Sample records for voivodeships mortality indices


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    Brunon Zemła


    Full Text Available Background: The incidence of morbidity and mortality of cancers rapidly increase in the world and so it is in case of Poland and Silesia Voivodeship. Therefore an attempt is made to assess this phenomenon in projection scale within Silesia Voivodeship. Materials and methods: The time-trends analysis of the six most common types of cancer have been selected: stomach, colorectal, pancreas and lung (among both genders, prostate (among males and breast (among females. For the period 1990–2008 age standardized mortality rates have been determined. Time-trends in mortality with employment of joinpoint regression have been estimated and depending on trends linear or log-linear regression models were used which set up the base for short-term projection. Results: For the year 2018 projection values of mortality rates among males will drop (with the exception of lung and colorectal cancers. For prostate cancer – the values will be increasing. Among females stomach mortality rates will drop, but again lung cancer mortality rate will double in comparison to data for 1990. Conclusions: 1. The prognostic number of death to 2018 year concern all studied cancer increasing, for exept stomach cancer. 2. Especially will be increasing cancer mortality standardized rates for lung cancer among females and prostate and colorectal cancers among males.

  2. Diversification Synthetic Indicator for Evaluating the Financial Capacity of Local Government. The Case of Polish Voivodeships

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    Paweł Dziekański


    Full Text Available Financial situation is a fundamental issue for the local government. Financial problems could result in insolvency that is why the analysis of financial situation is essential not only for current management, but also for the protection against side effects of economic downturn. One of the most important determinants of the development of the local government unit is its financial situation, which has an undeniable impact on the whole activities conducted by the local government. The aim of the article is to present the financial situation of the territorial self‑government – the voivodeship, and its changes in the years 2009–2014. The voivodeships which are in good financial situation are more competitive and efficient in conducting development policy. The best voivodeships in 2014 and 2011 were Mazowieckie and Dolnośląskie, in 2009 – Mazowieckie and Łódzkie; in 2014 were Lubuskie and Opolskie, in 2011 – Kujawsko‑pomorskie and Warmińsko‑mazurskie, and in 2009 – Lubuskie and Warmińsko‑mazurskie. The value of the index in 2014 fluctuated between 0.16 and 0.59, in 2011 between 0.22–0.64, and in 2009 – 0.16–0.64. The resulting measure depends on the number and type of variables taken for testing. It allows you to identify weaker areas and improved functioning of the unit, if its own position in relation to competitors. The behavior indicated methodology, and partial variables, allows the assessment of individuals between countries.

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

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    Brunon Zemła


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





    The article presents a proposal of the ‘GAMBIT KUJAWSKO-POMORSKI’ Road Safety Improvement Programme. The main idea of the Programme is to establish and initiate systems that will be responsible for the most important areas of activity within road safety, including road safety control, supervision, and management systems in the whole Voivodeship. In total, the creation and start of nine such systems has been proposed, namely: the Road Safety Management, the Integrated Road Rescue Service, the ...


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    Full Text Available The article presents a proposal of the ‘GAMBIT KUJAWSKO-POMORSKI’ Road Safety Improvement Programme. The main idea of the Programme is to establish and initiate systems that will be responsible for the most important areas of activity within road safety, including road safety control, supervision, and management systems in the whole Voivodeship. In total, the creation and start of nine such systems has been proposed, namely: the Road Safety Management, the Integrated Road Rescue Service, the Personnel Continuing Education, the Hazardous Road Behaviour Monitoring, the Social Education for Safe Behaviour on Road, the Teaching Personnel Improvement, the Area Development and Planning Process Improvement, the Road Infrastructure Design Quality Improvement, and the Road and Traffic Management Process Efficiency Improvement. The basic aim of each system has been discussed as well as the most important tasks implemented as its part. The Road Safety Improvement Programme for the Kujawsko-Pomorskie Voivodeship presented in this article is a part of the National Road Safety Programme 2013-2020. Moreover, it is not only an original programme in Poland, but also a universal project that may be adapted for other voivodeships as well.

  6. Exploring the association between macroeconomic indicators and dialysis mortality. (United States)

    Kramer, Anneke; Stel, Vianda S; Caskey, Fergus J; Stengel, Benedicte; Elliott, Robert F; Covic, Adrian; Geue, Claudia; Cusumano, Ana; Macleod, Alison M; Jager, Kitty J


    Mortality on dialysis varies greatly worldwide, with patient-level factors explaining only a small part of this variation. The aim of this study was to examine the association of national-level macroeconomic indicators with the mortality of incident dialysis populations and explore potential explanations through renal service indicators, incidence of dialysis, and characteristics of the dialysis population. Aggregated unadjusted survival probabilities were obtained from 22 renal registries worldwide for patients starting dialysis in 2003-2005. General population age and health, macroeconomic indices, and renal service organization data were collected from secondary sources and questionnaires. Linear modeling with log-log transformation of the outcome variable was applied to establish factors associated with survival on dialysis. Two-year survival on dialysis ranged from 62.3% in Iceland to 89.8% in Romania. A higher gross domestic product per capita (hazard ratio=1.02 per 1000 US dollar increase), a higher percentage of gross domestic product spent on healthcare (1.10 per percent increase), and a higher intrinsic mortality of the dialysis population (i.e., general population-derived mortality risk of the dialysis population in that country standardized for age and sex; hazard ratio=1.04 per death per 10,000 person years) were associated with a higher mortality of the dialysis population. The incidence of dialysis and renal service indicators were not associated with mortality on dialysis. Macroeconomic factors and the intrinsic mortality of the dialysis population are associated with international differences in the mortality on dialysis. Renal service organizational factors and incidence of dialysis seem less important.

  7. Suffering from Loneliness Indicates Significant Mortality Risk of Older People

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    Reijo S. Tilvis


    Full Text Available Background. The harmful associates of suffering from loneliness are still in dispute. Objective. To examine the association of feelings of loneliness with all-cause mortality in a general aged population. Methods. A postal questionnaire was sent to randomly selected community-dwelling of elderly people (>74 years from the Finnish National Population Register. The questionnaire included demographic characteristics, living conditions, functioning, health, and need for help. Suffering from loneliness was assessed with one question and participants were categorized as lonely or not lonely. Total mortality was retrieved from the National Population Information System. Results. Of 3687 respondents, 39% suffered from loneliness. Lonely people were more likely to be deceased during the 57-month follow-up (31% than subjects not feeling lonely (23%, <.001. Excess mortality (HR=1.38, 95% CI=1.21-1.57 of lonely people increased over time. After controlling for age and gender, the mortality risk of the lonely individuals was 1.33 (95% CI=1.17-1.51 and after further controlling for subjective health 1.17 (CI=1.02-1.33. The excess mortality was consistent in all major subgroups. Conclusion. Suffering from loneliness is common and indicates significant mortality risk in old age.


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    Joanna Szczykowska


    Full Text Available The study was carried out using water samples from two small retention reservoirs located in the communes: Czarna Białostocka and Turośń Kościelna in Podlaskie Voivodeship. The main tasks of both reservoirs are to improve the water balance by means of regulating the levels and water outflow. Three characteristic measurement and control points were selected on both reservoirs in accordance to the water flow in the longitudinal section. The first and third points were located near the inflow and outflow of water, while the second in the middle of the reservoirs. Samples of water for the study were collected from the surface layer of the shore zone of the reservoirs once a month from March 2015 to February 2017 (water from two hydrological years was analyzed. Water samples were subject to determination of total phosphorus, total nitrogen, and chlorophyll “a” concentrations, as well as turbidity. Contamination of the water reservoirs with biogenic compounds is a common problem and at the same time difficult to eliminate due to the scattered nature of external sources of pollution, especially in the case of agricultural catchments, as well as the inflow of untreated sewage from areas directly adjacent to the reservoirs. Based on achieved results, high values of TSI (TN, TSI (TP, TSI (Chl, and overall TSI, clearly indicate the progressive degradation of water quality in analyzed reservoirs. Appearing water blooms due to the mass development of phytoplankton adversely affect the quality of water in the reservoirs and biochemical processes occurring both in water and bottom sediments, are conditioned by progressive eutrophication.

  9. An outbreak of aseptic meningitis in Podlaskie Voivodeship in 2014

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    Magda Orzechowska


    Full Text Available Enteroviruses cause common infections with various clinical course and forms, such as hand-foot-and-mouth disease (Boston exanthem disease, herpangina, myocarditis and pericarditis, widespread myositis (epidemic pleurodynia, Bornholm disease, or aseptic inflammation of the nervous system, among children and adolescents. An increase in aseptic meningitis cases of enteroviral aetiology, including the E30 virus, was occasionally observed in various European countries. In 2014, an outbreak of aseptic meningitis was reported in Podlaskie Voivodeship. A total of 640 cases were reported between June 1 and November 30, 2014, of which 228 had confirmed enteroviral aetiology. Summer and autumn seasons favour the incidence of viral infections of the central nervous system. Symptomatic infections are more common in males than females. Infections with enterovirus show the tendency to form endemic regions.

  10. Predictive indications of operation and mortality following renal trauma

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    Chia-Shen Yang


    Conclusion: In conclusion, ISS ≥ 16 and RIS ≥ 4 are predictive factors for necessitating an operation, and higher injury severity (ISS ≥ 16 and lower consciousness level (GCS < 8 scores are significantly associated with mortality after renal trauma.

  11. Regional socioeconomic indicators and ethnicity as predictors of regional infant mortality rate in Slovakia

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    Rosicova, Katarina; Geckova, Andrea Madarasova; van Dijk, Jitse P.; Kollarova, Jana; Rosic, Martin; Groothoff, Johan W.


    Objective Exploring the associations of regional differences in infant mortality with selected socioeconomic indicators and ethnicity could offer important clues for designing public health policy measures. Methods Data included perinatal and infant mortality in the 79 districts of the Slovak

  12. Indications, Complications and Mortality of Nephrectomy in Tikur ...

    African Journals Online (AJOL)

    Background: Nephrectomy is a standard therapeutic urological procedure for malignancy of kidneys and upper urinary tract, and for damaged kidneys with little or no contribution to the overall renal function. There are geographical variations in indications for nephrectomy as certain urological diseases are more prevalent in ...

  13. Geography of Electoral Volatility in the Warmia and Mazury Voivodeship of Poland

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    Tarasov Ilya N.


    Full Text Available The authors describe the impact of administrative reforms on the electoral volatility in the Warmia and Mazury voivodeship of Poland. The administrative reforms resulted in the formation of a new territorial organization of power. Using three large administrative units of Poland as an example, the authors analyse the experience of the formation of a geographic region by merging several politically diverse territories. The merger took place in a changing political environment. It inevitably affected the strategy and tactics of the development of local self-governance. The formation of the region has been going on in such a manner that differences in the electoral preferences and political behaviour of the urban population (the regional metropolis and the periphery remain unchanged. Having performed the index analysis and a comparative analysis of the electoral data, the authors conclude that the consistency of administrative decisions on the formation of the region and the electoral performance have been weakening over time. During the initial phase, the electoral volatility was mainly due to the sluggishness and inertia of the previous territorial organization. After the phase of stabilization, the electoral volatility indices in different geographical areas changed due to a combination of social and political factors. The authors show that the ‘looseness’ of the Polish party system affect the electoral volatility in the region more than institutional decisions of the administrative reforms.

  14. The use of instruments of logistics and marketing in transport enterprises in lubuskie voivodeship

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    Agnieszka Perzyńska


    Full Text Available Background: The aim of the article is to verify the logistics and marketing instruments used in transport enterprises in Lubuskie voivodeship. The article presents the results of surveys of transport companies. Based on these studies in transport enterprises in Lubuskie, the current level of the use of logistics and marketing instruments was determined. Logistics and marketing instruments were separated to study the needs of transport companies in Lubuskie voivodeship. The choice of these instruments gave rise to a study f the possibility of using them in the implementation of business operations. From the findings it can be inferred that they are useful for the voivodeship, and that such a system can be implemented in the whole country. Methods: The study was conducted in the second half of 2014 and 140 transport enterprises in Lubuskie. Based on the research results, classifications of instruments were developed using logistics and marketing division at their levels. Results: On the basis of these findings and observations, the authors have analysed the levels of identification instruments, logistics and marketing. On this basis, it was possible to identify the instruments used by logistics and marketing in these companies. Conclusions: Based on the study of transport companies in Lubuskie voivodeship, a selection of logistics and marketing instruments were identified, along with a classification of the logistics and marketing instruments used. With the implementation of the above steps to classify the usage level of logistics and marketing instruments, the ability to match these levels to data transport companies was established.

  15. Effect of Governance Indicators on Under-Five Mortality in OECD Nations: Generalized Method of Moments. (United States)

    Emamgholipour, Sara; Asemane, Zahra


    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.

  16. Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators. (United States)

    Ang, Darwin; McKenney, Mark; Norwood, Scott; Kurek, Stanley; Kimbrell, Brian; Liu, Huazhi; Ziglar, Michele; Hurst, James


    Improving clinical outcomes of trauma patients is a challenging problem at a statewide level, particularly if data from the state's registry are not publicly available. Promotion of optimal care throughout the state is not possible unless clinical benchmarks are available for comparison. Using publicly available administrative data from the State Department of Health and the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs), we sought to create a statewide method for benchmarking trauma mortality and at the same time also identifying a pattern of unique complications that have an independent influence on mortality. Data for this study were obtained from State of Florida Agency for Health Care Administration. Adult trauma patients were identified as having International Classification of Disease ninth edition codes defined by the state. Multivariate logistic regression was used to create a predictive inpatient expected mortality model. The expected value of PSIs was created using the multivariate model and their beta coefficients provided by the AHRQ. Case-mix adjusted mortality results were reported as observed to expected (O/E) ratios to examine mortality, PSIs, failure to prevent complications, and failure to rescue from death. There were 50,596 trauma patients evaluated during the study period. The overall fit of the expected mortality model was very strong at a c-statistic of 0.93. Twelve of 25 trauma centers had O/E ratios benchmarking method that screens at risk trauma centers in the state for higher than expected mortality. Stratifying mortality based on failure to prevent PSIs may identify areas of needed improvement at a statewide level. Copyright © 2015 Elsevier Inc. All rights reserved.


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    Agnieszka Malec


    Full Text Available This paper presents the results of the studies of metal content in precipitation water in 2013, recorded at measuring points within Lubelskie and Lubuskie Voivodeships. It provides a detailed description of the method of collecting and analysing water samples in respect of light- and heavy-metal determination. Based on the results, a general assessment was made of the condition of the environment in the areas in question. Also, the sources of pollution in wet precipitation, and the effects of their introduction into the environment, were determined. It was found that the main pollution elements of precipitation water were linked to anthropogenic sources. The study also established that precipitation water, especially in the sparsely industrialised Włodawa region in the Lubelskie Voivodeship, had generally low pollution levels. It was also noted that in 2013, due to low total precipitation, the environmental impact of metal content was lower than in the preceding years.

  18. Economic Status and Adult Mortality in India: Is the Relationship Sensitive to Choice of Indicators? (United States)

    Barik, Debasis; Desai, Sonalde; Vanneman, Reeve


    Research on economic status and adult mortality is often stymied by the reciprocity of this relationship and lack of clarity on which aspect of economic status matters. While financial resources increase access to healthcare and nutrition and reduce mortality, sickness also reduces labor force participation, thereby reducing income. Without longitudinal data, it is difficult to study the linkage between economic status and mortality. Using data from a national sample of 132,116 Indian adults aged 15 years and above, this paper examines their likelihood of death between wave 1 of the India Human Development Survey (IHDS), conducted in 2004-2005 and wave 2, conducted in 2011-2012. The results show that mortality between the two waves is strongly linked to the economic status of the household at wave 1 regardless of the choice of indicator for economic status. However, negative relationship between economic status and mortality for individuals already suffering from cardiovascular and metabolic conditions varies between three markers of economic status - income, consumption and ownership of consumer durables - varies, reflecting two-way relationship between short and long term markers of economic status and morbidity.

  19. Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias

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    Matute-Cruz Petra


    Full Text Available Abstract Background Mortality from invasive meningococcal disease (IMD has remained stable over the last thirty years and it is unclear whether pre-hospital antibiotherapy actually produces a decrease in this mortality. Our aim was to examine whether pre-hospital oral antibiotherapy reduces mortality from IMD, adjusting for indication bias. Methods A retrospective analysis was made of clinical reports of all patients (n = 848 diagnosed with IMD from 1995 to 2000 in Andalusia and the Canary Islands, Spain, and of the relationship between the use of pre-hospital oral antibiotherapy and mortality. Indication bias was controlled for by the propensity score technique, and a multivariate analysis was performed to determine the probability of each patient receiving antibiotics, according to the symptoms identified before admission. Data on in-hospital death, use of antibiotics and demographic variables were collected. A logistic regression analysis was then carried out, using death as the dependent variable, and pre-hospital antibiotic use, age, time from onset of symptoms to parenteral antibiotics and the propensity score as independent variables. Results Data were recorded on 848 patients, 49 (5.72% of whom died. Of the total number of patients, 226 had received oral antibiotics before admission, mainly betalactams during the previous 48 hours. After adjusting the association between the use of antibiotics and death for age, time between onset of symptoms and in-hospital antibiotic treatment, pre-hospital oral antibiotherapy remained a significant protective factor (Odds Ratio for death 0.37, 95% confidence interval 0.15–0.93. Conclusion Pre-hospital oral antibiotherapy appears to reduce IMD mortality.

  20. "Guilty until proven innocent": the contested use of maternal mortality indicators in global health. (United States)

    Storeng, Katerini T; Béhague, Dominique P


    The MMR - maternal mortality ratio - has risen from obscurity to become a major global health indicator, even appearing as an indicator of progress towards the global Sustainable Development Goals. This has happened despite intractable challenges relating to the measurement of maternal mortality. Even after three decades of measurement innovation, maternal mortality data are widely presumed to be of poor quality, or, as one leading measurement expert has put it, 'guilty until proven innocent'. This paper explores how and why leading epidemiologists, demographers and statisticians have devoted the better part of the last three decades to producing ever more sophisticated and expensive surveys and mathematical models of globally comparable MMR estimates. The development of better metrics is publicly justified by the need to know which interventions save lives and at what cost. We show, however, that measurement experts' work has also been driven by the need to secure political priority for safe motherhood and by donors' need to justify and monitor the results of investment flows. We explore the many effects and consequences of this measurement work, including the eclipsing of attention to strengthening much-needed national health information systems. We analyse this measurement work in relation to broader political and economic changes affecting the global health field, not least the incursion of neoliberal, business-oriented donors such as the World Bank and the Bill and Melinda Gates Foundation whose institutional structures have introduced new forms of administrative oversight and accountability that depend on indicators.

  1. Directions of development for areas with unfavourable conditions for agricultural production, an example of the podlaskie voivodeship (Poland

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    Kazimierz Niewiadomski


    Full Text Available This paper is dedicated to the directions of development of rural areas, primarily agricultural areas of the Podlaskie voivodeship, which in light of current criteria has been qualified almost entirely as problem area (ONW. Results presented are culmination of research related to issues of problem areas primarily in the area of the Podlaskie voivodeship by the author of the herewith paper during last few years. In conclusion to the results of the research it can be said that the primary direction of the development of rural areas in the Podlaskie voivodeship will be modern, large-scale farms able to adjust to current conditions, in particular environmental and soil conditions. In problem areas these will be mostly farms focusing on production of cattle and milk, developing production based on very high share of grassland areas. Complementary role in relation to conventional agriculture will be fulfilled by farms developing organic farming and agro-touristic farms. More intensive development of conventional tourism in rural areas can be expected once new tourism products and services have been developed. Assessment of the current economic development parameters of the Podlaskie voivodeship does not point at the convergence with other regions and possibility of decreasing the distance between the Podlaskie voivodeship and average results for Poland in the near future. However, some positive trends in terms of convergence with other regions in Poland can be observed in agriculture, primarily due to relatively good results in production of cattle and milk.

  2. Urban–rural inequalities in suicide mortality: a comparison of urbanicity indicators

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    M. Helbich


    Full Text Available Abstract Background Urban–rural disparities in suicide mortality have received considerable attention. Varying conceptualizations of urbanity may contribute to the conflicting findings. This ecological study on Germany assessed how and to what extent urban–rural suicide associations are affected by 14 different urban–rural indicators. Methods Indicators were based on continuous or k-means classified population data, land-use data, planning typologies, or represented population-based accessibility indicators. Agreements between indicators were tested with correlation analyses. Spatial Bayesian Poisson regressions were estimated to examine urban–rural suicide associations while adjusting for risk and protective factors. Results Urban–rural differences in suicide rates per 100,000 persons were found irrespective of the indicator. Strong and significant correlation was observed between different urban–rural indicators. Although the effect sign consistently referred to a reduced risk in urban areas, statistical significance was not universally confirmed by all regressions. Goodness-of-fit statistics suggested that the population potential score performs best, and that population density is the second best indicator of urbanicity. Numerical indicators are favored over classified ones. Regional planning typologies are not supported. Conclusions The strength of suicide urban–rural associations varies with respect to the applied indicator of urbanicity. Future studies that put urban–rural inequalities central are recommended to apply either unclassified population potentials or population density indicators, but sensitivity analyses are advised.

  3. Time-course mortality and radiosensitivity indices in Tribolium spp. developing from irradiated pupae

    International Nuclear Information System (INIS)

    Hasan, Md Mahbub


    Effects of gamma irradiation (1-5 Krad) on the time-course mortality and radiosensitivity indices in adults of Tribolium anaphe, T. brevicornis, T. castaneum, T. destructor, T. freemani developing from irradiated 1 day old and pre-emergence (4-5 day old) pupae were studied. Adult longevity was significantly (P<0.001) affected by irradiation and was linearly dose dependent. T. destructor was markedly more radioresistant than the other species at all dose levels and had a longer life expectancy. The mean survival times of adults developing from irradiated early and late pupae were shorter in females than in males for all the species. The radiosensitivity indices did not vary widely among the species and these values decreased as the dose increased in all the species which clearly indicate that the resistance of the species was dose-dependent. (author)

  4. Watermills – a Forgotten River Valley Heritage – selected examples from the Silesian voivodeship, Poland

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    Fajer Maria


    Full Text Available This study is an attempt to describe the current condition of the watermills situated in the river valleys of the Silesian voivodeship. Changes in the number and distribution of mills from the late 18th century until the 20th century have been presented (as exemplified by the Liswarta River basin in the northern part of the voivodeship. Watermills have been discussed both as industrial monuments that document the history of the milling industry and as tourist attractions. Currently, working mills that serve the local population in rural areas are a rarity, and working watermills are unique sites that should be protected as industrial monuments that constitute an important part of our cultural heritage. They are among those industrial monuments that are particularly vulnerable to destruction. Such mills increasingly attract the interest of industrial tourism promoters. Activities aimed at promoting watermills as cultural heritage sites and leading to their protection and preservation as part of the river valley landscape have also been discussed. In the Silesian voivodeship, there are many watermills that deserve attention; some of these are listed in the register of monuments maintained by the National Heritage Board of Poland. Unfortunately, most disused mills are falling into disrepair and are slowly disappearing; only a few have been preserved in good condition. Many of these have long histories and they are also situated in areas attractive for tourists. There is no doubt that watermills should be preserved. Their inclusion in open-air museums is not the only solution – any form of protection in situ by putting them to different uses is also valuable. Changing the function of a mill to serve as a hotel, restaurant, cultural centre, etc. makes it possible to maintain these sites as parts of river valley landscapes.


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    Joanna Smoluk-Sikorska


    Full Text Available The paper discusses results of the research concerning potential and strategy of competitiveness of companies of fruit and vegetable processing industry located in the Wielkopolskie voivodeship. Special attention was paid to the assessment of the companies’ financial situation, their production resources, management system and adopted development strategies. The investigated companies are characterised by strong domestic market position, which is mainly results of the assessment of their financial situation. They asses competitiveness potential very high, particularly human resources and related with them management skills. Furthermore, most of the companies assess the use of strategy of quality control and specialisation strategy as high or very high.

  6. High mortality during tuberculosis treatment does not indicate long diagnostic delays in Vietnam: a cohort study

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    Sy Dinh N


    Full Text Available Abstract Background Delay in tuberculosis diagnosis and treatment initiation may increase disease severity and mortality. In evaluations of tuberculosis control programmes high fatality rates during tuberculosis treatment, are used as an indicator of long delays in low HIV-prevalence settings. However, data for this presumed association between delay and fatality are lacking. We assessed the association between diagnostic delay and mortality of new smear-positive pulmonary tuberculosis patients in Vietnam. Methods Follow-up of a patient cohort included in a survey of diagnostic delay in 70 randomly selected districts. Data on diagnosis and treatment were extracted from routine registers. Patients who had died during the course of treatment were compared to those with reported cure, completed treatment or failure (survivors. Results Complete data were available for 1881/2093 (89.9% patients, of whom 82 (4.4% had died. Fatality was 4.5% for patients with ≤ 4 weeks delay, 5.0% for 5- ≤ 8 weeks delay (aOR 1.11, 95%CI 0.67–1.84 and 3.2% for > 9 weeks delay (aOR 0.69, 95%CI 0.37–1.30. Fatality tended to decline with increasing delay but this was not significant. Fatality was not associated with median diagnostic delay at district level (Spearman's rho = -0.08, P = 0.5. Conclusion Diagnostic delay is not associated with treatment mortality in Vietnam at individual nor district level, suggesting that high case fatality should not be used as an indicator of long diagnostic delay in national tuberculosis programmes.

  7. What indication, morbidity and mortality for central pancreatectomy in oncological surgery? A systematic review. (United States)

    Santangelo, Michele; Esposito, Anna; Tammaro, Vincenzo; Calogero, Armando; Criscitiello, Carmen; Roberti, Giuseppe; Candida, Maria; Rupealta, Niccolò; Pisani, Antonio; Carlomagno, Nicola


    Conventional pancreatic resections for pancreatic neck and body diseases include pancreaticoduodenectomy, distal pancreatectomy with or without splenectomy, and total pancreatectomy. Recent studies have reported encouraging results of non-traditional pancreatic resections, including central pancreatectomy (CP), for central pancreatic disease. This surgical approach offers the potentials of low postoperative morbidity and preservation of metabolic functions. This study performs a systematic review on CP. A comprehensive literature search was conducted, for the period 1992-2015, on three worldwide databases: PubMed, Scopus, ISI-Web of Knowledge. We focused on indications, morbidity and mortality of this surgical procedure. The review shows that CP is particularly suitable for small-medium size diseases localized into the pancreatic body. This procedure is associated with an increased postoperative morbidity but an excellent postoperative pancreatic function. CP is a safe and effective procedure when performed following the right indications. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  8. Prognostic indicators for early mortality after tracheostomy in the intensive care unit. (United States)

    Parsikia, Afshin; Goodwin, Matthew; Wells, Zachary; Gauthier, Zoe; Bascom, Molli; Suh, Moon; Meloro, Beth; Ortiz, Jorge; Joshi, Amit R T


    Tracheostomy is indicated for patients requiring prolonged mechanical ventilation. The aim of this study is to identify prognostic indicators for early mortality after tracheostomy to potentially avoid futility in the intensive care unit. Patients who underwent tracheostomy and died within 30 d of admission (futile group) were compared with patients who underwent tracheostomy and survived more than 30 d after admission (nonfutile group). Categorical data were analyzed using chi-square and Fisher's exact tests. Continuous variables were analyzed using T-tests and Mann-Whitney U tests. Prognostic factors were evaluated with univariable and multivariable logistic regression analyses. Overall, 88.3% of patients underwent nonfutile tracheostomy, while 11.7% underwent futile tracheostomy. Serum albumin level (1.5 g/dL versus 1.9 g/dL, P = 0.040) and mechanical ventilation duration before procedure (10 versus 12 d, P = 0.029) were significantly less in the futile group. Hypoalbuminemia (tracheostomy in multivariable analysis. Hypoalbuminemia may serve as a prognostic indicator and risk factor for early mortality after tracheostomy. In patients with hypoalbuminemia, treatment of underlying disease processes and trending serum albumin level recovery in response to treatment may provide some insight to clinicians with regard to timing of tracheostomy. Better prognostic tools are still needed for critically ill patients to avoid futility in the intensive care unit. In this cohort, 88.3% of patients undergoing tracheostomy survived past 30 d. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. La mortalidad infantil, indicador de excelencia Infant mortality, an indicator of excellence

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    Yurima Díaz Elejalde


    Full Text Available La mortalidad infantil es un indicador de gran importancia para el Sistema Nacional de Salud cubano y a nivel mundial. Es utilizado para evaluar el estado de salud de la población, por lo que se realizó un estudio descriptivo, retrospectivo y longitudinal con el objetivo de caracterizar el comportamiento de la mortalidad infantil en el municipio de Guanabacoa, desde el 1º de enero de 2000 al 30 de junio de 2005. Se estudió una muestra de 48 defunciones a través de variables maternas y del recién nacido, con la información obtenida de los registros médicos e historias clínicas. Se encontró que la tasa de mortalidad infantil de nuestro municipio, fundamentalmente en los 4 años iniciales, es irregular con tendencia decreciente, siendo las principales causas de muerte las infecciones (37,5 %, la sepsis (14,5 %, la asfixia (10,4 % y las malformaciones congénitas (10,4 %. Las variables maternas afectadas fueron los factores de riesgo en el embarazo: bajo peso materno, la moniliasis vaginal y la anemia ferropénica ; y en el recién nacido, el componente neonatal precoz y el sexo masculino.Infant mortality is an indicator of great importance for the Cuban National Health System and for the world. It is used to evaluate the health status of the population. A descriptive, retrospective and longitudinal study was conducted aimed at characterizing the behavior of infant mortality in the municipality of Guanabacoa from January 1st, 2000 to June 30th, 2005. A sample of 48 deaths was studied through variables of the mother and the newborn obtained from the medical registries and histories. It was found that infant mortality rate in our municipality, mainly in the 4 initial years is irregular with a decreasing trend. The main causes of death are infections (37.5 %, sepsis (14.5 %, asphyxia (10.4 % and congenital malformations (10.4 %. The affected maternal variables were the risk factors during pregnancy: maternal low weight, vaginal moniliasis

  10. The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation. (United States)

    Surapaneni, Sushama; S, Rajkumar; Reddy A, Vijaya Bhaskar


    To find out the significance of the Perforation-Operation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation. Case series. Place and Duration of the Study: Department of General Surgery, Konaseema Institute of Medical Sciences and RF Amalapuram, Andhra Pradesh, India from 2008-2011. This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated. Out of the 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C. The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation -operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation.

  11. Partial mortality in massive reef corals as an indicator of sediment stress on coral reefs

    International Nuclear Information System (INIS)

    Nugues, Maggy M.; Roberts, Callum M.


    Partial mortality and fission on colonies of four common massive coral species were examined at sites differing in their exposure to river sediments in St. Lucia, West Indies. Rates of partial mortality were higher close to the river mouths, where more sediments were deposited, than away from the rivers in two coral species. Frequency of fission showed no significant trend. The percent change in coral cover on reefs from 1995 to 1998 was negatively related to the rate of partial mortality estimated in 1998 in all species. This suggests that partial mortality rates could reflect longer-term temporal changes in coral communities. Similar conclusions could also be reached using a less precise measure and simply recording partial mortality on colonies as <50% and ≥50% dead tissue. We conclude that partial mortality in some species of massive reef corals, expressed as the amount of dead tissue per colony, could provide a rapid and effective means of detecting sediment stress on coral reefs

  12. Partial mortality in massive reef corals as an indicator of sediment stress on coral reefs

    Energy Technology Data Exchange (ETDEWEB)

    Nugues, Maggy M.; Roberts, Callum M


    Partial mortality and fission on colonies of four common massive coral species were examined at sites differing in their exposure to river sediments in St. Lucia, West Indies. Rates of partial mortality were higher close to the river mouths, where more sediments were deposited, than away from the rivers in two coral species. Frequency of fission showed no significant trend. The percent change in coral cover on reefs from 1995 to 1998 was negatively related to the rate of partial mortality estimated in 1998 in all species. This suggests that partial mortality rates could reflect longer-term temporal changes in coral communities. Similar conclusions could also be reached using a less precise measure and simply recording partial mortality on colonies as <50% and {>=}50% dead tissue. We conclude that partial mortality in some species of massive reef corals, expressed as the amount of dead tissue per colony, could provide a rapid and effective means of detecting sediment stress on coral reefs.

  13. Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

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    Badia BISBIS


    Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care  indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from  Nador, 2% from Bouarfa, 4% from  Taourirt and 2% from Jerrada. One might question about  the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential  problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.


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    Katarzyna Zajda


    Full Text Available In a knowledge-based economy, innovativeness is a quality desired on the labour market. It may increase young people’s employment opportunities. The article discusses the issue of young rural residents’ attitudes towards their own innovativeness. It presents the results of sociological research carried out in 2014–2015 in Łódzkie voivodeship among upper secondary school students from rural areas. Three components of the innovative attitude were analysed: cognitive, emotional/evaluative, and behavioral. The study was carried out using a case study method and an auditorium survey involving a total number of 209 people. On the basis of the study, conclusions were made referring to weak points of young rural residents’ attitude to their own innovativeness, and it was demonstrated that relatively few of them display an innovative attitude.


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    Łukasz Paluch


    Full Text Available  The aim of this elaboration is to identify the demographic situation and the economic activity of the population of rural communes in the Małopolska voivodeship and identifi cation of relations between their level of economic development and features which determine social aspect of their development. The choice of units for the research was based on multicriteria method of zero unitarization. The primary source of information were the statistical data for the years 2004–2011 published by the Local Data Bank and System of Analysis of Local Government. The conducted research demon strates the existence of statistical links between the level of economic development of local government units and the state and quality of their demographic determinants. 

  16. Moisture Content Impact on Mechanical Properties of Selected Cohesive Soils from the Wielkopolskie Voivodeship Southern Part

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    Pezowicz Piotr


    Full Text Available Results of investigations of shearing resistance and compressibility of fine-grained cohesive soil from the southern part of the wielkopolskie voivodeship in relation to the increasing moisture content are presented. The analysis of two series of samples, using soil paste for the consistency index of 0.9 and 0.4–0.3 was carried out. The results imply that the increasing moisture content causes a decrease in the angle of shearing resistance and cohesion and is also reflected in the higher compressibility of the soil. It was observed that regardless of the soil consistency, the angle of shearing resistance decreases and the cohesion value and the oedometric modulus of primary (consolidation and secondary compressibility grows with the increase in the clay fraction.

  17. Lichens of fruit trees in the selected locations in Podlaskie Voivodeship [North-Eastern Poland

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    Matwiejuk Anna


    Full Text Available The aim of this paper is to present the diversity of the lichen species on fruit trees (Malus sp., Pyrus sp., Prunus sp. and Cerasus sp. growing in orchards in selected villages and towns in the Podlaskie Voivodeship. Fifty-six species of lichens were found. These were dominated by common lichens found on the bark of trees growing in built-up areas with prevailing heliophilous and nitrophilous species of the genera Physcia and Phaeophyscia. A richer lichen biota is characteristic of apple trees (52 species and pear trees (36. Lichens of the apple trees constitute 78% of the biota of this phorophyte growing in the fruit orchards in Poland. Of the recorded species, only two (Ramalina farinacea, Usnea hirta are covered by partial protection in Poland.

  18. Excess mortality and guideline-indicated care following non-ST-elevation myocardial infarction. (United States)

    Dondo, Tatendashe B; Hall, Marlous; Timmis, Adam D; Gilthorpe, Mark S; Alabas, Oras A; Batin, Phillip D; Deanfield, John E; Hemingway, Harry; Gale, Chris P


    Adherence to guideline-indicated care for the treatment of non-ST-elevation myocardial infarction (NSTEMI) is associated with improved outcomes. We investigated the extent and consequences of non-adherence to guideline-indicated care across a national health system. A cohort study ( identifier: NCT02436187) was conducted using data from the Myocardial Ischaemia National Audit Project ( n = 389,057 NSTEMI, n = 247 hospitals, England and Wales, 2003-2013). Accelerated failure time models were used to quantify the impact of non-adherence on survival according to dates of guideline publication. Over a period of 1,079,044 person-years (median 2.2 years of follow-up), 113,586 (29.2%) NSTEMI patients died. Of those eligible to receive care, 337,881 (86.9%) did not receive one or more guideline-indicated intervention; the most frequently missed were dietary advice ( n = 254,869, 68.1%), smoking cessation advice ( n = 245,357, 87.9%), P2Y12 inhibitors ( n = 192,906, 66.3%) and coronary angiography ( n = 161,853, 43.4%). Missed interventions with the strongest impact on reduced survival were coronary angiography (time ratio: 0.18, 95% confidence interval (CI): 0.17-0.18), cardiac rehabilitation (time ratio: 0.49, 95% CI: 0.48-0.50), smoking cessation advice (time ratio: 0.53, 95% CI: 0.51-0.57) and statins (time ratio: 0.56, 95% CI: 0.55-0.58). If all eligible patients in the study had received optimal care at the time of guideline publication, then 32,765 (28.9%) deaths (95% CI: 30,531-33,509) may have been prevented. The majority of patients hospitalised with NSTEMI missed at least one guideline-indicated intervention for which they were eligible. This was significantly associated with excess mortality. Greater attention to the provision of guideline-indicated care for the management of NSTEMI will reduce premature cardiovascular deaths.

  19. Aquatic bird disease and mortality as an indicator of changing ecosystem health (United States)

    Newman, Scott H.; Chmura, Aleksei; Converse, Kathy; Kilpatrick, A. Marm; Patel, Nikkita; Lammers, Emily; Daszak, Peter


    We analyzed data from pathologic investigations in the United States, collected by the USGS National Wildlife Health Center between 1971 and 2005, into aquatic bird mortality events. A total of 3619 mortality events was documented for aquatic birds, involving at least 633 708 dead birds from 158 species belonging to 23 families. Environmental causes accounted for the largest proportion of mortality events (1737 or 48%) and dead birds (437 258 or 69%); these numbers increased between 1971 and 2000, with biotoxin mortalities due to botulinum intoxication (Types C and E) being the leading cause of death. Infectious diseases were the second leading cause of mortality events (20%) and dead birds (20%), with both viral diseases, including duck plague (Herpes virus), paramyxovirus of cormorants (Paramyxovirus PMV1) and West Nile virus (Flavivirus), and bacterial diseases, including avian cholera (Pasteurella multocida), chlamydiosis (Chalmydia psittici), and salmonellosis (Salmonella sp.), contributing. Pelagic, coastal marine birds and species that use marine and freshwater habitats were impacted most frequently by environmental causes of death, with biotoxin exposure, primarily botulinum toxin, resulting in mortalities of both coastal and freshwater species. Pelagic birds were impacted most severely by emaciation and starvation, which may reflect increased anthropogenic pressure on the marine habitat from over-fishing, pollution, and other factors. Our study provides important information on broad trends in aquatic bird mortality and highlights how long-term wildlife disease studies can be used to identify anthropogenic threats to wildlife conservation and ecosystem health. In particular, mortality data for the past 30 yr suggest that biotoxins, viral, and bacterial diseases could have impacted >5 million aquatic birds.

  20. Socio-economic conditioning as a determinant of rural development in the Opole voivodeship – an attempt to diagnose

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    Anna Mijal


    Full Text Available The issue of multidimensional changes taking place in rural areas has become a subject of interest to both sociologists, gerontoeducators, economists and management experts. The detailed analysis of rural areas under conditions of ambiguity and clear differences in their characteristic features (depopulation, suburbanization enables taking into consideration not only trends of alterations, but also their causes, consequences and corrective measures in the development strategy. In this context, the analysis of the changes that have occurred in rural areas in the Opole voivodeship in 2000-2010 in the perspective of 2035 seems to be especially interesting. The main aim of the article is to draw attention to the impact of socio-economic conditioning (demography, migration, economic and professional activity on contemporary and authentic view of the fine, but clearly aging country in the Opole voivodeship, burdened with adverse population growth and high net migration rate.

  1. Mortality indicators and risk factors for intra-abdominal hypertension in severe acute pancreatitis. (United States)

    Zhao, J G; Liao, Q; Zhao, Y P; Hu, Y


    This study assessed the risk factors associated with mortality and the development of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP). To identify significant risk factors, we assessed the following variables in 102 patients with SAP: age, gender, etiology, serum amylase level, white blood cell (WBC) count, serum calcium level, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, computed tomography severity index (CTSI) score, pancreatic necrosis, surgical interventions, and multiple organ dysfunction syndrome (MODS). Statistically significant differences were identified using the Student t test and the χ (2) test. Independent risk factors for survival were analyzed by Cox proportional hazards regression. The following variables were significantly related to both mortality and IAH: WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, pancreatic necrosis >50%, and MODS. However, it was found that surgical intervention had no significant association with mortality. MODS and pancreatic necrosis >50% were found to be independent risk factors for survival in patients with SAP. Mortality and IAH from SAP were significantly related to WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, and MODS. However, Surgical intervention did not result in higher mortality. Moreover, MODS and pancreatic necrosis >50% predicted a worse prognosis in SAP patients.

  2. Indicators of child health, service utilization and mortality in Zhejiang Province of China, 1998-2011.

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    Wei Fang Zhang

    Full Text Available OBJECTIVE: To investigate the levels of primary health care services for children and their changes in Zhejiang Province, China from 1998 to 2011. METHODS: The data were drawn from Zhejiang maternal and child health statistics collected under the supervision of the Health Bureau of Zhejiang Province. Primary health care coverage, hospital deliveries, low birth weight, postnatal visits, breastfeeding, underweight, early neonatal (<7 days mortality, neonatal mortality, infant mortality and under-5 mortality were investigated. RESULTS: The coverage rates for children under 3 years old and children under 7 years old increased in the last 14 years. The hospital delivery rate was high during the study period, and the overall difference narrowed. There was a significant difference (P<0.001 between the prevalence of low birth weight in 1998 (2.03% and the prevalence in 2011 (2.71%. The increase in low birth weight was more significant in urban areas than in rural areas. The postnatal visit rate increased from 95.00% to 98.45% with a significant difference (P<0.001. The breastfeeding rate was the highest in 2004 at 74.79% and lowest in 2008 at 53.86%. The prevalence of underweight in children under 5 years old decreased from 1.63% to 0.65%, and the prevalence was higher in rural areas. The early neonatal, neonatal, infant and under-5 mortality rates decreased from 6.66‰, 8.67‰, 11.99‰ and 15.28‰ to 1.69‰, 2.36‰, 3.89‰ and 5.42‰, respectively (P<0.001. The mortality rates in rural areas were slightly higher than those in urban areas each year, and the mortality rates were lower in Ningbo, Wenzhou, and Jiaxing regions and higher in Quzhou and Lishui regions. CONCLUSION: Primary health care services for children in Zhejiang Province improved from 1998 to 2011. Continued high rates of low birth weight in urban areas and mortality in rural areas may be addressed with improvements in health awareness and medical technology.


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    Joanna Szczykowska


    Full Text Available The necessity and purposefulness of the investments related to water retention are justified mostly due to the preservation of the environment equilibrium as well as due to its farming, anti-flood, landscape and recreation aspects. Reasonable water management where various forms of retention are used gives large chances for the mitigation of the effects of unfavorable phenomena related to its insufficient amount. The creation of plans regarding the formation of reservoirs accumulating water is not necessarily synonymous with their realization. The reason of problems connected with the implementation of plans regarding the formation of new reservoirs lies mainly in financial measures and in problems with obtaining them. Water deficit in Poland is the reason for which the principles of its national usage need to be complied with. Realization of plans at both Voivodeship and municipality level that are focused on small retention will contribute to considerable increase in the retention capacity and will enable considerable increase in available resources in hydrographic catchments of both the characterized area and the entire country. The paper presents the characteristics of the present state and assumes the perspective development of small water retention in the Podlaskie Voivodeship using the example of the Podlaskie Voivodeship.

  4. Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis. (United States)

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


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

  5. National economic and development indicators and international variation in prostate cancer incidence and mortality: an ecological analysis. (United States)

    Neupane, Subas; Bray, Freddie; Auvinen, Anssi


    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.

  6. Some reproductive health indicators in Ukraine : A study with special emphasis on factors behind induced aboartion and perinatal mortality


    Mogilevkina, Iryna


    Objectives: To study indicators specifically reflecting the reproductive health of Ukrainian women and to analyse factors behind the indicators. Methods: Induced abortion and maternal mortality were studied in some countries/regions of the former Soviet Union, using official statistics. Abortion rates, contraceptive practices and intentions in Ukrainian women were analysed by a large self-completion survey in 1996, and by a classroom questionnaire to first year medical students in 1999 in Do...

  7. Is thrombocytosis a valid indicator of advanced stage and high mortality of gynecological cancer?

    DEFF Research Database (Denmark)

    Andersen, Christen Bertel L; Eskelund, Christian W.; Siersma, Volkert Dirk


    Objective: Thrombocytosis has been associated with higher stage and mortality of cancer, however, the evidence is conflicting. We examined the stage distribution and prognosis of gynecologic cancer according to levels of prediagnostic platelet count. Methods: In a primary care resource with blood...... may have an important role in diagnosis and post-diagnostic control of gynecological cancer.......Objective: Thrombocytosis has been associated with higher stage and mortality of cancer, however, the evidence is conflicting. We examined the stage distribution and prognosis of gynecologic cancer according to levels of prediagnostic platelet count. Methods: In a primary care resource with blood...... cell counts from more than 500,000 individuals, we identified 581 women with a primary diagnosis of gynecological cancer. We divided the pre-diagnostic mean platelet count derived from the 3-year period prior to cancer diagnosis into three categories of thrombocytosis (no, 150–400 × 109 /L; mild, N400...

  8. Parental Opinions and Attitudes about Children’s Vaccination Safety in Silesian Voivodeship, Poland

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    Bogumiła Braczkowska


    Full Text Available Despite mandatory vaccinations in Poland, the final decision on vaccination in children is taken by their parents or legal guardians. Understanding parents’ attitudes and opinions regarding vaccinations is essential for planning and undertaking extensive and properly targeted educational actions aimed at preventing their hesitancy. In 2016, a cross-sectional study was conducted in the Silesian Voivodeship (Poland in 11 randomly selected educational institutions. The authors’ self-administered questionnaire contained 24 mixed-type questions. It was distributed among 3000 parents or legal guardians of children aged 6–13 years; prior consent of the relevant bioethics committee had been obtained. The response rate was 41.3% (N = 1239. Data were analysed using descriptive and analytical statistics, and focused on parental opinions regarding the safety of vaccines. Results of simple and multivariable analyses showed that perceived risk of adverse vaccine reaction (AVR, contraindications and perception of the qualification procedure for vaccination as substandard were significant factors associated with the rating of children’s vaccination as unsafe (p < 0.001. Respondents with a lower level of education, compared with those with higher, more often declared vaccinations to be safe (p = 0.03; however, results of multivariable analysis did not confirm that effect. AVR occurrence, finding of contraindication to vaccinations and perception of qualification procedure for vaccination were found to be the most important factors responsible for influencing general public opinions in the field of vaccination safety.


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    Maria Klonowska-Matynia


    Full Text Available The main aim of this article is to analyse and asses spatial diversity and seasonality of unemployment rate on labour market in selected seaside districts (rural, urban and rural-urban in the Zachodniopomorskie voivodeship in Poland. The following thesis was formulated: the location of the examined districts in the coastal zone determines their nature tourism and similar behaviour in the observed seasonal unemployment changes. Seasonal changes of the monthly unemployment rate were studied in the period 2001--2012. Data from the Central Statistical Office, Regional Data Bank and the Regional Labour Office in Szczecin were used in research process. The results confirm the authors’ assumptions about a relatively high sensitivity of the surveyed markets to seasonal changes, which is determined by the tourist nature of the area of the surveyed districts. There is no reason to assess that all the coastal districts react in a similar way. It has been observed that rural markets are more sensitive to seasonal unemployment changes in relation to the urban markets.


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    Stanisława Sokołowska


    Full Text Available Farm advisory system is a unique form of long-lasting education of framers and rural area dwellers. This attribute is significant as far as a transformation of European agriculture is concerned which resulted in creating a farm advisory system for the territorial scope Europe. The effectiveness of the system depends on many factors mainly, however, on active trust of farmers in the knowledge they acquire. The case study uses a questionnaire data collecting method in the households of the Opole voivodeship. On their basis the place and aim of a farm advisory organisation in the system of both agricultural knowledge and information have been determined as well as kinds of knowledge sought by farmers. The respondents’ evaluation of the significance of this institutional structure in the development of households and in the local development has also been presented. A question of the use of regional internet platforms in the realisation of farm advisory system tasks has been considered. The case study ends with conclusions and recommendation referring to the challenges to be faced by the regional structures of a farm advisory system.

  11. Adaptation of the opole voivodeship agricultural holdings to new managing conditions

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    Stanisława Sokołowska


    Full Text Available A new outlook at the position, role and function of agriculture in the economy is connected with an attempt to answer the question how its development potential can be used as factors of economical growth. At the microeconomic level, not only the estimation of effectiveness of used production factors is important but also the identification of incentives which influence decisions, concerning the ways of economic activity of holdings, made by their managers. The second issue is important due to the fact that the institutions close to the reformed CAP direct agriculture onto the path of a balanced development, which requires the new types of its multifunctionality to take shape. The following work suggests the mechanism of this process as “the autonomic aims of the agricultural holdings” which are a mean of implementation of universal aims. The research was based on a survey held in 150 holdings in the Opole voivodeship. The results confirm that the structures, which co-govern agriculture and are shaped by CAP, encourage the holdings to look for market benefits, as well as for institutional benefits which enable their multi-functioning.

  12. Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands. (United States)

    von Bartheld, Martin B; Annema, Jouke T


    Endosonography is being implemented rapidly in pulmonary medicine for the diagnosis and staging of lung cancer, the assessment of sarcoidosis, and the assessment of mediastinal lesions. Although serious adverse events (SAEs) have been described, safety data outside cohort studies are scarce. To assess the SAE and mortality rate of EUS-guided FNA (EUS-FNA) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal and/or hilar analysis. Nationwide, retrospective survey by using questionnaires. All hospitals in the Netherlands. All patients undergoing EUS-FNA and EBUS-TBNA for intrathoracic analysis in the period 1999 to 2011. EUS-FNA and EBUS-TBNA. Occurrence of fatal outcomes and SAEs. Detailed information was obtained for each reported case, and all cases were reviewed independently by 2 investigators, including identification of risk factors. All 89 hospitals (100%) responded. An estimated 14,075 EUS-FNA and 2675 EBUS procedures were performed. Seven patients died after endosonography (5 EUS-FNA, 2 EBUS [mortality rate 0.04%]). All fatalities occurred in patients of poor performance status (American Society of Anesthesiologists Physical Status Classification System score of III/IV). Twenty-five SAEs were reported (22 EUS-FNA, 3 EBUS [SAE rate of 0.15%; EUS-FNA 0.16%, EBUS 0.11%]). SAEs were mostly (64%) of infectious origin. No specific risk factors for infectious adverse events could be identified. Retrospective study, possible recall bias, overrepresentation of EUS-FNA cases. Endosonography appears to be a safe technique for the analysis of mediastinal and/or hilar lesions. Poor performance status is a risk factor for fatal outcomes. Mediastinitis and/or mediastinal abscess formation is rare but is a potential and dangerous adverse event of endosonography. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  13. Social aspects of revitalization of rural areas. Implementation of the rural revival programme in lodzkie voivodeship. Assumptions for sociological research

    Directory of Open Access Journals (Sweden)

    Pamela Jeziorska-Biel


    Full Text Available Essential elements of the process of rural renovation programme are: stimulating activity of local communities, cooperation for development, while preserving social identity, cultural heritage and natural environment. Implementing a rural revival programme in Poland: Sectoral Operational Programme “The Restructuring and Modernisation of the Food Sector and the Development of Rural Areas in 2004-2006” (action 2.3 “Rural renovation and protection and preservation of cultural heritage” evokes criticism. A wide discussion is carried amongst researchers, politicians, social activists, and local government practitioners. The main question remains: “is rural renovation process in Poland conducted in accordance with the rules in European countries or it is only a new formula of rural modernisation with the use of European funds?” The authors are joining the discussion and in the second part of the article they are presenting the assumption of sociological research. The aim of the analysis is to grasp the essence of revitalization of rural areas located in Łódzkie voivodeship, and analyse the question of specificity of rural Revival Programmes. What is the scope and manner of use of local capital? If so, are the results obtained from implementing a rural revival programme in 2004-2006 within the scope of sustainable development? What activities are predominant in the process of project implementation? Is it rural modernisation, revitalization of the rural areas, barrier removal and change in Infrastructure, or creation of social capital and subjectivity of the local community? Has the process of rural renovation in Łódzkie voivodeship got the so called “social face” and if so, to what extent? The major assumption is that rural renovation programme in Łódzkie voivodeship relates more to revitalization material aspects than “spirituality”.

  14. The Lyme disease as the increasing health problem in Małopolskie voivodeship compared with Poland in 1998-2014 (United States)

    Bandoła, Katarzyna; Koperny, Magdalena; Seweryn, Michał; Żak, Jacek; Bała, Małgorzata M

    Lyme disease is one of the most known tick borne diseases in Poland caused by spirochetes of the genus Borrelia burgdorferi. Most cases of Lyme disease are diagnosed in the northeastern Poland and the south of Poland, in Śląskie, Małopolskie, Podkarpackie voivodeship. The aim of the study was to evaluate epidemiological data of Lyme disease in Małopolskie voivodeship and other voivodeships in Poland and frequency analysis of the Lyme disease as an occupational disease. The authors analyzed prevalence from 1998 to 2014. Incidence of the Lyme disease was evaluated through review data from „Choroby zakaźne i zatrucia” Bulletin and Lyme disease as an occupational disease obtained data from the Nofer Institute of Occupational Medicine in Łódź. It is estimated that the number of Lyme disease cases in Poland increased 18 times between 1998 and 2014 year (2,0 to 36 per 100,000 population), in the same period it was over 35 times of sudden rise in Lyme disease incidence in Małopolskie voivodeship. In years 2005-2014 the number of cases of Lyme disease as an occupational disease fluctuated with a slight upward trend both in Poland and Małopolskie voivoideship. In Poland number of reported cases is systematically increasing. Podlaskie and Warmińsko- Mazurskie voivodeships are areas of high prevalence. Exponential increase in the number of cases is observed in southern Poland, especially in Małopolskie voivodeship from 2013.

  15. Conditions of lighting in reading-rooms located in public and school libraries in Silesian Voivodeship

    Directory of Open Access Journals (Sweden)

    Magdalena Sitek


    Full Text Available Introduction: Reading-room is a place where special lighting conditions are required to make the reader feel comfortable and satisfied.. Lighting requirements are enclosed in the Polish Standard PN-EN 12464-1:2004. Accordingly, illuminance in the reading-rooms should be 500 lx. The aim of the study was to measure illuminance in reading-rooms in various libraries and make relative comparisons to standard values. Material and methods: Measurements of illuminance were performed in 22 reading-rooms in Silesia Voivodeship. Half of them were made in public libraries and half in reading-rooms at junior lower high schools. Illuminance was measured in 5 measurement points in reading-rooms by digital lux meter Lx-105 manufactured by Lutron. Furthermore , 100 readers of school libraries and 89 readers of public libraries completed a questionnaire on lighting conditions in these places. Results: Only 5 out of 22 reading-rooms meet the requirements of the Polish Standard concerning illuminance. Only in one reading room at junior lower high school illuminance exceeded 500 lx. In two other reading places the requirements were met due to additional desk lamps. Despite the results, 76.4% of approached readers of public libraries and 60% of pupils think that lighting in readingrooms is satisfactory and almost 63% of the readers and 53% of the pupils don’t demand additional lighting. Conclusions: Most of the scrutinized reading rooms do not meet lighting requirements according to the Polish Standard. Lighting conditions in school libraries are worse than in public libraries. According to the respondents lighting in public libraries is adequate.

  16. Low serum transferrin correlates with acute-on-chronic organ failure and indicates short-term mortality in decompensated cirrhosis. (United States)

    Bruns, Tony; Nuraldeen, Renwar; Mai, Martina; Stengel, Sven; Zimmermann, Henning W; Yagmur, Eray; Trautwein, Christian; Stallmach, Andreas; Strnad, Pavel


    Iron represents an essential, but potentially harmful micronutrient, whose regulation has been associated with poor outcome in liver disease. Its homeostasis is tightly linked to oxidative stress, bacterial infections and systemic inflammation. To study the prognostic short-term significance of iron parameters in a cohort study of patients with decompensation of cirrhosis at risk of acute-on-chronic liver failure (ACLF). Ferritin, transferrin, iron, transferrin saturation (TSAT) and hepcidin were determined in sera from 292 German patients hospitalized for decompensation of cirrhosis with ascites, of which 78 (27%) had ACLF. Short-term mortality was prospectively assessed 30 and 90 days after inclusion. Transferrin concentrations were significantly lower, whereas ferritin and TSAT were higher in patients with ACLF compared to patients without ACLF (P≤.006). Transferrin, TSAT and ferritin differentially correlated with the severity of organ failure, active alcoholism and surrogates of systemic inflammation and macrophage activation. As compared with survivors, 30-day non-survivors displayed lower serum transferrin (P=.0003) and higher TSAT (P=.003), whereas 90-day non-survivors presented with higher ferritin (P=.03) and lower transferrin (P=.02). Lower transferrin (continuous or dichotomized at 87 mg/dL) and consecutively higher TSAT (continuous or dichotomized >41%) indicated increased mortality within 30 days and remained significant after adjustment for organ failure and inflammation in multivariate regression models and across subgroups of patients. Among the investigated indicators of iron metabolism, serum transferrin concentration was the best indicator of organ failure and an independent predictor of short-term mortality at 30 days. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. The history of the integration between Russia’s Kaliningrad region and Poland’s northeastern voivodeships: A programme approach

    Directory of Open Access Journals (Sweden)

    Mironyuk D. A.


    Full Text Available This article considers the development of integration between Russia’s Kaliningrad region and Poland’s northeastern voivodeships in 1946—2016. The authors set out to identify the main results of Russian-Polish cross-border cooperation in the context of the changing historical and political paradigms in the Baltic region. The authors conduct a brief historical analysis of this sphere of international relations. The genesis of integration at the regional level is explored by identifying the major areas and tools for collaboration. The authors address research works of Russian (Soviet and Polish researchers, intergovernmental agreements, EU-Russia crossborder cooperation programmes, expert interviews, and relevant analytical reports. Special attention is paid to programme-based interregional and cross-border cooperation as the most efficient form of collaboration for accelerating integration and socio-economic development in border areas. Based on their evaluation of the major achievements, the authors conclude that Russian-Polish cross-border cooperation has been successful. Yet, there is a need for developing a long-term empirical model of Russian-Polish relations in view of the many-years’ collaboration between the Kaliningrad region and the Polish voivodeships.

  18. Influence of metabolic indicators, smoking, alcohol and socioeconomic position on mortality after breast cancer

    DEFF Research Database (Denmark)

    Larsen, Signe Benzon; Kroman, Niels; Ibfelt, Else Helene


    BACKGROUND: Factors differently distributed among social groups like obesity, metabolic syndrome, diabetes, smoking, and alcohol intake predict survival after breast cancer diagnosis and therefore might mediate part of the observed social inequality in survival. MATERIAL AND METHODS: We conducted...... a cohort study among 1250 postmenopausal breast cancer patients identified among 29 875 women in the Danish Diet, Cancer and Health Study. Participants completed questionnaires and anthropometric measurements were made at enrollment. Information on survival, socioeconomic position, and comorbidity...... circumference and diabetes, and smoking and alcohol affected but did not explain the social gradient. CONCLUSION: The findings indicate that these factors explain some but not all the social inequality in survival after breast cancer and that improvement of lifestyle to some extent would improve survival among...

  19. Prognostic indicators associated with early mortality of wild raptors admitted to a wildlife rehabilitation centre in Spain. (United States)

    Molina-López, Rafael A; Casal, Jordi; Darwich, Laila


    Assessment of the prognostic indicators of wildlife casualties is critical in wildlife rehabilitation practice, to optimize the use of economical resources, and to protect animal welfare. Few studies have been conducted in this field. To identify the prognostic indicators associated with raptor mortality during the first week of hospitalization. Complete medical records of 1722 wild raptor cases admitted to a wildlife rehabilitation centre from 1995 to 2007 were used. Regression models were created to determine mortality-related factors for different variables (order, sex, body condition (BC), clinical signs, and available haematological and biochemical parameters). In the bivariate analysis, the presence of nervous (OR = 11.9, 95%CI:5.1-27.6) or musculoskeletal (OR = 12.1, 95%CI:5.8-25.3) signs, a poor BC (OR = 32.9, 95%CI:19-81.2), and low values of packed cell volume (PCV), haemoglobin or total solids (TS), were all associated with early mortality. After adjusting variables in the multivariate model, BC was excluded due to co-linearity with other variables, and alteration of the nervous system was the only significant risk factor (OR = 4.0; 95%CI:1.9-8.8). In species specific analysis, poor prognosis was related to neurological signs in Athene noctua, poor BC in Strix aluco, trauma in Acciptiter nisus and Tyto alba, low PCV in Buteo buteo and Falco tinnunculus and low TS in Falco tinnunculus. Raptors with a poor BC, low values of PCV and those presenting with neurological signs, had the highest risk of dying in the first days of admittance. Thus, either medical care or humane euthanasia for poor prognosis should be performed to address animal welfare.

  20. Tree Mortality (United States)

    Mark J. Ambrose


    Tree mortality is a natural process in all forest ecosystems. However, extremely high mortality also can be an indicator of forest health issues. On a regional scale, high mortality levels may indicate widespread insect or disease problems. High mortality may also occur if a large proportion of the forest in a particular region is made up of older, senescent stands....

  1. Impact of cesarean section in a private health service in Brazil: indications and neonatal morbidity and mortality rates. (United States)

    Almeida, M A; Araujo Júnior, E; Camano, L; Peixoto, A B; Martins, W P; Mattar, R


    To evaluate the incidence of, indications of, and maternal and neonatal morbidity and mortality rates in cesarean sections in a private health service in Brazil. Retrospective and observational study. Private health service in Vitória, Espírito Santo, Brazil. The patients were interviewed using a structured questionnaire to determine maternal age, gestational age at the time of delivery, number of previous deliveries, type of delivery performed, duration of labor, indications for cesarean delivery, point at which cesarean section was performed, physician responsible for delivery, and maternal morbidity, fetal morbidity, and fetal mortality rates. A descriptive analysis of the data was conducted. Students t-test was performed to compare quantitative variables, and Fishers exact test was performed for categorical variables. A total of 584 patients were evaluated. Of these, 91.8% (536/584) had cesarean sections, while only 8.2% (48/584) had vaginal deliveries. There were no reports of forceps-assisted vaginal deliveries. In 87.49% of the deliveries, the number of gestational weeks was more than 37. In terms of indications for performing cesarean section, 48.5% were for maternal causes, 30.41% were for fetal causes, and 17.17% were elective. Maternal re-hospitalization due to puerperal complications was necessary in 10.42% of the vaginal deliveries and in 0.93% of the cesarean deliveries (pcesarean section. Of the newborns with complications at birth, 40.59% (41/101) had to be admitted to the neonatal intensive care unit. There were no cases of maternal death. There were seven cases of fetal/neonatal death. We observed that the vast majority of deliveries in the private sector are performed by cesarean section, without labor, and by the patients obstetrician. We found no serious maternal complications or increased neonatal morbidity rates associated with cesarean section.

  2. The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care. (United States)

    Sunkara, Vasu; Hébert, James R


    Disparities in cancer screening, incidence, treatment, and survival are worsening globally. The mortality-to-incidence ratio (MIR) has been used previously to evaluate such disparities. The MIR for colorectal cancer is calculated for all Organisation for Economic Cooperation and Development (OECD) countries using the 2012 GLOBOCAN incidence and mortality statistics. Health system rankings were obtained from the World Health Organization. Two linear regression models were fit with the MIR as the dependent variable and health system ranking as the independent variable; one included all countries and one model had the "divergents" removed. The regression model for all countries explained 24% of the total variance in the MIR. Nine countries were found to have regression-calculated MIRs that differed from the actual MIR by >20%. Countries with lower-than-expected MIRs were found to have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs lack screening programs. When these divergent points were removed from the data set, the recalculated regression model explained 60% of the total variance in the MIR. The MIR proved useful for identifying disparities in cancer screening and treatment internationally. It has potential as an indicator of the long-term success of cancer surveillance programs and may be extended to other cancer types for these purposes. © 2015 American Cancer Society.

  3. 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


    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.

  4. [GeSIDA quality care indicators associated with mortality and hospital admission for the care of persons infected by HIV/AIDS]. (United States)

    Delgado-Mejía, Elena; Frontera-Juan, Guillem; Murillas-Angoiti, Javier; Campins-Roselló, Antoni Abdon; Gil-Alonso, Leire; Peñaranda-Vera, María; Ribas Del Blanco, María Angels; Martín-Pena, María Luisa; Riera-Jaume, Melchor


    In 2010, the AIDS Study Group (Grupo de Estudio del SIDA [GESIDA]) developed 66 quality care indicators. The aim of this study is to determine which of these indicators are associated with mortality and hospital admission, and to perform a preliminary assessment of a prediction rule for mortality and hospital admission in patients on treatment and follow-up. A retrospective cohort study was conducted in the Hospital Universitario Son Espases (Palma de Mallorca, Spain). Eligible participants were patients with human immunodeficiency syndrome≥18 years old who began follow-up in the Infectious Disease Section between 1 January 2000 and 31 December 2012. A descriptive analysis was performed to evaluate anthropometric variables, and a logistic regression analysis to assess the association between GESIDA indicators and mortality/admission. The mortality probability model was built using logistic regression. A total of 1,944 adults were eligible (median age: 37 years old, 78.8% male). In the multivariate analysis, the quality of care indicators associated with mortality in the follow-up patient group were the items 7, 16 and 20, and in the group of patients on treatment were 7, 16, 20, 35, and 38. The quality of care indicators associated with hospital admissions in the follow-up patients group were the same as those in the mortality analysis, plus number 31. In the treatment group the associated quality of care indicators were items 7, 16, 20, 35, 38, and 40. Some GeSIDA quality of care indicators were associated with mortality and/or hospital admissions. These indicators are associated with delayed diagnosis, regular monitoring, prevention of infections, and control of comorbidities. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. Association between mortality and indicators of traffic-related air pollution in the Netherlands: A cohort study

    NARCIS (Netherlands)

    Hoek, G.; Brunekreef, B.; Goldbohm, S.; Fischer, P.; Brandt, P.A. van den


    Background: Long-term exposure to particulate matter air pollution has been associated with increased cardiopulmonary mortality in the USA. We aimed to assess the relation between traffic-related air pollution and mortality in participants of the Netherlands Cohort study on Diet and Cancer (NLCS),

  6. Bereavement, multimorbidity and mortality: a population-based study using bereavement as an indicator of mental stress

    DEFF Research Database (Denmark)

    Prior, A; Fenger-Grøn, M; Davydow, D S


    BACKGROUND: Mental stress is associated with higher mortality, but it remains controversial whether the association is causal or a consequence of a higher physical disease burden in those with a high mental stress load. Understanding causality is important when developing targeted interventions. We...... with bereavement rose with increasing number of physical diseases (1.33 v. 7.00 excess death per 1000 person-months for individuals with 0 v. ⩾3 physical conditions during the first month) and was exacerbated by the presence of mental illness. The excess mortality among bereaved individuals was primarily due...... aimed to estimate the effect of mental stress on mortality by performing a 'natural' experiment using spousal bereavement as a disease-independent mental stressor. METHODS: We followed a population-based matched cohort, including all individuals in Denmark bereaved in 1997-2014, for 17 years...

  7. Science-Economy-Technology Concordance Matrix for Development and Implementation of Regional Smart Specializations in the Silesian Voivodeship, Poland. (United States)

    Smoliński, Adam; Bondaruk, Jan; Pichlak, Magdalena; Trząski, Leszek; Uszok, Elżbieta


    The regional smart specializations include the innovative activities within a common science-economy-technology sector, which open the opportunities to gain a competitive advantage. The original procedure of science-economy-technology concordance matrix development on an example of smart specializations of the Silesian Voivodeship was presented in the paper. The procedure developed includes recognition of the research and economic components of the regional smart specialization and the connection between the economic components of the regional specialization and the technological innovation through the international patent classification. It also comprises recognition of key enabling technologies (KETs) and high technologies (of high R&D intensity) other than KET in the economic and technological dimensions of innovation as well as the high R&D intensity services in the economic dimension of innovation. The in-depth expert analyses with the application of the Delphi method were also taken into account. The methodological approach developed and the visualization method applied are both of cognitive and practical importance since they contribute significantly to the creation of efficient development policies, to the enhancement and facilitation of cross-sectoral cooperation, and to the focusing on the fields of key importance in terms of the competitive advantage of a region.

  8. Science-Economy-Technology Concordance Matrix for Development and Implementation of Regional Smart Specializations in the Silesian Voivodeship, Poland

    Directory of Open Access Journals (Sweden)

    Adam Smoliński


    Full Text Available The regional smart specializations include the innovative activities within a common science-economy-technology sector, which open the opportunities to gain a competitive advantage. The original procedure of science-economy-technology concordance matrix development on an example of smart specializations of the Silesian Voivodeship was presented in the paper. The procedure developed includes recognition of the research and economic components of the regional smart specialization and the connection between the economic components of the regional specialization and the technological innovation through the international patent classification. It also comprises recognition of key enabling technologies (KETs and high technologies (of high R&D intensity other than KET in the economic and technological dimensions of innovation as well as the high R&D intensity services in the economic dimension of innovation. The in-depth expert analyses with the application of the Delphi method were also taken into account. The methodological approach developed and the visualization method applied are both of cognitive and practical importance since they contribute significantly to the creation of efficient development policies, to the enhancement and facilitation of cross-sectoral cooperation, and to the focusing on the fields of key importance in terms of the competitive advantage of a region.

  9. Penalized regression techniques for prediction: a case study for predicting tree mortality using remotely sensed vegetation indices

    NARCIS (Netherlands)

    Lazaridis, D.C.; Verbesselt, J.; Robinson, A.P.


    Constructing models can be complicated when the available fitting data are highly correlated and of high dimension. However, the complications depend on whether the goal is prediction instead of estimation. We focus on predicting tree mortality (measured as the number of dead trees) from change

  10. Assessment of risk perception connected with exposure to indoor air pollution in the group of inhabitants of Silesian Voivodeship

    Directory of Open Access Journals (Sweden)

    Karolina Krupa


    Full Text Available Introduction. Population increasingly draws attention to the issues concerning the environment degraded by the progress of civilization and the impact of this process on health. However, public awareness of the risk exposure to indoor contaminants is lagging a long way behind knowledge regarding outdoor environmental hazards. The aim of the study was to assess the risk perception related to exposure to indoor environmental factors in the population of Silesia. Materials and methods. In this study the electronic version of a questionnaire survey – downloaded on the website was used. During the 3-months duration of the project 552 subjects participated in the survey. In the study participated the Silesian Voivodeship inhabitants such as chat rooms users, newsgroups and online forum participants. Data analysis was performed by using statistical program – STATA Version 8 SE [9], where the Kruskall-Wallis test and χ2 test were applied. Statistical significance was assessed at p value *0.05. Results. Despite the low perception of environmental health hazards inside the dwellings, the majority of respondents were able to indentify health effects and ways to reduce exposure to indoor air pollution. Both gender, place of residence, education level and age significantly affected the level of perception of respondents on the risk connected with exposure to indoor air pollution. Conclusion. It is necessary to continuously work on raising public awareness of environmental health hazards in confined spaces, the causes of their occurrence, types, effects and above all the ways to counter these threats.


    Directory of Open Access Journals (Sweden)

    Jan Czeczelewski


    Full Text Available An increasing awareness of consumers is reflected in a growing demand for products which are manufactured in a particular way, with unique ingredients, or which are of a particular origin. The analysis of consumers’ preferences makes it possible to define factors which determine the purchase of regional products. The aim of the work was to identify factors which determine the purchase of regional products from Lubelskie Voivodeship on the basis of cluster analysis using Ward’s hierarchical agglomerative clustering method. The research was carried out in 2016 and included 383 individuals. Statistical analysis of results was conducted on the basis of frequency analysis and cluster analysis. According to the respondents, the most frequently purchased regional products included bakery products (47%, dairy products (35.3%, meat (33.3%, and alcoholic beverages (29.4%. Over 53% of the respondents claimed that the prices of regional products are too high, every third person (29.6% concluded that they are reasonable, while slightly over 3% of the respondents said they are low. Television and the Internet as well as close relatives and friends appeared to be the best forms of reaching the client with information concerning regional products when bringing them out on the market. However, the most common places where regional products were purchased were food fairs and festivals. Every second respondent purchased regional products at least once a month. Additionally, it was revealed that the consumers’ income was not a decisive factor when purchasing regional products. Despite financial stability, individuals who could be defined as “rich” in Polish conditions purchased regional products relatively rarely.

  12. Long-term forest resilience to climate change indicated by mortality, regeneration, and growth in semiarid southern Siberia. (United States)

    Xu, Chongyang; Liu, Hongyan; Anenkhonov, Oleg A; Korolyuk, Andrey Yu; Sandanov, Denis V; Balsanova, Larisa D; Naidanov, Bulat B; Wu, Xiuchen


    Several studies have documented that regional climate warming and the resulting increase in drought stress have triggered increased tree mortality in semiarid forests with unavoidable impacts on regional and global carbon sequestration. Although climate warming is projected to continue into the future, studies examining long-term resilience of semiarid forests against climate change are limited. In this study, long-term forest resilience was defined as the capacity of forest recruitment to compensate for losses from mortality. We observed an obvious change in long-term forest resilience along a local aridity gradient by reconstructing tree growth trend and disturbance history and investigating postdisturbance regeneration in semiarid forests in southern Siberia. In our study, with increased severity of local aridity, forests became vulnerable to drought stress, and regeneration first accelerated and then ceased. Radial growth of trees during 1900-2012 was also relatively stable on the moderately arid site. Furthermore, we found that smaller forest patches always have relatively weaker resilience under the same climatic conditions. Our results imply a relatively higher resilience in arid timberline forest patches than in continuous forests; however, further climate warming and increased drought could possibly cause the disappearance of small forest patches around the arid tree line. This study sheds light on climate change adaptation and provides insight into managing vulnerable semiarid forests. © 2016 John Wiley & Sons Ltd.

  13. Right ventricular ejection fraction: an indicator of increased mortality in patients with congestive heart failure associated with coronary artery disease

    International Nuclear Information System (INIS)

    Polak, J.F.; Holman, B.L.; Wynne, J.; Colucci, W.S.


    The predictive value of radionuclide ventriculography was studied in 34 patients with depressed left ventricular ejection fraction (less than 40%) and clinically evident congestive heart failure secondary to atherosclerotic coronary artery disease. In addition to left ventricular ejection fraction, right ventricular ejection fraction and extent of left ventricular paradox were obtained in an attempt to identify a subgroup at increased risk of mortality during the ensuing months. The 16 patients who were alive after a 2 year follow-up period had a higher right ventricular ejection fraction and less extensive left ventricular dyskinesia. When a right ventricular ejection fraction of less than 35% was used as a discriminant, mortality was significantly greater among the 21 patients with a depressed right ventricular ejection fraction (71 versus 23%), a finding confirmed by a life table analysis. It appears that the multiple factors contributing to the reduction in right ventricular ejection fraction make it a useful index not only for assessing biventricular function, but also for predicting patient outcome

  14. Mortality, readmission and length of stay have different relationships using hospital-level versus patient-level data: an example of the ecological fallacy affecting hospital performance indicators. (United States)

    Hofstede, Stefanie N; van Bodegom-Vos, Leti; Kringos, Dionne S; Steyerberg, Ewout; Marang-van de Mheen, Perla J


    Ecological fallacy refers to an erroneous inference about individuals on the basis of findings for the group to which those individuals belong. Suppose analysis of a large database shows that hospitals with a high proportion of long length of stay (LOS) patients also have higher than average in-hospital mortality. This may prompt efforts to reduce mortality among patients with long LOS. But patients with long LOS may not be the ones at higher risk of death. It may be that hospitals with higher mortality (regardless of LOS) also have more long LOS patients-either because of quality problems on both counts or because of unaccounted differences in case mix. To provide more insight how the ecological fallacy influences the evaluation of hospital performance indicators, we assessed whether hospital-level associations between in-hospital mortality, readmission and long LOS reflect patient-level associations. Patient admissions from the Dutch National Medical Registration (2007-2012) for specific diseases (stroke, colorectal carcinoma, heart failure, acute myocardial infarction and hip/knee replacements in patients with osteoarthritis) were analysed, as well as all admissions. Logistic regression analysis was used to assess patient-level associations. Pearson correlation coefficients were used to quantify hospital-level associations. Overall, we observed 2.2% in-hospital mortality, 8.1% readmissions and a mean LOS of 5.9 days among 8 478 884 admissions in 95 hospitals. Of the 10 disease-specific associations tested, 2 were reversed at hospital-level, 3 were consistent and 5 were only significant at either hospital-level or patient-level. A reversed association was found for stroke: patients with long LOS had 58% lower in-hospital mortality (OR 0.42 (95% CI 0.40 to 0.44)), whereas the hospital-level association was reversed (r=0.30, plevel associations were found for each hospital, but LOS varied across hospitals, thereby resulting in a positive hospital-level association

  15. Mortalidade hospitalar como indicador de qualidade: uma revisão Hospital mortality as an indicator of clinical performance: a review

    Directory of Open Access Journals (Sweden)

    Claudia Travassos


    Full Text Available Este artigo visa a discutir as principais questões metodológicas relacionadas à mortalidade hospitalar como indicador de qualidade. Variações nos valores deste indicador se devem a inúmeros fatores, associados ao doente e à doença, que devem ser examinados para que possamos utilizá-lo como medida de desempenho. Presença de comorbidades e a gravidade do caso estão associadas à chance de morrer . Aspectos metodológicos, relevantes para a construção deste indicador, incluem a qualidade das fontes de dados, o intervalo de tempo no qual elas são calculadas e os diferentes tipos de agregação. São discutidos diversos modelos, tanto para classificação da gravidade, quanto para o ajuste das taxas de mortalidade entre serviços. São examinados ainda modelos explicativos para a variação de mortalidade. Conclui-se que nas condições em que a morte não é um evento raro, o emprego de taxas de mortalidade hospitalar representa uma ferramenta útil para indicar serviços com eventuais problemas de qualidade.This article discusses the principal methodological problems related to hospital mortality as an indicator of clinical performance. Hospital mortality rates variation are due to various factors associated with patients' characteristics and to the specific diseases they are suffering. Socio-demographic variables, presence of comorbidity and severity may define case-mixes were chances of dying are not associated to technology deployed or quality of care. Relevant methodological aspects for calculating the rates include the quality of the source of data, time period and aggregation criteria. Various models that exist both for classifying severity of cases and for risk adjustment are presented and discussed. Explanatory models for mortality rates variation are also examined. The authors conclude that outcome indicators can be used as tool for health care service evaluation. For those conditions which death is not a rare event hospital

  16. Do the Results of the Process Indicators in the Norwegian Breast Cancer Screening Program Predict Future Mortality Reduction from Breast Cancer?

    International Nuclear Information System (INIS)

    Hofvind, Solveig; Wang, Hege; Thoresen, Steinar


    Continuous emphases of quality control are required to achieve reduction in mortality from breast cancer as a consequence of breast cancer screening. Results of the process indicators in the first 6 years in 4 counties in the Norwegian Breast Cancer Screening Program are evaluated and will be presented. Data from women who had their initial (n=173?402) and subsequent (n=220?058) screening provide the basis for the analysis. The breast cancer detection ratio was 3.2 the expected incidence (based on the incidence before the screening started, 1991-1995) among the initially screened women, decreasing to 2.3 among the subsequently screened. The ratio of interval cancer among the initially screened was 0.25 and 0.72 of the expected incidence, 0-12 and 13-23 months after screening, respectively. For those subsequently screened the proportions were 0.22 and 0.64, respectively. More than 50% of the invasive tumors were less than 15 mm in size, and more than 75% were lymph node negative, among both the initially and subsequently screened. The process indicators achieved in the NBCSP are promising as regards future mortality reduction. The incidence of interval cancer 13-24 months after screening is higher than recommended in the European guidelines

  17. Exploration of Key Success Factors that Influence Business Performance: The Experiences of Women Micro-entrepreneurs from Mazovia Voivodeship of Poland

    Directory of Open Access Journals (Sweden)

    Leszczyński Dariusz


    Full Text Available Women-owned businesses are one of the fastest growing categories of firms in the world, but they are greatly understudied in countries from the Central and Eastern Europe (CEE [Zapalska et al., 2005]. The purpose of this paper is to examine the relationship between business success predictors and the performance of female-owned micro-enterprises from the Mazovia Voivodeship in Poland during the period 2011–2013, using an Internet-based survey questionnaire. The data were collected by the CAWI (computer assisted web interview and CATI (computer assisted telephone interview methods. Exploratory factor analysis, correlation coefficients analysis and multivariate regression models were deployed to investigate the empirical data.


    Directory of Open Access Journals (Sweden)

    Zbigniew Brodziński


    Full Text Available The aim of the article was getting to know the factors, determining socio-economic activity of small and mediumsized businesses on border areas in Warmińsko-Mazurskie voivodeship. The study was conducted by telephone interviewing in 2015 amongst randomly selected group of 76 entrepreneurs. The gathered empirical data allowed to determine the areas which need taking action from local authorities to work for socio-economic development of border areas and improve the functionality conditions of the already existing companies. In entrepreneurs’ opinion, an important element in small and medium-sized businesses development is advertisement of the area and introduction of investment incentives. The study shows that endogenous possibilities of entrepreneurship development are limited. The most frequently raised issues were connected with the functioning of companies in their remote location, and also progressing depopulation of the area and low purchasing power of the local community.

  19. The Impact Of Shopping Centers In Rural Areas And Small Towns In The Outer Metropolitan Zone (The Example Of The Silesian Voivodeship

    Directory of Open Access Journals (Sweden)

    Heffner Krystian


    Full Text Available Shopping centers in the Silesian Voivodeship have a significant impact on smaller settlement units located in outer areas of agglomerations. It consists mainly in changes related to social, economic, as well as functional and spatial spheres. Studies shows that shopping centers take over more and more functions of higher order (services, public culture, administration and restrict the economic activity in rural areas outer areas of agglomerations. At the stage of the irrepressible process of suburbanisation of rural areas surrounding large urban agglomerations and structural changes in towns, it is difficult to conclusively assess the consequences of the operation of shopping centers in outer metropolitan areas. The impact of shopping centers on small towns and rural areas is a very dynamic process and requires systematic research.

  20. Traditional sectors based on natural resources – a blessing or a curse for less developed regions? A case study of Podlaskie Voivodeship

    Directory of Open Access Journals (Sweden)

    Dąbrowska Anna


    Full Text Available The natural environment, as a source of natural resources, has long been perceived as being a factor in determining the development of many states and regions, especially less developed areas. The main research question in this article is what role is played by natural resources and traditional industry sectors based on natural resources (milk production and tourism, in the process of establishing a competitive advantage for Podlaskie Voivodeship, which is one of the less developed regions in Poland. The results of the research reveal weaknesses that are inherent in earlier ways of thinking about these industries and, at the same time, emphasise the importance of making use of natural resources in an integrated way and combining them with new technologies.

  1. Chapter 5 - Tree Mortality (United States)

    Mark J. Ambrose


    Tree mortality is a natural process in all forest ecosystems. Extremely high mortality, however, can also be an indicator of forest health issues. On a regional scale, high mortality levels may indicate widespread insect or disease problems. High mortality may also occur if a large proportion of the forest in a particular region is made up of older, senescent stands....

  2. Trends in pneumoconiosis mortality and morbidity for the United States, 1968-2005, and relationship with indicators of extent of exposure

    Energy Technology Data Exchange (ETDEWEB)

    Attfield, M D; Bang, K M; Petsonk, E L; Schleiff, P L; Mazurek, J M, E-mail: mda1@cdc.go [Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control, 1095 Willowdale Road, Morgantown, WV, 26505 (United States)


    This surveillance report examines trends in selected pneumoconioses in the U.S. for 1968-2005 and their relationship with past indicators of extent of exposure. Numbers of deaths with asbestosis, silicosis, and coal workers' pneumoconiosis (CWP) were tabulated by time and age at death. Worker monitoring CWP prevalence data were tabulated by tenure group. Information on indicators of extent and intensity of exposure were obtained from various sources. Asbestosis deaths from 1968--2005 closely followed the historical trend in asbestos consumption, and appear to be declining in most age groups. Given appropriate exposure control, asbestosis could be eliminated by 2050. Silicosis deaths decreased substantially from 1968-2005, but levelled off after 1998 in all age groups, indicating a continuing occupational risk. In the anthracite coal region, CWP mortality has been declining rapidly. If there is no resurgence in the industry, CWP could disappear in that region by 2030. In the much larger bituminous region, deaths have declined over time but may be increasing among younger individuals. In addition, although CWP prevalence in working coal miners declined substantially from 1970 to 1994, it increased from 1995 to 2006. This indicates the need for increased vigilance in dust control in underground coal mining.

  3. Trends in pneumoconiosis mortality and morbidity for the United States, 1968-2005, and relationship with indicators of extent of exposure

    International Nuclear Information System (INIS)

    Attfield, M D; Bang, K M; Petsonk, E L; Schleiff, P L; Mazurek, J M


    This surveillance report examines trends in selected pneumoconioses in the U.S. for 1968-2005 and their relationship with past indicators of extent of exposure. Numbers of deaths with asbestosis, silicosis, and coal workers' pneumoconiosis (CWP) were tabulated by time and age at death. Worker monitoring CWP prevalence data were tabulated by tenure group. Information on indicators of extent and intensity of exposure were obtained from various sources. Asbestosis deaths from 1968--2005 closely followed the historical trend in asbestos consumption, and appear to be declining in most age groups. Given appropriate exposure control, asbestosis could be eliminated by 2050. Silicosis deaths decreased substantially from 1968-2005, but levelled off after 1998 in all age groups, indicating a continuing occupational risk. In the anthracite coal region, CWP mortality has been declining rapidly. If there is no resurgence in the industry, CWP could disappear in that region by 2030. In the much larger bituminous region, deaths have declined over time but may be increasing among younger individuals. In addition, although CWP prevalence in working coal miners declined substantially from 1970 to 1994, it increased from 1995 to 2006. This indicates the need for increased vigilance in dust control in underground coal mining.

  4. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study (United States)

    Prince, Martin; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Rodriguez, Juan J Llibre; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D; Dewey, Michael E; Acosta, Isaac; Jotheeswaran, Amuthavalli T; Liu, Zhaorui


    Summary Background Results of the few cohort studies from countries with low incomes or middle incomes suggest a lower incidence of dementia than in high-income countries. We assessed incidence of dementia according to criteria from the 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, the effect of dementia at baseline on mortality, and the independent effects of age, sex, socioeconomic position, and indicators of cognitive reserve. Methods We did a population-based cohort study of all people aged 65 years and older living in urban sites in Cuba, the Dominican Republic, and Venezuela, and rural and urban sites in Peru, Mexico, and China, with ascertainment of incident 10/66 and DSM-IV dementia 3–5 years after cohort inception. We used questionnaires to obtain information about age in years, sex, educational level, literacy, occupational attainment, and number of household assets. We obtained information about mortality from all sites. For participants who had died, we interviewed a friend or relative to ascertain the likelihood that they had dementia before death. Findings 12 887 participants were interviewed at baseline. 11 718 were free of dementia, of whom 8137 (69%) were reinterviewed, contributing 34 718 person-years of follow-up. Incidence for 10/66 dementia varied between 18·2 and 30·4 per 1000 person-years, and were 1·4–2·7 times higher than were those for DSM-IV dementia (9·9–15·7 per 1000 person-years). Mortality hazards were 1·56–5·69 times higher in individuals with dementia at baseline than in those who were dementia-free. Informant reports suggested a high incidence of dementia before death; overall incidence might be 4–19% higher if these data were included. 10/66 dementia incidence was independently associated with increased age (HR 1·67; 95% CI 1·56–1·79), female sex (0·72; 0·61–0·84), and low education (0·89; 0·81–0·97), but not with occupational attainment (1

  5. Hospital Outcome and Risk Indices of Mortality after redo-mitral valve surgery in Potential Candidates for Transcatheter Procedures: Results From a European Registry. (United States)

    Onorati, Francesco; Mariscalco, Giovanni; Reichart, Daniel; Perrotti, Andrea; Gatti, Giuseppe; De Feo, Marisa; Rubino, Antonio; Santarpino, Giuseppe; Biancari, Fausto; Detter, Christian; Santini, Francesco; Faggian, Giuseppe


    Transcatheter mitral valve-in-valve/valve-in-ring procedures (TM-VIVoR) are increasing. The authors aimed to identify independent predictors for hospital mortality in redo mitral valve surgery as possible future selection criteria for TM-VIVoR. Retrospective multicenter registry. Tertiary university and community hospitals. Two-hundred and sixty patients (out of 920 enrolled) who are potentially candidates for TM-VIVoR undergoing redo-surgery. Redo mitral surgery. Regression analyzes and receiver operating characteristic (ROC) curves identified independent predictors of death. Patients potentially candidates for TM-VIVoR reported significant hospital mortality (9.2%; EuroSCORE II: 13.2 ± 13.1, Society of Thoracic Surgeons [STS] score: 6.2 ± 3.1) and major morbidity (3.8% acute myocardial infarction, 5% stroke, 16.9% perioperative respiratory failure, 16.5% acute renal insufficiency, 25% massive transfusions). EuroSCORE II (odds ration [OR] 1.06; confidence interval [CI] 1.01-1.10; p = 0.005), STS score (OR 1.58; CI 1.27-1.97; p = 0.001), age at surgery (OR 1.05; CI 1.00-1.15; p = 0.05), preoperative dialysis (OR 2.5; CI 1.8-12.6; p = 0.042), left ventricular ejection fraction (LVEF) 13.1; 70.8% sensitivity and 68.2% specificity) and better prediction for STS score (AUC: 0.81; cut-off value: 7.4; 75.0% sensitivity and 66.2% specificity). Quintiles stratification identified EuroSCORE II ≥18.7 (5th quintile, observed mortality: 19.3%) and STS score >9.1 as strong predictors of death within each risk-categorization (OR 5.9 and 12.1, respectively). High EuroSCORE II and STS scores, advanced age at surgery, LVEF indications for TM-VIVoR in the redo-mitral surgery scenario. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The effect of selected ovulation-inducing preparations on post-stripping mortality and reproductive indicators of farmed European grayling (Thymallus thymallus L.

    Directory of Open Access Journals (Sweden)

    Jan Turek


    Full Text Available An experiment on the effects of hormonal preparations (Gonazon™ and Supergestran containing gonadotropin-releasing hormone on the course of reproduction of farmed grayling (Thymallus thymallus L. broodstock and their post-stripping mortality was performed at the hatchery in spring 2009. Four-year-old marked grayling females (n = 80 were randomly divided into four groups. The fish were intramuscularly injected with Supergestran at a dose of 30 μg·kg-1 body weight (Group 1, with GonazonTM at a dose of 30 μg·kg-1 (Group 2 and with saline 0.9% NaCl (Group 3, while fish of Group 4 were left without treatment (control group. No effect of treatment on the total number of ovulated females (70–80% was found at the end of the stripping period. Slightly higher (non-significant percentage of ovulated fish in the first stripping time (3 days post injection was observed in fish treated with Gonazon. The 30-days post-ovulatory mortality remained unaffected by hormone treatments in all groups. Significant differences (P < 0.001 were found in the fertilization rate of egg samples from the first stripping time. The highest fertilization rate (98.6% was found in fish treated with Supergestran, lower fertilization rates (61% and 65% in fish treated with saline and control, respectively, and the lowest fertilization rate (39% in fish treated with Gonazon. Other reproductive indicators remained unaffected by treatment in all groups. Based on our results, Supergestran is the most suitable preparation for the enhancing of artificial reproduction efficiency of farmed European grayling in fishery practice. The study brings important information about artificial reproduction of grayling broodstocks reared in controlled conditions.

  7. [Knowledge to the subject of legal highs and popularity of their use amongst secondary-school students from the Silesian Voivodeship]. (United States)

    Margasińska, Joanna; Dworak, Daria; Goc, Sara; Ahnert, Bożena; Wiechuła, Danuta

    Evaluation of knowledge to the subject of legal highs and popularity of their use amongst secondary-school students from the Silesian Voivodeship. Studies were conducted in spring of 2016 in two randomly selected secondary schools in Katowice and Dąbrowa Górnicza. The survey was carried out amongst students of these schools and concerned question about the knowledge of legal highs effect on the body and their use by young people. The study consisted of 336 questionnaire forms, 159 filled by secondaryschool students from Katowice and 177 by secondary-school students from Dąbrowa Górnicza. Legal highs for 78.3% of young people are as dangerous as drugs. Almost 70% of respondents believe that legal highs strongly affected the physical health, psyche, may cause a loss of life or health, as well as cause addiction. As the main effects of legal highs, young people point to strong agitation and aggression, as well as visions and hallucinations. 12.5% of respondents answered “Yes” to the question, whether they ever took legal highs. Most of students (69.7%) think that legal highs should be forbidden. The use of legal highs declared 12.5% of secondaryschool students. Most of respondents are aware of threats to health associated with use of legal highs.

  8. Mortality rates or sociomedical indicators? The work of the League of Nations on standardizing the effects of the Great Depression on health. (United States)

    Garcia, Monica


    This article explores the first international effort by the League of Nations Health Organization (LNHO) to standardize the study of the effects of the economic crisis of the 1930s on health. Instead of analysing this effort with the benefit of hindsight, this article takes into account the actors' perspectives and, therefore, it relies on the documents produced by the LNHO and public health experts of the 1930s, as well as on the historical scholarship on this subject. This article shows that, despite the declining death rates in Europe and in the US during the crisis, the LNHO considered that death rates concealed a more subtle effect of the crisis on health; hence, they launched a project aimed at making the effect visible. It describes the LNHO programme and the guidelines and methods set out by the organization in 1932 to observe this subtle effect through sociomedical investigations. The results of these surveys are summarized and the article discusses how the eugenic arguments used to explain them were not accepted by the LNHO. The article also shows how some members of the LNHO considered the results of the sociomedical surveys inconclusive and questioned the usefulness of socioeconomic indicators; in so doing, they raised concerns about the intervention of the LNHO in national matters and about the risks of crossing the established limits between science and politics. This article shows that an historical analysis, which takes into account the points of view of the actors involved, illuminates the factors that led the LNHO to conclude that mortality rates were the best method for measuring the effects of the economic crisis on health and that, as they were declining, the Great Depression was not having any deleterious effect on public health.

  9. 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. (United States)

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


    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

  10. An European concerted action investigating the validity of perinatal mortality as an outcome indicator for the quality of antenatal and perinatal care

    NARCIS (Netherlands)

    Richardus, J.H.; Graafmans, W.C.; Pal-de Bruin, K.M. van der; Amelink-Verburg, M.P.; Verloove-Vanhorick, S.P.; Mackenbach, J.P.


    In this paper the concepts, objectives, design, and data analysis procedures of the EuroNatal study are described. This sutdy started in 1996 and is a concerted action including 14 countries in Europe. The EuroNatal study aims at determining the validity of national perinatal mortality rates as an

  11. 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


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


    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). ...

  12. Evaluation of the Apache II and the oncologic history, as indicative predictions of mortality in the unit of intensive care of the INC September 1996 -December 1997

    International Nuclear Information System (INIS)

    Camargo, David O; Gomez, Clara; Martinez, Teresa


    They are multiple the indexes of severity that have been carried out to value the predict and the quality of a patient's life, especially when this it enters to the unit of intensive care (UIC); however, the oncologic patient presents particularities in their mobility, that it supposes a different behavior in the results of the Indexes. Presently work is compared the Apache scale and the oncologic history like morbid mortality as predictors in the UCI. 207 patients were included that entered the UCI between September of 1996 and December of 1997. It was a mortality of 29%, the stay of most of this group of patient smaller than 24 hours or bigger than 8 days. To the entrance, 50% of the patients presented superior averages at 15 in the Apache Scale and at the 48 hours, alone 30.4% continued with this value. The patients with hematologic neoplasia presented superior average at 15 in 87%, with a mortality of 63.3% with average between 15 and 24 to the entrance, the risk of dying was 9.8 times but that with inferior average. In the hematologic patient, the risk of dying was 5.7 times but regarding the solid tumors. The system but altered it was the breathing one, with an increase in the risk of dying from 2,8 times for each increment utility in the scale. Contrary to described in the literature, the oncologic diagnoses and the neoplasia statistic they didn't influence in the mortality of the patients

  13. Comparison of UTCI with other thermal indices in the assessment of heat and cold effects on cardiovascular mortality in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Urban, Aleš; Kyselý, Jan


    Roč. 11, č. 1 (2014), s. 952-967 ISSN 1660-4601 R&D Projects: GA ČR(CZ) GAP209/11/1985 Institutional support: RVO:68378289 Keywords : UTCI * human thermal comfort * mortality * cardiovascular diseases * heat stress * cold stress Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 2.063, year: 2014

  14. Reducing the impact of pesticides on biological control in Australian vineyards: pesticide mortality and fecundity effects on an indicator species, the predatory mite Euseius victoriensis (Acari: Phytoseiidae). (United States)

    Bernard, Martina B; Cole, Peter; Kobelt, Amanda; Horne, Paul A; Altmann, James; Wratten, Stephen D; Yen, Alan L


    Laboratory bioassays on detached soybean, Glycine max (L.) Merr., leaves were used to test 23 fungicides, five insecticides, two acaricides, one herbicide, and two adjuvants on a key Australian predatory mite species Euseius victoriensis (Womersley) in "worst-case scenario" direct overspray assays. Zero- to 48-h-old juveniles, their initial food, and water supply were sprayed to runoff with a Potter tower; spinosad and wettable sulfur residues also were tested. Tests were standardized to deliver a pesticide dose comparable with commercial application of highest label rates at 1,000 liter/ha. Cumulative mortality was assessed 48 h, 4 d, and 7 d after spraying. Fecundity was assessed for 7 d from start of oviposition. No significant mortality or fecundity effects were detected for the following compounds at single-use application at 1,000 liter/ha: azoxystrobin, Bacillus thuringiensis (Bt) subsp. kurstaki, captan, chlorothalonil, copper hydroxide, fenarimol, glyphosate, hexaconazole, indoxacarb, metalaxyl/copper hydroxide, myclobutanil, nonyl phenol ethylene oxide, phosphorous acid, potassium bicarbonate, pyraclostrobin, quinoxyfen, spiroxamine, synthetic latex, tebufenozide, triadimenol, and trifloxystrobin. Iprodione and penconazole had some detrimental effect on fecundity. Canola oil as acaricide (2 liter/100 liter) and wettable sulfur (200 g/100 liter) had some detrimental effect on survival and fecundity and cyprodinil/fludioxonil on survivor. The following compounds were highly toxic (high 48-h mortality): benomyl, carbendazim, emamectin benzoate, mancozeb, spinosad (direct overspray and residue), wettable sulfur (> or = 400 g/100 liter), and pyrimethanil; pyrimethanil had no significant effect on fecundity of surviving females. Indoxacarb safety to E. victoriensis contrasts with its toxicity to key parasitoids and chrysopid predators. Potential impact of findings is discussed.

  15. Temporal Profile of Microtubule-Associated Protein 2: A Novel Indicator of Diffuse Brain Injury Severity and Early Mortality after Brain Trauma. (United States)

    Papa, Linda; Robicsek, Steven A; Brophy, Gretchen M; Wang, Kevin K W; Hannay, H Julia; Heaton, Shelley; Schmalfuss, Ilona; Gabrielli, Andrea; Hayes, Ronald L; Robertson, Claudia S


    This study compared cerebrospinal fluid (CSF) levels of microtubule-associated protein 2 (MAP-2) from adult patients with severe traumatic brain injury (TBI) with uninjured controls over 10 days, and examined the relationship between MAP-2 concentrations and acute clinical and radiologic measures of injury severity along with mortality at 2 weeks and over 6 months. This prospective study, conducted at two Level 1 trauma centers, enrolled adults with severe TBI (Glasgow Coma Scale [GCS] score ≤8) requiring a ventriculostomy, as well as controls. Ventricular CSF was sampled from each patient at 6, 12, 24, 48, 72, 96, 120, 144, 168, 192, 216, and 240 h following TBI and analyzed via enzyme-linked immunosorbent assay for MAP-2 (ng/mL). Injury severity was assessed by the GCS score, Marshall Classification on computed tomography (CT), Rotterdam CT score, and mortality. There were 151 patients enrolled-130 TBI and 21 control patients. MAP-2 was detectable within 6 h of injury and was significantly elevated compared with controls (p < 0.001) at each time-point. MAP-2 was highest within 72 h of injury and decreased gradually over 10 days. The area under the receiver operating characteristic curve for deciphering TBI versus controls at the earliest time-point CSF was obtained was 0.96 (95% CI 0.93-0.99) and for the maximal 24-h level was 0.98 (95% CI 0.97-1.00). The area under the curve for initial MAP-2 levels predicting 2-week mortality was 0.80 at 6 h, 0.81 at 12 h, 0.75 at 18 h, 0.75 at 24 h, and 0.80 at 48 h. Those with Diffuse Injury III-IV had much higher initial (p = 0.033) and maximal (p = 0.003) MAP-2 levels than those with Diffuse Injury I-II. There was a graded increase in the overall levels and peaks of MAP-2 as the degree of diffuse injury increased within the first 120 h post-injury. These data suggest that early levels of MAP-2 reflect severity of diffuse brain injury and predict 2-week mortality in TBI patients. These

  16. Infant Mortality (United States)

    ... After hours (404) 639-2888 Contact Media Infant Mortality Recommend on Facebook Tweet Share Compartir On This ... differences in rates among population groups. About Infant Mortality Infant mortality is the death of an infant ...

  17. Tendencias e indicadores sociales de la mortalidad por cáncer de mama y cuello uterino: Antioquia, Colombia, 2000-2007 Trends and social indicators of both mortality breast cancer and cervical cancer in Antioquia, Colombia, 2000-2007

    Directory of Open Access Journals (Sweden)

    Armando Baena


    Full Text Available OBJETIVO: Estimar tasas estandarizadas por edad (TEE de mortalidad por cáncer de mama y cérvix 2000-2007 y explorar indicadores sociales que expliquen la variabilidad de las tasas. MATERIAL Y MÉTODOS: Las TEE de mortalidad se estimaron por el método directo y mediante regresión lineal se relacionaron con indicadores sociales por subregión. RESULTADOS: La TEE de cáncer de mama en Antioquia fue 11.3 por 100 000 mujeres-año y para cáncer cervical 9.1. En Medellín, la TEE de cáncer de mama fue 12.5, 1.8 veces la tasa de cáncer cervical. Se observó una disminución del cáncer cervical en Medellín (valor-p=0.03 entre 2000 y 2007, pero no en el resto de Antioquia. La mortalidad de cáncer cervical se relacionó con el porcentaje de miseria (valor-p=0.0003. CONCLUSIONES: La mortalidad por estas neoplasias ha permanecido constante en Antioquia, con una amplia variación de la mortalidad por cáncer cervical por subregión asociada con niveles de pobreza.OBJECTIVE: To estimate the mortality age-standardized rates (ASR for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. MATERIAL AND METHODS: The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. RESULTS: Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03 but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003. CONCLUSIONS: Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty.

  18. Loneliness, health and mortality

    DEFF Research Database (Denmark)

    Henriksen, J; Larsen, E R; Mattisson, C


    Aims.: Literature suggests an association between loneliness and mortality for both males and females. Yet, the linkage of loneliness to mortality is not thoroughly examined, and need to be replicated with a long follow-up time. This study assessed the association between loneliness and mortality...... not been previously reported. If replicated, our results indicate that loneliness may have differential physical implications in some subgroups. Future studies are needed to further investigate the influence of gender on the relationship....

  19. Urinary uric acid excretion as an indicator of severe hypoxia and mortality in patients with obstructive sleep apnea and chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    E. Ozanturk


    Full Text Available Objective: Uric acid (UA is the end product of adenosine triphosphate degradation, and could increase due to hypoxia. We investigated the association of UA metabolites with nocturnal hypoxemia, apnea-hypopnea index (AHI, noninvasive mechanical ventilation (NIMV usage and five-year mortality. Materials/subjects and methods: We obtained urinary specimen before and after the night polysomnography in order to measure UA excretion and overnight change in urinary UA/creatinine ratio (ΔUA/Cr in 75 subjects (14 controls, 15 chronic obstructive pulmonary disease (COPD without nocturnal hypoxemia (NH, 15 COPD with NH, 16 obstructive sleep apnea syndrome (OSAS without NH, 15 OSAS with NH. Percentage of time spent below SaO2 of 90% (T90% for >10% of sleep time was considered as nocturnal hypoxemia. Patients were contacted after 5 years with a questionnaire including information on the use of NIMV treatment (n: 58 and urinary specimen analysis (n: 35. Results: T90% was found to be significantly correlated with UA excretion (coefficient: 0.005, 95%CI: 0.003–0.007 and ΔUA/Cr (coefficient: 0.8, 95%CI: 0.3–1.2 after adjustments for age, gender, body mass index and apnea-hypopnea index. Median and IQR (interquartile range of baseline UA excretion were 0.79 (0.51–0.89 and 0.41 (0.31–0.55 in 10 deceased and 58 surviving patients, respectively (p = 0.001. UA excretion median and IQR of baseline and 5 years of NIMV treatment were 0.41 (0.36–0.57 and 0.29 (0.23–0.37, respectively (p = 0.01. Conclusion: UA excretion, as a marker of tissue hypoxia, may be useful in the management of OSA and COPD patients. Keywords: Uric acid, Hypoxia, Obstructive sleep apnea, COPD

  20. Occupational mortality

    DEFF Research Database (Denmark)

    Lynge, Elsebeth


    -1975 revealed a considerable social class gradient in male mortality where university teachers and farmers had a 40% lower mortality and waiters and seamen had an about 100% higher mortality than the average for economically active men. The social class gradient was less steep for women. A similar pattern...

  1. Variación de los indicadores de mortalidad evitable entre comunas chilenas como aproximación a las desigualdades de salud Using different indicators of preventable mortality as an approach to measuring health inequalities in Chilean municipalities

    Directory of Open Access Journals (Sweden)

    Cesar Gattini


    ón, basada en datos de 1992, para iniciar un monitoreo de las desigualdades de salud entre áreas geográficas pequeñas, en este caso las comunas. Aunque las iniciativas por mejorar la equidad se concentran en las comunas de menor desarrollo socioeconómico y mayor mortalidad evitable, reducir esta última implica una tarea con un enfoque doble: dar prioridad de intervención a las comunas más postergadas por un lado, y cubrir la mayoría de las comunas para prevenir la mortalidad evitable por el otro.OBJECTIVES: To analyze differences in avoidable mortality among communes in Chile, using different indicators as an operational approach to estimating health inequalities. METHODS: Small area variation analysis in a sample of 117 of all 335 Chilean communes that existed in 1992. By using secondary data, we developed and compared some avoidable-mortality indicators, such as potential years of life lost (PYLL, avoidable mortality (AM (based on background and criteria drawn from the literature, health care avoidable mortality (HCAMR, and life expectancy. A socioeconomic development index (SEDI was also developed. The scope of the variation was estimated through the weighted variation coefficient, the Gini coefficient, the ratio between the values for the quintiles at both extremes of the SEDI distribution, and the ratio of the lowest SEDI quintile to the group of municipalities having a SEDI greater than 0.90 (optimal empirical reference value. The socioeconomic pattern of variations was examined through concentration curves and by comparing communal quintiles based on their SEDI. RESULTS: The various avoidable-mortality indicators used showed an inverse and statistically significant correlation with socioeconomic development, as well as with the profile of the various SEDI quintiles and with the majority of specific causes of avoidable mortality. The distribution profile of AM indicators among SEDI communal quintiles reflects the same tendency, along with most of the mortality

  2. Polysomnographic indicators of mortality in stroke patients

    DEFF Research Database (Denmark)

    Ponsaing, Laura B; Iversen, Helle K; Jennum, Poul


    a 19-37-month follow-up period. RESULTS: Of the 57 stroke and 6 TIA patients, 9 stroke patients died during follow-up. All nine had moderate or severe sleep-related breathing disorders (SRBDs). Binarily divided, the group with the highest apnea hypopnea index (AHI) had an almost 10-fold higher...... receive increased attention....

  3. Development and Validation of an Agency for Healthcare Research and Quality Indicator for Mortality After Congenital Heart Surgery Harmonized With Risk Adjustment for Congenital Heart Surgery (RACHS-1) Methodology. (United States)

    Jenkins, Kathy J; Koch Kupiec, Jennifer; Owens, Pamela L; Romano, Patrick S; Geppert, Jeffrey J; Gauvreau, Kimberlee


    The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by the Agency for Healthcare Research and Quality (AHRQ). Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies. Parameters that were identical between the 2 methods were retained. AHRQ's Healthcare Cost and Utilization Project State Inpatient Databases (SID) 2008 were used to select optimal parameters where differences existed, with a goal to maximize model performance and face validity. Inclusion criteria were not changed and included all discharges for patients model includes procedure risk group, age (0-28 days, 29-90 days, 91-364 days, 1-17 years), low birth weight (500-2499 g), other congenital anomalies (Clinical Classifications Software 217, except for 758.xx), multiple procedures, and transfer-in status. Among 17 945 eligible cases in the SID 2008, the c statistic for model performance was 0.82. In the SID 2013 validation data set, the c statistic was 0.82. Risk-adjusted mortality rates by center ranged from 0.9% to 4.1% (5th-95th percentile). Congenital heart surgery programs can now obtain national benchmarking reports by applying AHRQ Quality Indicator software to hospital administrative data, based on the harmonized RACHS-1 method, with high discrimination and face validity. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. Turbine related fish mortality

    International Nuclear Information System (INIS)

    Eicher, G.J.


    A literature review was conducted to assess the factors affecting turbine-related fish mortality. The mechanics of fish passage through a turbine is outlined, and various turbine related stresses are described, including pressure and shear effects, hydraulic head, turbine efficiency, and tailwater level. The methodologies used in determining the effects of fish passage are evaluated. The necessity of adequate controls in each test is noted. It is concluded that mortality is the result of several factors such as hardiness of study fish, fish size, concentrations of dissolved gases, and amounts of cavitation. Comparisons between Francis and Kaplan turbines indicate little difference in percent mortality. 27 refs., 5 figs

  5. Koncepcja rozwoju Wojewódzkiego Ośrodka Sportu i Rekreacji w Drzonkowie „Farma Zdrowia” = The Concept of Development of Voivodeship Sport and Recreation Centre in Drzonkow “Health Farm”

    Directory of Open Access Journals (Sweden)

    Mirosław Mrozkowiak


      Słowa kluczowe: sport, rekreacja.   Streszczenie Ośrodek w Drzonkowie zawsze przyciągał mieszkańców nie tylko Regionu Lubuskiego. Z jego bazy treningowej korzystają sportowcy polscy i zagraniczni. Niestety z biegiem lat wskutek stopniowej dekapitalizacji obiektów i licznych zmian organizacyjnych, funkcjonalność Wojewódzkiego Ośrodka Sportu i Rekreacji przestała odpowiadać współczesnym standardom. Struktura organizacyjna i niewydolne zarządzanie nie zahamowały tego procesu.      Ośrodek musi być wielofunkcyjny i powszechnie dostępny. Powinien spełniać oczekiwania mieszkańców nie tylko regionu. Opracowanie szczegółowych założeń modernizacji WOSiR, w zakresie przyszłych funkcji i procesu inwestycyjnego będzie pierwszym krokiem w kierunku naprawy i rozwoju. Krok drugi, to inwestycje własne i wdrożenie partnerstwa społeczno - prywatnego, które pozwoli na szybkie i oszczędne sfinalizowanie zamierzeń.      Wizja rozwoju ośrodka jest możliwa do realizowania dzięki dotychczas dokonanym przedsięwzięciom, których zrealizowanie było możliwe przy wsparciu finansowemu organu założycielskiego, środkom pozyskanym z funduszy pomocowych, sponsorów i działań własnych. Dyrekcja dobrze zaplanowała i wykorzystała środki pomocowe przekazane na modernizację bazy hotelowej i sportowej, jednak zmiany muszą być radykalne.   Keywords: sport, recreation.   Abstract The Voivodeship Sport and Recreation Centre (Wojewódzki Ośrodek Sportu i Rekreacji, WOSiR in Drzonkow has always attracted inhabitant of both Lubusz Voivodeship and other regions of the country. Its sports facilities are used by Polish and foreign sportsmen. Unfortunately, in the course of time, as a result of gradual decapitalization of sports centres and numerous organizational transitions, functions of the Voivodeship Sport and Recreation Centre stopped meeting contemporary standards. Organizational structure and inefficient management did not prevent

  6. Overall human mortality and morbidity due to exposure to air pollution. (United States)

    Samek, Lucyna


    Concentrations of particulate matter that contains particles with diameter ≤ 10 mm (PM10) and diameter ≤ 2.5 mm (PM2.5) as well as nitrogen dioxide (NO2) have considerable impact on human mortality, especially in the cases when cardiovascular or respiratory causes are attributed. Additionally, they affect morbidity. An estimation of human mortality and morbidity due to the increased concentrations of PM10, PM2.5 and NO2 between the years 2005-2013 was performed for the city of Kraków, Poland. For this purpose the Air Quality Health Impact Assessment Tool (AirQ) software was successfully applied. The Air Quality Health Impact Assessment Tool was used for the calculation of the total, cardiovascular and respiratory mortality as well as hospital admissions related to cardiovascular and respiratory diseases. Data on concentrations of PM10, PM2.5 and NO2, which was obtained from the website of the Voivodeship Inspectorate for Environmental Protection (WIOS) in Kraków, was used in this study. Total mortality due to exposure to PM10 in 2005 was found to be 41 deaths per 100 000 and dropped to 30 deaths per 100 000 in 2013. Cardiovascular mortality was 2 times lower than the total mortality. However, hospital admissions due to respiratory diseases were more than an order of magnitude higher than the respiratory mortality. The calculated total mortality due to PM2.5 was higher than that due to PM10. Air pollution was determined to have a significant effect on human health. The values obtained by the use of the AirQ software for the city of Kraków imply that exposure to polluted air can result in serious health problems. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. Overall human mortality and morbidity due to exposure to air pollution

    Directory of Open Access Journals (Sweden)

    Lucyna Samek


    Full Text Available Objectives: Concentrations of particulate matter that contains particles with diameter ≤ 10 mm (PM10 and diameter ≤ 2.5 mm (PM2.5 as well as nitrogen dioxide (NO2 have considerable impact on human mortality, especially in the cases when cardiovascular or respiratory causes are attributed. Additionally, they affect morbidity. An estimation of human mortality and morbidity due to the increased concentrations of PM10, PM2.5 and NO2 between the years 2005–2013 was performed for the city of Kraków, Poland. For this purpose the Air Quality Health Impact Assessment Tool (AirQ software was successfully applied. Material and Methods: The Air Quality Health Impact Assessment Tool was used for the calculation of the total, cardiovascular and respiratory mortality as well as hospital admissions related to cardiovascular and respiratory diseases. Data on concentrations of PM10, PM2.5 and NO2, which was obtained from the website of the Voivodeship Inspectorate for Environmental Protection (WIOS in Kraków, was used in this study. Results: Total mortality due to exposure to PM10 in 2005 was found to be 41 deaths per 100 000 and dropped to 30 deaths per 100 000 in 2013. Cardiovascular mortality was 2 times lower than the total mortality. However, hospital admissions due to respiratory diseases were more than an order of magnitude higher than the respiratory mortality. Conclusions: The calculated total mortality due to PM2.5 was higher than that due to PM10. Air pollution was determined to have a significant effect on human health. The values obtained by the use of the AirQ software for the city of Kraków imply that exposure to polluted air can result in serious health problems.

  8. Reducing infant mortality. (United States)

    Johnson, T R


    Public health and social policies at the population level (e.g., oral rehydration therapy and immunization) are responsible for the major reduction in infant mortality worldwide. The gap in infant mortality rates between developing and developed regions is much less than that in maternal mortality rates. This indicates that maternal and child health (MCH) programs and women's health care should be combined. Since 1950, 66% of infant deaths occur in the 1st 28 days, indicating adverse prenatal and intrapartum events (e.g., congenital malformation and birth injuries). Infection, especially pneumonia and diarrhea, and low birth weight are the major causes of infant mortality worldwide. An estimated US$25 billion are needed to secure the resources to control major childhood diseases, reduce malnutrition 50%, reduce child deaths by 4 million/year, provide potable water and sanitation to all communities, provide basic education, and make family planning available to all. This cost for saving children's lives is lower than current expenditures for cigarettes (US$50 billion in Europe/year). Vitamin A supplementation, breast feeding, and prenatal diagnosis of congenital malformations are low-cost strategies that can significantly affect infant well-being and reduce child mortality in many developing countries. The US has a higher infant mortality rate than have other developed countries. The American College of Obstetricians and Gynecologists and the US National Institutes of Health are focusing on prematurity, low birth weight, multiple pregnancy, violence, alcohol abuse, and poverty to reduce infant mortality. Obstetricians should be important members of MCH teams, which also include traditional birth attendants, community health workers, nurses, midwives, and medical officers. We have the financial resources to allocate resources to improve MCH care and to reduce infant mortality.

  9. Transgranichnoe sotrudnichestvo nepravitel'stvennyh organizacij v Pomorskom i Varmin'sko-Mazurskom voevodstvah [Cross-border cooperation between nongovernmental organisations in the Pomeranian and Warmian-Masurian voivodeships

    Directory of Open Access Journals (Sweden)

    Gomulka Christina


    Full Text Available This article is devoted to the issues of cross-border cooperation carried out by agents resident in the Pomeranian and Warmian-Masurian voivodeships. Among such agents there are non-governmental organizations. This article aims to identify the role of NGOs in cross-border cooperation and the predominant fields of their cooperation, as well as to assess their activity in attracting funding from European budgets. The article widely applies the results of surveys of NGOs conducted by the author, compares the results of performance reports submitted by these organisations within international projects, and offers the data presented in relevant publications (Euroregion Baltic documents and Phare CBC reports, Interreg IIIA and, Interreg IIIB, NMF, and Polish-Swiss Cooperation reports, as well as the data of the Central Department of Statistics. The research covers the period from the late 90s to 2012. The article highlights the difficulties agents face in forging and implementing cross-border cooperation, resulting from the mismatching definitions of the tertiary sector in Poland’s neighbour states.

  10. Cancer mortality

    International Nuclear Information System (INIS)

    Kato, H.


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

  11. Mortality Implications of Mortality Plateaus

    DEFF Research Database (Denmark)

    Missov, T. I.; Vaupel, J. W.


    This article aims to describe in a unified framework all plateau-generating random effects models in terms of (i) plausible distributions for the hazard (baseline mortality) and the random effect (unobserved heterogeneity, frailty) as well as (ii) the impact of frailty on the baseline hazard...

  12. The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005 Impacto de los cambios en los indicadores de salud sobre las tasas de mortalidad infantil en Brasil, 2000 y 2005

    Directory of Open Access Journals (Sweden)

    Fernando M. Volpe


    Full Text Available OBJECTIVES: To investigate the associations between changes in indicators of health-related resources and coverage, and variations in infant mortality rates (IMR in Brazil's 27 states in 2000 and 2005. METHODS: Data were obtained from the Ministry of Health's online database, DATASUS. Stepwise multiple regressions were performed to model changes in IMR and its components (early, late, and post-neonatal mortality, using changes in the selected health indicators as predictors. RESULTS: Regression analysis showed that improving access to prenatal care (B = -0.89 per 1 000; P OBJETIVOS: Investigar las asociaciones entre los cambios en los indicadores de recursos y cobertura relacionados con la salud y las variaciones en las tasas de mortalidad infantil (TMI en los 27 estados de Brasil entre los años 2000 y 2005. MÉTODOS: Los datos se obtuvieron de la base de datos en línea del Ministerio de Salud, DATASUS. Mediante regresión múltiple paso a paso se modelaron los cambios en la TMI y sus componentes (mortalidades temprana, tardía y posneonatal, utilizando como predictores los cambios en indicadores seleccionados de salud. RESULTADOS: Según el análisis de regresión, el mejoramiento del acceso a la atención prenatal (B = -0,89 por 1 000; P < 0,001 y al suministro de agua (B = -0,22 por 1 000; P = 0,033, y el aumento del gasto público en salud como proporción del producto interno bruto (PIB (B = -0,72 por 1 000; P = 0,031 se asociaron con reducciones significativas de las TMI. Las reducciones de las tasas de mortalidad neonatal temprana se asociaron con la atención prenatal (B = -0,14 por 1 000; P = 0,026 y el acceso a servicios de saneamiento (B = -0,05 por 1 000; P = 0,026. Las reducciones en las tasas de mortalidad neonatal tardía se asociaron con la atención prenatal (B = -0,12 por 1 000; P = 0,003 e, inversamente, con la tasa de partos por cesárea (B = 0,13 por 1 000; P = 0,005. Las reducciones en las tasas de mortalidad posneonatal

  13. The Analysis of Differences in Residential Property Price Indices

    Directory of Open Access Journals (Sweden)

    Kokot Sebastian


    Full Text Available Residential property price indices can serve as a useful tool in the practice of real property market analysts, investment advisers, property developers, certified property appraisers, estate agents and managers. They can also be applied in property price valorization in specific legal positions. The Polish Act on Real Estate Management puts an obligation on the President of the Central Statistical Office to announce real property price indices, but the CSO fails to fulfill this obligation. The author’s rationale for this article is to contribute to works on rules of how to build property price indices. Presented within are the results of research on determining the price indices of such types of residential property as: a part of a building constituting a separate property and strata titles in housing cooperatives. The flats were divided into categories by floor area and by their location in 16 voivodeship capitals. The major purpose of the study is to prove that the prices of flats of different floor area change at different rates. Consequently, it seems worth considering whether a more detailed segmentation of the real estate market would be worthwhile for the sake of more accurate real property price indicators.

  14. Neonatal mortality in Utah. (United States)

    Woolley, F R; Schuman, K L; Lyon, J L


    A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

  15. Mortality, fog and atmospheric pollution

    Energy Technology Data Exchange (ETDEWEB)

    Martin, A E; Bradley, W H


    A study was made associating climate and atmospheric pollution with excess mortality in greater London during the winter of 1958 and 1959. It was a particularly foggy winter with 6 major episodes, 4 of which resembled previous dangerous smogs. There were two additional periods of high pollution without fog. Excess mortality during these 8 periods ranged from 70 to 230. During one period, a flu epidemic accompanied the fog. In 4 to 6 foggy periods, morbidity (hospital bed demand) also increased. This small number of observations indicates mortality association: on 2/3 of days with high SO/sub 2/ (2.5 pphM) or high particulate soot (10 mg/m/sup 3/), and on all days with thick fog, there was an increase in mortality (20 deaths more than previous day) on that or the following day. Fifteen-day moving mortality index and bronchitis mortality index were significantly correlated with black suspended matter and SO/sub 2/; association with pneumonia was not significant. Also little or no relation between mortality and humidity, mean temperature, or barometric pressure was found. Rapid response of mortality to air pollution may indicate that pollution affects mostly those already ill.

  16. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M


    In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000 li...... indicates that over the past decade the surveyed area has greatly reduced neonatal and NNT mortality. Possible strategies for accelerated NNT control have been identified by the survey....

  17. Migrant mortality from diabetes mellitus across Europe

    DEFF Research Database (Denmark)

    Vandenheede, Hadewijch; Deboosere, Patrick; Stirbu, Irina


    ) is more affluent than the country of birth (COB). We obtained mortality data from 7 European countries. To assess migrant diabetes mortality, we used direct standardization and Poisson regression. First, migrant mortality was estimated for each country separately. Then, we merged the data from all......The first objective of this study was to determine and quantify variations in diabetes mortality by migrant status in different European countries. The second objective was to investigate the hypothesis that diabetes mortality is higher in migrant groups for whom the country of residence (COR...... mortality registers. Subsequently, to examine the second hypothesis, we introduced gross domestic product (GDP) per capita of COB in the models, as an indicator of socio-economic circumstances. The overall pattern shows higher diabetes mortality in migrant populations compared to local-born populations...

  18. Mortality table construction (United States)



    Mortality tables play important role in actuarial studies such as life annuities, premium determination, premium reserve, valuation pension plan, pension funding. Some known mortality tables are CSO mortality table, Indonesian Mortality Table, Bowers mortality table, Japan Mortality table. For actuary applications some tables are constructed with different environment such as single decrement, double decrement, and multiple decrement. There exist two approaches in mortality table construction : mathematics approach and statistical approach. Distribution model and estimation theory are the statistical concepts that are used in mortality table construction. This article aims to discuss the statistical approach in mortality table construction. The distributional assumptions are uniform death distribution (UDD) and constant force (exponential). Moment estimation and maximum likelihood are used to estimate the mortality parameter. Moment estimation methods are easier to manipulate compared to maximum likelihood estimation (mle). However, the complete mortality data are not used in moment estimation method. Maximum likelihood exploited all available information in mortality estimation. Some mle equations are complicated and solved using numerical methods. The article focus on single decrement estimation using moment and maximum likelihood estimation. Some extension to double decrement will introduced. Simple dataset will be used to illustrated the mortality estimation, and mortality table.

  19. Empirical Productivity Indices and Indicators

    NARCIS (Netherlands)

    B.M. Balk (Bert)


    textabstractThe empirical measurement of productivity change (or difference) by means of indices and indicators starts with the ex post profit/loss accounts of a production unit. Key concepts are profit, leading to indicators, and profitability, leading to indices. The main task for the productivity

  20. Remotely sensed predictors of conifer tree mortality during severe drought (United States)

    Brodrick, P. G.; Asner, G. P.


    Widespread, drought-induced forest mortality has been documented on every forested continent over the last two decades, yet early pre-mortality indicators of tree death remain poorly understood. Remotely sensed physiological-based measures offer a means for large-scale analysis to understand and predict drought-induced mortality. Here, we use laser-guided imaging spectroscopy from multiple years of aerial surveys to assess the impact of sustained canopy water loss on tree mortality. We analyze both gross canopy mortality in 2016 and the change in mortality between 2015 and 2016 in millions of sampled conifer forest locations throughout the Sierra Nevada mountains in California. On average, sustained water loss and gross mortality are strongly related, and year-to-year water loss within the drought indicates subsequent mortality. Both relationships are consistent after controlling for location and tree community composition, suggesting that these metrics may serve as indicators of mortality during a drought.

  1. Telomere Length and Mortality

    DEFF Research Database (Denmark)

    Kimura, Masayuki; Hjelmborg, Jacob V B; Gardner, Jeffrey P


    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...

  2. Waste indicators

    Energy Technology Data Exchange (ETDEWEB)

    Dall, O.; Lassen, C.; Hansen, E. [Cowi A/S, Lyngby (Denmark)


    The Waste Indicator Project focuses on methods to evaluate the efficiency of waste management. The project proposes the use of three indicators for resource consumption, primary energy and landfill requirements, based on the life-cycle principles applied in the EDIP Project. Trial runs are made With the indicators on paper, glass packaging and aluminium, and two models are identified for mapping the Danish waste management, of which the least extensive focuses on real and potential savings. (au)

  3. Waste indicators

    International Nuclear Information System (INIS)

    Dall, O.; Lassen, C.; Hansen, E.


    The Waste Indicator Project focuses on methods to evaluate the efficiency of waste management. The project proposes the use of three indicators for resource consumption, primary energy and landfill requirements, based on the life-cycle principles applied in the EDIP Project. Trial runs are made With the indicators on paper, glass packaging and aluminium, and two models are identified for mapping the Danish waste management, of which the least extensive focuses on real and potential savings. (au)

  4. Excess mortality in hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans; Pedersen, Dorthe Almind; Christensen, Kaare


    Hyperthyroidism is associated with severe comorbidity, such as stroke, and seems to confer increased mortality. However, it is unknown whether this increased mortality is explained by hyperthyroidism per se, comorbidity, and/or genetic confounding.......Hyperthyroidism is associated with severe comorbidity, such as stroke, and seems to confer increased mortality. However, it is unknown whether this increased mortality is explained by hyperthyroidism per se, comorbidity, and/or genetic confounding....

  5. Quality indicators

    DEFF Research Database (Denmark)

    Hjorth-Andersen, Christian


    In recent literature it has been suggested that consumers need have no knowledge of product quality as a number of quality indicators (or signals) may be used as substitutes. Very little attention has been paid to the empirical verification of these studies. The present paper is devoted...... to the issue of how well these indicators perform, using market data provided by consumer magazines from 3 countries. The results strongly indicate that price is a poor quality indicator. The paper also presents some evidence which suggests that seller reputation and easily observable characteristics are also...

  6. Mortality among anesthesiologists in Denmark, 1973-95

    DEFF Research Database (Denmark)

    Juel, K; Husum, Bent; Viby-Mogensen, J


    Preliminary data from Sweden indicating that anesthesiologists have a high mortality risk has caused a lot of concern in Denmark. The aim of this study therefore was to compare mortality between consultant anesthesiologists and other consultants in Denmark.......Preliminary data from Sweden indicating that anesthesiologists have a high mortality risk has caused a lot of concern in Denmark. The aim of this study therefore was to compare mortality between consultant anesthesiologists and other consultants in Denmark....

  7. General indicators

    International Nuclear Information System (INIS)


    This document summarizes the main 2002 energy indicators for France. A first table lists the evolution of general indicators between 1973 and 2002: energy bill, price of imported crude oil, energy independence, primary and final energy consumption. The main 2002 results are detailed separately for natural gas, petroleum and coal (consumption, imports, exports, production, stocks, prices). (J.S.)

  8. Solar Indices (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  9. Morbidity And Mortality Following Emergency Obstetric ...

    African Journals Online (AJOL)

    Morbidity And Mortality Following Emergency Obstetric Hysterectomy In Calabar, Nigeria. ... Nigerian Journal of Clinical Practice ... in 15 (33.3%) of the case and hysterectomy for puerperal sepsis was an indication in 3 (6.7%) of the cases

  10. Respiratory tract mortality in cement workers: a proportionate mortality study (United States)


    Background The evidence regarding the association between lung cancer and occupational exposure to cement is controversial. This study investigated causes of deaths from cancer of respiratory tract among cement workers. Methods The deaths of the Greek Cement Workers Compensation Scheme were analyzed covering the period 1969-1998. All respiratory, lung, laryngeal and urinary bladder cancer proportionate mortality were calculated for cement production, maintenance, and office workers in the cement industry. Mortality from urinary bladder cancer was used as an indirect indicator of the confounding effect of smoking. Results Mortality from all respiratory cancer was significantly increased in cement production workers (PMR = 1.91; 95% CI 1.54 to 2.33). The proportionate mortality from lung cancer was significantly elevated (PMR = 2.05; 95% CI 1.65 to 2.52). A statistically significant increase in proportionate mortality due to respiratory (PMR = 1.7; 95% CI 1.2 to 2.34). and lung cancer (PMR = 1.67;95% CI = 1.15-2.34) among maintenance workers has been observed. The PMR among the three groups of workers (production, maintenance, office) did differ significantly for lung cancer (p = 0.001), while the PMR for urinary bladder cancer found to be similar among the three groups of cement workers. Conclusion Cement production, and maintenance workers presented increased lung and respiratory cancer proportionate mortality, and this finding probably cannot be explained by the confounding effect of smoking alone. Further research including use of prospective cohort studies is needed in order to establish a causal association between occupational exposure to cement and risk of lung cancer. PMID:22738120

  11. Operational indicators

    International Nuclear Information System (INIS)


    The chapter presents the operational indicators related to budget, travel costs and tickets, the evolution of the annual program for regulatory inspection, the scientific production, requested patents and the numbers related to the production of the services offered by the Institution

  12. VSRR - Quarterly provisional estimates for selected indicators of mortality (United States)

    U.S. Department of Health & Human Services — Provisional estimates of death rates. Estimates are presented for each of the 15 leading causes of death plus estimates for deaths attributed to drug overdose, falls...

  13. Diseño y análisis comparativo de un inventario de indicadores de mortalidad evitable adaptado a las condiciones sanitarias de Colombia Design and comparative analysis of an inventory of avoidable mortality indicators specific to health conditions in Colombia

    Directory of Open Access Journals (Sweden)

    Rubén Darío Gómez-Arias


    Full Text Available OBJETIVOS: Elaborar un inventario de indicadores de mortalidad evitable (INIME que permita analizar las fallas en el control de los riesgos de mortalidad predominantes en Colombia y comparar los resultados de su aplicación con los obtenidos mediante dos enfoques ampliamente utilizados. MÉTODOS: Se revisaron los registros oficiales de mortalidad de Colombia de 1985 a 2001; las causas básicas de muerte se clasificaron según la CIE-9. Se seleccionaron los indicadores de mortalidad evitable (ME mediante un algoritmo que combinó las listas de Holland y de Taucher, la definición de Rutstein y colaboradores y el principio de Uemura. Se compararon las proporciones de muertes evitables resultantes de aplicar el INIME y las dos listas de ME a una base de datos con los registros oficiales de defunciones de Colombia de 1993 a 1996. RESULTADOS: De las 680617 defunciones registradas en el período de estudio, se clasificaron como evitables 18,2% según la lista de Holland y 51,3% según la lista de Taucher. La ME según el INIME ascendió a 76,7%. Este patrón se mantuvo relativamente estable entre 1993 y 1996. Las diferencias observadas en la proporción de muertes evitables según el INIME y las dos listas de ME se relacionaron con el perfil epidemiológico local y el enfoque conceptual de cada lista. CONCLUSIONES: Las diferencias entre el INIME y las listas de ME de Holland y de Taucher muestran las consecuencias de usar una u otra clasificación en el contexto colombiano. El INIME puede constituir un recurso valioso para fundamentar y evaluar políticas sanitarias, pero debe ajustarse a la situación específica en que se aplique.OBJECTIVES: To develop a list of indicators of avoidable mortality (LIAM in order to analyze failed efforts to control the mortality risks prevalent in Colombia, and to compare its results to those of two widely-used approaches. METHODS: The official mortality records of Colombia for 1985-2001 were reviewed; the basic

  14. Under-Five Mortality

    African Journals Online (AJOL)

    under-five mortality rate (U5MR) by two thirds between. 1990 and 2015. For Zambia, this means ... 1Institute of Economic and Social Research, University of Zambia ... live births;. 2. Neonatal mortality: Deaths during the first 28 days of life. 3. Post-neonatal ... children born/woman) and rapid (3%) population growth on living ...

  15. Mortality in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lie, Elisabeth; Lindström, Ulf


    OBJECTIVES: Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population. METHODS: Nationwide cohorts of patients with AS diagnosed at rheumatology or int...

  16. Mortality associated with phaeochromocytoma. (United States)

    Prejbisz, A; Lenders, J W M; Eisenhofer, G; Januszewicz, A


    Two major categories of mortality are distinguished in patients with phaeochromocytoma. First, the effects of excessive circulating catecholamines may result in lethal complications if the disease is not diagnosed and/or treated timely. The second category of mortality is related to development of metastatic disease or other neoplasms. Improvements in disease recognition and diagnosis over the past few decades have reduced mortality from undiagnosed tumours. Nevertheless, many tumours remain unrecognised until they cause severe complications. Death resulting from unrecognised or untreated tumour is caused by cardiovascular complications. There are also numerous drugs and diagnostic or therapeutic manipulations that can cause fatal complications in patients with phaeochromocytoma. Previously it has been reported that operative mortality was as high as 50% in unprepared patients with phaeochromocytoma who were operated and in whom the diagnosis was unsuspected. Today mortality during surgery in medically prepared patients with the tumour is minimal. Phaeochromocytomas may be malignant at presentation or metastases may develop later, but both scenarios are associated with a potentially lethal outcome. Patients with phaeochromocytoma run an increased risk to develop other tumours, resulting in an increased mortality risk compared to the general population. Phaeochromocytoma during pregnancy represents a condition with potentially high maternal and foetal mortality. However, today phaeochromocytoma in pregnancy is recognised earlier and in conjunction with improved medical management, maternal mortality has decreased to less than 5%. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Maternal Mortality in Texas. (United States)

    Baeva, Sonia; Archer, Natalie P; Ruggiero, Karen; Hall, Manda; Stagg, Julie; Interis, Evelyn Coronado; Vega, Rachelle; Delgado, Evelyn; Hellerstedt, John; Hankins, Gary; Hollier, Lisa M


    A commentary on maternal mortality in Texas is provided in response to a 2016 article in Obstetrics & Gynecology by MacDorman et al. While the Texas Department of State Health Services and the Texas Maternal Mortality and Morbidity Task Force agree that maternal mortality increased sharply from 2010 to 2011, the percentage change or the magnitude of the increase in the maternal mortality rate in Texas differs depending on the statistical methods used to compute and display it. Methodologic challenges in identifying maternal death are also discussed, as well as risk factors and causes of maternal death in Texas. Finally, several state efforts currently underway to address maternal mortality in Texas are described. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Gallstone disease and mortality

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted; Sørensen, Lars Tue; Jørgensen, Torben


    OBJECTIVES: The objective of this cohort study was to determine whether subjects with gallstone disease identified by screening of a general population had increased overall mortality when compared to gallstone-free participants and to explore causes of death. METHODS: The study population (N...... built. RESULTS: Gallstone disease was present in 10%. Mortality was 46% during median 24.7 years of follow-up with 1% lost. Overall mortality and death from cardiovascular diseases were significantly associated to gallstone disease. Death from unknown causes was significantly associated to gallstone...... disease and death from cancer and gastrointestinal disease was not associated. No differences in mortality for ultrasound-proven gallstones or cholecystectomy were identified. CONCLUSIONS: Gallstone disease is associated with increased overall mortality and to death from cardiovascular disease. Gallstones...

  19. Effect of healthcare on mortality: trends in avoidable mortality in Umbria, Italy, 1994-2009

    Directory of Open Access Journals (Sweden)

    Fabrizio Stracci


    Full Text Available OBJECTIVE: Avoidable mortality trends over the period 1994-2009 were calculated to evaluate health intervention by the health system of Umbria, a region of central Italy. MATERIALS AND METHODS: Mortality data were supplied by the regional causes of death registry. Rates were standardized to the 2001 census Italian population. Joinpoint regression was used to analyze the trends. RESULTS: Overall avoidable mortality rates decreased significantly both in males (-3.9% per year and in females (-3.6% per year. Mortality rates from ischemic heart and cerebrovascular disease about halved in the study period in both sexes. Avoidable mortality increased slightly only for a few causes (e.g. lung cancer in females. CONCLUSION: The overall trend of avoidable mortality indicates that the regional health/ preventive system is performing well.

  20. Assessment of sampling mortality of larval fishes

    International Nuclear Information System (INIS)

    Cada, G.F.; Hergenrader, G.L.


    A study was initiated to assess the mortality of larval fishes that were entrained in the condenser cooling systems of two nuclear power plants on the Missouri River in Nebraska. High mortalities were observed not only in the discharge collections but also in control samples taken upriver from the plants where no entrainment effects were possible. As a result, entrainment mortality generally could not be demonstrated. A technique was developed which indicated that (1) a significant portion of the observed mortality above the power plants was the result of net-induced sampling mortality, and (2) a direct relationship existed between observed mortality and water velocity in the nets when sampling at the control sites, which was described by linear regression equations. When these equations were subsequently used to remove the effects of wide differences in sampling velocities between control and discharge collections, significant entrainment mortality was noted in all cases. The equations were also used to derive estimates of the natural mortality of ichthyoplankton in this portion of the Missouri River

  1. Tempo effects in mortality: An appraisal

    Directory of Open Access Journals (Sweden)

    Michel Guillot


    Full Text Available This study examines the existence of tempo effects in mortality and evaluates the procedure developed by Bongaarts and Feeney for calculating a tempo-adjusted life expectancy. It is shown that Bongaarts and Feeney's index can be interpreted as an indicator reflecting current mortality conditions under specific assumptions regarding the effects of changing period mortality conditions on the timing of future cohort deaths. It is argued, however, that currently there is no clear evidence about the existence of such effects in actual populations. This paper concludes that until the existence of these effects can be demonstrated, it is preferable to continue using the conventional life expectancy as an indicator of current mortality conditions.

  2. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

    Salanave, B; Bouvier-Colle, M H; Varnoux, N


    OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel....... This change was substantial in three countries (P statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per...... of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were...

  3. Sunnier European countries have lower melanoma mortality. (United States)

    Shipman, A R; Clark, A B; Levell, N J


    Doubt has been cast on sunlight as the major causative factor for malignant melanoma. We performed statistical analysis of the average annual sunlight hours in 36 European capital cities compared with the country's melanoma mortality rate. A significant inverse proportionality was identified in both men and women, indicating that sun exposure is unlikely to be the strongest factor affecting mortality from malignant melanoma. © The Author(s). CED © 2011 British Association of Dermatologists.

  4. Mortality after shoulder arthroplasty

    DEFF Research Database (Denmark)

    Amundsen, Alexander; Rasmussen, Jeppe Vejlgaard; Olsen, Bo Sanderhoff


    BACKGROUND: The primary aim was to quantify the 30-day, 90-day, and 1-year mortality rates after primary shoulder replacement. The secondary aims were to assess the association between mortality and diagnoses and to compare the mortality rate with that of the general population. METHODS: The study...... included 5853 primary operations reported to the Danish Shoulder Arthroplasty Registry between 2006 and 2012. Information about deaths was obtained from the Danish Cause of Death Register and the Danish Civil Registration System. Age- and sex-adjusted control groups were retrieved from Statistics Denmark...

  5. Coral Reefs: Beyond Mortality?

    Directory of Open Access Journals (Sweden)

    Charles Sheppard


    Full Text Available The scale of the collapse of coral reef communities in 1998 following a warming episode (Wilkinson, 2000 was unprecedented, and took many people by surprise. The Indian Ocean was the worst affected with a coral mortality over 75% in many areas such as the Chagos Archipelago (Sheppard, 1999, Seychelles (Spencer et al., 2000 and Maldives (McClanahan, 2000. Several other locations were affected at least as much, with mortality reaching 100% (to the nearest whole number; this is being compiled by various authors (e.g., CORDIO, in press. For example, in the Arabian Gulf, coral mortality is almost total across many large areas of shallow water (Sheppard, unpublished; D. George and D. John, personal communication. The mortality is patchy of course, depending on currents, location inside or outside lagoons, etc., but it is now possible to swim for over 200 m and see not one remaining living coral or soft coral on some previously rich reefs.

  6. Mortalidade perinatal por sífilis congênita: indicador da qualidade da atenção à mulher e à criança Perinatal mortality due to congenital syphilis: a quality-of-care indicator for women's and children's healthcare

    Directory of Open Access Journals (Sweden)

    Valéria Saraceni


    perinatal mortality rate due to congenital syphilis be used as an impact indicator for activities to control and eliminate congenital syphilis, based on the investigational reports for fetal and neonatal deaths. Such reports could be extended to the surveillance of other avoidable perinatal disease outcomes.

  7. Parental Incarceration and Child Mortality in Denmark (United States)

    Andersen, Signe Hald; Lee, Hedwig; Karlson, Kristian Bernt


    Objectives. We used Danish registry data to examine the association between parental incarceration and child mortality risk. Methods. We used a sample of all Danish children born in 1991 linked with parental information. We conducted discrete-time survival analysis separately for boys (n = 30 146) and girls (n = 28 702) to estimate the association of paternal and maternal incarceration with child mortality, controlling for parental sociodemographic characteristics. We followed the children until age 20 years or death, whichever came first. Results. Results indicated a positive association between paternal and maternal imprisonment and male child mortality. Paternal imprisonment was associated with lower child mortality risks for girls. The relationship between maternal imprisonment and female child mortality changed directions depending on the model, suggesting no clear association. Conclusions. These results indicate that the incarceration of a parent may influence child mortality but that it is important to consider the gender of both the child and the incarcerated parent. PMID:24432916

  8. Social integration and mortality in Australia. (United States)

    Siahpush, M; Singh, G K


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

  9. On hunger and child mortality in India. (United States)

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


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

  10. Mortality impact of extreme winter temperatures (United States)

    Díaz, Julio; García, Ricardo; López, César; Linares, Cristina; Tobías, Aurelio; Prieto, Luis


    During the last few years great attention has been paid to the evaluation of the impact of extreme temperatures on human health. This paper examines the effect of extreme winter temperature on mortality in Madrid for people older than 65, using ARIMA and GAM models. Data correspond to 1,815 winter days over the period 1986 1997, during which time a total of 133,000 deaths occurred. The daily maximum temperature (Tmax) was shown to be the best thermal indicator of the impact of climate on mortality. When total mortality was considered, the maximum impact occured 7 8 days after a temperature extreme; for circulatory diseases the lag was between 7 and 14 days. When respiratory causes were considered, two mortality peaks were evident at 4 5 and 11 days. When the impact of winter extreme temperatures was compared with that associated with summer extremes, it was found to occur over a longer term, and appeared to be more indirect.

  11. Mortality in epilepsy. (United States)

    Hitiris, Nikolas; Mohanraj, Rajiv; Norrie, John; Brodie, Martin J


    All studies report an increased mortality risk for people with epilepsy compared with the general population. Population-based studies have demonstrated that the increased mortality is often related to the cause of the epilepsy. Common etiologies include neoplasia, cerebrovascular disease, and pneumonia. Deaths in selected cohorts, such as sudden unexpected death in epilepsy (SUDEP), status epilepticus (SE), suicides, and accidents are more frequently epilepsy-related. SUDEP is a particular cause for concern in younger people, and whether and when SUDEP should be discussed with patients with epilepsy remain problematic issues. Risk factors for SUDEP include generalized tonic-clonic seizures, increased seizure frequency, concomitant learning disability, and antiepileptic drug polypharmacy. The overall incidence of SE may be increasing, although case fatality rates remain constant. Mortality is frequently secondary to acute symptomatic disorders. Poor compliance with treatment in patients with epilepsy accounts for a small proportion of deaths from SE. The incidence of suicide is increased, particularly for individuals with epilepsy and comorbid psychiatric conditions. Late mortality figures in patients undergoing epilepsy surgery vary and are likely to reflect differences in case selection. Future studies of mortality should be prospective and follow agreed guidelines to better quantify risk and causation in individual populations.

  12. Occupational Mortality, Background on

    DEFF Research Database (Denmark)

    Lynge, Elsebeth


    in England and Wales from 1851 to 1979–1983, and these studies have provided key data on social inequalities in health. Death certificate studies have been used for identification of occupational groups with high excess risks from specific diseases. Follow-up studies require linkage of individual records......The study of occupational mortality involves the systematic tabulation of mortality by occupational or socioeconomic groups. Three main methods are used to conduct these studies: cross-sectional studies, death certificate studies, and follow-up studies. Cross-sectional studies were undertaken...

  13. Mortality Dynamics of Spodoptera frugiperda (Lepidoptera: Noctuidae Immatures in Maize.

    Directory of Open Access Journals (Sweden)

    Andrea Corrêa Varella

    Full Text Available We characterized the dynamics of mortality factors affecting immature developmental stages of the fall armyworm, Spodoptera frugiperda (J.E. Smith (Lepidoptera: Noctuidae. Multiple decrement life tables for egg and early larval stages of S. frugiperda in maize (Zea mays L. fields were developed with and without augmentative releases of Telenomus remus Nixon (Hymenoptera: Platygastridae from 2009 to 2011. Total egg mortality ranged from 73 to 81% and the greatest egg mortality was due to inviability, dislodgement, and predation. Parasitoids did not cause significant mortality in egg or early larval stages and the releases of T. remus did not increase egg mortality. Greater than 95% of early larvae died from predation, drowning, and dislodgment by rainfall. Total mortality due to these factors was largely irreplaceable. Results indicate that a greater effect in reducing generational survival may be achieved by adding mortality to the early larval stage of S. frugiperda.

  14. Mortality Dynamics of Spodoptera frugiperda (Lepidoptera: Noctuidae) Immatures in Maize (United States)

    Varella, Andrea Corrêa; Menezes-Netto, Alexandre Carlos; Alonso, Juliana Duarte de Souza; Caixeta, Daniel Ferreira; Peterson, Robert K. D.; Fernandes, Odair Aparecido


    We characterized the dynamics of mortality factors affecting immature developmental stages of the fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae). Multiple decrement life tables for egg and early larval stages of S. frugiperda in maize (Zea mays L.) fields were developed with and without augmentative releases of Telenomus remus Nixon (Hymenoptera: Platygastridae) from 2009 to 2011. Total egg mortality ranged from 73 to 81% and the greatest egg mortality was due to inviability, dislodgement, and predation. Parasitoids did not cause significant mortality in egg or early larval stages and the releases of T. remus did not increase egg mortality. Greater than 95% of early larvae died from predation, drowning, and dislodgment by rainfall. Total mortality due to these factors was largely irreplaceable. Results indicate that a greater effect in reducing generational survival may be achieved by adding mortality to the early larval stage of S. frugiperda. PMID:26098422

  15. Mortality Dynamics of Spodoptera frugiperda (Lepidoptera: Noctuidae) Immatures in Maize. (United States)

    Varella, Andrea Corrêa; Menezes-Netto, Alexandre Carlos; Alonso, Juliana Duarte de Souza; Caixeta, Daniel Ferreira; Peterson, Robert K D; Fernandes, Odair Aparecido


    We characterized the dynamics of mortality factors affecting immature developmental stages of the fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae). Multiple decrement life tables for egg and early larval stages of S. frugiperda in maize (Zea mays L.) fields were developed with and without augmentative releases of Telenomus remus Nixon (Hymenoptera: Platygastridae) from 2009 to 2011. Total egg mortality ranged from 73 to 81% and the greatest egg mortality was due to inviability, dislodgement, and predation. Parasitoids did not cause significant mortality in egg or early larval stages and the releases of T. remus did not increase egg mortality. Greater than 95% of early larvae died from predation, drowning, and dislodgment by rainfall. Total mortality due to these factors was largely irreplaceable. Results indicate that a greater effect in reducing generational survival may be achieved by adding mortality to the early larval stage of S. frugiperda.

  16. Characterizing mortality in pediatric tracheostomy patients. (United States)

    Funamura, Jamie L; Yuen, Sonia; Kawai, Kosuke; Gergin, Ozgul; Adil, Eelam; Rahbar, Reza; Watters, Karen


    To assess the longitudinal risk of death following tracheostomy in the pediatric age group. Retrospective cohort study. Hospital records of 513 children (≤18 years) at a tertiary care children's hospital who underwent tracheostomy between 1984 and 2015 were reviewed. The primary outcome measure was time from tracheostomy to death. Secondary patient demographic and clinical characteristics were assessed, with likelihood of death using χ 2 tests and the Cox proportional hazards model. Median age at time of tracheostomy was 0.8 years (interquartile range, 0.3-5.2 years).The highest mortality rate (27.8%) was observed in patients in the 13- to 18-year-old age category; their mortality rate was significantly higher when compared to the lowest mortality risk group patients (age 1-4 years, P = .031). Timing of death was evenly distributed: 1 year after tracheostomy (35.3%). Patients who underwent tracheostomy for cardiopulmonary disease had an increased risk of mortality compared with airway obstruction (adjusted hazard ratio: 3.53, 95% confidence interval: 1.72-7.24, P tracheostomy have a high mortality rate, with an increased risk of death associated with a cardiopulmonary indication for undergoing tracheostomy. The majority of deaths occur after the index hospitalization during which the tracheostomy was performed. BPD and CHD are independent predictors of mortality in pediatric tracheostomy patients. 4 Laryngoscope, 127:1701-1706, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Macroeconomic fluctuations and mortality in postwar Japan. (United States)

    Granados, José A Tapia


    Recent research has shown that after long-term declining trends are excluded, mortality rates in industrial countries tend to rise in economic expansions and fall in economic recessions. In the present work, co-movements between economic fluctuations and mortality changes in postwar Japan are investigated by analyzing time series of mortality rates and eight economic indicators. To eliminate spurious associations attributable to trends, series are detrended either via Hodrick-Prescott filtering or through differencing. As previously found in other industrial economies, general mortality and age-specific death rates in Japan tend to increase in expansions and drop in recessions, for both males and females. The effect, which is slightly stronger for males, is particularly noticeable in those aged 45-64. Deaths attributed to heart disease, pneumonia, accidents, liver disease, and senility--making up about 41% of total mortality--tend to fluctuate procyclically, increasing in expansions. Suicides, as well as deaths attributable to diabetes and hypertensive disease, make up about 4% of total mortality and fluctuate countercyclically, increasing in recessions. Deaths attributed to other causes, making up about half of total deaths, don't show a clearly defined relationship with the fluctuations of the economy.

  18. Infant mortality in the Marshall Islands. (United States)

    Levy, S J; Booth, H


    Levy and Booth present previously unpublished infant mortality rates for the Marshall Islands. They use an indirect method to estimate infant mortality from the 1973 and 1980 censuses, then apply indirect and direct methods of estimation to data from the Marshall Islands Women's Health Survey of 1985. Comparing the results with estimates of infant mortality obtained from vital registration data enables them to estimate the extent of underregistration of infant deaths. The authors conclude that 1973 census appears to be the most valid information source. Direct estimates from the Women's Health Survey data suggest that infant mortality has increased since 1970-1974, whereas the indirect estimates indicate a decreasing trend in infant mortality rates, converging with the direct estimates in more recent years. In view of increased efforts to improve maternal and child health in the mid-1970s, the decreasing trend is plausible. It is impossible to estimate accurately infant mortality in the Marshall Islands during 1980-1984 from the available data. Estimates based on registration data for 1975-1979 are at least 40% too low. The authors speculate that the estimate of 33 deaths per 1000 live births obtained from registration data for 1984 is 40-50% too low. In round figures, a value of 60 deaths per 1000 may be taken as the final estimate for 1980-1984.

  19. Affine stochastic mortality

    NARCIS (Netherlands)

    Schrager, D.F.


    We propose a new model for stochastic mortality. The model is based on the literature on affine term structure models. It satisfies three important requirements for application in practice: analytical tractibility, clear interpretation of the factors and compatibility with financial option pricing

  20. Mortality and GH deficiency

    DEFF Research Database (Denmark)

    Stochholm, Kirstine; Gravholt, Claus Højbjerg; Laursen, Torben


    into childhood onset (CO) and adult onset (AO), discriminated by an age cutoff below or above 18 years at onset of GHD. METHOD: Data on death were identified in national registries. Sex- and cause-specific mortalities were identified in CO and AO GHD when compared with controls. RESULTS: Mortality was increased......OBJECTIVE: To estimate the mortality in Denmark in patients suffering from GH deficiency (GHD). DESIGN: Mortality was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in GHD patients were studied and additional morbidity noted. Patients were divided...... in CO and AO GHD in both genders, when compared with controls. The hazard ratio (HR) for CO males was 8.3 (95% confidence interval (CI) 4.5-15.1) and for females 9.4 (CI 4.6-19.4). For AO males, HR was 1.9 (CI 1.7-2.2) and for females 3.4 (CI 2.9-4.0). We found a significantly higher HR in AO females...

  1. Caesarean section and mortality

    African Journals Online (AJOL)

    Hawkins JL, Gibbs CP, Orleans M, et al. Obstetric anesthesia work force survey, versus 1992. Anesthesiology. 1981;1997(87):135–43. 2. Bert CJ, Atrash HK, Koonin KM, et al. Pregnacy related mortality in the. United States, 1987–1990. Obstet Gynecol. 1996;88:161–7. Received: 10-08-2015 Accepted: 14-08-2015.

  2. Stillbirth and Infant Mortality

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard


    mechanisms behind these associations remain largely unknown. Although maternal obesity is associated with a wide range of complications in the mother and neonate that may impair fetal and infant survival, the increased risk of stillbirth and infant mortality is virtually unchanged when accounting...

  3. Sex differentials in mortality. (United States)


    The questions leing considered are whether a higher female than male mortality rate exists in Ceylon, India, and Pakistan, and whether this sex differential can account for the observed high male sex ratios. There is a choice between explaining the recorded masculinity of the Indian population by assuming that the subordinate position of women caused their omission from the census or that it caused their unrecorded death in childhood. The 1951 census report of India states that there is a traditional fondness for male issues in most parts of the country and a corresponding dislike for female children. However, a life table for India applied to the 1951 census gave a higher average female age at death 34.7 years as opposed to 33.5 years for male. Other estimates for India and Pakistan for the period 1951-1961 give 37.8 years for life expectancy for males and 36.98 for females. In 1953 the female death rate in Ceylon was over 80% higher than that of the males in the most reproductive ages, 20-29. In 1963 the female excess mortality at the same ages was still 25%, and in the age group 30-34 almost a 1/3 higher. In India the female death rate at ages 15-44 was 38% higher than that of the males in the 1958-1959 survey and as much as 174% higher in the Khanna rural survey, 1956-1960. In Pakistan a Population growth Estimate experiment conducted during 1962-1965 on a national probability sample has shown that in the ages 15-44 the female death rate was 75% higher than that of the males. High maternal mortality was the major reason. In addition, female mortality among young children over age 1 year was 24% higher in 1965 and 1963. There was little difference between the rates of mortality of the 2 sexes at age 45 and above. Recent trends in Ceylon show considerable improvement in maternal mortality which has reduced by 22% the ratio of female to male mortality at age 15-44. Also the ratio at ages 1-9 fell by 8%. to .1 of a year for every calendar year to 1980.

  4. Iraq War mortality estimates: A systematic review

    Directory of Open Access Journals (Sweden)

    Guyatt Gordon H


    Full Text Available Abstract Background In March 2003, the United States invaded Iraq. The subsequent number, rates, and causes of mortality in Iraq resulting from the war remain unclear, despite intense international attention. Understanding mortality estimates from modern warfare, where the majority of casualties are civilian, is of critical importance for public health and protection afforded under international humanitarian law. We aimed to review the studies, reports and counts on Iraqi deaths since the start of the war and assessed their methodological quality and results. Methods We performed a systematic search of 15 electronic databases from inception to January 2008. In addition, we conducted a non-structured search of 3 other databases, reviewed study reference lists and contacted subject matter experts. We included studies that provided estimates of Iraqi deaths based on primary research over a reported period of time since the invasion. We excluded studies that summarized mortality estimates and combined non-fatal injuries and also studies of specific sub-populations, e.g. under-5 mortality. We calculated crude and cause-specific mortality rates attributable to violence and average deaths per day for each study, where not already provided. Results Thirteen studies met the eligibility criteria. The studies used a wide range of methodologies, varying from sentinel-data collection to population-based surveys. Studies assessed as the highest quality, those using population-based methods, yielded the highest estimates. Average deaths per day ranged from 48 to 759. The cause-specific mortality rates attributable to violence ranged from 0.64 to 10.25 per 1,000 per year. Conclusion Our review indicates that, despite varying estimates, the mortality burden of the war and its sequelae on Iraq is large. The use of established epidemiological methods is rare. This review illustrates the pressing need to promote sound epidemiologic approaches to determining

  5. Hypothyroidism and Mortality among Dialysis Patients (United States)

    Rhee, Connie M.; Alexander, Erik K.; Bhan, Ishir


    Summary Background and objectives Hypothyroidism is highly prevalent among ESRD patients, but its clinical significance and the benefits of thyroid hormone replacement in this context remain unclear. Design, setting, participants, & measurements This study examined the association between hypothyroidism and all-cause mortality among 2715 adult dialysis patients with baseline thyrotropin levels measured between April of 2005 and April of 2011. Mortality was ascertained from Social Security Death Master Index and local registration systems. The association between hypothyroidism (thyrotropin greater than assay upper limit normal) and mortality was estimated using Cox proportional hazards models. To reduce the risk of observing reverse-causal associations, models included a 30-day lag between thyrotropin measurement and at-risk time. Results Among 350 (12.9%) hypothyroid and 2365 (87.1%) euthyroid (assay within referent range) patients, 917 deaths were observed during 5352 patient-years of at-risk time. Hypothyroidism was associated with higher mortality. Compared with thyrotropin in the low-normal range (0.4–2.9 mIU/L), subclinical hypothyroidism (thyrotropin >upper limit normal and ≤10.0 mIU/L) was associated with higher mortality; high-normal thyrotropin (≥3.0 mIU/L and ≤upper limit normal) and overt hypothyroidism (thyrotropin >10.0 mIU/L) were associated with numerically greater risk, but estimates were not statistically significant. Compared with spontaneously euthyroid controls, patients who were euthyroid while on exogenous thyroid replacement were not at higher mortality risk, whereas patients who were hypothyroid were at higher mortality risk. Sensitivity analyses indicated that effects on cardiovascular risk factors may mediate the observed association between hypothyroidism and death. Conclusions These data suggest that hypothyroidism is associated with higher mortality in dialysis patients, which may be ameliorated by thyroid hormone replacement

  6. Low birthweight and mortality

    DEFF Research Database (Denmark)

    Bakketeig, Leiv S.; Jacobsen, Geir; Skjærven, Rolv


    . The analysis considered 7 803 of these births, as 8 were excluded due to insufficient information. 30% of these second order LBW children had an older sibling who was also LBW. Early neonatal mortality of a “repeat” LBW birth was about 13% lower than among “non-repeat” LBW births (p..., the infant mortality was significantly higher among non-repeat LBW births (78.4 vs 60.8 per 1000, RR 1.30, CI 1.06, 1.56). Both after 1 and 5 minutes a significantly greater proportion of LBW repeat births had Apgar scores of 7 or above. Repeat second order LBW births weighed on average 68 grams more than...... non-repeat LBW births (pvs 2...

  7. Regional inequalities in mortality.


    Illsley, R; Le Grand, J


    STUDY OBJECTIVE--To examine the hypothesis of sustained and persistent inequalities in health between British regions and to ask how far they are a consequence of using standardised mortality ratios as the tool of measurement. DESIGN, SETTING AND PARTICIPANTS--Data are regional, age specific death rates at seven points in time from 1931 to 1987-89 for the British regions, reconstructed to make them comparable with the 1981 regional definitions. Log variance is used to measure inequality; regi...

  8. Mortality in necrotizing fasciitis

    International Nuclear Information System (INIS)

    Waseem, A.R.; Samad, A.


    The objective of this study was to determine the mortality rate in patients presenting with Necrotizing Fasciitis. This prospective study was conducted at ward 26, JPMC Karachi over a period of two years from March 2001 to Feb 2003. All patients above the age of 12 years diagnosed to be having Necrotizing Fasciitis and admitted through the Accident and emergency department were included in this study. After resuscitation, the patients underwent the emergency exploration and aggressive surgical debridement. Post-operatively, the patients were managed in isolated section of the ward. The patients requiring grafting were referred to plastic surgery unit. The patients were followed up in outpatients department for about two years. Over all, 25 male and 5 female patients fulfilled the inclusion criteria and were included in this study. The common clinical manifestations include redness, swelling, discharging abscess, pain, fever, skin necrosis and foul smelling discharge etc. The most common predisposing factor was Diabetes mellitus whereas the most commonly involved site was perineum. All patients underwent aggressive and extensive surgical debridements. The common additional procedures included Skin grafting, Secondary suturing, Cystostomy and Orchidectomy. Bacteroides and E. coli were the main micro-organisms isolated in this study. Bacteroides was the most common microorganism isolated among the eight patients who died. Necrotizing Fasciitis is a potentially life threatening emergency condition and carries the mortality rate of about 26.6%. The major contributing factors to increase the mortality missed initially diagnosed, old age, diabetes mellitus truncal involvement and late presentation. Anorectal involvement of disease carry worse prognosis. Hyperbaric oxygen therapy and proper use of unprocessed honey reduced the mortality rate. (author)

  9. Deciphering infant mortality (United States)

    Berrut, Sylvie; Pouillard, Violette; Richmond, Peter; Roehner, Bertrand M.


    This paper is about infant mortality. In line with reliability theory, "infant" refers to the time interval following birth during which the mortality (or failure) rate decreases. This definition provides a systems science perspective in which birth constitutes a sudden transition falling within the field of application of the Transient Shock (TS) conjecture put forward in Richmond and Roehner (2016c). This conjecture provides predictions about the timing and shape of the death rate peak. It says that there will be a death rate spike whenever external conditions change abruptly and drastically and also predicts that after a steep rise there will be a much longer hyperbolic relaxation process. These predictions can be tested by considering living organisms for which the transient shock occurs several days after birth. Thus, for fish there are three stages: egg, yolk-sac and young adult phases. The TS conjecture predicts a mortality spike at the end of the yolk-sac phase and this timing is indeed confirmed by observation. Secondly, the hyperbolic nature of the relaxation process can be tested using very accurate Swiss statistics for postnatal death rates spanning the period from one hour immediately after birth through to age 10 years. It turns out that since the 19th century despite a significant and large reduction in infant mortality, the shape of the age-specific death rate has remained basically unchanged. Moreover the hyperbolic pattern observed for humans is also found for small primates as recorded in the archives of zoological gardens. Our overall objective is to identify a series of cases which start from simple systems and move step by step to more complex organisms. The cases discussed here we believe represent initial landmarks in this quest.

  10. Revision and update of the EGIB land-use database using the airborne laser scanning point cloud - the case study of Tuklecz village in 'wietokrzyskie voivodeship. (Polish Title: Weryfikacja i aktualizacja bazy klaso-użytków EGIB w oparciu o analizy chmury punktów z lotniczego skanowania laserowego na przykładzie wsi Tuklęcz w województwie świętokrzyskim) (United States)

    Wężyk, P.; Gęca, T.


    Dynamic economic and social changes taking place for the past 20 years in Poland, effects often of such loss of extensive agriculture and abandonment of agricultural activities particularly on small and narrow plots , usually on the soils of poor grading. Even before the Polish accession to the EU, set - aside and fallow areas cover approx. 2.3 million ha (in 2002), but in subsequent years the area drastically decreased from 1.3 million ha (in 2004) , by 1.0 million ha ( 2 005 ) to 0.4 million hectares (2011). As a result of cessation of mowing meadows, grazing pastures and agricultural measures , we can observed the phenomenon of secondary forest succession ( plant communities of a forest properties ) leading to changes in land use and land cover classes structure . Recording changes in the agro - forestry space, update reference registers of the land and building (EGiB) and control granted to farmers subsidies ( direct EU payments) requires an efficient and automated technology acquisition, processing and analysis of spatial data. In addition to the used by ARiMR (in the LPIS system) vector data and aerial orthophotomaps , there is still a need to strengthen the decision - making process such as update of current ranges of land - use cla sses. One of the GI technologies that could be a real breakthrough is the Airborne Laser Scanning (ALS) . The study area cover 137.17 ha in the village Tuklęcz (commune Rytwiany, Staszów County , ?więtokrzyskie Voivodeship ). The EGiB geo data came from PODGiK in Staszów. They were two ALS point cloud data sets: one provided by the RZGW in Krakow (from airborne campaign Nov. 2009; density ~ 2 pts / m2) and the second from ISOK project (Nov. 2012; density ~ 4 pts / m2 ). The Terrasolid and FUSION (USDA Forest Service) and ArcGIS Esri software were used in the study . Detection of vegetation was carried out in 4 variants differ in the "height above ground" of the class "succession" (thresholds: from 0.4m , 1m, 2m and 3m ). The

  11. Prevalence and associated factors of neonatal mortality in North ...

    African Journals Online (AJOL)


    Bekana Kebede1, Abebaw Gebeyehu2, Hardeep Rai Sharma3, Sisay Yifru4. Abstract. Background: Childhood mortality is often used as a broad indicator of the social development and health conditions of a country. Updated information on neonatal mortality does thus influence policy, improve services and lead to better.

  12. [An explanation of recent trends in infant mortality in Venezuela]. (United States)

    Picouet, M R


    An analysis of recent trends in infant mortality in Venezuela is presented using official data. The results show a strong decline up to 1968, followed by a period of fluctuation due to sporadic outbreaks of epidemics. However, the most recent data reveal a continuing decline in mortality, indicating that the problems posed by epidemics have been resolved. (summary in ENG, SPA)

  13. Maternal mortality following caesarean sections. (United States)

    Sikdar, K; Kundu, S; Mandal, G S


    A study of 26 maternal deaths following 3647 caesarean sections was conducted in Eden Hospital from 1974-1977. During the time period there were 35,544 births and 308 total maternal deaths (8.74/1000). Indications for Caesarean sections included: 1) abnormal presentation; 2) cephalopelvic disproportion; 3) toxemia; 4) prolonged labor; 5) fetal distress; and 6) post-caesarean pregnancies. Highest mortality rates were among cephalopelvic disproportion, toxemia, and prolonged labor patients. 38.4% of the patients died due to septicaemia and peritonitis, but other deaths were due to preclampsia, shock, and hemorrhage. Proper antenatal care may have prevented anemia and preclampsia and treated other pre-existing or superimposed diseases.

  14. Leisure Time Physical Activity and Mortality

    DEFF Research Database (Denmark)

    Johnsen, Nina Føns; Ekblond, Annette; Thomsen, Birthe Lykke


    BACKGROUND: Some studies indicate that a large part of the beneficial effect of physical activity on mortality is confined to a threshold effect of participation. METHODS: Self-reported physical activity was investigated in relation to all-cause mortality in the Danish Diet, Cancer and Health...... cohort, including 29,129 women and 26,576 men aged 50-64 years at baseline 1993-1997. Using Cox proportional hazards models we investigated the associations between mortality rate and leisure time physical activity by exploring 1) participation (yes/no) in each type of activity; 2) a simple dose...... in specific leisure time physical activities, but not with more time spent on those activities. This could suggest that avoiding a sedative lifestyle is more important than a high volume of activity. Nonparticipation in these types of physical activity may be considered as risk factors....

  15. Fetal Echocardiography and Indications

    Directory of Open Access Journals (Sweden)

    Melih Atahan Güven


    Full Text Available Congenital heart diseases are encountered in 0.8% of live births and are among the most frequently diagnosed malformations. At least half of these anomalies end up with death or require surgical interventions and are responsible for 30% of the perinatal mortality. Fetal echocardiography is the sum of knowledge, skill and orientation rather than knowing the embryologic details of the fetal heart. The purpose of fetal echocardiography is to document the presence of normal fetal cardiac anatomy and rhythm in high risk group and to define the anomaly and arrhythmia if present. A certain sequence should be followed during the evaluation of fetal heart. Sequential segmental analysis (SSA and basic definition terminology made it possible to determine a lot of complex cardiac anomalies during prenatal period. By the end of 1970’s, Shinebourne started using sequential segmental analysis for fetal cardiac evaluation and today, prenatal diagnosis of congenital heart disease is possible without any confusion. In this manner, whole fetal heart can be evaluated as the relation of three segments (atria, ventricles and the great arteries with each other, irrelevant of complexity of a possible cardiac anomaly. Presence of increased nuchal thickness during early gestation and abnormal four-chamber-view during ultrasonography by the obstetrician presents a clear indication for fetal echocardiography,however, one should keep in mind that 80-90% of the babies born with a congenital heart disease do not have a familial or maternal risk factor. In addition, it should be remembered that expectant mothers with diabetes mellitus pose an indication for fetal echocardiography.

  16. Mortality in acromegaly: a metaanalysis

    NARCIS (Netherlands)

    Dekkers, O. M.; Biermasz, N. R.; Pereira, A. M.; Romijn, J. A.; Vandenbroucke, J. P.


    Several studies have assessed mortality risk in patients treated for acromegaly. All studies found a mortality that was higher than expected for the general population, but most of these increases were not statistically significant. For this reason, it is not formally established whether mortality

  17. Simulations of forest mortality in Colorado River basin (United States)

    Wei, L.; Xu, C.; Johnson, D. J.; Zhou, H.; McDowell, N.


    The Colorado River Basin (CRB) had experienced multiple severe forest mortality events under the recent changing climate. Such forest mortality events may have great impacts on ecosystem services and water budget of the watershed. It is hence important to estimate and predict the forest mortality in the CRB with climate change. We simulated forest mortality in the CRB with a model of plant hydraulics within the FATES (the Functionally Assembled Terrestrial Ecosystem Simulator) coupled to the DOE Earth System model (ACME: Accelerated Climate Model of Energy) at a 0.5 x 0.5 degree resolution. Moreover, we incorporated a stable carbon isotope (δ13C) module to ACME(FATE) and used it as a new predictor of forest mortality. The δ13C values of plants with C3 photosynthetic pathway (almost all trees are C3 plants) can indicate the water stress plants experiencing (the more intensive stress, the less negative δ13C value). We set a δ13C threshold in model simulation, above which forest mortality initiates. We validate the mortality simulations with field data based on Forest Inventory and Analysis (FIA) data, which were aggregated into the same spatial resolution as the model simulations. Different mortality schemes in the model (carbon starvation, hydraulic failure, and δ13C) were tested and compared. Each scheme demonstrated its strength and the plant hydraulics module provided more reliable simulations of forest mortality than the earlier ACME(FATE) version. Further testing is required for better forest mortality modelling.

  18. Osteoporosis-Related Mortality: Time-Trends and Predictive Factors

    Directory of Open Access Journals (Sweden)

    Nelly Ziadé


    Full Text Available Osteoporosis is one of the leading causes of handicap worldwide and a major contributor to the global burden of diseases. In particular, osteoporosis is associated with excess mortality. We reviewed the impact of osteoporosis on mortality in a population by defining three categories: mortality following hip fractures, mortality following other sites of fractures, and mortality associated with low bone mineral density (BMD. Hip fractures, as well as other fractures at major sites are all associated with excess mortality, except at the forearm site. This excess mortality is higher during the first 3-6 months after the fracture and then declines over time, but remains higher than the mortality of the normal population up to 22 years after the fracture. Low BMD is also associated with high mortality, with hazard ratios of around 1.3 for every decrease in 1 standard deviation of bone density at 5 years, independently of fractures, reflecting a more fragile population. Finally predictors of mortality were identified and categorised in demographic known factors (age and male gender and in factors reflecting a poor general health status such as the number of comorbidities, low mental status, or level of social dependence. Our results indicate that the management of a patient with osteoporosis should include a multivariate approach that could be based on predictive models in the future.

  19. Estimating spatial inequalities of urban child mortality

    Directory of Open Access Journals (Sweden)

    John R. Weeks


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

  20. Countries with women inequalities have higher stroke mortality. (United States)

    Kim, Young Dae; Jung, Yo Han; Caso, Valeria; Bushnell, Cheryl D; Saposnik, Gustavo


    Background Stroke outcomes can differ by women's legal or socioeconomic status. Aim We investigated whether differences in women's rights or gender inequalities were associated with stroke mortality at the country-level. Methods We used age-standardized stroke mortality data from 2008 obtained from the World Health Organization. We compared female-to-male stroke mortality ratio and stroke mortality rates in women and men between countries according to 50 indices of women's rights from Women, Business and the Law 2016 and Gender Inequality Index from the Human Development Report by the United Nations Development Programme. We also compared stroke mortality rate and income at the country-level. Results In our study, 176 countries with data available on stroke mortality rate in 2008 and indices of women's rights were included. There were 46 (26.1%) countries where stroke mortality in women was higher than stroke mortality in men. Among them, 29 (63%) countries were located in Sub-Saharan African region. After adjusting by country income level, higher female-to-male stroke mortality ratio was associated with 14 indices of women's rights, including differences in getting a job or opening a bank account, existence of domestic violence legislation, and inequalities in ownership right to property. Moreover, there was a higher female-to-male stroke mortality ratio among countries with higher Gender Inequality Index (r = 0.397, p Gender Inequality Index was more likely to be associated with stroke mortality rate in women than that in men (p gender inequality status is associated with women's stroke outcomes.

  1. Risk factors of neonatal mortality and child mortality in Bangladesh. (United States)

    Maniruzzaman, Md; Suri, Harman S; Kumar, Nishith; Abedin, Md Menhazul; Rahman, Md Jahanur; El-Baz, Ayman; Bhoot, Makrand; Teji, Jagjit S; Suri, Jasjit S


    Child and neonatal mortality is a serious problem in Bangladesh. The main objective of this study was to determine the most significant socio-economic factors (covariates) between the years 2011 and 2014 that influences on neonatal and child mortality and to further suggest the plausible policy proposals. We modeled the neonatal and child mortality as categorical dependent variable (alive vs death of the child) while 16 covariates are used as independent variables using χ 2 statistic and multiple logistic regression (MLR) based on maximum likelihood estimate. Using the MLR, for neonatal mortality, diarrhea showed the highest positive coefficient (β = 1.130; P  economic conditions for neonatal mortality. For child mortality, birth order between 2-6 years and 7 and above years showed the highest positive coefficients (β = 1.042; P  economic conditions for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh. In 2014, mother's age and father's education were also still significant covariates for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh.

  2. mortality after clinical management of aids-associated cryptococcal

    African Journals Online (AJOL)


    May 1, 2014 ... among HIV/AIDS patients and is becoming a leading cause of morbidity and mortality in Africa. The short-term .... of potassium chloride, therapeutic lumbar puncture. (LP), fundoscopy ..... Kenya AIDS Indicator. Survey 2012: ...

  3. The role of some biochemical and hemotological factors in animal mortality

    International Nuclear Information System (INIS)

    Zapol'skaya, N.A.; Fedorova, A.V.; Yakovleva, N.G.


    Correlations were sought between mortality of animals and some biochemical indices. These included elevated levels of deoxycytidine in urine (an indicator of DNA metabolism), elevated levels of histamine, reduced cholinesterase activity in blood, and changes in peripheral blood morphology (reduced erythrocyte and lymphocyte counts). These indices were found to correlate directly with mortality. Regression equations were derived for all the indices studied

  4. Herd factors associated with dairy cow mortality. (United States)

    McConnel, C; Lombard, J; Wagner, B; Kopral, C; Garry, F


    Summary studies of dairy cow removal indicate increasing levels of mortality over the past several decades. This poses a serious problem for the US dairy industry. The objective of this project was to evaluate associations between facilities, herd management practices, disease occurrence and death rates on US dairy operations through an analysis of the National Animal Health Monitoring System's Dairy 2007 survey. The survey included farms in 17 states that represented 79.5% of US dairy operations and 82.5% of the US dairy cow population. During the first phase of the study operations were randomly selected from a sampling list maintained by the National Agricultural Statistics Service. Only farms that participated in phase I and had 30 or more dairy cows were eligible to participate in phase II. In total, 459 farms had complete data for all selected variables and were included in this analysis. Univariable associations between dairy cow mortality and 162 a priori identified operation-level management practices or characteristics were evaluated. Sixty of the 162 management factors explored in the univariate analysis met initial screening criteria and were further evaluated in a multivariable model exploring more complex relationships. The final weighted, negative binomial regression model included six variables. Based on the incidence rate ratio, this model predicted 32.0% less mortality for operations that vaccinated heifers for at least one of the following: bovine viral diarrhea, infectious bovine rhinotracheitis, parainfluenza 3, bovine respiratory syncytial virus, Haemophilus somnus, leptospirosis, Salmonella, Escherichia coli or clostridia. The final multivariable model also predicted a 27.0% increase in mortality for operations from which a bulk tank milk sample tested ELISA positive for bovine leukosis virus. Additionally, an 18.0% higher mortality was predicted for operations that used necropsies to determine the cause of death for some proportion of dead

  5. Age structure and mortality of walleyes in Kansas reservoirs: Use of mortality caps to establish realistic management objectives (United States)

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


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

  6. Allograft Pancreatectomy: Indications and Outcomes. (United States)

    Nagai, S; Powelson, J A; Taber, T E; Goble, M L; Mangus, R S; Fridell, J A


    This study evaluated the indications, surgical techniques, and outcomes of allograft pancreatectomy based on a single center experience. Between 2003 and 2013, 47 patients developed pancreas allograft failure, excluding mortality with a functioning pancreas allograft. Early graft loss (within 14 days) occurred in 16, and late graft loss in 31. All patients with early graft loss eventually required allograft pancreatectomy. Nineteen of 31 patients (61%) with late graft loss underwent allograft pancreatectomy. The main indication for early allograft pancreatectomy included vascular thrombosis with or without severe pancreatitis, whereas one recipient required urgent allograft pancreatectomy for gastrointestinal hemorrhage secondary to an arterioenteric fistula. In cases of late allograft pancreatectomy, graft failure with clinical symptoms such as abdominal discomfort, pain, and nausea were the main indications (13/19 [68%]), simultaneous retransplantation without clinical symptoms in 3 (16%), and vascular catastrophes including pseudoaneurysm and enteric arterial fistula in 3 (16%). Postoperative morbidity included one case each of pulmonary embolism leading to mortality, formation of pseudoaneurysm requiring placement of covered stent, and postoperative bleeding requiring relaparotomy eventually leading to femoro-femoral bypass surgery 2 years after allograftectomy. Allograft pancreatectomy can be performed safely, does not preclude subsequent retransplantation, and may be lifesaving in certain instances. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  7. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann


    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... = 0.03). CONCLUSIONS: More than one-third of individuals die in the first month after hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated......, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients...

  8. Age dependent mortality in the pilocarpine model of status epilepticus (United States)

    Blair, Robert E.; Deshpande, Laxmikant S.; Holbert, William H.; Churn, Severn B.; DeLorenzo, Robert J.


    Status epilepticus (SE) is an acute neurological emergency associated with significant morbidity and mortality. Age has been shown to be a critical factor in determining outcome after SE. Understanding the causes of this increased mortality with aging by developing an animal model to study this condition would play a major role in studying mechanisms to limit the mortality due to SE. Here we employed pilocarpine to induce SE in rats aged between 5 to 28 weeks. Similar to clinical studies in man, we observed that age was a significant predictor of mortality following SE. While no deaths were observed in 5-week old animals, mortality due to SE increased progressively with age and reached 90% in 28-week old animals. There was no correlation between the age of animals and severity of SE. With increasing age mortality occurred earlier after the onset of SE. These results indicate that pilocarpine-induced SE in the rat provides a useful model to study age-dependent SE-induced mortality and indicates the importance of using animal models to elucidate the mechanisms contributing to SE-induced mortality and the development of novel therapeutic interventions to prevent SE-induced death. PMID:19429042

  9. Vulnerability to temperature-related mortality in Seoul, Korea

    International Nuclear Information System (INIS)

    Son, Ji-Young; Anderson, G Brooke; Bell, Michelle L; Lee, Jong-Tae


    Studies indicate that the mortality effects of temperature may vary by population and region, although little is known about the vulnerability of subgroups to these risks in Korea. This study examined the relationship between temperature and cause-specific mortality for Seoul, Korea, for the period 2000-7, including whether some subgroups are particularly vulnerable with respect to sex, age, education and place of death. The authors applied time-series models allowing nonlinear relationships for heat- and cold-related mortality, and generated exposure-response curves. Both high and low ambient temperatures were associated with increased risk for daily mortality. Mortality risk was 10.2% (95% confidence interval 7.43, 13.0%) higher at the 90th percentile of daily mean temperatures (25 deg. C) compared to the 50th percentile (15 deg. C). Mortality risk was 12.2% (3.69, 21.3%) comparing the 10th (-1 deg. C) and 50th percentiles of temperature. Cardiovascular deaths showed a higher risk to cold, whereas respiratory deaths showed a higher risk to heat effect, although the differences were not statistically significant. Susceptible populations were identified such as females, the elderly, those with no education, and deaths occurring outside of a hospital for heat- and cold-related total mortality. Our findings provide supportive evidence of a temperature-mortality relationship in Korea and indicate that some subpopulations are particularly vulnerable.

  10. Cervical cancer incidence and mortality in Fiji 2003-2009. (United States)

    Kuehn, Rebecca; Fong, James; Taylor, Richard; Gyaneshwar, Rajanishwar; Carter, Karen


    Previous studies indicate that cervical cancer is the second most frequent cancer and most common cause of cancer mortality among women in Fiji. There is little published data on the epidemiology of cervical cancer in Pacific countries. To determine the incidence 2003-2009 of, and mortality 2003-2008 from, cervical cancer by ethnicity and period in Fiji, identify evidence of secular change and relate these data to other Pacific countries, Australia and New Zealand. Counts of incident cervical cancer cases (2003-2009) and unit record mortality data (2003-2008) from the Fiji Ministry of Health were used to calculate age-standardised (to the WHO World Population) cervical cancer incidence and mortality rates, and cervical or uterine cancer mortality rates, by ethnicity, with 95% confidence intervals. On the basis of comparison of cervical cancer mortality with cervical or uterine cancer mortality in Fiji with similar populations, misclassification of cervical cancer deaths is unlikely. There is no evidence of secular change in cervical cancer incidence and mortality rates for the study period. For women of all ages and ethnicities, the age-standardised incidence rate of cervical cancer (2003-2009) was 27.6 per 100,000 (95% CI 25.4-29.8) and the age-standardised mortality rate (2003-2008) was 23.9 per 100,000 (95% CI 21.5-26.4). The mortality/incidence ratio was 87%. Fijians had statistically significant higher age-standardised incidence and mortality rates than Indians. Fiji has one of the highest estimated rates of cervical cancer incidence and mortality in the Pacific region. Cervical cancer screening in Fiji needs to be expanded and strengthened. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Siberian Pine Decline and Mortality in Southern Siberian Mountains (United States)

    Kharuk, V. I.; Im, S. T.; Oskorbin, P. A.; Petrov, I. A.; Ranson, K. J.


    The causes and resulting spatial patterns of Siberian pine mortality in eastern Kuznetzky Alatau Mountains, Siberia were analyzed based on satellite (Landsat, MODIS) and dendrochronology data. Climate variables studied included temperature, precipitation and Standardized Precipitation-Evapotranspiration Index (SPEI) drought index. Landsat data analysis showed that stand mortality was first detected in the year 2006 at an elevation of 650 m, and extended up to 900 m by the year 2012. Mortality was accompanied by a decrease in MODIS derived vegetation index (EVI).. The area of dead stands and the upper mortality line were correlated with increased drought. The uphill margin of mortality was limited by elevational precipitation gradients. Dead stands (i.e., >75% tree mortality) were located mainly on southern slopes. With respect to slope, mortality was observed within a 7 deg - 20 deg range with greatest mortality occurring on convex terrain. Tree radial incrementmeasurements correlate and were synchronous with SPEI (r sq = 0.37, r(sub s) = 80). Increasing synchrony between tree ring growth and SPEI indicates that drought has reduced the ecological niche of Siberian pine. The results also showed the primary role of drought stress on Siberian pine mortality. A secondary role may be played by bark beetles and root fungi attacks. The observed Siberian pine mortality is part of a broader phenomenon of "dark needle conifers" (DNC, i.e., Siberian pine, fir and spruce) decline and mortality in European Russia, Siberia, and the Russian Far East. All locations of DNC decline coincided with areas of observed drought increase. The results obtained are one of the first observations of drought-induced decline and mortality of DNC at the southern border of boreal forests. Meanwhile if model projections of increased aridity are correct DNC, within the southern part of its range may be replaced by drought-resistant Pinus silvestris and Larix sibirica.

  12. Excess Early Mortality in Schizophrenia

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Nordentoft, Merete; Mortensen, Preben Bo


    Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality...... as well as possible ways to reduce it. Persons with schizophrenia have an exceptionally short life expectancy. High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population. Evidence suggests that persons with schizophrenia may...... not have seen the same improvement in life expectancy as the general population during the past decades. Thus, the mortality gap not only persists but may actually have increased. The most urgent research agenda concerns primary candidates for modifiable risk factors contributing to this excess mortality...


    Directory of Open Access Journals (Sweden)



    Full Text Available Mortality is the only indicator that presents a series of aspects meant to emphasize both the demographic evolution of a population and its social determinants that confers it an increasing or decreasing tendency associated in most cases with a specific level of development.Mortality, through the manifestation of present variations is caused by a series of socio-economic factors such as the level of education with consequences on the attitude towards the health care, the population age, as well as by certain exogenous factors related to the geographic environment.The analysis of the general mortality among the Roma population intends to grasp a series of variables specific for this indicator; the values that the general mortality registers within the Roma population are in the trend of the values for this indicator measured for the overall population.

  14. Adult mortality in preindustrial Quebec

    Directory of Open Access Journals (Sweden)

    Claudine Lacroix - - - Bertrand Desjardins


    Full Text Available This paper presents the main results of a detailed study on adult mortality in French Canadians born before 1750 and having married inthe colony of New France. Using data from parish registers, mortality is studied using abridged life tables, with staggered entries according to age at first marriage. Survival tables and log-Rank tests are used to support the results. Three features were selected for the study of differential mortality: gender, type of residence area (urban or rural, and cohort. The mortality of French Canadians is compared to that of their French contemporaries.

  15. Income inequality, social capital and self-inflicted injury and violence-related mortality

    NARCIS (Netherlands)

    Huisman, M.; Oldehinkel, A. J.

    Background: The objective of the study was to investigate the relation of income inequality and indicators of social capital to self-inflicted injury mortality (suicide) and violence-related mortality, and to the share of total mortality that is due to these two causes of death in 35 developed

  16. Past Decline Versus Current eGFR and Subsequent Mortality Risk

    NARCIS (Netherlands)

    Naimark, David M. J.; Grams, Morgan E.; Matsushita, Kunihiro; Black, Corri; Drion, Iefke; Fox, Caroline S.; Inker, Lesley A.; Ishani, Areef; Jee, Sun Ha; Kitamura, Akihiko; Lea, Janice P.; Nally, Joseph; Peralta, Carmen Alicia; Rothenbacher, Dietrich; Ryu, Seungho; Tonelli, Marcello; Yatsuya, Hiroshi; Coresh, Josef; Gansevoort, Ron T.; Warnock, David G.; Woodward, Mark; de Jong, Paul E.

    A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope,

  17. Inequalities in mortality: study rates, not standardised mortality ratios [Letter

    NARCIS (Netherlands)

    Bonneux, L.G.A.


    In their study from 1921 to 2007 Thomas and colleagues conclude on the basis of standardised mortality ratios that inequalities in mortality continue to rise and are now almost as high as in the 1930s. Relative ratios are, however, misleading when absolute rates change strongly. I calculated the

  18. [Family planning can reduce maternal mortality]. (United States)

    Potts, M


    Although the maternal mortality rate receives no newspaper headlines, the number of mothers dying throughout the world is equivalent to a full jumbo jet crashing every 5 hours. Population surveys carried out between 1981-83 by Family Health International indicated maternal mortality rates of 1.9/1000 live births in Menoufia, Egypt, and 7.2/1000 in Bali, Indonesia. 20-25% of all deaths in women aged 15-49 were directly related to pregnancy and delivery, compared to 1% in western countries where there is better prenatal care, medical assistance in almost all deliveries, and elimination of most high risk pregnancies through voluntary fertility control. Maternal mortality could be controlled by teaching traditional midwives to identify high risk patients at the beginning of their pregnancies and to refer them to appropriate health services. Maternal survival would also be improved if all women were in good health at the beginning of pregnancy. Families should be taught to seek medical care for the mother in cases of prolonged labor; many women arrive at hospitals beyond hope of recovery after hours or days of futile labor. Health policy makers should set new priorities. Sri Lanka, for example, has a lower per capita income than Pakistan, but also a lower maternal mortality rate because of better use of family planning services, more emphasis on prenatal care, and a tradition of care and attention on the part of the public health services.

  19. Political party affiliation, political ideology and mortality. (United States)

    Pabayo, Roman; Kawachi, Ichiro; Muennig, Peter


    Ecological and cross-sectional studies have indicated that conservative political ideology is associated with better health. Longitudinal analyses of mortality are needed because subjective assessments of ideology may confound subjective assessments of health, particularly in cross-sectional analyses. Data were derived from the 2008 General Social Survey-National Death Index data set. Cox proportional analysis models were used to determine whether political party affiliation or political ideology was associated with time to death. Also, we attempted to identify whether self-reported happiness and self-rated health acted as mediators between political beliefs and time to death. In this analysis of 32,830 participants and a total follow-up time of 498,845 person-years, we find that political party affiliation and political ideology are associated with mortality. However, with the exception of independents (adjusted HR (AHR)=0.93, 95% CI 0.90 to 0.97), political party differences are explained by the participants' underlying sociodemographic characteristics. With respect to ideology, conservatives (AHR=1.06, 95% CI 1.01 to 1.12) and moderates (AHR=1.06, 95% CI 1.01 to 1.11) are at greater risk for mortality during follow-up than liberals. Political party affiliation and political ideology appear to be different predictors of mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  20. Effect of stress on turbine fish passage mortality estimates

    International Nuclear Information System (INIS)

    Ruggles, C.P.


    Tests were conducted with juvenile alewife to determine the effects of four experimental protocols upon turbine fish passage mortality estimates. Three protocols determined the effect of cumulative stresses upon fish, while the fourth determined the effect of long range truck transportation prior to release into the penstock or tailrace. The wide range in results were attributed to the presence or absence of additional stress factors associated with the experiments. For instance, fish may survive passage through a turbine, or non-turbine related stresses imposed by the investigator; however, when both are imposed, the cumulative stresses may be lethal. The impact of protocol stress on turbine mortality estimates becomes almost exponential after control mortality exceeds 10%. Valid turbine related mortalities may be determined only after stresses associated with experimental protocol are adequately reduced. This is usually indicated by a control mortality of less than 10%. 14 refs., 5 figs., 6 tabs

  1. Egg mortality: predation and hydrography in the central Baltic

    DEFF Research Database (Denmark)

    Voss, R.; Hinrichsen, H.-H.; Stepputtis, D.


    during the egg phase to be of critical importance. Two years of extensive field investigations in the Bornholm Basin, central Baltic Sea, were undertaken. In 2002, a typical stagnation situation characterized by low salinity and poor oxygen conditions was investigated, and in early 2003, a major inflow...... of North Sea water completely changed the hydrographic conditions by increasing salinity and oxygen content, thereby altering ecological conditions. The goal was to quantify egg mortality caused by predation and hydrography, and to compare these estimates with independent estimates based on cohort analysis....... Results indicated high intra-annual variability in egg mortality. Cod and sprat egg mortality responded differently to the major Baltic inflow: mortality related to hydrographic conditions increased for sprat and decreased for cod. On the other hand, predation mortality during peak spawning decreased...

  2. Global Mortality Impact of the 1957-1959 Influenza Pandemic

    DEFF Research Database (Denmark)

    Viboud, Cécile; Simonsen, Lone; Fuentes, Rodrigo


    BACKGROUND: Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics. METHODS: We used annual rates of age- and cause-specific deaths to estimate pandemic-related mortality in excess of background...... levels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortality and development indicators to extrapolate the global burden of the pandemic. RESULTS: The pandemic-associated excess respiratory mortality rate was 1.9/10,000 population (95...... excess deaths (95% CI, .7 million-1.5 million excess deaths) globally to the 1957-1959 pandemic. CONCLUSIONS: The global mortality rate of the 1957-1959 influenza pandemic was moderate relative to that of the 1918 pandemic but was approximately 10-fold greater than that of the 2009 pandemic. The impact...

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

    Directory of Open Access Journals (Sweden)

    Ngo Anh D


    deaths occurring on-site or prior to hospital admission indicates a need for effective pre-hospital first aid services and timely access to emergency facilities. In the absence of standardised death certification, sustained efforts are needed to strengthen mortality surveillance sites supplemented by VA to support evidence based monitoring and control of RTI mortality.

  4. Business cycles and mortality: results from Swedish microdata. (United States)

    Gerdtham, Ulf-G; Johannesson, Magnus


    We assess the relationship between business cycles and mortality risk using a large individual level data set on over 40,000 individuals in Sweden who were followed for 10-16 years (leading to over 500,000 person-year observations). We test the effect of six alternative business cycle indicators on the mortality risk: the unemployment rate, the notification rate, the deviation from the GDP trend, the GDP change, the industry capacity utilization, and the industry confidence indicator. For men we find a significant countercyclical relationship between the business cycle and the mortality risk for four of the indicators and a non-significant effect for the other two indicators. For women we cannot reject the null hypothesis of no effect for any of the business cycle indicators.

  5. Infant Mortality and Hispanic Americans (United States)

    ... Infant Mortality Statistics from the 2013 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports . Table 5. [PDF | 994KB] Infant deaths and mortality rates for the top 4 leading cause of death ...

  6. Hostility, drinking pattern and mortality

    DEFF Research Database (Denmark)

    Boyle, Stephen H; Mortensen, Laust Hvas; Grønbaek, Morten


    This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality.......This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality....

  7. Old age mortality in Eastern and South-Eastern Asia

    Directory of Open Access Journals (Sweden)

    Danan Gu


    Full Text Available Background: Eastern and South-Eastern Asian countries have witnessed a marked decline in old age mortality in recent decades. Yet no studies have investigated the trends and patterns in old age morality and cause-of-death in the region. Objective: We reviewed the trends and patterns of old age mortality and cause-of-death for countries in the region. Methods: We examined data on old age mortality in terms of life expectancy at age 65 and age-specific death rates from the 2012 Revision of the World Population Prospects for 14 countries in the region (China, Hong Kong, Democratic People's Republic of Korea, Indonesia, Japan, Lao People's Democratic Republic, Myanmar, Malaysia, Mongolia, Philippines, Republic of Korea, Singapore, Thailand, and Viet Nam and data on cause-of-death from the WHO for five countries (China, Hong Kong, Japan, Republic of Korea, and Singapore from 1980 to 2010. Results: While mortality transitions in these populations took place in different times, and at different levels of socioeconomic development and living environment, changes in their age patterns and sex differentials in mortality showed certain similarities: women witnessed a similar decline to men in spite of their lower mortality, and young elders had a larger decline than the oldest-old. In all five countries examined for cause-of-death, most of the increases in life expectancy at age 65 in both men and women were attributable to declines in mortality from stroke and heart disease. GDP per capita, educational level, and urbanization explained much of the variations in life expectancy and cause-specific mortality, indicating critical contributions of these basic socioeconomic development indicators to the mortality decline over time in the region. Conclusions: These findings shed light on the relationship between epidemiological transition, changing age patterns of mortality, and improving life expectancy in these populations.

  8. Female circumcision and child mortality in urban Somalia. (United States)

    Mohamud, O A


    In Somalia, a demographer analyzed urban data obtained from the Family Health Survey to examine the effect female circumcision has on child mortality and the mechanism of that effect. Girls undergo female circumcision between 5-12 years old in Somalia. Since sunni circumcision (removal of the clitoral prepuce and tip of the clitoris) and clitoridectomy (removal of the entire clitoris) did not affect child mortality, he used them as the reference group. Infibulation (entire removal of the clitoris and of the labia minora and majora with the remains of the labia majora being sewn together allowing only a small opening for passage of urine) did affect child mortality. Female children who underwent infibulation and whose mothers most likely also underwent infibulation experienced higher mortality (13-72%) than those from other circumcised mothers. Female mortality exceeded male mortality indicating possible son preference. Mothers with clitoridectomy or infibulation had significantly higher infant mortality than those with sunni circumcision with the strongest effects during the neonatal period (95% and 42% higher mortality, respectively; p=.01). The effect of female circumcision on child mortality decreased with increased child's age. This higher than expected mortality among women with clitoridectomy may have been because women with infibulation had more stillbirths which were not counted as births. The exposed vagina of clitoridectomized women is more likely to be infected resulting in high risk of stillbirths and premature births than the closed vagina of infibulated women. The researcher suggested that the policies promoting education and consciousness raising may eventually eradicate female circumcision. This longterm campaign should use mass media, senior women of high status, and respected religious leaders. Legislation prohibiting this practice would only drive it underground under unsanitary conditions. Demographers should no longer ignore female circumcision

  9. Intrinsic and extrinsic mortality reunited

    DEFF Research Database (Denmark)

    Koopman, Jacob J E; Wensink, Maarten J; Rozing, Maarten P


    Intrinsic and extrinsic mortality are often separated in order to understand and measure aging. Intrinsic mortality is assumed to be a result of aging and to increase over age, whereas extrinsic mortality is assumed to be a result of environmental hazards and be constant over age. However......, allegedly intrinsic and extrinsic mortality have an exponentially increasing age pattern in common. Theories of aging assert that a combination of intrinsic and extrinsic stressors underlies the increasing risk of death. Epidemiological and biological data support that the control of intrinsic as well...... as extrinsic stressors can alleviate the aging process. We argue that aging and death can be better explained by the interaction of intrinsic and extrinsic stressors than by classifying mortality itself as being either intrinsic or extrinsic. Recognition of the tight interaction between intrinsic and extrinsic...

  10. Heat Mortality Versus Cold Mortality: A Study of Conflicting Databases in the United States. (United States)

    Dixon, P. G.; Brommer, D. M.; Hedquist, B. C.; Kalkstein, A. J.; Goodrich, G. B.; Walter, J. C.; Dickerson, C. C., IV; Penny, S. J.; Cerveny, R. S.


    Studies, public reports, news reports, and Web sites cite a wide range of values associated with deaths resulting from excessive heat and excessive cold. For example, in the United States, the National Climatic Data Center's Storm Data statistics of temperature- related deaths are skewed heavily toward heat-related deaths, while the National Center for Health Statistics Compressed Mortality Database indicates the reverse—4 times more people die of “excessive cold” conditions in a given year than of “excessive heat.” In this study, we address the fundamental differences in the various temperature-related mortality databases, assess their benefits and limitations, and offer suggestions as to their use. These datasets suffer from potential incompleteness of source information, long compilation times, limited quality control, and the subjective determination of a direct versus indirect cause of death. In general, these separate mortality datasets should not be combined or compared, particularly with regard to policy determination. The use of gross mortality numbers appears to be one of the best means of determining temperature-related mortality, but those data must be detrended into order to remove a persistent winter-dominant death maximum and are difficult to obtain on a regional daily basis.

  11. Determinants of culinary tourism development in Pomeranian Voivodeship

    Directory of Open Access Journals (Sweden)

    Przemysław Charzyński


    Full Text Available Pomeranian cuisine is characterized in the paper, It is a region in Northern Poland whose culinary heritage has been partially forgotten in the communist period, and is now being rediscovered. Typical dishes of traditional and modern Kashubian and Kociewie cuisine were presented, that can be a motivation for tourists interested in discovering and tasting of the regional dishes to visit this region. Geographical, historical and cultural heritage of Pomerania are the primary determinants of the formation of culinary trails and organization of  interesting food related events, which enables the development of this type of tourism in the studied area.

  12. Explaining inequalities in women's mortality between U.S. States

    Directory of Open Access Journals (Sweden)

    Jennifer Karas Montez


    Full Text Available Inequalities in women's mortality between U.S. states are large and growing. It is unknown whether they reflect differences between states in their population characteristics, contextual characteristics, or both. This study systematically examines the large inequalities in women's mortality between U.S. states using a multilevel approach. It focuses on “fundamental” social determinants of mortality at the individual and state levels as potential explanations. We analyze data from the 2013 public-use National Longitudinal Mortality Study on women aged 45–89 years and estimate multilevel logistic regression models. The models include women's personal characteristics (age, race/ethnicity, education, employment, income, and marriage and states’ contextual characteristics (economic environment, social cohesion, sociopolitical orientation, physical infrastructure, and tobacco environment. We found that variation in women's mortality across states was significant (p<0.001. Adjusting for women's personal characteristics explained 30% of the variation. Additionally adjusting for states’ contextual characteristics explained 62% of the variation; the most important characteristics were social cohesion and economic conditions. No significant mortality differences between any two states remained after accounting for individual and contextual characteristics. Supplementary analyses of men indicate that state contexts have stronger and more pernicious consequences for women than men. Taken together, the findings underscore the importance of ‘bringing context back in’ and taking a multilevel approach when investigating geographic inequalities in U.S. mortality. Keywords: Mortality, Gender, Inequality, Social determinants, U.S. states, Multilevel

  13. Ischaemic heart disease mortality and the business cycle in Australia. (United States)

    Bunn, A R


    Trends in Australian heart disease mortality were assessed for association with the business cycle. Correlation models of mortality and unemployment series were used to test for association. An indicator series of "national stress" was developed. The three series were analyzed in path models to quantify the links between unemployment, national stress, and heart disease. Ischemic heart disease (IHD) mortality and national stress were found to follow the business cycle. The two periods of accelerating IHD mortality coincided with economic recession. The proposed "wave hypothesis" links the trend in IHD mortality to the high unemployment of severe recession. The mortality trend describes a typical epidemic parabolic path from the Great Depression to 1975, with a smaller parabolic trend at the 1961 recession. These findings appear consistent with the hypothesis that heart disease is, to some degree, a point source epidemic arising with periods of severe economic recession. Forecasts under the hypothesis indicate a turning point in the mortality trend between 1976 and 1978. (Am J Public Health 69:772-781, 1979). PMID:453409

  14. Ozone, area social conditions, and mortality in Mexico City

    International Nuclear Information System (INIS)

    O'Neill, M.S.; Loomis, Dana; Borja-Aburto, V.H.


    We investigated whether the association of daily mortality and ambient ozone differs by age and area social conditions of the region of residence using a time-series analysis. The study setting was metropolitan Mexico City, a high altitude city situated in a valley, with an estimated 20 million inhabitants, large socioeconomic gradients, and ozone levels frequently exceeding international standards. We stratified daily deaths by six census-derived socioeconomic indicators, based on characteristics of the county where decedents lived. We used Poisson regression to model the association between daily mortality and ozone levels (on the day of death and the previous day) in separate models, stratified by area socioeconomic level and age, and controlling for time trends and temperature. Ozone was positively associated with total mortality [0.65% increase per 10 ppb increment, 95% confidence interval (CI): 0.02%, 1.28%] and for mortality among those over age 65 [1.39% increase per 10 ppb increment, 95% CI: 0.51%, 2.28%]. Associations between ozone and all-age mortality did not show any consistent patterns according to socioeconomic gradients. We conclude that elderly people are at higher risk for ozone-associated mortality. Though county-level social indicators in Mexico City were not strong markers of vulnerability to ozone-associated acute mortality in this analysis, complex associations between individual and area-level factors may exist that would require additional data and further analyses to elucidate

  15. [Mortality in Mexico. Some considerations on rural-urban differentials]. (United States)

    Camposortega Cruz, S


    "In this essay, certain aspects related to rural-urban mortality differentials in Mexico are analyzed....[These include] the availability, advantages, and limitations of different sources of information and the disparity of levels and tendencies according to particular indicators of acceptable reliability, especially those deriving from recent demographic surveys conducted in Mexico. The findings confirm an inverse ratio between size of settlement and mortality, and reveal a widening of the differentials over time." (SUMMARY IN ENG) excerpt

  16. Base Deficit as an Indicator of Significant Blunt Abdominal Trauma

    African Journals Online (AJOL)


    important cause of morbidity and mortality among trauma patients. ... the use of BD as an indicator of significant BAT. Methods: ... Key words: Base deficit, Blunt abdominal trauma,. Predictor. ..... Delineate Risk for Torso Injury in Stable Patients.


    Directory of Open Access Journals (Sweden)

    M. Serhat Yucel, FRM


    Full Text Available Mortality and longevity risk is usually one of the main risk components ineconomic capital models of insurance companies. Above all, future mortalityexpectations are an important input in the modeling and pricing of long termproducts. Deviations from the expectation can lead insurance company even todefault if sufficient reserves and capital is not held. Thus, Modeling of mortalitytime series accurately is a vital concern for the insurance industry. The aim of thisstudy is to perform distributional and spectral testing to the mortality data andpracticed discrete and continuous time modeling. We believe, the results and thetechniques used in this study will provide a basis for Value at Risk formula incase of mortality.

  18. Mortality after acute myocardial infarction according to income and education

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe Nørgaard; Rasmussen, Søren; Gislason, Gunnar H


    OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI i...... that both educational level and income substantially and independently affect mortality after AMI, indicating that each indicator has specific effects on mortality and that these indicators are not interchangeable.......OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI...... in Denmark in 1995-2002. MAIN OUTCOME MEASURES: Relative risk (RR) of 30 day mortality and long term mortality (31 days until 31 December 2003) associated with income (adjusted for education) or educational level (adjusted for income) and further adjusted for sex, age, civil status, and comorbidity. RESULTS...

  19. CDC WONDER: Mortality - Infant Deaths (United States)

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

  20. Physical activity, obesity and mortality

    DEFF Research Database (Denmark)

    Bauman, Adrian E.; Grunseit, Anne C.; Rangul, Vegar


    Background: Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether 'PA patterns' (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality...

  1. Predictors of paediatric injury mortality

    African Journals Online (AJOL)

    PTS) and Glasgow Coma Score (GCS) were tested against outcome by binary logistic regression analysis. Results. Five hundred and seventy-six children presented with injury during the study period with 22 deaths, giving an injury mortality ...

  2. NCHS - Injury Mortality: United States (United States)

    U.S. Department of Health & Human Services — This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury...

  3. Mortality studies of Hanford workers

    International Nuclear Information System (INIS)

    Gilbert, E.S.


    The relationships of cancer mortality with radiation exposure as influenced by age, sex, follow-up time length of employment, and job category are discussed in relation to workers at the Hanford facilities

  4. Stressful social relations and mortality

    DEFF Research Database (Denmark)

    Lund, Rikke; Christensen, Ulla; Nilsson, Charlotte Juul


    BACKGROUND: Few studies have examined the relationship between stressful social relations in private life and all-cause mortality. OBJECTIVE: To evaluate the association between stressful social relations (with partner, children, other family, friends and neighbours, respectively) and all...... men and women aged 36-52 years, linked to the Danish Cause of Death Registry for information on all-cause mortality until 31 December 2011. Associations between stressful social relations with partner, children, other family, friends and neighbours, respectively, and all-cause mortality were examined....... CONCLUSIONS: Stressful social relations are associated with increased mortality risk among middle-aged men and women for a variety of different social roles. Those outside the labour force and men seem especially vulnerable to exposure....

  5. The effect of neighbourhood mortality shocks on fertility preferences: a spatial econometric approach. (United States)

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


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

  6. Geomagnetic Indices Bulletin (GIB) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Geomagnetic Indices Bulletin is a one page sheet containing the magnetic indices Kp, Ap, Cp, An, As, Am and the provisional aa indices. The bulletin is published...

  7. Cancer mortality in Hanford workers

    International Nuclear Information System (INIS)

    Marks, S.; Gilbert, E.S.; Breitenstein, B.D.


    Personnel and radiation exposure data for past and present employees of the Hanford plant have been collected and analysed for a possible relationship of exposure to mortality. The occurrence of death in workers was established by the Social Security Administration and the cause of death obtained from death certificates. Mortality from all causes, all cancer cases and specific cancer types was related to the population at risk. Standardized mortality ratios were calculated for white males, using age- and calendar year-specific mortality rates for the U.S. population in the calculation of expected deaths. This analysis showed a substantial 'healthy worker effect' and no significantly high standardized mortality ratios for specific disease categories. A test for association of mortality with levels of radiation exposure revealed no correlation for all causes and all cancer. In carrying out this test, adjustment was made for age and calendar year of death, length of employment and occupational category. A statistically significant test for trend was obtained for multiple myeloma and carcinoma of the pancreas. However, in view of the absence of such a correlation for diseases more commonly associated with radiation exposure such as myeloid leukaemia, as well as the small number of deaths in higher exposure groups, the results cannot be considered definitive. Any conclusions based on these associations should be viewed in relation to the results of other studies. These results are compared with those of other investigators who have analysed the Hanford data. (author)

  8. High mortality in the Thule cohort

    DEFF Research Database (Denmark)

    Juel, K


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

  9. Precipitation Indices Low Countries (United States)

    van Engelen, A. F. V.; Ynsen, F.; Buisman, J.; van der Schrier, G.


    (+2): Wide scale river flooding, marshy acres and meadows.-Farmers cope with poor harvests of hay, grains, fruit etc. resulting in famines.-Late grape harvests, poor yield quantity and quality of wine. Wet period (+1): High water levels cq discharges of major rivers, tributaries and brooks, local river floodings, marshy acres and meadows in the low lying areas.-Wearisome and hampered agriculture. Normal (0) Dry period (-1): Low water levels cq discharges of major rivers, tributaries and brooks. Some brooks may dry up.-Summer half year: local short of yield of grass, hay and other forage.-Summer half year: moor-, peat- and forest fires. Very dry period (-2): Very low water levels cq discharges of major rivers and tributaries. Brooks and wells dry up. Serious shortage of drinking water; especially in summer.-Major agricultural damage, shortage of water, mortality stock of cattle. Shortage of grain. Flour can not be produced due to water mills running out of water, shortage of bread, bread riots, famines.-Large scale forest and peat areas, resulting in serious air pollution. Town fires. By verifying the historical evidence on these criterions, a series of 5 step indices ranging from very dry to very wet for summer and winter half year of the Low Countries was obtained. Subsequently these indices series were compared with the instrumentally observed seasonal precipitation sums for De Bilt (1735-2008), which is considered to be representative for the Central Netherlands. For winter (Oct-March) and summer half year (Apr.-Sept.) the accumulated precipitation amounts are calculated; these amounts are approximately normally distributed. Based on this distribution, the cumulative frequency distribution is calculated. By tabulating the number of summers in the pre-instrumental period 1201-1750 for each of the drought classes, a distribution is calculated which is then related to the modern accumulated precipitation distribution. Assuming that the accumulated precipitation amount

  10. Drought impact on vegetation growth and mortality (United States)

    Xu, C.; Wang, M.; Allen, C. D.; McDowell, N. G.; Middleton, R. S.


    Vegetation is a key regulator of the global carbon cycle via CO2 absorption through photosynthesis and subsequent growth; however, low water availability, heat stress, and disturbances associated with droughts could substantially reduce vegetation growth and increase vegetation mortality. As far as we know, there are few studies have assessed the drought impact on vegetation growth and mortality at regional and global scales. In this study, we analyzed 13 Earth System models (ESMs) to quantify the impact of drought on GPP and linked the remote-sensing based tree mortality to observed drought indices to assess the drought impact on tree mortality in continental US (CONUS). Our analysis of 13 Earth System models (ESMs) shows that the average global gross primary production (GPP) reduction per year associated with extreme droughts over years 2075-2099 is predicted to be 3-5 times larger than that over years 1850-1999. The annual drought-associated reduction in GPP over years 2075-2099 could be 52 and 74 % of annual fossil fuel carbon emission during years 2000-2007. Increasing drought impacts on GPP are driven primarily by the increasing drought frequency. The risks of drought-associated GPP reduction are particularly high for temperate and tropical regions. The consistent prediction of higher drought-associated reduction in NPP across 13 ESMs suggests increasing impacts of drought on the global carbon cycle with atmospheric warming. Our analysis of drought impact on tree mortality showed that drought-associated carbon loss accounts for 12% of forest carbon loss in CONUS for 2000-2014, which is about one-fifth of that resulting from timber harvesting and 1.35 % of average annual fossil fuel emissions in the U.S. for the same period. The carbon stock loss from natural disturbances for 2000-2014 is approximately 75% of the total carbon loss from anthropogenic disturbance (timber harvesting), suggesting that natural disturbances play a very important role on forest

  11. Mortality as a function of obesity and diabetes mellitus. (United States)

    Pettitt, D J; Lisse, J R; Knowler, W C; Bennett, P H


    Mortality according to body mass index (weight/height2) was studied in 2197 Pima Indians aged 15-74 years, as part of the longitudinal study of diabetes begun in 1965 in the Gila River Indian Community of Arizona. The Pima Indians are a population with a high prevalence of obesity, and they have the highest known incidence of type II (non-insulin dependent) diabetes mellitus. Among males, mortality was greatest in those with a body mass index of at least 40 kg/m2, but obesity had little effect on mortality at body mass indices below 40 kg/m2. Age-specific death rates in women were not consistently related to obesity, although mortality in subjects with diabetes was higher than in those without. In men, diabetes had little effect on mortality. In this study, as in several other mortality studies, the lowest mortality rates were experienced by people with body weights well above those recommended as "desirable" by the Society of Actuaries in 1959. Thus, the applicability of the "desirable" weight standards in common use is questioned.

  12. The stranding anomaly as population indicator

    DEFF Research Database (Denmark)

    Peltier, Helene; Baagøe, Hans J.; Camphuysen, Kees C. J.


    Ecological indicators for monitoring strategies are expected to combine three major characteristics: ecological significance, statistical credibility, and cost-effectiveness. Strategies based on stranding networks rank highly in cost-effectiveness, but their ecological significance and statistica...... surveys, mostly SCANS surveys (1994 and 2005). This new indicator could be applied to cetacean populations across the world and more widely to marine megafauna....... credibility are disputed. Our present goal is to improve the value of stranding data as population indicator as part of monitoring strategies by constructing the spatial and temporal null hypothesis for strandings. The null hypothesis is defined as: small cetacean distribution and mortality are uniform...

  13. Mortality of workers employed in shoe manufacturing: an update. (United States)

    Lehman, Everett J; Hein, Misty J


    In the late 1970s, the National Institute for Occupational Safety and Health identified two shoe manufacturing facilities where workers experienced relatively "pure" exposures to toluene. A mortality study was conducted through December 31, 1982. An original study did not detect elevated leukemia mortality but did detect increased lung cancer mortality. The present study is an update of the mortality of the original cohort. The study cohort consisted of workers employed 1 month or more between 1940 and 1979 at two Ohio shoe manufacturing plants. Vital status was ascertained through December 31, 1999. Seven thousand eight hundred twenty eight workers, contributing 300,777 person years, were available for analysis. An excess of lung cancer deaths persisted with additional years of follow-up (SMR = 1.36, 95% confidence interval (CI) = 1.19-1.54). Trend tests did not indicate a positive trend between lung cancer risk and duration of employment. Mortality from leukemia was not significantly elevated in the updated analysis. Results indicate a possible association between lung cancer mortality and exposure to chronic, low-levels of organic solvents. Although the strength of this conclusion was weakened by the lack of increasing lung cancer risk in relation to duration of employment, other studies have supported this association. Published 2006 Wiley-Liss, Inc.

  14. [Liver cirrhosis mortality in Mexico. II. Excess mortality and pulque consumption]. (United States)

    Narro-Robles, J; Gutiérrez-Avila, J H; López-Cervantes, M; Borges, G; Rosovsky, H


    Over the years high cirrhosis mortality rates have been reported in Mexico City and in the surrounding states (Hidalgo, Tlaxcala, Puebla and the State of Mexico); on the contrary, well defined areas, such as the northern states, have shown a considerably lower mortality rate. This situation may indicate that some factors such as the pattern of alcoholic intake and other environmental characteristics could explain this striking difference. To determine the role of alcohol, the availability and consumption of alcohol at regional and state level were compared with cirrhosis mortality rates. A high and statistically significant correlation was found with pulque availability and consumption (r = 72-92%, p less than 0.01) in all periods of time under examination. On the contrary, a statistically significant negative association was observed with beer consumption and a positive, but not significant correlation, with distilled alcoholic beverages. Infectious hepatitis incidence, prevalence of exclusive use of native languages (as an indirect index of ethnic background) and nutritional deficiencies were also studied as possible risk factors. Nutritional deficiencies and the prevalence of exclusive use of náhuatl and otomí languages were positively correlated. These results can be useful to conduct further epidemiological studies still needed to determine the etiologic role of pulque consumption as well as of the other risk factors. Nonetheless, the current data stress the need to implement public health programs to reduce alcohol consumption, especially pulque, and to minimize the impact of these risk factors in high mortality areas.

  15. Maternal mortality: a cross-sectional study in global health. (United States)

    Sajedinejad, Sima; Majdzadeh, Reza; Vedadhir, AbouAli; Tabatabaei, Mahmoud Ghazi; Mohammad, Kazem


    Although most of maternal deaths are preventable, maternal mortality reduction programs have not been completely successful. As targeting individuals alone does not seem to be an effective strategy to reduce maternal mortality (Millennium Development Goal 5), the present study sought to reveal the role of many distant macrostructural factors affecting maternal mortality at the global level. After preparing a global dataset, 439 indicators were selected from nearly 1800 indicators based on their relevance and the application of proper inclusion and exclusion criteria. Then Pearson correlation coefficients were computed to assess the relationship between these indicators and maternal mortality. Only indicators with statistically significant correlation more than 0.2, and missing values less than 20% were maintained. Due to the high multicollinearity among the remaining indicators, after missing values analysis and imputation, factor analysis was performed with principal component analysis as the method of extraction. Ten factors were finally extracted and entered into a multiple regression analysis. The findings of this study not only consolidated the results of earlier studies about maternal mortality, but also added new evidence. Education (std. B = -0.442), private sector and trade (std. B = -0.316), and governance (std. B = -0.280) were found to be the most important macrostructural factors associated with maternal mortality. Employment and labor structure, economic policy and debt, agriculture and food production, private sector infrastructure investment, and health finance were also some other critical factors. These distal factors explained about 65% of the variability in maternal mortality between different countries. Decreasing maternal mortality requires dealing with various factors other than individual determinants including political will, reallocation of national resources (especially health resources) in the governmental sector, education

  16. Spatial elements of mortality risk in old-growth forests (United States)

    Das, Adrian; Battles, John; van Mantgem, Phillip J.; Stephenson, Nathan L.


    For many species of long-lived organisms, such as trees, survival appears to be the most critical vital rate affecting population persistence. However, methods commonly used to quantify tree death, such as relating tree mortality risk solely to diameter growth, almost certainly do not account for important spatial processes. Our goal in this study was to detect and, if present, to quantify the relevance of such processes. For this purpose, we examined purely spatial aspects of mortality for four species, Abies concolor, Abies magnifica, Calocedrus decurrens, and Pinus lambertiana, in an old-growth conifer forest in the Sierra Nevada of California, USA. The analysis was performed using data from nine fully mapped long-term monitoring plots.In three cases, the results unequivocally supported the inclusion of spatial information in models used to predict mortality. For Abies concolor, our results suggested that growth rate may not always adequately capture increased mortality risk due to competition. We also found evidence of a facilitative effect for this species, with mortality risk decreasing with proximity to conspecific neighbors. For Pinus lambertiana, mortality risk increased with density of conspecific neighbors, in keeping with a mechanism of increased pathogen or insect pressure (i.e., a Janzen-Connell type effect). Finally, we found that models estimating risk of being crushed were strongly improved by the inclusion of a simple index of spatial proximity.Not only did spatial indices improve models, those improvements were relevant for mortality prediction. For P. lambertiana, spatial factors were important for estimation of mortality risk regardless of growth rate. For A. concolor, although most of the population fell within spatial conditions in which mortality risk was well described by growth, trees that died occurred outside those conditions in a disproportionate fashion. Furthermore, as stands of A. concolor become increasingly dense, such spatial

  17. The influence of neighborhood unemployment on mortality after stroke. (United States)

    Unrath, Michael; Wellmann, Jürgen; Diederichs, Claudia; Binse, Lisa; Kalic, Marianne; Heuschmann, Peter Ulrich; Berger, Klaus


    Few studies have investigated the impact of neighborhood characteristics on mortality after stroke. Aim of our study was to analyze the influence of district unemployment as indicator of neighborhood socioeconomic status (SES-NH) on poststroke mortality, and to compare these results with the mortality in the underlying general population. Our analyses involve 2 prospective cohort studies from the city of Dortmund, Germany. In the Dortmund Stroke Register (DOST), consecutive stroke patients (N=1883) were recruited from acute care hospitals. In the Dortmund Health Study (DHS), a random general population sample was drawn (n=2291; response rate 66.9%). Vital status was ascertained in the city's registration office and information on district unemployment was obtained from the city's statistical office. We performed multilevel survival analyses to examine the association between district unemployment and mortality. The association between neighborhood unemployment and mortality was weak and not statistically significant in the stroke cohort. Only stroke patients exposed to the highest district unemployment (fourth quartile) had slightly higher mortality risks. In the general population sample, higher district unemployment was significantly associated with higher mortality following a social gradient. After adjustment for education, health-related behavior and morbidity was made the strength of this association decreased. The impact of SES-NH on mortality was different for stroke patients and the general population. Differences in the association between SES-NH and mortality may be partly explained by disease-related characteristics of the stroke cohort such as homogeneous lifestyles, similar morbidity profiles, medical factors, and old age. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Prevalence and factors influencing perinatal mortality in rural mysore, India. (United States)

    Siddalingappa, Hugara; Murthy M R, Nrayana; Kulkarni, Praveen; N C, Ashok


    With decreasing Infant Mortality Rate, Perinatal Mortality is gaining importance as it takes into consideration most of the factors influencing child birth and its survival, mortality during this period is a better indicator of quality of Maternal and Child Health services. To estimate the Prevalence of perinatal mortality and its associated risk factors. Cross sectional community based study was carried out in rural field practice area catering 26,700 population. All births during 2010 among permanent residents of this area were included. House to house survey was conducted to collect details regarding Antenatal, intra-natal and post-natal history by interviewing mother using a pre-tested questionnaire. Hospital records were also referred when available. Nine perinatal deaths had occurred out of 314 births in a span of one year with a perinatal, early neonatal mortality rates of 28.93, 19.29 per 1000 live births respectively and still birth rate of 9.55 per 100 total births. Higher Perinatal Mortality Rate(PNMR) was observed in mothers who got married before 18 years, conceived during teenage, having anaemia, delivered at home, normal vaginal deliveries and having suffered by intra-partal and placental complications. Male babies, babies fed with prelacteal feeds, born out of intra-uterine complications, having low birth weight, had delayed first cry, premature births and twin births showed higher risk for mortality. The prevalence of perinatal mortality in the present study was 28.93 per 1000 live births. Even though this was well below the national and state values indicating improved quality of Maternal and Child Health care, it also gives way for relooking into strategies for further bringing down the perinatal deaths.

  19. Intrinsic and extrinsic mortality reunited. (United States)

    Koopman, Jacob J E; Wensink, Maarten J; Rozing, Maarten P; van Bodegom, David; Westendorp, Rudi G J


    Intrinsic and extrinsic mortality are often separated in order to understand and measure aging. Intrinsic mortality is assumed to be a result of aging and to increase over age, whereas extrinsic mortality is assumed to be a result of environmental hazards and be constant over age. However, allegedly intrinsic and extrinsic mortality have an exponentially increasing age pattern in common. Theories of aging assert that a combination of intrinsic and extrinsic stressors underlies the increasing risk of death. Epidemiological and biological data support that the control of intrinsic as well as extrinsic stressors can alleviate the aging process. We argue that aging and death can be better explained by the interaction of intrinsic and extrinsic stressors than by classifying mortality itself as being either intrinsic or extrinsic. Recognition of the tight interaction between intrinsic and extrinsic stressors in the causation of aging leads to the recognition that aging is not inevitable, but malleable through the environment. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Universal mortality law and immortality (United States)

    Azbel', Mark Ya.


    Well-protected human and laboratory animal populations with abundant resources are evolutionarily unprecedented. Physical approach, which takes advantage of their extensively quantified mortality, establishes that its dominant fraction yields the exact law, which is universal for all animals from yeast to humans. Singularities of the law demonstrate new kinds of stepwise adaptation. The law proves that universal mortality is an evolutionary by-product, which at any given age is reversible, independent of previous life history, and disposable. Life expectancy may be extended, arguably to immortality, by minor biological amendments in the animals. Indeed, in nematodes with a small number of perturbed genes and tissues it increased 6-fold (to 430 years in human terms), with no apparent loss in health and vitality. The law relates universal mortality to specific processes in cells and their genetic regulation.

  1. Decline in breast cancer mortality

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Schwartz, Walter; Blichert-Toft, Mogens


    OBJECTIVES: When estimating the decline in breast cancer mortality attributable to screening, the challenge is to provide valid comparison groups and to distinguish the screening effect from other effects. In Funen, Denmark, multidisciplinary breast cancer management teams started before screening...... was introduced; both activities came later in the rest of Denmark. Because Denmark had national protocols for breast cancer treatment, but hardly any opportunistic screening, Funen formed a "natural experiment", providing valid comparison groups and enabling the separation of the effect of screening from other...... factors. METHODS: Using Poisson regression we compared the observed breast cancer mortality rate in Funen after implementation of screening with the expected rate without screening. The latter was estimated from breast cancer mortality in the rest of Denmark controlled for historical differences between...

  2. Geographic Variation in Morbidity and Mortality of Cerebrovascular Diseases in Korea during 2011-2015. (United States)

    Lee, Juyeon; Bahk, Jinwook; Kim, Ikhan; Kim, Yeon-Yong; Yun, Sung-Cheol; Kang, Hee-Yeon; Lee, Jeehye; Park, Jong Heon; Shin, Soon-Ae; Khang, Young-Ho


    Little is known about within-country variation in morbidity and mortality of cerebrovascular diseases (CVDs). Geographic differences in CVD morbidity and mortality have yet to be properly examined. This study examined geographic variation in morbidity and mortality of CVD, neighborhood factors for CVD morbidity and mortality, and the association between CVD morbidity and mortality across the 245 local districts in Korea during 2011-2015. District-level health care utilization and mortality data were obtained to estimate age-standardized CVD morbidity and mortality. The bivariate Pearson correlation was used to examine the linear relationship between district-level CVD morbidity and mortality Z-scores. Simple linear regression and multivariate analyses were conducted to investigate the associations of area characteristics with CVD morbidity, mortality, and discrepancies between morbidity and mortality. Substantial variation was found in CVD morbidity and mortality across the country, with 1074.9 excess CVD inpatients and 73.8 excess CVD deaths per 100,000 between the districts with the lowest and highest CVD morbidity and mortality, respectively. Higher rates of CVD admissions and deaths were clustered in the noncapital regions. A moderate geographic correlation between CVD morbidity and mortality was found (Pearson correlation coefficient = .62 for both genders). Neighborhood level indicators for socioeconomic disadvantages, undersupply of health care resources, and unhealthy behaviors were positively associated with CVD morbidity and mortality and the relative standing of CVD mortality vis-à-vis morbidity. Policy actions targeting life-course socioeconomic conditions, equitable distribution of health care resources, and behavioral risk factors may help reduce geographic differences in CVD morbidity and mortality in Korea. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Examining geographic patterns of mortality: the atlas of mortality in small areas in Spain (1987-1995). (United States)

    Benach, Joan; Yasui, Yutaka; Borrell, Carme; Rosa, Elisabeth; Pasarín, M Isabel; Benach, Núria; Español, Esther; Martínez, José Miguel; Daponte, Antonio


    Small-area mortality atlases have been demonstrated to be a useful tool for both showing general geographical patterns in mortality data and identifying specific high-risk locations. In Spain no study has so far systematically examined geographic patterns of small-area mortality for the main causes of death. This paper presents the main features, contents and potential uses of the Spanish Atlas of Mortality in small areas (1987-1995). Population data for 2,218 small areas were drawn from the 1991 Census. Aggregated mortality data for 14 specific causes of death for the period 1987-1995 were obtained for each small area. Empirical Bayes-model-based estimates of age-adjusted relative risk were displayed in small-area maps for each cause/gender/age group (0-64 or 65 and over) combination using the same range of values (i.e. septiles) and colour schemes. The 'Spanish Atlas of Mortality' includes multiple choropleth (area-shaded) small-area maps and graphs to answer different questions about the data. The atlas is divided into three main sections. Section 1 includes the methods and comments on the main maps. Section 2 presents a two-page layout for each leading cause of death by gender including 1) a large map with relative risk estimates, 2) a map that indicates high- and low-risk small areas, 3) a graph with median and interquartile range of relative risk estimates for 17 large regions of Spain, and 4) relative-risk maps for two age groups. Section 3 provides specific information on the geographical units of analysis, statistical methods and other supplemental maps. The 'Spanish Atlas of Mortality' is a useful tool for examining geographical patterns of mortality risk and identifying specific high-risk areas. Mortality patterns displayed in the atlas may have important implications for research and social/health policy planning purposes.

  4. Predicting mortality from human faces. (United States)

    Dykiert, Dominika; Bates, Timothy C; Gow, Alan J; Penke, Lars; Starr, John M; Deary, Ian J


    To investigate whether and to what extent mortality is predictable from facial photographs of older people. High-quality facial photographs of 292 members of the Lothian Birth Cohort 1921, taken at the age of about 83 years, were rated in terms of apparent age, health, attractiveness, facial symmetry, intelligence, and well-being by 12 young-adult raters. Cox proportional hazards regression was used to study associations between these ratings and mortality during a 7-year follow-up period. All ratings had adequate reliability. Concurrent validity was found for facial symmetry and intelligence (as determined by correlations with actual measures of fluctuating asymmetry in the faces and Raven Standard Progressive Matrices score, respectively), but not for the other traits. Age as rated from facial photographs, adjusted for sex and chronological age, was a significant predictor of mortality (hazard ratio = 1.36, 95% confidence interval = 1.12-1.65) and remained significant even after controlling for concurrent, objectively measured health and cognitive ability, and the other ratings. Health as rated from facial photographs, adjusted for sex and chronological age, significantly predicted mortality (hazard ratio = 0.81, 95% confidence interval = 0.67-0.99) but not after adjusting for rated age or objectively measured health and cognition. Rated attractiveness, symmetry, intelligence, and well-being were not significantly associated with mortality risk. Rated age of the face is a significant predictor of mortality risk among older people, with predictive value over and above that of objective or rated health status and cognitive ability.

  5. Indicators and their functions

    DEFF Research Database (Denmark)

    Gudmundsson, Henrik; Joumard, Robert; Aschemann, Ralf


    indicators? How can several indicators be jointly considered? And how can indicators be used in planning and decision making? Firstly we provide definition of 'indicator of environmental sustainability in transport'. The functions, strengths and weaknesses of indicators as measurement tools, and as decision...... for indicators and assessments. As the decision making context influences the perceived and actual needs for indicators and methods, we also analysed the dimensions and context of decision making. We derived criteria and methods for the assessment and selection of indicators of environmental sustainability......This report is the final report of the action COST 356 'EST - Towards the definition of a measurable environmentally sustainable transport'. It tries to answer the following questions: How can environmental impacts of transport be measured? How can measurements be transformed into operational...

  6. Geomagnetic aa Indices (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa indices are the continuation of the series beginning in the year 1868. A full description of these indices is given in the International...

  7. Predicting Early Mortality After Hip Fracture Surgery: The Hip Fracture Estimator of Mortality Amsterdam. (United States)

    Karres, Julian; Kieviet, Noera; Eerenberg, Jan-Peter; Vrouenraets, Bart C


    Early mortality after hip fracture surgery is high and preoperative risk assessment for the individual patient is challenging. A risk model could identify patients in need of more intensive perioperative care, provide insight in the prognosis, and allow for risk adjustment in audits. This study aimed to develop and validate a risk prediction model for 30-day mortality after hip fracture surgery: the Hip fracture Estimator of Mortality Amsterdam (HEMA). Data on 1050 consecutive patients undergoing hip fracture surgery between 2004 and 2010 were retrospectively collected and randomly split into a development cohort (746 patients) and validation cohort (304 patients). Logistic regression analysis was performed in the development cohort to determine risk factors for the HEMA. Discrimination and calibration were assessed in both cohorts using the area under the receiver operating characteristic curve (AUC), the Hosmer-Lemeshow goodness-of-fit test, and by stratification into low-, medium- and high-risk groups. Nine predictors for 30-day mortality were identified and used in the final model: age ≥85 years, in-hospital fracture, signs of malnutrition, myocardial infarction, congestive heart failure, current pneumonia, renal failure, malignancy, and serum urea >9 mmol/L. The HEMA showed good discrimination in the development cohort (AUC = 0.81) and the validation cohort (AUC = 0.79). The Hosmer-Lemeshow test indicated no lack of fit in either cohort (P > 0.05). The HEMA is based on preoperative variables and can be used to predict the risk of 30-day mortality after hip fracture surgery for the individual patient. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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

    Directory of Open Access Journals (Sweden)

    Irianto Joko


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

  9. Maternal mortality ratio in Lebanon in 2008: a hospital-based reproductive age mortality study (RAMOS). (United States)

    Hobeika, Elie; Abi Chaker, Samer; Harb, Hilda; Rahbany Saad, Rita; Ammar, Walid; Adib, Salim


    International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy

  10. [Adult mortality differentials in Argentina]. (United States)

    Rofman, R


    Adult mortality differentials in Argentina are estimated and analyzed using data from the National Social Security Administration. The study of adult mortality has attracted little attention in developing countries because of the scarcity of reliable statistics and the greater importance assigned to demographic phenomena traditionally associated with development, such as infant mortality and fertility. A sample of 39,421 records of retired persons surviving as of June 30, 1988, was analyzed by age, sex, region of residence, relative amount of pension, and social security fund of membership prior to the consolidation of the system in 1967. The thirteen former funds were grouped into the five categories of government, commerce, industry, self-employed, and other, which were assumed to be proxies for the activity sector in which the individual spent his active life. The sample is not representative of the Argentine population, since it excludes the lowest and highest socioeconomic strata and overrepresents men and urban residents. It is, however, believed to be adequate for explaining mortality differentials for most of the population covered by the social security system. The study methodology was based on the technique of logistic analysis and on the use of regional model life tables developed by Coale and others. To evaluate the effect of the study variables on the probability of dying, a regression model of maximal verisimilitude was estimated. The model relates the logit of the probability of death between ages 65 and 95 to the available explanatory variables, including their possible interactions. Life tables were constructed by sex, region of residence, previous pension fund, and income. As a test of external consistency, a model including only age and sex as explanatory variables was constructed using the methodology. The results confirmed consistency between the estimated values and other published estimates. A significant conclusion of the study was that

  11. [Chile: mortality between 1 and 4 years of age. Trends and causes]. (United States)

    Taucher, E


    The great decline in infant mortality in Chile in the last 2 decades provokes interest in the current situation in child mortality (for children 1-4 years of age). For the present analysis, central death rates and probabilities of dying are used, calculated with Greville's method from birth and death data. Mortality trends of the group between 1961-78, sex differentials, and causes of death are studied. The findings indicate that mortality in this age group has declined dramatically during the period of analysis, mainly due to the decrease in mortality from respiratory diseases, diarrhea, and diseases avoidable through vaccination. To attain the future approach of the Chilean rate to that of more developed countries, the reduction of mortality from respiratory diseases and diarrhea should continue together with the achievement of substantial reduction in mortality from violence and accidents. This, the primary cause of death in children, ages 1-4, has not varied during the period under study. (author's)

  12. Short-term mortality and prognostic factors related to status epilepticus

    Directory of Open Access Journals (Sweden)

    Fernando Gustavo Stelzer


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

  13. NRC performance indicator program

    International Nuclear Information System (INIS)

    Singh, R.N.


    The performance indicator development work of the US Nuclear Regulatory Commission (NRC) interoffice task group involved several major activities that included selection of candidate indicators for a trial program, data collection and review, validation of the trial indicators, display method development, interactions with the industry, and selection of an optimum set of indicators for the program. After evaluating 27 potential indicators against certain ideal attributes, the task group selected 17 for the trial program. The pertinent data for these indicators were then collected from 50 plants at 30 sites. The validation of the indicators consisted of two primary processes: logical validity and statistical analysis. The six indicators currently in the program are scrams, safety system actuations, significant events, safety system failures, forced outage rate, and equipment forced outages per 100 critical hours. A report containing data on the six performance indicators and some supplemental information is issued on a quarterly basis. The NRC staff is also working on refinements of existing indicators and development of additional indicators as directed by the commission

  14. Does reservoir host mortality enhance transmission of West Nile virus?

    Directory of Open Access Journals (Sweden)

    Foppa Ivo M


    Full Text Available Abstract Background Since its 1999 emergence in New York City, West Nile virus (WNV has become the most important and widespread cause of mosquito-transmitted disease in North America. Its sweeping spread from the Atlantic to the Pacific coast was accompanied by widespread mortality among wild birds, especially corvids. Only sporadic avian mortality had previously been associated with this infection in the Old World. Here, we examine the possibility that reservoir host mortality may intensify transmission, both by concentrating vector mosquitoes on remaining hosts and by preventing the accumulation of "herd immunity". Results Inspection of the Ross-Macdonald expression of the basic reproductive number (R0 suggests that this quantity may increase with reservoir host mortality. Computer simulation confirms this finding and indicates that the level of virulence is positively associated with the numbers of infectious mosquitoes by the end of the epizootic. The presence of reservoir incompetent hosts in even moderate numbers largely eliminated the transmission-enhancing effect of host mortality. Local host die-off may prevent mosquitoes to "waste" infectious blood meals on immune host and may thus facilitate perpetuation and spread of transmission. Conclusion Under certain conditions, host mortality may enhance transmission of WNV and similarly maintained arboviruses and thus facilitate their emergence and spread. The validity of the assumptions upon which this argument is built need to be empirically examined.

  15. Independent predictors of morbidity and mortality in blunt colon trauma. (United States)

    Ricciardi, R; Paterson, C A; Islam, S; Sweeney, W B; Baker, S P; Counihan, T C


    We sought to determine the impact of (1) grade of the colon injury, (2) the formation of an ostomy, and (3) associated injuries on outcomes such as morbidity and mortality after blunt colon injuries. We retrospectively reviewed 16,814 cases of blunt abdominal trauma. Patients with colonic injuries were selected and charts reviewed for demographic, clinical, and outcomes data. Injuries were grouped by the Colon Injury Scale (grades I-V). Independent risk factors of morbidity included spine and lung injuries, as well as increased age. A higher grade of colon injury trended toward a significant association with intra-abdominal complications. Independent risk factors of mortality included liver, heart, and lung injuries, as well as intracerebral blood and female gender. The grade of colon injury, the formation of an ostomy, and management of the colon trauma did not independently predict increased intra-abdominal complications, morbidity, or mortality. These results indicate that patients afflicted with blunt colon trauma experience a high rate of morbidity and mortality from associated injuries and or increased age. Treatment regimens directed at these factors will be most helpful in reducing the high morbidity and mortality after blunt colon trauma. Factors such as ostomy formation and management strategy are not associated with increased morbidity or mortality after blunt colon trauma.

  16. [Unnecessary premature and avoidable mortality in Costa Rica]. (United States)

    Llorca Castro, Fernando; Ortún Rubio, Vicente


    With the intention of establishing economic inequities, the article analyzes the variations of the Unnecessarily Premature and Sanitarily Avoidable Mortality (MIPSE) of each of the 81 cantons of Costa Rica during 2000-2005. It is important to identify those inequities, to establish policies and strategies trying to mitigate them. It applies the MIPSE classification proposed by members of the Information and Studies Service, of the Catalunya's Sanitary Resources Headquarter, Spain. By an Indicator of Socioeconomic Development (IDSE) of a University of Costa Rica economist's team, it organised each canton in groups of quintiles (I for the richest, V for the poorest), previous people standardization. We found as a major causes of mortality MIPSE in the country: Heart Isquemic Disease (19,55% MIPSE causes), Traffic Accidents with Motor Vehicles (11,60%), Brain Vascular Disease (6,95%), Perinatal (6,92%) and Suicide (5,14%). The VIH infection - AIDS mortality, the Best Cancer in Women, Uterus Cancer, Skin Cancer and Hepatic Disease Secondary to Alcohol Consumption, affects more the cantons with better financial conditions and the Prostate Benign Hyperplasia mortality, Mothers mortality related with Pregnancy, Childbirth or Puerperal Stage and the Abdominal Hernia mortality, affects more to those with worst economic level. Two MIPSE groups were identified with similar inequality: Leukaemia and Congenital Cardiovascular Disease.

  17. Child mortality in rural India

    NARCIS (Netherlands)

    van der Klaauw, B.; Wang, L.


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

  18. Child mortality in rural India

    NARCIS (Netherlands)

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


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

  19. Educational differences in cardiovascular mortality

    DEFF Research Database (Denmark)

    Kjøllesdal, M. K. R.; Ariansen, I.; Mortensen, L. H.


    Aims: To explore the confounding effects of early family factors shared by siblings and cardiovascular risk factors in midlife on the educational differences in mortality from cardiovascular disease (CVD). Methods: Data from national and regional health surveys in Norway (1974–2003) were linked...

  20. Oral health problems and mortality

    Directory of Open Access Journals (Sweden)

    Jung Ki Kim


    Conclusion: Individual oral health conditions—tooth loss, root caries, and periodontal disease—were not related to mortality when sociodemographic, health, and/or health behavioral factors were considered, and there was no differential pattern between the three conditions. Multiple oral health problems were associated with a higher risk of dying.

  1. [Beer, wine, spirits and mortality]. (United States)

    Grønbaek, M N; Sørensen, T I; Johansen, D; Becker, U; Gottschau, A; Schnohr, P; Hein, H O; Jensen, G


    A population based cohort study investigates the association between alcohol intake and mortality from all causes, coronary heart disease and cancer. The design is prospective with baseline assessment of intake of beer, wine and spirits, smoking habits, educational level, physical activity, and body mass index and a total of 257,859 person-years follow-up on mortality. A total of 4,833 participants died, of these 1,075 from coronary heart disease and 1,552 of cancer. Compared with non-drinkers, light drinkers who avoided wine, had a relative risk of death from all causes of 0.90 (0.82-0.99) and those who drank wine had a relative risk of 0.66 (0.55-0.77). Heavy drinkers who avoided wine were at higher risk of death from all causes than were heavy drinkers who included wine in their alcohol intake. Wine drinkers had significantly lower mortality from both coronary heart disease and cancer than did non-wine drinkers (p = 0.007 and p = 0.004, respectively). In conclusion, wine intake may have a beneficial effect on all cause mortality that is additive to that of alcohol. This effect may be attributable to a reduction in death from both coronary heart disease and cancer.

  2. Manatee mortality in Puerto Rico (United States)

    Mignucci-Giannoni, A. A.; Montoya-Ospina, R. A.; Jimenez-Marrero, N. M.; Rodriguez-Lopez, M.; Williams, E.H.; Bonde, R.K.


    The most pressing problem in the effective management of the West Indian manatee (Trichechus manatus) in Puerto Rico is mortality due to human activities. We assessed 90 cases of manatee strandings in Puerto Rico based on historical data and a coordinated carcass salvage effort from 1990 through 1995. We determined patterns of mortality, including type of event, condition of carcasses, spatial and temporal distribution, gender, size/age class, and the cause of death. The spatial distribution of stranding events was not uniform, with the north, northeast, and south coasts having the highest numbers. Six clusters representing the highest incidence included the areas of Fajardo and Ceiba, Bahia de Jobos, Toa Baja, Guayanilla, Cabo Rojo, and Rio Grande to Luquillo. The number of reported cases has increased at an average rate of 9.6%/yr since 1990. The seasonality of stranding events showed a bimodal pattern, from February through April and in August and September. Most identified causes of death were due to human interaction, especially captures and watercraft collisions. Natural causes usually involved dependent calves. From 1990 through 1995, most deaths were attributed to watercraft collisions. A reduction in anthropogenic mortality of this endangered species can be accomplished only through education and a proactive management and conservation plan that includes law enforcement, mortality assessment, scientific research, rescue and rehabilitation, and inter- and intraagency cooperation.

  3. Infant Mortality: An American Tragedy. (United States)

    Hale, Christiane B.


    Assesses the complex problem of infant deaths in America and reviews the policy options before the nation. High infant mortality rates have been attributed to population heterogeneity, poverty, or differences in the way health services are organized. Links health policy issues to the larger issue of social and economic equity. (AF)

  4. Effects of the APOE ε2 Allele on Mortality and Cognitive Function in the Oldest Old

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Rune; Tan, Qihua; Mengel-From, Jonas


    Some studies indicate that the APOE ε2 allele may have a protective effect on mortality and mental health among the elderly adults. We investigated the effect of the APOE ε2 allele on cognitive function and mortality in 1651 members of the virtually extinct Danish 1905 birth cohort. We found...... no protective effect of the APOE ε2 allele on mortality compared with the APOE ε3 allele. The point estimates indicated an increased protection against cognitive decline over time for persons with the APOE ε2 allele. Cognitive score did not significantly modify the mortality risk of the various APOE genotypes....... We did not find a protective effect of the APOE ε2 allele on mortality among the oldest old, but in agreement with our previous findings, we found a 22% increased mortality risk for APOE ε4 carriers. The APOE ε2 allele may be protective on cognitive decline among the oldest old....

  5. Low dose irradiation reduces cancer mortality rates

    International Nuclear Information System (INIS)

    Luckey, T.D.


    Low doses of ionizing radiation stimulate development, growth, memory, sensual acuity, fecundity, and immunity (Luckey, T.D., ''Radiation Hormesis'', CRC Press, 1991). Increased immune competence reduces cancer mortality rates and provides increased average lifespan in animals. Decreased cancer mortality rates in atom bomb victims who received low dose irradiation makes it desirable to examine populations exposed to low dose irradiation. Studies with over 300,000 workers and 7 million person-years provide a valid comparison of radiation exposed and control unclear workers (Luckey, T.D., Nurture with Ionizing Radiation, Nutrition and Cancer, 34:1-11, 1999). Careful selection of controls eliminated any ''healthy worker effect''. The person-year corrected average indicated the cancer mortality rate of exposed workers was only 51% that of control workers. Lung cancer mortality rates showed a highly significant negative correlation with radon concentrations in 272,000 U.S. homes (Cohen, B.L., Health Physics 68:157-174, 1995). In contrast, radon concentrations showed no effect on lung cancer rates in miners from different countries (Lubin, J.H. Am. J. Epidemiology 140:323-332, 1994). This provides evidence that excessive lung cancer in miners is caused by particulates (the major factor) or toxic gases. The relative risk for cancer mortality was 3.7% in 10,000 Taiwanese exposed to low level of radiation from 60 Co in their steel supported homes (Luan, Y.C. et al., Am. Nuclear Soc. Trans. Boston, 1999). This remarkable finding needs further study. A major mechanism for reduced cancer mortality rates is increased immune competence; this includes both cell and humoral components. Low dose irradiation increases circulating lymphocytes. Macrophage and ''natural killer'' cells can destroy altered (cancer) cells before the mass becomes too large. Low dose irradiation also kills suppressor T-cells; this allows helper T-cells to activate killer cells and antibody producing cells

  6. Mortality among California highway workers. (United States)

    Maizlish, N; Beaumont, J; Singleton, J


    Standardized proportional mortality ratios (PMR) were computed for a population of highway workers. Hazards of highway maintenance work include exposure to solvents, herbicides, asphalt and welding fumes, diesel and auto exhaust, asbestos, abrasive dusts, hazardous material spills, and moving motor vehicles. Underlying cause of death was obtained for 1,570 workers who separated from the California Department of Transportation between 1970 and 1983, and who died in California between 1970 and 1983 (inclusive). Among 1,260 white males, the major findings were statistically significant excesses of cancers of digestive organs (PMR = 128), skin (PMR = 218), lymphopoietic cancer (PMR = 157), benign neoplasms (PMR = 343), motor vehicle accidents (PMR = 141), and suicide (PMR = 154). Black males (N = 66) experienced nonsignificant excesses of cancer of the digestive organs (PMR = 191) and arteriosclerotic heart disease (PMR = 143). Among 168 white females, deaths from lung cancer (PMR = 189) and suicide (PMR = 215) were elevated. White male retirees, a subgroup with 5 or more years of service, experienced excess mortality due to cancers of the colon (PMR = 245), skin (PMR = 738), brain (PMR = 556), and lymphosarcomas and reticulosarcomas (PMR = 514). Deaths from external causes (PMR = 135) and cirrhosis of the liver (PMR = 229) were elevated among white males with a last job in landscape maintenance. White males whose last job was highway maintenance experienced a deficit in mortality from circulatory diseases (PMR = 83) and excess mortality from emphysema (PMR = 250) and motor vehicle accidents (PMR = 196). Further epidemiologic and industrial hygiene studies are needed to confirm the apparent excess mortality and to quantify occupational and nonoccupational exposures. However, reduction of recognized hazards among highway maintenance workers is a prudent precautionary measure.

  7. Lower Mortality in Magnet Hospitals (United States)

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.


    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  8. Marital status, health and mortality. (United States)

    Robards, James; Evandrou, Maria; Falkingham, Jane; Vlachantoni, Athina


    Marital status and living arrangements, along with changes in these in mid-life and older ages, have implications for an individual's health and mortality. Literature on health and mortality by marital status has consistently identified that unmarried individuals generally report poorer health and have a higher mortality risk than their married counterparts, with men being particularly affected in this respect. With evidence of increasing changes in partnership and living arrangements in older ages, with rising divorce amongst younger cohorts offsetting the lower risk of widowhood, it is important to consider the implications of such changes for health in later life. Within research which has examined changes in marital status and living arrangements in later life a key distinction has been between work using cross-sectional data and that which has used longitudinal data. In this context, two key debates have been the focus of research; firstly, research pointing to a possible selection of less healthy individuals into singlehood, separation or divorce, while the second debate relates to the extent to which an individual's transitions earlier in the life course in terms of marital status and living arrangements have a differential impact on their health and mortality compared with transitions over shorter time periods. After reviewing the relevant literature, this paper argues that in order to fully account for changes in living arrangements as a determinant of health and mortality transitions, future research will increasingly need to consider a longer perspective and take into account transitions in living arrangements throughout an individual's life course rather than simply focussing at one stage of the life course. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Breastfeeding and the risk for diarrhea morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Victora Cesar


    Full Text Available Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52 and to any breastfeeding among children aged 6-23 months (RR: 2.18. Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.

  10. Climate-induced mortality of spruce stands in Belarus (United States)

    Kharuk, Viacheslav I.; Im, Sergei T.; Dvinskaya, Maria L.; Golukov, Alexei S.; Ranson, Kenneth J.


    The aim of this work is an analysis of the causes of spruce (Picea abies L.) decline and mortality in Belarus. The analysis was based on forest inventory and Landsat satellite (land cover classification, climate variables (air temperature, precipitation, evaporation, vapor pressure deficit, SPEI drought index)), and GRACE-derived soil moisture estimation (equivalent of water thickness anomalies, EWTA). We found a difference in spatial patterns between dead stands and all stands (i.e., before mortality). Dead stands were located preferentially on relief features with higher water stress risk (i.e., higher elevations, steeper slopes, south and southwestern exposure). Spruce mortality followed a series of repeated droughts between 1990 and 2010. Mortality was negatively correlated with air humidity (r = -0.52), and precipitation (r = -0.57), and positively correlated with the prior year vapor pressure deficit (r = 0.47), and drought increase (r = 0.57). Mortality increased with the increase in occurrence of spring frosts (r = 0.5), and decreased with an increase in winter cloud cover (r = -0.37). Spruce mortality was negatively correlated with snow water accumulation (r = -0.81) and previous year anomalies in water soil content (r = -0.8). Weakened by water stress, spruce stands were attacked by pests and phytopathogens. Overall, spruce mortality in Belarussian forests was caused by drought episodes and drought increase in synergy with pest and phytopathogen attacks. Vast Picea abies mortality in Belarus and adjacent areas of Russia and Eastern Europe is a result of low adaptation of that species to increased drought. This indicates the necessity of spruce replacement by drought-tolerant indigenous (e.g., Pinus sylvestris, Querqus robur) or introduced (e.g., Larix sp. or Pseudotsuga menzieslii) species to obtain sustainable forest growth management.

  11. Inhibitor development and mortality in non-severe hemophilia A. (United States)

    Eckhardt, C L; Loomans, J I; van Velzen, A S; Peters, M; Mauser-Bunschoten, E P; Schwaab, R; Mazzucconi, M G; Tagliaferri, A; Siegmund, B; Reitter-Pfoertner, S E; van der Bom, J G; Fijnvandraat, K


    The life expectancy of non-severe hemophilia A (HA) patients equals the life expectancy of the non-hemophilic population. However, data on the effect of inhibitor development on mortality and on hemophilia-related causes of death are scarce. The development of neutralizing factor VIII antibodies in non-severe HA patients may dramatically change their clinical outcome due to severe bleeding complications. We assessed the association between the occurrence of inhibitors and mortality in patients with non-severe HA. In this retrospective cohort study, clinical data and vital status were collected for 2709 non-severe HA patients (107 with inhibitors) who were treated between 1980 and 2011 in 34 European and Australian centers. Mortality rates for patients with and without inhibitors were compared. During 64,200 patient-years of follow-up, 148 patients died (mortality rate, 2.30 per 1000 person-years; 95% confidence interval (CI), 1.96-2.70) at a median age of 64 years (interquartile range [IQR], 49-76). In 62 patients (42%) the cause of death was hemophilia related. Sixteen inhibitor patients died at a median age of 71 years (IQR, 60-81). In ten patients the inhibitor was present at time of death; seven of them died of severe bleeding complications. The all-cause mortality rate in inhibitor patients was > 5 times increased compared with that for those without inhibitors (age-adjusted mortality rate ratio, 5.6). Inhibitor development in non-severe hemophilia is associated with increased mortality. High rates of hemophilia-related mortality in this study indicate that non-severe hemophilia is not mild at all and stress the importance of close follow-up for these patients. © 2015 International Society on Thrombosis and Haemostasis.

  12. eHealth indicators

    DEFF Research Database (Denmark)

    HYPPÖNEN, Hannele; AMMENWERTH, Elske; Nøhr, Christian


    eHealth indicators are needed to measure defined aspects of national eHealth implementations. However, until now, eHealth indicators are ambiguous or unclear. Therefore, an expert workshop "Towards an International Minimum Dataset for Monitoring National Health Information System Implementations......" was organized. The objective was to develop ideas for a minimum eHealth indicator set. The proposed ideas for indicators were classified based on EUnetHTA and De-Lone & McClean, and classification was compared with health IT evaluation criteria classification by Ammenwerth & Keizer. Analysis of the workshop...... results emphasized the need for a common methodological framework for defining and classifying eHealth indicators. It also showed the importance of setting the indicators into context. The results will benefit policy makers, developers and researchers in pursuit of provision and use of evidence...

  13. Mortality during winter smog episodes 1982, 1985, 1987 and 1993 in the Czech Republic. (United States)

    Jelínková, J; Branis, M


    Severe air pollution episodes were recorded during the 1980s and early 1990s in the Czech Republic as a result of widespread combustion of brown coal. A population-based retrospective study investigated the relationship between air pollution and daily mortality in six highly polluted areas of the Czech Republic during smog episodes in 1982, 1985, 1987, and 1993. Total daily mortality, mortality by gender and age, cardiovascular mortality, respiratory mortality, data on weekly incidence of acute respiratory diseases and daily mean concentrations of sulphur dioxide and suspended particulate matter were used in the model. The effects of smog on daily mortality were estimated by multiple linear regression analysis. Significant increases in mortality were observed for the 1982 and 1987 episodes (6% and 9%). In 1982, mortality was significantly associated with mean concentration of sulphur dioxide (SO2) of the current and the preceding days and with the 4-day moving average. In the 1985 episode a significant increase in respiratory mortality in men and in both genders together, lagging by 2 and 3 days, was detected. During the 1987 episode significant associations of total daily mortality, mortality in persons over 65 years of age and mortality from cardiovascular or respiratory diseases with 4-day moving average of both pollutants were found. For the 1993 episode a significant association between mortality in women under 65, lagging by 3 days, and mean concentration of suspended particulate matter (SPM) was observed. Most of the results are consistent with other studies aimed at episodic air pollution during the 1950s and 1960s in Western Europe and the USA, in which outdoor air pollution was shown to be a significant predictor of mortality. However, non-significant or opposite associations between air pollution and mortality indicate that other factors may also play an important role. A stronger effect on men under 65 years of age, suggested by a previous Czech study

  14. Float level indicator

    International Nuclear Information System (INIS)

    Grishchuk, M.Kh.; Laptev, A.G.; Pashkov, V.A.


    Specially developed level indicator is suggested with differential to-transformer converter of the float motion, operating in line with a movable electronic block, intended for indicating the level of the dissociating nitrogen tetroxide liquid phase. On the basis of the indicator elements the device is realized to measure the time of calibrated volume fillino. in by liquid nitrogen tetroxide in steady state operation of the experimental bench-marks [ru

  15. Climate Change Indicators (United States)

    Presents information, charts and graphs showing measured climate changes across 40 indicators related to greenhouse gases, weather and climate, oceans, snow and ice, heath and society, and ecosystems.

  16. VP Ellipsis without Indices

    DEFF Research Database (Denmark)

    Hardt, Daniel; Asher, Nicholas; Hunter, Julie


    This paper compares two views on the status of indices in syntactic and logical representations. On a structural view, indices are syntactic formants on a par with node labels and phrase bracketings, and are thus a part of the logical forms that are derived from syntactic representations. On the ......This paper compares two views on the status of indices in syntactic and logical representations. On a structural view, indices are syntactic formants on a par with node labels and phrase bracketings, and are thus a part of the logical forms that are derived from syntactic representations...

  17. Socioeconomic Status (SES) and Childhood Acute Myeloid Leukemia (AML) Mortality (United States)

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


    Socioeconomic status (SES) is a complex construct of multiple indicators, known to impact cancer outcomes, but has not been adequately examined among pediatric AML patients. This study aimed to identify the patterns of co-occurrence of multiple community-level SES indicators and to explore associations between various patterns of these indicators and pediatric AML mortality risk. A nationally representative US sample of 3,651 pediatric AML patients, aged 0–19 years at diagnosis was drawn from 17 Surveillance, Epidemiology, and End Results (SEER) database registries created between 1973 and 2012. Factor analysis, cluster analysis, stratified univariable and multivariable Cox proportional hazards models were used. Four SES factors accounting for 87% of the variance in SES indicators were identified: F1) economic/educational disadvantage, less immigration; F2) immigration-related features (foreign-born, language-isolation, crowding), less mobility F3) housing instability; and, F4) absence of moving. F1 and F3 showed elevated risk of mortality, adjusted hazards ratios (aHR) (95% CI): 1.07(1.02–1.12) and 1.05(1.00–1.10), respectively. Seven SES-defined cluster groups were identified. Cluster 1: (low economic/educational disadvantage, few immigration-related features, and residential-stability) showed the minimum risk of mortality. Compared to Cluster 1, Cluster 3: (high economic/educational disadvantage, high-mobility) and Cluster 6: (moderately-high economic/educational disadvantages, housing-instability and immigration-related features) exhibited substantially greater risk of mortality, aHR(95% CI) = 1.19(1.0–1.4) and 1.23 (1.1–1.5), respectively. Factors of correlated SES-indicators and their pattern-based groups demonstrated differential risks in the pediatric AML mortality indicating the need of special public-health attention in areas with economic-educational disadvantages, housing-instability and immigration-related features. PMID:27543948

  18. Long-term particulate matter exposure and mortality: a review of European epidemiological studies

    Directory of Open Access Journals (Sweden)

    Boffetta Paolo


    Full Text Available Abstract Background Several studies considered the relation between long-term exposure to particulate matter (PM and total mortality, as well as mortality from cardiovascular and respiratory diseases. Our aim was to provide a comprehensive review of European epidemiological studies on the issue. Methods We searched the Medline database for epidemiological studies on air pollution and health outcomes published between January 2002 and December 2007. We also examined the reference lists of individual papers and reviews. Two independent reviewers classified the studies according to type of air pollutant, duration of exposure and health outcome considered. Among European investigations that examined long-term PM exposure we found 4 cohort studies (considering total and cardiopulmonary mortality, 1 case-control study (considering mortality from myocardial infarction, and 4 ecologic studies (2 studies considering total and cardiopulmonary mortality and 2 studies focused on cardiovascular mortality. Results Measurement indicators of PM exposure used in European studies, including PM10, PM2.5, total suspended particulate and black smoke, were heterogeneous. This notwithstanding, in all analytic studies total mortality was directly associated with long-term exposure to PM. The excesses in mortality were mainly due to cardiovascular and respiratory causes. Three out of 4 ecologic studies found significant direct associations between PM indexes and mortality. Conclusion European studies on long-term exposure to PM indicate a direct association with mortality, particularly from cardiovascular and respiratory diseases.

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

    Directory of Open Access Journals (Sweden)

    Andrew Fenelon


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

  20. Seeking explanations for high levels of infant mortality in Pakistan. (United States)

    Sathar, Z A


    Data from the Fertility Module of the 1979 Population, Labour Force and Migration (PLM) Survey of Pakistan were analyzed to determine which of 4 factors were primarily responsible for the high infant mortality rate. The factors examined were poverty, childbearing and childrearing practices, distribution of health care and lack of individual attention given to children due to ignorance. These items were presented in a discussion format. Infant mortality in Pakistan is high at about 125-140/1000, for a country with mid-level per capita income. Income was not a good indicator of child mortality, primarily because it was difficult to determine, particularly in rural areas where non-cash income predominates. Wealth and status were good indicators of child survival. Child-rearing practices were somewhat important, as judged by birth order, breastfeeding duration and gender. Childbearing practices as shown by spacing were important determinants of survival. Health care facilities were somewhat important, indicated by higher mortality in rural areas. Rural neonates die from tetanus due to lack of immunization, or later from diarrheal disease due to lack of potable water or poor weaning practices. Maternal education was a strong indicator of survival, much more so than paternal education. Similarly, female heads of households increased survival, probably because they control financial allocations. The study suggested that rather than attempting to eliminate poverty overall, improvements in maternal education, nutrition, health care facilities and their use, and childbearing and child-rearing methods would do more to improve child survival in Pakistan.

  1. Improving Emergency Attendance and Mortality – The Case for Unit ...

    African Journals Online (AJOL)

    BACKGROUND: Emergency attendance and mortality which are reliable indicators of quality of care, have been of concern to many health institutions. Different models are being proposed to improve emergency outcomes in different parts of the world. A model to separate a single emergency Unit into multiple emergency ...

  2. Neonatal Morbidity And Mortality In Calabar, Nigeria: A Hospital ...

    African Journals Online (AJOL)

    Background: The morbidity and mortality pattern amongst neonates admitted into the University of Calabar Teaching Hospital were reviewed from 1st June 2003 to 30th November 2004. Results: The major indications for admission for inborn babies were infections (27.4%), jaundice (21%) and low birth weight (LBW) ...

  3. Quality indicators in radiotherapy

    International Nuclear Information System (INIS)

    Cionini, Luca; Gardani, Gianstefano; Gabriele, Pietro; Magri, Secondo; Morosini, Pier Luigi; Rosi, Antonella; Viti, Vincenza


    Background and purpose: There is a widespread and increasing tendency to develop hospital performance indicators in the field of accreditation/certification systems and quality benchmarking. A study has been undertaken to develop a set of performance indicators for a typical radiotherapy Centre and to evaluate their ability to provide a continuous quality improvement. Materials and methods: A working group consisting of radiation oncologists, medical physicists and radiation technologists under the coordination of experts in health technology assessment has elaborated a set of general indicators able to monitor performances and the quality level of a typical radiotherapy Centre. The work has been carried out through four steps: a preliminary set of indicators was selected; data on these indicators were collected in a number of Italian radiotherapy Centres and medical physics Services; problems in collection and analysis of data were discussed; a final set of indicators was developed. Results: A final set of 13 indicators is here presented. They concern general structural and/or operational features, health physics activities and accuracy and technical complexity of the treatment. Conclusions: The indicators tested in a few Italian Centres of radiotherapy and medical physics Services are now ready to be utilized by a larger community

  4. Indicators of sustainable tourism

    Directory of Open Access Journals (Sweden)

    Jovičić Dobrica


    Full Text Available The indicators, precisely describing the linkages between tourism and the environment, social and cultural base, are not easily available. How ever, some relevant organizations (WTO, EU, OECD, etc., institutions and experts, have been hardly working to create the indicators of sustainable tourism. Whereas the economic objectives are easily defined by the use of the traditional indicators used in national and business economics, it is very difficult to identify widely applicable environmental, social and cultural indicators. In order to stimulate and alleviate the process of sustainable tourism development, EU created the list of comparative indicators of sustainable tourism. In preparing this list, special attention is paid to identification of valid indicators of real tourism impacts on the social and cultural environment (the entire set of traditions, customs, history, hospitality and culture that characterize a given area, that is a very complex task. Assuming the fact that the related indicators have been analyzed in many European countries, this paper is focused on applying the related indicators in research of tourism development in villages of the Kosjerić community. .

  5. Key performance indicators

    NARCIS (Netherlands)

    Zwetsloot, G.I.J.M.


    This paper addresses how organisations can use OSH performance indicators. This is an important way to mainstream OSH into business management. Key performance indicators (KPIs) should provide objective data on the OSH situation. It is often said that ‘what gets measured gets managed’. Without

  6. Indicators for environmental sustainability

    DEFF Research Database (Denmark)

    Dong, Yan; Hauschild, Michael Zwicky


    . In this study, we reviewed indicators applied in life cycle assessment (LCA), planetary boundary framework (PB), and Sustainable Development Goals (SDGs) developed under United Nation. The aim is to 1) identify their applications and relevant decision context; 2) Review their indicators and categorize them...

  7. Evaluating Living Standard Indicators

    Directory of Open Access Journals (Sweden)

    Birčiaková Naďa


    Full Text Available This paper deals with the evaluation of selected available indicators of living standards, divided into three groups, namely economic, environmental, and social. We have selected six countries of the European Union for analysis: Bulgaria, the Czech Republic, Hungary, Luxembourg, France, and Great Britain. The aim of this paper is to evaluate indicators measuring living standards and suggest the most important factors which should be included in the final measurement. We have tried to determine what factors influence each indicator and what factors affect living standards. We have chosen regression analysis as our main method. From the study of factors, we can deduce their impact on living standards, and thus the value of indicators of living standards. Indicators with a high degree of reliability include the following factors: size and density of population, health care and spending on education. Emissions of carbon dioxide in the atmosphere also have a certain lower degree of reliability.

  8. Core damage risk indicators

    International Nuclear Information System (INIS)

    Szikszai, T.


    The purpose of this document is to show a method for the fast recalculation of the PSA. To avoid the information loose, it is necessary to simplify the PSA models, or at least reorganize them. The method, introduced in this document, require that preparation, so we try to show, how to do that. This document is an introduction. This is the starting point of the work related to the development of the risk indicators. In the future, with the application of this method, we are going to show an everyday use of the PSA results to produce the indicators of the core damage risk. There are two different indicators of the plant safety performance, related to the core damage risk. The first is the core damage frequency indicator (CDFI), and the second is the core damage probability indicator (CDPI). Of course, we cannot describe all of the possible ways to use these indicators, rather we will try to introduce the requirements to establish such an indicator system and the calculation process

  9. Social isolation and all-cause mortality

    DEFF Research Database (Denmark)

    Laugesen, Kristina; Baggesen, Lisbeth Munksgård; Schmidt, Sigrún Alba Jóhannesdóttir


    and Syme's social network index (SNI), which combines four components of social networks (partnership, interaction with family/friends, religious activities, and membership in organizations/clubs) into an index, ranging from 0/1 (most socially isolated) to 4 (least socially isolated). We estimated.......6% for SNI 0/1 and 3.9% for SNI 4. Adjusted MRRs comparing SNI 0/1 with SNI 4 were 1.7 (95% CI: 1.1-2.6) among men and 1.6 (95% CI: 0.83-2.9) among women. Having no partner was associated with an adjusted MRR of 1.5 (95% CI: 1.2-2.1) for men and 1.7 (95% CI: 1.2-2.4) for women. In conclusion, social......Social isolation is associated with increased mortality. Meta-analytic results, however, indicate heterogeneity in effect sizes. We aimed to provide new evidence to the association between social isolation and mortality by conducting a population-based cohort study. We reconstructed the Berkman...

  10. Mortality of Hanford radiation workers

    International Nuclear Information System (INIS)

    Gilbert, E.S.


    Mortality from all causes for white males employed at Hanford for at least two years is 75 percent of that expected on the basis of US vital statistics. Mortality from cancer is 85 percent of that expected. These results are typical of a working population. Neither death from all causes nor death from all cancer types shows a positive correlation with external radiation exposures. Myeloid leukemia, the disease that several studies have found to be associated most strongly with radiation exposure, is not correlated with external radiation exposure of Hanford workers. Two specific cancers, multiple myeloma and to a lesser extent cancer of the pancreas, were found to be positively correlated with radiation exposure. The correlations identified result entirely from a small number of deaths (3 each for multiple myeloma and cancer of the pancreas) with cumulative exposure greater than 15 rem

  11. Physical Inactivity and Mortality Risk

    Directory of Open Access Journals (Sweden)

    Peter Kokkinos


    Full Text Available In recent years a plethora of epidemiologic evidence accumulated supports a strong, independent and inverse, association between physical activity and the fitness status of an individual and mortality in apparently healthy individuals and diseased populations. These health benefits are realized at relatively low fitness levels and increase with higher physical activity patterns or fitness status in a dose-response fashion. The risk reduction is at least in part attributed to the favorable effect of exercise or physical activity on the cardiovascular risk factors, namely, blood pressure, diabetes mellitus and obesity. In this review, we examine evidence from epidemiologic and interventional studies in support of the association between exercise and physical activity and health. In addition, we present the exercise effects on the aforementioned risk factors. Finally, we include select dietary approaches and their impact on risk factors and overall mortality risk.

  12. Safety performance indicators program

    International Nuclear Information System (INIS)

    Vidal, Patricia G.


    In 1997 the Nuclear Regulatory Authority (ARN) initiated a program to define and implement a Safety Performance Indicators System for the two operating nuclear power plants, Atucha I and Embalse. The objective of the program was to incorporate a set of safety performance indicators to be used as a new regulatory tool providing an additional view of the operational performance of the nuclear power plants, improving the ability to detect degradation on safety related areas. A set of twenty-four safety performance indicators was developed and improved throughout pilot implementation initiated in July 1998. This paper summarises the program development, the main criteria applied in each stage and the results obtained. (author)

  13. Population growth and infant mortality


    Fabella, Christina


    The relationship between population growth and economic outcomes is an issue of great policy significance. In the era of the Millennium Development Goals, poverty and its correlates have become the compelling issues. Economic growth may not automatically translate into reductions in poverty and its correlates (may not trickle down) if income distribution is at the same time worsening. We therefore investigate the direct effect of population growth on infant mortality for various income catego...

  14. Mortality of nitrate fertiliser workers. (United States)

    Al-Dabbagh, S; Forman, D; Bryson, D; Stratton, I; Doll, R


    An epidemiological cohort study was conducted to investigate the mortality patterns among a group of workers engaged in the production of nitrate based fertilisers. This study was designed to test the hypothesis that individuals exposed to high concentrations of nitrates might be at increased risk of developing cancers, particularly gastric cancer. A total of 1327 male workers who had been employed in the production of fertilisers between 1946 and 1981 and who had been occupationally exposed to nitrates for at least one year were followed up until 1 March 1981. In total, 304 deaths were observed in this group and these were compared with expected numbers calculated from mortality rates in the northern region of England, where the factory was located. Analysis was also carried out separately for a subgroup of the cohort who had been heavily exposed to nitrates--that is, working in an environment likely to contain more than 10 mg nitrate/m3 for a year or longer. In neither the entire cohort nor the subgroup was any significant excess observed for all causes of mortality or for mortality from any of five broad categories of cause or from four specific types of cancer. A small excess of lung cancer was noted more than 20 years after first exposure in men heavily exposed for more than 10 years. That men were exposed to high concentrations of nitrate was confirmed by comparing concentrations of nitrates in the saliva of a sample of currently employed men with control men, employed at the same factory but not in fertiliser production. The men exposed to nitrate had substantially raised concentrations of nitrate in their saliva compared with both controls within the industry and with men in the general population and resident nearby. The results of this study therefore weight against the idea that exposure to nitrates in the environment leads to the formation in vivo of material amounts of carcinogens. PMID:3015194

  15. Macroeconomic Conditions, Health and Mortality


    Christopher J. Ruhm


    Although health is conventionally believed to deteriorate during macroeconomic downturns, the empirical evidence supporting this view is quite weak and comes from studies containing methodological shortcomings that are difficult to remedy. Recent research that better controls for many sources of omitted variables bias instead suggests that mortality decreases and physical health improves when the economy temporarily weakens. This partially reflects reductions in external sources of death, suc...

  16. Fifty consecutive pancreatectomies without mortality

    Directory of Open Access Journals (Sweden)

    Enio Campos Amico

    Full Text Available Objective: to report the group's experience with a series of patients undergoing pancreatic resection presenting null mortality rates. Methods: we prospectively studied 50 consecutive patients undergoing pancreatic resections for peri-ampullary or pancreatic diseases. Main local complications were defined according to international criteria. In-hospital mortality was defined as death occurring in the first 90 postoperative days. Results: patients' age ranged between 16 and 90 years (average: 53.3. We found anemia (Hb < 12g/dl and preoperative jaundice in 38% and 40% of cases, respectively. Most patients presented with peri-ampullary tumors (66%. The most common surgical procedure was the Kausch - Whipple operation (70%. Six patients (12% needed to undergo resection of a segment of the mesenteric-portal axis. The mean operative time was 445.1 minutes. Twenty two patients (44% showed no clinical complications and presented mean hospital stay of 10.3 days. The most frequent complications were pancreatic fistula (56%, delayed gastric emptying (17.1% and bleeding (16%. Conclusion : within the last three decades, pancreatic resection is still considered a challenge, especially outside large specialized centers. Nevertheless, even in our country (Brazil, teams seasoned in such procedure can reach low mortality rates.

  17. Solar Indices - Solar Flares (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  18. NOHSS Child Indicators (United States)

    U.S. Department of Health & Human Services — Data for School year-end 1994 through year-end 2016. State oral health surveys are the data sources for these indicators. States periodically conduct independent...

  19. NOHSS Adult Indicators (United States)

    U.S. Department of Health & Human Services — 2012-2014 (even years). Data from BRFSS for indicators of adult oral health for even years from 2012 through 2014. National estimates are represented by the median...

  20. Environmental indicators for buildings

    DEFF Research Database (Denmark)

    Dammann, Sven

    Environmental Indicators for Buildings are studied using two different perspectives: with a technological, environmental scientific departing point and with a social scientific departing point. Different relevant groups in the building sector are identified and analysed, using the Social...

  1. Solar Indices - Sunspot Numbers (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  2. Solar Indices Bulletin (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Solar Indices Bulletin is a prompt monthly information product that is distributed within two weeks after the observation month closes. For the month just ended,...

  3. Indicators and SEA

    DEFF Research Database (Denmark)

    Gao, Jingjing; Kørnøv, Lone; Christensen, Per

    Abstract: Indicators are widely used in SEA to measure, communicate and monitor impacts from a proposed policy, plan or programme, and can improve the effectiveness for the SEA by simplifying the complexity of both assessment and presentation. Indicators can be seen as part of the implementation...... and if the information requirement for different target groups is not addressed. Indicators are widely used in SEA to measure, communicate and monitor impacts from a proposed policy, plan or programme, and can improve the effectiveness for the SEA by simplifying the complexity of both assessment and presentation...... process helping to understand, communicate and, integrate important environmental issues in planning and decision-making. On the other hand, use of indicators can also limit SEA effectiveness, if the ones chosen are biased or limited, if the aggregation gives incorrect interpretation...

  4. Fishery Performance Indicators (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Performance indicators for landings, effort, revenue and distribution of revenue are collected for various fisheries nation-wide. The fisheries include catch and...

  5. Indicators: Sediment Enzymes (United States)

    Sediment enzymes are proteins that are produced by microorganisms living in the sediment or soil. They are indicators of key ecosystem processes and can help determine which nutrients are affecting the biological community of a waterbody.

  6. Solar Indices - Plage Regions (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  7. Solar Indices - Solar Ultraviolet (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  8. Solar Indices - Solar Corona (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  9. Solar Indices - Solar Irradiance (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  10. NOHSS Child Indicators (United States)

    U.S. Department of Health & Human Services — Data for School year-end 1994 through year-end 2017. State oral health surveys are the data sources for these indicators. States periodically conduct independent...

  11. Indicators of Ecological Change (United States)


    H. 1990. Strategy for monitoring the effects of land use change on atmospheric CO2 concentrations . In Proceedings of “Global Natural Resource...Working Group in Santiago , Chile , February 1995, ten nations agreed to a comprehensive set of criteria and indicators for forest conservation and...chemistry variables, the concentrations of total and inorganic suspended sediments during baseflow and storm periods were excellent indicators of

  12. Widening Geographical Disparities in Cardiovascular Disease Mortality in the United States, 1969-2011

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD


    Full Text Available Objectives: This study examined trends in geographical disparities in cardiovascular-disease (CVD mortality in the United States between 1969 and 2011. Methods: National vital statistics data and the National Longitudinal Mortality Study were used to estimate regional, state, and county-level disparities in CVD mortality over time. Log-linear, weighted least squares, and Cox regression were used to analyze mortality trends and differentials. Results: During 1969-2011, CVD mortality rates declined fastest in New England and Mid-Atlantic regions and slowest in the Southeast and Southwestern regions. In 1969, the mortality rate was 9% higher in the Southeast than in New England, but the differential increased to 48% in 2011. In 2011, Southeastern states, Mississippi and Alabama, had the highest CVD mortality rates, nearly twice the rates for Minnesota and Hawaii. Controlling for individual-level covariates reduced state differentials. State- and county-level differentials in CVD mortality rates widened over time as geographical disparity in CVD mortality increased by 50% between 1969 and 2011. Area deprivation, smoking, obesity, physical inactivity, diabetes prevalence, urbanization, lack of health insurance, and lower access to primary medical care were all significant predictors of county-level CVD mortality rates and accounted for 52.7% of the county variance. Conclusions and Global Health Implications: Although CVD mortality has declined for all geographical areas in the United States, geographical disparity has widened over time as certain regions and states, particularly those in the South, have lagged behind in mortality reduction. Geographical disparities in CVD mortality reflect inequalities in socioeconomic conditions and behavioral risk factors. With the global CVD burden on the rise, monitoring geographical disparities, particularly in low- and middle-income countries, could indicate the extent to which reductions in CVD mortality are

  13. The Effect of Cardiorespiratory Fitness and Obesity on Cancer Mortality in Women and Men. (United States)

    Evenson, Kelly R.; Stevens, June; Cai, Jianwen; Thomas, Ratna; Thomas, Olivia


    Investigated the independent and combined effects of cardiorespiratory fitness and obesity on all-cause cancer mortality for women and men. Data from the Lipids Research Clinics Prevalence Study indicated that higher fitness level was a stronger predictor of reduced cancer mortality among men, while high body mass index was a stronger predictor of…

  14. All-cause mortality among young children in western Kenya. VI: the Asembo Bay Cohort Project

    NARCIS (Netherlands)

    McElroy, P. D.; ter Kuile, F. O.; Hightower, A. W.; Hawley, W. A.; Phillips-Howard, P. A.; Oloo, A. J.; Lal, A. A.; Nahlen, B. L.


    Although all-cause mortality has been used as an indicator of the health status of childhood populations, such data are sparse for most rural areas of sub-Saharan Africa, particularly community-based estimates of infant mortality rates. The longitudinal follow-up of more than 1,500 children enrolled

  15. CDC WONDER: Mortality - Underlying Cause of Death (United States)

    U.S. Department of Health & Human Services — The CDC WONDER Mortality - Underlying Cause of Death online database is a county-level national mortality and population database spanning the years since 1979. Data...

  16. CDC WONDER: Mortality - Multiple Cause of Death (United States)

    U.S. Department of Health & Human Services — The Mortality - Multiple Cause of Death data on CDC WONDER are county-level national mortality and population data spanning the years 1999-2009. Data are based on...


    African Journals Online (AJOL)

    Dr Oboro VO

    AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY MAY 2011 ... RESULTS: Nine cases of diphtheria were seen and three mortalities were recorded giving a mortality rate ... tissue edema and airway obstruction by the.

  18. Infant Mortality and Asians and Pacific Islanders (United States)

    ... infant mortality rates than the overall population, however statistics for Asian American subgroups are very limited for ... 1 0.4 Source: CDC 2015. Infant Mortality Statistics from the 2013 Period Linked Birth/Infant Death ...

  19. CDC WONDER: Mortality - Multiple Cause of Death (United States)

    U.S. Department of Health & Human Services — The Mortality - Multiple Cause of Death data on CDC WONDER are county-level national mortality and population data spanning the years 1999-2006. These data are...

  20. Continuing study of mortality in Hanford workers

    International Nuclear Information System (INIS)

    Marks, S.; Gilbert, E.S.


    The mortality of workers at the Hanford Plant in southeastern Washington who have been exposed to penetrating external ionizing radiation is studied. Deaths are analyzed statistically and compared to standardized mortality ratios. Cancer deaths in particular are examined

  1. Global Volcano Mortality Risks and Distribution (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...

  2. Mortality rates in people with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Rachael Williams


    National English data confirm that patients with ID have higher mortality rates than those without. Mortality rates for patients with ID were higher across all age/sex groups and causes, with almost half of deaths classified as avoidable.

  3. Computational Intelligence. Mortality Models for the Actuary

    NARCIS (Netherlands)

    Willemse, W.J.


    This thesis applies computational intelligence to the field of actuarial (insurance) science. In particular, this thesis deals with life insurance where mortality modelling is important. Actuaries use ancient models (mortality laws) from the nineteenth century, for example Gompertz' and Makeham's

  4. Global Drought Mortality Risks and Distribution (United States)

    National Aeronautics and Space Administration — Global Drought Mortality Risks and Distribution is a 2.5 minute grid of global drought mortality risks. Gridded Population of the World, Version 3 (GPWv3) data...

  5. Air quality indicators

    International Nuclear Information System (INIS)

    Clench-Aas, Jocelyn; Guerreiro, Cristina; Bartonova, Alena


    This report proposes and describes in detail several air quality indicators that may be used to describe population exposure. The suggested indicators account for temporal and spatial patterns of pollution and movements of individuals between different micro-environments. The Air Quality Indicator /AQI) should represent both the spatial and temporal aspects of pollution exposure that may have important effects on health. Two indicators are needed, the Population Air Quality Indicator and the Individual Air Quality Indicator. Mean concentrations, 98th percentile and maximum values are the traditional indicators for estimating exposure. the temporal variability of PM-10 and NO 2 , however, is here described by means of: 1) The rate of change of pollution as the difference between two consecutive hourly values and of 2) episodes, described in terms of number, duration and winter episode period, maximum concentration in the episode and integrated episode exposure (episode AOT50/100). The spatial variation of AQIs can be described in several ways, e.g.: 1) Concentrations in neighbouring grid squares can be compared as an indication of spatial variation and 2) point estimates can be compared to grid values for a description of variation within a grid. Both methods are presented here. A test of the representativity of static point estimates for pollution exposure is to compare them to an estimate of air pollution exposure accounting for movements between different locations, obtained using diaries. The ultimate aim of AQIs is to describe the population exposure to ambient pollution. This is done by estimating the number of people exposed using different characteristics of AQIs. The data used to describe these indicators originates from dispersion modelling of short-term air pollution concentrations in Oslo. Two series of data are used. One represents hour-for hour concentrations in the 1 km 2 grid system covering the city of Oslo, winter 1994/95, calculated by the grid

  6. [Mortality after the Second World War]. (United States)

    Valkovics, E


    Mortality trends in Hungary since the Second World War are analyzed. Two periods are distinguished; the first, from 1946 to 1966, was a period of declining mortality and increasing life expectancy, and the second, from 1966 until the present, a period of rising mortality and declining life expectancy, particularly for males, coupled with relatively stable mortality levels for females. The author analyzes differences in causes of death by age in these two periods. (ANNOTATION)

  7. Mortality of male members of the Danish semiskilled workers' union. Standardization by county

    DEFF Research Database (Denmark)

    Jeune, B


    The mortality of male members of the Danish Semiskilled Workers' Union in 1973 has been analysed in an earlier publication. The aim of the present study was to see if previously indicated trends are being maintained after standardizing mortality rates by county for the period 1973-75. Although...... regional variations are seen, standardization by county produces only slight differences in age and cause-specific standardized mortality ratios. Earlier members of the Semiskilled Workers' Union, especially in younger age groups, are confirmed. Low mortality in older age groups, which show a deficit...... of deaths from circulatory diseases and other chronic illnesses, suggests the possibility of a survival population effect....

  8. Anxiety Predicts Mortality in ICD Patients

    DEFF Research Database (Denmark)

    Kikkenborg Berg, Selina; Caspar Thygesen, Lau; Hastrup Svendsen, Jesper


    BACKGROUND: Although highly effective in preventing arrhythmic death, patients receiving an implantable cardioverter defibrillator (ICD) may still experience psychological difficulties such as anxiety, depression, and reduced quality of life. The objectives of this study were to describe patient...... receiving ICD between January 1, 2011 and June 30, 2011 (n = 499). The following instruments were used: SF-36, Hospital Anxiety and Depression Scale, HeartQoL, EQ-5D, and the Multidimensional Fatigue Inventory. RESULTS: The response rate was 72%. Mean age was 65.5 years and 82% patients were males. Fifty...... of perceived health, quality of life, and fatigue; for example, physical health 39.8 versus 44.3 points, compared to secondary prevention indication. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality, anxiety being the strongest with an adjusted odds ratio of 4...

  9. Impact of the Grameen Bank on childhood mortality in Bangladesh. (United States)

    Rahman, M; Davanzo, J; Sutradhar, S C


    The Grameen Bank (GB) is a highly innovative and well-supervised credit program for the rural poor in Bangladesh. About 95% of over 2 million participants are women. GB can positively affect child survival among its participants through its income-generation and consciousness-raising activities. The study examines if GB influences childhood mortality among its participants. An integrated family life survey was carried out during 1993-94 among about 2500 married women in landless households who are eligible for membership in GB. The survey was carried out among randomly selected married women regardless of GB membership in 3 thanas of Tangail district and 1 thana of Mymensingh district. The study permits an analysis in a "before-after" and "treatment-comparison" framework for measuring the impact of GB on childhood mortality. Estimation was done through proportional hazards models, where the effects of confounding factors like calendar year, maternal age, parity, maternal education, economic conditions, and areal variation were controlled for. There was a 34% and significant reduction in childhood (under-5) mortality after the mothers joined the GB. Similar effects of other NGOs on childhood mortality were also observed. Childhood mortality was similar between the GB members before joining the Bank and never-members, indicating that the GB members were not from a selective group. Childhood mortality was 21% and significantly lower among women who worked for income generation than those women who did not work. Income generation and social development programs modeled after the GB and other NGOs can reduce childhood mortality in Bangladesh and similar settings.

  10. Cardiovascular morbidity and mortality risk factors in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Jovanović Dijana B.


    Full Text Available Cardiovascular (CVS morbidity and mortality in the endstage renal disease (ESRD patients on peritoneal dialysis therapy is 10-30 folds higher than in general population. The prevalence of well known traditional risk factors such as age, sex, race, arterial hypertension, hyperlipidaemia, diabetes, smoking, physical inactivity is higher in the uraemic patients. Besides these, there are specific, nontraditional risk factors for dialysis patients. Mild inflammation present in peritoneal dialysis (PD patients which can be confirmed by specific inflammatory markers is the cause of CVS morbidity and mortality in these patients. Hypoalbuminaemia, hyperhomocysteinaemia and a higher level of leptin are important predictors of vascular complications as well as CVS events in the PD patients. Plasma norepinephrine, an indicator of sympathetic activity, is high in the ESRD patients and higher in the PD patients than in the patients on haemodialysis (HD. Therefore, norepinephrine may be a stronger risk factor in the PD patients. The same applies to asymmetric dimethylargine (ADMA, an endogenous inhibitor of nitric oxide synthase, which is an important risk factor of CVS morbidity and mortality 15 % higher in the PD than the HD patients. Hyperphosphataemia, secondary hyperparathyroidism and high calcium x phosphate product have been associated with the progression of the coronary artery calcification and valvular calcifications and predict all-cause CVS mortality in the PD patients. Residual renal function (RRF declines with time on dialysis but is slower in the PD than the HD patients. RRF decline is associated with the rise of proinflammatory cytokines and the onset of hypervolaemia and hypertension which increase the risk of CVS diseases, mortality in general and CVS mortality. In conclusion, it is very important to establish all CVS risk factors in the PD patients to prevent CVS diseases and CVS mortality in this population.

  11. Functional status and mortality prediction in community-acquired pneumonia. (United States)

    Jeon, Kyeongman; Yoo, Hongseok; Jeong, Byeong-Ho; Park, Hye Yun; Koh, Won-Jung; Suh, Gee Young; Guallar, Eliseo


    Poor functional status (FS) has been suggested as a poor prognostic factor in both pneumonia and severe pneumonia in elderly patients. However, it is still unclear whether FS is associated with outcomes and improves survival prediction in community-acquired pneumonia (CAP) in the general population. Data on hospitalized patients with CAP and FS, assessed by the Eastern Cooperative Oncology Group (ECOG) scale were prospectively collected between January 2008 and December 2012. The independent association of FS with 30-day mortality in CAP patients was evaluated using multivariable logistic regression. Improvement in mortality prediction when FS was added to the CRB-65 (confusion, respiratory rate, blood pressure and age 65) score was evaluated for discrimination, reclassification and calibration. The 30-day mortality of study participants (n = 1526) was 10%. Mortality significantly increased with higher ECOG score (P for trend <0.001). In multivariable analysis, ECOG ≥3 was strongly associated with 30-day mortality (adjusted OR: 5.70; 95% CI: 3.82-8.50). Adding ECOG ≥3 significantly improved the discriminatory power of CRB-65. Reclassification indices also confirmed the improvement in discrimination ability when FS was combined with the CRB-65, with a categorized net reclassification index (NRI) of 0.561 (0.437-0.686), a continuous NRI of 0.858 (0.696-1.019) and a relative integrated discrimination improvement in the discrimination slope of 139.8 % (110.8-154.6). FS predicted 30-day mortality and improved discrimination and reclassification in consecutive CAP patients. Assessment of premorbid FS should be considered in mortality prediction in patients with CAP. © 2017 Asian Pacific Society of Respirology.

  12. Mortality and Clostridium difficile infection in an Australian setting. (United States)

    Mitchell, Brett G; Gardner, Anne; Hiller, Janet E


    To quantify the risk of death associated with Clostridium difficile infection, in an Australian tertiary hospital. Two reviews examining Clostridium difficile infection and mortality indicate that Clostridium difficile infection is associated with increased mortality in hospitalized patients. Studies investigating the mortality of Clostridium difficile infection in settings outside of Europe and North America are required, so that the epidemiology of Clostridium difficile infection in these regions can be understood and appropriate prevention strategies made. An observational non-concurrent cohort study design was used. Data from all persons who had (exposed) and a matched sample of persons who did not have Clostridium difficile infection, for the calendar years 2007-2010, were analysed. The risk of dying within 30, 60, 90 and 180 days was compared using the two groups. Kaplan-Meier survival analysis and conditional logistic regression models were applied to the data to examine time to death and mortality risk adjusted for comorbidities using the Charlson Comorbidity Index. One hundred and fifty-eight cases of infection were identified. A statistically significant difference in all-cause mortality was identified between exposed and non-exposed groups at 60 and 180 days. In a conditional regression model, mortality in the exposed group was significantly higher at 180 days. In this Australian study, Clostridium difficile infection was associated with increased mortality. In doing so, it highlights the need for nurses to immediately instigate contact precautions for persons suspected of having Clostridium difficile infection and to facilitate a timely faecal collection for testing. Our findings support ongoing surveillance of Clostridium difficile infection and associated prevention and control activities. © 2013 Blackwell Publishing Ltd.

  13. The remarkable geographical pattern of gastric cancer mortality in Ecuador. (United States)

    Montero-Oleas, Nadia; Núñez-González, Solange; Simancas-Racines, Daniel


    This study was aimed to describe the gastric cancer mortality trend, and to analyze the spatial distribution of gastric cancer mortality in Ecuador, between 2004 and 2015. Data were collected from the National Institute of Statistics and Census (INEC) database. Crude gastric cancer mortality rates, standardized mortality ratios (SMRs) and indirect standardized mortality rates (ISMRs) were calculated per 100,000 persons. For time trend analysis, joinpoint regression was used. The annual percentage rate change (APC) and the average annual percent change (AAPC) was computed for each province. Spatial age-adjusted analysis was used to detect high risk clusters of gastric cancer mortality, from 2010 to 2015, using Kulldorff spatial scan statistics. In Ecuador, between 2004 and 2015, gastric cancer caused a total of 19,115 deaths: 10,679 in men and 8436 in women. When crude rates were analyzed, a significant decline was detected (AAPC: -1.8%; p<0.001). ISMR also decreased, but this change was not statistically significant (APC: -0.53%; p=0.36). From 2004 to 2007 and from 2008 to 2011 the province with the highest ISMR was Carchi; and, from 2012 to 2015, was Cotopaxi. The most likely high occurrence cluster included Bolívar, Los Ríos, Chimborazo, Tungurahua, and Cotopaxi provinces, with a relative risk of 1.34 (p<0.001). There is a substantial geographic variation in gastric cancer mortality rates among Ecuadorian provinces. The spatial analysis indicates the presence of high occurrence clusters throughout the Andes Mountains. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Education and Mortality in the Rome Longitudinal Study. (United States)

    Cacciani, Laura; Bargagli, Anna Maria; Cesaroni, Giulia; Forastiere, Francesco; Agabiti, Nera; Davoli, Marina


    A large body of evidence supports an inverse association between socioeconomic status and mortality. We analysed data from a large cohort of residents in Rome followed-up between 2001 and 2012 to assess the relationship between individual education and mortality. We distinguished five causes of death and investigated the role of age, gender, and birthplace. From the Municipal Register we enrolled residents of Rome on October 21st 2001 and collected information on educational level attained from the 2001 Census. We selected Italian citizens aged 30-74 years and followed-up their vital status until 2012 (n = 1,283,767), identifying the cause of death from the Regional Mortality Registry. We calculated hazard ratios (HRs) for overall and cause-specific mortality in relation to education. We used age, gender, and birthplace for adjusted or stratified analyses. We used the inverse probability weighting approach to account for right censoring due to emigration. We observed an inverse association between education (none vs. post-secondary+ level) and overall mortality (HRs(95%CIs): 2.1(1.98-2.17), males; 1.5(1.46-1.59), females) varying according to demographic characteristics. Cause-specific analysis also indicated an inverse association with education, in particular for respiratory, digestive or circulatory system related-mortality, and the youngest people seemed to be more vulnerable to low education. Our results confirm the inverse association between education and overall or cause-specific mortality and show differentials particularly marked among young people compared to the elderly. The findings provide further evidence from the Mediterranean area, and may contribute to national and cross-country comparisons in Europe to understand the mechanisms generating socioeconomic differentials especially during the current recession period.

  15. Indicators for energy security

    International Nuclear Information System (INIS)

    Kruyt, Bert; Van Vuuren, D.P.; De Vries, H.J.M.; Groenenberg, H.


    The concept of energy security is widely used, yet there is no consensus on its precise interpretation. In this research, we have provided an overview of available indicators for long-term security of supply (SOS). We distinguished four dimensions of energy security that relate to the availability, accessibility, affordability and acceptability of energy and classified indicators for energy security according to this taxonomy. There is no one ideal indicator, as the notion of energy security is highly context dependent. Rather, applying multiple indicators leads to a broader understanding. Incorporating these indicators in model-based scenario analysis showed accelerated depletion of currently known fossil resources due to increasing global demand. Coupled with increasing spatial discrepancy between consumption and production, international trade in energy carriers is projected to have increased by 142% in 2050 compared to 2008. Oil production is projected to become increasingly concentrated in a few countries up to 2030, after which production from other regions diversifies the market. Under stringent climate policies, this diversification may not occur due to reduced demand for oil. Possible benefits of climate policy include increased fuel diversity and slower depletion of fossil resources. (author)

  16. CREDIT Performance Indicator Framework

    DEFF Research Database (Denmark)

    Frandsen, Anne Kathrine; Bertelsen, Niels Haldor; Haugbølle, Kim


    During the past two years the Nordic Baltic research project CREDIT (Construction and Real Estate – Developing Indicators for Transparency) has worked with the aim to improve transparency of value creation in building and real estate. One of the central deliverables of the CREDIT project was a fr......During the past two years the Nordic Baltic research project CREDIT (Construction and Real Estate – Developing Indicators for Transparency) has worked with the aim to improve transparency of value creation in building and real estate. One of the central deliverables of the CREDIT project...... was a framework of indicators relevant in building and real estate and applicable in the Nordic and Baltic countries as well as a proposal for a set of key indicators. The study resulting in CREDIT Performance Indicator Framework has been based on 28 case studies of evaluation practises in the building and real...... estate sector each addressing three interlinked levels: building/ projects level, company or enterprise level and benchmarking system level. Additionally it has been based on dialogue with researchers and professional organisation, international research and standardisation work and national building...


    Five U.S. states share the northern coast of the Gulf, and each has a program to monitor mortalities of aquatic organisms (fish, shellfish, birds). However, each state has different standards, procedures, and documentation of mortality events. The Gulf of Mexico Aquatic Mortality...

  18. Rise in maternal mortality in the Netherlands

    NARCIS (Netherlands)

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


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

  19. Plaice egg mortality: can we determine survivorschip?

    NARCIS (Netherlands)

    Dickey-Collas, M.; Fox, C.J.; Nash, R.D.M.; O'Brien, C.M.


    The daily mortality rate of cohorts of plaice eggs in the Irish Sea is estimated throughout the spawning season in 1995 and 2000, using general additive models of egg production. Daily mortality (z) was found to vary between 0.15 and 0.29. Mortality rates declined through the season in 1995 but not

  20. Continuing increase in mesothelioma mortality in Britain. (United States)

    Peto, J; Hodgson, J T; Matthews, F E; Jones, J R


    Mesothelioma is closely related to exposure to asbestos, and mesothelioma mortality can be taken as an index of past exposure to asbestos in the population. We analysed mesothelioma mortality since 1968 to assess the current state of the mesothelioma epidemic, and to predict its future course. We found that rates of mesothelioma in men formed a clear pattern defined by age and date of birth. Rates rose steeply with age showing a very similar pattern in all five-year birth cohorts. By date of birth, rates increased from mid-1893 to mid-1948, and then fell. Relative to the 1943-48 cohort, the risk for the 1948-53 cohort is 0.79 and for the 1953-58 cohort 0.48. Despite these falls, if the age profile of rates for these cohorts follows the pattern of past cohorts, their predicted lifetime mesothelioma risks will be 1.3%, 1.0%, and 0.6%. Combining projections for all cohorts results in a peak of annual male mesothelioma deaths in about the year 2020 of between 2700 and 3300 deaths. If diagnostic trend is responsible for a 20% growth in recorded cases every 5 years--an extreme but arguable case--and if this trend has now ceased, the peak of annual male deaths will be reduced to 1300, reached around the year 2010. Analysis of occupations recorded on death certificates indicate that building workers, especially plumbers and gas fitters, carpenters and electricians are the largest high-risk group. These data indicate that mesothelioma deaths will continue to increase for at least 15 and more likely 25 years. For the worst affected cohorts--men born in the 1940s--mesothelioma may account for around 1% of all deaths. Asbestos exposure at work in construction and building maintenance will account for a large proportion of these deaths, and it is important that such workers should be aware of the risks and take appropriate precautions.

  1. [Socioeconomic inequalities and infant mortality in Bolivia]. (United States)

    Maydana, Edgar; Serral, Gemma; Borrell, Carme


    To evaluate socioeconomic inequalities and its relation to infant mortality in Bolivia's municipalities in 2001. An ecological study based on data from the 2001 National Census on Population and Housing (Censo Nacional de Población y Vivienda) covering the 327 municipalities in Bolivia's nine departments. The dependent variable was the infant mortality rate (IMR); the independent variables were indirect socioeconomic indicators (the percentage of illiterates older than 15 years of age, and the building materials and sanitation features of the houses). The geographic distribution of each indicator was determined and the associations between IMR and each socioeconomic indicator were calculate using Spearman's rank correlation coefficient and adjusted with Poisson regression models. The resulting IMR for Bolivia in 2001 was 67 per 1000 live births. Rates ranged from <0.1 per 1000 live births in the Magdalena municipality, Beni department, to 170.0 per 1000 live births in the Caripuyo municipality, Potosí department. The mean rate of illiteracy per municipality was 17.5%; the mean percentage of houses without running water was 90.4%, and for those lacking sanitation services, 67.6%. The IMR was inversely associated with all of the socioeconomic indicators studied. The highest relative risk was found in housing without sanitation services. Multifactorial models adjusted for illiteracy showed that the following indicators were still strongly associated with the IMR: no sanitation services (Relative risk (RR)=1.54; 95% Confidence Interval (95%CI)=1.38-1.66); adobe, stone, or mud walls (RR=1.54; 95%CI: 1.43-1.67); and, corrugated metal, straw, or palm branch roof (RR=1.34; 95%CI: 1.26-1.43). A significant association was found between poor socioeconomic status and high IMR in Bolivia's municipalities in 2001. The municipalities in the country's central and southeastern areas had lower socioeconomic status and higher IMR. The lack of education, absence of basic sanitation

  2. Publication point indicators

    DEFF Research Database (Denmark)

    Elleby, Anita; Ingwersen, Peter


    ; the Cumulated Publication Point Indicator (CPPI), which graphically illustrates the cumulated gain of obtained vs. ideal points, both seen as vectors; and the normalized Cumulated Publication Point Index (nCPPI) that represents the cumulated gain of publication success as index values, either graphically......The paper presents comparative analyses of two publication point systems, The Norwegian and the in-house system from the interdisciplinary Danish Institute of International Studies (DIIS), used as case in the study for publications published 2006, and compares central citation-based indicators...... with novel publication point indicators (PPIs) that are formalized and exemplified. Two diachronic citation windows are applied: 2006-07 and 2006-08. Web of Science (WoS) as well as Google Scholar (GS) are applied to observe the cite delay and citedness for the different document types published by DIIS...

  3. Minimum risk trigger indices

    International Nuclear Information System (INIS)

    Tingey, F.H.


    A viable safeguards system includes among other things the development and use of indices which trigger various courses of action. The usual limit of error calculation provides such an index. The classical approach is one of constructing tests which, under certain assumptions, make the likelihood of a false alarm small. Of concern also is the test's failure to indicate a loss (diversion) when in fact one has occurred. Since false alarms are usually costly and losses both costly and of extreme strategic sinificance, there remains the task of balancing the probability of false alarm and its consequences against the probability of undetected loss and its consequences. The application of other than classical hypothesis testing procedures are considered in this paper. Using various consequence models, trigger indices are derived which have certain optimum properties. Application of the techniques would enhance the material control function

  4. Patterns and Drivers of Tree Mortality in Iberian Forests: Climatic Effects Are Modified by Competition (United States)

    Ruiz-Benito, Paloma; Lines, Emily R.; Gómez-Aparicio, Lorena; Zavala, Miguel A.; Coomes, David A.


    Tree mortality is a key process underlying forest dynamics and community assembly. Understanding how tree mortality is driven by simultaneous drivers is needed to evaluate potential effects of climate change on forest composition. Using repeat-measure information from c. 400,000 trees from the Spanish Forest Inventory, we quantified the relative importance of tree size, competition, climate and edaphic conditions on tree mortality of 11 species, and explored the combined effect of climate and competition. Tree mortality was affected by all of these multiple drivers, especially tree size and asymmetric competition, and strong interactions between climate and competition were found. All species showed L-shaped mortality patterns (i.e. showed decreasing mortality with tree size), but pines were more sensitive to asymmetric competition than broadleaved species. Among climatic variables, the negative effect of temperature on tree mortality was much larger than the effect of precipitation. Moreover, the effect of climate (mean annual temperature and annual precipitation) on tree mortality was aggravated at high competition levels for all species, but especially for broadleaved species. The significant interaction between climate and competition on tree mortality indicated that global change in Mediterranean regions, causing hotter and drier conditions and denser stands, could lead to profound effects on forest structure and composition. Therefore, to evaluate the potential effects of climatic change on tree mortality, forest structure must be considered, since two systems of similar composition but different structure could radically differ in their response to climatic conditions. PMID:23451096

  5. Role of Crassicauda sp. in natural mortality of pantropical spotted dolphins Stenella attenuata: a reassessment. (United States)

    Balbuena, Juan Antonio; Simpkin, Andrew


    Evaluating the effect of parasites on population size is essential for designing management and conservation plans of wild animal populations. Although knowledge in this area is scarce in cetaceans, current evidence suggests that species of the nematode genus Crassicauda may play an important regulatory role in some populations. In the present study, a semiparametric regression technique was applied to a previously published dataset to re-examine the role of Crassicauda sp. in natural mortality of pantropical spotted dolphins Stenella attenuata. The resulting model indicated parasite-induced mortality at ages between 6.5 and 9 yr and at roughly 12 yr. The maximum mortality estimates obtained could represent 2 to 4% of natural mortality in dolphins 6 to 8 yr old. This estimate is substantially smaller than previously published values, but in contrast with previous research, our model provides clear statistical evidence for parasite-induced mortality because the bootstrapped 95% confidence intervals of the estimated mortality rates excluded the 0 value. We also evaluated, through simulations, how potential sampling biases of infected dolphins could overestimate parasite-induced mortality. Small differences in sampling selectivity between infected and uninfected animals could substantially reduce the mortality estimates. However, the simulated models also supported the notion of statistically significant mortality in juvenile dolphins. Given that dolphins older than 16 yr were poorly represented in the dataset, further research is needed to establish whether Crassicauda sp. causes meaningful mortality for population dynamics among adult individuals.

  6. Trend in infant mortality rate in Argentina within the framework of the Millennium Development Goals. (United States)

    Finkelstein, Juliana Z; Duhau, Mariana; Speranza, Ana


    Infant mortality rate (IMR) is an indicator of the health status of a population and of the quality of and access to health care services. In 2000, and within the framework of the Millennium Development Goals, Argentina committed to achieve by 2015 a reduction by two thirds of its 1990 infant mortality rate, and to identify and close inter-jurisdictional gaps. The objective of this article is to describe the trend in infant mortality rate in Argentina and interjurisdictional gaps, infant mortality magnitude and causes, in compliance with the Millennium Development Goals. A descriptive study on infant mortality was conducted in Argentina in 1990 and between 2000 and 2013, based on vital statistics data published by the Health Statistics and Information Department of the Ministry of Health of Argentina. The following reductions were confirmed: 57.8% in IMR, 52.6% in neonatal mortality rate and 63.8% in post-neonatal mortality rate. The inter-provincial Gini coefficient for IMR decreased by 27%. The population attributable risk decreased by 16.6% for IMR, 38.8% for neonatal mortality rate and 51.5% for post-neonatal mortality rate in 2013 versus 1990. A significant reduction in infant mortality and its components has been shown, but not enough to meet the Millennium Development Goals. The reduction in IMR gaps reached the set goal; however, inequalities still persist. Sociedad Argentina de Pediatría.

  7. The effects of war losses on mortality estimates for Italy: A first attempt

    Directory of Open Access Journals (Sweden)

    Silvia Bruzzone


    Full Text Available For countries that experience substantial war losses in a given time period, the exclusion of military deaths can have an important impact on estimates of mortality and life expectancy. In this paper, we start by reviewing Vallin's work in accounting for French war losses. We then attempt to apply comparable methods to Italy in order to account for the effects of war. The results indicate that estimates currently available from the Human Mortality Database (HMD greatly underestimate period mortality during wartime among all Italian males, and may even underestimate mortality among civilian males. Finally, we discuss how failing to account for war mortality presents problems in making inter-country mortality comparisons.

  8. Impacts of Austrian Climate Variability on Honey Bee Mortality (United States)

    Switanek, Matt; Brodschneider, Robert; Crailsheim, Karl; Truhetz, Heimo


    Global food production, as it is today, is not possible without pollinators such as the honey bee. It is therefore alarming that honey bee populations across the world have seen increased mortality rates in the last few decades. The challenges facing the honey bee calls into question the future of our food supply. Beside various infectious diseases, Varroa destructor is one of the main culprits leading to increased rates of honey bee mortality. Varroa destructor is a parasitic mite which strongly depends on honey bee brood for reproduction and can wipe out entire colonies. However, climate variability may also importantly influence honey bee breeding cycles and bee mortality rates. Persistent weather events affects vegetation and hence foraging possibilities for honey bees. This study first defines critical statistical relationships between key climate indicators (e.g., precipitation and temperature) and bee mortality rates across Austria, using 6 consecutive years of data. Next, these leading indicators, as they vary in space and time, are used to build a statistical model to predict bee mortality rates and the respective number of colonies affected. Using leave-one-out cross validation, the model reduces the Root Mean Square Error (RMSE) by 21% with respect to predictions made with the mean mortality rate and the number of colonies. Furthermore, a Monte Carlo test is used to establish that the model's predictions are statistically significant at the 99.9% confidence level. These results highlight the influence of climate variables on honey bee populations, although variability in climate, by itself, cannot fully explain colony losses. This study was funded by the Austrian project 'Zukunft Biene'.

  9. Temperature indicating device

    International Nuclear Information System (INIS)

    Angus, J.P.; Salt, D.


    A temperature indicating device comprises a plurality of planar elements some undergoing a reversible change in appearance at a given temperature the remainder undergoing an irreversible change in appearance at a given temperature. The device is useful in indicating the temperature which an object has achieved as well as its actual temperature. The reversible change is produced by liquid crystal devices. The irreversible change is produced by an absorbent surface carrying substances e.g. waxes which melt at predetermined temperatures and are absorbed by the surface; alternatively paints may be used. The device is used for monitoring processes of encapsulation of radio active waste. (author)

  10. Injector of solid indicator

    Energy Technology Data Exchange (ETDEWEB)

    Chernyshev, G.I.; Luk' yanov, E.P.; Pruslin, Y.A.; Zabrodin, P.I.


    The injector can be used with remote introduction of indicators into a borehole for study in an oil well of the parameters of movement of fluid currents, control of the state of the equipment, and study of the properties of the rocks. Proposed is a method of increasing the reliability of operation of the injector by stabilizing the rate of its dispersing. Introduced to the injector of a solid indicator are auxiliary brackets and a cathode made from nonmetallic electrical conducting material and reinforced at the end by an elastic bracket. The auxillary cathode is attached to the end surface of the anode and cathode.

  11. Economic Indicators Selected Countries. (United States)


    DEFENCE I ECONOMIC INDICATORS SELECTED COUNTRIES DECEMBER QUARTER 1987 . ’-H ISSUED BY MANPOWER POLICY & STRATEGIES BRANCH " "’ :.S S ’,1l f ,am -m mW...100 Sour:e: Main Economic Indicators (OECD) Manufactured Basic Metal Year Goods Chemicals Metals Products 1980 100 100 100 100 1981 110 117 102 107...Earnings of all 1982 1986 7.4 Male Employees (a) Aug 1986 Aug 1987 4.8 Hourly Wace Rates 3 1979 1987 lt.2 Garden Island 1983 1987 6.7 Dockyards Dec

  12. Indications for coronary angiography

    International Nuclear Information System (INIS)

    Kaltenbach, M.; Vallbracht, C.


    Today selective coronary angiography, introduced by Sones in 1957, is used as clinical routine for diagnosing morphological changes in the coronary arteries. Hitherto, more recent techniques such as digital subtraction angiography cannot provide comparable information. Strict criteria for its indication depending on possible therapeutic consequences, have to be applied, although the risk is low with a letality of 0.01 to 0.05 percent. Radionuclear investigations can be used as additional tool in selected cases. The careful indication for coronary angiography usually implies the possible need for coronary bypass graft surgery of balloon angioplasty. (orig./MG) [de

  13. Socioeconomic inequality and its determinants regarding infant mortality in iran. (United States)

    Damghanian, Maryam; Shariati, Mohammad; Mirzaiinajmabadi, Khadigeh; Yunesian, Masud; Emamian, Mohammad Hassan


    Infant mortality rate is a useful indicator of health conditions in the society, the racial and socioeconomic inequality of which is from the most important measures of social inequality. The aim of this study was to determine the socioeconomic inequality and its determinants regarding infant mortality in an Iranian population. This cross-sectional study was performed on 3794 children born during 2010-2011 in Shahroud, Iran. Based on children's addresses and phone numbers, 3412 were available and finally 3297 participated in the study. A data collection form was filled out through interviewing the mothers as well as using health records. Using principal component analysis, the study population was divided to high and low socioeconomic groups based on the case's home asset, education and job of the household's head, marital status, and composition of the household members. Inequality between the groups with regard to infant mortality was investigated by Blinder-Oaxaca decomposition method. The mortality rate was 15.1 per 1000 live births in the high socioeconomic group and 42.3 per 1000 in the low socioeconomic group. Mother's education, consanguinity of parents, and infant's nutrition type and birth weight constituted 44% of the gap contributing factors. Child's gender, high-risk pregnancy, and living area had no impact on the gap. There was considerable socioeconomic inequality regarding infant mortality in Shahroud. Mother's education was the most contributing factor in this inequality.

  14. 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.


    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

  15. Socioeconomic Inequality and Its Determinants Regarding Infant Mortality in Iran (United States)

    Damghanian, Maryam; Shariati, Mohammad; Mirzaiinajmabadi, Khadigeh; Yunesian, Masud; Emamian, Mohammad Hassan


    Background: Infant mortality rate is a useful indicator of health conditions in the society, the racial and socioeconomic inequality of which is from the most important measures of social inequality. Objectives: The aim of this study was to determine the socioeconomic inequality and its determinants regarding infant mortality in an Iranian population. Patients and Methods: This cross-sectional study was performed on 3794 children born during 2010-2011 in Shahroud, Iran. Based on children’s addresses and phone numbers, 3412 were available and finally 3297 participated in the study. A data collection form was filled out through interviewing the mothers as well as using health records. Using principal component analysis, the study population was divided to high and low socioeconomic groups based on the case’s home asset, education and job of the household’s head, marital status, and composition of the household members. Inequality between the groups with regard to infant mortality was investigated by Blinder-Oaxaca decomposition method. Results: The mortality rate was 15.1 per 1000 live births in the high socioeconomic group and 42.3 per 1000 in the low socioeconomic group. Mother's education, consanguinity of parents, and infant's nutrition type and birth weight constituted 44% of the gap contributing factors. Child's gender, high-risk pregnancy, and living area had no impact on the gap. Conclusions: There was considerable socioeconomic inequality regarding infant mortality in Shahroud. Mother's education was the most contributing factor in this inequality. PMID:25068048

  16. Mortality risk factors during readmission at the Department of Medicine. (United States)

    Trakulthong, Chayanis; Phunmanee, Anakapong


    Readmission is an indicator of quality of inpatient care. A study from Hong Kong found readmission mortality rate to be 5.1%. There are limited reports on risk factors for mortality other than co-morbid diseases in readmission patients. This study, thus, aims to evaluate risk factors for mortality during readmission. This study was conducted at a university hospital in Thailand. The inclusion criteria were patients aged ≥15 years and readmission to internal medicine wards within 28 days after discharge. The outcome of the study was death during readmission. Risk factors for readmission mortality were analyzed using multivariate logistic regression analysis. There were 10,389 admissions to the Department of Medicine, Khon Kaen University, of which 407 required readmission (3.90%). Of those patients, 75 (18.43%) died during readmission. There were 6 independent factors associated with death in patients who were readmitted, including advanced age (>60 years), presence of more than 2 co-morbid diseases, admission duration of >14 days, fever at previous discharge, low hemoglobin (readmission duration, presence of low hemoglobin at previous discharge, and numbers of procedures at readmission were significantly associated with increased mortality risk for readmission patients.

  17. Bone Marrow Pathology Predicts Mortality in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Cheng-Hao Weng


    Full Text Available Introduction. A bone marrow biopsy is a useful procedure for the diagnosis and staging of various hematologic and systemic diseases. The objective of this study was to investigate whether the findings of bone marrow studies can predict mortality in chronic hemodialysis patients. Methods. Seventy-eight end-stage renal disease patients on maintenance hemodialysis underwent bone marrow biopsies between 2000 and 2011, with the most common indication being unexplained anemia followed by unexplained leukocytosis and leukopenia. Results. The survivors had a higher incidence of abnormal megakaryocyte distribution P=0.001, band and segmented cells P=0.021, and lymphoid cells P=0.029 than the nonsurvivors. The overall mortality rate was 38.5% (30/78, and the most common cause of mortality was sepsis (83.3% followed by respiratory failure (10%. In multivariate Cox regression analysis, both decreased (OR 3.714, 95% CI 1.671–8.253, P=0.001 and absent (OR 9.751, 95% CI 2.030–45.115, P=0.004 megakaryocyte distribution (normal megakaryocyte distribution as the reference group, as well as myeloid/erythroid ratio (OR 1.054, CI 1.012–1.098, P=0.011, were predictive of mortality. Conclusion. The results of a bone marrow biopsy can be used to assess the pathology, and, in addition, myeloid/erythroid ratio and abnormal megakaryocyte distribution can predict mortality in chronic hemodialysis patients.

  18. [Mortality by homicides in Colombia, 1998-2012]. (United States)

    Chaparro-Narváez, Pablo; Cotes-Cantillo, Karol; León-Quevedo, Willian; Castañeda-Orjuela, Carlos


    Homicide is a universal indicator of social violence with large public health consequences. To describe mortality by homicides and to analyze its trends and geographic distribution in Colombia between 1998 and 2012. We conducted a descriptive study of deaths by homicide in Colombia between 1998 and 2012 using official mortality databases and the population projections of the Departamento Administrativo Nacional de Estadística, DANE. We calculated age- and sex-specific mortality rates, and we analyzed the geographical distribution of mean-adjusted homicide mortality rates at municipal level. Between 1998 and 2012, 331,470 homicides were reported in Colombia. The mean crude rate was 51.5 per 100,000 inhabitants: 95.9 in men and 8.2 in women. Since 2003, a decrease in the number of deaths and rates was observed; 91.9% of the victims were men and the highest mortality rates were reported in the 20-29 years old group. The most frequently involved mechanism was the firearm: Eight of 10 homicides in men, and seven of 10 homicides in women. Out of 1,122 municipalities, 186 were in the highest quintile, accumulating 50.1% of all deaths. In Colombia, homicides have been one of the leading causes of death with a trend towards reduction since 2002. Its geographical distribution has been heterogeneous. To continue addressing this public health issue we must recur to multidisciplinary analytical methodologies for a better understanding of the phenomenon.

  19. Social relationships and mortality risk: a meta-analytic review. (United States)

    Holt-Lunstad, Julianne; Smith, Timothy B; Layton, J Bradley


    The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality. This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk. Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships. Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (psocial relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary.

  20. Asthma mortality in Uruguay, 1984-1998. (United States)

    Baluga, J C; Sueta, A; Ceni, M


    Asthma mortality rates have increased worldwide during the past several years despite the increased availability of new and effective medications. Few studies show reliable data from Latin American countries. To determine asthma mortality rates from 1984 to 1998 and to relate mortality to sales of asthma medications. We conducted a retrospective epidemiologic study in the total population of Uruguay. Data were obtained from the Department of Statistics of the Ministry of Public Health. Trends in mortality rates were analyzed using linear regression procedures. Spearman rank correlations were used to relate mortality rates to sales of asthma medications. The mean overall mortality rate was 5.10 per 100,000 during the period 1984 to 1998, (range 6.08 to 3.39) and showed a decreasing trend (P = 0.001). During the period 1995 to 1998, a more pronounced decrease was observed (mean mortality rate, 4.10 per 100,000). In the 5- to 34-year-old age group the mean mortality rate was 0.43 (range 0.65 to 0.13). Similarly, the mortality rate in this age group decreased particularly in the 1994 to 1998 period (mean 0.19; P = 0.005). Finally, the mortality rate was inversely correlated with sales of inhaled corticosteroids; for the overall mortality rate, p = -0.71, P = 0.003; for 5- to 34-year-old age group, p = -0.63, P = 0.01. Although mortality attributable to asthma seems to be decreasing, the overall mortality rate is still high compared with more economically developed countries. A more pronounced decrease in asthma mortality has been seen in the 5- to 34-year-old group. At present, Uruguay is a Latin American country with a low rate of asthma mortality. This is probably related to the use of new therapies to treat asthma.

  1. Russian mortality beyond vital statistics

    Directory of Open Access Journals (Sweden)


    Full Text Available Analyses of routine data have established that the extreme mortality fluctuations among young and middle-aged men are the most important single component of both temporal changes in Russian life expectancy at birth and in the gap between male and female life expectancy. It is also responsible for the largest share of the life expectancy gap between Russia and other industrialised countries. A case-control study has been used to identify factors associated with mortality among men aged 20 to 55 in the five major cities of the Udmurt Republic in 1998-99. Men dying from external causes and circulatory disease are taken as cases. Matched controls were selected from men of the same age living in the same neighbourhood of residence. Information about characteristics of cases and controls was obtained by interviewing proxies who were family members or friends of the subjects. After exclusion of those deaths for which proxy informant could not be identified, a total of 205 circulatory disease and 333 external cause cases were included together with the same number of controls. Educational level was significantly associated with mortality from circulatory diseases and external causes in a crude analysis. However, this could largely be explained by adjustment for employment, marital status, smoking and alcohol consumption. Smoking was associated with mortality from circulatory disease (crude OR=2.44, 95% CI 1.36-4.36, this effect being slightly attenuated after adjustment for socio-economic factors and alcohol consumption. Unemployment was associated with a large increase in the risk of death from external causes (crude OR=3.63, 95% CI 2.17-6.08, an effect that was still substantial after adjustment for other variables (adjusted OR=2.52, 95% CI 1.43-4.43. A reported history of periods of heavy drinking was linked to both deaths from circulatory disease (crude OR=4.21, 95% CI 2.35-7.55 and external cause mortality (crude OR=2.65, 95% CI 1

  2. The logarithmic hypervolume indicator

    DEFF Research Database (Denmark)

    Friedrich, Tobias; Bringmann, Karl; Voß, Thomas


    It was recently proven that sets of points maximizing the hypervolume indicator do not give a good multiplicative approximation of the Pareto front. We introduce a new “logarithmic hypervolume indicator” and prove that it achieves a close-to-optimal multiplicative approximation ratio. This is exp...

  3. Maslov indices and monodromy

    International Nuclear Information System (INIS)

    Dullin, H R; Robbins, J M; Waalkens, H; Creagh, S C; Tanner, G


    We prove that for a Hamiltonian system on a cotangent bundle that is Liouville-integrable and has monodromy the vector of Maslov indices is an eigenvector of the monodromy matrix with eigenvalue 1. As a corollary, the resulting restrictions on the monodromy matrix are derived. (letter to the editor)

  4. Lichen indicator [Section 4 (United States)

    Paul L. Patterson; Susan Will-Wolf; Marie T. Trest


    Lichens are very responsive to environmental stressors in forests, including changes in forest structure, air quality, and climate. Each lichen species on a plot is an indicator of how lichen communities respond to ecological conditions. Individual lichen species occur erratically and even common species are often absent from plots with suitable habitat. The combined...

  5. Human mortality improvement in evolutionary context

    DEFF Research Database (Denmark)

    Burger, Oskar; Baudisch, Annette; Vaupel, James W


    Life expectancy is increasing in most countries and has exceeded 80 in several, as low-mortality nations continue to make progress in averting deaths. The health and economic implications of mortality reduction have been given substantial attention, but the observed malleability of human mortality...... about 4 of the roughly 8,000 human generations that have ever lived. Moreover, mortality improvement in humans is on par with or greater than the reductions in mortality in other species achieved by laboratory selection experiments and endocrine pathway mutations. This observed plasticity in age...

  6. Mortality in Patients with Endogenous Cushing's Syndrome. (United States)

    Javanmard, Pedram; Duan, Daisy; Geer, Eliza B


    Cushing's syndrome is associated with increased morbidity and mortality. Cardiovascular events, sepsis, and thromboembolism are the leading causes of mortality. Patient's with Cushing's due to a pituitary adenoma and those with Cushing's due to benign adrenal adenoma have relatively good survival outcomes often mirroring that of the general population. Persistent or recurrent disease is associated with high mortality risk. Ectopic Cushing's syndrome and Cushing's due to adrenocortical carcinoma confer the highest mortality risk among Cushing's etiologies. Prompt diagnosis and treatment, and specific monitoring for and treatment of associated comorbidities are essential to decrease the burden of mortality from Cushing's. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Evaluation of morbidity from mortality. (United States)

    Damiani, P; Massé, H; Aubenque, M


    The authors have attempted to measure morbidity involved in mortality, from French regional statistics of causes of death, for the 1968-1970 period. Particularly, they have estimated prevalence rates (proportion of patients at a given moment) and incidence rates (annual proportion of new patients). These rates have been assessed by sex, and for age groups: 15-44 years, 45-64 years, 65-74 years, 75 years and more, and for 18 leading causes of death, according to the International Classification of Diseases (1965). Statistics of causes of deaths have been corrected to take into account non specified causes of death.

  8. Morbidity and mortality following poliomyelitis

    DEFF Research Database (Denmark)

    Kay, L; Nielsen, N M; Wanscher, B


    : Data from official registers for a cohort of 3606 Danes hospitalized for PM in the period 1940-1954 were compared with 13 762 age- and gender-matched controls. RESULTS: Compared with controls, mortality was moderately increased for both paralytic as well as non-paralytic PM cases; Hazard Ratio, 1.......31 (95% confidence interval, 1.18-1.44) and 1.09 (95% confidence interval, 1.00-1.19), respectively. Hospitalization rates were approximately 1.5 times higher among both paralytic and non-paralytic PM cases as compared with controls. Discharge diagnoses showed a broad spectrum of diseases. There were...

  9. Mortality of children under five and prevalence of newborn congenital anomalies in relation to macroeconomic and socioeconomic factors in Latvia. (United States)

    Ebela, Inguna; Zile, Irisa; Zakis, Aleksandrs; Folkmanis, Valdis; Rumba-Rozenfelde, Ingrida


    Mortality of infants and children younger than 5 years is a globally recognized and broad national welfare indicator. Scientific literature has data on the correlation of mortality indicators with macroeconomic indicators. It is important to study the associations between prevalence and mortality indicators and socioeconomic factors, since deaths from congenital anomalies account for approximately 25%-30% of all deaths in infancy. The aim of the study was to analyze the overall trend in mortality of infants and young children aged 0 to 4 years in relation to macroeconomic factors in Latvia and prevalence of congenital anomalies in newborns in relation to socioeconomic factors. The Newborns' Register and Causes of Death Register were used as data sources; data on specific socioeconomic factors were retrieved from the Central Statistics Office. The results of the study show a strong correlation between mortality in children younger than 5 years and gross domestic product, as well as health budget in LVL per capita and the national unemployment level. The average decrease in infant mortality from congenital anomalies in Latvia was found to be 6.8 cases per 100,000 live births. There is a strong correlation between child mortality and socioeconomic situation in the country. There is a need to analyze the data on child mortality in a transnational context on a regular basis and studying the correlations between child mortality indicators and socioeconomic indicators and health care management parameters.

  10. Dzuds, droughts, and livestock mortality in Mongolia (United States)

    Palat Rao, Mukund; Davi, Nicole K.; D'Arrigo, Rosanne D.; Skees, Jerry; Nachin, Baatarbileg; Leland, Caroline; Lyon, Bradfield; Wang, Shih-Yu; Byambasuren, Oyunsanaa


    Recent incidences of mass livestock mortality, known as dzud, have called into question the sustainability of pastoral nomadic herding, the cornerstone of Mongolian culture. A total of 20 million head of livestock perished in the mortality events of 2000-2002, and 2009-2010. To mitigate the effects of such events on the lives of herders, international agencies such as the World Bank are taking increasing interest in developing tailored market-based solutions like index-insurance. Their ultimate success depends on understanding the historical context and underlying causes of mortality. In this paper we examine mortality in 21 Mongolian aimags (provinces) between 1955 and 2013 in order to explain its density independent cause(s) related to climate variability. We show that livestock mortality is most strongly linked to winter (November-February) temperatures, with incidences of mass mortality being most likely to occur because of an anomalously cold winter. Additionally, we find prior summer (July-September) drought and precipitation deficit to be important triggers for mortality that intensifies the effect of upcoming winter temperatures on livestock. Our density independent mortality model based on winter temperature, summer drought, summer precipitation, and summer potential evaporanspiration explains 48.4% of the total variability in the mortality dataset. The Mongolian index based livestock insurance program uses a threshold of 6% mortality to trigger payouts. We find that on average for Mongolia, the probability of exceedance of 6% mortality in any given year is 26% over the 59 year period between 1955 and 2013.

  11. Global Incidence and Mortality for Prostate Cancer: Analysis of Temporal Patterns and Trends in 36 Countries. (United States)

    Wong, Martin C S; Goggins, William B; Wang, Harry H X; Fung, Franklin D H; Leung, Colette; Wong, Samuel Y S; Ng, Chi Fai; Sung, Joseph J Y


    Prostate cancer (PCa) is a leading cause of mortality and morbidity globally, but its specific geographic patterns and temporal trends are under-researched. To test the hypotheses that PCa incidence is higher and PCa mortality is lower in countries with higher socioeconomic development, and that temporal trends for PCa incidence have increased while mortality has decreased over time. Data on age-standardized incidence and mortality rates in 2012 were retrieved from the GLOBOCAN database. Temporal patterns were assessed for 36 countries using data obtained from Cancer incidence in five continents volumes I-X and the World Health Organization mortality database. Correlations between incidence or mortality rates and socioeconomic indicators (human development index [HDI] and gross domestic product [GDP]) were evaluated. The average annual percent change in PCa incidence and mortality in the most recent 10 yr according to join-point regression. Reported PCa incidence rates varied more than 25-fold worldwide in 2012, with the highest incidence rates observed in Micronesia/Polynesia, the USA, and European countries. Mortality rates paralleled the incidence rates except for Africa, where PCa mortality rates were the highest. Countries with higher HDI (r=0.58) and per capita GDP (r=0.62) reported greater incidence rates. According to the most recent 10-yr temporal data available, most countries experienced increases in incidence, with sharp rises in incidence rates in Asia and Northern and Western Europe. A substantial reduction in mortality rates was reported in most countries, except in some Asian countries and Eastern Europe, where mortality increased. Data in regional registries could be underestimated. PCa incidence has increased while PCa mortality has decreased in most countries. The reported incidence was higher in countries with higher socioeconomic development. The incidence of prostate cancer has shown high variations geographically and over time, with smaller

  12. Subjective social status and mortality: the English Longitudinal Study of Ageing. (United States)

    Demakakos, Panayotes; Biddulph, Jane P; de Oliveira, Cesar; Tsakos, Georgios; Marmot, Michael G


    Self-perceptions of own social position are potentially a key aspect of socioeconomic inequalities in health, but their association with mortality remains poorly understood. We examined whether subjective social status (SSS), a measure of the self-perceived element of social position, was associated with mortality and its role in the associations between objective socioeconomic position (SEP) measures and mortality. We used Cox regression to model the associations between SSS, objective SEP measures and mortality in a sample of 9972 people aged ≥ 50 years from the English Longitudinal Study of Ageing over a 10-year follow-up (2002-2013). Our findings indicate that SSS was associated with all-cause, cardiovascular, cancer and other mortality. A unit decrease in the 10-point continuous SSS measure increased by 24 and 8% the mortality risk of people aged 50-64 and ≥ 65 years, respectively, after adjustment for age, sex and marital status. The respective estimates for cardiovascular mortality were 36 and 11%. Adjustment for all covariates fully explained the association between SSS and cancer mortality, and partially the remaining associations. In people aged 50-64 years, SSS mediated to a varying extent the associations between objective SEP measures and all-cause mortality. In people aged ≥ 65 years, SSS mediated to a lesser extent these associations, and to some extent was associated with mortality independent of objective SEP measures. Nevertheless, in both age groups, wealth partially explained the association between SSS and mortality. In conclusion, SSS is a strong predictor of mortality at older ages, but its role in socioeconomic inequalities in mortality appears to be complex.

  13. Transferrin saturation ratio and risk of total and cardiovascular mortality in the general population.

    LENUS (Irish Health Repository)

    Stack, A G


    The transferrin saturation (TSAT) ratio is a commonly used indicator of iron deficiency and iron overload in clinical practice but precise relationships with total and cardiovascular mortality are unclear.

  14. AFSC/RACE/GAP/Conrath: Delayed discard mortality of the North Pacific giant octopus (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The majority of octopus bycatch occurs in Pacific cod pot fisheries and recent data collected by North Pacific Groundfish Observers indicate that immediate mortality...


    International Nuclear Information System (INIS)



    This paper documents Fluor Hanford's use of Leading Indicators, management leadership, and statistical methodology in order to improve safe performance of work. By applying these methods, Fluor Hanford achieved a significant reduction in injury rates in 2003 and 2004, and the improvement continues today. The integration of data, leadership, and teamwork pays off with improved safety performance and credibility with the customer. The use of Statistical Process Control, Pareto Charts, and Systems Thinking and their effect on management decisions and employee involvement are discussed. Included are practical examples of choosing leading indicators. A statistically based color coded dashboard presentation system methodology is provided. These tools, management theories and methods, coupled with involved leadership and employee efforts, directly led to significant improvements in worker safety and health, and environmental protection and restoration at one of the nation's largest nuclear cleanup sites

  16. Environmental indicators for buildings

    DEFF Research Database (Denmark)

    Dammann, S.

    Whenever we shop, the products we consider buying are labelled with the economical price we have to pay if we want to purchase them - an important parameter in our decisions as purchasers. The increrasing awareness for environmental limits and backlashes of human activities also in the building...... sector have fostered the wish to define 'the ecological price' of a building as a help for environmental conscious decision-making. In a social constructivist approach this Ph.D. thesis looks across and beyond the manifold existing approaches for environmental indicators for buildings. It acknowledges...... in the Netherlands. It identifies lines of conflict and areas of consent betweeen the relevant actors and elaborates scenarios for a possible closure of ongoing debate about environmental indicators for buildings....

  17. 15. Basic economic indicators

    International Nuclear Information System (INIS)

    Carless, J.; Dow, B.; Farivari, R.; O'Connor, J.; Fox, T.; Tunstall, D.; Mentzingen, M.


    The clear value of economic data and analysis to decisionmakers has motivated them to mandate the creation of extensive global economic data sets. This chapter contains a set of these basic economic data, which provides the context for understanding the causes and the consequences of many of the decisions that affect the world's resources. Many traditional economic indicators fail to account for the depletion or deterioration of natural resources, the long-term consequences of such depletion, the equitable distribution of income within a country, or the sustainability of current economic practices. The type of measurement shown here, however, is still useful in showing the great differences between the wealthiest and the poorest countries. Tables are given on the following: Gross national product and official development assistance 1969-89; External debt indicators 1979-89; Central government expenditures; and World commodity indexes and prices 1975-89

  18. Trochleoplasty: Indications and Technique. (United States)

    Nolan, John E; Schottel, Patrick C; Endres, Nathan K


    Trochlear dysplasia is a well-described risk factor for patellar instability. Trochleoplasty has emerged as a procedure within the surgical armamentarium for patellar instability, yet its role is unclear. A variety of trochleoplasty procedures have emerged. The purpose of this review is to clarify indications for trochleoplasty, outline the technical steps involved in performing common trochleoplasties and report the published outcomes and potential complications of these procedures. Patellar instability with severe trochlear dysplasia is the main indication for trochleoplasty. Three types of trochleoplasty have emerged: (1) lateral facet elevation; (2) sulcus deepening; and (3) recession wedge. Deepening and recession wedge trochleoplasties are the most commonly performed. Trochleoplasty is a surgical option for addressing patellar instability in patients with severe trochlear dysplasia. Deepening and recession wedge trochleoplasties that address Dejour B and D dysplastic trochleas are the most studied, with both short- and midterm outcomes reported. Long-term outcomes are lacking and comparative studies are needed.

  19. Lichens as bio indicators

    International Nuclear Information System (INIS)


    This publication discusses the use of lichens as biological indicators. Perennial growth, long life, efficient take-up of mineral nutrients from air and rain and small loss of nutrition are properties that make lichens suitable as biological indicators. In surveys and monitoring, species diversity and coverage by organisms that live as epiphytes on tree trunks have been the most commonly used parameters. A decline in the occurrence of this type of lichen is often related to the content of sulphur compounds in the air and it has been demonstrated that many species are sensitive to sulphur dioxide. It is also known that the growth of many types of lichens increases with a moderate increase in available nitrogen. In South Norway, pollution sensitive species such as Bryoria spp. have advanced strongly, which is probably due to less sulphur in the rain and a higher content of nutrition in the form of nitrate and ammonium

  20. Publication point indicators

    DEFF Research Database (Denmark)

    Elleby, Anita; Ingwersen, Peter


    The paper presents comparative analyses of two publication point systems, The Norwegian and the in-house system from the interdiscplinary Danish Institute for International Studies (DIIS), used as case in the study for publications published 2006, and compares central citation-based indicators...... with novel publication point indicators (PPIs) that are formalized and exemplified. Two diachronic citation windows are applied: 2006-07 and 2006-08. Web of Science (WoS) as well as Google Scholar (GS) are applied to observe the cite delay and citedness for the different document types published by DIIS...... for all document types. Statistical significant correlations were only found between WoS and GS and the two publication point systems in between, respectively. The study demonstrates how the nCPPI can be applied to institutions as evaluation tools supplementary to JCI in various combinations...

  1. Income Inequality and Child Mortality in Wealthy Nations. (United States)

    Collison, David


    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.

  2. Mortality study of lead workers

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, W C; Gaffey, W R


    The mortality of 7,032 men employed for one or more years in lead production facilities or battery plants was followed over a 23-year period, 1947-70. Lead absorption in many of these men was greatly in excess of currently accepted standards based upon urinary and blood lead concentrations available for a portion of the group. There were 1,356 deaths reported. The standardized mortality ratio (SMR) for all causes was 107 for smelter workers and 99 for battery plant workers. Death from neoplasms were in slight excess in smelters, but not significantly increased in battery plants. There were no excess deaths from kidney tumors. The SMR for cardiovascular-renal disease was 96 for smelter workers and 101 for battery plant workers. There was definitely no excess in deaths from either stroke or hypertensive heart disease; however, deaths classified as other hypertensive disease and unspecified nephritis or renal sclerosis were higher than expected. The life expectancy of lead workers was calculated to be approximately the same as that of all U.S. males.

  3. Increased mortality risk in women with depression and diabetes mellitus (United States)

    Pan, An; Lucas, Michel; Sun, Qi; van Dam, Rob M.; Franco, Oscar H.; Willett, Walter C.; Manson, JoAnn E.; Rexrode, Kathryn M.; Ascherio, Alberto; Hu, Frank B.


    Context Both depression and diabetes have been associated with an increased risk of all-cause and cardiovascular diseases (CVD) mortality. However, data evaluating the joint effects of these two conditions on mortality are sparse. Objectives To evaluate the individual and joint effects of depression and diabetes on all-cause and CVD mortality in a prospective cohort study. Design, Settings and Participants A total of 78282 female participants in the Nurses' Health Study aged 54-79 years at baseline in 2000 were followed until 2006. Depression was defined as having self-reported diagnosed depression, treatment with antidepressant medications, or a score indicating severe depressive symptomatology, i.e., a five-item Mental Health Index score ≤52. Self-reported type 2 diabetes was confirmed using a supplementary questionnaire. Main outcome measures All-cause and CVD-specific mortality. Results During 6 years of follow-up (433066 person-years), 4654 deaths were documented, including 979 deaths from CVD. Compared to participants without either condition, the age-adjusted relative risks (95% confidence interval, CI) for all-cause mortality were 1.76 (1.64-1.89) for women with depression only, 1.71 (1.54-1.89) for individuals with diabetes only, and 3.11 (2.70-3.58) for those with both conditions. The corresponding age-adjusted relative risks of CVD mortality were 1.81 (1.54-2.13), 2.67 (2.20-3.23), and 5.38 (4.19-6.91), respectively. These associations were attenuated after multivariate adjustment for other demographic variables, body mass index, smoking status, alcohol intake, physical activity, and major comorbidities (including hypertension, hypercholesterolemia, heart diseases, stroke and cancer) but remained significant, with the highest relative risks for all-cause and CVD mortality found in those with both conditions (2.07 [95% CI, 1.79-2.40] and 2.72 [95% CI, 2.09-3.54], respectively). Furthermore, the combination of depression with a long duration of diabetes

  4. Risk Factors for Mortality in Lower Intestinal Bleeding (United States)

    Strate, Lisa L.; Ayanian, John Z.; Kotler, Gregory; Syngal, Sapna


    Background and Aims Previous studies of Lower Intestinal Bleeding (LIB) have limited power to study mortality. We sought to identify characteristics associated with in-hospital mortality in a large cohort of patients with LIB. Methods We used the 2002 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) to study a cross-sectional cohort of 227,022 hospitalized patients with discharge diagnoses indicating LIB. Predictors of mortality were identified using multiple logistic regression. Results In 2002, an estimated 8,737 patients with LIB (3.9%) died while hospitalized. Independent predictors of in-hospital mortality were age (age >70 vs. <50, odds ratio (OR) 4.91; 95% CI 2.45–9.87), intestinal ischemia (OR 3.47; 95% CI 2.57–4.68), comorbid illness (≥ 2 vs. 0 comorbidities, OR 3.00; 95% CI 2.25–3.98), bleeding while hospitalized for a separate process (OR 2.35; 95% CI 1.81–3.04), coagulation defects (OR 2.34; 95% CI 1.50–3.65), hypovolemia (OR 2.22; 95% CI 1.69–2.90), transfusion of packed red blood cells (OR 1.60; 95% CI 1.23–2.08), and male gender (OR 1.52; 95% CI 1.21–1.92). Colorectal polyps (OR 0.26, 95% CI 0.15–0.45), and hemorrhoids (OR 0.42; 95% CI 0.28–0.64) were associated with a lower risk of mortality, as was diagnostic testing for LIB when added to the multivariate model (OR 0.37, 95% CI 0.28–0.48; p<0.001). Hospital characteristics were not significantly related to mortality. Predictors of mortality were similar in an analysis restricted to patients with diverticular bleeding. Conclusions The all-cause in-hospital mortality rate in LIB is low (3.9%). Advanced age, intestinal ischemia and comorbid illness were the strongest predictors of mortality. PMID:18558513

  5. Sleep duration and ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Åse Marie; Holtermann, Andreas


    This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association.......This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association....

  6. State infant mortality: an ecologic study to determine modifiable risks and adjusted infant mortality rates. (United States)

    Paul, David A; Mackley, Amy; Locke, Robert G; Stefano, John L; Kroelinger, Charlan


    To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization procedures. Final risk adjusted IMR's were standardized and states were compared with the United States adjusted rates. Models for IMR in individual states in 2001 (r2 = 0.66, P < 0.01) and 2002 (r2 = 0.81, P < 0.01) were tested. African-American race, teen birth rate, and smoking during pregnancy remained independently associated with state infant mortality rates for 2001 and 2002. Ninety five percent confidence intervals (CI) were calculated around the regression lines to model the expected IMR. After adjustment, some states maintained a consistent IMR; for instance, Vermont and New Hampshire remained low, while Delaware and Louisiana remained high. However, other states such as Mississippi, which have traditionally high infant mortality rates, remained within the expected 95% CI for IMR after adjustment indicating confounding affected the initial unadjusted rates. Non-modifiable demographic variables, including the percentage of non-Hispanic African-American and Hispanic populations of the state are major factors contributing to individual variation in state IMR. Race and ethnicity may confound or modify the IMR in states that shifted inside or outside the 95% CI following adjustment. Other factors including smoking during pregnancy and teen birth rate, which are

  7. Reduction of infant mortality in India. (United States)

    Kumar, V; Datta, N


    In India the infant mortality rate (IMR) registered an impressive decline during the first 5-6 decades of the 20th century, but in the last 30 years a significant decline has not been documented. The IMR continues to be in the range of 120-130/1000. In many developed countries it is reported as less than 20/1000. The World Health Organization (WHO) has recommended that by the year 2000 the IMR should be reduced to below 50/1000. India's government has set a target of 60/1000 to be reached by 2000. In Kerala this target has already been achieved. Several projects throughout India have indicated that this task can be accomplished. Many lessons can be learned from Kerala and the successful projects. 1 major constraint in information on IMR in India is the lack of uniformity and reliability in the system of recording vital events. Mere knowledge of IMR is insufficient for planning and execution of an appropriate intervention strategy. It is also important to understand the various causes of death. Based on the available information and a review of the literature, it is clear that 50% of the deaths in infancy occurred during the neonatal period. The common preventable causes of death in infancy identified are acute respiratory infections, acute diarrheal disease, low birth weight, protein energy malnutrition, tetanus neonatorum, and communicable diseases like measles, whooping cough, and typhoid. The high IMR can be reduced by general measures which can only be recommended as medium-term and longterm plans. These include an increase in the gross national product and female literacy, a decreasing birthrate, and an increasing capita food intake. At this time India is not experiencing rapid gains in any of these areas. Many of the strategies to reduce IMR have been reviewed objectively by Bhargava et al. Each strategy has merit, but, due to limited resources, it is essential to set priorities. The selection of priorities should be based on 4 basic questions: how common is

  8. Radioisotopic indicators in microbiology

    International Nuclear Information System (INIS)

    Isamov, N.N.


    The book comprises data obtained by the laboratory of radiobiology (Uzbek Research Veterinary Institute) for 15 years and sums up data of domestic and foreign scientists; it discusses problems of the utilization of radioactive isotopes of sulphur, cadmium, phosphorus and other chemical elements by microorganisms; indicates the specificity of the utilization of radioisotopes in microbiology. The influence is considered of external factors on the inclusion of radioisotopes into microorganisms, methods are discussed of obtaining labelled microorganisms and their antigens, radioactivity of bacteria is considered as affected by the consistency and composition of the nutritive medium and other problems

  9. Health indicators 1991. (United States)

    Dawson, N


    This is the second edition of a database developed by the Canadian Centre for Health Information (CCHI). It features 49 health indicators, under one cover containing the most recent data available from a variety of national surveys. This information may be used to establish health goals for the population and to offer objective measures of their success. The database can be accessed through CANSIM, Statistics Canada's socio-economic electronic database and retrieval system, or through a personal computer package which enables the user to retrieve and analyze the 1.2 million data points in the system.

  10. Main economics indicators

    International Nuclear Information System (INIS)


    This monthly publication, based on the most up-to-date techniques of tabular and graphical presentation, is designed to provide at a glance a picture of the most recent changes in the economies of the OECD countries, and a collection of international statistics on the economic developments which have affected the OECD area in the past few years. The indicators selected cover national accounts, industrial production, business surveys, deliveries, stocks and orders, construction, internal trade, labour, wages, prices, domestic and foreign finance, interest rates, trade and payments. (author)

  11. Morbidity and mortality associated with obstetric hysterectomy

    International Nuclear Information System (INIS)

    Shaikh, N.B.; Shaikh, S.; Shaikh, J.M.


    Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

  12. Determinants of all cause mortality in Poland. (United States)

    Genowska, Agnieszka; Jamiołkowski, Jacek; Szpak, Andrzej; Pajak, Andrzej


    The study objective was to evaluate quantitatively the relationship between demographic characteristics, socio-economic status and medical care resources with all cause mortality in Poland. Ecological study was performed using data for the population of 66 subregions of Poland, obtained from the Central Statistical Office of Poland. The information on the determinants of health and all cause mortality covered the period from 1st January 2005 to 31st December 2010. Results for the repeated measures were analyzed using Generalized Estimating Equations GEE model. In the model 16 independent variables describing health determinants were used, including 6 demographic variables, 6 socio-economic variables, 4 medical care variables. The dependent variable, was age standardized all cause mortality rate. There was a large variation in all cause mortality, demographic features, socio-economic characteristics, and medical care resources by subregion. All cause mortality showed weak associations with demographic features, among which only the increased divorce rate was associated with higher mortality rate. Increased education level, salaries, gross domestic product (GDP) per capita, local government expenditures per capita and the number of non-governmental organizations per 10 thousand population was associated with decrease in all cause mortality. The increase of unemployment rate was related with a decrease of all cause mortality. Beneficial relationship between employment of medical staff and mortality was observed. Variation in mortality from all causes in Poland was explained partly by variation in socio-economic determinants and health care resources.

  13. Infant Mortality and Native Hawaiians/Pacific Islanders (United States)

    ... Hawaiian/Other Pacific Islander > Infant Health & Mortality Infant Mortality and Native Hawaiians/Pacific Islanders While the overall ... data for this ethnic group is limited. Infant Mortality Rate Infant mortality rate per 1,000 live ...

  14. Infant Mortality and American Indians/Alaska Natives (United States)

    ... American Indian/Alaska Native > Infant Health & Mortality Infant Mortality and American Indians/Alaska Natives American Indian/Alaska ... as compared to non-Hispanic white mothers. Infant Mortality Rate: Infant mortality rate per 1,000 live ...

  15. Maternal Mortality – A Challenge?

    Directory of Open Access Journals (Sweden)

    Shital G. Sonone


    Full Text Available Background : The current maternal mortality rate (MMR in Maharashtra is 104/100000 live births, ranking 3rd in India. There is scope for reducing it as majority of the causes of MMR are preventable and curable. Aims and Objectives: To study the sociodemographic profile and causes of maternal deaths at Dr. V. M. Govt. Medical College, Solapur. Material and Methods: The study population included all deliveries i.e. women admitted in the hospital during pregnancy, child-birth or within 42 days of termination of pregnancy from any cause related to or aggravated due to pregnancy during the period of 2 years from 1st August 2009 to 31st July 2011. IPD case records and autopsy reports of all maternal deaths were taken and various variables were studied. The present study is prospective study of maternal mortality conducted in Dept. of Obstetrics and Gynaecology, Dr. V. M. Medical College Solapur. Cases were distributed ac-cording to their age, literacy rate, residence,socioeconomic status, ante-natal care, gestational age, gravida/parity, place of referral, pregnancy outcome, and place of delivery, perinatal outcome and etiological factors. This study also suggests the measures to reduce maternal mortality. Results: The total number of live births during the study period were 13,188 and total number of maternal deaths were 63 and MMR was 477 per 1, 00,000 live births. In the maternal deaths studied, 1/3rd of the women were illiterate, half of the women belonged to urban slum areas and of lower socioeconomic class.1/3rd of the deaths occurred in primigravida,within 24 hrs from admission, 58.73% of the patients were referred from outside. Out of that 86.49% of women were sent from private hospital and died in post partum period, having poor perinatal outcome. Haemorrhage (28.57% and hypertension (12.69% are two direct causes and severe anemia (33.33% is most common in direct cause of maternal death in our study.

  16. Mortality among sulfide ore miners

    International Nuclear Information System (INIS)

    Ahlman, K.; Koskela, R.S.; Kuikka, P.; Koponen, M.; Annanmaeki, M.


    Lung cancer mortality was studied during 1965-1985 in Outokumpu township in North Karelia, where an old copper mine was located. Age-specific lung cancer death rates (1968-1985) were higher among the male population of Outokumpu than among the North Karelian male population of the same age excluding the Outokumpu district (p less than .01). Of all 106 persons who died from lung cancer during 1965-1985 in Outokumpu township, 47 were miners of the old mine, 39 of whom had worked there for at least three years and been heavily exposed to radon daughters and silica dust. The study cohort consisted of 597 miners first employed between 1954 and 1973 by a new copper mine and a zinc mine, and employed there for at least 3 years. The period of follow-up was 1954-1986. The number of person-years was 14,782. The total number of deaths was 102; the expected number was 72.8 based on the general male population and 97.8 based on the mortality of the male population of North Karelia. The excess mortality among miners was due mainly to ischemic heart disease (IHD); 44 were observed, the expected number was 22.1, based on the general male population, and the North Karelian expected number was 31.2 (p less than .05). Of the 44 miners who died from IHD, 20 were drillers or chargers exposed to nitroglycerin in dynamite charges, but also to several simultaneous stress factors including PAHs, noise, vibration, heavy work, accident risk, and working alone. Altogether 16 tumors were observed in the cohort. Ten of these were lung cancers, the expected number being 4.3. Miners who had died from lung cancer were 35-64 years old, and had entered mining work between 1954 and 1960. Five of the ten lung cancer cases came from the zinc mine (1.7 expected). Three of them were conductors of diesel-powered ore trains

  17. Position indicating device

    International Nuclear Information System (INIS)

    Fellchenfeld, M.M.; Connors, G.R.


    This patent describes a position indicating device for producing an indication of the position of a displaceable structure comprising: a position representing member mounted for movement in response to displacement of the structure; sensing elements spaced apart along the defined path such that each element is associated with a respective location along the defined path; means operatively coupling the elements into respective pairs of elements, having, for each pair of elements, an output producing a signal only when a single element of its respective pair is responding to the presence of the member; signal producing members each operative for producing a signal representing a predetermined logic state in response to a predetermined input signal, the number of the signal producing members being smaller than the number of the sensing elements; and circuit means operatively connecting the outputs to the signal producing members for causing a signal at each output to produce a predetermined input signal at a corresponding signal producing member and for causing a predetermined input signal to be produced at least one the signal producing member whenever a signal is present at either one of at least two of the outputs

  18. Tamper indicating packaging

    International Nuclear Information System (INIS)

    Baumann, M.J.; Bartberger, J.C.; Welch, T.D.


    Protecting sensitive items from undetected tampering in an unattended environment is crucial to the success of non-proliferation efforts relying on the verification of critical activities. Tamper Indicating Packaging (TIP) technologies are applied to containers, packages, and equipment that require an indication of a tamper attempt. Examples include: the transportation and storage of nuclear material, the operation and shipment of surveillance equipment and monitoring sensors, and the retail storage of medicine and food products. The spectrum of adversarial tampering ranges from attempted concealment of a pin-hole sized penetration to the complete container replacement, which would involve counterfeiting efforts of various degrees. Sandia National Laboratories (SNL) has developed a technology base for advanced TIP materials, sensors, designs, and processes which can be adapted to various future monitoring systems. The purpose of this technology base is to investigate potential new technologies, and to perform basic research of advanced technologies. This paper will describe the theory of TIP technologies and recent investigations of TIP technologies at SNL

  19. Postoperative mortality after inpatient surgery: Incidence and risk factors

    Directory of Open Access Journals (Sweden)

    Karamarie Fecho


    Full Text Available Karamarie Fecho1, Anne T Lunney1, Philip G Boysen1, Peter Rock2, Edward A Norfleet11Department of Anesthesiology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; 2Department of Anesthesiology, University of Maryland, Baltimore, MD, USAPurpose: This study determined the incidence of and identified risk factors for 48 hour (h and 30 day (d postoperative mortality after inpatient operations.Methods: A retrospective cohort study was conducted using Anesthesiology’s Quality Indicator database as the main data source. The database was queried for data related to the surgical procedure, anesthetic care, perioperative adverse events, and birth/death/operation dates. The 48 h and 30 d cumulative incidence of postoperative mortality was calculated and data were analyzed using Chi-square or Fisher’s exact test and generalized estimating equations.Results: The 48 h and 30 d incidence of postoperative mortality was 0.57% and 2.1%, respectively. Higher American Society of Anesthesiologists physical status scores, extremes of age, emergencies, perioperative adverse events and postoperative Intensive Care Unit admission were identified as risk factors. The use of monitored anesthesia care or general anesthesia versus regional or combined anesthesia was a risk factor for 30 d postoperative mortality only. Time under anesthesia care, perioperative hypothermia, trauma, deliberate hypotension and invasive monitoring via arterial, pulmonary artery or cardiovascular catheters were not identified as risk factors.Conclusions: Our findings can be used to track postoperative mortality rates and to test preventative interventions at our institution and elsewhere.Keywords: postoperative mortality, risk factors, operations, anesthesia, inpatient surgery

  20. Temperature extremes reduce seagrass growth and induce mortality

    International Nuclear Information System (INIS)

    Collier, C.J.; Waycott, M.


    Highlights: • Temperature extremes occur during low tide in shallow seagrass meadows. • The effects of temperature extremes were tested experimentally at 35 °C, 40 °C and 43 °C. • 40 °C was a critical threshold with a large impact on growth and mortality. • At 43 °C there was complete mortality after 2–3 days. • Lower light conditions (e.g. poor water quality) led to a greater negative impact. - Abstract: Extreme heating (up to 43 °C measured from five-year temperature records) occurs in shallow coastal seagrass meadows of the Great Barrier Reef at low tide. We measured effective quantum yield (ϕ PSII ), growth, senescence and mortality in four tropical seagrasses to experimental short-duration (2.5 h) spikes in water temperature to 35 °C, 40 °C and 43 °C, for 6 days followed by one day at ambient temperature. Increasing temperature to 35 °C had positive effects on ϕ PSII (the magnitude varied between days and was highly correlated with PPFD), with no effects on growth or mortality. 40 °C represented a critical threshold as there were strong species differences and there was a large impact on growth and mortality. At 43 °C there was complete mortality after 2–3 days. These findings indicate that increasing duration (more days in a row) of thermal events above 40 °C is likely to affect the ecological function of tropical seagrass meadows

  1. Ethnic Inequalities in Mortality: The Case of Arab-Americans (United States)

    El-Sayed, Abdulrahman M.; Tracy, Melissa; Scarborough, Peter; Galea, Sandro


    Background Although nearly 112 million residents of the United States belong to a non-white ethnic group, the literature about differences in health indicators across ethnic groups is limited almost exclusively to Hispanics. Features of the social experience of many ethnic groups including immigration, discrimination, and acculturation may plausibly influence mortality risk. We explored life expectancy and age-adjusted mortality risk of Arab-Americans (AAs), relative to non-Arab and non-Hispanic Whites in Michigan, the state with the largest per capita population of AAs in the US. Methodology/Principal Findings Data were collected about all deaths to AAs and non-Arab and non-Hispanic Whites in Michigan between 1990 and 2007, and year 2000 census data were collected for population denominators. We calculated life expectancy, age-adjusted all-cause, cause-specific, and age-specific mortality rates stratified by ethnicity and gender among AAs and non-Arab and non-Hispanic Whites. Among AAs, life expectancies among men and women were 2.0 and 1.4 years lower than among non-Arab and non-Hispanic White men and women, respectively. AA men had higher mortality than non-Arab and non-Hispanic White men due to infectious diseases, chronic diseases, and homicide. AA women had higher mortality than non-Arab and non-Hispanic White women due to chronic diseases. Conclusions/Significance Despite better education and higher income, AAs have higher age-adjusted mortality risk than non-Arab and non-Hispanic Whites, particularly due to chronic diseases. Features specific to AA culture may explain some of these findings. PMID:22216204


    EPA has obtained a 3-year database of particulate matter (PM) in Phoenix, AZ from 1995 - 1997 that includes elemental analysis by XRF of daily PM2.5. During this time period PM1 and PM2.5 TEOMs were run simultaneously for about 7 months during two periods of the year. Regressio...

  3. Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands

    NARCIS (Netherlands)

    von Bartheld, Martin B.; Annema, Jouke T.


    Endosonography is being implemented rapidly in pulmonary medicine for the diagnosis and staging of lung cancer, the assessment of sarcoidosis, and the assessment of mediastinal lesions. Although serious adverse events (SAEs) have been described, safety data outside cohort studies are scarce. To

  4. New forecasting methodology indicates more disease and earlier mortality ahead for today's younger Americans. (United States)

    Reither, Eric N; Olshansky, S Jay; Yang, Yang


    Traditional methods of projecting population health statistics, such as estimating future death rates, can give inaccurate results and lead to inferior or even poor policy decisions. A new "three-dimensional" method of forecasting vital health statistics is more accurate because it takes into account the delayed effects of the health risks being accumulated by today's younger generations. Applying this forecasting technique to the US obesity epidemic suggests that future death rates and health care expenditures could be far worse than currently anticipated. We suggest that public policy makers adopt this more robust forecasting tool and redouble efforts to develop and implement effective obesity-related prevention programs and interventions.

  5. Global justice, poverty and maternal mortality

    Directory of Open Access Journals (Sweden)

    Flor de María Cáceres M


    Full Text Available Global justice is currently situated in an ambiance of tension and debate, facing a series of statements attempting to explain relationships among countries, based on the background of agreements already accomplished by supranational agencies. This network of relationships, not always fair nor equitable, has resulted in an increased accumulation of wealth in just a few hands and poverty in a growing number of people in poor countries and geographic areas with restrictions to access both to resources and to technological and scientific advances. Poverty, exclusion and inequalities limit all together the opportunities for development in these communities, with the outcome of serious consequences such as the deterioration in basic indicators of development. Maternal mortality rate (mm is considered a sentinel indicator since it belongs in most cases to premature deaths which would be avoidable through proper measures in education, health promotion and timely access to quality health services. The purpose of this essay is to defend the thesis that the lack of global justice has limited the scope of the goals related to poverty and mm reduction

  6. Time trends in avoidable cancer mortality in Switzerland and neighbouring European countries 1996-2010. (United States)

    Feller, Anita; Mark, Michael Thomas; Steiner, Annik; Clough-Gorr, Kerri M


    What are the trends in avoidable cancer mortality in Switzerland and neighbouring countries? Mortality data and population estimates 1996-2010 were obtained from the Swiss Federal Statistical Office for Switzerland and the World Health Organization Mortality Database ( for Austria, Germany, France and Italy. Age standardised mortality rates (ASMRs, European standard) per 100 000 person-years were calculated for the population Switzerland and neighbouring countries cancer mortality in persons Switzerland from 16.2 to 20.3 per 100 000 person years, EAPC 2.0 [95% CI 1.4 to 2.6]). Compared with its neighbouring countries, Switzerland showed the lowest rates for all groups of avoidable cancer mortality in males 2008-2010. Overall avoidable cancer mortality decreased, indicating achievements in cancer care and related health policies. However, increasing trends in avoidable cancer mortality through primary prevention for females suggest there is a need in Switzerland and its European neighbouring countries to improve primary prevention.

  7. Mortality among white, black, and Hispanic male and female state prisoners, 2001–2009

    Directory of Open Access Journals (Sweden)

    Christopher Wildeman


    Full Text Available Although much research considers the relationship between imprisonment and mortality, little existing research has tested whether the short-term mortality advantage enjoyed by prisoners extends to Hispanics. We compared the mortality rates of non-Hispanic white, non-Hispanic black, and Hispanic male and female state prisoners to mortality rates in the general population using data from the Deaths in Custody Reporting Program, the National Prisoner Statistics, the National Corrections Reporting Program, and the Centers for Disease Control and Prevention. The results indicate that the mortality advantage for prisoners was greatest for black males, followed by black females, Hispanic males, white females, and white males. Hispanic female prisoners were the only group not at a mortality advantage relative to the general population, with an SMR of 1.18 [95% CI: 0.93–1.43]. Taken together, the results suggest that future research should seek to better understand the curious imprisonment–mortality relationship among Hispanic females, although given the small number of inmate deaths that happen to this group (~0.6%, this research should not detract from broader research on imprisonment and mortality. Keywords: Imprisonment, Mortality, Population health, Racial disparities

  8. Mortality outcomes in trauma patients undergoing prehospital red blood cell transfusion: a systematic literature review. (United States)

    Huang, Gregory S; Dunham, C Michael


    The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. Eligible studies were combined for meta-analysis when tests for heterogeneity were insignificant. The synthesized mortality was 35.6% for systolic blood pressure ≤ 90 mmHg; 51.1% for ≤ 80 mmHg; and 63.9% for ≤ 70 mmHg. For patients with either hypotension or emergency trauma center transfused RBCs, the synthesized Injury Severity Score (ISS) was 27.0 and mortality was 36.2%; the ISS and mortality correlation was r = 0.766 ( P = 0.0096). For civilian patients receiving prehospital RBC transfusions, the synthesized ISS was 27.5 and mortality was 39.5%. One civilian study suggested a decrement in mortality with prehospital RBC transfusion; however, patient recruitment was only one per center per year and mortality was 16 showed similar mortality with and without prehospital RBC availability (27.6% versus 32.0%; P = 0.343). Trauma patient mortality increases with the magnitude of hemodynamic instability and anatomic injury. Some literature evidence indicates no survival advantage with prehospital RBC availability. However, other data suggesting a potential benefit is confounded or likely to be biased.

  9. Modelling seasonal effects of temperature and precipitation on honey bee winter mortality in a temperate climate. (United States)

    Switanek, Matthew; Crailsheim, Karl; Truhetz, Heimo; Brodschneider, Robert


    Insect pollinators are essential to global food production. For this reason, it is alarming that honey bee (Apis mellifera) populations across the world have recently seen increased rates of mortality. These changes in colony mortality are often ascribed to one or more factors including parasites, diseases, pesticides, nutrition, habitat dynamics, weather and/or climate. However, the effect of climate on colony mortality has never been demonstrated. Therefore, in this study, we focus on longer-term weather conditions and/or climate's influence on honey bee winter mortality rates across Austria. Statistical correlations between monthly climate variables and winter mortality rates were investigated. Our results indicate that warmer and drier weather conditions in the preceding year were accompanied by increased winter mortality. We subsequently built a statistical model to predict colony mortality using temperature and precipitation data as predictors. Our model reduces the mean absolute error between predicted and observed colony mortalities by 9% and is statistically significant at the 99.9% confidence level. This is the first study to show clear evidence of a link between climate variability and honey bee winter mortality. Copyright © 2016 British Geological Survey, NERC. Published by Elsevier B.V. All rights reserved.

  10. Data base on animal mortality

    International Nuclear Information System (INIS)

    Jones, T.D.


    A data base on animal mortality has been compiled. The literature on LD 50 and the dose-response function for radiation-induced lethality, reflect several inconsistencies - primarily due to dose assignments and to analytical methods and/or mathematical models used. Thus, in order to make the individual experiments which were included in the data base as consistent as possible, an estimate of the uniform dose received by the bone marrow in each treatment group was made so that the interspecies differences are minimized. The LD 50 was recalculated using a single estimation procedure for all studies for which sufficient experimental data are available. For small animals such as mice, the dose to the hematopoietic system is approximately equal to the treatment dose, but for large animals the marrow dose may be about half of the treatment dose

  11. Cancer mortality around nuclear sites

    International Nuclear Information System (INIS)

    Hill, C.; LaPlanche, A.


    Studies (including that of Gardner) of cancer mortality around individual nuclear sites in Britain show an excess of childhood leukemia near such sites. These have been attributed to radioactive discharges, increased radiation doses and radiation doses to the fathers of affected children. However, no such excess has been found in studies in other countries including France, Canada and the USA where similar radiation doses could have been received. Several explanations of this discrepancy are reviewed. It is possible that results from the small UK samples may be due to chance. A difference in external and internal doses for reprocessing plant workers may also be a factor. The possibility of a viral infection for leukemia spreading in new town populations is also mentioned. Whilst the studies in other countries are reassuring, the childhood leukemia excesses found in Britain round nuclear sites are still unexplained. (UK)

  12. Air pollution and human mortality

    Energy Technology Data Exchange (ETDEWEB)

    Lave, L B [Carnegie-Mellon Univ., Pittsburgh, PA (USA). Dept. of Economics; Seskin, E P [Department of Commerce, Washington, DC (USA). Environmental and Nonmarket Economics Div.


    Investigations have been made on the quantitative relationship between air pollution and human mortality. While primary focus has been on suspended particulates and sulfates from stationary sources of pollution, the evidence relating to air pollutants attributed to mobile sources was also examined. Using statistical analyses for a large number of US metropolitan areas, it was concluded that the benefits associated with a substantial abatement of air pollution from stationary sources are greater than the costs of such abatement. In contrast, the situation for mobile sources-chiefly cars and trucks is less clear-cut. That is, the costs of implementing the currently mandated US standards for automobile emissions probably exeed their potential health benefits.

  13. Cancer mortality studied by Dounreay

    International Nuclear Information System (INIS)

    Wood, R.; Smith, N.D.


    A report is given of a cancer mortality study in Caithness, Sutherland, Orkney and Shetland between 1958 and 1982. For Caithness and Sutherland, the numbers of male deaths from all kinds of cancer was significantly less than the numbers expected from figures for Scotland as a whole; for females no difference was observed; the parish of Latheron showed an excess of leukaemia cases. For Orkney and Shetland, the total number of cancer deaths for both sexes was significantly less than for Scotland as a whole. In Shetland, there was an excess of lymphatic leukaemia in Northmaven based on four deaths observed. In Orkney, one parish showed an excess of lymphatic and haematopoietic cancers. (UK)

  14. Age-dependent mortality in the pilocarpine model of status epilepticus. (United States)

    Blair, Robert E; Deshpande, Laxmikant S; Holbert, William H; Churn, Severn B; DeLorenzo, Robert J


    Status epilepticus (SE) is an acute neurological emergency associated with significant morbidity and mortality. Age has been shown to be a critical factor in determining outcome after SE. Understanding the causes of this increased mortality with aging by developing an animal model to study this condition would play a major role in studying mechanisms to limit the mortality due to SE. Here we employed pilocarpine to induce SE in rats aged between 5 and 28 weeks. Similar to clinical studies in man, we observed that age was a significant predictor of mortality following SE. While no deaths were observed in 5-week-old animals, mortality due to SE increased progressively with age and reached 90% in 28-week-old animals. There was no correlation between the age of animals and severity of SE. With increasing age mortality occurred earlier after the onset of SE. These results indicate that pilocarpine-induced SE in the rat provides a useful model to study age-dependent SE-induced mortality and indicates the importance of using animal models to elucidate the mechanisms contributing to SE-induced mortality and the development of novel therapeutic interventions to prevent SE-induced death.

  15. Population health and the economy: Mortality and the Great Recession in Europe. (United States)

    Tapia Granados, José A; Ionides, Edward L


    We analyze the evolution of mortality-based health indicators in 27 European countries before and after the start of the Great Recession. We find that in the countries where the crisis has been particularly severe, mortality reductions in 2007-2010 were considerably bigger than in 2004-2007. Panel models adjusted for space-invariant and time-invariant factors show that an increase of 1 percentage point in the national unemployment rate is associated with a reduction of 0.5% (p rate of age-adjusted mortality. The pattern of mortality oscillating procyclically is found for total and sex-specific mortality, cause-specific mortality due to major causes of death, and mortality for ages 30-44 and 75 and over, but not for ages 0-14. Suicides appear increasing when the economy decelerates-countercyclically-but the evidence is weak. Results are robust to using different weights in the regression, applying nonlinear methods for detrending, expanding the sample, and using as business cycle indicator gross domestic product per capita or employment-to-population ratios rather than the unemployment rate. We conclude that in the European experience of the past 20 years, recessions, on average, have beneficial short-term effects on mortality of the adult population. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Maternal mortality: a global overview. (United States)

    Choolani, M; Ratnam, S S


    Reduction of maternal mortality in developing countries is possible through elimination of unsafe abortion, active management of labor, appropriate management of pregnancy complications, and availability of adequate facilities. Prevention and early recognition are key factors in preventing maternal deaths due to ruptured uteri. A well equipped hospital is the appropriate place for delivery of mothers with a history of previous cesarean sections, a grossly contracted pelvis, previous myomectomies, previous multiple births, and previous abnormal births or complications during delivery. Complicated procedures, use of oxytocins, and administration of anesthesia should be performed with experienced, trained medical personnel. Surveillance of and correction for anemia should occur during the course of the pregnancy. Infections can be controlled with tetanus toxoid immunization and use of chest X-rays. The health care system should be tiered with primary health care services located in suburbs and rural districts. Services should be situated to account for population distribution, extent of maternal mortality in the region, transportation facilities, and the nearest secondary hospital. Birthing homes with sanitary facilities are an option for rural districts. A two-way referral system should be established between the primary, secondary, and tertiary level hospitals. Audits should be conducted as a means of checking for needed improvements in the system. Planning that includes proper roads, transportation, and communication facilities is important. Funding can come in the form of money, materials, and manpower. Safe motherhood requires the commitment of local people and local governments. The first step in a safe motherhood program is creating awareness among the political and economic elite. Governments are encouraged to shift resources from the military to housing, transportation, communications, education, and health during peace-times. Local professional associations

  17. Enhanced tamper indicator (United States)

    Garcia, Anthony R.; Johnston, Roger G.


    The present invention provides an apparatus and method whereby the reliability and tamper-resistance of tamper indicators can be improved. A flexible connector may be routed through a latch for an enclosure such as a door or container, and the free ends of the flexible connector may be passed through a first locking member and firmly attached to an insert through the use of one or more attachment members such as set screws. A second locking member may then be assembled in interlocking relation with the first locking member to form an interlocked assembly around the insert. The insert may have one or more sharp projections extending toward the first or second locking member so that any compressive force applied in an attempt to disassemble the interlocked assembly results in permanent, visible damage to the first or second locking member.

  18. Position indication apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Masuda, T


    A plurality of magnetically operated switches are spaced equally in the hollow tube of a control rod actuating mechanism. One side of each switch is connected, via a low resistance, to a corresponding tap of a low resistance voltage divider network consisting of an equivalent number of low resistance sections with the opposite side of each switch connected to a common conducting wire A. To both ends of the voltage dividing network are connected, respectively, conducting wires B and C. Wires A, B, and C are further coupled to a fuel rod position indicator comprising a voltmeter and power source external to the control rod actuating member. The control rod actuating member is adapted to slide in the hollow tube so that switches passing a position facing a magnet secured to the lower end of the actuating member are rendered closed. Hence, the position of the control rod may be read by reading the voltage off the meter.

  19. Lichens as pollution indicators

    Energy Technology Data Exchange (ETDEWEB)

    Rose, F


    Although lichens are generally considered to be of little use to man, their sensitivity to air pollution makes them good biological indicators. The author describes how this feature can help to establish relative degrees of air pollution. He notes areas where lichens are reduced in number and vigor, and some in which they have disappeared altogether. He challenges the idea that dryness is responsible, since they have also disappeared from damp woodland areas. Experimental work supports the view that sulfur dioxide is the major factor rather than smoke, although there is no definitive proof. Lichen damage correlates best with mean winter levels of air pollution by SO/sub 2/. 16 references, 1 figure.

  20. Cytological indicators: Haematopoetic effects

    International Nuclear Information System (INIS)

    Fliedner, T.M.; Nothdurft, W.


    It is the aim of this paper, intended more as a general outline than a comprehensive review, to elucidate the most prominent events in the sequence of radiation induced cytological changes in the hemopoietic system taking its functional organisation and the cytokinetics of blood cell production into consideration. As could be shown, there are about ten different categories of quantitative and qualitative parameters based on methods ranging from stem cell determinations to tests for mature blood cell function that in principle are available for assessment of radiation damage to the bone marrow and that have been applied to men exposed to ionizing radiation. Some of these indicator systems have proven for a long period of time to be of essential value and to be quite feasible in practice under routine conditions. Considerable methodological progress, however, is needed for others before decisions about their practical applicability can be made. (orig.)

  1. International energy indicators

    International Nuclear Information System (INIS)

    Rossi, E. Jr.


    Data are tabulated and graphically represented on international energy indicators. The following are presented: world crude oil production, 1974 to October 1981; OPEC crude oil productive capacity; world crude oil and refined product inventory levels, 1975 to October, 1981; oil consumption in OECD countries, 1975 to October 1981; USSR crude oil production and exports, 1975 to October, 1981; free world and US nuclear electricity generation, 1973 to December, 1981 and current capacity. Specific US data presented are: US domestic oil supply, 1977 to June, 1981; US gross imports of crude oil and products, 1973 to October, 1981; landed cost of Saudi crude current and 1974 dollars; US coal trade, 1975 to September, 1981; US natural gas trade, 1975 to October, 1981; summary of US merchandise trade, 1977 to October, 1981; and energy/GNP ratio

  2. Flammability Indices for Refrigerants (United States)

    Kataoka, Osami

    This paper introduces a new index to classify flammable refrigerants. A question on flammability indices that ASHRAE employs arose from combustion test results of R152a and ammonia. Conventional methods of not only ASHRAE but also ISO and Japanese High-pressure gas safety law to classify the flammability of refrigerants are evaluated to show why these methods conflict with the test results. The key finding of this paper is that the ratio of stoichiometric concentration to LFL concentration (R factor) represents the test results most precisely. In addition, it has excellent correlation with other flammability parameters such as flame speed and pressure rise coefficient. Classification according to this index gives reasonable flammability order of substances including ammonia, R152a and carbon monoxide. Theoretical background why this index gives good correlation is also discussed as well as the insufficient part of this method.

  3. Teriparatide - Indications beyond osteoporosis

    Directory of Open Access Journals (Sweden)

    Marilyn Lee Cheng


    Full Text Available Osteoporosis is a condition of impaired bone strength that results in an increased risk of fracture. The current and most popular pharmacological options for the treatment of osteoporosis include antiresorptive therapy, in particular, oral bisphosphonates (alendronate, risedronate, ibandronate. Anabolic agents like teriparatide have widened our therapeutic options. They act by directly stimulating bone formation and improving bone mass quantity and quality. Two forms of recombinant human parathyroid hormone (PTH are available : full-length PTH (PTH 1-84; approved in the EU only and the 1-34 N-terminal active fragment of PTH (teriparatide, US FDA approved. This review aims to discuss the benefits of teriparatide beyond the currently licensed indications like fracture healing, dental stability, osteonecrosis of jaw, hypoparathyroidism, and hypocalcemia.

  4. Mortality following Stroke, the Weekend Effect and Related Factors: Record Linkage Study.

    Directory of Open Access Journals (Sweden)

    Stephen E Roberts

    Full Text Available Increased mortality following hospitalisation for stroke has been reported from many but not all studies that have investigated a 'weekend effect' for stroke. However, it is not known whether the weekend effect is affected by factors including hospital size, season and patient distance from hospital.To assess changes over time in mortality following hospitalisation for stroke and how any increased mortality for admissions on weekends is related to factors including the size of the hospital, seasonal factors and distance from hospital.A population study using person linked inpatient, mortality and primary care data for stroke from 2004 to 2012. The outcome measures were, firstly, mortality at seven days and secondly, mortality at 30 days and one year.Overall mortality for 37 888 people hospitalised following stroke was 11.6% at seven days, 21.4% at 30 days and 37.7% at one year. Mortality at seven and 30 days fell significantly by 1.7% and 3.1% per annum respectively from 2004 to 2012. When compared with week days, mortality at seven days was increased significantly by 19% for admissions on weekends, although the admission rate was 21% lower on weekends. Although not significant, there were indications of increased mortality at seven days for weekend admissions during winter months (31%, in community (81% rather than large hospitals (8% and for patients resident furthest from hospital (32% for distances of >20 kilometres. The weekend effect was significantly increased (by 39% for strokes of 'unspecified' subtype.Mortality following stroke has fallen over time. Mortality was increased for admissions at weekends, when compared with normal week days, but may be influenced by a higher stroke severity threshold for admission on weekends. Other than for unspecified strokes, we found no significant variation in the weekend effect for hospital size, season and distance from hospital.

  5. Birth dimensions, parental mortality, and mortality in early adult age: a cohort study of Danish men born in 1953

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Osler, Merete


    liver cirrhosis. Offspring birth dimensions showed an inverse association with parental mortality, which was most pronounced for maternal mortality. CONCLUSIONS: The strong inverse association between birth dimensions and adult mortality, but lack of association between ponderal index and mortality...

  6. Handgrip Strength: Indications of Paternal Inheritance in Three European Regions

    DEFF Research Database (Denmark)

    Cournil, Amandine; Jeune, Bernard; Skytthe, Axel


    BACKGROUND: Handgrip strength is an indicator of overall muscle strength. Poor handgrip strength is a risk factor for disability and mortality. We aimed to investigate the pattern of inheritance of handgrip strength in a sample of parent-offspring pairs from three different European regions...

  7. Indications Et Suites Operatoires De La Cesarienne En Milieu Rural ...

    African Journals Online (AJOL)

    Objective: To evaluate the frequency of cesarean section in a rural maternity Black Africa; specify indications and to evaluate the morbidity and maternal mortality experience: maternity hospital Saint Joseph of Dacha in Togo. Results: The cesarean rate was 25.10%, with 34% of patients referred. Fetal distress was the ...

  8. Trends in cancer mortality in Mexico: 1990–2012

    Directory of Open Access Journals (Sweden)

    Pedro Rizo-Ríos


    Discussion: In Mexico, cancer is a major public health problem. Although mortality is an indicator of the access and effectiveness of medical care, it is necessary to create population-based cancer registries to have basic information in the planning and quality assessment of medical services such as prevention, early diagnosis and treatment, as well as to develop strategies to allocate resources and necessities to fulfil the population's demand for medical assistance.

  9. Air pollution and mortality in Barcelona.


    Sunyer, J; Castellsagué, J; Sáez, M; Tobias, A; Antó, J M


    STUDY OBJECTIVES: Studies conducted in Barcelona reported a short term relation between daily air pollutant values and emergency department admissions for exacerbation of chronic obstructive pulmonary diseases and asthma. Air pollution in Barcelona is mainly generated by vehicle exhaust and is below the World Health Organization air quality guidelines. The acute relation between air pollution and mortality was assessed. DESIGN: Daily variations in total mortality, mortality in subjects older ...

  10. Socioeconomic Inequality in mortality using 12-year follow-up data from nationally representative surveys in South Korea. (United States)

    Khang, Young-Ho; Kim, Hye-Ryun


    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.

  11. Infection increases mortality in necrotizing pancreatitis

    DEFF Research Database (Denmark)

    Werge, Mikkel; Novovic, Srdjan; Schmidt, Palle N


    OBJECTIVES: To assess the influence of infection on mortality in necrotizing pancreatitis. METHODS: Eligible prospective and retrospective studies were identified through manual and electronic searches (August 2015). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Meta...... sterile necrosis and organ failure was associated with a mortality of 19.8%. If the patients had infected necrosis without organ failure the mortality was 1.4%. CONCLUSIONS: Patients with necrotizing pancreatitis are more than twice as likely to die if the necrosis becomes infected. Both organ failure...... and infected necrosis increase mortality in necrotizing pancreatitis....

  12. Abdominal obesity in Japanese-Brazilians: which measure is best for predicting all-cause and cardiovascular mortality?

    Directory of Open Access Journals (Sweden)

    Marselle Rodrigues Bevilacqua

    Full Text Available This study aimed to verify which anthropometric measure of abdominal obesity was the best predictor of all-cause and cardiovascular mortality in Japanese-Brazilians. The study followed 1,581 subjects for 14 years. Socio-demographic, lifestyle, metabolic, and anthropometric data were collected. The dependent variable was vital status (alive or dead at the end of the study, and the independent variable was presence of abdominal obesity according to different baseline measures. The mortality rate was estimated, and Poisson regression was used to obtain mortality rate ratios with abdominal obesity, adjusted simultaneously for the other variables. The mortality rate was 10.68/thousand person-years. Male gender, age > 60 years, and arterial hypertension were independent risk factors for mortality. The results indicate that prevalence of abdominal obesity was high among Japanese-Brazilians, and that waist/hip ratio was the measure with the greatest capacity to predict mortality (especially cardiovascular mortality in this group.

  13. Cardiorespiratory hospitalisation and mortality reductions after smoking bans in Switzerland. (United States)

    Vicedo-Cabrera, Ana M; Röösli, Martin; Radovanovic, Dragana; Grize, Leticia; Witassek, Fabienne; Schindler, Christian; Perez, Laura


    Smoking bans are considered one of the most effective policies to reduce population exposure to tobacco smoke and prevent adverse health outcomes. However, evidence on the effect of contextual variables on the effectiveness of smoking bans is still lacking. The patchwork of cantonal smoke-free laws in Switzerland was used as a quasi-experimental setting to assess changes after their introduction in: hospitalisations and mortality due to cardiorespiratory diseases in adults; total hospitalisations and hospitalisations due to respiratory disorders in children; and the modifying effects of contextual factors and the effectiveness of the laws. Using hospital and mortality registry data for residents in Switzerland (2005-2012), we conducted canton-specific interrupted time-series analyses followed by random effects meta-analyses to obtain nationwide smoking ban estimates by subgroups of age, sex and causes of hospitalisation or death. Heterogeneity of the impact caused by strictness of the ban and other smoking-related characteristics of the cantons was explored through meta-regression. Total hospitalisation rates due to cardiovascular and respiratory diseases did not significantly change after the introduction of the ban. Post-ban changes were detected in ischaemic heart disease hospitalisations, with a 2.5% reduction (95% confidence interval [CI)] -6.2 to 1.3%) for all ages and 5.5% (95% CI -10.8 to -0.2%) in adults 35-64 years old. Total mortality due to respiratory diseases decreased by 8.2% (95% CI -15.2 to -0.6%) over all ages, and chronic obstructive pulmonary disease mortality decreased by 14.0% (95% CI -22.3 to -4.5%) in adults ≥65 years old. Cardiovascular mortality did not change after the introduction of the ban, but there was an indication of post-ban reductions in mortality due to hypertensive disorders (-5.4%, 95% CI -12.6 to 2.3%), and congestive heart failure (-6.0%, 95% CI -14.5 to 3.4%). No benefits were observed for hospitalisations due to

  14. [Associations between mortality and alcohol consumption in Lithuanian population]. (United States)

    Grabauskas, Vilius; Prochorskas, Remigijus; Veryga, Aurelijus


    The objective of the study was to assess alcohol-related mortality that potentially might explain an increasing trend in overall mortality of Lithuanian population, which started after 2000 and peaked in 2005. An empiric analysis of national mortality and other statistical data as well as their international comparisons. An analysis of available data clearly indicates that a decline in mortality in 1998-2000, i.e. during the beginning of the National Programme of Health, as well as its increase in 2001 and 2005 were predominantly determined by cause-specific deaths of two groups: deaths from diseases of the circulatory system (mainly ischemic heart disease) and alcohol consumption-related deaths (liver cirrhosis, accidental poisoning by alcohol, accidents, etc.). A certain proportion of deaths, which were caused by alcohol, were wrongly assigned to the deaths from diseases of the circulatory system due to uncertainties in filling-in death certificates. By approximate estimates, at least one-quarter of increase in all-cause mortality between 2002-2004 and 2005-2007 could be explained by an increase in alcohol consumption, accounting for additional 880 deaths on average per year. In the year 2007, 12.6% (n=5760) of all deaths were somehow related to alcohol consumption. A comparative analysis demonstrated that mortality and alcohol consumption trends were going in parallel over the last decade. The systemic decline in mortality observed in Lithuania from 1995 stopped in 2000 after a decrease in alcohol taxes, which resulted in an increase in alcohol accessibility and consumption. An average annual increase in alcohol consumption over the period of 2001-2004 was 7%; it increased up to 17% in 2005 and accounted for 12% annual increase on average within 2005-2007. Negative trends in alcohol-related morbidity and mortality in Lithuanian population most notably registered in 2001 and 2005 were largely influenced by uncontrollable increase in alcohol consumption over the

  15. Serbia within the European context: An analysis of premature mortality

    Directory of Open Access Journals (Sweden)

    Marinkovic Jelena


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

  16. Challenges in assessing hospital-level stroke mortality as a quality measure: comparison of ischemic, intracerebral hemorrhage, and total stroke mortality rates. (United States)

    Xian, Ying; Holloway, Robert G; Pan, Wenqin; Peterson, Eric D


    Public reporting efforts currently profile hospitals based on overall stroke mortality rates, yet the "mix" of hemorrhagic and ischemic stroke cases may impact this rate. Using the 2005 to 2006 New York state data, we examined the degree to which hospital stroke mortality rankings varied regarding ischemic versus hemorrhagic versus total stroke. Observed/expected ratio was calculated using the Agency for Healthcare Research and Quality Inpatient Quality Indicator software. The observed/expected ratio and outlier status based on stroke types across hospitals were examined using Pearson correlation coefficients (r) and weighted κ. Overall 30-day stroke mortality rates were 15.2% and varied from 11.3% for ischemic stroke and 37.3% for intracerebral hemorrhage. Hospital risk-adjusted ischemic stroke observed/expected ratio was weakly correlated with its own intracerebral hemorrhage observed/expected ratio (r=0.38). When examining hospital performance group (mortality better, worse, or no different than average), disagreement was observed in 35 of 81 hospitals (κ=0.23). Total stroke mortality observed/expected ratio and rankings were correlated with intracerebral hemorrhage (r=0.61 and κ=0.36) and ischemic stroke (r=0.94 and κ=0.71), but many hospitals still switched classification depending on mortality metrics. However, hospitals treating a higher percent of hemorrhagic stroke did not have a statistically significant higher total stroke mortality rate relative to those treating fewer hemorrhagic strokes. Hospital stroke mortality ratings varied considerably depending on whether ischemic, hemorrhagic, or total stroke mortality rates were used. Public reporting of stroke mortality measures should consider providing risk-adjusted outcome on separate stroke types.

  17. The unfinished health agenda: Neonatal mortality in Cambodia.

    Directory of Open Access Journals (Sweden)

    Rathmony Hong

    education level (none, primary, secondary+ and household wealth (asset-based index. Data on antenatal care, tetanus injection and skilled assistance at birth were used for the mother's last child. Between 2000 and 2014, Cambodia achieved a considerable reduction in neonatal mortality (46% reduction rate. By 2014, gender inequities became almost non-existent (for all measures of equality; inequity related to mother's education decreased for all time periods; improvements were observed for differences in neonatal mortality by preceding birth interval; and a reduction in neonatal mortality rates could be noted among all the regional subgroups. Inequities increased between mothers who had limited antenatal care and those who received more than four antenatal care visits. In most scale indicators, the Slope Index of Inequality and Relative Index of Inequality estimates for all four rounds of the survey suggest inequity exacerbated in deprived communities. Also, wealth and residence (urban/rural divide continued to be major determinants in neonatal mortality rates and related inequity trends.Analysis highlighted some of the complex patterns and determinants of neonatal mortality, in Cambodia. There has been a considerable decline in neonatal mortality which echoes global trends. Our analysis reveals that despite these advances, additional socio-economic and demographic characteristics considerably affected neonatal mortality rates and its inequities. There continue to be pockets of vulnerable groups that are lagging behind. This analysis highlights the determinants along the urban-rural and rich-poor divides in neonatal mortality inequities and how these affect access to and utilization of quality basic health services. This calls for future policy and programming efforts to be deliberate in their equity approach. Quality improvements in health services and targeted interventions for specific socio-economic groups will be required to further accelerate progress in reducing

  18. The unfinished health agenda: Neonatal mortality in Cambodia. (United States)

    Hong, Rathmony; Ahn, Pauline Yongeun; Wieringa, Frank; Rathavy, Tung; Gauthier, Ludovic; Hong, Rathavuth; Laillou, Arnaud; Van Geystelen, Judit; Berger, Jacques; Poirot, Etienne


    , secondary+) and household wealth (asset-based index). Data on antenatal care, tetanus injection and skilled assistance at birth were used for the mother's last child. Between 2000 and 2014, Cambodia achieved a considerable reduction in neonatal mortality (46% reduction rate). By 2014, gender inequities became almost non-existent (for all measures of equality); inequity related to mother's education decreased for all time periods; improvements were observed for differences in neonatal mortality by preceding birth interval; and a reduction in neonatal mortality rates could be noted among all the regional subgroups. Inequities increased between mothers who had limited antenatal care and those who received more than four antenatal care visits. In most scale indicators, the Slope Index of Inequality and Relative Index of Inequality estimates for all four rounds of the survey suggest inequity exacerbated in deprived communities. Also, wealth and residence (urban/rural divide) continued to be major determinants in neonatal mortality rates and related inequity trends. Analysis highlighted some of the complex patterns and determinants of neonatal mortality, in Cambodia. There has been a considerable decline in neonatal mortality which echoes global trends. Our analysis reveals that despite these advances, additional socio-economic and demographic characteristics considerably affected neonatal mortality rates and its inequities. There continue to be pockets of vulnerable groups that are lagging behind. This analysis highlights the determinants along the urban-rural and rich-poor divides in neonatal mortality inequities and how these affect access to and utilization of quality basic health services. This calls for future policy and programming efforts to be deliberate in their equity approach. Quality improvements in health services and targeted interventions for specific socio-economic groups will be required to further accelerate progress in reducing neonatal mortality and address

  19. Risk of Cardiovascular Morbidity and Mortality in Relation to Temperature (United States)

    Mathes, Robert; Ito, Kazuhiko; Matte, Thomas


    outcomes. For our sensitivity analysis, we included PM2.5 and O3 in our model. Results During the cold season, CVD-related ED visits and hospitalizations increased, while mortality decreased, with increasing mean temperature on the same day and lagged days. Extremely cold temperature was associated with a small increase of same day in-hospital mortality though generally cold temperatures did not appear to be associated with higher mortality. The opposite was observed in the warm season as ED visits and hospitalizations decreased, and mortality increased, with increasing mean temperature on the same day and on lagged days. Our sensitivity analysis, in which we controlled for PM2.5 and O3, demonstrated little effect of these air pollutants on the relationship between temperature and CVD outcomes. Conclusions Our results suggest a decline in risk of a CVD-related ED visit and hospitalization during extreme temperatures on the same day and on recent day lags for both cold and warm seasons. In contrast, our findings for mortality indicate an increase in risk of CVD-related deaths during hot temperatures. No mortality effect was observed during cold temperatures. The effects of extreme temperatures on CVD-related morbidity may be explained by behavioral patterns, as people are more likely to stay indoors on the coldest and hottest days.

  20. Particulate air pollution and daily mortality in Detroit. (United States)

    Schwartz, J


    Particulate air pollution has been associated with increased mortality during episodes of high pollution concentrations. The relationship at lower concentrations has been more controversial, as has the relative role of particles and sulfur dioxide. Replication has been difficult because suspended particle concentrations are usually measured only every sixth day in the U.S. This study used concurrent measurements of total suspended particulates (TSP) and airport visibility from every sixth day sampling for 10 years to fit a predictive model for TSP. Predicted daily TSP concentrations were then correlated with daily mortality counts in Poisson regression models controlling for season, weather, time trends, overdispersion, and serial correlation. A significant correlation (P less than 0.0001) was found between predicted TSP and daily mortality. This correlation was independent of sulfur dioxide, but not vice versa. The magnitude of the effect was very similar to results recently reported from Steubenville, Ohio (using actual TSP measurements), with each 100 micrograms/m3 increase in TSP resulting in a 6% increase in mortality. Graphical analysis indicated a dose-response relationship with no evidence of a threshold down to concentrations below half of the National Ambient Air Quality Standards for particulate matter.

  1. Colorectal Cancer Incidence and Mortality Disparities in New Mexico

    International Nuclear Information System (INIS)

    Hoffman, R. M.; Gonzales, M.; Wiggins, C. L.; Hoffman, R. M.


    Previous analyses indicated that New Mexican Hispanics and American Indians (AI) did not experience the declining colorectal cancer (CRC) incidence and mortality rates observed among non-Hispanic whites (NHW). We evaluated more recent data to determine whether racial/ethnic differences persisted. Methods. We used New Mexico Surveillance Epidemiology and End Results data from 1995 to 2009 to calculate age-specific incidence rates and age-adjusted incidence rates overall and by tumor stage. We calculated mortality rates using National Center for Health Statistics’ data. We used join point regression to determine annual percentage change (APC) in age-adjusted incidence rates. Analyses were stratified by race/ethnicity and gender. Results. Incidence rates continued declining in NHW (APC −1.45% men, −1.06% women), while non significantly increasing for AI (1.67% men, 1.26% women) and Hispanic women (0.24%). The APC initially increased in Hispanic men through 2001 (3.33%, P = 0.06), before declining (−3.10%, P = 0,003). Incidence rates declined in NHW and Hispanics aged 75 and older. Incidence rates for distant-stage cancer remained stable for all groups. Mortality rates declined significantly in NHW and Hispanics. Conclusions. Racial/ethnic disparities in CRC persist in New Mexico. Incidence differences could be related to risk factors or access to screening; mortality differences could be due to patterns of care for screening or treatment.

  2. Alcohol Prices and Mortality Due to Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Jon P. Nelson


    Full Text Available This study estimates a reduced-form regression model for mortality rates due to alcoholic liver diseases, with alcohol prices and income as explanatory variables. Panel data cover the years 2000-2010 for 21 member countries of the European Union. In the reduced form, prices affect mortality rates indirectly through the demand for alcohol, while income has potential direct and indirect effects. Country and time fixed effects are used to control for other factors that influence alcohol consumption and mortality. Special attention is paid to outliers in the data, and final results are based on the MS-estimator for robust regressions. Regression results for alcohol prices and income are sensitive to adjustments for stationary data and down-weighting of outliers and other influential data points. Final results indicate that alcohol prices do not affect mortality rates due to chronic liver diseases. Empirical results in the study do not lend support to broad price-based approaches to alcohol policy.

  3. Success in reducing maternal and child mortality in Afghanistan. (United States)

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


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

  4. Temperature extremes reduce seagrass growth and induce mortality. (United States)

    Collier, C J; Waycott, M


    Extreme heating (up to 43 °C measured from five-year temperature records) occurs in shallow coastal seagrass meadows of the Great Barrier Reef at low tide. We measured effective quantum yield (ϕPSII), growth, senescence and mortality in four tropical seagrasses to experimental short-duration (2.5h) spikes in water temperature to 35 °C, 40 °C and 43 °C, for 6 days followed by one day at ambient temperature. Increasing temperature to 35 °C had positive effects on ϕPSII (the magnitude varied between days and was highly correlated with PPFD), with no effects on growth or mortality. 40 °C represented a critical threshold as there were strong species differences and there was a large impact on growth and mortality. At 43 °C there was complete mortality after 2-3 days. These findings indicate that increasing duration (more days in a row) of thermal events above 40 °C is likely to affect the ecological function of tropical seagrass meadows. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Correlation between national income, HIV/AIDS and political status and mortalities in African countries. (United States)

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


    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.

  6. Electronic health indicators in the selected countries: Are these indicators the best? (United States)

    Afshari, Somaye; Khorasani, Elahe; Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Darab, Mohsen Ghaffari


    Many changes have been made in different sciences by developing and advancing information and communication technology in last two decades. E-health is a very broad term that includes many different activities related to the use of electronic devices, software as well as hardware in health organizations. The aim of this study is comparing electronic health indicators in the selected countries and discussion on the best indicators. This study has chosen 12 countries randomly based on the regional division of the WHO. The relevant numbers of health indicators and general indicators and information technology indicators are extracted of these countries. We use data from the Bitarf's comparative study, which is conducted by the Iranian Supreme Council of Information Technology in 2007. By using Pearson correlation test, the relations between health general indicators and IT indicators are studied. Data was analyzed based on the research objectives using SPSS software and in accordance with research questions Pearson correlation test were used. The findings show that there is a positive relation between indicators related to IT and "Total per capita health, healthy life expectancy, percent literacy". Furthermore, there is a mutual relation between IT indicators and "mortality indicator". This study showed differences between selective indicators among different countries. The modern world, with its technological advances, is not powerless in the face of these geographic and health disparity challenges. Researchers must not rely on the available indicators. They must consider indicators like e-business companies, electronic data internet, medical supplies, health electronic record, health information system, etc., In future, continuous studies in this field, to provide the exact and regular reports of amount of using of these indicators through different countries must be necessary.

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

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim


    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...

  8. Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) - Smoking-Attributable Mortality (SAM) (United States)

    U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable mortality (SAM) is the number of deaths caused by cigarette...

  9. Hyperprolactinemia and the Association with All-Cause Mortality and Cardiovascular Mortality

    DEFF Research Database (Denmark)

    Krogh, Jesper; Selmer, Christian; Torp-Pedersen, Christian


    Hyperprolactinemia has been suspected to increase mortality risk, but the available data are conflicting. The objective of this study was to estimate the association between hyperprolactinemia and all-cause and cardiovascular mortality among patients referred for assessment of prolactin......-cause mortality (95% CI 1.22-2.82) and 2.55 (95% CI 1.43-4.55) for cardiovascular mortality. The IRR for all-cause mortality was reduced to 1.37 (0.90-2.08) when adjusted for the use of antipsychotic medication. The association between hyperprolactinemia and cardiovascular mortality remained after adjusting...... for confounders, for example, chronic renal failure, diabetes, and antipsychotic medication. In females, hyperprolactinemia was not associated with all-cause mortality (IRR 1.45; CI 0.86-2.47) or cardiovascular mortality (IRR 0.58; CI 0.14-2.39). In conclusion, hyperprolactinemia was associated with increased...

  10. Maternal mortality in Kassala State - Eastern Sudan: community-based study using Reproductive age mortality survey (RAMOS

    Directory of Open Access Journals (Sweden)

    Mohammed Abdalla A


    Full Text Available Abstract Background The maternal mortality ratio in Sudan was estimated at 750/100,000 live births. Sudan was one of eleven countries that are responsible for 65% of global maternal deaths according to a recent World Health Organization (WHO estimate. Maternal mortality in Kassala State was high in national demographic surveys. This study was conducted to investigate the causes and contributing factors of maternal deaths and to identify any discrepancies in rates and causes between different areas. Methods A reproductive age mortality survey (RAMOS was conducted to study maternal mortality in Kassala State. Deaths of women of reproductive age (WRA in four purposively selected areas were identified by interviewing key informants in each village followed by verbal autopsy. Results Over a three-year period, 168 maternal deaths were identified among 26,066 WRA. Verbal autopsies were conducted in 148 (88.1% of these cases. Of these, 64 (43.2% were due to pregnancy and childbirth complications. Maternal mortality rates and ratios were 80.6 per 100,000 WRA and 713.6 per 100,000 live births (LB, respectively. There was a wide discrepancy between urban and rural maternal mortality ratios (369 and 872100,000 LB, respectively. Direct obstetric causes were responsible for 58.4% of deaths. Severe anemia (20.3% and acute febrile illness (9.4% were the major indirect causes of maternal death whereas obstetric hemorrhage (15.6%, obstructed labor (14.1% and puerperal sepsis (10.9% were the major obstetric causes. Of the contributing factors, we found delay of referral in 73.4% of cases in spite of a high problem recognition rate (75%. 67.2% of deaths occurred at home, indicating under utilization of health facilities, and transportation problems were found in 54.7% of deaths. There was a high illiteracy rate among the deceased and their husbands (62.5% and 48.4%, respectively. Conclusions Maternal mortality rates and ratios were found to be high, with a wide

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

    International Nuclear Information System (INIS)

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


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

  12. Stage-specific mortality of Baltic cod ( Gadus morhua L.) eggs

    DEFF Research Database (Denmark)

    Wieland, Kai; Hinrichsen, H.H.; Grønkjær, P.


    A study on cod egg mortality was carried out in the Bornholm Basin (southern central Baltic Sea) toward the end of July 1996. An initial egg aggregation marked by a satellite-tracked drifter buoy was sampled repeatedly over an Ii-day period; profiles of temperature, salinity and dissolved oxygen...... were concurrently recorded. Three replicate estimates of mortality were obtained for each pair of subsequent developmental stages from newly spawned eggs to early larvae. A consistent pattern of stage-specific mortality coincided well with previous experimental observations. Average daily mortality...... rates were 7.2% (eggs IA/IB), 38.7% (eggs (IB/II), 25.6% (eggs II/III), 40.0% (eggs III/IV), and 42.3% (eggs IV/early larvae). The cumulative mortality until hatch amounted to 99.9%. Results from hydrodynamic modelling, however, indicated that the drifter's trajectory was influenced by wind stress...

  13. Perceived extrinsic mortality risk and reported effort in looking after health: testing a behavioral ecological prediction. (United States)

    Pepper, Gillian V; Nettle, Daniel


    Socioeconomic gradients in health behavior are pervasive and well documented. Yet, there is little consensus on their causes. Behavioral ecological theory predicts that, if people of lower socioeconomic position (SEP) perceive greater personal extrinsic mortality risk than those of higher SEP, they should disinvest in their future health. We surveyed North American adults for reported effort in looking after health, perceived extrinsic and intrinsic mortality risks, and measures of SEP. We examined the relationships between these variables and found that lower subjective SEP predicted lower reported health effort. Lower subjective SEP was also associated with higher perceived extrinsic mortality risk, which in turn predicted lower reported health effort. The effect of subjective SEP on reported health effort was completely mediated by perceived extrinsic mortality risk. Our findings indicate that perceived extrinsic mortality risk may be a key factor underlying SEP gradients in motivation to invest in future health.

  14. Postdiagnosis statin use and mortality in danish patients with prostate cancer

    DEFF Research Database (Denmark)

    Larsen, Signe Benzon; Dehlendorff, Christian; Skriver, Charlotte


    Purpose Increasing evidence indicates that statin use may reduce mortality from prostate cancer. In this work, we examined whether postdiagnosis statin use was associated with reduced cancer-specific mortality or all-cause mortality among patients with prostate cancer in Denmark. Material...... and Methods From nationwide Danish registries, we identified all patients with incident prostate adenocarcinoma from 1998 to 2011 and retrieved data on tumor and patient characteristics, drug use, and primary treatment. We defined postdiagnosis use (two or more prescriptions) of statins as a time......-varying covariate with 1-year lag. Cox proportional hazards regression models used to compute hazard ratios (HRs) for prostate cancer-specific mortality and all-cause mortality through 2013 associated with postdiagnosis statin use. In secondary and sensitivity analyses, we assessed statin use within exposure...

  15. Nonstructural leaf carbohydrate dynamics of Pinus edulis during drought-induced tree mortality reveal role for carbon metabolism in mortality mechanism. (United States)

    Adams, Henry D; Germino, Matthew J; Breshears, David D; Barron-Gafford, Greg A; Guardiola-Claramonte, Maite; Zou, Chris B; Huxman, Travis E


    Vegetation change is expected with global climate change, potentially altering ecosystem function and climate feedbacks. However, causes of plant mortality, which are central to vegetation change, are understudied, and physiological mechanisms remain unclear, particularly the roles of carbon metabolism and xylem function. We report analysis of foliar nonstructural carbohydrates (NSCs) and associated physiology from a previous experiment where earlier drought-induced mortality of Pinus edulis at elevated temperatures was associated with greater cumulative respiration. Here, we predicted faster NSC decline for warmed trees than for ambient-temperature trees. Foliar NSC in droughted trees declined by 30% through mortality and was lower than in watered controls. NSC decline resulted primarily from decreased sugar concentrations. Starch initially declined, and then increased above pre-drought concentrations before mortality. Although temperature did not affect NSC and sugar, starch concentrations ceased declining and increased earlier with higher temperatures. Reduced foliar NSC during lethal drought indicates a carbon metabolism role in mortality mechanism. Although carbohydrates were not completely exhausted at mortality, temperature differences in starch accumulation timing suggest that carbon metabolism changes are associated with time to death. Drought mortality appears to be related to temperature-dependent carbon dynamics concurrent with increasing hydraulic stress in P. edulis and potentially other similar species. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

  16. [Mortality in the perinatal period]. (United States)

    Gutiérrez Avila, J H; Villalobos Olivas, A; Contreras Lemus, J


    A comparative study was conducted between 1978-79 in the pediatric department of the Mexican General Hospital to investigate social and physiopathological conditions leading to neonatal mortality. 100 newborn infants who had survived the first week of life were compared to 100 who had died. Social variables such as maternal age, education, socioeconomic status, marital status, and prenatal care were investigated, as well as physiopathological characteristics such as toxemia, length of gestation, diabetes, bleeding during the last trimester of pregnancy, type of presentation at delivery, congenital malformations, length of delivery, fetal cardiac frequency, and Apgar scores. Considerable social risk factors were identified in unmarried mothers (45.2% of those whose babies died, as compared to 21.4% in the control group), and lack of prenatal care (73.7% versus 41.1%). Physiopathological risk factors were low birth weight (80.5% versus 22%), probable diabetes of the mother (57.3% versus 8.7%), gestation of less than 37 weeks (70.4% versus 17.7%), low Apgar scores at 5 minutes of life (71.0% versus 10.3%), and fetal bradycardia (68.3% versus 6.3% in the control group). Abdominal or cesarean delivery seemed to represent a lesser risk than the use of forceps or the need for manual maneuvers. The need for comprehensive prenatal care programs, especially among the economically poor, is stressed.

  17. Projecting future mortality in the Netherlands taking into account mortality delay and smoking

    NARCIS (Netherlands)

    Janssen, F.; de Beer, J.A.A.


    Estimates of future mortality often prove inaccurate as conventional extrapolative mortality projection methods do not capture the impact of smoking nor the mortality delay: the shift in the age-at-death distribution towards older ages. The added value of incorporating information on smoking into

  18. Winter mortality in relation to climate

    NARCIS (Netherlands)

    Keatinge, W. R.; Donaldson, G. C.; Bucher, K.; Jendritzky, G.; Cordioli, E.; Martinelli, M.; Katsouyanni, K.; Kunst, A. E.; McDonald, C.; Näyhä, S.; Vuori, I.


    We report further details of the Eurowinter survey of cold related mortalities and protective measures against cold in seven regions of Europe, and review these with other evidence on the relationship of winter mortality to climate. Data for the oldest subject group studied, aged 65-74, showed that

  19. Trends in mortality decrease and economic growth

    NARCIS (Netherlands)

    Niu, G.; Melenberg, B.


    The vast literature on extrapolative stochastic mortality models focuses mainly on the extrapolation of past mortality trends and summarizes the trends by one or more latent factors. However, the interpretation of these trends is typically not very clear. On the other hand, explanation methods are

  20. Excess mortality in giant cell arteritis

    DEFF Research Database (Denmark)

    Bisgård, C; Sloth, H; Keiding, Niels


    A 13-year departmental sample of 34 patients with definite (biopsy-verified) giant cell arteritis (GCA) was reviewed. The mortality of this material was compared to sex-, age- and time-specific death rates in the Danish population. The standardized mortality ratio (SMR) was 1.8 (95% confidence...

  1. Mortality in patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Wermuth, L; Stenager, E; Stenager, E


    INTRODUCTION: After the introduction of L-dopa the mortality rate in Parkinson's disease (PD) patients has changed, but is still higher than in the background population. MATERIAL & METHODS: Mortality, age at death and cause of death in a group of PD patients compared with the background population...

  2. VSRR - Quarterly provisional estimates for infant mortality (United States)

    U.S. Department of Health & Human Services — Provisional estimates of infant mortality (deaths of infants under 1 year per 1,000 live births), neonatal mortality (deaths of infants aged 0-27 days per 1,000 live...

  3. Diuretics and mortality in acute renal failure

    NARCIS (Netherlands)

    Uchino, Shigehiko; Doig, Gordon S.; Bellomo, Renaldo; Morimatsu, Hiroshi; Morgera, Stanislao; Schetz, Miet; Tan, Ian; Bouman, Catherine; Nacedo, Ettiene; Gibney, Noel; Tolwani, Ashita; Ronco, Claudio; Kellum, John A.


    According to recent research, diuretics may increase mortality in acute renal failure patients. The administration of diuretics in such patients has been discouraged. Our objective was to determine the impact of diuretics on the mortality rate of critically ill patients with acute renal failure.

  4. Epidemiology of Maternal Mortality in Malawi

    African Journals Online (AJOL)

    live births. Causes and determinants of maternal mortal- ity. Global causes of maternal mortality. Across the globe the causes of maternal deaths are strik- ..... at home”. Findings from Thyolo, Mangochi and Chik- wawa were similar". Perceived qua/ity of care. Like anywhere in the world, the perceived quality of care in ...

  5. Cancer mortality in Ireland, 1976-1986

    International Nuclear Information System (INIS)

    Seymour, C.; Herity, B.; Moriarty, M.J.


    This volume brings together in easily accessible form up-to-date mortality statistics for cancer for the Republic of Ireland. Because of small numbers in many of the malignant neoplasms studied rates and standardised mortality ratios have been calculated for the 11 year period 1976-86. Basic data only is presented, based on cancer type, location, sex and age group

  6. Regional differences in Dutch maternal mortality

    NARCIS (Netherlands)

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


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

  7. Regional differences in Dutch maternal mortality.

    NARCIS (Netherlands)

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


    Please cite this paper as: de Graaf J, Schutte J, Poeran J, van Roosmalen J, Bonsel G, Steegers E. Regional differences in Dutch maternal mortality. BJOG 2012;119:582-588. Objective To study regional differences in maternal mortality in the Netherlands. Design Confidential inquiry into the causes of

  8. Mortality and reduced growth hormone secretion

    DEFF Research Database (Denmark)

    Stochholm, Kirstine; Christiansen, Jens; Laursen, Torben


    BACKGROUND: Data regarding the mortality rates of patients with growth hormone deficiency (GHD), whether or not treated with growth hormone (GH), are limited, but an increased mortality rate among hypopituitary patients compared with the general population has been documented. Cardiovascular dise...

  9. Alcohol consumption and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    on the relationship between liver cirrhosis mortality and alcohol consumption is included. The conclusion is that the total level of alcohol consumption as well as the specific beverages - beer, wine and spirits - contributes to liver cirrhosis mortality, but the present study also reveals that directly addressing...

  10. Social inequality in infant mortality: what explains variation across low and middle income countries? (United States)

    Hajizadeh, Mohammad; Nandi, Arijit; Heymann, Jody


    Growing work demonstrates social gradients in infant mortality within countries. However, few studies have compared the magnitude of these inequalities cross-nationally. Even fewer have assessed the determinants of social inequalities in infant mortality across countries. This study provides a comprehensive and comparative analysis of social inequalities in infant mortality in 53 low-and-middle-income countries (LMICs). We used the most recent nationally representative household samples (n = 874,207) collected through the Demographic Health Surveys (DHS) to calculate rates of infant mortality. The relative and absolute concentration indices were used to quantify social inequalities in infant mortality. Additionally, we used meta-regression analyses to examine whether levels of inequality in proximate determinants of infant mortality were associated with social inequalities in infant mortality across countries. Estimates of both the relative and the absolute concentration indices showed a substantial variation in social inequalities in infant mortality among LMICs. Meta-regression analyses showed that, across countries, the relative concentration of teenage pregnancy among poorer households was positively associated with the relative concentration of infant mortality among these groups (beta = 0.333, 95% CI = 0.115 0.551). Our results demonstrate that the concentration of infant deaths among socioeconomically disadvantaged households in the majority of LMICs remains an important health and social policy concern. The findings suggest that policies designed to reduce the concentration of teenage pregnancy among mothers in lower socioeconomic groups may mitigate social inequalities in infant mortality. Copyright © 2013 Elsevier Ltd. All rights reserved.


    Koç, İsmet; Eryurt, Mehmet Alİ


    Turkey has high levels of infant mortality and consanguineous marriages. It has had a high level of infant mortality for its economic level for many years. Over recent decades, although adult mortality rates have not been very different from those of other countries with similar socioeconomic structures, its life expectancy at birth has remained low due to its high infant mortality rate. This has been called the Turkish Puzzle. According to the Turkey Family Structure and Population Issues Survey, 27% of women had a consanguineous marriage in 1968. Subsequent Turkish Demographic and Health Surveys (TDHSs) found the rate of consanguineous marriages to be stagnated at 22-24%, with a resistance to reduction. According to the TDHS-2008, 24% of women had a consanguineous marriage. Numerous studies in various countries of the world have indicated that consanguineous marriages, particularly of first-degree, have the effect of increasing infant mortality. The main aim of this study was to assess the causal impact of consanguineous, particularly first-degree consanguineous, marriages on infant mortality, controlling for individual, cultural, bio-demographic and environmental factors. Data were merged from four Turkish DHS data sets (1993, 1998, 2003 and 2008). Multivariate analysis revealed that first-degree consanguineous marriages have increased infant mortality by 45% in Turkey: 57% in urban areas and 39% in rural areas. The results indicate that there is a causal relationship between consanguineous marriages and infant mortality. This finding should be taken into account when planning policies to reduce infant mortality in Turkey, and in other countries with high rates of consanguineous marriage and infant mortality.

  12. Income related inequalities in avoidable mortality in Norway: A population-based study using data from 1994-2011. (United States)

    Kinge, Jonas Minet; Vallejo-Torres, Laura; Morris, Stephen


    The aim of this study was to measure income-related inequalities in avoidable, amenable and preventable mortality in Norway over the period 1994-2011. We undertook a register-based population study of Norwegian residents aged 18-65 years between 1994 and 2011, using data from the Norwegian Income Register and the Cause of Death Registry. Concentration indices were used to measure income-related inequalities in avoidable, amenable and preventable mortality for each year. We compared the trend in income-related inequality in avoidable mortality with the trend in income inequality, measured by the Gini coefficient for income. Avoidable, amenable and preventable deaths in Norway have declined over time. There were persistent pro-poor socioeconomic inequalities in avoidable, amenable and preventable mortality, and the degree of inequality was larger in preventable mortality than in amenable mortality throughout the period. The income-avoidable mortality association was positively correlated with income inequalities in avoidable mortality over time. There was little or no relationship between variations in the Gini coefficient due to tax reforms and socioeconomic inequalities in avoidable mortality. Income-related inequalities in avoidable, amenable and preventable mortality have remained relatively constant between 1994 and 2011 in Norway. They were mainly correlated with the relationship between income and avoidable mortality rather than with variations in the Gini coefficient of income inequality. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Size matters: a meta-analysis on the impact of hospital size on patient mortality. (United States)

    Fareed, Naleef


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

  14. An Overview of Infant Mortality Trends in Qatar from 2004 to 2014. (United States)

    Al-Thani, Mohammed; Al-Thani, Al-Anoud; Toumi, Amine; Khalifa, Shams Eldin; Akram, Hammad


    Background Infant mortality is an important health indicator that estimates population well-being. Infant mortality has declined globally but is still a major public health challenge. This article provides the characteristics, causes, burden, and trends of infant mortality in Qatar. Methods Frequencies, percentages, and rates were calculated using data from birth-death registries over 2004-2014 to describe infant mortality by nationality, gender, and age group. We calculated the relative risks of the top causes of infant mortality among subgroups according to the 10 th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, Version 2016). Results During 2004-2014, 204,224 live births and 1,505 infant deaths were recorded. The infant mortality rate (IMR) averaged 7.4/1000 live births (males 8.1, females 6.6, non-Qataris 7.7, and Qataris 6.8). IMR declined 20% from 2004 to 2014. The decline in IMR was significant for the overall population of infants (p=0.006), male infants (p=0.04), females (p=0.006), and for non-Qatari males (p=0.007) and non-Qatari females (p=0.007). The leading causes of infant mortality were congenital malformations (all types) (34.5%), low birth weight (LBW) (27%), and respiratory distress of newborns (2.8%). Male infants had a higher risk of mortality than female infants due to a congenital malformation of lungs (p=0.02), other congenital malformations, not elsewhere classified (p=0.01), and cardiovascular disorders (p=0.05). Conclusion The study shows that infant mortality among male infants is high due to the top infant mortality-related disorders, and male infants have a higher risk of mortality than female infants.

  15. Are the Poor Dying Younger in Malaysia? An Examination of the Socioeconomic Gradient in Mortality. (United States)

    Mariapun, Jeevitha; Hairi, Noran N; Ng, Chiu-Wan


    Socioeconomic inequalities in health represent unfairness in the health distribution of a population. Efforts to produce information on mortality distributions in many low and middle income countries (LMICs) are mostly hampered by lack of data disaggregated by socioeconomic groups. In this paper we describe how mortality statistics obtained from multiple data sources were combined to provide an evaluation of the socioeconomic distribution of mortality in Malaysia, a LMIC located in the Asia Pacific region. This study has an ecological design. As a measure of socioeconomic status, we used principal component analysis to construct a socioeconomic index using census data. Districts were ranked according to the standardised median index of households and assigned to each individual in the 5-year mortality data. The mortality indicators of interest were potential years of life lost (PYLL), standardised mortality ratio (SMR), infant mortality rate (IMR) and under-5 mortality rate (U5MR). Both socioeconomic status and mortality outcomes were used compute the concentration index which provided the summary measure of the magnitude of inequality. Socially disadvantaged districts were found to have worse mortality outcomes compared to more advantaged districts. The values of the concentration index for the overall population of the Peninsula are C = -0.1334 (95% CI: -0.1605 to -0.1063) for the PYLL, C = -0.0685 (95% CI: -0.0928 to -0.0441) for the SMR, C = -0.0997 (95% CI: -0.1343 to -0.0652) for the IMR and C = -0.1207 (95% CI: -0.1523 to -0.0891) for the U5MR. Mortality outcomes within ethnic groups were also found to be less favourable among the poor. The findings of this study suggest that socioeconomic inequalities disfavouring the poor exist in Malaysia.

  16. Effects of economic downturns on child mortality: a global economic analysis, 1981-2010. (United States)

    Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Zeltner, Thomas; Raine, Rosalind; Atun, Rifat


    To analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels. Retrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation. Global. 204 countries between 1981 and 2010. Child mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors. 197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0-21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1-5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001). Economic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries.

  17. The contribution of competition to tree mortality in old-growth coniferous forests (United States)

    Das, A.; Battles, J.; Stephenson, N.L.; van Mantgem, P.J.


    Competition is a well-documented contributor to tree mortality in temperate forests, with numerous studies documenting a relationship between tree death and the competitive environment. Models frequently rely on competition as the only non-random mechanism affecting tree mortality. However, for mature forests, competition may cease to be the primary driver of mortality.We use a large, long-term dataset to study the importance of competition in determining tree mortality in old-growth forests on the western slope of the Sierra Nevada of California, U.S.A. We make use of the comparative spatial configuration of dead and live trees, changes in tree spatial pattern through time, and field assessments of contributors to an individual tree's death to quantify competitive effects.Competition was apparently a significant contributor to tree mortality in these forests. Trees that died tended to be in more competitive environments than trees that survived, and suppression frequently appeared as a factor contributing to mortality. On the other hand, based on spatial pattern analyses, only three of 14 plots demonstrated compelling evidence that competition was dominating mortality. Most of the rest of the plots fell within the expectation for random mortality, and three fit neither the random nor the competition model. These results suggest that while competition is often playing a significant role in tree mortality processes in these forests it only infrequently governs those processes. In addition, the field assessments indicated a substantial presence of biotic mortality agents in trees that died.While competition is almost certainly important, demographics in these forests cannot accurately be characterized without a better grasp of other mortality processes. In particular, we likely need a better understanding of biotic agents and their interactions with one another and with competition. ?? 2011.

  18. Recent trends in cancer mortality in Uruguay

    International Nuclear Information System (INIS)

    Garau, M.; Alonso, R.; Musetti, C.; Barrios, E.


    Objective: To analyze trends in cancer mortality in Uruguay in the period 1989-2008. Methodology: The National Cancer Registry (NCR) collects information from cancer mortality from the death certificates: 147 631 deaths were identified in the period from cancer, which was recorded topography, sex and age. They were calculated for each year mortality rates adjusted for age (TMAE) using as standard the world population. Trends were assessed using the method and calculated the joinpoint Estimated Annual Percent Change (ESPP). Results: The TMAE presents downward trend in both sexes (ESPP = significant -0.60 in men and -0.49 In women). In the period studied, mortality presented decreasing trend when it comes to cancer breast cancer in women (ESPP -0.79, significant), and increased for prostate cancer (ESPP = 0.70) and kidney (ESPP = 1.82 and 1.71 in men and women respectively). As regards the digestive system decreased mortality observed for esophageal cancer (ESPP in = -1.93 men and women = -1.78) and stomach (ESPP = -2.22 men and women -2.24 ). Mortality for cancer of colorectum is stable in men (ESPP = 0.35 No significant (NS)) and shows a decline slight but steady in women (ESPP -0.5). As for cancers that show strong association with smoking, decreased mortality observed lung and laryngeal cancer in men (ESPP = -1.11 and -2.05 respectively), confirming the trend found between 1990 and 2001; in women there is increased mortality from lung cancer (ESPP = 2.76) that is not accompanied by increased mortality from laryngeal cancer (-0.1 ESPP = NS). Mortality from cancers oral cavity and pharynx is stable, but in women a significant increase (ESPP = 1.84) is observed when the oral cavity is analyzed in isolation (lip, tongue, gums, palate). As cervical cancer, mortality trends in 20 years is to increase (ESPP = 1.14), however, if consider only the past decade, mortality appears stabilized (ESPP = 0.57 NS). Conclusions: The overall trend of cancer mortality (all sites

  19. Mortality in mothers after perinatal loss

    DEFF Research Database (Denmark)

    Hvidtjørn, Dorte; Wu, C; Schendel, D


    OBJECTIVE: To assess whether mothers who lost a child from stillbirth or in the first week of life have an increased overall mortality and cause-specific mortality. DESIGN: A population based follow-up study. SETTING: Data from Danish national registers. POPULATION: All mothers in Denmark were...... included in the cohort at time of their first delivery from 1 January 1980 to 31 December 2008 and followed until 31 December 2009 or death, whichever came first. METHODS: The association between perinatal loss and total and cause-specific mortality in mothers was estimated with hazard ratios (HR) and 95......% confidence intervals (95% CI) calculated using Cox proportional hazards regression analyses. MAIN OUTCOME MEASURES: Overall mortality and cause-specific mortality. RESULTS: During the follow-up period, 838 331 mothers in the cohort gave birth to one or more children and 7690 mothers (0.92%) experienced...

  20. Long-term mortality after poliomyelitis

    DEFF Research Database (Denmark)

    Nielsen, Nete Munk; Rostgaard, Klaus; Juel, Knud


    BACKGROUND: Few studies have described mortality and cause of death among persons with a history of polio. METHODS: We identified a group of patients diagnosed with poliomyelitis in Copenhagen between 1919 and 1954. We obtained information on vital status through May 1997 and on cause of death...... by linkage with the Danish Civil Registration System and the Danish Cause-of-Death Register. Overall and cause-specific standardized mortality ratios served as the measure of mortality risk relative to that of the general population. RESULTS: We observed 1295 deaths among 5977 polio patients compared...... with an expected 1141 deaths (standardized mortality ratio = 1.14; 95% confidence interval = 1.07-1.20). Excess mortality was restricted to polio patients with a history of severe paralysis of the extremities (1.69; 1.32-2.15) or patients who had been treated for respiratory failure during the epidemics (2.71; 2...

  1. The gestational age pattern of human mortality

    DEFF Research Database (Denmark)

    Schöley, Jonas; Vaupel, James W.; Jacobsen, Rune

    -infant lifetable by gestational age spanning week 23 until week 100 after the last menstrual period of the mother. This joint lifetable shows a remarkable regularity in the gestational age profile of fetal- and infant mortality: Mortality rates are declining over the whole observed age range with the exception......In order to check hypotheses about the cause for "ontogenescense" -- the phenomenon of a declining force of mortality prior to maturity -- I analyse data on human mortality by gestational age. Based on extensive microdata on births, fetal- and infant deaths in the US 2009 I calculate a joint fetal...... of a "birth hump" peaking week 38. The absolute rate of decline slows down over age. The observed gestational age pattern of the force of mortality is consistent with three hypotheses concerning the causes for ontogenescense: 1) Adaptation: as the organism growths it becomes more resilient towards death, 2...

  2. Vitamin D with calcium reduces mortality

    DEFF Research Database (Denmark)

    Rejnmark, Lars; Avenell, Alison; Masud, Tahir


    Introduction: Vitamin D may affect multiple health outcomes. If so, an effect on mortality is to be expected. Using pooled data from randomized controlled trials, we performed individual patient data (IPD) and trial level meta-analyses to assess mortality among participants randomized to either...... vitamin D alone or vitamin D with calcium. Subjects and Methods: Through a systematic literature search, we identified 24 randomized controlled trials reporting data on mortality in which vitamin D was given either alone or with calcium. From a total of 13 trials with more than 1000 participants each......,528 randomized participants (86.8% females) with a median age of 70 (interquartile range, 62-77) yr. Vitamin D with or without calcium reduced mortality by 7% [hazard ratio, 0.93; 95% confidence interval (CI), 0.88-0.99]. However, vitamin D alone did not affect mortality, but risk of death was reduced if vitamin...

  3. Isolated microalbuminuria indicates a poor medical prognosis. (United States)

    Scheven, Lieneke; Van der Velde, Marije; Lambers Heerspink, Hiddo J; De Jong, Paul E; Gansevoort, Ron T


    Microalbuminuria is often regarded as a sign of end-organ damage due to diabetes and/or hypertension, and as such to be associated with an increased risk for cardiovascular events. It has been questioned whether isolated microalbuminuria, that is microalbuminuria in the absence of a cardiovascular disease (CVD) history, hypertension and diabetes has clinical relevance. Included were 8356 subjects who participated in the first four screening rounds of the PREVEND study, a prospective, community-based, observational cohort study. Isolated microalbuminuria was defined as microalbuminuria (30-300 mg/24 h), in the absence of a CVD history, hypertension (blood pressuredefinition of isolated microalbuminuria, in which 2250 person-years of follow-up were available. In subjects with isolated microalbuminuria, the incidence rates of cardiovascular events and mortality, hypertension and diabetes were 15.3, 28.9 and 8.9 per 1000 person-year follow-up, respectively. Subjects with isolated microalbuminuria had an increased risk for cardiovascular events and mortality [crude HR 2.23 (1.63-3.07); Phypertension [OR 1.95 (1.47-2.59); Phypertension and/or diabetes. This increased risk remained significant after adjustment for age and gender. The relative risk held by isolated microalbuminuria was similar to the relative risk held by microalbuminuria in subjects that did have a CVD history, hypertension and/or diabetes. Isolated microalbuminuria indicates a poor prognosis and warrants medical attention.

  4. [Mortality and morbidity in surgery for abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Banke, A.B.; Andersen, Jakob Steen; Heslet, L.


    Care Unit's (ICU) Critical Information System, a blood bank and the database of a vascular surgery unit. RESULTS: The perioperative mortality was 8%, ICU mortality 22%, postoperative mortality 33% and 30-day mortality 39%. The ICU mortality for patients with renal failure and septic shock...... was significantly higher than the overall ICU mortality. The ICU mortality and morbidity increased with the amount of postoperative blood loss. Patients with an initial serum creatinine concentration of

  5. Patterns of mortality rates in Darfur conflict. (United States)

    Degomme, Olivier; Guha-Sapir, Debarati


    Several mortality estimates for the Darfur conflict have been reported since 2004, but few accounted for conflict dynamics such as changing displacement and causes of deaths. We analyse changes over time for crude and cause-specific mortality rates, and assess the effect of displacement on mortality rates. Retrospective mortality surveys were gathered from an online database. Quasi-Poisson models were used to assess mortality rates with place and period in which the survey was done, and the proportions of displaced people in the samples were the explanatory variables. Predicted mortality rates for five periods were computed and applied to population data taken from the UN's series about Darfur to obtain the number of deaths. 63 of 107 mortality surveys met all criteria for analysis. Our results show significant reductions in mortality rates from early 2004 to the end of 2008, although rates were higher during deployment of fewer humanitarian aid workers. In general, the reduction in rate was more important for violence-related than for diarrhoea-related mortality. Displacement correlated with increased rates of deaths associated with diarrhoea, but also with reduction in violent deaths. We estimated the excess number of deaths to be 298 271 (95% CI 178 258-461 520). Although violence was the main cause of death during 2004, diseases have been the cause of most deaths since 2005, with displaced populations being the most susceptible. Any reduction in humanitarian assistance could lead to worsening mortality rates, as was the case between mid 2006 and mid 2007. Copyright 2010 Elsevier Ltd. All rights reserved.

  6. Cardiovascular disease mortality in Asian Americans. (United States)

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


    Asian Americans are a rapidly growing racial/ethnic group in the United States. Our current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups. The purpose of the study was to examine heart disease and stroke mortality rates in Asian-American subgroups to determine racial/ethnic differences in cardiovascular disease mortality within the United States. We examined heart disease and stroke mortality rates for the 6 largest Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) from 2003 to 2010. U.S. death records were used to identify race/ethnicity and cause of death by International Classification of Diseases-10th revision coding. Using both U.S. Census data and death record data, standardized mortality ratios (SMRs), relative SMRs (rSMRs), and proportional mortality ratios were calculated for each sex and ethnic group relative to non-Hispanic whites (NHWs). In this study, 10,442,034 death records were examined. Whereas NHW men and women had the highest overall mortality rates, Asian Indian men and women and Filipino men had greater proportionate mortality burden from ischemic heart disease. The proportionate mortality burden of hypertensive heart disease and cerebrovascular disease, especially hemorrhagic stroke, was higher in every Asian-American subgroup compared with NHWs. The heterogeneity in cardiovascular disease mortality patterns among diverse Asian-American subgroups calls attention to the need for more research to help direct more specific treatment and prevention efforts, in particular with hypertension and stroke, to reduce health disparities for this growing population. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Detecting early warning signals of tree mortality in boreal North America using multiscale satellite data. (United States)

    Rogers, Brendan M; Solvik, Kylen; Hogg, Edward H; Ju, Junchang; Masek, Jeffrey G; Michaelian, Michael; Berner, Logan T; Goetz, Scott J


    Increasing tree mortality from global change drivers such as drought and biotic infestations is a widespread phenomenon, including in the boreal zone where climate changes and feedbacks to the Earth system are relatively large. Despite the importance for science and management communities, our ability to forecast tree mortality at landscape to continental scales is limited. However, two independent information streams have the potential to inform and improve mortality forecasts: repeat forest inventories and satellite remote sensing. Time series of tree-level growth patterns indicate that productivity declines and related temporal dynamics often precede mortality years to decades before death. Plot-level productivity, in turn, has been related to satellite-based indices such as the Normalized difference vegetation index (NDVI). Here we link these two data sources to show that early warning signals of mortality are evident in several NDVI-based metrics up to 24 years before death. We focus on two repeat forest inventories and three NDVI products across western boreal North America where productivity and mortality dynamics are influenced by periodic drought. These data sources capture a range of forest conditions and spatial resolution to highlight the sensitivity and limitations of our approach. Overall, results indicate potential to use satellite NDVI for early warning signals of mortality. Relationships are broadly consistent across inventories, species, and spatial resolutions, although the utility of coarse-scale imagery in the heterogeneous aspen parkland was limited. Longer-term NDVI data and annually remeasured sites with high mortality levels generate the strongest signals, although we still found robust relationships at sites remeasured at a typical 5 year frequency. The approach and relationships developed here can be used as a basis for improving forest mortality models and monitoring systems. © 2018 John Wiley & Sons Ltd.

  8. Bioclimatic Extremes Drive Forest Mortality in Southwest, Western Australia

    Directory of Open Access Journals (Sweden)

    Bradley John Evans


    Full Text Available Extreme and persistent reductions in annual precipitation and an increase in the mean diurnal temperature range have resulted in patch scale forest mortality following the summer of 2010–2011 within the Forest study area near Perth, Western Australia. The impacts of 20 bioclimatic indicators derived from temperature, precipitation and of actual and potential evapotranspiration are quantified. We found that spatially aggregated seasonal climatologies across the study area show 2011 with an annual mean of 17.7 °C (± 5.3 °C was 1.1 °C warmer than the mean over recent decades (1981–2011,- 16.6 °C ± 4.6 °C and the mean has been increasing over the last decade. Compared to the same period, 2010–2011 summer maximum temperatures were 1.4 °C (31.6 °C ± 2.0 °C higher and the annual mean diurnal temperature range (Tmax−Tmin was 1.6 °C higher (14.7 °C ± 0.5 °C. In 2009, the year before the forest mortality began, annual precipitation across the study area was 69% less (301 mm ± 38 mm than the mean of 1981–2010 (907 mm ± 69 mm. Using Système Pour l'Observation de la Terre mission 5 (SPOT-5 satellite imagery captured after the summer of 2010–2011 we map a broad scale forest mortality event across the Forested study area. This satellite-climatology based methodology provides a means of monitoring and mapping similar forest mortality events- a critical contribution to our understanding the dynamical bioclimatic drivers of forest mortality events.

  9. Fir Decline and Mortality in the Southern Siberian Mountains (United States)

    Kharuk, Viacheslav I.; Im, Sergei T.; Petrov, Ilya A.; Dvinskaya, Mariya, L.; Fedotova, Elena V.; Ranson, Kenneth J.


    Increased dieback and mortality of dark needle conifer (DNC) stands (composed of fir (Abies sibirica),Siberian pine (Pinus sibirica) and spruce (Picea obovata))were documented in Russia during recent decades. Here we analyzed spatial and temporal patterns of fir decline and mortality in the southern Siberian Mountains based on satellite, in situ and dendrochronological data. The studied stands are located within the boundary between DNC taiga to the north and forest-steppe to the south. Fir decline and mortality were observed to originate where topographic features contributed to maximal water-stress risk, i.e., steep (1825),convex, south-facing slopes with a shallow well-drained root zone. Fir regeneration survived droughts and increased stem radial growth, while upper canopy trees died. Tree ring width(TRW) growth negatively correlated with vapor pressure deficit (VPD), drought index and occurrence of late frosts, and positively with soil water content. Previous year growth conditions (i.e., drought index, VPD, soil water anomalies)have a high impact on current TRW (r 0.600.74). Fir mortality was induced by increased water stress and severe droughts (as a primary factor) in synergy with bark-beetles and fungi attacks (as secondary factors). Dendrochronology data indicated that fir mortality is a periodic process. In a future climate with increased aridity and drought frequency, fir (and Siberian pine) may disappear from portions of its current range (primarily within the boundary with the forest steppe)and is likely to be replaced by drought-tolerant species such as Pinus sylvestris and Larix sibirica.

  10. [The role of supply-side characteristics of services in AIDS mortality in Mexico]. (United States)

    Bautista-Arredondo, Sergio; Serván-Mori, Edson; Silverman-Retana, Omar; Contreras-Loya, David; Romero-Martínez, Martín; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Lozano, Rafael


    To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

  11. The effect of parity on cause-specific mortality among married men and women. (United States)

    Jaffe, Dena H; Eisenbach, Zvi; Manor, Orly


    The objective of this study was to examine mortality differentials among men and women by parity for deaths from cardio-vascular disease (CVD), cancer and other causes. The census-based Israel Longitudinal Mortality Study II (1995-2004) was used to identify 71,733 married men and 62,822 married women (45-89 years). During the 9-year follow-up period, 19,347 deaths were reported. Cox proportional hazard models adjusted for age, origin, and social class were used. A non-linear association between parity and CVD mortality was detected for men and women. Excess CVD mortality risks were observed among middle-aged women with no children (hazard ratio [HR] 2.43, 95% confidence interval [CI] 1.49, 3.96) and among middle-aged women and men with 8+ children (HR(women) 1.64, CI 1.02, 2.65; HR(men) 1.40, CI 1.01, 1.93) compared to those with two children. No clear pattern of association between cancer mortality and parity was apparent for men. Elderly women with 8+ children showed reduced mortality risks from reproductive cancers (HR 0.22, CI 0.05, 0.91). Similar parity-related mortality patterns were observed for men and women for deaths from CVD and other causes indicating biosocial pathways. The association between parity and cancer mortality differed by gender, age and type of cancer.

  12. Strong regional links between socio-economic background factors and disability and mortality in Oslo, Norway

    International Nuclear Information System (INIS)

    Rognerud, Marit Aase; Krueger, Oystein; Gjertsen, Finn; Thelle, Dag Steinar


    Study objective: To study geographical differences in mortality and disability and sosio-economic status in Oslo, Norway. Setting: A total of 25 local authority districts within the city of Oslo. Design: Analysis of age adjusted mortality rates aged 0-74 in the period 1991-1994, and cross sectional data on disability pensioners aged 50-66 and socio-economic indicators (low education, single parenthood, unemployment, high income) in 1994. Main outcome measures: The levels of correlation between the health outcomes (mortality and disability) and sosio-economic exposure variables. Main results: The geographical patterns of mortality and disability display substantial similarities and show strong linear correlation with area measures of socio-economic deprivation. The ratios between the highest and lowest area mortality rates were 3.3 for men and 2.1 for women, while the high-low ratios of disability were 7.0 for men and 3.8 for women. For women deprivation measures are better correlated with disability than mortality. While disability and mortality display similar correlations with deprivation measures for men. Conclusions: The social gradients in health are substantial in Oslo. Further ecological analysis of cause specific morbidity and mortality and the distribution of risk factors ought to be done to identify problem areas suitable for interventions. However, to understand the mechanisms and the relative importance of each etiological factor, studies based on individual data have to be performed

  13. Mini Nutritional Assessment and Mortality after Hip Fracture Surgery in the Elderly. (United States)

    van Wissen, J; van Stijn, M F M; Doodeman, H J; Houdijk, A P J


    Hip fracture surgery in elderly patients is associated with a poor postoperative outcome and a high mortality. Malnutrition is a frequent problem in elderly patients and may be associated with mortality after hip fracture surgery. The Mini Nutritional Assessment (MNA) is a valuable tool to identify malnourished patients and those at risk for malnutrition. To evaluate the association between the preoperative MNA score and mortality after surgery for hip fractures in elderly patients. Patients with a hip fracture and an indication for surgery were included in our study. This study was part of a randomized trial on the effect of taurine on postoperative outcome in elderly hip fracture patients. The MNA was assessed on admission before surgery. Length of stay, postoperative complications and mortality were documented. The association of the MNA score on postoperative outcome and mortality was analyzed using Cox regression analysis. The one-year survival rate in 226 elderly hip fracture patients was 79%. In-hospital mortality rates and 1-year mortality were 27% and 46% in malnourished patients, 12% and 26% in patients at risk for malnutrition and 7% and 17% in well-nourished patients as assessed by MNA. Preoperative malnutrition measured by the MNA is associated with mortality in elderly hip fracture patients.

  14. Physical activity and mortality: is the association explained by genetic selection? (United States)

    Carlsson, Sofia; Andersson, Tomas; Lichtenstein, Paul; Michaëlsson, Karl; Ahlbom, Anders


    Public health recommendations promote physical activity to improve health and longevity. Recent data suggest that the association between physical activity and mortality may be due to genetic selection. Using data on twins, the authors investigated whether genetic selection explains the association between physical activity and mortality. Data were based on a postal questionnaire answered by 13,109 Swedish twin pairs in 1972. The national Cause of Death Register was used for information about all-cause mortality (n=1,800) and cardiovascular disease mortality (n=638) during 1975-2004. The risk of death was reduced by 34% for men (relative risk=0.64, 95% confidence interval: 0.50, 0.83) and by 25% for women (relative risk=0.75, 95% confidence interval: 0.50, 1.14) reporting high physical activity levels. Within-pair comparisons of monozygotic twins showed that, compared with their less active co-twin, the more active twin had a 20% (odds ratio=0.80, 95% confidence interval: 0.65, 0.99) reduced risk of all-cause mortality and a 32% (odds ratio=0.68, 95% confidence interval: 0.49, 0.95) reduced risk of cardiovascular disease mortality. Results indicate that physical activity is associated with a reduced risk of mortality not due to genetic selection. This finding supports a causal link between physical activity and mortality.

  15. Farmers' perceptions of goat kid mortality under communal farming in Eastern Cape, South Africa. (United States)

    Slayi, Mhlangabezi; Maphosa, Viola; Fayemi, Olutope Peter; Mapfumo, Lizwell


    Rearing of goats under communal farming conditions is characterised by high kid mortality and low weaning percentages. A survey was conducted to determine farmers' perceptions on the causes of kid mortality during summer under the communal farming system in Nkonkobe Local Municipality in the Eastern Cape, South Africa. This was done by administering questionnaires to a total of 162 respondents in 14 villages around Nkonkobe Local Municipality. The study showed that majority of farmers (75 %) keep flock sizes of less than 10 goats and kids, and this indicates that goat production in Nkonkobe Local Municipality is suppressed. According to the farmers, diseases (89 %), endo-parasites (72 %) and ecto-parasites (68 %) were perceived as the major causes of kid mortality. Other causes reported include starvation (15 %), extreme weather conditions (28 %), abortion (7 %), theft (35 %), diarrhoea (43 %), accidents (10 %) and wounds (9 %). The low number of goats could be attributed to high mortalities. It was also found that all causes reported by farmers played a role in high kid mortality in Nkonkobe Local Municipality. However, the causes which require more emphasis to formulate extension support were tick-borne diseases and parasites. This study provided baseline information on possible causes of kid mortalities in Nkonkobe Local Municipality. There is, however, a need to conduct further studies to determine actual causes of high kid mortalities so as to develop preventive strategies that would minimize kid mortality for good economic returns.

  16. Influenza vaccine coverage, influenza-associated morbidity and all-cause mortality in Catalonia (Spain). (United States)

    Muñoz, M Pilar; Soldevila, Núria; Martínez, Anna; Carmona, Glòria; Batalla, Joan; Acosta, Lesly M; Domínguez, Angela


    The objective of this work was to study the behaviour of influenza with respect to morbidity and all-cause mortality in Catalonia, and their association with influenza vaccination coverage. The study was carried out over 13 influenza seasons, from epidemiological week 40 of 1994 to week 20 of 2007, and included confirmed cases of influenza and all-cause mortality. Two generalized linear models were fitted: influenza-associated morbidity was modelled by Poisson regression and all-cause mortality by negative binomial regression. The seasonal component was modelled with the periodic function formed by the sum of the sinus and cosines. Expected influenza mortality during periods of influenza virus circulation was estimated by Poisson regression and its confidence intervals using the Bootstrap approach. Vaccination coverage was associated with a reduction in influenza-associated morbidity (pcase of influenza-associated morbidity, an increase of 5% in vaccination coverage represented a reduction of 3% in the incidence rate of influenza. There was a positive association between influenza-associated morbidity and all-cause mortality. Excess mortality attributable to influenza epidemics was estimated as 34.4 (95% CI: 28.4-40.8) weekly deaths. In conclusion, all-cause mortality is a good indicator of influenza surveillance and vaccination coverage is associated with a reduction in influenza-associated morbidity but not with all-cause mortality. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Mansoor Ahmed


    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.

  18. Cross-National Systematic Review of Neonatal Mortality and Postnatal Newborn Care: Special Focus on Pakistan. (United States)

    Ahmed, Mansoor; Won, Youngjoon


    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.

  19. [Obstetric hysterectomy. Incidence, indications and complications]. (United States)

    Vázquez, Juan A Reveles; Rivera, Geannyne Villegas; Higareda, Salvador Hernández; Páez, Fernando Grover; Vega, Carmen C Hernández; Segura, Agustin Patiño


    Obstetric hysterectomy is indicated when patient's life is at risk, and it is a procedure that requires a highly experienced and skilled medical team to solve any complication. To identify incidence, indications, and complications of obstetric hysterectomy within a high-risk population. Transversal, retrospective study from July 1st 2004 to June 30 2006 at Unidad Medica de Alta Especialidad, Hospital de Ginecoobstetricia, Centro Medico Nacional de Occidente, IMSS. There were reviewed 103 patient' files with obstetric hysterectomy. Incidence was calculated, and clinical and socio-demographic characteristics, indications, and complications of obstetric hysterectomy identified and expressed in frequency, percentages, and central tendency measurements. Incidence of obstetric hysterectomy was 8 cases within every 1,000 obstetric consultation. Age average was 31.1 +/- 5.1 years. 72.8% had cesarean surgery history. Main indication was placenta previa associated with placenta accreta (33%), followed by uterine hypotony (22.3%). Complications were hypovolemic shock (56.3%), and vesical injuries (5.8%). There were no maternal deaths. Cesarean history induces higher obstetric hysterectomy incidence in women with high-risk pregnancy, due to its relation to placentation disorders, as placenta previa that increases hemorrhage possibility, and thus, maternal morbidity and mortality.

  20. Inotropes do not increase mortality in advanced heart failure

    Directory of Open Access Journals (Sweden)

    Guglin M


    Full Text Available Maya Guglin, Marc KaufmanUniversity of South Florida, Tampa, FL, USAAbstract: Inotrope use is one of the most controversial topics in the management of heart failure. While the heart failure community utilizes them and recognizes the state of inotrope dependency, retrospective analyses and registry data have overwhelmingly suggested high mortality, which is logically to be expected given the advanced disease states of those requiring their use. Currently, there is a relative paucity of randomized control trials due to the ethical dilemma of creating control groups by withholding inotropes from patients who require them. Nonetheless, results of such trials have been mixed. Many were also performed with agents no longer in use, on patients without an indication for inotropes, or at a time before automatic cardio-defibrillators were recommended for primary prevention. Thus, their results may not be generalizable to current clinical practice. In this review, we discuss current indications for inotrope use, specifically dobutamine and milrinone, depicting their mechanisms of action, delineating their patterns of use in clinical practice, defining the state of inotrope dependency, and ultimately examining the literature to ascertain whether evidence is sufficient to support the current view that these agents increase mortality in patients with heart failure. Our conclusion is that the evidence is insufficient to link inotropes and increased mortality in low output heart failure.Keywords: inotropes, dobutamine, milrinone, heart failure