competition, pathogens, etc.) may partially determine postfire mortality, especially when accounting for delayed mortality following fire.

  11. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

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    Librero Julián

    2012-01-01

    Full Text Available Abstract Background While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery ( Results Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%. However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not.

  12. Seroprevalence of hepatitis B virus and hepatitis C virus co-infection among people living with HIV/AIDS visiting antiretroviral therapy centres in Nepal: a first nationally representative study

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    G. Ionita

    2017-07-01

    Conclusion: This first ever national assessment of HIV, HBV, and HCV co-infection performed among PLHIV in Nepal demonstrates that HCV and HBV infections are a health threat to this population and that interventions are required to mitigate the effects of co-infection and to prevent further morbidity and mortality.

  13. A workforce survey of Australian osteopathy: analysis of a nationally-representative sample of osteopaths from the Osteopathy Research and Innovation Network (ORION) project.

    Science.gov (United States)

    Adams, Jon; Sibbritt, David; Steel, Amie; Peng, Wenbo

    2018-05-10

    Limited information is available regarding the profile and clinical practice characteristics of the osteopathy workforce in Australia. This paper reports such information by analysing data from a nationally-representative sample of Australian osteopaths. Data was obtained from a workforce survey of Australian osteopathy, investigating the characteristics of the practitioner, their practice, clinical management features and perceptions regarding research. The survey questionnaire was distributed to all registered osteopaths across Australia in 2016 as part of the Osteopathy Research and Innovation Network (ORION) project. A total of 992 Australian osteopaths participated in this study representing a response rate of 49.1%. The average age of the participants was 38.0 years with 58.1% being female and the majority holding a Bachelor or higher degree qualification related to the osteopathy professional. Approximately 80.0% of the osteopaths were practicing in an urban area, with most osteopaths working in multi-practitioner locations, having referral relationships with a range of health care practitioners, managing patients a number of musculoskeletal disorders, and providing multi-model treatment options. A total of 3.9 million patients were estimated to consult with osteopaths every year and an average of approximate 3.0 million hours were spent delivering osteopathy services per year. Further research is required to provide rich, in-depth examination regarding a range of osteopathy workforce issues which will help ensure safe, effective patient care to all receiving and providing treatments as part of the broader Australian health system.

  14. Spatially Explicit Landscape-Level Ecological Risks Induced by Land Use and Land Cover Change in a National Ecologically Representative Region in China

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    Jian Gong

    2015-11-01

    Full Text Available Land use and land cover change is driven by multiple influential factors from environmental and social dimensions in a land system. Land use practices of human decision-makers modify the landscape of the land system, possibly leading to landscape fragmentation, biodiversity loss, or environmental pollution—severe environmental or ecological impacts. While landscape-level ecological risk assessment supports the evaluation of these impacts, investigations on how these ecological risks induced by land use practices change over space and time in response to alternative policy intervention remain inadequate. In this article, we conducted spatially explicit landscape ecological risk analysis in Ezhou City, China. Our study area is a national ecologically representative region experiencing drastic land use and land cover change, and is regulated by multiple policies represented by farmland protection, ecological conservation, and urban development. We employed landscape metrics to consider the influence of potential landscape-level disturbance for the evaluation of landscape ecological risks. Using spatiotemporal simulation, we designed scenarios to examine spatiotemporal patterns in landscape ecological risks in response to policy intervention. Our study demonstrated that spatially explicit landscape ecological risk analysis combined with simulation-driven scenario analysis is of particular importance for guiding the sustainable development of ecologically vulnerable land systems.

  15. The malaria testing and treatment landscape in Kenya: results from a nationally representative survey among the public and private sector in 2016.

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    Musuva, Anne; Ejersa, Waqo; Kiptui, Rebecca; Memusi, Dorothy; Abwao, Edward

    2017-12-21

    Since 2004, Kenya's national malaria treatment guidelines have stipulated artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria, and since 2014, confirmatory diagnosis of malaria in all cases before treatment has been recommended. A number of strategies to support national guidelines have been implemented in the public and private sectors in recent years. A nationally-representative malaria outlet survey, implemented across four epidemiological zones, was conducted between June and August 2016 to provide practical evidence to inform strategies and policies in Kenya towards achieving national malaria control goals. A total of 17,852 outlets were screened and 2271 outlets were eligible and interviewed. 78.3% of all screened public health facilities stocked both malaria diagnostic testing and quality-assured ACT (QAACT). Sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment in pregnancy was available in 70% of public health facilities in endemic areas where it is recommended for treatment. SP was rarely found in the public sector outside of the endemic areas (private sector had lower levels of QAACT (46.7%) and malaria blood testing (20.8%) availability but accounted for majority of anti-malarial distribution (70.6% of the national market share). More than 40% of anti-malarials were distributed by unregistered pharmacies (37.3%) and general retailers (7.1%). QAACT accounted for 58.2% of the total anti-malarial market share, while market share for non-QAACT was 15.8% and for SP, 24.8%. In endemic areas, 74.9% of anti-malarials distributed were QAACT. Elsewhere, QAACT market share was 49.4% in the endemic-prone areas, 33.2% in seasonal-transmission areas and 37.9% in low-risk areas. Although public sector availability of QAACT and malaria diagnosis is relatively high, there is a gap in availability of both testing and treatment that must be addressed. The private sector in Kenya, where the majority of anti

  16. Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey.

    Science.gov (United States)

    Montagu, Dominic; Sudhinaraset, May; Lwin, Thandar; Onozaki, Ikushi; Win, Zaw; Aung, Tin

    2013-01-10

    Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. The study uses data from two sources: 1) Myanmar's first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p  0.05). Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas.

  17. Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey

    Directory of Open Access Journals (Sweden)

    Montagu Dominic

    2013-01-01

    Full Text Available Abstract Introduction Since 2004, the Sun Quality Health (SQH franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. Methods The study uses data from two sources: 1 Myanmar’s first nationally representative TB prevalence study conducted in 2009, and 2 client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. Results TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05. After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p  0.05. Conclusion Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas.

  18. Socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in India: analysis of nationally-representative survey data.

    Science.gov (United States)

    Moser, Kath A; Agrawal, Sutapa; Davey Smith, George; Ebrahim, Shah

    2014-01-01

    Hypertension is a major contributing factor to the current epidemic of cardiovascular disease in India. Small studies suggest high, and increasing, prevalence especially in urban areas, with poor detection and management, but national data has been lacking. The aim of the current study was to use nationally-representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indian adults. Using data on self-reported diagnosis and treatment, and blood pressure measurement, collected from 12,198 respondents aged 18+ in the 2007 WHO Study on Global Ageing and Adult Health in India, factors associated with prevalence, diagnosis and treatment of hypertension were investigated. 22% men and 26% women had hypertension; prevalence increased steeply with body mass index (wealth. Adequate blood pressure control was sub-optimal in urban men. Hypertension is very common in India, even among underweight adults and those of lower socioeconomic position. Improved detection is needed to reduce the burden of disease attributable to hypertension. Levels of treatment and control are relatively good, particularly in women, although urban men require more careful attention.

  19. Differences in symptom expression between unipolar and bipolar spectrum depression: Results from a nationally representative sample using item response theory (IRT).

    Science.gov (United States)

    Hoertel, Nicolas; Blanco, Carlos; Peyre, Hugo; Wall, Melanie M; McMahon, Kibby; Gorwood, Philip; Lemogne, Cédric; Limosin, Frédéric

    2016-11-01

    The inclusion of subsyndromal forms of bipolarity in the fifth edition of the DSM has major implications for the way in which we approach the diagnosis of individuals with depressive symptoms. The aim of the present study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of depression severity, there are differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) between subjects with and without a lifetime history of manic symptoms. We conducted these analyses using a large, nationally representative sample from the USA (n=34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions. The items sadness, appetite disturbance and psychomotor symptoms were better indicators of depression severity in participants without a lifetime history of manic symptoms, in a clinically meaningful way. DSM-IV symptoms of MDE were substantially less informative in participants with a lifetime history of manic symptoms than in those without such history. Clinical information on DSM-IV depressive and manic symptoms was based on retrospective self-report The clinical presentation of depressive symptoms may substantially differ in individuals with and without a lifetime history of manic symptoms. These findings alert to the possibility of atypical symptomatic presentations among individuals with co-occurring symptoms or disorders and highlight the importance of continued research into specific pathophysiology differentiating unipolar and bipolar depression. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey

    Science.gov (United States)

    2013-01-01

    Introduction Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. Methods The study uses data from two sources: 1) Myanmar’s first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. Results TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p  0.05). Conclusion Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas. PMID:23305063

  1. Frequency of Cannabis Use and Medical Cannabis Use Among Persons Living With HIV in the United States: Findings From a Nationally Representative Sample.

    Science.gov (United States)

    Pacek, Lauren R; Towe, Sheri L; Hobkirk, Andrea L; Nash, Denis; Goodwin, Renee D

    2018-04-01

    Little is known about cannabis use frequency, medical cannabis use, or correlates of use among persons living with HIV (PLWH) in United States nationally representative samples. Data came from 626 PLWH from the 2005-2015 National Survey on Drug Use and Health. Logistic regression identified characteristics associated with frequency of cannabis use. Chi-squares identified characteristics associated with medial cannabis use. Non-daily and daily cannabis use was reported by 26.9% and 8.0%. Greater perceived risk of cannabis use was negatively associated with daily and non-daily use. Younger age, substance use, and binge drinking were positively associated with non-daily cannabis use. Smoking and depression were associated with non-daily and daily use. One-quarter reported medical cannabis use. Medical users were more likely to be White, married, and nondrinkers. Cannabis use was common among PLWH. Findings help to differentiate between cannabis users based on frequency of use and medical versus recreational use.

  2. Prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: insight from the National Health and Nutrition Examination Survey III (NHANES-III).

    Science.gov (United States)

    Doran, Bethany; Guo, Yu; Xu, Jinfeng; Weintraub, Howard; Mora, Samia; Maron, David J; Bangalore, Sripal

    2014-08-12

    National and international guidelines recommend fasting lipid panel measurement for risk stratification of patients for prevention of cardiovascular events. However, the prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol (LDL-C) is uncertain. Patients enrolled in the National Health and Nutrition Examination Survey III (NHANES-III), a nationally representative cross-sectional survey performed from 1988 to 1994, were stratified on the basis of fasting status (≥8 or fasting and nonfasting cohorts with similar baseline characteristics. The risk of outcomes as a function of LDL-C and fasting status was assessed with the use of receiver operating characteristic curves and bootstrapping methods. The interaction between fasting status and LDL-C was assessed with Cox proportional hazards modeling. Primary outcome was all-cause mortality. Secondary outcome was cardiovascular mortality. One-to-one matching based on propensity score yielded 4299 pairs of fasting and nonfasting individuals. For the primary outcome, fasting LDL-C yielded prognostic value similar to that for nonfasting LDL-C (C stat