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Sample records for voivodeships mortality indices

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

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    Paweł Dziekański

    2017-01-01

    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.

  2. 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

    2013-09-01

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

  3. Polysomnographic indicators of mortality in stroke patients

    DEFF Research Database (Denmark)

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

    2017-01-01

    PURPOSE: The purpose of the study was to assess polysomnographic indicators of increased mortality risk in patients with stroke or a transient ischemic attack (TIA). METHODS: We performed polysomnographies in 63 acute stroke/TIA patients. Mortality data were collected from a national database after...... 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...... mortality risk (hazard ratio (HR) 9.71; 95 % confidence interval (CI) 1.20-78.29; p = 0.033) compared to the patients with the lowest AHI. The patients with the longest versus shortest nocturnal wake time had a higher mortality (HR 8.78; 95 % CI 1.1-71.8; p = 0.0428). Lung disease increased mortality (HR 9...

  4. PROPOSAL OF VOIVODESHIP ROAD SAFETY IMPROVEMENT PROGRAMME

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    Tomasz SZCZURASZEK

    2016-07-01

    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.

  5. Organization of crop and animal production in dairy farms localised in three chosen regions of lubelskie voivodeship

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    Jolanta Bojarszczuk

    2010-01-01

    Full Text Available The evaluation of organization of crop and animal production in dairy farms localised in three regions in Lubelskie voivodeship was presented in the paper. The data source was questionnaire research. The study was trained in 145 farms. The provided analysis showed that cereals had significantly share in pattern system in tested farms. Researched farms are differentiated of occupied differentiation of cropping pattern and density livestock between farms localised in different regions of Lubelskie voivodeship caused different level of intensity of organization animal and crops production. The differentiation of indicators was especially significant between farms in Krasnystaw and Ryki.

  6. [Epidemiology of asthma in adults living in the Silesian voivodeship according to secondary epidemiological data].

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    Niewiadomska, Ewa; Kowalska, Małgorzata

    2017-06-27

    Asthma is a serious public health challenge because of the increasing number of people with a new diagnosis and consequently the increasing costs of medical treatment (direct and indirect). The aim of this study is to analyze available epidemiological data with respect to their spatial and temporal variability in the Silesian voivodeship. In addition, the costs incurred by the National Health Fund (Narodowy Fundusz Zdrowia - NFZ) in treating asthmaic patients are analyzed. The epidemiological descriptive study concerns adult inhabitants of the Silesian voivodeship with asthma diagnosed under the health service delivery system, financed by NFZ, as well as diagnossis and/or hospitalization registed in the routine register run by the NFZ in Katowice. Crude and standardized incidence and prevalence rates are calculated and their changes are evaluated. Spatial variability in districts is evaluated as well and costs incurred by NFZ are revealed. In the years 2006-2010 the standardized rate of asthma remained at a high level of 392.3-469.6/100 000 inhabitants. Greater values were related to women than to men, as well as to inhabitants of districts located in the central and southern parts of the Silesian voivodeship. A slight decrease in the values of crude prevalence rates, from 52/100 000 inhabitants to 42/100 000, is reported. The annual cost of new cases treatment is 17 million PLN while the annual cost of all hospitalizations is at the level of 10 million PLN. Variability of incidence and prevalence due to asthma in the Silesian voivodeship is observed. An attempt at explaining this diversity requires in-depth research. A slight decrease in the values of both rates over time indicates less significant reduction in expenditure devoted to hospital treatment of asthmatic patients. Med Pr 2017;68(4):479-489. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. Exploring the Association between Macroeconomic Indicators and Dialysis Mortality

    NARCIS (Netherlands)

    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.

    2012-01-01

    Background and objectives 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

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

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    Reijo S. Tilvis

    2011-01-01

    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.

  9. TROPHIC STATE OF SMALL RETENTION RESERVOIRS IN PODLASIE VOIVODESHIP

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    Joanna Szczykowska

    2017-09-01

    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.

  10. The labour market of the Silesian voivodeship (Poland, and its determinants

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    Kłosowski Franciszek

    2014-09-01

    Full Text Available The aim of this study was to characterise the labour market of the Silesian voivodeship and its determinants between 2010 and 2012, although in order to show certain trends in changes data from the beginning of the 21st century are also used as a basis whereas from the more forward-looking perspective, projections up until 2020 were used. This market is very important from the nationwide perspective, and this is due to its complexity, size (it concentrates 2 million employed people, that is 14.4% of the whole workforce of Poland and specificity (industry still plays a crucial role. In order to achieve the objective indicated above, a set of measures relating to the number of employed people, business entities or GDP were used for the purpose of the analysis. The presented material shows the high volatility of the situation on the labour market both at the voivodeship level and individual communities – this is particularly true of the number of employed people and the rate of unemployment. An advantage of the newly created jobs over those that are shed which has been continuously recorded since 2008 and a decrease in the unemployment rate are positive symptoms. Katowice being the largest market and, moreover, characterised by the highest rank range of its impact and lowest unemployment rate have gained a dominant position in the regional labour market. Bielsko-Biała, Tychy, Gliwice and Bieruń-Lędziny County also clearly stand out against the background of other communities. The most difficult situation can be observed in Bytom, Świętochłowice, Piekary Śląskie and in the counties located in the northern part of the voivodeship, that is Częstochowa, Myszków and Zawiercie. Not only today but also in the coming decade, in terms of demand the labour market of the Silesian voivodeship will be strongly affected by its demographic situation; population decline, ageing population, migration, including, in particular, foreign migration will

  11. Predictive indications of operation and mortality following renal trauma

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    Chia-Shen Yang

    2012-01-01

    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.

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

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    Magda Orzechowska

    2016-12-01

    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.

  13. 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 ...

  14. Osobennosti prigranichnogo sotrudnichestva Varmin'sko-Mazurskogo voevodstva i Kaliningradskoj oblasti v sfere turizma [Cross-border cooperation in tourism between the War-mian-Masurian voivodeship and the Kaliningrad region

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    Batyk Iwona

    2013-01-01

    Full Text Available The border location of the Warmian-Masurian voivodeship and the Kaliningrad region is a prerequisite for active cooperation at different institutional levels. The development of cross-border cooperation between the Kaliningrad region and the Warmian-Masurian voivodeship was launched in 1992, when the first agreements on international cooperation were signed. As of today, a high emphasis is placed on cross-border cooperation between the Warmian-Masurian voivodeship and the Kaliningrad region, which is manifested in a series of partner agreements and contracts. The local border traffic agreement between the Kaliningrad region and selected areas of the Republic of Poland should give an additional impetus for the developmentof the economies, services sectors, and tourism industries of the border territories and facilitate the development of these regions. The article makes an attempt to identify the determinants of cross-border cooperation between the Kaliningrad region and the Warmian-Masurian voivodeship that contribute to the development of tourism between the regions, as well as to outline the barriers to their cooperation. The results of the survey presented in the article indicate that the current activities aimed at the development of cross-border cooperation between the Kaliningrad region and the border regions of Poland are not sufficient. On the basis of the survey the authors identify the major barriers to cross-border cooperation as seen by the regions’ residents and authorities. The removal of these barriers can form the basis for developmental measures to improve the situation.

  15. Investigations of Section Speed on Rural Roads in Podlaskie Voivodeship

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    Ziolkowski, Robert

    2017-10-01

    Excessive speed is one of the most important factors considered in road safety and not only affects the severity of a crash but is also related to the risk of being involved in a crash. In Poland the problem of speeding drivers is widely common. Properly recognized and defined drivers behaviour is the base for any effective activities taken towards road safety improvements. Effective enforcement of speed limits especially on rural road plays an important role but conducted speed investigations basically focus on spot speed omitting travel speed on longer sections of roads which can better reflect driver’s behaviour. Possible solutions for rural roads are limited to administrative means of speed limitations, installations of speed cameras and police enforcement. However due to their limited proved effectiveness new solutions are still being sought. High expectations are associated with the sectional speed system that has recently been introduced in Poland and covered a number of national road sections. The aim of this paper is to investigate section speed on chosen regional and district roads located in Podlaskie Voivodeship. Test sections included 19 road segments varied in terms of functional and geometric characteristics. Speed measurements on regional and district roads were performed with the use of a set of two ANPR (Automatic Number Plate Recognition) cameras. Conducted research allowed to compare driver’s behaviour in terms of travel speed depending on roads’ functional classification as well as to evaluate the influence of chosen geometric parameters on average section speed.

  16. Typology and description of the endemic areas with a long-time biggest and smallest colorectal incidence rates in the Silesia voivodeship populations

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    Brunon Zemła

    2013-09-01

    Full Text Available Background: The colorectal cancers (C18–C21, by ICD – X revision = RJG, it a big social-clinical problem. The high level differentiation (dependent of particular countries and regions within them; for example: Silesia voivodeship common for frequency of incidence. Therefore an attempt looking for an endemic area with a longtime biggest and smallest incidence rates in the smaller population scale, what a make easy fight against cancers. Materials and methods: In the years 1999–2009 20682 persons were diagnosed for RJG. Basing on the data (as above and demographic data, the different type of rates were calculated. All statistic procedures were in detail described anywhere [4–6]. Results: In the years 1999– 2009, in Silesia voivodeship, 20 682 cases of RJG were diagnosed, i.e. 53.5% among males and 46.5% among females. Age-adjusted rate for the whole Silesia voivodeship is 31.4 per 100 thousands to men and 19.5/100 thousands to women. In comparison between two extremely periods (1999–2009 : 2006–2009, age – adjusted incidence rates among men increased about 2.9%, and among women decreased about 6.5%. The distribution of age-standardized colorectal cancer rates within Silesia voivodeship, in the years 1999–2009, taking into account 36 counties – was very unequal so among males and at the same among females. But the most important epidemiological problem was the endemic areas with significantly biggest incidence rates among males: towns on the law of county: Częstochowa, Katowice, Bielsko-Biała and counties: mikołowski and wodzisławski; among females the endemic areas of this type were Bielsko-Biała town and his county. Conclusions: 1 Within Silesia voivodeship were revealed the endemic areas at statistically significantly high or low (in a long-time then the overall incidence rate for the colorectal cancer among men and women. 2 The endemic areas with the biggest incidence colorectal rates (fig. 1D and 2D, it indications to

  17. Ratio analysis of the financial situation in local governments of the wielkopolska voivodeship

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    Aldona Standar

    2013-03-01

    Full Text Available This article presents the different levels of the financial situation of communes in Wielkopolska voivodeship according to their type. For this purpose, an analysis of the indicator was used, and particular attention is focused on the budget and debt ratios. The difference between the level of the indicators tested using ANOVA and post-hoc Tukey’s test. Studies have shown that the test of time perspective (2006-2010 due to the financial situation of communes can be divided into two periods: 2006-2008, when the situation was more favourable, and 2009-2010, when the situation deteriorated due to lower financial independence and the growing debt. Generally, though urban centers are characterised by a higher level of debt, they are also characterised by greater financial independence, while the growth of debt is the highest in the rural communities with a relatively low financial independence. Such a situation may lead to increased financial risk for business operation of commune.

  18. Evolution of socioeconomic indicators and cardiovascular mortality in three Brazilian states.

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    Soares, Gabriel Porto; Brum, Júlia Dias; Oliveira, Gláucia Maria Moraes de; Klein, Carlos Henrique; Souza e Silva, Nelson Albuquerque

    2013-02-01

    Cardiovascular diseases are the major cause of death in Brazil. To correlate cardiovascular mortality rates in the states of Rio de Janeiro, São Paulo and Rio Grande do Sul, and in their capitals, between 1980 and 2008, with socioeconomic indicators collected from 1949 onwards. Population and death data were obtained from the Brazilian Unified Health System databank (Datasus). Mortality rates due to the following were calculated and adjusted by use of the direct method and compensated for poorly defined causes: ischemic heart diseases; cerebrovascular diseases; cardiovascular diseases; poorly defined causes; and all causes. Child mortality data were obtained from state and municipal health secretariats and from the Brazilian Institute of Geography and Statistics (IBGE). Information on gross domestic product (GDP) and educational level was obtained from the Brazilian Institute of Applied Economic Research (Ipea). The mortality rates and socioeconomic indicators were correlated by using the estimation of Pearson linear coefficients to determine optimized year lag. The inclination coefficients of the regression between the dependent variable "disease" and the independent variable "socioeconomic indicator" were estimated. The three states showed a reduction in mortality, which was especially due to a decrease in cardiovascular mortality, mainly of cerebrovascular diseases. The decrease in cardiovascular mortality was preceded by a reduction in child mortality, an elevation in the per capita GDP, and an increase in the educational level, and a strong correlation between indicators and mortality rates was observed. The three indicators showed an almost maximum correlation with the reduction in cardiovascular mortality. Such relationship indicates the importance of improving quality of life to reduce cardiovascular mortality.

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

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    Tarasov Ilya N.

    2016-12-01

    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.

  20. Vegetation optical depth measured by microwave radiometry as an indicator of tree mortality risk

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    Rao, K.; Anderegg, W.; Sala, A.; Martínez-Vilalta, J.; Konings, A. G.

    2017-12-01

    Increased drought-related tree mortality has been observed across several regions in recent years. Vast spatial extent and high temporal variability makes field monitoring of tree mortality cumbersome and expensive. With global coverage and high temporal revisit, satellite remote sensing offers an unprecedented tool to monitor terrestrial ecosystems and identify areas at risk of large drought-driven tree mortality events. To date, studies that use remote sensing data to monitor tree mortality have focused on external climatic thresholds such as temperature and evapotranspiration. However, this approach fails to consider internal water stress in vegetation - which can vary across trees even for similar climatic conditions due to differences in hydraulic behavior, soil type, etc - and may therefore be a poor basis for measuring mortality events. There is a consensus that xylem hydraulic failure often precedes drought-induced mortality, suggesting depleted canopy water content shortly before onset of mortality. Observations of vegetation optical depth (VOD) derived from passive microwave are proportional to canopy water content. In this study, we propose to use variations in VOD as an indicator of potential tree mortality. Since VOD accounts for intrinsic water stress undergone by vegetation, it is expected to be more accurate than external climatic stress indicators. Analysis of tree mortality events in California, USA observed by airborne detection shows a consistent relationship between mortality and the proposed VOD metric. Although this approach is limited by the kilometer-scale resolution of passive microwave radiometry, our results nevertheless demonstrate that microwave-derived estimates of vegetation water content can be used to study drought-driven tree mortality, and may be a valuable tool for mortality predictions if they can be combined with higher-resolution variables.

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

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    Agnieszka Perzyńska

    2016-09-01

    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.

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

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    Emamgholipour, Sara; Asemane, Zahra

    2016-01-01

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

  3. Annual observations of radon activity concentrations in dwellings of Silesian Voivodeship

    International Nuclear Information System (INIS)

    Wysocka, M.; Chmielewska, I.; Kozlowska, B.; Dorda, J.; Klos, B.; Rubin, J.; Karpinska, M.; Dohojda, M.

    2010-01-01

    In the paper, results of year-long measurements of radon levels in dwellings on the premises of Silesian Voivodeship are presented. Track etched detectors with polymer CR-39 foils were used in the investigations. As the studied buildings were located in different regions of Silesian Voivodeship, therefore results of measurements were analysed due to possible influence of geological structure or effect of mining operations in places, where given dwellings were situated. Elevated concentrations of radon were measured mostly in dwellings located in areas, where permeable Triassic limestone and dolomite occur, as it has been predicted. On the other hand, the impact of mining activity such as disintegration of rock-body and activation of faults plays an important role, too, because it enables radon migration and its entry into buildings. Beside the analysis of seasonal variations of radon activity concentration, the impact of temperature and pressure on these fluctuations outdoor and indoor buildings has been analysed. (authors)

  4. DIFFERENTIATION OF DISTRICTS OF THE MAŁOPOLSKIE VOIVODESHIP WITH RESPECT TO CHOSEN SOCIAL PROBLEMS

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    Jadwiga Bożek

    2016-06-01

    Full Text Available The phenomenon of unemployment and exacerbating demographic situation can be seen as major social problem of nowadays in Poland. The paper is an attempt to compare districts of the Małopolskie voivodeship with respect to chosen features characterizing these phenomena. On the basis of the data from the Central Statistical Offi ce and with the help of taxonomic methods, grouping of districts has been carried out with respect to the level of features under investigation. The procedure allowed for distinguishing 5 groups of signifi - cant inter-group diff erentiation. The application of taxonomic methods resulted in obtaining a general and, at the same time, accurate picture of diff erentiation of the Małopolskie voivodeship with respect to social problems being analysed and distinction of districts with the most diffi cult situation in this area.

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

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    Matute-Cruz Petra

    2009-04-01

    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.

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

    Science.gov (United States)

    Perea-Milla, Emilio; Olalla, Julián; Sánchez-Cantalejo, Emilio; Martos, Francisco; Matute-Cruz, Petra; Carmona-López, Guadalupe; Fornieles, Yolanda; Cayuela, Aurelio; García-Alegría, Javier

    2009-04-03

    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. 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. 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). Pre-hospital oral antibiotherapy appears to reduce IMD mortality.

  7. “Guilty until proven innocent”: the contested use of maternal mortality indicators in global health

    Science.gov (United States)

    Storeng, Katerini T.; Béhague, Dominique P.

    2017-01-01

    Abstract 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. PMID:28392630

  8. "Guilty until proven innocent": the contested use of maternal mortality indicators in global health.

    Science.gov (United States)

    Storeng, Katerini T; Béhague, Dominique P

    2017-03-15

    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.

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

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    M. Helbich

    2017-10-01

    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.

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

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    Kazimierz Niewiadomski

    2012-01-01

    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.

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

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    Sy Dinh N

    2007-08-01

    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.

  12. SELECTED ISSUES OF COMPETITIVENESS POTENTIAL OF FRUIT AND VEGETABLE PROCESSING COMPANIES LOCATED IN THE WIELKOPOLSKIE VOIVODESHIP

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    Joanna Smoluk-Sikorska

    2014-09-01

    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.

  13. SOCIAL ACTIVITY FROM THE POINT OF VIEW OF THE COMMUNE OF THE ZACHODNIOPOMORSKIE VOIVODESHIP

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    Barbara Kryk

    2017-09-01

    Full Text Available In the new paradigm of territorial development, cooperation between local government units and society is important, as a factor of local development. This cooperation is determined, among others. The activity of citizens to engage in local affairs. Hence, the aim of this article is to evaluate it based on the opinion of the communes of Zachodniopomorskie Voivodeship in the context of the contemporary development paradigm. The paper uses methods of literature analysis, results of surveys conducted in the communes of the West Pomeranian Province and inference. They allowed a synthetic assessment of the level of social activity.

  14. SPATIAL ANALYSIS OF THE CHOSEN SOCIO-ECONOMIC DETERMINANTS OF CRIME IN POMERANIAN VOIVODESHIP IN 2015

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    Bartosz KORINTH

    2017-12-01

    Full Text Available The main assumption of the study conducted by the authors was to analyse the chosen determinants of crime in pomeranian voivodeship in 2015 with particular focus on their spatial variability. The collected data was intercorrelated using the method of signboard. One can notice a particular division of this administrative unit of Poland, where the dominant role in the crime phenomenon is played by social (e.g. in slupski district or economic (e.g. in chojnicki district factors. The results of the study provide a new outlook on the geography of crime, particularly the one covering the regions of Poland.

  15. What indication, morbidity and mortality for central pancreatectomy in oncological surgery? A systematic review.

    Science.gov (United States)

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

    2016-04-01

    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.

  16. Prognostic indicators for early mortality after tracheostomy in the intensive care unit.

    Science.gov (United States)

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

    2016-11-01

    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.

  17. Socioeconomic indicators and ethnicity as determinants of regional mortality rates in Slovakia

    NARCIS (Netherlands)

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

    Regional differences in mortality might reflect socioeconomic and ethnic differences between regions. The present study examines the relationship between education, unemployment, income, Roma population and regional mortality in the Slovak Republic. Separately for males and females, data on

  18. Assessment of knowledge on cardiovascular disease risk factors by postal survey in residents of Małopolska Voivodeship. Małopolska CArdiovascular PReventive Intervention Study (M-CAPRI

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    Anna Waśniowska

    2017-05-01

    Using a postal questionnaire for the assessment of knowledge of CVD RFs in the population of Małopolska Voivodeship appeared to have serious limitations due to low participation in the study. Despite this, the results of the study indicate that knowledge on CVD RFs is insufficient. Female gender and higher education were related to more prevalent knowledge on RFs. Family history of CVD was related to better knowledge in women only. Male residents of rural areas and small towns had slightly less knowledge on CVD RFs

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

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    Yurima Díaz Elejalde

    2008-06-01

    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

  20. INDICATORS OF INTENSIVE CARE UNIT-ACQUIRED INFECTIONS AND MORTALITY: TRENDS IN FIVE ICUs IN CATANIA

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    Placido D'Agati

    2015-04-01

    Full Text Available Background: Hospital-acquired infections (HAIs pose a significant clinical and economic burden worldwide. Surveillance has been associated with a reduction of HAI rates in Intensive Care Unit (ICU patients, although the particular reasons for this decrease are still difficult to determine. The present study was conducted in order to report HAI surveillance data during an eight-year period in five ICUs in Catania. Methods: A patient-based HAI surveillance was conducted in the framework of the first four surveys of the Italian Nosocomial Infections Surveillance in ICUs network (SPIN-UTI of the GISIO-SItI. Each survey consisted in a six-months surveillance conducted in: 2006-2007; 2008-2009; 2010-2011 and 2012-2013. During the study period, HAI cumulative incidence, incidence density and mortality were calculated overall and for each survey. Findings: From 2006 to 2013, a total of 2070 patients were admitted in the five participating ICUs and were included in the study. The cumulative incidences of infected patients in each survey were: 13.3, 17.0, 18.9 and 8.9 per 100 patients, respectively. Accordingly, the risk of ICU-acquired infections increased in the third survey compared with the first (RR: 1.43; 95%CI: 1.06-1.92 but it decreased in the fourth survey compared with the second (RR: 0.64; 95%CI: 0.47-0.86 and the third (RR: 0.57; 95%CI: 0.43-0.76. A similar trend was observed considering incidence of infections and incidence density. Although mortality did not show a significant trend between the four surveys, the risk of death increased for infected patients. Conclusions: The patient-based cohort design allowed us to analyze HAI indicators during an eight-years period, in five ICUs in Catania. Particularly, the risk of ICUacquired infections increased in the third survey compared with the first, whereas it decreased in the fourth survey compared with the second and the third surveys. Furthermore, mortality remained unchanged, however the risk

  1. The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation.

    Science.gov (United States)

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

    2013-05-01

    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.

  2. District-level surgery in Uganda: Indications, interventions and perioperative mortality.

    Science.gov (United States)

    Löfgren, Jenny; Kadobera, Daniel; Forsberg, Birger C; Mulowooza, Jude; Wladis, Andreas; Nordin, Pär

    2015-07-01

    The world's poorest 2 billion people, benefit from no more than about 3.5% of the world's operative procedures. The burden of surgical disease is greatest in Africa, where operations could save many lives. Previous facility-based studies have described operative procedure caseloads, but prospective studies investigating interventions, indications and perioperative mortality rates (POMR), are rare. A prospective, questionnaire-based collection of data on all major and minor operative procedures was undertaken at 2 hospitals in rural Uganda covering 4 and 3 months in 2011, respectively. Data included patient characteristics, indications for the interventions performed, and outcome after surgery. We recorded 2,790 operative procedures on 2,701 patients. The rate of major operative procedures per 100,000 population per year was 225. Patients undergoing major operative procedures (n = 1,051) were mostly women (n = 923; 88%) because most interventions were performed owing to pregnancy-related complications (n = 747; 67%) or gynecologic conditions (n = 114; 10%). General operative interventions registered included herniorrhaphy (n = 103; 9%), exploratory laparotomy (n = 60; 5%), and appendectomy (n = 31; 3%). The POMR for major operative procedures was 1% (n = 14) and was greatest after exploratory laparotomy (13%; n = 8) and caesarean delivery (1%; n = 4). Most deaths (n = 16) were a result of sepsis (n = 10-11) or hemorrhage (n = 3-5). The volume of surgery was low relative to the size of the catchment population. The POMR was high. Exploratory laparotomy and caesarean section were identified as high-risk procedures. Increased availability of blood, improved perioperative monitoring, and early intervention could be part of a solution to reduce the POMR. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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    Pezowicz Piotr

    2015-12-01

    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.

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

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    Matwiejuk Anna

    2017-12-01

    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.

  5. ATTITUDES OF YOUNG RURAL RESIDENTS FROM ŁÓDZKIE VOIVODESHIP TOWARDS THEIR OWN INNOVATIVENESS

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    Katarzyna Zajda

    2016-09-01

    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.

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

    Science.gov (United States)

    Zhang, Wei Fang; Xu, Yan Hua; Yang, Ru Lai; Zhao, Zheng Yan

    2013-01-01

    To investigate the levels of primary health care services for children and their changes in Zhejiang Province, China from 1998 to 2011. 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 (mortality, neonatal mortality, infant mortality and under-5 mortality were investigated. 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 (Pinfant 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 (Pmortality 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. 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.

  7. Aquatic bird disease and mortality as an indicator of changing ecosystem health

    Science.gov (United States)

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

    2007-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Neupane, Subas; Bray, Freddie; Auvinen, Anssi

    2017-06-01

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

  10. Predictors, Including Blood, Urine, Anthropometry, and Nutritional Indices, of All-Cause Mortality among Institutionalized Individuals with Intellectual Disability

    Science.gov (United States)

    Ohwada, Hiroko; Nakayama, Takeo; Tomono, Yuji; Yamanaka, Keiko

    2013-01-01

    As the life expectancy of people with intellectual disability (ID) increases, it is becoming necessary to understand factors affecting survival. However, predictors that are typically assessed among healthy people have not been examined. Predictors of all-cause mortality, including blood, urine, anthropometry, and nutritional indices, were…

  11. THE PRESENT CONDITION OF SMALL WATER RETENTION AND THE PROSPECTS OF ITS DEVELOPMENT USING THE EXAMPLE OF THE PODLASKIE VOIVODESHIP

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    Joanna Szczykowska

    2014-07-01

    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.

  12. 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

    2015-01-01

    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...

  13. POSSIBILITIES OF ACQUIRING AND ENERGETIC USE OF BIOMASS IN COMMUNES IN MAŁOPOLSKA VOIVODESHIP

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    Wojciech Sroka

    2016-12-01

    Full Text Available This analysis touches upon an evaluation and estimation of the potential of communes in Małopolska voivodeship in terms of energetic use of plant biomass. The research results showed that if biomass, in the form of straw and hay not used in agriculture and willow (salix cultivated on lands out of agricultural production, was marked for energetic aims, the generation of about 8.3 PJ of energy would be possible. It was also pinpointed that within the group of communes with the highest potential of hay and willow for energetic use (25% of communes, environmental (the quality of production space and economic factors (the area structure, and confi guration, etc. will hinder the development of the biomass market. The same conditions which contributed to the regress of agriculture are seen as an obstacle to eff ective and profi table biomass production. The only real opportunity for development of the biomass market is seen in straw, which can be acquired in communes with the best natural and economic conditions.

  14. FUNCTIONING OF A FARM ADVISORY SYSTEM ACCORDING TO THE FARMERS OF THE OPOLE VOIVODESHIP

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    Stanisława Sokołowska

    2014-03-01

    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.

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

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    Bogumiła Braczkowska

    2018-04-01

    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.

  16. SPATIAL DIFFERENTIATION OF THE SEASONAL UNEMPLOYMENT. AN EXAMPLE OF COASTAL DISTRICTS OF ZACHODNIOPOMORSKIE VOIVODESHIP IN POLAND

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    Maria Klonowska-Matynia

    2014-12-01

    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.

  17. Parental Opinions and Attitudes about Children's Vaccination Safety in Silesian Voivodeship, Poland.

    Science.gov (United States)

    Braczkowska, Bogumiła; Kowalska, Małgorzata; Barański, Kamil; Gajda, Maksymilian; Kurowski, Tomasz; Zejda, Jan E

    2018-04-15

    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 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.

  18. The Lyme disease as the increasing health problem in Małopolskie voivodeship compared with Poland in 1998-2014

    Science.gov (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.

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

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    Pamela Jeziorska-Biel

    2012-04-01

    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”.

  20. [Contamination of soil with geohelminth eggs on vegetable organic farms in the Lublin voivodeship, Poland].

    Science.gov (United States)

    Kłapeć, Teresa

    2009-01-01

    Organic farming, despite being more difficult and labour consuming than traditional farming, gains increasingly more followers among farmers. Currently in Poland there are approximately 10 000 organic farms. Pure, uncontaminated soil in the Lublin voivodeship makes this area an ideal location for organic agriculture production. In 2006-2007, 102 soil samples were examined from 40 organic farms specializing in vegetables and berries. Farms for the study were selected by ecology- and food-production specialists from the Lublin Agriculture Advisory Centre in Końskowola. The following plants were cultivated on the farms examined: berry-bearing plants, carrots, parsley, zucchini, cabbage, lettuce, cucumbers, cauliflowers, leeks, onions, kidney beans, beetroots, potatoes, pumpkins, broad beans, rhubarb and herbs. The presently reported parasitological survey was performed on 102 soil samples. Each sample consisted of 100 g of soil and the methodology followed that of the Polish Standard PN-Z-19000-4 (flotation method by Quinn et al.). The survey yielded eggs of parasites representing genera: Ascaris, Trichuris and Toxocara. Contamination with eggs of intestinal parasites was noted in 43 (42.16%) soil samples. Toxocara spp. eggs were found in 24 samples (55.81%). Eggs of Ascaris spp. were detected in 18 samples (41.86%) while eggs of Trichuris spp were present in one sample (2.32%). In total, 29 eggs of Toxocara spp., 19 eggs of Ascaris spp., and 1 egg of Trichuris spp. were found. The largest amount of soil for examination was taken across the plantations of berry-bearing plants - 57 samples. In the group examined, plantations of raspberries and strawberries dominated. The soil was contaminated with the eggs of Toxocara spp. and Ascaris spp. No eggs of Trichuris spp. were detected. The presence of eggs of intestinal parasites in soil poses a threat of geohelminthoses to people who eat contaminated fresh fruits and vegetables.

  1. 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

    2015-01-01

    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...... as outcome. RESULTS: Median follow-up was 9.6 years [interquartile range (IQR), 2.2-17.0 years]. The hazard ratio (HR) for death from all causes increased with lower education (p for trend, 0.01). Adjustment for disease-related prognostic factors, comorbidity and metabolic indicators measured as BMI, waist...... 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...

  2. Impact of traffic related air pollution indicators on non-cystic fibrosis bronchiectasis mortality: a cohort analysis.

    Science.gov (United States)

    Goeminne, Pieter C; Bijnens, Esmee; Nemery, Ben; Nawrot, Tim S; Dupont, Lieven J

    2014-09-03

    Mortality in non-cystic fibrosis bronchiectasis (NCFB) is known to be influenced by a number of factors such as gender, age, smoking history and Pseudomonas aeruginosa, but the impact of traffic related air pollution indicators on NCFB mortality is unknown. We followed 183 patients aged 18 to 65 years with a HRCT proven diagnosis of NCFB and typical symptoms, who had visited the outpatient clinic at the University Hospital of Leuven, Belgium, between June 2006 and October 2012. We estimated hazard ratios (HR) for mortality in relation to proximity of the home to major roads and traffic load, adjusting for relevant covariables (age, gender, disease severity, chronic macrolide use, smoking history, socioeconomic status and Pseudomonas aeruginosa colonization status). Fifteen out of the 183 included patients died during the observation period. Residential proximity to a major road was associated with the risk of dying with a HR 0.28 (CI 95% 0.10-0.77; p = 0.013) for a tenfold increase in distance to a major road. Mortality was also associated with distance-weighted traffic density within 100 meters (HR for each tenfold increase in traffic density 3.80; CI 95% 1.07-13.51; p = 0.04) and 200 meters from the patient's home address (HR for each tenfold increase in traffic density 4.14; CI 95% 1.13-15.22; p = 0.032). Traffic-related air pollution appears to increase the risk of dying in patients with NCFB. The study was approved by the local ethical committee of the UZ Leuven, Belgium (ML-5028), registered at ClinicalTrial.gov (NCT01906047).

  3. Hospital quality measures: are process indicators associated with hospital standardized mortality ratios in French acute care hospitals?

    Science.gov (United States)

    Ngantcha, Marcus; Le-Pogam, Marie-Annick; Calmus, Sophie; Grenier, Catherine; Evrard, Isabelle; Lamarche-Vadel, Agathe; Rey, Grégoire

    2017-08-22

    Results of associations between process and mortality indicators, both used for the external assessment of hospital care quality or public reporting, differ strongly across studies. However, most of those studies were conducted in North America or United Kingdom. Providing new evidence based on French data could fuel the international debate on quality of care indicators and help inform French policy-makers. The objective of our study was to explore whether optimal care delivery in French hospitals as assessed by their Hospital Process Indicators (HPIs) is associated with low Hospital Standardized Mortality Ratios (HSMRs). The French National Authority for Health (HAS) routinely collects for each hospital located in France, a set of mandatory HPIs. Five HPIs were selected among the process indicators collected by the HAS in 2009. They were measured using random samples of 60 to 80 medical records from inpatients admitted between January 1st, 2009 and December 31, 2009 in respect with some selection criteria. HSMRs were estimated at 30, 60 and 90 days post-admission (dpa) using administrative health data extracted from the national health insurance information system (SNIIR-AM) which covers 77% of the French population. Associations between HPIs and HSMRs were assessed by Poisson regression models corrected for measurement errors with a simulation-extrapolation (SIMEX) method. Most associations studied were not statistically significant. Only two process indicators were found associated with HSMRs. Completeness and quality of anesthetic records was negatively associated with 30 dpa HSMR (0.72 [0.52-0.99]). Early detection of nutritional disorders was negatively associated with all HSMRs: 30 dpa HSMR (0.71 [0.54-0.95]), 60 dpa HSMR (0.51 [0.39-0.67]) and 90 dpa HSMR (0.52 [0.40-0.68]). In absence of gold standard of quality of care measurement, the limited number of associations suggested to drive in-depth improvements in order to better determine associations

  4. 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.

    2017-06-01

    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.

  5. Tree Mortality

    Science.gov (United States)

    Mark J. Ambrose

    2012-01-01

    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....

  6. Impact of cesarean section in a private health service in Brazil: indications and neonatal morbidity and mortality rates.

    Science.gov (United States)

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

    2018-01-01

    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.

  7. The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care.

    Science.gov (United States)

    Sunkara, Vasu; Hébert, James R

    2015-05-15

    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.

  8. Increases in Terrestrial Nitrogen Availability and Microbial Biogeochemical Indicators in Association with Extent of Surrounding Tree Mortality in Bark Beetle Impacted Forests

    Science.gov (United States)

    Sharp, J.; Bokman, C.; Brouillard, B.; Mikkelson, K. M.

    2016-12-01

    Recent increases in the magnitude and occurrence of bark beetle-induced tree mortality are disrupting evergreen forests globally. To better understand how these perturbed ecosystems respond, we investigated whether the extent of local tree mortality is an important parameter to predict terrestrial biogeochemical and microbial responses in lodgepole pines (Pinus contorta) infested by mountain pine beetles in the Colorado Rocky Mountains. Soil biogeochemical parameters within three near-surface soil horizons were compared between healthy and deceased trees surrounded by varying extents of tree mortality in order to isolate the effects of surrounding tree mortality on carbon and nitrogen cycling. Results revealed that C:N ratios decreased as surrounding tree mortality increased in the upper soil litter and organic horizons. A threshold response was found for ammonium in these layers, which accumulated only under trees surrounded by at least 40% tree mortality. Concurrently, the extent of tree mortality and the C:N ratio also affected the soil microbial community structure and function. Bacterial clades specific to nitrogen cycling and exoenzyme activity were more strongly related to changes in C:N ratio than surrounding tree mortality. Alpha diversity within the bacterial soil community increased and beta diversity clustered in accordance with more extensive surrounding tree mortality. These biogeochemical and microbial indicators suggest that high degrees of beetle-induced mortality may be shifting the terrestrial environment of Rocky Mountain lodgepole pine forests from an N-limited ecosystem to one where N is in excess with implications for forest recovery and nitrogen export.

  9. Independent and joint associations of nutritional status indicators with mortality risk among chronic hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS).

    Science.gov (United States)

    Lopes, Antonio Alberto; Bragg-Gresham, Jennifer L; Elder, Stacey J; Ginsberg, Nancy; Goodkin, David A; Pifer, Trinh; Lameire, Norbert; Marshall, Mark R; Asano, Yasushi; Akizawa, Tadao; Pisoni, Ronald L; Young, Eric W; Port, Friedrich K

    2010-07-01

    To consider the Kidney Disease Outcomes Quality Initiative recommendation of using multiple nutritional measurements for patients on maintenance dialysis, we explored data for independent and joint associations of nutritional indicators with mortality risk among maintenance hemodialysis patients treated in 12 countries. Dialysis units in seven European countries, the United States, Canada, Australia, New Zealand, and Japan. Mortality risk. We conducted a prospective cohort study of 40,950 patients from phases I to III of the Dialysis Outcomes and Practice Patterns Study (1996-2008). Independent and joint effects (interactions) of nutritional indicators (serum creatinine, serum albumin, normalized protein catabolic rate, body mass index [BMI]) on mortality risk were assessed by Cox regression with adjustments for demographics, years on dialysis, and comorbidities. Important variations in nutritional indicators were seen by country and patient characteristics. Poorer nutritional status assessed by each indicator was independently associated with higher mortality risk across regions. Significant multiplicative interactions (each p 10.5 mg/dL (relative risk = 0.68) but with higher mortality risk among those with creatinine nutritional indicators on mortality indicate the need to use multiple measurements when assessing the nutritional status of hemodialysis patients. Copyright 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  10. A new multidimensional population health indicator for policy makers: absolute level, inequality and spatial clustering - an empirical application using global sub-national infant mortality data

    Directory of Open Access Journals (Sweden)

    Benn K.D. Sartorius

    2014-11-01

    Full Text Available The need for a multidimensional measure of population health that accounts for its distribution remains a central problem to guide the allocation of limited resources. Absolute proxy measures, like the infant mortality rate (IMR, are limi- ted because they ignore inequality and spatial clustering. We propose a novel, three-part, multidimensional mortality indi- cator that can be used as the first step to differentiate interventions in a region or country. The three-part indicator (MortalityABC index combines absolute mortality rate, the Theil Index to calculate mortality inequality and the Getis-Ord G statistic to determine the degree of spatial clustering. The analysis utilises global sub-national IMR data to empirically illu- strate the proposed indicator. The three-part indicator is mapped globally to display regional/country variation and further highlight its potential application. Developing countries (e.g. in sub-Saharan Africa display high levels of absolute mortality as well as variable mortality inequality with evidence of spatial clustering within certain sub-national units (“hotspots”. Although greater inequality is observed outside developed regions, high mortality inequality and spatial clustering are com- mon in both developed and developing countries. Significant positive correlation was observed between the degree of spatial clustering and absolute mortality. The proposed multidimensional indicator should prove useful for spatial allocation of healthcare resources within a country, because it can prompt a wide range of policy options and prioritise high-risk areas. The new indicator demonstrates the inadequacy of IMR as a single measure of population health, and it can also be adapted to lower administrative levels within a country and other population health measures.

  11. The impact of demographic factors on the level of knowledge about primary and secondary prevention of cervical cancer among patients in Lublin voivodeship

    Directory of Open Access Journals (Sweden)

    Anna Puzio

    2016-09-01

    Full Text Available Background. Cervical cancer (CC is among the most-commonly detected cancers affecting women worldwide. The primary means of preventing CC is the Human Papillomavirus (HPV vaccine. Moreover, CC can be detected early by a screening test, which is available free of charge in Poland for women in the 25–59 year-old age group (i.e., those at the greatest risk of CC. Objectives. To assess the level of knowledge among patients in Lublin voivodeship, Poland, concerning both the primary and secondary prevention of CC; to analyze the impact of demographic factors on participation in CC screening. Material and methods. The study was carried out on a group of patients (n = 230, who filled out a questionnaire including questions on the primary and secondary prevention of CC. Participation was voluntary and anonymous. The data was analyzed using Statistica 10.0 software (StatSoft, USA . Results . It was shown that subjects from small towns and rural areas formed the largest group of women who indicated that they had fewer than one gynecological visit per year. 40% (n = 28 of the inhabitants of rural areas, 29% (n = 9 of the inhabitants of small towns and 70% (n = 57 of the inhabitants of cities reported that they had had a cytological test at least once in their life. 25% (n = 57 of all respondents had been vaccinated against HPV. Among rural inhabitants, 83% (n = 58 reported that they had not received a HPV vaccination. Conclusions . Currently, the priority is to focus on prevention campaigns in rural areas and small towns, where the level of knowledge about the risk of CC is much lower than in larger cities.

  12. [The estimation of intake of selected and permissible preservatives used in food industry among people from Podlaskie voivodeship].

    Science.gov (United States)

    Szczerbiński, Robert; Karczewski, Jan

    2011-01-01

    The work aimed at estimating intake of food containing permissible preservatives. The data was comprised of food samples from 14 poviats of Podlaskie voivodeship taken to detect presence of preservatives (sodium nitrate, nitrite, benzoic acid and its salt, sorbic acid and its salt). The samples were collected between 2004 and 2007 by food inspection agency. Data concerning consumption of food provided results for an average consumption of some foodstuffs in households in which consumption of given foodstuff has been recorded by Polish Central Statistical Office, whereas data concerning consumption of soft drinks was provided by the report from March, 2008 (soft drinks market in Poland). It was stated that an average intake of the considered preservatives with an average diet is not a threat to people. Taking into account the fact data concerning consumption of foodstuffs in households is limited, it is advised to create databases comprising consumption of foodstuffs which would help in more precise evaluation of the intake.

  13. SOCIAL SIDE OF AGRICULTURAL CO-OPERATIVES. THE CASE OF AGRICULTURAL PRODUCTION CO-OPERATIVES IN THE OPOLE VOIVODESHIP

    Directory of Open Access Journals (Sweden)

    Małgorzata Matyja

    2014-09-01

    Full Text Available The aim of the article is to describe the social side of agricultural co-operatives and also to analyse what factors can in- or decrease this part of activity of agricultural production co-operatives (APCs. In the introduction to the article a definition of the aim of the paper, is provided, as well as a short explanation what the APCs really are. Next, the article describes the social side of activity of agricultural co-operatives. Then it presents how to measure it using the rate of social activity (RSA proposed by the author. The last part of the article is the analysis, based on the data collected from the 28 APCs that operate in the Opole voivodeship shows the influence of selected factors on social activity in co-operatives. The findings show what and how strongly can increase the social activity in agricultural cooperatives.

  14. [GeSIDA quality care indicators associated with mortality and hospital admission for the care of persons infected by HIV/AIDS].

    Science.gov (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

    2017-02-01

    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.

  15. 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

    2002-01-01

    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),

  16. 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

    2017-01-01

    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...... 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...... to death from natural causes. CONCLUSIONS: Bereavement was associated with increased short-term and long-term mortality, even after adjustment for morbidities, which suggests that mental stress may play a causal role in excess mortality....

  17. 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.

    2011-01-01

    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

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

    Science.gov (United States)

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

    2015-01-01

    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.

  19. 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

    2015-01-01

    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.

  20. Anthropometrics indices of obesity, and all-cause and cardiovascular disease-related mortality, in an Asian cohort with type 2 diabetes mellitus.

    Science.gov (United States)

    Lim, R B T; Chen, C; Naidoo, N; Gay, G; Tang, W E; Seah, D; Chen, R; Tan, N C; Lee, J; Tai, E S; Chia, K S; Lim, W Y

    2015-09-01

    The study investigated the relationship of general (body mass index [BMI]) and central (waist circumference [WC]; waist-hip ratio [WHipR]; waist-height ratio [WHeightR]) adiposity with all-cause and cardiovascular disease (CVD)-related mortality in an Asian population with diabetes. A total of 13,278 participants with type 2 diabetes mellitus (T2DM) recruited from public-sector primary-care and specialist outpatients clinics in Singapore were followed-up for a median duration of 2.9 years, during which time there were 524 deaths. Cox proportional-hazards regression and competing-risk models were used to obtain hazard ratios (HRs) for anthropometric variables of all-cause and CVD-related mortality. After adjusting for BMI, the highest quintiles of WC, WHipR and WHeightR were all positively associated with mortality compared with the lowest quintiles, with WHeightR exhibiting the largest effect sizes [all-cause mortality HR: 2.13, 95% confidence interval (CI): 1.33-3.42; CVD-related mortality HR: 3.42, 95% CI: 1.62-7.19]. Being overweight but not obese (BMI:≥23.0 butobesity, was associated with a reduction in risk of mortality. This was seen in T2DM patients aged≥65 years, but not in those younger than this. At the same BMI, having higher central-obesity indices such as WC, WHipR and WHeightR also increased the risk of mortality. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A: consecutive case analysis.

    Science.gov (United States)

    Shin, Hye Sun; Kim, Sae Pyul; Han, Sang Hoon; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang-Hyub; Chon, Chae Yoon; Park, Jun Yong

    2014-07-01

    Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD≥23.5 was significantly more predictive than a SIRS score≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. MELD and SIRS scores≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores≥3 were valuable in predicting mortality of patients with a MELD≥23.5.

  2. Predicting Mechanical Ventilation and Mortality: Early and Late Indicators in Steven-Johnson Syndrome and Toxic Epidermal Necrolysis.

    Science.gov (United States)

    Beck, Anna; Cooney, Ryan; Gamelli, Richard L; Mosier, Michael J

    2016-01-01

    Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are characterized by loss of the epidermis, often accompanied by sloughing of the oral mucosa and airway, which may be associated with the need for mechanical ventilation. We retrospectively examined our SJS and TEN population for factors predictive of the need for mechanical ventilation and mortality. Over more than a 7-year period, 74 subjects of ≥18 years old with biopsy-confirmed SJS-TEN were identified. Variables within the first 3 days of admission and throughout the entire hospital stay were analyzed for their value in predicting the need for mechanical ventilation and mortality. Predictive variables were examined using univariate and multivariate logistic regression analyses. Of our 74 subjects, 28 (37.8%) required mechanical ventilation and 11 (13.9%) died, all of whom were intubated. Patients requiring ventilation had a significantly higher %TBSA loss of epidermis on admission and progressive epidermal loss after admission. On multivariate analysis, acute kidney injury within the first 3 days of admission and fewer days from symptom onset to admission were statistically significant in predicting need for mechanical ventilation. In addition, the early need for mechanical ventilation, early serum bicarbonate mechanical ventilation in adult TEN subjects is associated with higher mortality. This is the first time that mechanical ventilation has been specifically examined in the recent U.S. SJS and TEN population. The early recognition of patients at risk for ventilation may help guide management, especially in those patients admitted early after symptom development with acute kidney injury and extensive, progressing epidermal loss.

  3. Long-term forest resilience to climate change indicated by mortality, regeneration, and growth in semiarid southern Siberia.

    Science.gov (United States)

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

    2017-06-01

    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.

  4. Female breast cancer in Świętokrzyskie Voivodeship in 1999–2012. New cases and the incidence of invasive breast cancer

    Directory of Open Access Journals (Sweden)

    Ewa Błaszkiewicz

    2015-07-01

    Full Text Available Introduction : Breast cancer is the most common malignant tumour among women in Poland. In 2012 invasive breast cancer was diagnosed in 17,000 Polish women. The effective fight against breast cancer is based on activities to prevent its occurrence or to enable early detection of the disease and then its effective treatment (cure. Aim of the research: To assess the prevalence of invasive breast cancer in women in Świętokrzyskie Voivodeship in 1999–2012. Material and methods: A total of 6079 new female invasive breast cancer cases were analysed. Crude rates (CRs and age-standarised rates (ASRs per 100,000 population were calculated. The total value of incidence rates was analysed for all ages (0–85+ and in separate age groups (15–49, 50–69, and 70–85+. Results : In 1999–2012 in Świętokrzyskie Voivodeship 6079 new invasive female breast cancer cases were diagnosed. Fifty-three percent of them were in the age group of 50–69 years, 25.0% in the age group 70–85+, and 21.5% in the age group 15–49 years. The incidence of BC in general (0–85+ increased from 41.2/105 in 1999 to 43.8/105 in 2012. In the women aged 15–49 years the value of ASRs of incidence increased. In the age group of 50–69 years the value of ASRs increased from 146.6/105 in 1999 to 163.5/105 in 2012. The increase in the incidence of breast cancer was reported among women in perimenopausal age and in premenopausal women. The decrease in breast cancer cases was observed among young, premenopausal women (15–49 years as well as among women over 70 years of age. Conclusions: Świętokrzyskie Voivodeship is a region in Poland with moderate risk of breast cancer.

  5. 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

    2012-09-01

    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 www.moja-ankiety.pl. 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.

  6. THE USE OF CLUSTER ANALYSIS IN THE RESEARCH ON SHOPPING PREFERENCES REGARDING REGIONAL PRODUCTS FROM LUBELSKIE VOIVODESHIP

    Directory of Open Access Journals (Sweden)

    Jan Czeczelewski

    2017-03-01

    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.

  7. Reducing maternal mortality: better monitoring, indicators and benchmarks needed to improve emergency obstetric care. Research summary for policymakers.

    Science.gov (United States)

    Collender, Guy; Gabrysch, Sabine; Campbell, Oona M R

    2012-06-01

    Several limitations of emergency obstetric care (EmOC) indicators and benchmarks are analysed in this short paper, which synthesises recent research on this topic. A comparison between Sri Lanka and Zambia is used to highlight the inconsistencies and shortcomings in current methods of monitoring EmOC. Recommendations are made to improve the usefulness and accuracy of EmOC indicators and benchmarks in the future. © 2012 Blackwell Publishing Ltd.

  8. Guidelines on constructing funnel plots for quality indicators: A case study on mortality in intensive care unit patients.

    Science.gov (United States)

    Verburg, Ilona Wm; Holman, Rebecca; Peek, Niels; Abu-Hanna, Ameen; de Keizer, Nicolette F

    2017-01-01

    Funnel plots are graphical tools to assess and compare clinical performance of a group of care professionals or care institutions on a quality indicator against a benchmark. Incorrect construction of funnel plots may lead to erroneous assessment and incorrect decisions potentially with severe consequences. We provide workflow-based guidance for data analysts on constructing funnel plots for the evaluation of binary quality indicators, expressed as proportions, risk-adjusted rates or standardised rates. Our guidelines assume the following steps: (1) defining policy level input; (2) checking the quality of models used for case-mix correction; (3) examining whether the number of observations per hospital is sufficient; (4) testing for overdispersion of the values of the quality indicator; (5) testing whether the values of quality indicators are associated with institutional characteristics; and (6) specifying how the funnel plot should be constructed. We illustrate our guidelines using data from the Dutch National Intensive Care Evaluation registry. We expect that our guidelines will be useful to data analysts preparing funnel plots and to registries, or other organisations publishing quality indicators. This is particularly true if these people and organisations wish to use standard operating procedures when constructing funnel plots, perhaps to comply with the demands of certification.

  9. Mortality as an indicator of patient safety in orthopaedics: lessons from qualitative analysis of a database of medical errors

    Directory of Open Access Journals (Sweden)

    Panesar Sukhmeet S

    2012-06-01

    Full Text Available Abstract Background Orthopaedic surgery is a high-risk specialty in which errors will undoubtedly occur. Patient safety incidents can yield valuable information to generate solutions and prevent future cases of avoidable harm. The aim of this study was to understand the causative factors leading to all unnecessary deaths in orthopaedics and trauma surgery reported to the National Patient Safety Agency (NPSA over a four-year period (2005–2009, using a qualitative approach. Methods Reports made to the NPSA are categorised and stored in the database as free-text data. A search was undertaken to identify the cases of all-cause mortality in orthopaedic and trauma surgery, and the free-text elements were used for thematic analysis. Descriptive statistics were calculated based on the incidents reported. This included presenting the number of times categories of incidents had the same or similar response. Superordinate and subordinate categories were created. Results A total of 257 incident reports were analysed. Four main thematic categories emerged. These were: (1 stages of the surgical journey – 118/191 (62% of deaths occurred in the post-operative phase; (2 causes of patient deaths – 32% were related to severe infections; (3 reported quality of medical interventions – 65% of patients experienced minimal or delayed treatment; (4 skills of healthcare professionals – 44% of deaths had a failure in non-technical skills. Conclusions Most complications in orthopaedic surgery can be dealt with adequately, provided they are anticipated and that risk-reduction strategies are instituted. Surgeons take pride in the precision of operative techniques; perhaps it is time to enshrine the multimodal tools available to ensure safer patient care.

  10. Guidelines on constructing funnel plots for quality indicators: A case study on mortality in intensive care unit patients

    NARCIS (Netherlands)

    Verburg, Ilona W. M.; Holman, Rebecca; Peek, Niels; Abu-Hanna, Ameen; de Keizer, Nicolette F.

    2017-01-01

    Funnel plots are graphical tools to assess and compare clinical performance of a group of care professionals or care institutions on a quality indicator against a benchmark. Incorrect construction of funnel plots may lead to erroneous assessment and incorrect decisions potentially with severe

  11. 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

    1999-01-01

    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

  12. 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

    2004-01-01

    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

  13. DETERMINANTS OF CHOICE OF ECOLOGICAL FOOD ACCORDING TO CONSUMERS FROM THE PODKARPACKIE VOIVODESHIP

    Directory of Open Access Journals (Sweden)

    Magdalena Konieczny

    2016-06-01

    Full Text Available The aim of this study was to identify the determinants of the choice of organic foods in the opinion of consumers of the Podkarpackie Voivodship. The study was conducted in the second quarter of 2015 by the means of a questionnaire. The subjects of the research were 308 consumers of organic food in Podkarpackie Voivodship. It was discovered that the consumers perceive organic food as an element of the food category that guarantees health security and excellent taste. Despite the desire to buy such food, the consumers who are supplying themselves with organic products think that the range of products available on the market is insufficient. A very high percentage of the respondents indicated a preference for purchasing food produced in their own country, preferably in their own region, and buying directly from a manufacturer. More than a third of the respondents, especially under 35 years old, is supplying themselves with organic products in specialist stores and supermarkets. The primary barrier in buying organic foods is its too high price. 

  14. Differences between adiposity indicators for predicting all-cause mortality in a representative sample of United States non-elderly adults.

    Directory of Open Access Journals (Sweden)

    Henry S Kahn

    Full Text Available BACKGROUND: Adiposity predicts health outcomes, but this relationship could depend on population characteristics and adiposity indicator employed. In a representative sample of 11,437 US adults (National Health and Nutrition Examination Survey, 1988-1994, ages 18-64 we estimated associations with all-cause mortality for body mass index (BMI and four abdominal adiposity indicators (waist circumference [WC], waist-to-height ratio [WHtR], waist-to-hip ratio [WHR], and waist-to-thigh ratio [WTR]. In a fasting subsample we considered the lipid accumulation product (LAP; [WC enlargement*triglycerides]. METHODS AND FINDINGS: For each adiposity indicator we estimated linear and categorical mortality risks using sex-specific, proportional-hazards models adjusted for age, black ancestry, tobacco exposure, and socioeconomic position. There were 1,081 deaths through 2006. Using linear models we found little difference among indicators (adjusted hazard ratios [aHRs] per SD increase 1.2-1.4 for men, 1.3-1.5 for women. Using categorical models, men in adiposity midrange (quartiles 2+3; compared to quartile 1 were not at significantly increased risk (aHRs1.1, especially black men assessed by WTR (aHR 1.9 [1.4-2.6] and black women by LAP (aHR 2.2 [1.4-3.5]. Quartile 4 of WC or WHtR carried no significant risk for diabetic persons (aHRs 0.7-1.1, but elevated risks for those without diabetes (aHRs>1.5. For both sexes, quartile 4 of LAP carried increased risks for tobacco-exposed persons (aHRs>1.6 but not for non-exposed (aHRs<1.0. CONCLUSIONS: Predictions of mortality risk associated with top-quartile adiposity vary with the indicator used, sex, ancestry, and other characteristics. Interpretations of adiposity should consider how variation in the physiology and expandability of regional adipose-tissue depots impacts health.

  15. Chapter 5 - Tree Mortality

    Science.gov (United States)

    Mark J. Ambrose

    2014-01-01

    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....

  16. Extracellular Fluid/Intracellular Fluid Volume Ratio as a Novel Risk Indicator for All-Cause Mortality and Cardiovascular Disease in Hemodialysis Patients.

    Directory of Open Access Journals (Sweden)

    Eun-Jung Kim

    Full Text Available In hemodialysis patients, fluid overload and malnutrition are accompanied by extracellular fluid (ECF expansion and intracellular fluid (ICF depletion, respectively. We investigated the relationship between ECF/ICF ratio (as an integrated marker reflecting both fluid overload and malnutrition and survival and cardiovascular disease (CVD in the context of malnutrition-inflammation-arteriosclerosis (MIA complex.Seventy-seven patients from a single hemodialysis unit were prospectively enrolled. The ECF/ICF volume was measured by segmental multi-frequency bioimpedance analysis. MIA and volume status were measured by serum albumin, C-reactive protein (CRP, pulse wave velocity (PWV and plasma B-type natriuretic peptide (BNP, respectively.The mean ECF/ICF ratio was 0.56±0.06 and the cut-off value for maximum discrimination of survival was 0.57. Compared with the low ECF/ICF group, the high ECF/ICF group (ratio≥0.57, 42% had higher all-cause mortality, CVD, CRP, PWV, and BNP, but lower serum albumin. During the 5-year follow-up, 24 all-cause mortality and 38 CVD occurred (18 and 24, respectively, in the high ECF/ICF group versus 6 and 14 respectively in the low ECF/ICF group, P<0.001. In the adjusted Cox analysis, the ECF/ICF ratio nullifies the effects of the MIA and volume status on survival and CVD and was an independent predictor of all-cause mortality and CVD: hazard ratio (95% confidence interval; 1.12 (1.01-1.25 and 1.09 (1.01-1.18 for a 0.01 increase in the ECF/ICF ratio. The degree of malnutrition (albumin, inflammation (CRP, arteriosclerosis (PWV, and fluid overload (BNP were correlated well with the ECF/ICF ratio.Hemodialysis patients with high ECF/ICF ratio are not only fluid overloaded, but malnourished and have stiff artery with more inflammation. The ECF/ICF ratio is highly related to the MIA complex, and is a major risk indicator for all-cause mortality and CVD.

  17. SOCIO-ECONOMIC ACTIVITY DETERMINANTS OF SMALL AND MEDIUM-SIZED BUSINESSES ON BORDER AREAS IN WARMIŃSKO-MAZURSKIE VOIVODESHIP

    Directory of Open Access Journals (Sweden)

    Zbigniew Brodziński

    2016-03-01

    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.

  18. 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

    2017-09-01

    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.

  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

    2015-06-01

    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. Integrated biomarker responses of the invasive species Corbicula fluminea in relation to environmental abiotic conditions: a potential indicator of the likelihood of clam's summer mortality syndrome.

    Science.gov (United States)

    Oliveira, Cristiana; Vilares, Pedro; Guilhermino, Lúcia

    2015-04-01

    The aim of this study was to investigate the variation of several biomarkers in wild populations of Corbicula fluminea in relation to abiotic condition changes to identify environmental factors associated with increased stress in this species potentially leading to massive mortality events. The study was carried out from July to October in the freshwater tidal areas of the estuaries of Minho and Lima Rivers (NW Iberian Peninsula). Monthly, 7 biomarkers (biotransformation, energy production, anti-oxidant defenses and lipid peroxidation damages) were determined in C. fluminea and 17 abiotic parameters were determined in water or sediments in 4 sampling sites: M1, M2 and M3 in Minho (up=> downstream); and L in Lima estuaries. The results of biomarkers were integrated using the Integrated Biomarker Response (IBR), Index and also analysed in relation to environmental parameters by Redundancy Analysis (RDA). Overall, the findings of the present study indicate that July and August are particularly stressful months for the studied C. fluminea populations, especially at downstream sites; the increase of nutrients and ammonium water concentrations, water temperature and conductivity are major contributors for this increased stress; the biomarkers indicated that in July/August C. fluminea is exposed to oxidative stress inducers, environmental chemical contaminants biotransformed by esterases and glutathione S-transferase enzymes, and that organisms need additional energy to cope with the chemical and/or thermally-induced stress. The findings of the present study stress the importance of biomonitoring the health condition of C. fluminea because it may allow determining the likelihood of summer/post summer mortality syndrome in this species. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (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

    2018-04-01

    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.

  2. 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.

    Science.gov (United States)

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

    2012-07-07

    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. 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. 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 (1·04; 0·95-1·13). Our results provide supportive evidence

  3. 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

    Science.gov (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

    2012-01-01

    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

  4. Different Duck Species Infected Intramuscularly with Duck-Origin Genotype IX APMV-1 Show Discrepant Mortality and Indicate Another Fatal Genotype APMV-1 to Ducks.

    Science.gov (United States)

    Fu, Guanghua; Cheng, Longfei; Fu, Qiuling; Qi, Baomin; Chen, Cuiteng; Shi, Shaohua; Chen, Hongmei; Wan, Chunhe; Liu, Rongchang; Huang, Yu

    2017-03-01

    Isolations of genotype IX (gIX) avian paramyxovirus type 1 (APMV-1) from various bird species have been more common recently, with isolates showing variable pathogenicity in different species of poultry. Here we sequenced the genome of a Muscovy duck origin gIX virus strain XBT14 and characterized the virulence and pathogenicity of this isolate in chickens and ducks. The genome sequence of strain XBT14 is 15,192 nt in length, containing multiple basic amino acids at the fusion protein cleavage site. The XBT14 strain shared 91.6%-91.9% nucleotide identities with early-genotype viruses (such as genotype III and IV) and shared 85.3%-85.9% nucleotide homologies with later genotype viruses (such as genotype VII). Pathogenicity tests showed that strain XBT14 could cause death in different duck breeds with a mortality rate of 44.4% in Muscovy duck, 25.9% in Sheldrake, and 11.1% in Cherry Valley duck, respectively. Similar mortality discrepancies were also observed in different ducks when infected with chicken-origin gIX virus strain F48E8. These results indicate that XBT14-like velogenic gIX APMV-1 (such as XBT14, F48E8, and GD09-2) could cause fatal infection in duck, and genotype IX is another genotype velogenic to duck as well as genotype VII. Accompanied by genetic differences in the vaccine strains or dominant strains prevailing in poultry, the virulent XBT14-like gIX viruses might become potentially endemic strains in poultry in the future.

  5. Mortality rates or sociomedical indicators? The work of the League of Nations on standardizing the effects of the Great Depression on health.

    Science.gov (United States)

    Garcia, Monica

    2014-01-01

    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.

  6. 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

    1999-01-01

    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

  7. Surgical volume and postoperative mortality rate at a referral hospital in Western Uganda: Measuring the Lancet Commission on Global Surgery indicators in low-resource settings.

    Science.gov (United States)

    Anderson, Geoffrey A; Ilcisin, Lenka; Abesiga, Lenard; Mayanja, Ronald; Portal Benetiz, Noralis; Ngonzi, Joseph; Kayima, Peter; Shrime, Mark G

    2017-06-01

    The Lancet Commission on Global Surgery recommends that every country report its surgical volume and postoperative mortality rate. Little is known, however, about the numbers of operations performed and the associated postoperative mortality rate in low-income countries or how to best collect these data. For one month, every patient who underwent an operation at a referral hospital in western Uganda was observed. These patients and their outcomes were followed until discharge. Prospective data were compared with data obtained from logbooks and patient charts to determine the validity of using retrospective methods for collecting these metrics. Surgical volume at this regional hospital in Uganda is 8,515 operations/y, compared to 4,000 operations/y reported in the only other published data. The postoperative mortality rate at this hospital is 2.4%, similar to other hospitals in low-income countries. Finding patient files in the medical records department was time consuming and yielded only 62% of the files. Furthermore, a comparison of missing versus found charts revealed that the missing charts were significantly different from the found charts. Logbooks, on the other hand, captured 99% of the operations and 94% of the deaths. Our results describe a simple, reproducible, accurate, and inexpensive method for collection of the Lancet Commission on Global Surgery variables using logbooks that already exist in most hospitals in low-income countries. While some have suggested using risk-adjusted postoperative mortality rate as a more equitable variable, our data suggest that only a limited amount of risk adjustment is possible given the limited available data. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. 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

    2014-01-01

    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 http://www.mdpi.com/1660-4601/11/1/952

  9. Desigualdades socioeconómicas entre departmentos y su asociación con indicadores de mortalidad en Colombia en 2000 Socioeconomic inequality and its association with mortality indicators in the departments of Colombia in 2000

    Directory of Open Access Journals (Sweden)

    Jesús Rodríguez García

    2007-03-01

    entre la mortalidad por diabetes mellitus y los indicadores socioeconómicos puede deberse a un error sistemático al clasificar dicha enfermedad como causa básica de muerte en departamentos de bajo nivel de desarrollo. El departamento resulta una unidad de análisis muy grande, lo que puede dificultar la identificación de la asociación entre las mortalidades por agresiones y accidentes del tránsito, y los indicadores socioeconómicos.OBJECTIVES: To study the inequalities in various mortality indicators for the departments of Colombia with respect to national figures, and to identify associations between the departmental mortality indicators and departmental socioeconomic indicators. METHODS: To determine mortality rates and the Gini coefficient for mortality for the departments, data from the death registry were adjusted by the estimated registry coverage for each of the departments. Five socioeconomic indicators were selected: Gini coefficient for income distribution, Human Development Index, per capita gross domestic product, per capita social investment (in health care, etc., and percentage of the population with health care services from the country's social security system. The differences among the departments were then studied and compared to the national averages. The Spearman's rank correlation coefficient was calculated to find associations between the mortality indicators and each of the five socioeconomic indicators. RESULTS: For Colombia overall, death registry coverage was estimated at 76%, with Chocó department having the lowest coverage (35%, and Caldas department the highest (88%. The associations between the Gini coefficient for mortality and four of the socioeconomic indicators studied were significant. The national mortality rate was significantly associated with one socioeconomic indicator. Death caused by diabetes mellitus was associated with all the socioeconomic indicators; death caused by undernutrition or by diarrhea, with four

  10. 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).

    Science.gov (United States)

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

    2010-12-01

    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.

  11. Temporal Profile of Microtubule-Associated Protein 2: A Novel Indicator of Diffuse Brain Injury Severity and Early Mortality after Brain Trauma.

    Science.gov (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

    2018-01-01

    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

  12. Tourist attractiveness of rural communes of natural values in the Warmińsko-mazurskie and Podlaskie voivodeships

    Directory of Open Access Journals (Sweden)

    Milena Bera

    2013-06-01

    Full Text Available The condition of the natural environment is seen as one of the most important factors shaping the size and structure of tourism in the commune. To protect the natural diversity of the most valuable areas, protected areas are created. They require specific treatments to reduce the negative impact of tourists on the natural environment. On the other hand, represent an opportunity for the community, to achieve economic results through the development of the supply of tourist services. Research was carried on communes located in the Warmia-Mazury and Podlasie carried area where a national / landscape park exists or a commune area of minimum 50% area included in the Natura 2000 program. To analyse the tourist attractiveness of respondents communes a set of three measures was used: Baretje and Defert’s indicator, Charvát’s and Schneider’s indicator. An opportunity for a comprehensive development of these communities is the proper management of valuable natural areas according to the concept of sustainable development.

  13. 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

    2011-12-01

    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.

  14. Evolução de indicadores socioeconômicos e da mortalidade cardiovascular em três estados do Brasil Evolution of socioeconomic indicators and cardiovascular mortality in three brazilian states

    Directory of Open Access Journals (Sweden)

    Gabriel Porto Soares

    2013-02-01

    Rio de Janeiro, São Paulo and Rio Grande do Sul, and in their capitals, between 1980 and 2008, with socioeconomic indicators collected from 1949 onwards. METHODS: Population and death data were obtained from the Brazilian Unified Health System databank (Datasus. Mortality rates due to the following were calculated and adjusted by use of the direct method and compensated for poorly defined causes: ischemic heart diseases; cerebrovascular diseases; cardiovascular diseases; poorly defined causes; and all causes. Child mortality data were obtained from state and municipal health secretariats and from the Brazilian Institute of Geography and Statistics (IBGE. Information on gross domestic product (GDP and educational level was obtained from the Brazilian Institute of Applied Economic Research (Ipea. The mortality rates and socioeconomic indicators were correlated by using the estimation of Pearson linear coefficients to determine optimized year lag. The inclination coefficients of the regression between the dependent variable "disease" and the independent variable "socioeconomic indicator" were estimated. RESULTS: The three states showed a reduction in mortality, which was especially due to a decrease in cardiovascular mortality, mainly of cerebrovascular diseases. The decrease in cardiovascular mortality was preceded by a reduction in child mortality, an elevation in the per capita GDP, and an increase in the educational level, and a strong correlation between indicators and mortality rates was observed. CONCLUSIONS: The three indicators showed an almost maximum correlation with the reduction in cardiovascular mortality. Such relationship indicates the importance of improving quality of life to reduce cardiovascular mortality.

  15. Infant Mortality

    Science.gov (United States)

    ... Midwest. Top of Page Infant Mortality Rates by Race and Ethnicity, 2015 *Source: Table 1 (p. 79) ... 1.27MB] . In 2015, infant mortality rates by race and ethnicity were as follows: Non-Hispanic black ...

  16. Occupational mortality

    DEFF Research Database (Denmark)

    Lynge, Elsebeth

    2011-01-01

    INTRODUCTION: This paper aims to present the methods and main results from the Danish occupational mortality studies, and to set the Danish studies into the international context of occupational mortality studies. RESEARCH TOPICS: The first Danish occupational mortality study from 1970...

  17. Looking for new measures of local government debt. Case study of an example of repayment period of communes of Kujawsko-Pomorskie voivodeship in the years 2002–2015

    Directory of Open Access Journals (Sweden)

    Daniel Jurewicz

    2017-03-01

    Full Text Available The debt of local government units is, to a large extent, the sum of repayment of commitments contracted to carry out investment projects. It is not surprising that in the literature of the subject local government debt is presented mainly as good, profitable or constructive. Commitment to repayment obligations is always associated with the possibility of an occurrence of negative effects which often appear to be underestimated. In numerous scientific and public publications, the indebtedness of the Polish self-governments is assessed first of all by the prism of its relation to earned incomes. However, it is imperative to look for metrics and data sources to look at this debt from new perspectives. The purpose of this study is to present the results of research conducted in the communes of the Kujawsko-Pomorskie voivodeship using new measures of their debt.

  18. 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

    2002-12-01

    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

  19. Turbine related fish mortality

    International Nuclear Information System (INIS)

    Eicher, G.J.

    1993-01-01

    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

  20. Cancer mortality

    International Nuclear Information System (INIS)

    Kato, H.

    1986-01-01

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

  1. The Analysis of Differences in Residential Property Price Indices

    Directory of Open Access Journals (Sweden)

    Kokot Sebastian

    2014-10-01

    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.

  2. Mortality Implications of Mortality Plateaus

    DEFF Research Database (Denmark)

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

    2015-01-01

    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....... Mortality plateaus result from multiplicative (proportional) and additive hazards, but not from accelerated failure time models. Frailty can have any distribution with regularly-varying-at-0 density and the distribution of frailty among survivors to each subsequent age converges to a gamma distribution...

  3. 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

    2009-12-01

    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

  4. Métodos para la suavización de indicadores de mortalidad: aplicación al análisis de desigualdades en mortalidad en ciudades del Estado español (Proyecto MEDEA Methods to smooth mortality indicators: application to analysis of inequalities in mortality in Spanish cities (the MEDEA Project

    Directory of Open Access Journals (Sweden)

    M. Antònia Barceló

    2008-12-01

    observa en las zonas con un mayor nivel socioeconómico.Although there is some experience in the study of mortality inequalities in Spanish cities, there are large urban centers that have not yet been investigated using the census tract as the unit of territorial analysis. The coordinated project «Socioeconomic and environmental inequalities in mortality in Spanish cities. The MEDEA project» was designed to fill this gap, with the participation of 10 groups of researchers in Andalusia, Aragon, Catalonia, Galicia, Madrid, Valencia, and the Basque Country. The MEDEA project has four distinguishing features: a the census tract is used as the basic geographical area; b statistical methods that include the geographical structure of the region under study are employed for risk estimation; c data are drawn from three complementary data sources (information on air pollution, information on industrial pollution, and the records of mortality registrars, and d a coordinated, large-scale analysis, favored by the implantation of coordinated research networks, is carried out. The main objective of the present study was to explain the methods for smoothing mortality indicators in the context of the MEDEA project. This study focusses on the methodology and the results of the Besag, York and Mollié model (BYM in disease mapping. In the MEDEA project, standardized mortality ratios (SMR, corresponding to 17 large groups of causes of death and 28 specific causes, were smoothed by means of the BYM model; however, in the present study this methodology was applied to mortality due to cancer of the trachea, bronchi and lung in men and women in the city of Barcelona from 1996 to 2003. As a result of smoothing, a different geographical pattern for SMR in both genders was observed. In men, a SMR higher than unity was found in highly deprived areas. In contrast, in women, this pattern was observed in more affluent areas.

  5. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

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

    1999-01-01

    of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were....... This change was substantial in three countries (P mortality rate for participating countries was 7.7 per...... and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers....

  6. Neonatal mortality in Utah.

    Science.gov (United States)

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

    1982-09-01

    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.

  7. Loneliness, health and mortality.

    Science.gov (United States)

    Henriksen, J; Larsen, E R; Mattisson, C; Andersson, N W

    2017-10-30

    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, including associations to gender, in 1363 adult swedes. This community-based prospective cohort study from the Swedish Lundby Study included 1363 individuals of whom 296 individuals (21.7%) were identified as lonely with use of semi-structured interviews in 1997. The cohort was followed until 2011 and survival analyses were used to estimate the relative risk of death. Death occurred with an incidence rate of 2.63 per 100 person-years and 2.09 per 100 person-years for lonely and non-lonely individuals, respectively. In crude analysis, loneliness was associated with a significant increased mortality risk of 27% compared with non-lonely individuals [hazard ratio (HR) 1.27; 95% CI 1.01-1.60]. Unadjusted, lonely females had a significant increased risk (HR 1.76; 95% CI 1.31-2.34) and adjusted insignificant increased mortality risk of 27% (HR 1.27; 95% CI 0.92-1.74), compared with non-lonely females. Lonely males were found to have an adjusted significant decreased risk of mortality (HR 0.50; 95% CI 0.32-0.80), compared with non-lonely males. Findings suggest an association between loneliness and increased risk of mortality and that gender differences may exist, which have 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.

  8. Social isolation and all-cause mortality

    DEFF Research Database (Denmark)

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

    2018-01-01

    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...... cumulative mortality and adjusted mortality rate ratios (MRR) associated with SNI. We adjusted for potential important confounders, including psychiatric and somatic status, lifestyle, and socioeconomic status. Cumulative 7-year mortality in men was 11% for SNI 0/1 and 5.4% for SNI 4 and in women 9...... isolation was associated with 60-70% increased mortality. Having no partner was associated with highest MRR....

  9. Migrant mortality from diabetes mellitus across Europe

    DEFF Research Database (Denmark)

    Vandenheede, Hadewijch; Deboosere, Patrick; Stirbu, Irina

    2012-01-01

    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......) 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...... 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...

  10. Empirical Productivity Indices and Indicators

    NARCIS (Netherlands)

    B.M. Balk (Bert)

    2016-01-01

    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

  11. Parental incarceration and child mortality in Denmark.

    Science.gov (United States)

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

    2014-03-01

    We used Danish registry data to examine the association between parental incarceration and child mortality risk. 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 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. 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.

  12. Remotely sensed predictors of conifer tree mortality during severe drought

    Science.gov (United States)

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

    2017-11-01

    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.

  13. Waste indicators

    International Nuclear Information System (INIS)

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

    2003-01-01

    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)

  14. Waste indicators

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

    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)

  15. Quality indicators

    DEFF Research Database (Denmark)

    Hjorth-Andersen, Christian

    1991-01-01

    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...

  16. Challenge of Fetal Mortality

    Science.gov (United States)

    ... Technical Information Service NCHS The Challenge of Fetal Mortality Recommend on Facebook Tweet Share Compartir NCHS Data ... and ethnicity What is the impact of fetal mortality on U.S. families? In 2005, a total of ...

  17. Excess mortality in hyperthyroidism

    DEFF Research Database (Denmark)

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

    2012-01-01

    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....

  18. Solar Indices

    Data.gov (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...

  19. Geographical Indications

    OpenAIRE

    Anechitoae Constantin; Grigoru? Lavinia-Maria

    2011-01-01

    “The denomination of origin” may be the name of a region, a specific place or country used to describe an agricultural or food product. "The geographical indication" may be the name of a region, a specific place or a country, used to describe an agricultural or food product. The indication of provenance and the denomination of origin serve to identify the source and origin of goods or services.

  20. Loneliness, health and mortality

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...

  1. Mortality among anesthesiologists in Denmark, 1973-95

    DEFF Research Database (Denmark)

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

    2002-01-01

    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....

  2. Operational indicators

    International Nuclear Information System (INIS)

    2010-01-01

    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

  3. Anthropometric indices

    DEFF Research Database (Denmark)

    Oguoma, V. M.; Nwose, E. U.; Skinner, T. C.

    2016-01-01

    BACKGROUND: The current anthropometric indices used for diagnosis of cardio-metabolic syndrome (CMS) in sub-Saharan Africa are those widely validated in the western world. We hereby aim to compare the sensitivity and specificity of these tools in identifying risk factors for CMS. METHOD: The study...

  4. Respiratory tract mortality in cement workers: a proportionate mortality study

    Science.gov (United States)

    2012-01-01

    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

  5. Infant Mortality and African Americans

    Science.gov (United States)

    ... Profiles > Black/African American > Infant Health & Mortality Infant Mortality and African Americans African Americans have 2.2 ... to receive late or no prenatal care. Infant Mortality Rate Infant mortality rate per 1,000 live ...

  6. VSRR - Quarterly provisional estimates for selected indicators of mortality

    Data.gov (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...

  7. 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

    2009-11-01

    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

  8. Measuring corruption indicators and indices

    OpenAIRE

    MALITO, Debora Valentina

    2014-01-01

    This Working Paper is a background paper delivered to frame the workshop ‘Global Governance by Indicators: Measuring corruption and corruption indicators’ convened by the Global Governance Programme of the European University Institute in Florence on 17 and 18 October 2013. Successively it was developed further in EUI RSCAS WP 2014/37 - http://hdl.handle.net/1814/30582 The development of more sophisticated corruption measures has been stimulated by consistent and compelling demands for mor...

  9. 80 Asthma Mortality in Brazil (1998–2006)

    OpenAIRE

    Souza-Machado, Carolina; Souza-Machado, Adelmir; Carvalho Coelho, Ana Carla; Reis Amaral, Magali Teresópolis; Cruz, Alvaro

    2012-01-01

    Background Some countries have virtually abolished asthma deaths, thus demonstrating asthma mortality is largely preventable. Objectives To evaluate the specific mortality due to asthma in Brazil (1998–2006) and its correlation with access to health services and social indicators. Methods Data were obtained from the National Mortality Database from The Ministry of Health of Brazil. Mortality rates for each state and region were evaluated for the period 1998 to 2006 using linear regression mod...

  10. Mortality associated with phaeochromocytoma.

    Science.gov (United States)

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

    2013-02-01

    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.

  11. Maternal Mortality in Texas.

    Science.gov (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

    2017-05-01

    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.

  12. Gallstone disease and mortality

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...

  13. Mortality in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lie, Elisabeth; Lindström, Ulf

    2016-01-01

    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...... mortality and predictors for death in the AS cohort. RESULTS: There were 496 deaths in the AS cohort and 1533 deaths in the control cohort resulting in an age-adjusted and sex-adjusted HR of 1.60 (95% CI 1.44 to 1.77), with increased mortality for men (age-adjusted HR=1.53, 95% CI 1.36 to 1.72) and women...... (age-adjusted HR=1.83, 95% CI 1.50 to 2.22). Within the AS cohort, statistically significant predictors for death were a lower level of education, general comorbidities (diabetes, infections, cardiovascular, pulmonary and malignant diseases) and previous hip replacement surgery. CONCLUSIONS: Mortality...

  14. Assessment of sampling mortality of larval fishes

    International Nuclear Information System (INIS)

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

    1978-01-01

    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

  15. Social Welfare Expenditures and Infant Mortality.

    Science.gov (United States)

    Shim, Joyce

    2015-01-01

    This study examines the effects of social welfare expenditures on infant mortality (deaths younger than age 1 per 1,000 live births) across 19 Organisation for Economic Co-operation and Development (OECD) countries from 1980 to 2010. Data are obtained from various sources including the OECD, World Health Organization, and World Bank. The findings indicate that among three social welfare expenditure measures for families, the expenditures on family cash allowances are predicted to reduce infant mortality. However, the other two measures-the expenditures on parental and maternity leave and expenditures on family services-have no significant effects on infant mortality.

  16. Mortality and GH deficiency

    DEFF Research Database (Denmark)

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

    2007-01-01

    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 into chil......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...... a significantly increased mortality in GHD patients when compared with controls, possibly due to their hypopituitary status. Mortality was increased in AO female patients when compared with males. For CO and AO GHD, different causes of significantly increased mortality were identified...

  17. Mortality after shoulder arthroplasty

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  18. 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

    2005-08-01

    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.

  19. Endogenous testosterone and mortality risk

    Directory of Open Access Journals (Sweden)

    Emily J Meyer

    2018-01-01

    Full Text Available In men, obesity and metabolic complications are associated with lower serum testosterone (T and dihydrotestosterone (DHT and an increased risk of, and mortality from, multiple chronic diseases in addition to cardiovascular disease (CVD. The causal interrelationships between these factors remain a matter of debate. In men with untreated congenital and lifelong forms of hypogonadotropic hypogonadism, there appears to be no increased risk. Men with Klinefelter's syndrome have an increased risk of various types of cancers, as well as CVD, which persist despite T therapy. In the absence of pathology of the hypothalamic–pituitary–gonadal axis, the effect of modest reductions in serum T in aging men is unclear. The prevalence of low serum T concentrations is high in men with cancer, renal disease, and respiratory disease and is likely to be an indicator of severity of systemic disease, not hypogonadism. Some population-based studies have found low serum T to be associated with a higher risk of deaths attributed to cancer, renal disease, and respiratory disease, while others have not. Although a meta-analysis of longitudinal studies has shown an association between low serum T and all-cause mortality, marked heterogeneity between studies limited a firm conclusion. Therefore, while a decrease in T particularly occurring later in life may be associated with an increase in all-cause and specific types of mortality in men, the differential effects, if any, of T and other sex steroids as compared to health and lifestyle factors are unknown at the current time.

  20. Maternal mortality – a public health problem

    Directory of Open Access Journals (Sweden)

    Sonia Shirin

    2012-07-01

    Full Text Available Maternal mortality is an important indicator which reflects the health status of a community. It can be calculated by maternal mortality ratio (MMR, maternal mortality rate (MMRate, and adult life time risk of maternal death. MMR estimates are based on varieties of methods that include household surveys, sisterhood methods, reproductive-age mortality studies (RAMOS, verbal autopsies and censuses. Main causes of maternal mortality are hemorrhage, infection, unsafe abortion, hypertensive disorder of pregnancy and obstructed labour. Factors of maternal mortality have been conceptualized by three delays model. Estimates of maternal mortality ratio (MMR trend between 1990 and 2010 (over 20 years period suggest a global reduction (47%, with a greater reduction in developing countries (47% including Bangladesh than in developed countries (39%. However, to meet the challenge of Fifth Millennium Development Goal (MDG5 i.e. to ensure 75% reduction of MMR by the year 2015, the annual rate of MMR decline and increase of skilled attendant at birth need to be still faster. Ibrahim Med. Coll. J. 2012; 6(2: 64-69

  1. Disparities in cervical and breast cancer mortality in Brazil

    Science.gov (United States)

    Girianelli, Vania Reis; Gamarra, Carmen Justina; Azevedo e Silva, Gulnar

    2014-01-01

    OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson’s correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment.  PMID:25119941

  2. The relationships among National Socio-Economic Indicators and ...

    African Journals Online (AJOL)

    Under-5 mortality rate was observed to be a better statistical indicator of child welfare than infant mortality rates, and it was influenced significantly by a country's level of educational attainment, maternal mortality rate, gross domestic product, and inflation rate. JOURNAL OF THE GHANA SCIENCE ASSOCIATION Volume 1 ...

  3. Social integration and mortality in Australia.

    Science.gov (United States)

    Siahpush, M; Singh, G K

    1999-12-01

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

  4. On hunger and child mortality in India.

    Science.gov (United States)

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

    2012-01-01

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

  5. Power relations and premature mortality in Spain's autonomous communities.

    Science.gov (United States)

    Rodríguez-Sanz, Maica; Borrell, Carme; Urbanos, Rosa; Pasarín, M Isabel; Rico, Ana; Fraile, Marta; Ramos, Xavier; Navarro, Vicente

    2003-01-01

    This trends ecological study analyzes, across 17 autonomous communities of Spain from 1989 to 1998, the relationship between mortality (total and by main causes of death) and power relations (type of government: social democratic (SDP), conservative (CDP), and others), labor market variables, welfare state variables, income inequality, absolute income, poverty, and number of civil associations. The authors conducted a descriptive analysis; a bivariate analysis (Pearson correlation coefficients) between mortality and each of the independent variables; and a multivariate analysis, adjusting multilevel linear regression models. All dimensions of the conceptual power relations model were related to premature mortality in the direction hypothesized. The cross-pooled multilevel regression models show that total premature mortality in males, male and female cerebrovascular mortality, male and female cirrhosis mortality, and male lung cancer mortality decreased somewhat more in communities where primary health care reform was implemented more quickly. Premature mortality decreased somewhat more in SDP than in CDP communities for male and female total premature mortality, cerebrovascular mortality, and cirrhosis mortality, and male lung cancer mortality. These results are in accord with earlier studies that found a relationship among health indicators and variables related to labor market, welfare state, income inequalities, civil associations, and power relations.

  6. Telomere Length and Mortality

    DEFF Research Database (Denmark)

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

    2008-01-01

    Leukocyte telomere length, representing the mean length of all telomeres in leukocytes, is ostensibly a bioindicator of human aging. The authors hypothesized that shorter telomeres might forecast imminent mortality in elderly people better than leukocyte telomere length. They performed mortality...... telomeres predicted the death of the first co-twin better than the mTRFL did (mTRFL: 0.56, 95% confidence interval (CI): 0.49, 0.63; mTRFL(50): 0.59, 95% CI: 0.52, 0.66; mTRFL(25): 0.59, 95% CI: 0.52, 0.66; MTRFL: 0.60, 95% CI: 0.53, 0.67). The telomere-mortality association was stronger in years 3-4 than...

  7. Occupational Mortality, Background on

    DEFF Research Database (Denmark)

    Lynge, Elsebeth

    2016-01-01

    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...

  8. The UKEA mortality study

    International Nuclear Information System (INIS)

    Stott, A.N.B.

    1985-01-01

    In addition to the National Registry for Radiation Workers the United Kingdom Atomic Energy Authority conducts its own survey of the mortality experience of its employees. The survey studies the causes of death of all past and present employees with special reference to the effects of radiation exposure on mortality. The auditing of the collection of data and its subsequent analyses is carried out by the Medical Research Council. The population of the study currently comprises over 50,000 individuals. The results of the analyses should be available by the end of 1984

  9. Characterizing mortality in pediatric tracheostomy patients.

    Science.gov (United States)

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

    2017-07-01

    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.

  10. Affine stochastic mortality

    NARCIS (Netherlands)

    Schrager, D.F.

    2006-01-01

    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

  11. 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.

  12. Perinatal Mortality 2008

    OpenAIRE

    Public Health Agency

    2010-01-01

    CMACE provides information on perinatal deaths at local, regional and national level for health careproviders, commissioners and policy makers. This UK report complements the perinatal mortality reports which CMACE produces for the UK nations separately, Strategic Health Authorities (SHAs) in England and maternity providers.

  13. [Mortality in metropolitan regions].

    Science.gov (United States)

    Simoes Ccds

    1980-01-01

    Data from the 1970 census and a 1974-1975 survey carried out in Brazil by the Fundacao Instituto Brasileiro de Geografia e Estatistica are used to examine recent mortality trends in urban areas. Specifically, life expectancy in nine metropolitan areas is analyzed in relation to income, diet, and sanitary facilities in the home.

  14. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...

  15. Stillbirth and Infant Mortality

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard

    2012-01-01

    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...

  16. Social, Behavioral, and Biological Factors, and Sex Differences in Mortality

    OpenAIRE

    ROGERS, RICHARD G.; EVERETT, BETHANY G.; SAINT ONGE, JARRON M.; KRUEGER, PATRICK M.

    2010-01-01

    Few studies have examined whether sex differences in mortality are associated with different distributions of risk factors or result from the unique relationships between risk factors and mortality for men and women. We extend previous research by systematically testing a variety of factors, including health behaviors, social ties, socioeconomic status, and biological indicators of health. We employ the National Health and Nutritional Examination Survey III Linked Mortality File and use Cox p...

  17. Social, Behavioral, and Biological Factors, and Sex Differences in Mortality

    Science.gov (United States)

    ROGERS, RICHARD G.; EVERETT, BETHANY G.; SAINT ONGE, JARRON M.; KRUEGER, PATRICK M.

    2010-01-01

    Few studies have examined whether sex differences in mortality are associated with different distributions of risk factors or result from the unique relationships between risk factors and mortality for men and women. We extend previous research by systematically testing a variety of factors, including health behaviors, social ties, socioeconomic status, and biological indicators of health. We employ the National Health and Nutritional Examination Survey III Linked Mortality File and use Cox proportional hazards models to examine sex differences in adult mortality in the United States. Our findings document that social and behavioral characteristics are key factors related to the sex gap in mortality. Once we control for women’s lower levels of marriage, poverty, and exercise, the sex gap in mortality widens; and once we control for women’s greater propensity to visit with friends and relatives, attend religious services, and abstain from smoking, the sex gap in mortality narrows. Biological factors— including indicators of inflammation and cardiovascular risk—also inform sex differences in mortality. Nevertheless, persistent sex differences in mortality remain: compared with women, men have 30% to 83% higher risks of death over the follow-up period, depending on the covariates included in the model. Although the prevalence of risk factors differs by sex, the impact of those risk factors on mortality is similar for men and women. PMID:20879677

  18. Tackling maternal mortality in Africa after 2015

    African Journals Online (AJOL)

    AJRH Managing Editor

    daunting and unmet problem in development in sub-Saharan Africa after 2015. The countries which have recorded successes in reducing maternal mortality provide a glimmer of hope indicating that this goal ... address social justice and human development issues was the ... to address the problems of social inequity and.

  19. Leisure Time Physical Activity and Mortality

    DEFF Research Database (Denmark)

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

    2013-01-01

    -response relationship with hours spent on each activity, supplemented with indicators of participation in each activity; and 3) inflexion or nonmonotonic dose-response relationships using linear splines. RESULTS: A total of 2696 women and 4044 men died through March 2010. We found lower mortality with participation...

  20. Medidas de desigualdad en salud: la discusión de algunos aspectos metodológicos con una aplicación para la mortalidad neonatal en el Municipio de Rio de Janeiro, 2000 Health inequality indicators: a discussion of some methodological approaches as applied to neonatal mortality in the Municipality of Rio de Janeiro, 2000

    Directory of Open Access Journals (Sweden)

    Célia Landmann Szwarcwald

    2002-08-01

    assessment of health inequality indicators, focusing on the following: the redistribution principle and its application to health status; the influence of income inequality; epidemiological and statistical approaches to the problem; and evaluation of health system performance in reducing health inequalities. As an example, inequalities in the neonatal mortality rate are analyzed in the city of Rio de Janeiro, Brazil, 2000, according to the mother's level of schooling, reviewing the minimum requisites for defining an adequate health inequality indicator.

  1. 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

    2004-01-01

    BACKGROUND: Birthweight has, in several studies, been associated with mortality in adult age, even after adjustment for available socioeconomic factors. This association has been explained as a biological result of fetal undernutrition (fetal programming), by genetic predisposition, as a result...... in relative risk of cause-specific mortality, and the heterogeneity in the association between birth dimensions and maternal and paternal mortality, respectively, indicate that several mechanisms (factors related to social position, common genetic factors, and specific organ programming) may account...

  2. [Testosterone and mortality].

    Science.gov (United States)

    Stárka, Luboslav

    Subnormal levels of testosterone are frequently found in men of higher age category. Hypogonadal men have lower life expectancy than men with full androgenization and cardiovascular disease, obesity or diabetes is often associated with hypotestosteronemia. Low testosterone level is risk factor for these diseases. However, until now it is not clear whether testosterone deficiency is a cause or consequence of atherosclerosis or metabolic syndrome. A handful of symptoms and metabolic risk markers in hypogonadal men can be ameliorated by testosterone supplementation. Testosterone treatment increased sexual activity and well-being and had a moderate benefit with respect to depressive symptoms but no significant benefit to vitality. Testosterone has a beneficial effect on cardiovascular risk factors, but there is not clear whether it reduces mortality.Key words: civilization diseases - late onset hypogonadism - morbidity - mortality - testosterone - testosterone supplementation.

  3. Deciphering infant mortality

    Science.gov (United States)

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

    2016-12-01

    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.

  4. Mortality in necrotizing fasciitis

    International Nuclear Information System (INIS)

    Waseem, A.R.; Samad, A.

    2008-01-01

    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)

  5. 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)

    Science.gov (United States)

    Wężyk, P.; Gęca, T.

    2013-12-01

    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

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

    African Journals Online (AJOL)

    2mikitser

    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.

  7. Intrinsic religiosity reduces intergroup hostility under mortality salience

    NARCIS (Netherlands)

    De Zavala, Agnieszka Golec; Cichocka, Aleksandra; Orehek, Edward; Abdollahi, Abdolhossein

    Results of three studies indicate that intrinsic religiosity and mortality salience interact to predict intergroup hostility. Study 1, conducted among 200 American Christians and Jews, reveals that under mortality salience, intrinsic (but not extrinsic or quest) religiosity is related to decreased

  8. Prospective audit of perinatal mortality among inborn babies in a ...

    African Journals Online (AJOL)

    2010-05-05

    May 5, 2010 ... Background: The perinatal mortality rate remains an important indicator of maternal care and maternal health and nutrition, and ..... Switzerland; 2001. 3. Ekure EN, Iroha EO, Egri-Okwaji MT, Ogedengbe OK. Perinatal Mortality at the Close of the 20th Century in Lagos University Teaching Hospital. Nig J.

  9. Temporal and spatial evolution of maternal and neonatal mortality rates in Brazil, 1997–2012

    Directory of Open Access Journals (Sweden)

    Nádia Cristina Pinheiro Rodrigues

    2016-11-01

    Conclusion: Brazil's neonatal mortality rate has improved in recent times, but maternal mortality rates have stagnated, failing to meet the Millennium Development Goals. Public policies and intersectoral efforts may contribute to improvements in these health indicators.

  10. Prediction of long-term mortality in ICU patients: model validation and assessing the effect of using in-hospital versus long-term mortality on benchmarking

    NARCIS (Netherlands)

    Brinkman, Sylvia; Abu-Hanna, Ameen; de Jonge, Evert; de Keizer, Nicolette F.

    2013-01-01

    To analyze the influence of using mortality 1, 3, and 6 months after intensive care unit (ICU) admission instead of in-hospital mortality on the quality indicator standardized mortality ratio (SMR). A cohort study of 77,616 patients admitted to 44 Dutch mixed ICUs between 1 January 2008 and 1 July

  11. Estimating spatial inequalities of urban child mortality

    Directory of Open Access Journals (Sweden)

    John R. Weeks

    2013-01-01

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

  12. Simulations of forest mortality in Colorado River basin

    Science.gov (United States)

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

    2017-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Nelly Ziadé

    2014-07-01

    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.

  14. Allograft Pancreatectomy: Indications and Outcomes.

    Science.gov (United States)

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

    2015-09-01

    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.

  15. Socioeconomic inequalities in mortality in 16 European cities.

    Science.gov (United States)

    Borrell, Carme; Marí-Dell'olmo, Marc; Palència, Laia; Gotsens, Mercè; Burström, B O; Domínguez-Berjón, Felicitas; Rodríguez-Sanz, Maica; Dzúrová, Dagmar; Gandarillas, Ana; Hoffmann, Rasmus; Kovacs, Katalin; Marinacci, Chiara; Martikainen, Pekka; Pikhart, Hynek; Corman, Diana; Rosicova, Katarina; Saez, Marc; Santana, Paula; Tarkiainen, Lasse; Puigpinós, Rosa; Morrison, Joana; Pasarín, M Isabel; Díez, Èlia

    2014-05-01

    To explore inequalities in total mortality between small areas of 16 European cities for men and women, as well as to analyse the relationship between these geographical inequalities and their socioeconomic indicators. A cross-sectional ecological design was used to analyse small areas in 16 European cities (26,229,104 inhabitants). Most cities had mortality data for a period between 2000 and 2008 and population size data for the same period. Socioeconomic indicators included an index of socioeconomic deprivation, unemployment, and educational level. We estimated standardised mortality ratios and controlled for their variability using Bayesian models. We estimated relative risk of mortality and excess number of deaths according to socioeconomic indicators. We observed a consistent pattern of inequality in mortality in almost all cities, with mortality increasing in parallel with socioeconomic deprivation. Socioeconomic inequalities in mortality were more pronounced for men than women, and relative inequalities were greater in Eastern and Northern European cities, and lower in some Western (men) and Southern (women) European cities. The pattern of excess number of deaths was slightly different, with greater inequality in some Western and Northern European cities and also in Budapest, and lower among women in Madrid and Barcelona. In this study, we report a consistent pattern of socioeconomic inequalities in mortality in 16 European cities. Future studies should further explore specific causes of death, in order to determine whether the general pattern observed is consistent for each cause of death.

  16. 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.

    1978-01-01

    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

  17. Trends in Infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight

    OpenAIRE

    Barría-Pailaquilén, René Mauricio; Mendoza-Maldonado, Yessy; Urrutia-Toro, Yohana; Castro-Mora, Cristian; Santander-Manríquez, Gema

    2011-01-01

    The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at

  18. Low birthweight and mortality

    DEFF Research Database (Denmark)

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

    2006-01-01

    , 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...... and non-repeat LBW births. The study showed that the tendency to repeat LBW was associated with a reduced early neonatal and infant mortality compared to non-repeat LBW births. This was particularly the case for repeat LBW births born at term and Apgar scores were higher for the repeats. Repeat LBW births...... weighed significantly more. Apart from this difference in weight we have not been able to explain the improved survival for these repeat compared to the non-repeat births. And apart from differences in Apgar scores there were no differences in morbidity based on recorded hospitalizations in infancy....

  19. Herd factors associated with dairy cow mortality.

    Science.gov (United States)

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

    2015-08-01

    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

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

    Science.gov (United States)

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

    2004-01-01

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

  1. Infant Mortality and Asians and Pacific Islanders

    Science.gov (United States)

    ... Population Profiles > Asian American > Infant Health & Mortality Infant Mortality and Asians and Pacific Islanders Among Asian/Pacific ... as compared to non-Hispanic white mothers. Infant Mortality Rate Infant mortality rate per 1,000 live ...

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

    Science.gov (United States)

    Viboud, Cécile; Simonsen, Lone; Fuentes, Rodrigo; Flores, Jose; Miller, Mark A; Chowell, Gerardo

    2016-03-01

    Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics. 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. The pandemic-associated excess respiratory mortality rate was 1.9/10,000 population (95% confidence interval [CI], 1.2-2.6 cases/10,000 population) on average during 1957-1959. Excess mortality rates varied 70-fold across countries; Europe and Latin America experienced the lowest and highest rates, respectively. Excess mortality was delayed by 1-2 years in 18 countries (46%). Increases in the mortality rate relative to baseline were greatest in school-aged children and young adults, with no evidence that elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, explaining 35%-77% of the variance. Overall, we attribute 1.1 million excess deaths (95% CI, .7 million-1.5 million excess deaths) globally to the 1957-1959 pandemic. 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 of the pandemic on mortality was delayed in several countries, pointing to a window of opportunity for vaccination in a future pandemic. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  3. Global Mortality Impact of the 1957–1959 Influenza Pandemic

    Science.gov (United States)

    Viboud, Cécile; Simonsen, Lone; Fuentes, Rodrigo; Flores, Jose; Miller, Mark A.; Chowell, Gerardo

    2016-01-01

    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% confidence interval [CI], 1.2–2.6 cases/10 000 population) on average during 1957–1959. Excess mortality rates varied 70-fold across countries; Europe and Latin America experienced the lowest and highest rates, respectively. Excess mortality was delayed by 1–2 years in 18 countries (46%). Increases in the mortality rate relative to baseline were greatest in school-aged children and young adults, with no evidence that elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, explaining 35%–77% of the variance. Overall, we attribute 1.1 million 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 of the pandemic on mortality was delayed in several countries, pointing to a window of opportunity for vaccination in a future pandemic. PMID:26908781

  4. Examining Road Traffic Mortality Status in China: A Simulation Study.

    Science.gov (United States)

    Huang, Helai; Yin, Qingyi; Schwebel, David C; Li, Li; Hu, Guoqing

    2016-01-01

    Data from the Chinese police service suggest substantial reductions in road traffic injuries since 2002, but critics have questioned the accuracy of those data, especially considering conflicting data reported by the health department. To address the gap between police and health department data and to determine which may be more accurate, we conducted a simulation study based on the modified Smeed equation, which delineates a non-linear relation between road traffic mortality and the level of motorization in a country or region. Our goal was to simulate trends in road traffic mortality in China and compare performances in road traffic safety management between China and 13 other countries. Chinese police data indicate a peak in road traffic mortalities in 2002 and a significant and a gradual decrease in population-based road traffic mortality since 2002. Health department data show the road traffic mortality peaked in 2012. In addition, police data suggest China's road traffic mortality peaked at a much lower motorization level (0.061 motor vehicles per person) in 2002, followed by a reduction in mortality to a level comparable to that of developed countries. Simulation results based on health department data suggest high road traffic mortality, with a mortality peak in 2012 at a moderate motorization level (0.174 motor vehicles per person). Comparisons to the other 13 countries suggest the health data from China may be more valid than the police data. Our simulation data indicate China is still at a stage of high road traffic mortality, as suggested by health data, rather than a stage of low road traffic mortality, as suggested by police data. More efforts are needed to integrate safety into road design, improve road traffic management, improve data quality, and alter unsafe behaviors of pedestrians, drivers and passengers in China.

  5. 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

    2011-01-01

    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.

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

    Science.gov (United States)

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

    2011-07-01

    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 °C) compared to the 50th percentile (15 °C). Mortality risk was 12.2% (3.69, 21.3%) comparing the 10th (-1 °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.

  7. Siberian Pine Decline and Mortality in Southern Siberian Mountains

    Science.gov (United States)

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

    2013-01-01

    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.

  8. Cervical cancer incidence and mortality in Fiji 2003-2009.

    Science.gov (United States)

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

    2012-08-01

    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.

  9. Intervention strategies for reduction of infant mortality.

    Science.gov (United States)

    Kumar, V; Datta, N

    1985-01-01

    The Government of India has established the goal of a 50% reduction in the infant mortality rate by the year 2000 for the country as a whole as well as for each state and union territory. Experience has indicated that this is an achievable goal provided that the appropriate, cost-effective interventions are introduced. Choice of intervention strategies requires consideration of the contribution of various problems to overall infant mortality, the technical feasibility of various interventions within the context of primary health care, economic feasibility, and cultural acceptability. About 50% of deaths occur in the neonatal period, and the determinants of mortality in this stage differ from those in the postneonatal period. Pilot experiments have indicated that acute diarrheal disease can be reduced substantially by the use of oral rehydration solution. Neonatal tetanus is a completely preventable disease. Preventive interventions have a more limited role in the case of acute lower respiratory infections, although their diagnosis and treatment may be possible at the primary health care level. The problems of protein-energy malnutrition and low birthweight require improvements in maternal health and prenatal care, promotion of breastfeeding and child spacing, and growth monitoring. Longterm gains in this area require attention to behavioral and community development issues, including reduction of the sex and parity related differentials in mortality, enhancement of the status of women, improved female literacy and employment opportunities, improved intrafamilial food distribution patterns, maternity benefits, provision of potable water, intersectoral development to strengthen health care delivery, increased community participation, expanded health services, and enhancement of the pace of development. Pilot experiments and population-based studies carried out in 2 community development blocks in Haryana confirm the effectiveness of well thought-out interventions in

  10. Excess Early Mortality in Schizophrenia

    DEFF Research Database (Denmark)

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

    2014-01-01

    Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality...... as 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...

  11. Mortality of lead smelter workers

    Energy Technology Data Exchange (ETDEWEB)

    Selevan, S.G.; Landrigan, P.J.; Stern, F.B.; Jones, J.H.

    1985-10-01

    To examine patterns of death in lead smelter workers, a retrospective analysis of mortality was conducted in a cohort of 1,987 males employed between 1940 and 1965 at a primary lead smelter in Idaho. Overall mortality was similar to that of the United States white male population (standardized mortality ratio (SMR) = 98). Excess mortality, however, was found from chronic renal disease (SMR = 192; confidence interval (CI) = 88-364), and the risk of death from renal disease increased with increasing duration of employment, such that after 20 years employment, the standardized mortality ratio reached 392 (CI = 107-1,004). Excess mortality was also noted for nonmalignant respiratory disease (SMR = 187, CI = 128-264). Eight of 32 deaths in this category were caused by silicosis; at least five workers who died of silicosis had been miners for a part of their lives. An additional 11 deaths resulted from tuberculosis (SMR = 139; CI = 69-249); in six of these cases, silicosis was a contributory cause of death. Cancer mortality was not increased overall (SMR = 95; CI = 78-114). An increase, however, was noted for deaths from kidney cancer (six cases; SMR = 204; CI = 75-444). Finally, excess mortality was noted for injuries (SMR = 138; CI = 104-179); 13 (23%) of the 56 deaths in this category were caused by mining injuries. The data from this study are consistent with previous reports of increased mortality from chronic renal disease in persons exposed occupationally to lead.

  12. 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

  13. Perinatal Mortality in Southern Nigeria; less than half a decade to ...

    African Journals Online (AJOL)

    Background: Perinatal mortality is one of the essential indicators of the health status of a country and by extension its state of development. Reduction in perinatal mortality rate is an important aspect of the MDGs. Objectives: To determine the perinatal mortality rate (PMR) in 2 tertiary institutions in Southern Nigeria and the ...

  14. 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,

  15. Cancer mortality patterns among Turkish immigrants in four European countries and in Turkey

    DEFF Research Database (Denmark)

    Spallek, Jacob; Arnold, Melina; Razum, Oliver

    2012-01-01

    mortality among Turkish immigrants across four host countries (Belgium, Denmark, France and the Netherlands) was compared. Population-based cancer mortality data from these countries were included. Age-standardized mortality rates were computed for the local-born and Turkish population of each country......-cancer mortality than the local-born populations of their host countries, and mortality levels comparable to all-cancer mortality rates in Turkey. In the Netherlands and France breast cancer mortality was consistently lower in Turkish immigrants women than among local-born women. Lung cancer mortality was slightly...... lower in Turkish immigrants in the Netherlands and France but varied considerably between migrants in these two host countries. Stomach cancer mortality was significantly higher in Turkish immigrants when compared to local-born French and Dutch. Our findings indicate that exposures both in the country...

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

    NARCIS (Netherlands)

    Bonneux, L.G.A.

    2010-01-01

    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

  17. Alcohol and Mortality from All Causes

    Directory of Open Access Journals (Sweden)

    SERGE RENAUD

    2004-01-01

    Full Text Available A large number of prospective studies have observed an inverse relationship between a moderate intake of alcohol and coronary heart disease morbidity and mortality. Concerning death from all-causes, results are not unanimous. Alcohol intake was associated with a protection of all-cause mortality in England and USA physicians and the large study of the American Cancer Society. None of these studies separated the effects of different alcoholic beverages. In our prospective studies in France on 35 000 middle-aged men, we observed that only wine at moderate intake, was associated with a protective effect on all-cause mortality. The reason was that in addition to the known effect on cardiovascular diseases, a very moderate intake of wine, protected also from cancer and other causes as confirmed by Gronbaek in Denmark. Our recent results also indicate that the protective effect of a moderate intake of wine on all-cause mortality is observed at all levels of blood pressure and serum cholesterol.

  18. Political party affiliation, political ideology and mortality.

    Science.gov (United States)

    Pabayo, Roman; Kawachi, Ichiro; Muennig, Peter

    2015-05-01

    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 http://group.bmj.com/group/rights-licensing/permissions.

  19. Sex differences in health and mortality in Moscow and Denmark

    DEFF Research Database (Denmark)

    Oksuzyan, A; Shkolnikova, M; Vaupel, J W

    2014-01-01

    In high income countries females outlive men, although they generally report worse health, the so-called male-female health-survival paradox. Russia has one of the world's largest sex difference in life expectancy with a male disadvantage of more than 10 years. We compare components of the paradox...... between Denmark and Moscow by examining sex differences in mortality and several health measures. The Human Mortality Database and the Russian Fertility and Mortality Database were used to examine sex differences in all-cause death rates in Denmark, Russia, and Moscow in 2007-2008. Self-reported health...... in Denmark. The present study showed that despite similar directions of sex differences in health and mortality in Moscow and Denmark, the male-female health-survival paradox is very pronounced in Moscow suggesting a stronger sex-specific disconnect between health indicators and mortality among middle...

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

    DEFF Research Database (Denmark)

    Viboud, Cécile; Simonsen, Lone; Fuentes, Rodrigo

    2016-01-01

    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...

  1. Business cycles and mortality: results from Swedish microdata.

    Science.gov (United States)

    Gerdtham, Ulf-G; Johannesson, Magnus

    2005-01-01

    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.

  2. The rise of mortality from mental and neurological diseases in Europe, 1979-2009: Observational study

    OpenAIRE

    Mackenbach, Johan; Karanikolos, Marina; Looman, Caspar

    2014-01-01

    textabstractBackground: We studied recent trends in mortality from seven mental and neurological conditions and their determinants in 41 European countries. Methods. Age-standardized mortality rates were analysed using standard methods of descriptive epidemiology, and were related to cultural, economic and health care indicators using regression analysis. Results: Rising mortality from mental and neurological conditions is seen in most European countries, and is mainly due to rising mortality...

  3. The rise of mortality from mental and neurological diseases in Europe, 1979–2009: observational study

    OpenAIRE

    Mackenbach, Johan P; Karanikolos, Marina; Looman, Caspar WN

    2014-01-01

    Background We studied recent trends in mortality from seven mental and neurological conditions and their determinants in 41 European countries. Methods Age-standardized mortality rates were analysed using standard methods of descriptive epidemiology, and were related to cultural, economic and health care indicators using regression analysis. Results Rising mortality from mental and neurological conditions is seen in most European countries, and is mainly due to rising mortality from dementias...

  4. Rate and Time Trend of Perinatal, Infant, Maternal Mortality, Natality and Natural Population Growth in Kosovo

    OpenAIRE

    Azemi, Mehmedali; Gashi, Sanije; Berisha, Majlinda; Kolgeci, Selim; Ismaili-Jaha, Vlora

    2012-01-01

    Aim: The aim of work has been the presentation of the rate and time trends of some indicators of the heath condition of mothers and children in Kosovo: fetal mortality, early neonatal mortality, perinatal mortality, infant mortality, natality, natural growth of population etc. The treated patients were the newborn and infants in the post neonatal period, women during their pregnancy and those 42 days before and after the delivery. Methods: The data were taken from: register of the patients tr...

  5. 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

    2012-07-01

    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.

  6. Underweight and mortality.

    Science.gov (United States)

    Lee, Joo Young; Kim, Hyeon Chang; Kim, Changsoo; Park, Keeho; Ahn, Song Vogue; Kang, Dae Ryong; Khaw, Kay-Tee; Willett, Walter C; Suh, Il

    2016-07-01

    According to most prospective studies, being underweight (BMICorporation study with 14 years of follow-up. After excluding deaths within the first 5 years of follow-up (1993-1997) to minimize reverse causation and excluding participants without information about smoking and health status, 94 133 men and 48 496 women aged 35-59 years in 1990 were included. We documented 5411 (5·7 %) deaths in men and 762 (1·6 %) in women. Among never smokers, hazard ratios (HR) for underweight individuals were not significantly higher than those for normal-weight individuals (BMI=18·5-22·9 kg/m2): HR=0·87 (95 % CI 0·41, 1·84, P=0·72) for underweight men and HR=1·12 (95 % CI 0·76, 1·65, P=0·58) for underweight women. Among ex-smokers, HR=0·86 (95 % CI 0·38, 1·93, P=0·72) for underweight men and HR=3·77 (95 % CI 0·42, 32·29, P=0·24) for underweight women. Among current smokers, HR=1·60 (95 % CI 1·28, 2·01, Pmen and HR=2·07 (95 % CI 0·43, 9·94, P=0·36) for underweight women. The present study does not support that being underweight per se is associated with increased all-cause mortality in Korean men and women.

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

    Directory of Open Access Journals (Sweden)

    Danan Gu

    2013-11-01

    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. Hostility, drinking pattern and mortality

    DEFF Research Database (Denmark)

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

    2008-01-01

    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....

  9. Female circumcision and child mortality in urban Somalia.

    Science.gov (United States)

    Mohamud, O A

    1991-01-01

    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

  10. Stressful social relations and mortality

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... hazards model. RESULTS: Frequent worries/demands from partner or children were associated with 50-100% increased mortality risk. Frequent conflicts with any type of social relation were associated with 2-3 times increased mortality risk. Interaction between labour force participation and worries...

  11. Intrinsic and extrinsic mortality reunited

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  12. Assessment of infant mortality surveillance: case study

    Directory of Open Access Journals (Sweden)

    Conceição Maria de Oliveira

    Full Text Available Abstract Objectives: assess the implementation of child mortality surveillance in Recife/PE. Methods: an analytical evaluative study was conducted on its implementation. It was a single-case study that correlated degree of implementation with the of the result indicators surveillance. A logic model on this strategy and a matrix of indicators and judgments according to model components were drawn up. The degree of implementation was obtained from structure and process indicators and this was then correlated with result indicators, in a deductive approach based on intervention theory. Results: the structure approach presented superior results to the process in all evaluated components. This strategy was considered to have been partially implemented (75. 7%, however, the components of 'identification of deaths' (85.7%, 'epidemiological research' (88.1% and 'referral of proposals for promotion and health care and correction of official statistics' (95.8% were classified implemented. Regarding the relation of the degree of implantation of the surveillance and its results with the logical model, only one of the 17 indicators was considered inconsistent. Conclusions: this strategy was considered to have been partially implemented. The model of child mortality surveillance and its assessment were shown to be adequate for signaling the consistency of the interrelations between the activities proposed and the effects expected, and would be reproducible within other scenarios.

  13. Improving the measurement of maternal mortality: the sisterhood method revisited.

    Directory of Open Access Journals (Sweden)

    Leena Merdad

    Full Text Available BACKGROUND: Over the past several decades the efforts to improve maternal survival and the consequent demand for accurate estimates of maternal mortality have increased. However, measuring maternal mortality remains a difficult task especially in developing countries with weak information systems. Sibling histories included in household surveys (most notably the Demographic and Health Surveys (DHS have emerged as an important source of maternal mortality data. Data have been mainly collected from women and have not been widely collected from men due to concerns about data quality. We assess data quality of histories obtained from men and the potential to improve the efficiency of surveys measuring maternal mortality by collecting such data. METHODS AND FINDINGS: We used data from 10 Demographic and Health Surveys (DHS that have included a full sibling history in both their women's and men's questionnaires. We estimated adult and maternal mortality indicators from histories obtained from men and women. We assessed the completeness and accuracy of these histories using several indicators of data quality. Our study finds that mortality estimates based on sibling histories obtained from men do not systematically or significantly differ from those obtained from women. Quality indicators were similar when comparing data from men and women. Pooling data obtained from men and women produced narrower confidence intervals. CONCLUSION: From experience across nine developing countries, sibling history data obtained from men appear to be a reliable source of information on adult and maternal mortality. Given that there are no significant differences between mortality estimates based on data obtained from men and women, data can be pooled to increase efficiency. This finding improves the feasibility for countries to generate robust empirical estimates of adult and maternal mortality from surveys. Further we recommend that male sibling histories be collected

  14. Predictors of stroke - associated mortality in Africans.

    Science.gov (United States)

    Longo-Mbenza, B; Tonduangu, K; Muyeno, K; Phanzu, M; Kebolo Baku, A; Muvova, D; Lelo, T; Odio, W; Lukoki, L; Bikangi Nkiabungu, F; Kilembe, M; Tshiamala, P; Katalay, L; Mwema, M; Muyembe, T

    2000-01-01

    The objective of the study was to examine the association of the stroke-related mortality with gender, age, ethnicity, social class, blood pressure, fibrinogen, selected clinical data and meteorologic parameters in hospitalized Africans. A series of 1032 consecutively hospitalized incident cases of acute stroke between 1987 and 1991 was studied. Univariate and multivariate analyses were used to estimate the risk (odds ratio=OR) of stroke mortality for meteorologic parameters on the month before the accident onset and selected sociodemophysiological variables on the day of admission. The variables significantly associated with stroke mortality in multivariate analysis were male sex (OR= 2.3 [1.3 - 4.1]), low social class (OR= 2.0 [1.2 - 4.0]), migrant tribes (OR= 1.7 [1.5 - 1.8]), ischemic stroke (OR= 1.4 [1.2 - 1.6]), heart rate >=100 bpm (OR= 1.1 [1.0 - 1.2]), age > or =60 years (OR= 1.03 [1.01 - 1.06]), systolic blood pressure> 160 mmHg (OR= 1. 02 [1.01 - 1.03]), and fibrinogen > or =400 mg/dl (OR= 1.01 [1.002 - 1. 02]). However, diastolic blood pressure > 90 mmHg and global radiation< 340 Cal/cm(2)/day were significantly (p< 0.05) and inversely associated with stroke mortality. Our results indicate that male sex, older age, low social class, migration, ischemic stroke and higher baseline levels of heart rate, systolic blood pressure and fibrinogen are significant predictors of stroke mortality, but lower global radiation and higher diastolic blood pressure are inversely linked.

  15. Association of Human Mortality with Air Pollution of Hong Kong

    Directory of Open Access Journals (Sweden)

    Ka-In Hoi

    2014-05-01

    Full Text Available In this study, we attempted to investigate the general statistical association of air pollution with the cardiovascular and respiratory mortality of the elderly in Hong Kong. Based on six years of measurements including the major air pollutant concentrations (PM10, SO2, NO, NO2, O3, CO, ambient temperature, and mortality (respiratory, cardiovascular between 2005 and 2010, correlation analysis was carried out in annual, monthly and weekly time scales. From an annual perspective, it was found that the air pollution species may pose a constant effect on the respiratory and the cardiovascular mortality during the studied period since the elderly mortality rates and the air pollution annual concentrations show obvious constant trends. From a monthly time scale, it was found that NO2 and CO have high positive cross correlation with the respiratory mortality of the following 1 to 2 months. In addition, PM10 and CO also have similar delayed influence on the cardiovascular mortality. Among these four pollutants, only CO was found to exhibit high statistical association in the weekly time scale and it is most related to the cardiovascular mortality of the week after next. Therefore, it was concluded that the effect of air pollution on the elderly mortality of Hong Kong should be cumulative. This study implies that the establishment of weekly or monthly air quality indices is necessary for health implications.

  16. The Affordable Care Act's Dependent Care Coverage and Mortality.

    Science.gov (United States)

    McClellan, Chandler

    2017-05-01

    In September 2010, the Affordable Care Act (ACA) enabled young adults to gain insurance coverage under their parents' policies. Assess the impact of the ACA's dependent care coverage expansion on young adult mortality rates. Using the Multiple Cause Mortality public use database for 2008-2013, the impact of the ACA is examined with a difference-in-differences analysis of monthly mortality rates using individuals aged 26-30 as a natural control group for young adults aged 19-25. The average monthly disease-related mortality rate of the 19-25 years old group fell by between 3.1% and 6.1% in the wake of the dependent care coverage expansion. Reduction in mortality was primarily in disease-related causes which are amenable to general medical care such as cardiovascular disease, while mortality due to trauma-related causes, which must be treated regardless of insurance status under preexisting laws, was unaffected. The reduction in mortality from this single provision of the ACA indicates that larger gains in preventable mortality could be made as health insurance coverage continues to expand under the ACA.

  17. Ischaemic heart disease mortality and the business cycle in Australia.

    Science.gov (United States)

    Bunn, A R

    1979-01-01

    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

  18. Occupational physical activity and mortality among Danish workers

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Burr, Hermann; Hansen, Jørgen V

    2012-01-01

    PURPOSE: The relationship between occupational physical activity (OPA) and mortality has mainly been studied among males and shows conflicting results. This study examines this relationship in a cohort of both male and female workers. METHODS: OPA was determined by 4 self-reported questions.......79, CI: 1.19-2.70), but not among female workers (HR: 0.99, CI: 0.65-1.49) compared with workers in the lowest quartile of OPA. Among females, indications of a u-shaped relationship between occupational physical activity and all-cause mortality were found. CONCLUSIONS: The findings indicate that high...... occupational physical activity increases the risk for all-cause mortality among male workers. Future studies need to further examine gender differences in the effects of OPA on mortality....

  19. Amniotic fluid embolism mortality rate.

    Science.gov (United States)

    Benson, Michael D

    2017-11-01

    The objective of this study was to determine the mortality rate of amniotic fluid embolism (AFE) using population-based studies and case series. A literature search was conducted using the two key words: 'amniotic fluid embolism (AFE)' AND 'mortality rate'. Thirteen population-based studies were evaluated, as well as 36 case series including at least two patients. The mortality rate from population-based studies varied from 11% to 44%. When nine population-based studies with over 17 000 000 live births were aggregated, the maternal mortality rate was 20.4%. In contrast, the mortality rate of AFE in case series varies from 0% to 100% with numerous rates in between. The AFE mortality rate in population-based studies varied from 11% to 44% with the best available evidence supporting an overall mortality rate of 20.4%. Data from case series should no longer be used as a basis for describing the lethality of AFE. © 2017 Japan Society of Obstetrics and Gynecology.

  20. [Asthma mortality trends in Mexico].

    Science.gov (United States)

    Salas Ramírez, M; Segura Méndez, N H; Martínez-Cairo Cueto, S

    1994-04-01

    The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. Mortality and morbidity rates were adjusted for age using the direct method. From 1960 to 1987, mortality decreased for both sexes. The groups with the highest asthma mortality were those under 4 years of age and those over 50. From 1960 to the present, the state with the highest mortality was Tlaxcala. Hospitalizations increased from 10 to 140 per 100,000 population for the country as a whole. When both outpatient visits and hospitalizations were considered, the morbidity rates rose from 180 to 203.4 per 100,000 between 1960 and 1970. In 1970, hospital morbidity was higher among males than females. From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.

  1. Relative income, race, and mortality.

    Science.gov (United States)

    Miller, Douglas L; Paxson, Christina

    2006-09-01

    This paper examines the relationship between relative income and mortality. Our research is motivated by recent literature that posits that, holding individual income fixed, those whose income are low relative to the incomes of those in a reference group will have worse health. We develop an empirical model in which an individual's health is a function of his or her own income and the incomes of those who live in the same geographical area. We show how this individual-level model can be estimated using semi-aggregated data on the mortality rates of people categorized by age, race, gender, and place of residence. The model is estimated using mortality data from the 1980 and 1990 Compressed Mortality Files, merged with income data from the 1980 and 1990 5% Public Use samples of the US Census. We find no evidence that having relatively wealthy neighbors, holding own income fixed, is associated with higher mortality. Instead, we find evidence that among some demographic and age groups--in particular working-aged black males--having relatively wealthy neighbors is associated with lower mortality. For example, among younger (aged 25-64) black men, an increase in the income of others is estimated to have a beneficial effect on mortality that is 40% as large as an equivalent increase in own income.

  2. Geomagnetic Indices Bulletin (GIB)

    Data.gov (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...

  3. NCHS - Injury Mortality: United States

    Data.gov (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...

  4. CDC WONDER: Mortality - Infant Deaths

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2015-07-01

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

  6. CREDIT Performance Indicator Framework

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... regulations in the countries participating in CREDIT. The Performance Indicator Framework encompassed 187 indicators grouped in 7 main groups of indicators and 42 sub-groups. Based on the CREDIT case studies it was concluded that there neither is link between certain indicators and specific building types...

  7. Assessing preoperative frailty utilizing validated geriatric mortality calculators and their association with postoperative hip fracture mortality risk.

    Science.gov (United States)

    Dwyer, Jennifer G; Reynoso, Jason F; Seevers, Georgia A; Schmid, Kendra K; Muralidhar, Padmashri; Konigsberg, Beau; Lynch, Thomas G; Johanning, Jason M

    2014-09-01

    End-of-life surgical care is a major concern with a significant number of operations performed within the last year of life; surgery for hip fractures is a prime example. Unfortunately, no simple objective tool exists to assess life expectancy in the postoperative period. The goal of our study was to analyze 2 simple geriatric life expectancy calculators to compare with the current Veterans Affairs Surgical Quality Improvement Program (VASQIP) postoperative 30-day mortality calculator. This retrospective study assessed the utility of 3 validated calculators in 47 hip fracture repairs from July 2009 to May 2011. The tools included: 30-day VASQIP mortality calculator, 6-month Minimum Data Set Mortality Risk Index-Revised (MMRI-R), and Four-Year Mortality Index. The VASQIP calculator requires chart review, Current Procedural Terminology (CPT) codes, and laboratory analysis, whereas the mortality risk indices require simple patient questioning if prospective or simple chart review if retrospective. Scoring was performed and mortality risk was compared between survivors and nonsurvivors. A total of 47 hip fractures were repaired during the study period with 37 survivors and 10 nonsurvivors. In all, 7 died within 30 days, 2 died within 6 months, and 1 died greater than 6 months after surgery. The mean age (standard deviation [SD]) of all patients undergoing hip fracture repair was 73.6 (13.3) years. The VASQIP calculator mean (SD) 30-day mortality risk was 10.4% (5.4) for nonsurvivors compared to survivors 4.3% (5.5), P calculators showed significant differences in mortality risk between survivors versus nonsurvivors in a population with hip fracture. In contrast, the Four-Year Mortality calculator may not sufficiently discriminate operative risk. The easily obtained MMRI-R has the potential to provide information on short-term postoperative mortality risk.

  8. Excess mortality following hip fracture

    DEFF Research Database (Denmark)

    Abrahamsen, B; van Staa, T; Ariely, R

    2009-01-01

    Summary This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlig......Summary This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter...... and excess mortality rates for hip fracture. Although a lack of consistent study design precluded any formal meta-analysis or pooled analysis of the data, we have shown that hip fracture is associated with excess mortality (over and above mortality rates in nonhip fracture/community control populations......) during the first year after fracture ranging from 8.4% to 36%. In the identified studies, individuals experienced an increased relative risk for mortality following hip fracture that was at least double that for the age-matched control population, became less pronounced with advancing age, was higher...

  9. Drought impact on vegetation growth and mortality

    Science.gov (United States)

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

    2017-12-01

    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

  10. Mediterranean diet and Alzheimer disease mortality

    Science.gov (United States)

    Scarmeas, Nikolaos; Luchsinger, Jose A.; Mayeux, Richard; Stern, Yaakov

    2009-01-01

    Background We previously reported that the Mediterranean diet (MeDi) is related to lower risk for Alzheimer disease (AD). Whether MeDi is associated with subsequent AD course and outcomes has not been investigated. Objectives To examine the association between MeDi and mortality in patients with AD. Methods A total of 192 community-based individuals in New York who were diagnosed with AD were prospectively followed every 1.5 years. Adherence to the MeDi (0- to 9-point scale with higher scores indicating higher adherence) was the main predictor of mortality in Cox models that were adjusted for period of recruitment, age, gender, ethnicity, education, APOE genotype, caloric intake, smoking, and body mass index. Results Eighty-five patients with AD (44%) died during the course of 4.4 (±3.6, 0.2 to 13.6) years of follow-up. In unadjusted models, higher adherence to MeDi was associated with lower mortality risk (for each additional MeDi point hazard ratio 0.79; 95% CI 0.69 to 0.91; p = 0.001). This result remained significant after controlling for all covariates (0.76; 0.65 to 0.89; p = 0.001). In adjusted models, as compared with AD patients at the lowest MeDi adherence fertile, those at the middle fertile had lower mortality risk (0.65; 0.38 to 1.09; 1.33 years’ longer survival), whereas subjects at the highest fertile had an even lower risk (0.27; 0.10 to 0.69; 3.91 years’ longer survival; p for trend = 0.003). Conclusion Adherence to the Mediterranean diet (MeDi) may affect not only risk for Alzheimer disease (AD) but also subsequent disease course: Higher adherence to the MeDi is associated with lower mortality in AD. The gradual reduction in mortality risk for higher MeDi adherence tertiles suggests a possible dose–response effect. PMID:17846408

  11. Differences in open versus laparoscopic gastric bypass mortality risk using the Obesity Surgery Mortality Risk Score (OS-MRS).

    Science.gov (United States)

    Brolin, Robert E; Cody, Ronald P; Marcella, Stephen W

    2015-01-01

    The Obesity Surgery Mortality Risk Score (OS-MRS) was developed to ascertain preoperative mortality risk of patients having bariatric surgery. To date there has not been a comparison between open and laparoscopic operations using the OS-MRS. To determine whether there are differences in mortality risk between open and laparoscopic Roux-en-Y Gastric Bypass (RYGB) using the OS-MRS. Three university-affiliated hospitals. The 90-day mortality of 2467 consecutive patients who had primary open (1574) or laparoscopic (893) RYGB performed by one surgeon was determined. Univariate and multivariate analysis using 5 OS-MRS risk factors including body mass index (BMI) gender, age>45, presence of hypertension and preoperative deep vein thrombosis (DVT) risk was performed in each group. Each patient was placed in 1 of 3 OS-MRS risk classes based on the number of risks: A (0-1), B (2-3), and C (4-5). Preoperative BMI and DVT risk factors were significantly greater in the open group (OG). Preoperative age was significantly greater in the laparoscopic group (LG). There were significantly more class B and C patients in LG. Ninety-day mortality rates for OG and LG patients were 1.0% and .9%, respectively. Pulmonary embolism was the most common cause of death. All deaths in LG occurred during first 4 years of that experience. Mortality rate by class was A = .1%; B = 1.5%; C = 2.3%. The difference in mortality between class B and C patients was not significant. Univariate analysis in the OG indicated that BMI, age, gender, and DVT risk were significant predictors of mortality. In the LG only BMI and DVT were significant predictors of death. Presence of hypertension was not a significant predictor in either group. Multivariate analysis excluding hypertension found that age was predictive of mortality in the OG while BMI (P = .057) and gender (P = .065) approached statistical significance. Conversely, only BMI was predictive of mortality in the LG with age approaching significance (P

  12. Global mortality from storm surges is decreasing

    Science.gov (United States)

    Bouwer, Laurens M.; Jonkman, Sebastiaan N.

    2018-01-01

    Changes in society’s vulnerability to natural hazards are important to understand, as they determine current and future risks, and the need to improve protection. Very large impacts including high numbers of fatalities occur due to single storm surge flood events. Here, we report on impacts of global coastal storm surge events since the year 1900, based on a compilation of events and data on loss of life. We find that over the past, more than eight thousand people are killed and 1.5 million people are affected annually by storm surges. The occurrence of very substantial loss of life (>10 000 persons) from single events has however decreased over time. Moreover, there is a consistent decrease in event mortality, measured by the fraction of exposed people that are killed, for all global regions, except South East Asia. Average mortality for storm surges is slightly higher than for river floods, but lower than for flash floods. We also find that for the same coastal surge water level, mortality has decreased over time. This indicates that risk reduction efforts have been successful, but need to be continued with projected climate change, increased rates of sea-level rise and urbanisation in coastal zones.

  13. Mortality of workers employed in shoe manufacturing: an update.

    Science.gov (United States)

    Lehman, Everett J; Hein, Misty J

    2006-07-01

    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].

    Science.gov (United States)

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

    1992-01-01

    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. UV "Indices"-What Do They Indicate?

    Science.gov (United States)

    Moshammer, Hanns; Simic, Stana; Haluza, Daniela

    2016-10-24

    Ultra-Violet (UV) radiation covers the spectrum of wavelengths from 100 to 400 nm. The potency and biological activity for a variety of endpoints differ by wavelength. For monitoring and communication purposes, different UV action spectra have been developed. These spectra use different weighting functions. The action spectrum for erythemal dose is the most widely used one. This erythemal dose per time or dose-rate has been further simplified into a "UV index". Following this example, in our review we use the term "index" or (plural) "indices" in a more general description for all simplified single-value measures for any biologically effective UV dose, e.g., for human non-melanoma skin cancer and for previtamin D production rate. Ongoing discussion about the existence of an increased melanoma risk due to UV-A exposure underscores the uncertainties inherent in current weighting functions. Thus, we performed an online literature search to review the data basis for these indices, to understand their relevance for an individual, and to assess the applicability of the indices for a range of exposure scenarios. Even for natural (solar) UV, the spectral composition varies spatially and temporally. Artificial UV sources and personal protection introduce further variation to the spectral composition. Many biological effects are proposed for UV radiation. Only few endpoints have been studied sufficiently to estimate a reliable index. Weighting functions for chronic effects and most importantly for cancer endpoints have been developed in animal models, and often for proxy endpoints only. Epidemiological studies on biological effects of UV radiation should not only depend on single-value weighted UV dose estimates (indexes) but should strive for a more detailed description of the individual exposure. A better understanding of the adverse and beneficial effects of UV radiation by wavelength would also improve medical counseling and health communication regarding individual

  16. Geomagnetic aa Indices

    Data.gov (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...

  17. environmental stress indicators system

    African Journals Online (AJOL)

    EJIRO

    TESs =TELd/As = (DMI+DPO+2HF-I)/As. (7). From the above-mentioned calculated Formulas (4) (5) (7), it can be observed that TESg, TESn and TESs can help construct a country's total carried environmental stress via the material flow indicators. Ecological footprint intensity indicators and ecological overshoot indicators.

  18. Spatial elements of mortality risk in old-growth forests

    Science.gov (United States)

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

    2008-01-01

    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

  19. Educational Inequality in Obesity-Related Mortality in Korea.

    Science.gov (United States)

    Kim, Mi Hyun; Jung-Choi, Kyunghee; Ko, Hyeonyoung; Song, Yun Mi

    2017-03-01

    The prevalence of obesity has been increasing worldwide, which raises concerns about the disease burden associated with obesity. Socioeconomic status (SES) has been suggested to be associated with obesity and obesity related diseases. This study aimed to evaluate the time trend in socioeconomic inequality in obesity-related mortality over the last decade in Korean population. We evaluated the influence of education level, as an indicator of SES, on obesity-related mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases. The rate ratio of the mortality of people at the lowest education level as compared with those at the highest education level (relative index of inequality [RII]) was estimated using Poisson regression analysis. Between 2001 and 2011, RII (95% confidence interval) for overall obesity-related disease mortality increased from 2.10 (2.02-2.19) to 6.50 (6.19-6.82) in men, and from 1.94 (1.79-2.10) to 3.25 (3.05-3.45) in women, respectively. Cause-specifically, the same trend in RII was found for cardiovascular mortality and mortality from diabetes mellitus, whereas the RII of mortality from obesity-related cancers in men did not show the similar trend. Subgroup analysis stratified by age revealed that the RII of obesity-related mortality was much higher in younger people than in older people. In conclusion, there has been persistent socioeconomic inequality in obesity-related mortality in Korea, which was more evident in younger people than in older people and has been deepened over the last decade especially for cardiovascular disease and diabetes.

  20. Trends in mortality following hip fracture in older women.

    Science.gov (United States)

    Lo, Joan C; Srinivasan, Sowmya; Chandra, Malini; Patton, Mary; Budayr, Amer; Liu, Lucy H; Lau, Gene; Grimsrud, Christopher D

    2015-03-01

    To examine contemporary trends in mortality following hip fracture among older postmenopausal women in an integrated healthcare delivery system. Retrospective cohort study of 13,550 women aged ≥65 years with hip fracture during 2000 to 2010. Demographic factors, comorbidity index score, fracture history, early rehospitalization, and all-cause mortality within 1 year following hip fracture were examined using health plan databases and records. Temporal trends, risk factors, and the association of race/ethnicity and mortality within 1 year post fracture were examined using multivariable logistic regression. Among 13,550 women with hip fracture, 84.6% were aged ≥75 years: 83.6% were white, 2.8% black, 5.6% Hispanic, 4.5% Asian, and 3.5% of other/unknown race. Following hip fracture, 2.4% died during the index hospitalization, while 12.3% were rehospitalized within 30 days of discharge. Infection, pneumonia, and cardiovascular conditions were the most common nonorthopedic indications for readmission. Mortality rates at 6 months (17%) and 1 year (22.8%) following hip fracture were high and increased with age. Greater comorbidity and early rehospitalization were associated with increased mortality risk, while Asian and Hispanic race/ethnicity were associated with lower mortality risk (vs white). Temporal trends demonstrated a small but significant reduction in mortality risk during 2004 to 2010. While hip fracture morbidity and mortality remain high, temporal trends suggest recent declines in mortality risk, with risk of death following hip fracture lower for Asian and Hispanic women. Future studies should examine potential benefits of targeted interventions within integrated healthcare settings and factors contributing to observed racial/ethnic differences in post fracture survival.

  1. Sleep lengthening in late adulthood signals increased risk of mortality.

    Science.gov (United States)

    Soh, Avril Z; Chee, Michael W L; Yuan, Jian-Min; Koh, Woon-Puay

    2018-03-01

    Epidemiological evidence indicates that both short and long sleep at midlife increase mortality risk, but few studies have examined how change in sleep duration between midlife and later life affects this risk. We examined the association between change in sleep duration and mortality risk. The Singapore Chinese Health Study is a prospective cohort of 63257 Chinese in Singapore aged 45-74 years at recruitment (1993-1998). Self-reported sleep duration was collected from 39523 participants who completed both baseline (mean age 54.8 years) and follow-up II (mean age 67.9 years; 2006-2010) interviews, which were on average 12.7 years apart. Mortality data were obtained via linkage with national death registry up to December 31, 2015. Compared with participants who reported sleeping the recommended duration (7 hr) at both interviews, those with persistently short sleep (≤5 hr) had increased risk of all-cause mortality (hazard ratio [HR] 1.27, 95% confidence interval [CI] 1.06-1.53). Similarly, those with persistently long sleep (≥9 hr) had increased risk of all-cause (HR 1.47, 95% CI 1.24-1.73) and cardiovascular (HR 1.40, 95% CI 1.04-1.89) mortality. The proportion of long-sleepers increased with aging (6%-23.7%). Progression to long sleep from short (HR 1.50, 95% CI 1.24-1.81) or recommended (HR 1.43, 95% CI 1.25-1.64) duration was associated with increased all-cause mortality, especially for cardiovascular mortality. Change in sleep duration was not linked to cancer mortality. Persistent short or long sleep or increasing sleep duration in late adulthood was associated with increased risk of all-cause mortality, especially from cardiovascular causes.

  2. An appraisal of the maternal mortality decline in Nepal.

    Directory of Open Access Journals (Sweden)

    Julia Hussein

    Full Text Available BACKGROUND: A decline in the national maternal mortality ratio in Nepal has been observed from surveys conducted between 1996 and 2008. This paper aims to assess the plausibility of the decline and to identify drivers of change. METHODS: National and sub-national trends in mortality data were investigated using existing demographic and health surveys and maternal mortality and morbidity surveys. Potential drivers of the variation in maternal mortality between districts were identified by regressing district-level indicators from the Nepal demographic health surveys against maternal mortality estimates. RESULTS: A statistically significant decline of the maternal mortality ratio from 539 maternal deaths to 281 per 100,000 (95% CI 91,507 live births between 1993 and 2003 was demonstrated. The sub-national changes are of similar magnitude and direction to those observed nationally, and in the terai region (plains the differences are statistically significant with a reduction of 361 per 100,000 live births (95% CI 36,686 during the same time period. The reduction in fertility, changes in education and wealth, improvements in components of the human development index, gender empowerment and anaemia each explained more than 10% of the district variation in maternal mortality. A number of limitations in each of the data sources used were identified. Of these, the most important relate to the underestimation of numbers of deaths. CONCLUSION: It is likely that there has been a decline in Nepal's maternal mortality since 1993. This is good news for the country's sustained commitments in this area. Conclusions on the magnitude, pattern of the change and drivers of the decline are constrained by lack of data. We recommend close tracking of maternal mortality and its determinants in Nepal, attention to the communication of future estimates, and various options for bridging data gaps.

  3. Beverage-specific alcohol sales and violent mortality in Russia.

    Science.gov (United States)

    Razvodovsky, Yury Evgeny

    2010-01-01

    High violent mortality rate in Russia and its profound fluctuation over recent decades have attracted considerable interest. A mounting body of evidence points to the binge drinking pattern as a potentially important contributor to the violent mortality crisis in Russia. In line with this evidence, we assume that higher level of vodka consumption in conjunction with binge drinking pattern results in close aggregate-level association between vodka sales and violent mortality rates in Russia. To test this hypothesis, trends in beverage-specific alcohol sales per capita and mortality rates from external causes in Russia between 1980 and 2005 were analyzed by means of ARIMA time-series analysis. Results of the analysis indicate that violent mortality rates tend to be more responsive to change in vodka sales per capita than to change in total level of alcohol sales. The analysis suggests that a 1-litre increase in vodka sales per capita would result in a 5% increase in violent mortality rate, an 11.3% increase in accidents and injuries mortality rate, a 9.2% increase in suicide rate, a 12.5% increase in homicide rate, and a 21.9% increase in fatal alcohol poisoning rate. The outcomes of this study provide support for the hypothesis that alcohol played a crucial role in the fluctuation in violent mortality rate in Russia in recent decades. Assuming that drinking vodka is usually associated with intoxication episodes, these findings provide additional evidence that the binge drinking pattern is an important determinant of the violent mortality crisis in Russia.

  4. The influence of neighborhood unemployment on mortality after stroke.

    Science.gov (United States)

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

    2014-07-01

    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.

  5. NRC performance indicator program

    International Nuclear Information System (INIS)

    Singh, R.N.

    1987-01-01

    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

  6. CREDIT Performance Indicator Framework

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... regulations in the countries participating in CREDIT. The Performance Indicator Framework encompassed 187 indicators grouped in 7 main groups of indicators and 42 sub-groups. Based on the CREDIT case studies it was concluded that there neither is link between certain indicators and specific building types...

  7. Geographic Variation in Morbidity and Mortality of Cerebrovascular Diseases in Korea during 2011-2015.

    Science.gov (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

    2018-03-01

    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.

  8. Gender patterns in Vietnam's child mortality

    NARCIS (Netherlands)

    Le Pham, T.; Kooreman, P.; Koning, R.H.; Wiersma, D.

    2013-01-01

    We analyze child mortality in Vietnam focusing on gender aspects. Contrary to several other countries in the region, mortality rates for boys are substantially larger than for girls. The mortality rate of boys appears to be more sensitive to parents’ education levels than the mortality rate of

  9. Gender patterns in Vietnam's child mortality

    NARCIS (Netherlands)

    Thong Le Pham, [No Value; Kooreman, Peter; Koning, Ruud H.; Wiersma, Doede

    We analyze child mortality in Vietnam focusing on gender aspects. Contrary to several other countries in the region, mortality rates for boys are substantially larger than for girls. The mortality rate of boys appears to be more sensitive to parents' education levels than the mortality rate of

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

    Directory of Open Access Journals (Sweden)

    Irianto Joko

    2010-12-01

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

  11. Morbidity and mortality following poliomyelitis

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND AND PURPOSE: In the world today 10-20 million people are still living with late effects of poliomyelitis (PM), but the long-term consequences of the disease are not well known. The aim of this study was to describe lifelong morbidity and mortality among Danes who survived PM. METHODS...... no major differences in morbidities between paralytic and non-paralytic PM cases. CONCLUSIONS: Poliomyelitis has significant long-term consequences on morbidity and mortality of both paralytic and non-paralytic cases....

  12. Selection and Adaptation Components of Infant Mortality

    DEFF Research Database (Denmark)

    Schöley, Jonas; Oeppen, James; Lindahl-Jacobsen, Rune

    We test the selection hypothesis of infant mortality against the adaptation hypothesis by decomposing the mortality age pattern over the first year of life into an adaptation- and a selection component. We show that the population level decline in mortality over the first hour of life...... is significantly influenced by mortality selection, i.e.~the frailest infants leaving the population shortly after birth. The subsequent mortality decline predominantly results from mortality changes observed in homogeneous sub-populations. This confirms the common view of the infant mortality age pattern being...

  13. The differential effects of rural health care access on race-specific mortality.

    Science.gov (United States)

    Cossman, Jeralynn; James, Wesley; Wolf, Julia Kay

    2017-12-01

    We examined the relationship between race-specific rural mortality and the health infrastructure of rural counties in light of America's recent emergence of a rural mortality penalty. Using the Compressed Mortality File from National Center for Health Statistics (2008-2012) and county-level demographic, socioeconomic, and health care indicators from the Area Health Resource File and the US Census, we created a rural public health infrastructure index which encompasses four types of health care access (public health employees, critical access hospital/rural referral centers, rural health clinics, and emergency departments) within counties. We found that each unit increase in the index is associated with a decline in rural Black mortality, but is associated with an increase in rural White mortality. Policymakers could benefit from focusing on the declining rate of mortality improvement in many rural regions, specifically by trying to better understand how decisions concerning public health spending may influence mortality differently for Black and White residents.

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

    Directory of Open Access Journals (Sweden)

    Fernando Gustavo Stelzer

    2015-08-01

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

  15. Climate Change Indicators

    Science.gov (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. Chemical calcium indicators.

    Science.gov (United States)

    Paredes, R Madelaine; Etzler, Julie C; Watts, Lora Talley; Zheng, Wei; Lechleiter, James D

    2008-11-01

    Our understanding of the underlying mechanisms of Ca2+ signaling as well as our appreciation for its ubiquitous role in cellular processes has been rapidly advanced, in large part, due to the development of fluorescent Ca2+ indicators. In this chapter, we discuss some of the most common chemical Ca2+ indicators that are widely used for the investigation of intracellular Ca2+ signaling. Advantages, limitations and relevant procedures will be presented for each dye including their spectral qualities, dissociation constants, chemical forms, loading methods and equipment for optimal imaging. Chemical indicators now available allow for intracellular Ca2+ detection over a very large range (50 microM). High affinity indicators can be used to quantify Ca2+ levels in the cytosol while lower affinity indicators can be optimized for measuring Ca2+ in subcellular compartments with higher concentrations. Indicators can be classified into either single wavelength or ratiometric dyes. Both classes require specific lasers, filters, and/or detection methods that are dependent upon their spectral properties and both classes have advantages and limitations. Single wavelength indicators are generally very bright and optimal for Ca2+ detection when more than one fluorophore is being imaged. Ratiometric indicators can be calibrated very precisely and they minimize the most common problems associated with chemical Ca2+ indicators including uneven dye loading, leakage, photobleaching, and changes in cell volume. Recent technical advances that permit in vivo Ca2+ measurements will also be discussed.

  17. Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey.

    Science.gov (United States)

    Kodan, Lachmi R; Verschueren, Kim J C; van Roosmalen, Jos; Kanhai, Humphrey H H; Bloemenkamp, Kitty W M

    2017-08-29

    The fifth Millennium Development Goal (MDG-5) aimed to improve maternal health, targeting a maternal mortality ratio (MMR) reduction of 75% between 1990 and 2015. The objective of this study was to identify all maternal deaths in Suriname, determine the extent of underreporting, estimate the reduction, audit the maternal deaths and assess underlying causes and substandard care factors. A reproductive age mortality survey was conducted in Suriname (South-American upper-middle income country) between 2010 and 2014 to identify all maternal deaths in the country. MMR was compared to vital statistics and a previous confidential enquiry from 1991 to 1993 with a MMR 226. A maternal mortality committee audited the maternal deaths and identified underlying causes and substandard care factors. In the study period 65 maternal deaths were identified in 50,051 live births, indicating a MMR of 130 per 100.000 live births and implicating a 42% reduction of maternal deaths in the past 25 years. Vital registration indicated a MMR of 96, which marks underreporting of 26%. Maternal deaths mostly occurred in the urban hospitals (84%) and the causes were classified as direct (63%), indirect (32%) or unspecified (5%). Major underlying causes were obstetric and non-obstetric sepsis (27%) and haemorrhage (20%). Substandard care factors (95%) were mostly health professional related (80%) due to delay in diagnosis (59%), delay or wrong treatment (78%) or inadequate monitoring (59%). Substandard care factors most likely led to death in 47% of the cases. Despite the reduction in maternal mortality, Suriname did not reach MDG-5 in 2015. Steps to reach the Sustainable Development Goal in 2030 (MMR ≤ 70 per 100.000 live births) and eliminate preventable deaths include improving data surveillance, installing a maternal death review committee, and implementing national guidelines for prevention and management of major complications of pregnancy, childbirth and puerperium.

  18. Urban vegetation and heat-related mortality in Seoul, Korea.

    Science.gov (United States)

    Son, Ji-Young; Lane, Kevin J; Lee, Jong-Tae; Bell, Michelle L

    2016-11-01

    Urban areas are particularly vulnerable to heat-related health outcomes. Simultaneous trends of climate change and urbanization may increase the urban heat-related health burden. We investigated the effects of urban vegetation on heat-related mortality, and evaluated whether different levels of vegetation and individuals' characteristics affect the temperature-mortality associations within Seoul, Korea 2000-2009. We used Normalized Difference Vegetation Index (NDVI) to assess the urban vegetation within Seoul. We applied an overdispersed Poisson generalized linear model with interaction term between temperature and indicator of NDVI group (categorized in 3 levels) to assess the effect modification of the temperature-mortality association by urban vegetation. We conducted stratified analysis to explore whether associations are affected by individual characteristics of sex and age. The association between total mortality and a 1°C increase in temperature above the 90th percentile (25.1°C) (the "heat effect") was the highest for gus with low NDVI. The heat effect was a 4.1% (95% confidence interval (CI) 2.3, 5.9%), 3.0% (95% CI 0.2, 5.9%), and 2.2% (95% CI -0.5, 5.0%) increase in mortality risk for low, medium, and high NDVI group, respectively. Estimated risks showed similar effects by sex and age. Our findings suggest a higher mortality effect of high temperature in areas with lower vegetation in Seoul, Korea. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Coherent forecasts of mortality with compositional data analysis

    Directory of Open Access Journals (Sweden)

    Marie-Pier Bergeron-Boucher

    2017-08-01

    Full Text Available Background: Mortality trends for subpopulations, e.g., countries in a region or provinces in a country, tend to change similarly over time. However, when forecasting subpopulations independently, the forecast mortality trends often diverge. These divergent trends emerge from an inability of different forecast models to offer population-specific forecasts that are consistent with one another. Nondivergent forecasts between similar populations are often referred to as "coherent." Methods: We propose a new forecasting method that addresses the coherence problem for subpopulations, based on Compositional Data Analysis (CoDa of the life table distribution of deaths. We adapt existing coherent and noncoherent forecasting models to CoDa and compare their results. Results: We apply our coherent method to the female mortality of 15 Western European countries and show that our proposed strategy would have improved the forecast accuracy for many of the selected countries. The results also show that the CoDa adaptation of commonly used models allows the rates of mortality improvements (RMIs to change over time. Contribution: This study opens a discussion about the use of age-specific mortality indicators other than death rates to forecast mortality. The results show that the use of life table deaths and CoDa leads to less biased forecasts than more commonly used forecasting models based on the extrapolation of death rates. To the authors' knowledge, the present study is the first attempt to forecast coherently the distribution of deaths of many populations.

  20. Investigation Of Obesity-Related Mortality Rates In Delaware.

    Science.gov (United States)

    D'Souza, Malcolm J; Wentzien, Derald E; Bautista, Riza C; Gross, Catherine C

    2017-06-01

    As Delaware's adult obesity crisis continues to be a leading public health concern, we evaluated Delaware's 1999-2014 vital records to examine the association between obesity and mortality. We used the Delaware population death records from the Centers for Disease Control and Prevention (CDC) WONDER database and the Delaware Health Statistics Center (DHSC). Together with the vital records, we incorporated Microsoft Excel, SAS (Statistical Analysis System) and GIS (geographic information system) tools to analyze obesity influences from county residence, economic status, education, gender, and race. Using the 15-year (1999-2014) time span with the CDC WONDER database, we observed a statistically significant 28.7% increase in the age-adjusted Delaware obesity-related mortality rates (where obesity was a contributory factor). Furthermore, obesity influenced death counts in all three Delaware counties (New Castle, Kent, and Sussex). Kent County experienced the largest increase (66.0%), followed by New Castle County (47.4%), and Sussex County (25.2%). The DHSC mortality rates for all leading causes of death from 2000 to 2011 indicated relatively stable mortality rates for Delaware. However, using CDC WONDER data, the Delaware mortality rate for obesity as a single underlying cause in 2011 was 56.9% higher than mortality rate in 2000.

  1. Indicators of sustainable tourism

    Directory of Open Access Journals (Sweden)

    Jovičić Dobrica

    2010-01-01

    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. .

  2. eHealth indicators

    DEFF Research Database (Denmark)

    HYPPÖNEN, Hannele; AMMENWERTH, Elske; Nøhr, Christian

    2012-01-01

    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...... in management of eHealth systems....

  3. Key performance indicators

    NARCIS (Netherlands)

    Zwetsloot, G.I.J.M.

    2014-01-01

    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

  4. Quality indicators in radiotherapy

    International Nuclear Information System (INIS)

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

    2007-01-01

    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

  5. Indications for colonoscopy

    African Journals Online (AJOL)

    the procedure and the diagnostic yield, and to evaluate the suitability of colonoscopy for each indication. The seven major indications were rectal bleeding, iron deficiency anaemia, cancer follow-up, polyp follow-up, abdominal pain, abnormal bowel habit and 'other'. Four hundred and forty-eight procedures were included ...

  6. VP Ellipsis without Indices

    DEFF Research Database (Denmark)

    Hardt, Daniel; Asher, Nicholas; Hunter, Julie

    2013-01-01

    . On the process view, an index is not a syntactic object at all, but rather, an indication of the output of a resolution process.In this paper we argue that a recent body of data provides a clear empirical basis for distinguishing between these two views of indices. We argue that cases of sloppy VP ellipsis pose...

  7. Drought, Mortality and Social Structure.

    Science.gov (United States)

    Sharma, Sanjay

    1995-01-01

    Examines the relationship between the human population explosion, resource depletion, drought, malnutrition, and disease. As a sample study, mortality trends in Rajasthan State in India in the 1980s were analyzed to correlate the increased death rate with the drought of 1987. It is demonstrated that drought-induced malnutrition was the root cause…

  8. Infant Mortality: An American Tragedy.

    Science.gov (United States)

    Hale, Christiane B.

    1990-01-01

    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)

  9. Educational differences in cardiovascular mortality

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  10. Evaluating Living Standard Indicators

    Directory of Open Access Journals (Sweden)

    Birčiaková Naďa

    2015-09-01

    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.

  11. Indicators and their functions

    DEFF Research Database (Denmark)

    Gudmundsson, Henrik; Joumard, Robert; Aschemann, Ralf

    2010-01-01

    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...... 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...... support tools are discussed. We define what "environmental sustainability in transport" may mean through the transport system, the concepts of sustainable development and of environment. The concept of 'chain of causality' between a source and a final target is developed, as a common reference...

  12. The mortality of patients with diabetes mellitus in Latvia 2000-2012.

    Science.gov (United States)

    Pildava, Santa; Strēle, Ieva; Briģis, Girts

    2014-01-01

    In Latvia, like in other European countries, the incidence of diabetes mellitus is increasing and so it is important to find out what the trends in the mortality of diabetes mellitus in Latvia are. The aim of this study was to calculate the mortality indicators of diabetes patients in Latvia from 2000 to 2012 and compare mortality among diabetes mellitus patients with mortality among the population of Latvia. The study was carried out with a quantitative statistical analysis approach. In the study, all the registered patients with diabetes mellitus from 2000 to 2012 were included. Mortality in a population with diabetes decreased statistically significantly from 57.76 per 1000py in 2000 to 45.33 per 1000py in 2012. In the general population of Latvia, there were no statistically significant changes; the mortality in 2000 was 13.56 per 1000py, in 2012 - 14.24 per 1000py. The age-standardised mortality ratio of the population with diabetes and the population of Latvia decreased from 1.71 (95% CI=1.62-1.81) in 2000 to 1.23 (95% CI=1.19-1.27) in 2012. In Latvia the mortality of patients with diabetes exceeds mortality in the general population. Mortality rates are higher for men and older patients, however, compared to mortality in the general population, diabetes increases the risk of death; especially for women and for younger patients. There is a tendency that the mortality indicators of patients with diabetes and mortality indicators in the general population are becoming closer. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  13. Low dose irradiation reduces cancer mortality rates

    International Nuclear Information System (INIS)

    Luckey, T.D.

    2000-01-01

    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

  14. Breastfeeding and the risk for diarrhea morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Victora Cesar

    2011-04-01

    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.

  15. Inhibitor development and mortality in non-severe hemophilia A.

    Science.gov (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

    2015-07-01

    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.

  16. Mortality Caused by Surgery for Degenerative Lumbar Spine.

    Science.gov (United States)

    Salmenkivi, Jyrki; Sund, Reijo; Paavola, Mika; Ruuth, Iiris; Malmivaara, Antti

    2017-07-15

    Register study. The purpose of this study was to assess the safety of lumbar spine surgery for degenerative disorders and to assess the predictive factors for mortality and causes of death. Growing numbers and relative indications of spine surgery emphasize the importance of patient safety. We assessed the incidence of mortality related to surgery, overall case fatality and factors predicting mortality in elective spinal surgery. A national database was utilized to assess patient characteristics, surgical procedures, and outcomes of degenerative spinal surgery in Finland. Patients were classified into four diagnostic categories: disc herniation, spinal stenosis, degenerative disc disease, and spondylolysis and spondylolisthesis. The mortality related to surgery and overall mortality in each diagnostic group was analyzed at 7 days, 30 days, 90 days, and 1 year after surgery. We categorized the deaths into medical errors, sequelae of surgery, surgery probably a contributing factor, and deaths not associated with surgery. Age, sex, comorbid conditions, and hospital characteristics were considered as potential risk factors for mortality. Out of 408 deaths (0.67% of total of 61,166 patients) deaths that occurred during the 1-year follow up, 49 deaths (12% of deaths, 0.08% of patients) were classified as having an association with surgery: two deaths by medical errors, 28 deaths by complications after surgery and 19 deaths related to the surgery. The surgery-related 1-year mortality was 0.08%. Age >75 years, male sex, diabetes, and hypertension showed an association with increased risk of death related to surgery. Mortality caused by elective spinal surgery is rare. Cardiovascular incidents are the most common reasons for deaths occurring soon after surgery. Consideration of expected gains and risks of surgery, prevention of unintended errors during surgery and recognition and treatment of complications once they occur are recommended. 3.

  17. Community-level prejudice and mortality among immigrant groups.

    Science.gov (United States)

    Morey, Brittany N; Gee, Gilbert C; Muennig, Peter; Hatzenbuehler, Mark L

    2018-02-01

    This study assesses whether anti-immigrant prejudice at the community level is prospectively associated with mortality. We used 10 waves of data from the General Social Survey (GSS) that were linked to mortality data via the National Death Index (NDI) for the period between 1993 and 2014 (n = 13,242). The 2014 GSS-NDI dataset is a nationally representative sample reporting social characteristics and attitudes in the United States that was prospectively linked to mortality data. Community-level prejudice was measured with 5 questions regarding anti-immigrant sentiments across 123 communities, defined using primary sampling units. Cox proportional hazards models tested the association between anti-immigrant prejudice and mortality hazard, controlling for covariates at the individual and community levels. Findings showed that among "other race" respondents, those born in the US had higher risk of mortality in communities with greater anti-immigrant prejudice, whereas foreign-born "other race" respondents had lower risk of mortality in communities with greater anti-immigrant prejudice. Sensitivity analyses indicated that the "other race" category was comprised largely of Asians and Hispanics, and that these results were similar for both groups. In contrast, anti-immigrant prejudice was not associated with mortality for foreign-born immigrants who self-report as white or black. We provide various hypotheses for why US-born immigrant groups seem to suffer higher mortality risk, while foreign-born immigrant groups do not, when they live in communities with high levels of prejudice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Mortality among California highway workers.

    Science.gov (United States)

    Maizlish, N; Beaumont, J; Singleton, J

    1988-01-01

    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.

  19. Lower Mortality in Magnet Hospitals

    Science.gov (United States)

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

    2014-01-01

    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

  20. Marital status, health and mortality.

    Science.gov (United States)

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

    2012-12-01

    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.

  1. Mortality during winter smog episodes 1982, 1985, 1987 and 1993 in the Czech Republic.

    Science.gov (United States)

    Jelínková, J; Branis, M

    2001-10-01

    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

  2. Brazilian laboratory indicators program.

    Science.gov (United States)

    Shcolnik, Wilson; de Oliveira, Carla Albuquerque; de São José, Adriana Sá; de Oliveira Galoro, César Alex; Plebani, Mario; Burnett, David

    2012-11-01

    This paper describes the evolution, structure, operation and some outcomes of the Brazilian Laboratory Indicators Program created by the Brazilian Society of Clinical Pathology/Laboratory Medicine (Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial, or SBPC/ML), in partnership with ControlLab, a Brazilian Company that provides services for proficiency testing, internal control, calibration, and training indicators for clinical laboratories. This web-based program is confidential for all participants. It contains 61 indicators categorized into three groups. Program operation and data analysis methods are described and indicators are reported in box plot format, with grouping varying in accordance with the profiles of the participating laboratories. Three indicators were selected as examples of program effectiveness in 2011: hemolysis, blood re-collection and productivity. Participants profile, examples of three indicators for the year 2011 (hemolysis, blood re-collection and productivity) and exploratory research conducted in 2012 on the implementation of the program are presented. Data related to laboratories participating in the program from 2006 to 2011 were collected and graphically represented. The Brazilian Laboratory Indicators Program brings important benefits for participants, contributing to the improvement of existing health systems in Brazil.

  3. Core damage risk indicators

    International Nuclear Information System (INIS)

    Szikszai, T.

    1994-01-01

    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

  4. Effects of economic downturns on mortality of wild African elephants.

    Science.gov (United States)

    Wittemyer, George

    2011-10-01

    Declines in economic activity and associated changes in human livelihood strategies can increase threats of species overexploitation. This is exemplified by the effects of economic crises, which often drive intensification of subsistence poaching and greater reliance on natural resources. Whereas development theory links natural resource use to social-economic conditions, few empirical studies of the effect of economic downturns on wild animal species have been conducted. I assessed the relations between African elephant (Loxodonta africana) mortality and human-caused wounds in Samburu, Kenya and (1) livestock and maize prices (measures of local economic conditions), (2) change in national and regional gross domestic product (GDP) (measures of macroeconomic conditions), and (3) the normalized difference vegetation index (NDVI) (a correlate of primary productivity). In addition, I analyzed household survey data to determine the attitudes of local people toward protected areas and wild animals in the area. When cattle prices in the pastoralist study region were low, human-caused wounds to and adult mortality of elephants increased. The NDVI was negatively correlated with juvenile mortality, but not correlated with adult mortality. Changes in Kenyan and East Asian (primary market for ivory) GDP did not explain significant variation in mortality. Increased human wounding of elephants and elephant mortality during periods of low livestock prices (local economic downturns) likely reflect an economically driven increase in ivory poaching. Local but not macroeconomic indices explained significant variation in mortality, likely due to the dominance of the subsistence economy in the study area and its political and economic isolation. My results suggest economic metrics can serve as effective indicators of changes in human use of and resulting effects on natural resources. Such information can help focus management approaches (e.g., antipoaching effort or proffering of

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

    Directory of Open Access Journals (Sweden)

    Boffetta Paolo

    2009-12-01

    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.

  6. Psychological distress and mortality in systolic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Pedersen, Susanne S.; Schiffer, Angélique A

    2010-01-01

    Depression, anxiety, and type D ("distressed") personality (tendency to experience negative emotions paired with social inhibition) have been associated with poor prognosis in coronary heart disease, but little is known about their role in chronic heart failure. Therefore, we investigated whether...... these indicators of psychological distress are associated with mortality in chronic heart failure....

  7. Breastfeeding during the first hour of life and neonatal mortality

    Directory of Open Access Journals (Sweden)

    Cristiano Siqueira Boccolini

    2013-03-01

    Conclusion: The protective effect of breastfeeding during the first hour of life on neonatal mortality in this ecological study is consistent with findings from previous observational studies, indicating the importance of adopting breastfeeding within the first hour as a routine neonatal care practice.

  8. 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) ...

  9. Reasons for Persistently High Maternal and Perinatal Mortalities in ...

    African Journals Online (AJOL)

    For the majority of the data, regression analysis and Pearson correlation coefficient were used as a proxy indicator for the association of variables with maternal, fetal and neonatal mortality. RESULTS: Although there were variations in the methods for estimation, the TFR of women in Ethiopia declined from 5.9 to 4.8 in the ...

  10. Maternal Mortality at Federal Medical Centre Yola, Adamawa State ...

    African Journals Online (AJOL)

    6] Although regional variation in maternal mortality exist in Nigeria, the North. East has one of the worst indices in Nigeria.[7] The average MMR for Nigeria is 545/100,000 live births,[7] while that of Borno state ..... Eko Le Meridien Hotel. Victoria ...

  11. Trends and factors associated with maternal mortality in Abakaliki ...

    African Journals Online (AJOL)

    Maternal health indices are poor in Nigeria. Regular audit of maternal deaths is vital to planning and maternal care delivery. The aim of the study was ... especially immediate postpartum are advocated to reduce maternal mortality to the barest minimum in Nigeria. Keywords: trend, maternal death, delay, unbooked, referral.

  12. Diabetes, pulse pressure and cardiovascular mortality : the Hoorn Study

    NARCIS (Netherlands)

    Schram, Miranda T; Kostense, Pieter J; Van Dijk, Robert A; Dekker, Jacqueline M; Nijpels, Giel; Bouter, Lex M; Heine, Robert J; Stehouwer, Coen D

    OBJECTIVE: Type 2 diabetic patients have an increased arterial stiffness and a very high risk of cardiovascular death. The present study investigated the relationship between pulse pressure, an indicator of vascular stiffness, and risk of cardiovascular mortality among type 2 diabetic and

  13. Diabetes, pulse pressure and cardiovascular mortality: the Hoorn Study

    NARCIS (Netherlands)

    Schram, M.T.; Kostense, P.J.; van Dijk, R.A.J.M.; Dekker, J.M.; Nijpels, G.; Bouter, L.M.; Heine, R.J.; Stehouwer, C.D.A.

    2002-01-01

    Objective: Type 2 diabetic patients have an increased arterial stiffness and a very high risk of cardiovascular death. The present study investigated the relationship between pulse pressure, an indicator of vascular stiffness, and risk of cardiovascular mortality among type 2 diabetic and

  14. 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 ...

  15. Safety performance indicators program

    International Nuclear Information System (INIS)

    Vidal, Patricia G.

    2004-01-01

    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)

  16. Vitamin K antagonist use and mortality in dialysis patients.

    Science.gov (United States)

    Voskamp, Pauline W M; Rookmaaker, Maarten B; Verhaar, Marianne C; Dekker, Friedo W; Ocak, Gurbey

    2018-01-01

    The risk-benefit ratio of vitamin K antagonists for different CHA2DS2-VASc scores in patients with end-stage renal disease treated with dialysis is unknown. The aim of this study was to investigate the association between vitamin K antagonist use and mortality for different CHA2DS2-VASc scores in a cohort of end-stage renal disease patients receiving dialysis treatment. We prospectively followed 1718 incident dialysis patients. Hazard ratios were calculated for all-cause and cause-specific (stroke, bleeding, cardiovascular and other) mortality associated with vitamin K antagonist use. Vitamin K antagonist use as compared with no vitamin K antagonist use was associated with a 1.2-fold [95% confidence interval (95% CI) 1.0-1.5] increased all-cause mortality risk, a 1.5-fold (95% CI 0.6-4.0) increased stroke mortality risk, a 1.3-fold (95% CI 0.4-4.2) increased bleeding mortality risk, a 1.2-fold (95% CI 0.9-1.8) increased cardiovascular mortality risk and a 1.2-fold (95% CI 0.8-1.6) increased other mortality risk after adjustment. Within patients with a CHA2DS2-VASc score ≤1, vitamin K antagonist use was associated with a 2.8-fold (95% CI 1.0-7.8) increased all-cause mortality risk as compared with no vitamin K antagonist use, while vitamin K antagonist use within patients with a CHA2DS2-VASc score ≥2 was not associated with an increased mortality risk after adjustment. Vitamin K antagonist use was not associated with a protective effect on mortality in the different CHA2DS2-VASc scores in dialysis patients. The lack of knowledge on the indication for vitamin K antagonist use could lead to confounding by indication. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  17. Spatiotemporal Variations in Lung Cancer Mortality in China between 2006 and 2012: A Multilevel Analysis.

    Science.gov (United States)

    Liu, Yunning; Astell-Burt, Thomas; Liu, Jiangmei; Yin, Peng; Feng, Xiaoqi; You, Jinling; Page, Andrew; Zhou, Maigeng; Wang, Lijun

    2016-12-16

    We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000), with higher mortality rates evident in men compared to women. Median rate ratios (MRRs) indicated important geographical variation in lung cancer mortality between provinces (MRR = 1.622) and counties/districts (MRR = 1.447). On average, lung cancer mortality increased over time and was positively associated with county-level urbanization (relative risk (RR) = 1.15). Lung cancer mortality seemed to decrease in urban and increase in rural areas. Compared to the northwest, mortality was higher in the north (RR = 1.98), east (RR = 1.87), central (RR = 1.87), and northeast (RR = 2.44). Regional differences and county-level urbanization accounted for 49.4% and 8.7% of provincial and county variation, respectively. Reductions in lung cancer mortality in urban areas may reflect improvements in access to preventive healthcare and treatment services. Rising mortality in rural areas may reflect a clustering of risk factors associated with rapid urbanization.

  18. Spatiotemporal Variations in Lung Cancer Mortality in China between 2006 and 2012: A Multilevel Analysis

    Directory of Open Access Journals (Sweden)

    Yunning Liu

    2016-12-01

    Full Text Available We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000, with higher mortality rates evident in men compared to women. Median rate ratios (MRRs indicated important geographical variation in lung cancer mortality between provinces (MRR = 1.622 and counties/districts (MRR = 1.447. On average, lung cancer mortality increased over time and was positively associated with county-level urbanization (relative risk (RR = 1.15. Lung cancer mortality seemed to decrease in urban and increase in rural areas. Compared to the northwest, mortality was higher in the north (RR = 1.98, east (RR = 1.87, central (RR = 1.87, and northeast (RR = 2.44. Regional differences and county-level urbanization accounted for 49.4% and 8.7% of provincial and county variation, respectively. Reductions in lung cancer mortality in urban areas may reflect improvements in access to preventive healthcare and treatment services. Rising mortality in rural areas may reflect a clustering of risk factors associated with rapid urbanization.

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

    Directory of Open Access Journals (Sweden)

    Andrew Fenelon

    2013-09-01

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

  20. Mortality and health issues: mortality trends and patterns in Pakistan

    OpenAIRE

    Mohammad, Irfan

    1986-01-01

    The ESCAP Scretariate with financial support from the United Nations Fund for Population Activities initiated in 1984 the Project "Analysis of trends and patterns of mortality in the ESCAP region". Six countries including Bangladesh, China, Indonesia, Pakistan, Republic of Korea and Thailand were selected for indepth study and a standard study design was adopted by each country, which could be supplemented where appropriate with additional material and the basic source of information should b...

  1. Indicators for environmental sustainability

    DEFF Research Database (Denmark)

    Dong, Yan; Hauschild, Michael Zwicky

    2017-01-01

    Decision making on sustainable consumption and production requires scientifically based information on sustainability. Different environmental sustainability targets exist for specific decision problems. To observe how well these targets are met, relevant environmental indicators are needed...

  2. NOHSS Child Indicators

    Data.gov (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...

  3. NOHSS Child Indicators

    Data.gov (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...

  4. Fishery Performance Indicators

    Data.gov (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. NOHSS Adult Indicators

    Data.gov (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...

  6. Indicators: Sediment Enzymes

    Science.gov (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.

  7. Solar Indices - Sunspot Numbers

    Data.gov (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. Science and Technical Indicators

    Czech Academy of Sciences Publication Activity Database

    Laiblová Kadlecová, Ivana; Lhoták, Martin; Mika, Pavel

    -, č. 3 (2014) E-ISSN 1805-2800 Keywords : bibliometrics Subject RIV: AF - Documentation, Lib rarianship, Information Studies http://www. lib .cas.cz/casopis-informace/science-and-technical-indicators/

  9. Environmental indicators for buildings

    DEFF Research Database (Denmark)

    Dammann, Sven

    2004-01-01

    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...

  10. 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...

  11. 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...... 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...... 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...

  12. Indicators of Training Readiness

    National Research Council Canada - National Science Library

    Orlansky, Jesse

    1997-01-01

    ... officials in the Department of Defense. Although SORTS includes some subjective and potentially unreliable information, indicators of the amounts of training conducted, such as number of flying hours and steaming days, are robust...

  13. Indicators: Benthic Macroinvertebrates

    Science.gov (United States)

    Benthic (meaning “bottom-dwelling”) macroinvertebrates are small aquatic animals and the aquatic larval stages of insects. Benthic macroinvertebrates are commonly used as indicators of the biological condition of waterbodies.

  14. Solar Indices Bulletin

    Data.gov (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,...

  15. Solar Indices - Solar Irradiance

    Data.gov (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...

  16. Solar Indices - Solar Ultraviolet

    Data.gov (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...

  17. Solar Indices - Plage Regions

    Data.gov (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. Solar Indices - Solar Corona

    Data.gov (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...

  19. Solar Indices - Solar Flares

    Data.gov (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...

  20. Financial Soundness Indicators

    OpenAIRE

    Daniela Zapodeanu; Mihail-Ioan Cociuba

    2010-01-01

    Following the financial-economic crisis the financial systems worldwide have been subjected to enormous pressure, which called into question the need for financial system stability in general and in particular the one of the banking system. We overview the most important indicators in financial stability and we analyze the evolution of the main indicators of financial health for the Romanian banking system as a whole and for two banks, respectively BRD and Transylvania Bank . We find that ban...

  1. Monetary Conditions Indicators

    OpenAIRE

    Martin Èihák; Tomáš Holub

    2000-01-01

    Monetary Conditions IndicatorsMartin CIHAK ? International Monetary Fund, Washington, D.C.Tomas HOLUB ? Czech National Bank; Faculty of Social Sciences, Charles University, PragueThe article provides an overview of foreign-language (non-Czech) literature on monetary conditions indices. The authors also discuss the issues involved in the construction of a monetary conditions index for the Czech Republic. They argue that if a monetary conditions index is to have any use for practical monetary p...

  2. Summarizing multiple deprivation indicators

    OpenAIRE

    Cappellari, Lorenzo; Jenkins, Stephen P.

    2006-01-01

    Deprivation scales derived from multiple, typically dichotomous, indicators, are widely used to monitor households’ standards of living, and to complement measures of living standards based on income. We use an item response modelling (IRM) framework to address several issues concerning the derivation of deprivation scales in general and the use of sum-score deprivation indices in particular. Although we favour the IRM approach over the sum-score one in principle, we find in an illustrative...

  3. Comparing pandemic to seasonal influenza mortality: moderate impact overall but high mortality in young children.

    NARCIS (Netherlands)

    Wijngaard, C.C. van den; Asten, L. van; Koopmans, M.P.G.; Pelt, W. van; Nagelkerke, N.J.D.; Wielders, C.C.H.; Lier, A. van; Hoek, W. van der; Meijer, A.; Donker, G.A.; Dijkstra, F.; Harmsen, C.; Sande, M.A.B. van der; Kretzschmar, M.

    2012-01-01

    Background: We assessed the severity of the 2009 influenza pandemic by comparing pandemic mortality to seasonal influenza mortality. However, reported pandemic deaths were laboratory-confirmed - and thus an underestimation - whereas seasonal influenza mortality is often more inclusively estimated.

  4. Air quality indicators

    International Nuclear Information System (INIS)

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

    1999-06-01

    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

  5. Legal abortion mortality and general anesthesia.

    Science.gov (United States)

    Atrash, H K; Cheek, T G; Hogue, C J

    1988-02-01

    Legal abortion-related mortality as reported to the Centers for Disease Control declined eightfold between 1972 and 1981. However, the causes of legal abortion mortality have changed over time. We reviewed all legal abortion-related deaths that occurred between 1972 and 1985 in the United States. We found that, although the absolute number of legal abortion-related deaths caused by general anesthesia complications did not increase, the proportion of such deaths increased significantly, from 7.7% between 1972 and 1975 to 29.4% between 1980 and 1985. Women who died of general anesthesia complications did not differ by age, presence of preexisting medical conditions, or type of facility from women who died of other causes. However, the proportion of deaths from general anesthesia complications was significantly higher among women of black and other races, women obtaining abortions during the first trimester, and women obtaining abortions in the Northeast. Our results indicate that at least 23 of the 27 deaths were due to hypoventilation and/or loss of airway resulting in hypoxia. Persons administering general anesthesia for abortion must be skilled in airway management as well as the provision of general anesthesia.

  6. Physical Inactivity and Mortality Risk

    Directory of Open Access Journals (Sweden)

    Peter Kokkinos

    2011-01-01

    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.

  7. Diurnal temperature range and short-term mortality in large US communities

    Science.gov (United States)

    Lim, Youn-Hee; Reid, Colleen E.; Mann, Jennifer K.; Jerrett, Michael; Kim, Ho

    2015-09-01

    Research has shown that diurnal temperature range (DTR) is significantly associated with mortality and morbidity in regions of Asia; however, few studies have been conducted in other regions such as North America. Thus, we examined DTR effects on mortality in the USA. We used mortality and environmental data from the National Morbidity Mortality Air Pollution Study (NMMAPS). The data are daily mortality, air pollution, and temperature statistics from 95 large US communities collected between 1987 and 2000. To assess community-specific DTR effects on mortality, we used Poisson generalized linear models allowing for over-dispersion. After assessing community-specific DTR effects on mortality, we estimated region- and age-specific effects of DTR using two-level normal independent sampling estimation. We found a significant increase of 0.27 % [95 % confidence intervals (CI), 0.24-0.30 %] in nonaccidental mortality across 95 communities in the USA associated with a 1 °C increase in DTR, controlling for apparent temperature, day of the week, and time trend. This overall effect was driven mainly by effects of DTR on cardiovascular and respiratory mortality in the elderly: Mortality in the above 65 age group increased by 0.39 % (95 % CI, 0.33-0.44 %) and 0.33 % (95 % CI, 0.22-0.44 %), respectively. We found some evidence of regional differences in the effects of DTR on nonaccidental mortality with the highest effects in Southern California [0.31 % (95 % CI, 0.21-0.42 %)] and smallest effects in the Northwest and Upper Midwest regions [0.22 % (95 % CI, 0.11-0.33 %) and 0.22 % (95 % CI, 0.07-0.37 %), respectively]. These results indicate a statistically significant association between DTR and mortality on average for 95 large US communities. The findings indicate that DTR impacts on nonaccidental and cardiovascular-related mortality in most US regions and the elderly population was most vulnerable to the effects of DTR.

  8. Mortality of non-participants in cervical screening

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Lynge, Elsebeth; Rebolj, Matejka

    2014-01-01

    a HR of 2.09 (95% CI: 2.05-2.14) compared to regular participants. The HR for human papillomavirus (HPV)-related cancers other than cervical cancer was 3.80 (95% CI: 2.67-5.41). Younger women, whose coverage rates were higher, had higher all-cause mortality HRs. Women screened more frequently than......-cause mortality than participants, and a particularly increased risk of HPV-related causes of death. These results indicate that improper control for the selective uptake of cervical screening may result in overestimating its effectiveness....

  9. Population growth and infant mortality

    OpenAIRE

    Fabella, Christina

    2008-01-01

    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...

  10. Minimum risk trigger indices

    International Nuclear Information System (INIS)

    Tingey, F.H.

    1979-01-01

    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

  11. Pharmacotherapy to reduce arrhythmic mortality

    Directory of Open Access Journals (Sweden)

    Amit Vora

    2014-01-01

    Full Text Available Fatal ventricular arrhythmias and heart failure are the common modes of death in patients with cardiovascular diseases. Intracardiac defibrillator (ICD implantation reduces arrhythmic mortality to a significant extent in the high risk patient. However, there continues to be a need for effective drug therapy to reduce the arrhythmic and overall mortality in patients with or without an ICD. Although anti-arrhythmic drugs (AAD appear inferior to ICD, the role of beta-blockers and to an extent amiodarone along with non AAD like angiotensin converting enzyme inhibitors (ACE-I, mineralocorticoid blockers (MRB and HMG-CoA reductase inhibitors (statins need to be emphasized. There have been many drug trials and meta-analysis to this effect and we review the role of drugs especially in their ability to reduce arrhythmic mortality and sudden cardiac death (SCD. The focus is on post myocardial infarction (MI and heart failure patients with a brief overview of role of drugs in channelopathies.

  12. How access to urban potable water and sewerage connections affects child mortality

    OpenAIRE

    Shi, Anqing

    2000-01-01

    Using a city-level database of global Urban Indicators, the author finds that: 1) Improved access to urban potable water and sewerage connections is consistently associated with low child mortality. 2) Government involvement in providing water services, especially locally, significantly reduces child mortality. 3) Private or parastatal participation in providing sewerage connections is ass...

  13. Predictors of in-hospital mortality among stroke patients in Uyo ...

    African Journals Online (AJOL)

    Background: Stroke is the third leading cause of death in most industrialized countries. Several reports indicate that it is also becoming a major cause of morbidity and mortality in Nigeria and other developing countries. Aim: To identify risk factors and predictors of in-hospital mortality among patients admitted for stroke in a ...

  14. The Effect of Cardiorespiratory Fitness and Obesity on Cancer Mortality in Women and Men.

    Science.gov (United States)

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

    2003-01-01

    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…

  15. Early-Life Origins of the Race Gap in Men's Mortality

    Science.gov (United States)

    Warner, David F.; Hayward, Mark D.

    2006-01-01

    Using a life course framework, we examine the early life origins of the race gap in men's all-cause mortality. Using the National Longitudinal Survey of Older Men (1966-1990), we evaluate major social pathways by which early life conditions differentiate the mortality experiences of blacks and whites. Our findings indicate that early life…

  16. The logarithmic hypervolume indicator

    DEFF Research Database (Denmark)

    Friedrich, Tobias; Bringmann, Karl; Voß, Thomas

    2011-01-01

    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......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...

  17. Terminologie des indices boursiers

    OpenAIRE

    Van der Yeught, Michel

    2013-01-01

    Les indices boursiers sont omniprésents en anglais financier. Les plus importants sont universellement familiers mais leur nature et leur fonctionnement restent largement méconnus. Des distinctions (average/index, narrow index/broad index, price-weighted/market value-weighted, all share/ composite/ subindex) permettront à l’angliciste de spécialité d’adapter à chaque indice la terminologie française ou anglaise qui lui correspond. Des remarques sur des erreurs courantes, un mini-glossaire, un...

  18. Key health indicators database.

    Science.gov (United States)

    Menic, J L

    1990-01-01

    A new database developed by the Canadian Centre for Health Information (CCHI) contains 40 key health indicators and lets users select a range of disaggregations, categories and variables. The database can be accessed through CANSIM, Statistics Canada's electronic database and retrieval system, or through a package for personal computers. This package includes the database on diskettes, as well as software for retrieving and manipulating data and for producing graphics. A data dictionary, a user's guide and tables and graphs that highlight aspects of each indicator are also included.

  19. Temperature indicating device

    International Nuclear Information System (INIS)

    Angus, J.P.; Salt, D.

    1988-01-01

    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)

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

    Science.gov (United States)

    Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad; Williams, Shanita D

    2015-01-01

    This study examined trends in geographical disparities in cardiovascular-disease (CVD) mortality in the United States between 1969 and 2011. 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. 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. 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 achievable and may help identify effective policy strategies for CVD prevention and control.

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

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD

    2015-04-01

    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

  2. Continuing study of mortality in Hanford workers

    International Nuclear Information System (INIS)

    Marks, S.; Gilbert, E.S.

    1979-10-01

    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

  3. CDC WONDER: Mortality - Multiple Cause of Death

    Data.gov (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...

  4. CDC WONDER: Mortality - Multiple Cause of Death

    Data.gov (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...

  5. Global Volcano Mortality Risks and Distribution

    Data.gov (United States)

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

  6. Global Landslide Mortality Risks and Distribution

    Data.gov (United States)

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

  7. Global Flood Mortality Risks and Distribution

    Data.gov (United States)

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

  8. Global Cyclone Mortality Risks and Distribution

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Cyclone Mortality Risks and Distribution is a 2.5 by 2.5 minute grid of global cyclone mortality risks. Gridded Population of the World (GPW) Version 3 (beta)...

  9. Global Earthquake Mortality Risks and Distribution

    Data.gov (United States)

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

  10. Global Cyclone Mortality Risks and Distribution

    Data.gov (United States)

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

  11. CDC WONDER: Mortality - Underlying Cause of Death

    Data.gov (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...

  12. Global Drought Mortality Risks and Distribution

    Data.gov (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...

  13. Maslov indices and monodromy

    International Nuclear Information System (INIS)

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

    2005-01-01

    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)

  14. Lichen indicator [Section 4

    Science.gov (United States)

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

    2009-01-01

    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...

  15. Science & Engineering Indicators--1989.

    Science.gov (United States)

    National Science Foundation, Washington, DC. National Science Board.

    This volume is the ninth in the biennial "Science Indicators" series initiated by the National Science Board. The series provides a broad base of quantitative information about the structure and function of United States science and technology and comparisons with other advanced industrial countries. An overview of science and technology…

  16. Publication point indicators

    DEFF Research Database (Denmark)

    Elleby, Anita; Ingwersen, Peter

    2010-01-01

    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...

  17. Models and Indicators.

    Science.gov (United States)

    Land, Kenneth C.

    2001-01-01

    Examines the definition, construction, and interpretation of social indicators. Shows how standard classes of formalisms used to construct models in contemporary sociology are derived from the general theory of models. Reviews recent model building and evaluation related to active life expectancy among the elderly, fertility rates, and indicators…

  18. [Indications for retrosternal esophagocoloplasty].

    Science.gov (United States)

    Králík, J; Tomsů, M; Král, V

    1989-04-01

    The authors define, based on experience with 55 retrosternal oesophagocoloplasties, the indications for this operation. They divide the indications into three groups and describe them as 1. the most suitable operation, 2. as the only possible replacement of the oesophagus, 3. as a palliative operation in an otherwise insolvable disphagia due to an inoperable tumour. They emphasize the wide range of indications for the operation which can be implemented without influencing the basic disease of the oesophagus and which makes it possible to apply combined treatment. The operation, though pretentious and time consuming, has the advantage of an extrathoracic approach. As to technical aspects, the authors emphasize the importance to select a portion of the gut with an adequate blood supply. This demand is usually met by the transverse colon on a vascular pedicle of the vasa colica sin.; they also mention the conditions of safe deposition of the gut in the retrosternal tunnel. The paper is supplemented by several case-histories of particularly interesting and difficult situations. If the indication range of the operation and its technical principles are respected and the surgeon is experienced, the failures of the operation are proportional to the severity of the basic disease.

  19. Grassroots indicators for desertification

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

    Reports based on remote sensing data and agricultural forecasts had claimed that there was no famine in the North. But the people at the grassroots, using their own indicators and knowledge of the environment and food resources in their region, had denied this report. Indeed, remote sensing data had failed to take note of ...

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

    DEFF Research Database (Denmark)

    Jeune, B

    1980-01-01

    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....

  1. The role of marriage in the causal pathway from economic conditions early in life to mortality.

    Science.gov (United States)

    van den Berg, Gerard J; Gupta, Sumedha

    2015-03-01

    This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of early-life conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity. Results show that conditions around birth and school going ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage, whereas women suffer during childbearing ages. However, having been born under favorable economic conditions reduces female mortality during childbearing ages. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Anxiety Predicts Mortality in ICD Patients

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  3. Epidemiologic panorama of stomach cancer mortality in Mexico.

    Science.gov (United States)

    Tovar-Guzmán, V; Hernández-Girón, C; Barquera, S; Rodríguez-Salgado, N; López-Carrillo, L

    2001-01-01

    during the 1980-1997 period in Mexico. However, when analyzing the different indicators that reveal risks, magnitude, and prematurity of mortality, there is a differential trend in mortality by sex that includes regional patterns probably related to different socioeconomic levels.

  4. Microbleeds, Mortality, and Stroke in Alzheimer Disease: The MISTRAL Study.

    Science.gov (United States)

    Benedictus, Marije R; Prins, Niels D; Goos, Jeroen D C; Scheltens, Philip; Barkhof, Frederik; van der Flier, Wiesje M

    2015-05-01

    . In patients with AD, the presence of nonlobar microbleeds was associated with an increased risk for cardiovascular events and cardiovascular mortality. Patients with lobar microbleeds had an increased risk for stroke and stroke-related mortality, indicating that these patients should be treated with the utmost care.

  5. Temperature Variability and Mortality: A Multi-Country Study.

    Science.gov (United States)

    Guo, Yuming; Gasparrini, Antonio; Armstrong, Ben G; Tawatsupa, Benjawan; Tobias, Aurelio; Lavigne, Eric; Coelho, Micheline de Sousa Zanotti Stagliorio; Pan, Xiaochuan; Kim, Ho; Hashizume, Masahiro; Honda, Yasushi; Guo, Yue Leon; Wu, Chang-Fu; Zanobetti, Antonella; Schwartz, Joel D; Bell, Michelle L; Overcenco, Ala; Punnasiri, Kornwipa; Li, Shanshan; Tian, Linwei; Saldiva, Paulo; Williams, Gail; Tong, Shilu

    2016-10-01

    The evidence and method are limited for the associations between mortality and temperature variability (TV) within or between days. We developed a novel method to calculate TV and investigated TV-mortality associations using a large multicountry data set. We collected daily data for temperature and mortality from 372 locations in 12 countries/regions (Australia, Brazil, Canada, China, Japan, Moldova, South Korea, Spain, Taiwan, Thailand, the United Kingdom, and the United States). We calculated TV from the standard deviation of the minimum and maximum temperatures during the exposure days. Two-stage analyses were used to assess the relationship between TV and mortality. In the first stage, a Poisson regression model allowing over-dispersion was used to estimate the community-specific TV-mortality relationship, after controlling for potential confounders. In the second stage, a meta-analysis was used to pool the effect estimates within each country. There was a significant association between TV and mortality in all countries, even after controlling for the effects of daily mean temperature. In stratified analyses, TV was still significantly associated with mortality in cold, hot, and moderate seasons. Mortality risks related to TV were higher in hot areas than in cold areas when using short TV exposures (0-1 days), whereas TV-related mortality risks were higher in moderate areas than in cold and hot areas when using longer TV exposures (0-7 days). The results indicate that more attention should be paid to unstable weather conditions in order to protect health. These findings may have implications for developing public health policies to manage health risks of climate change. Guo Y, Gasparrini A, Armstrong BG, Tawatsupa B, Tobias A, Lavigne E, Coelho MS, Pan X, Kim H, Hashizume M, Honda Y, Guo YL, Wu CF, Zanobetti A, Schwartz JD, Bell ML, Overcenco A, Punnasiri K, Li S, Tian L, Saldiva P, Williams G, Tong S. 2016. Temperature variability and mortality: a multi

  6. Long-term mortality after poliomyelitis

    DEFF Research Database (Denmark)

    Nielsen, Nete Munk; Rostgaard, Klaus; Juel, Knud

    2003-01-01

    .18-3.37). Apart from polio patients with respiratory failure, long-term mortality did not appear to increase until 20 years after discharge. Contracting severe paralytic poliomyelitis at a young age seemed to increase long-term mortality. The most common causes of death were polio sequelae (standardized mortality...... patients. CONCLUSIONS: Survivors of poliomyelitis, especially severely paralyzed polio patients, have an increased long-term mortality....

  7. Gender Patterns in Vietnam's Child Mortality

    OpenAIRE

    Pham, Thong Le; Kooreman, Peter; Koning, Ruud H.; Wiersma, Doede

    2011-01-01

    We analyze child mortality in Vietnam focusing on gender aspects. Contrary to several other countries in the region, mortality rates for boys are substantially larger than for girls. A large rural-urban mortality difference exists, but much more so for boys than for girls. A higher education level of the mother reduces mortality risk, but the effect is stronger for girls than for boys.

  8. The remarkable geographical pattern of gastric cancer mortality in Ecuador.

    Science.gov (United States)

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

    2017-12-01

    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.

  9. Cancer mortality predictions for 2017 in Latin America.

    Science.gov (United States)

    Carioli, G; La Vecchia, C; Bertuccio, P; Rodriguez, T; Levi, F; Boffetta, P; Negri, E; Malvezzi, M

    2017-09-01

    From most recent available data, we predicted cancer mortality statistics in selected Latin American countries for the year 2017, with focus on lung cancer. We obtained death certification data from the World Health Organization and population data from the Pan American Health Organization database for all neoplasms and selected cancer sites. We derived figures for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela. Using a logarithmic Poisson count data joinpoint model, we estimated number of deaths and age-standardized (world population) mortality rates in 2017. Total cancer mortality rates are predicted to decline in all countries. The highest mortality rates for 2017 are in Cuba, i.e. 132.3/100 000 men and 93.3/100 000 women. Mexico had the lowest predicted rates, 64.7/100 000 men and 60.6/100 000 women. In contrast, the total number of cancer deaths is expected to rise due to population ageing and growth. Men showed declines in lung cancer trends in all countries and age groups considered, while only Colombian and Mexican women had downward trends. Stomach and (cervix) uteri rates are predicted to continue their declines, though mortality from these neoplasms remains comparatively high. Colorectal, breast and prostate cancer rates were predicted to decline moderately, as well as leukaemias. There was no clear pattern for pancreatic cancer. Between 1990 and 2017 about 420 000 cancer deaths were avoided in 5 of the 7 countries, no progress was observed in Brazil and Cuba. Cancer mortality rates for 2017 in seven selected Latin American countries are predicted to decline, though there was appreciable variability across countries. Mortality from major cancers-including lung and prostate-and all cancers remains comparatively high in Cuba, indicating the need for improved prevention and management.

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

    Directory of Open Access Journals (Sweden)

    Jovanović Dijana B.

    2008-01-01

    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. Continuing increase in mesothelioma mortality in Britain.

    Science.gov (United States)

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

    1995-03-04

    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.

  12. High mortality in the Thule cohort

    DEFF Research Database (Denmark)

    Juel, K

    1994-01-01

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

  13. Determinants of perinatal mortality in Marondera district ...

    African Journals Online (AJOL)

    Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, 2009: a case control study. ... Health worker training in emergency management of obstetric and neonatal care was initiated. Marondera District started holding perinatal mortality meetings. Key words: Perinatal mortality, ...

  14. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

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

    1993-01-01

    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...

  15. Plaice egg mortality: can we determine survivorschip?

    NARCIS (Netherlands)

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

    2003-01-01

    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

  16. Impacts of Austrian Climate Variability on Honey Bee Mortality

    Science.gov (United States)

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

    2015-04-01

    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'.

  17. Antipsychotic prescription and mortality in hospitalized older persons.

    Science.gov (United States)

    Chiesa, Deborah; Marengoni, Alessandra; Nobili, Alessandro; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Djade, Codjo D; Corrao, Salvatore; Salerno, Francesco; Marcucci, Maura; Romanelli, Giuseppe; Mannucci, Pier Mannuccio

    2017-11-01

    Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score ≥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score antipsychotic drugs (14.3% vs 9.4%; P = 0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. We found that the prescription of antipsychotic drugs during hospitalization was not associated with in-hospital or follow-up mortality. Short

  18. Asthma mortality in Danish children and young adults, 1973-1994

    DEFF Research Database (Denmark)

    Jørgensen, I M; Bülow, S; Jensen, V B

    2000-01-01

    Several reports indicate that asthma mortality has increased during the last few decades. International comparisons reveal some striking differences in the pattern of asthma mortality. The authors investigated the asthma mortality rate in the Danish child and youth population 1973-1994 and studied...... the validity of death certificates. The authors reviewed all death certificates coded as asthma death in the International Classification of Diseases (ICD 8-ICD 10 (1994)) and adjacent respiratory code numbers for the age group 1-19 yrs. Hospital records and autopsy reports were assessed to validate the cause...... of death. Age-standardized and age-specific mortality rates were calculated. From 1973 to 1987 there was a significant upward trend in the mortality. On subdivision, this trend was limited to the age group 15-19 yrs. Generally the mortality rate decreased from 1988 to 1994. Four per cent coded as asthma...

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    OBJECTIVES: To map and analyse geographical (spatial) variations of child mortality trends in mainland Tanzania. METHODS: We used a geographic information system to integrate data on child mortality and associated risk factors. We then applied spatial statistics to quantify the spatial component...... of child mortality trends, and employed multivariate analysis to break mortality down into a spatial and a local component. RESULTS: The results support our hypothesis that child mortality trends have a spatial component that can be attributed to broad-scale environmental and social-economic factors....... CONCLUSIONS: The method we used is a cost-effective way to systematically assess geographical variations in health outcomes. It can thus provide researchers and practitioners with a good first-line tool in understanding local contributions to differences in mortality and other indicators, and give authorities...

  20. Trends in corpus uteri cancer mortality in member states of the European Union.

    Science.gov (United States)

    Weiderpass, Elisabete; Antoine, Jerome; Bray, Freddie I; Oh, Jin-Kyoung; Arbyn, Marc

    2014-06-01

    The burden of corpus uteri cancer varies in the European Union (EU). We analysed trends in corpus uteri cancer mortality in 26 EU member states from 1970 onward. Population numbers and number of uterine cancer deaths were extracted from the World Health Organisation mortality database. Corpus uteri cancer mortality rates were corrected for certification problems using different reallocation rules for deaths registered as uterine cancer not otherwise specified, or using mixed disease codes. Join point regression was used to study the annual percentage change of age-standardised corpus uteri cancer mortality rates. Changes in corpus uteri cancer mortality rates by calendar period and standardised cohort mortality ratios were also estimated. In 2008, 12,903 women died from corpus uteri cancer in the EU. Corrected age-standardised corpus uteri cancer mortality rates have decreased significantly over the past decades in most member states, with exception of Malta and Bulgaria, where rates increased; Greece, where rates remained low but stable; and Sweden, where rates have been stable since 1970. Original member states showed a steeper decrease than newer member states. The standardised cohort mortality ratios indicated that corpus uteri cancer mortality does not decrease further, nor does it increase, among women born after 1940, although these birth cohorts may still be too young for corpus uteri cancer incidence to be fully evaluated. Our corrected corpus uteri cancer mortality rates showed a decrease in most EU member states among women born before 1940. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Income inequality and cause-specific mortality during economic development.

    Science.gov (United States)

    Lau, Elaine W; Schooling, C Mary; Tin, Keith Y; Leung, Gabriel M

    2012-04-01

    Life expectancy is strongly related to national income, whether there is an additional contribution of income inequality is unclear. We used negative binomial regression to examine the association of neighborhood-level Gini, adjusted for age, sex, and income, with mortality rates in Hong Kong from 1976 to 2006. The association of neighborhood Gini with all-cause mortality varied over time (p-value for interaction income. Similarly adjusted, Gini was not associated with all-cause mortality in 1976 to 1986 (IRR 0.96, 95% CI 0.93-1.00) but was in 1991 to 2006 (IRR 1.25, 95% CI 1.20-1.29), when Gini was also positively associated with death from cardiovascular diseases, respiratory diseases and some cancers. Independent of income, income inequality was positively associated with nonmedical mortality rates at a low level of spatial aggregation, indicating the consistent harms of social disharmony. However, the impact on medical mortality was less consistent, suggesting the relevance of contextual factors. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Mortality among workers at the Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  3. Governance matters: an ecological association between governance and child mortality.

    Science.gov (United States)

    Lin, Ro-Ting; Chien, Lung-Chang; Chen, Ya-Mei; Chan, Chang-Chuan

    2014-09-01

    Governance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control. We obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and national under-5 mortality rates for 149 countries between 1996 and 2010. We applied a semi-parametric generalized additive mixed model to examine associations after controlling for the effects of development factors (urbanization level and economy), disease control factors (hygienic conditions and vaccination rates), health expenditures, air quality, and time. Governance, development, and disease control showed clear inverse relations with the under-5 mortality rate (p<0.001). Per unit increases in governance, development, and disease control factors, the child mortality rate had a 0.901-, 0.823-, and 0.922-fold decrease, respectively, at fixed levels of the other two factors. In the effort to reduce the global under-5 mortality rate, addressing a country's need for better governance is as important as improvements in development and disease control. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  4. Socioeconomic inequality and its determinants regarding infant mortality in iran.

    Science.gov (United States)

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

    2014-06-01

    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.

  5. Bone Marrow Pathology Predicts Mortality in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Cheng-Hao Weng

    2015-01-01

    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.

  6. Lichens as bio indicators

    International Nuclear Information System (INIS)

    2003-01-01

    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

  7. LEADING WITH LEADING INDICATORS

    International Nuclear Information System (INIS)

    PREVETTE, S.S.

    2005-01-01

    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

  8. 15. Basic economic indicators

    International Nuclear Information System (INIS)

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

    1992-01-01

    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

  9. Wide range of socioeconomic factors associated with mortality among cities in Japan.

    Science.gov (United States)

    Fukuda, Yoshiharu; Nakamura, Keiko; Takano, Takehito

    2004-06-01

    The aim of this study was to identify socioeconomic factors associated with mortality among cities in Japan. Sex-specific and age-adjusted mortality rates for 1990 and 1995 were calculated by 779 local administrative units across the nation. One hundred indicators related to socioeconomic factors were compiled and divided into eight categories: economy, education, living conditions, vegetation and open space, transport, preventive activities, medical care and demography. Composite socioeconomic indices were formulated using factor analysis of the socioeconomic indicators by category, and the association between the indices and mortality rates was examined by correlation analysis and multiple regression analysis. Nineteen composite socioeconomic indices were obtained from factor analysis, and all indices except educational expenditure-related index were significantly correlated with mortality rates. Unemployment, old housing, primary health resources and density were independently positively associated, and higher education, public library activity, health check-up participation and population growth were independently negatively associated with both 1990 and 1995 male mortality rates. For female mortality, higher income, unemployment, spacious dwelling, old housing, less vegetation, road facility, numbers of cars per population, primary health resources and density were independently positively associated, and higher education, public library activity and health check-up participation were independently negatively associated. The relationship between mortality and socioeconomic conditions was stronger in males than in females, and higher income and less vegetation were associated with higher mortality only for females. The present study demonstrated a close link between mortality and a wide range of socioeconomic conditions by using a number of indicators compiled from various data sources. The results promote a deeper understanding of socioeconomic health

  10. Asthma mortality in Uruguay, 1984-1998.

    Science.gov (United States)

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

    2001-08-01

    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.

  11. Russian mortality beyond vital statistics

    Directory of Open Access Journals (Sweden)

    2004-04-01

    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

  12. Excess Mortality Associated with Influenza Epidemics in Portugal, 1980 to 2004

    Science.gov (United States)

    Nunes, Baltazar; Viboud, Cecile; Machado, Ausenda; Ringholz, Corinne; Rebelo-de-Andrade, Helena; Nogueira, Paulo; Miller, Mark

    2011-01-01

    Background Influenza epidemics have a substantial impact on human health, by increasing the mortality from pneumonia and influenza, respiratory and circulatory diseases, and all causes. This paper provides estimates of excess mortality rates associated with influenza virus circulation for 7 causes of death and 8 age groups in Portugal during the period of 1980–2004. Methodology/Principal Findings We compiled monthly mortality time series data by age for all-cause mortality, cerebrovascular diseases, ischemic heart diseases, diseases of the respiratory system, chronic respiratory diseases, pneumonia and influenza. We also used a control outcome, deaths from injuries. Age- and cause-specific baseline mortality was modelled by the ARIMA approach; excess deaths attributable to influenza were calculated by subtracting expected deaths from observed deaths during influenza epidemic periods. Influenza was associated with a seasonal average of 24.7 all-cause excess deaths per 100,000 inhabitants, approximately 90% of which were among seniors over 65 yrs. Excess mortality was 3–6 fold higher during seasons dominated by the A(H3N2) subtype than seasons dominated by A(H1N1)/B. High excess mortality impact was also seen in children under the age of four years. Seasonal excess mortality rates from all the studied causes of death were highly correlated with each other (Pearson correlation range, 0.65 to 0.95, P0.64, P<0.05). By contrast, there was no correlation with excess mortality from injuries. Conclusions/Significance Our excess mortality approach is specific to influenza virus activity and produces influenza-related mortality rates for Portugal that are similar to those published for other countries. Our results indicate that all-cause excess mortality is a robust indicator of influenza burden in Portugal, and could be used to monitor the impact of influenza epidemics in this country. Additional studies are warranted to confirm these findings in other settings. PMID

  13. Human mortality improvement in evolutionary context

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...

  14. Evaluation of morbidity from mortality.

    Science.gov (United States)

    Damiani, P; Massé, H; Aubenque, M

    1983-01-01

    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.

  15. Health indicators 1991.

    Science.gov (United States)

    Dawson, N

    1991-01-01

    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.

  16. Main economics indicators

    International Nuclear Information System (INIS)

    1995-11-01

    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)

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

    LENUS (Irish Health Repository)

    Stack, A G

    2014-08-01

    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.

  18. AFSC/RACE/GAP/Conrath: Delayed discard mortality of the North Pacific giant octopus

    Data.gov (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...

  19. Income Inequality and Child Mortality in Wealthy Nations.

    Science.gov (United States)

    Collison, David

    2016-01-01

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

  20. Tamper indicating packaging

    International Nuclear Information System (INIS)

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

    1994-01-01

    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

  1. Decline in maternal mortality in Matlab, Bangladesh: a cautionary tale.

    Science.gov (United States)

    Ronsmans, C; Vanneste, A M; Chakraborty, J; van Ginneken, J

    obstetric mortality in the areas covered by the programme, a decline also occurred in one of the areas not receiving any such interventions. Caution is required in the interpretation of short-term trends in one indicator in studies designed without random allocation of interventions into treatment and control groups.

  2. Patient Mortality During Unannounced Accreditation Surveys at US Hospitals

    Science.gov (United States)

    Barnett, Michael L.; Olenski, Andrew R.; Jena, Anupam B.

    2017-01-01

    IMPORTANCE In the United States, hospitals receive accreditation through unannounced on-site inspections (ie, surveys) by The Joint Commission (TJC), which are high-pressure periods to demonstrate compliance with best practices. No research has addressed whether the potential changes in behavior and heightened vigilance during a TJC survey are associated with changes in patient outcomes. OBJECTIVE To assess whether heightened vigilance during survey weeks is associated with improved patient outcomes compared with nonsurvey weeks, particularly in major teaching hospitals. DESIGN, SETTING, AND PARTICIPANTS Quasi-randomized analysis of Medicare admissions at 1984 surveyed hospitals from calendar year 2008 through 2012 in the period from 3 weeks before to 3 weeks after surveys. Outcomes between surveys and surrounding weeks were compared, adjusting for beneficiaries’ sociodemographic and clinical characteristics, with subanalyses for major teaching hospitals. Data analysis was conducted from January 1 to September 1, 2016. EXPOSURES Hospitalization during a TJC survey week vs nonsurvey weeks. MAIN OUTCOMES AND MEASURES The primary outcome was 30-day mortality. Secondary outcomes were rates of Clostridium difficile infections, in-hospital cardiac arrest mortality, and Patient Safety Indicators (PSI) 90 and PSI 4 measure events. RESULTS The study sample included 244 787 and 1 462 339 admissions during survey and nonsurvey weeks with similar patient characteristics, reason for admission, and in-hospital procedures across both groups. There were 811 598 (55.5%) women in the nonsurvey weeks (mean [SD] age, 72.84 [14.5] years) and 135 857 (55.5%) in the survey weeks (age, 72.76 [14.5] years). Overall, there was a significant reversible decrease in 30-day mortality for admissions during survey (7.03%) vs nonsurvey weeks (7.21%) (adjusted difference, −0.12%; 95% CI, −0.22% to −0.01%). This observed decrease was larger than 99.5% of mortality changes among 1000 random

  3. Patient Mortality During Unannounced Accreditation Surveys at US Hospitals.

    Science.gov (United States)

    Barnett, Michael L; Olenski, Andrew R; Jena, Anupam B

    2017-05-01

    In the United States, hospitals receive accreditation through unannounced on-site inspections (ie, surveys) by The Joint Commission (TJC), which are high-pressure periods to demonstrate compliance with best practices. No research has addressed whether the potential changes in behavior and heightened vigilance during a TJC survey are associated with changes in patient outcomes. To assess whether heightened vigilance during survey weeks is associated with improved patient outcomes compared with nonsurvey weeks, particularly in major teaching hospitals. Quasi-randomized analysis of Medicare admissions at 1984 surveyed hospitals from calendar year 2008 through 2012 in the period from 3 weeks before to 3 weeks after surveys. Outcomes between surveys and surrounding weeks were compared, adjusting for beneficiaries' sociodemographic and clinical characteristics, with subanalyses for major teaching hospitals. Data analysis was conducted from January 1 to September 1, 2016. Hospitalization during a TJC survey week vs nonsurvey weeks. The primary outcome was 30-day mortality. Secondary outcomes were rates of Clostridium difficile infections, in-hospital cardiac arrest mortality, and Patient Safety Indicators (PSI) 90 and PSI 4 measure events. The study sample included 244 787 and 1 462 339 admissions during survey and nonsurvey weeks with similar patient characteristics, reason for admission, and in-hospital procedures across both groups. There were 811 598 (55.5%) women in the nonsurvey weeks (mean [SD] age, 72.84 [14.5] years) and 135 857 (55.5%) in the survey weeks (age, 72.76 [14.5] years). Overall, there was a significant reversible decrease in 30-day mortality for admissions during survey (7.03%) vs nonsurvey weeks (7.21%) (adjusted difference, -0.12%; 95% CI, -0.22% to -0.01%). This observed decrease was larger than 99.5% of mortality changes among 1000 random permutations of hospital survey date combinations, suggesting that observed mortality changes were

  4. Risk Factors for Mortality in Lower Intestinal Bleeding

    Science.gov (United States)

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

    2009-01-01

    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

    2013-01-01

    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. Teriparatide - Indications beyond osteoporosis

    Directory of Open Access Journals (Sweden)

    Marilyn Lee Cheng

    2012-01-01

    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.

  7. 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...... that among the relevant actors in the building sector the scientific view is only one perspective among others. This study combines natural-scientific knowledge with social-scientific knowledge, obtained in a close co-operation with actors in the building sector in Denmark and a research period...

  8. International energy indicators

    International Nuclear Information System (INIS)

    Rossi, E. Jr.

    1981-12-01

    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

  9. CARDIOVASCULAR MORTALITY IN PHOENIX: PM1 IS A BETTER INDICATOR THAN PM2.5.

    Science.gov (United States)

    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...

  10. Suicide mortality trends in Galicia, Spain and their relationship with economic indicators.

    Science.gov (United States)

    Fernández-Navarro, P; Barrigón, M L; Lopez-Castroman, J; Sanchez-Alonso, M; Páramo, M; Serrano, M; Arrojo, M; Baca-García, E

    2016-10-01

    Recent research has shown an association between unemployment and suicide, but the mediating factors in this relationship are still unknown. In this study, we investigated the effect of unemployment and economic recession on suicide rates in the Spanish region of Galicia between 1975 and 2012 Method. We analysed age-standardised suicide rates in men and women and in four age groups: less than 25 years, 25-45 years, 45-65 years and more than 65 years and performed a joinpoint analysis to determine trend changes throughout 1975-2012 period. Also we analysed the association between suicide, recession and unemployment by means of a temporal trend model with a Generalised Additive Model. Suicide rates increased from 145 suicides in 1975 to a high in 1993, with 377 deaths by suicide, representing 1.38% of all causes of death, and thereafter they tend to decrease to 335 suicides in 2012. Joinpoint analyses revealed that suicide rates changed differently across sex and age groups. For men, the annual percentage of change (APC) between 1975 and 1988 (CI 95% 1986-1994) was 5.45 (CI 95% = 3.5, -7.2) but from 1988 the APC became negative [-0.66 (CI 95% = -1.3, -0.1)]. For women, APC between 1974 and 1990 (CI 95% 1986-1992) was 4.86 (CI 95% = 3.2, -6.4) and -1.46 subsequently (CI 95% = -2.2, -0.5). Women aged 24 years or less showed stable suicide rates while men from 45-65 years showed two incidence peaks. When we studied the independent correlation between unemployment, recession and suicide, we found a significant association between unemployment and suicide, but not between recession and suicide for both sexes together and for men while for women there was no significant correlation between suicide and unemployment or recession. Finally, when we studied the effect of the interaction between unemployment and recession on suicide we found economic recession and unemployment interacted with regards to suicide rates (F = 5.902; df = 4.167; p = 0.00098) and after adjusting by sex, the effect was confirmed among men (F = 4.827; df = 2.823; p = 0.0087), but not among women (F = 0.001; df = 1.000; p = 0.979). Although suicide rates in Galicia are gradually decreasing in the last decades, there are important sex and age differences. Unemployment was related with suicide during economic recession periods according to our results.

  11. [Analysis of mortality in the Zilina district].

    Science.gov (United States)

    Pavelek, J; Hudáková, G

    1975-01-01

    From death certificates assemble in the Zilina district in three years (1968-1970) the authors prepared and coded questionnaires with 29 criteria. In the present article they submit some results obtained by automatic computing and biometric evaluation of these data. In the introduction they draw attention to and explain the rising trend of mortality in the Zilina district as well as in the Slovak Socialist Republic. Significant differences were revealed in the marital status of men and women with a predominance of married man and widows. The investigated variations of the number of deceased per day or week is not statistically significant; they were significant only in the course of the year with the maximum of deaths in March and the minimum in August. The specific mortality by decades revealed that men have from birth throughout life a higher death rate than women. As regards causes of death according to the 17 classes of the International Classification four classes dominate similarly an in the entire Slovak Socialist Republic, i. e. cardiovascular diseases 40.8%, tumours 17.8%, respiratory diseases 17.2% and accidents 7.5% all diagnoses. The order of diseases is the same for men and women only in the five most numerous classes and even there is a significant difference in the mortality level in three. Trichotomic classification of communities throws some light on the problem of causes of death of the rural and urban population. The last doctor attending the patient before death was in 48,3% the health community doctor, in 39,1% the hospital, in 8,9% (accidents and acute attacks) nobody whereby the percentage structure of men and women differs significantly also in this indicator. Finally the authors draw attention to the fact that the number of post mortem examinations (31,8%) is highest, as compared with the Central Slovak region (19,9%), the Slovak Socialist Republic (21,1%), the Czech Socialist Republic (29,8%) and the CSSR (27,6%).

  12. Reduction of infant mortality in India.

    Science.gov (United States)

    Kumar, V; Datta, N

    1982-01-01

    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

  13. Morbidity and mortality associated with obstetric hysterectomy

    International Nuclear Information System (INIS)

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

    2010-01-01

    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)

  14. Assessment of Uterine and Umbilical Arteries Doppler Indices in ...

    African Journals Online (AJOL)

    Pregnancy induced hypertension (PIH) is a major cause of maternal and perinatal morbidity and mortality in developing countries including Nigeria. Doppler velocimetric indices of the uterine and umbilical arteries may predict the impact of PIH on perfusion of the uteroplacental and fetoplacental circulations respectively.

  15. Indicators of sustainable fishing for South African sardine Sardinops ...

    African Journals Online (AJOL)

    Six indicators were investigated for South African sardine Sardinops sagax and anchovy Engraulis encrasicolus: mean length of catch, length-at-50% maturity, total mortality, exploitation rate, ratio of bycatch, and centre of gravity of commercial catches. Sardine length-at-50% maturity is the most promising as a descriptive ...

  16. 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 ...

  17. Doe productivity indices and sire effects of a heterogeneous rabbit ...

    African Journals Online (AJOL)

    Rabbits for this study were obtained from heterogeneous populations reared in south-western Nigeria, and a total of fifty-six adult rabbits (6 months old) ... It was concluded that, the major factors affecting doe productivity indices in this population were low litter size at birth, long kindling interval and pre-weaning mortality.

  18. Infant Mortality and American Indians/Alaska Natives

    Science.gov (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 ...

  19. Infant Mortality and Native Hawaiians/Pacific Islanders

    Science.gov (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 ...

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

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2017-01-01

    Background Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exem...... levels, could provide insight into the means to accelerate progress in nations where progress has stalled. Funding Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health....

  1. Ethnic inequalities in mortality: the case of Arab-Americans.

    Science.gov (United States)

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

    2011-01-01

    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. 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. 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. © 2011 El-Sayed et al.

  2. Ethnic Inequalities in Mortality: The Case of Arab-Americans

    Science.gov (United States)

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

    2011-01-01

    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

  3. Ethnic inequalities in mortality: the case of Arab-Americans.

    Directory of Open Access Journals (Sweden)

    Abdulrahman M El-Sayed

    Full Text Available 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.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.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.

  4. Global justice, poverty and maternal mortality

    Directory of Open Access Journals (Sweden)

    Flor de María Cáceres M

    2010-11-01

    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

  5. Ergodicity of financial indices

    Science.gov (United States)

    Kolesnikov, A. V.; Rühl, T.

    2010-05-01

    We introduce the concept of the ensemble averaging for financial markets. We address the question of equality of ensemble and time averaging in their sequence and investigate if these averagings are equivalent for large amount of equity indices and branches. We start with the model of Gaussian-distributed returns, equal-weighted stocks in each index and absence of correlations within a single day and show that even this oversimplified model captures already the run of the corresponding index reasonably well due to its self-averaging properties. We introduce the concept of the instant cross-sectional volatility and discuss its relation to the ordinary time-resolved counterpart. The role of the cross-sectional volatility for the description of the corresponding index as well as the role of correlations between the single stocks and the role of non-Gaussianity of stock distributions is briefly discussed. Our model reveals quickly and efficiently some anomalies or bubbles in a particular financial market and gives an estimate of how large these effects can be and how quickly they disappear.

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

    Science.gov (United States)

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

    2015-01-01

    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 (http://www.who.int/healthinfo/mortality_data/en/) 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. Income Inequality in Non-communicable Diseases Mortality among the Regions of the Slovak Republic.

    Science.gov (United States)

    Gavurová, Beáta; Kováč, Viliam; Šoltés, Michal; Kot, Sebastian; Majerník, Jaroslav

    2017-12-01

    A great amount of non-communicable disease deaths poses a threat for all people and therefore represents the challenge for health policy makers, health providers and other health or social policy actors. The aim of this study is to analyse regional differences in non-communicable disease mortality in the Slovak Republic, and to quantify the relationship between mortality and economic indicators of the Slovak regions. Standardised mortality rates adjusted for age, sex, region, and period were calculated applying direct standardisation methods with the European standard population covering the time span from 2005 to 2013. The impact of income indicators on standardised mortality rates was calculated using the panel regression models. The Bratislava region reaches the lowest values of standardised mortality rate for non-communicable diseases for both sexes. On the other side, the Nitra region has the highest standardised mortality rate for non-communicable diseases. Income quintile ratio has the highest effect on mortality, however, the expected positive impact is not confirmed. Gini coefficient at the 0.001 significance level and social benefits at the 0.01 significance level look like the most influencing variables on the standardised mortality rate. By addition of one percentage point of Gini coefficient, mortality rate increases by 148.19 units. When a share of population receiving social benefits increases by one percentage point, the standardised mortality rate will increase by 22.36 units. Non-communicable disease mortality together with income inequalities among the regions of the Slovak Republic highlight the importance of economic impact on population health. Copyright© by the National Institute of Public Health, Prague 2017.

  8. Decline in breast cancer mortality

    DEFF Research Database (Denmark)

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

    2015-01-01

    Funen/rest of Denmark. As multidisciplinary teams were introduced gradually in the rest of Denmark from 1994, the screening effect was slightly underestimated. RESULTS: Over 14 years, women targeted by screening in Funen experienced a 22% (95% confidence interval 11%-32%) reduction in breast cancer......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...

  9. Maternal mortality: a global overview.

    Science.gov (United States)

    Choolani, M; Ratnam, S S

    1995-02-01

    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

  10. Monte Carlo simulation-based estimation for the minimum mortality temperature in temperature-mortality association study.

    Science.gov (United States)

    Lee, Whanhee; Kim, Ho; Hwang, Sunghee; Zanobetti, Antonella; Schwartz, Joel D; Chung, Yeonseung

    2017-09-07

    Rich literature has reported that there exists a nonlinear association between temperature and mortality. One important feature in the temperature-mortality association is the minimum mortality temperature (MMT). The commonly used approach for estimating the MMT is to determine the MMT as the temperature at which mortality is minimized in the estimated temperature-mortality association curve. Also, an approximate bootstrap approach was proposed to calculate the standard errors and the confidence interval for the MMT. However, the statistical properties of these methods were not fully studied. Our research assessed the statistical properties of the previously proposed methods in various types of the temperature-mortality association. We also suggested an alternative approach to provide a point and an interval estimates for the MMT, which improve upon the previous approach if some prior knowledge is available on the MMT. We compare the previous and alternative methods through a simulation study and an application. In addition, as the MMT is often used as a reference temperature to calculate the cold- and heat-related relative risk (RR), we examined how the uncertainty in the MMT affects the estimation of the RRs. The previously proposed method of estimating the MMT as a point (indicated as Argmin2) may increase bias or mean squared error in some types of temperature-mortality association. The approximate bootstrap method to calculate the confidence interval (indicated as Empirical1) performs properly achieving near 95% coverage but the length can be unnecessarily extremely large in some types of the association. We showed that an alternative approach (indicated as Empirical2), which can be applied if some prior knowledge is available on the MMT, works better reducing the bias and the mean squared error in point estimation and achieving near 95% coverage while shortening the length of the interval estimates. The Monte Carlo simulation-based approach to estimate the

  11. Governance matters: an ecological association between governance and child mortality

    OpenAIRE

    Lin, Ro-Ting; Chien, Lung-Chang; Chen, Ya-Mei; Chan, Chang-Chuan

    2014-01-01

    Background Governance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control. Methods We obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and na...

  12. Electronic health indicators in the selected countries: Are these indicators the best?

    Science.gov (United States)

    Afshari, Somaye; Khorasani, Elahe; Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Darab, Mohsen Ghaffari

    2013-01-01

    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.

  13. Serum Irisin Predicts Mortality Risk in Acute Heart Failure Patients

    Directory of Open Access Journals (Sweden)

    Shutong Shen

    2017-06-01

    Full Text Available Background/Aims: Irisin is a peptide hormone cleaved from a plasma membrane protein fibronectin type III domain containing protein 5 (FNDC5. Emerging studies have indicated association between serum irisin and many major chronic diseases including cardiovascular diseases. However, the role of serum irisin as a predictor for mortality risk in acute heart failure (AHF patients is not clear. Methods: AHF patients were enrolled and serum was collected at the admission and all patients were followed up for 1 year. Enzyme-linked immunosorbent assay was used to measure serum irisin levels. To explore predictors for AHF mortality, the univariate and multivariate logistic regression analysis, and receiver-operator characteristic (ROC curve analysis were used. To determine the role of serum irisin levels in predicting survival, Kaplan-Meier survival analysis was used. Results: In this study, 161 AHF patients were enrolled and serum irisin level was found to be significantly higher in patients deceased in 1-year follow-up. The univariate logistic regression analysis identified 18 variables associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 2 variables namely blood urea nitrogen and serum irisin. ROC curve analysis indicated that blood urea nitrogen and the most commonly used biomarker, NT-pro-BNP, displayed poor prognostic value for AHF (AUCs ≤ 0.700 compared to serum irisin (AUC = 0.753. Kaplan-Meier survival analysis demonstrated that AHF patients with higher serum irisin had significantly higher mortality (P<0.001. Conclusion: Collectively, our study identified serum irisin as a predictive biomarker for 1-year all-cause mortality in AHF patients though large multicenter studies are highly needed.

  14. Mortality and reduced growth hormone secretion

    DEFF Research Database (Denmark)

    Stochholm, Kirstine; Christiansen, Jens; Laursen, Torben

    2007-01-01

    BACKGROUND: Data regarding the mortality rates of patients with growth hormone deficiency (GHD), whether or not treated with growth hormone (GH), are limited, but an increased mortality rate among hypopituitary patients compared with the general population has been documented. Cardiovascular...... disease has been suggested as a primary cause of death, whereas cancer statistics might be influenced by the number of malignancies causing the pituitary disease. Furthermore, differences in mortality rates in females and males have been reported. METHODS: Epidemiological studies of mortality...... in hypopituitary and GHD patients were identified and reviewed. RESULTS: Most studies showed an increased mortality rate in hypopituitary and GHD patients and an increased mortality among female compared with male patients. There is a possibility that differences between patients with adult-onset and childhood...

  15. HEALTH AS THE QUALITY OF LIFE KEY INDICATOR

    Directory of Open Access Journals (Sweden)

    Z.Z. Biktimirova

    2006-09-01

    Full Text Available In this review health is regarded in the Quality of Life (QOL concept context. Definitions of health that go beyond other components of national well-being and allow to use it as the QOL indicator are distinguished. Systemic approaches to health estimation, their benefits and shortcomings are analyzed. We propose to use birth rate, newborn, infant and maternal mortality as the most important indicators.

  16. Semai Senoi mortality: Two-census method.

    Science.gov (United States)

    Fix, Alan G

    1989-01-01

    The mortality pattern of a subpopulation of Semai Senoi of Malaysia is studied by using a two-census method. The method yields abridged life tables for both sexes as well as an estimate of the birth rate. The life tables show that Semai mortality is reduced compared to estimates based on stable population methods for the population prior to 1969. Increased health care availability seems to account for this lower mortality. Copyright © 1989 Wiley-Liss, Inc., A Wiley Company.

  17. Factors affecting infant and child mortality.

    Science.gov (United States)

    Adlakha, A L; Suchindran, C M

    1985-10-01

    This paper examines the determinants of infant and child mortality variations in Jordan, Yemen, Egypt, and Tunisia using data from WFS surveys. The analysis considers biological correlates of mortality--mother's age, birth order, birth interval, and previous infant loss--and several social factors--mother's and father's education, mother's residence, father's occupation, and mother's work experience since marriage. The estimates for the 4 countries show large variations in the mortality rates and an expected pattern of declining infant and child mortality during the period of 20 years prior to the survey. Further, the proportionate decline in child mortality in each country was generally greater than the proportionate decline in infant mortality. A persistent pattern of higher child mortality for females than for males is found, suggesting preferential care and treatment of male offspring. The higher mortality risk is found for infants born to very young and very old mothers, with short previous birth intervals, of higher birth orders, and where the previous infant had died. Among the socioeconomic characteristics, the education of the mother and rural-urban residence are found to affect infant survival. In childhood, among the demographic factors, only birth interval shows a significant effect on mortality. The risk of child mortality decreases considerably with the increase in the birth interval. The analysis of the effect of breastfeeding on mortality, although based on limited information, clearly shows the beneficial effect of breastfeeding on the infant's survival, especially during the early months of life. For all countries, the mortality rate for the non-breastfeeders is substantially higher than for the breastfeeders even when the effect of the other covariates is controlled.

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

    Science.gov (United States)

    Khang, Young-Ho; Kim, Hye-Ryun

    2016-03-22

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

  19. 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.

  20. Infection increases mortality in necrotizing pancreatitis

    DEFF Research Database (Denmark)

    Werge, Mikkel; Novovic, Srdjan; Schmidt, Palle N

    2016-01-01

    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....

  1. Excess mortality in giant cell arteritis

    DEFF Research Database (Denmark)

    Bisgård, C; Sloth, H; Keiding, Niels

    1991-01-01

    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...... with respect to SMR, sex distribution or age. In the group of patients with department-diagnosed GCA (definite + probable = 180 patients), the 95% confidence interval for the SMR of the women included 1.0. In all other subgroups there was a significant excess mortality. Excess mortality has been found in two...

  2. Cardiorespiratory hospitalisation and mortality reductions after smoking bans in Switzerland.

    Science.gov (United States)

    Vicedo-Cabrera, Ana M; Röösli, Martin; Radovanovic, Dragana; Grize, Leticia; Witassek, Fabienne; Schindler, Christian; Perez, Laura

    2017-01-19

    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

  3. Beyond Black and White: Color and Mortality in Post Reconstruction Era North Carolina

    Science.gov (United States)

    Green, Tiffany L; Hamilton, Tod G.

    2014-01-01

    A growing empirical literature in economics and sociology documents the existence of differences in social and economic outcomes between mixed-race blacks and other blacks . However, few researchers have considered whether the advantages associated with mixed-race status may have also translated into differences in mortality outcomes between subgroups of blacks and how both groups compared to whites. We employ previously untapped 1880 North Carolina Mortality census records in conjunction with data from the 1880 North Carolina Population Census to examine whether mulatto, or mixed-race blacks may have experienced mortality advantages over to their colored, or non-mixed race counterparts. For men between the ages of 20-44, estimates demonstrate that all black males are more likely than whites to die. Although our results indicate that there are no statistically significant differences in mortality between mulatto and colored blacks, there are some indications that mulatto males may have enjoyed a slight mortality advantage compared to their colored counterparts. However, we find a substantial mortality advantage associated with mixed-race status among women. These findings indicate that mixed-race women, rather than men, may have accrued any mortality advantages associated with color and white ancestry. PMID:25722496

  4. 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

  5. The unfinished health agenda: Neonatal mortality in Cambodia.

    Science.gov (United States)

    Hong, Rathmony; Ahn, Pauline Yongeun; Wieringa, Frank; Rathavy, Tung; Gauthier, Ludovic; Hong, Rathavuth; Laillou, Arnaud; Van Geystelen, Judit; Berger, Jacques; Poirot, Etienne

    2017-01-01

    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 Cambodia's pressing unfinished agenda in health.

  6. Longitudinal Change of Self-Perceptions of Aging and Mortality

    Science.gov (United States)

    2014-01-01

    Objective. To understand the association between self-perceptions of aging (SPA) and mortality in late life. Method. The sample (n = 1,507) was drawn from the Australian Longitudinal Study of Aging (baseline age = 65–103 years). We used joint growth curve and survival models on 5 waves of data for a period of 16 years to investigate the random intercept and slope of SPA for predicting all-cause mortality. Results. The unadjusted model revealed that poor SPA at baseline, as well as decline in SPA, increased the risk of mortality (SPA intercept hazard ratio [HR] = 1.21, 95% confidence interval [CI] = 1.13, 1.31; SPA slope HR = 1.17, 95% CI = 1.02, 1.33). This relationship remained significant for the SPA intercept after adjusting for other risk factors including demographics, physical health, cognitive functioning, and well-being. Conclusion. These findings suggest that a single measurement of SPA in late life may be very informative of future long-term vulnerability to health decline and mortality. Furthermore, a dynamic measure of SPA may be indicative of adaptation to age-related changes. This supports a “self-fulfilling” hypothesis, whereby SPA is a lens through which age-related changes are interpreted, and these interpretations can affect future health and health behaviors. PMID:23419867

  7. Airborne pollen and suicide mortality in Tokyo, 2001-2011.

    Science.gov (United States)

    Stickley, Andrew; Sheng Ng, Chris Fook; Konishi, Shoko; Koyanagi, Ai; Watanabe, Chiho

    2017-05-01

    Prior research has indicated that pollen might be linked to suicide mortality although the few studies that have been undertaken to date have produced conflicting findings and been limited to Western settings. This study examined the association between the level of airborne pollen and suicide mortality in Tokyo, Japan in the period from 2001 to 2011. The daily number of suicide deaths was obtained from the Japanese Ministry of Health, Labour and Welfare, with pollen data being obtained from the Tokyo Metropolitan Institute of Public Health. A time-stratified case-crossover study was performed to examine the association between different levels of pollen concentration and suicide mortality. During the study period there were 5185 male and 2332 female suicides in the pollen season (February to April). For men there was no association between airborne pollen and suicide mortality. For women, compared to when there was no airborne pollen, the same-day (lag 0) pollen level of 30 to Tokyo. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. English language use, health and mortality in older Mexican Americans.

    Science.gov (United States)

    Salinas, Jennifer J; Sheffield, Kristin M

    2011-04-01

    The purpose of this study is to determine if English language use is associated with smoking, diabetes, hypertension, limitations in Activities of Daily Living (ADL), and 12-year mortality in older Mexican Americans. Using data from a cohort of 3,050 Mexican Americans aged 65 years and older, we examined prevalence of 4 health indicators and survival over 12 years of follow-up by English language use. English language use is associated with increased odds of hypertension in men, independent of nativity and sociodemographic control variables. Among women, English language use is associated with lower odds of ADL limitations and increased odds of smoking. The associations for women were partially explained by occupational status and nativity. After adjusting for health conditions, sociodemographics, and nativity, English language use was associated with increased mortality among men. Interaction terms revealed that for both men and women, higher English language use was associated with mortality for respondents with the highest level of income only. English language use is a predictor of health and mortality in older Mexican Americans separate from country of birth.

  9. Trends in Infectious Disease Mortality, South Korea, 1983–2015

    Science.gov (United States)

    Choe, Young June; Choe, Seung-Ah

    2018-01-01

    We used national statistics from 1983–2015 to evaluate trends in mortality caused by infectious diseases in South Korea. Age-standardized mortality from infectious disease decreased from 43.5/100,000 population in 1983 to 16.5/100,000 in 1996, and then increased to 44.6/100,000 in 2015. Tuberculosis was the most common cause of death in 1983 and respiratory tract infections in 2015. We observed a significant decline in infant deaths caused by infectious diseases, but mortality in persons age >65 years increased from 135 deaths/100,000 population in 1996 to 307/100,000 in 2015. The relative inequality indices for respiratory tract infections, sepsis, and tuberculosis tended to increase over time. Although substantial progress has been achieved in terms of infant mortality, death rates from infectious disease has not decreased overall. Elderly populations with lower education levels and subgroups susceptible to respiratory infections and sepsis should be the focus of preventive policies. PMID:29350153

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

    Directory of Open Access Journals (Sweden)

    Samuel P. Scott

    2014-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  12. 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

    2011-12-01

    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

  13. [Current aspects of the Russian Federation population's mortality from diseases of the respiratory system].

    Science.gov (United States)

    Kakorkina, E P; Efimov, D M; Chemiakina, S-D N

    2010-01-01

    Diseases of the respiratory system are in the lead of general mortality of population, they tend to increase, particularly with regard to pneumonias, chronic obstructive pulmonary diseases, bronchial asthma and others. The paper surveys the structure and levels of mortality from diseases of the respiratory system, sex and age indices with special reference to the working age, the mortality dynamics since 2000, levels of mortality by regions with special reference to subjects with the minimum and maximum levels both for the total and by the main nosologies (pneumonia, diseases of the lower respiratory tract, bronchial asthma); an attempt is made to carry out the correlation analysis of the level of mortality from diseases by the main nosologies.

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

    International Nuclear Information System (INIS)

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

    1982-12-01

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

  15. Hyperprolactinemia and the Association with All-Cause Mortality and Cardiovascular Mortality

    DEFF Research Database (Denmark)

    Krogh, Jesper; Selmer, Christian; Torp-Pedersen, Christian

    2017-01-01

    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...

  16. Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) - Smoking-Attributable Mortality (SAM)

    Data.gov (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...

  17. Isolated microalbuminuria indicates a poor medical prognosis.

    Science.gov (United States)

    Scheven, Lieneke; Van der Velde, Marije; Lambers Heerspink, Hiddo J; De Jong, Paul E; Gansevoort, Ron T

    2013-07-01

    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.

  18. [Tricuspid valve regurgitation : Indications and operative techniques].

    Science.gov (United States)

    Lange, R; Piazza, N; Günther, T

    2017-11-01

    Functional tricuspid valve (TV) regurgitation secondary to left heart disease (e.g. mitral insufficiency and stenosis) is observed in 75% of the patients with TV regurgitation and is thus the most common etiology; therefore, the majority of patients who require TV surgery, undergo concomitant mitral and/or aortic valve surgery. Uncorrected moderate and severe TV regurgitation may persist or even worsen after mitral valve surgery, leading to progressive heart failure and death. Patients with moderate to severe TV regurgitation show a 3-year survival rate of 40%. Surgery is indicated in patients with severe TV regurgitation undergoing left-sided valve surgery and in patients with severe isolated primary regurgitation without severe right ventricular (RV) dysfunction. For patients requiring mitral valve surgery, tricuspid valve annuloplasty should be considered even in the absence of significant regurgitation, when severe annular dilatation (≥40 mm or >21 mm/m 2 ) is present. Functional TV regurgitation is primarily treated with valve reconstruction which carries a lower perioperative risk than valve replacement. Valve replacement is rarely required. Tricuspid valve repair with ring annuloplasty is associated with better survival and a lower reoperation rate than suture annuloplasty. Long-term results are not available. The severity of the heart insufficiency and comorbidities (e.g. renal failure and liver dysfunction) are the essential determinants of operative mortality and long-term survival. Tricuspid valve reoperations are rarely necessary and associated with a considerable mortality.

  19. Assessing the Relationship Between Meteorological Parameters, Air Pollution And Cardiovascular Mortality of Mashhad City Based on Time Series Model

    OpenAIRE

    Morteza Hatami; Mitra Mohammadi Mohammadi; Reza Esmaeli; Mandana Mohammadi

    2017-01-01

    Epidemiological studies conducted in the past two decades indicate that air pollution causes increase in cardiovascular, breathing and chronic bronchitis disorders and even causes cardiovascular mortality. Therefore, the aim of this study was to investigate the relationship between meteorological parameters, air pollution and cardiovascular mortality in the city of Mashhad in 2014 by a time series model. Data on mortality from cardiovascular disease, meteorological parameters and air pollutio...

  20. The effectiveness of health systems in influencing avoidable mortality: a study in Valencia, Spain, 1975-90.

    OpenAIRE

    Albert, X; Bayo, A; Alfonso, J L; Cortina, P; Corella, D

    1996-01-01

    OBJECTIVES: To measure variations in the Holland and Charlton classifications of avoidable death causes and to estimate the effect of the Spanish national health system on avoidable mortality. DESIGN: Mortality in the Valencian Community was assessed between 1975 and 1990. The classifications of Holland and Charlton, used to assess avoidable causes of death, were compared. Holland's classification was then used to divide avoidable mortality into two groups--medical care indicators (MCI), whic...

  1. Cause-Specific Excess Mortality in Siblings of Patients Co-Infected with HIV and Hepatitis C Virus

    OpenAIRE

    Hansen, Ann-Brit Eg; Lohse, Nicolai; Gerstoft, Jan; Kronborg, Gitte; Laursen, Alex; Pedersen, Court; Sørensen, Henrik Toft; Obel, Niels

    2007-01-01

    BACKGROUND: Co-infection with hepatitis C in HIV-infected individuals is associated with 3- to 4-fold higher mortality among these patients' siblings, compared with siblings of mono-infected HIV-patients or population controls. This indicates that risk factors shared by family members partially account for the excess mortality of HIV/HCV-co-infected patients. We aimed to explore the causes of death contributing to the excess sibling mortality. METHODOLOGY AND PRINCIPAL FINDINGS: We retrieved ...

  2. Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.

    Science.gov (United States)

    de Andrade, Luciano; Zanini, Vanessa; Batilana, Adelia Portero; de Carvalho, Elias Cesar Araujo; Pietrobon, Ricardo; Nihei, Oscar Kenji; de Barros Carvalho, Maria Dalva

    2013-01-01

    High technology in the field of interventional cardiology applied in tertiary hospitals has brought enormous benefits in the treatment of ischemic heart disease (IHD). However, IHD mortality rates remain high. We analyzed the relationship between IHD mortality rate and the socioeconomic, demographic, and geographic conditions in 399 cities in Parana state, Brazil, from 2006 to 2010. Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics and evaluated through Exploratory Spatial Data Analysis. GeoDa™ was used to analyze 29.351 deaths across 399 cities. We found a positive spatial autocorrelation regarding IHD mortality (I = 0.5913, p = 0.001). There was a significant positive association between each of three socioeconomic and demographic indicators and IHD mortality rate: Population Elderly Index (I = 0.3436), Illiteracy Rate (I = 0.1873) and City Development Index (I = 0.0900). In addition, two indicators presented significant negative association with IHD mortality rate: Adjusted Population Size (I = -0.1216) and Gross Domestic Product (I = -0.0864). We also found a positive association between IHD mortality rates and the geographic distances between patients' city of residence and their corresponding regional referral centers in interventional cardiology (I = 0.3368). Cities located within Regional Health Units with Reference Interventional Cardiology Center presented a significantly lower average specific mortality rate by IHD. The high mortality rate by IHD within the Regional Health Units was not restricted to socioeconomic and demographic variables, but dependent on the distance between each city and their reference interventional cardiology center. We conclude that geographic factors play a significant role in IHD mortality within cities. These findings have important policy implications regarding the geographic distribution of cardiac health care networks in Latin

  3. Social inequality in infant mortality: what explains variation across low and middle income countries?

    Science.gov (United States)

    Hajizadeh, Mohammad; Nandi, Arijit; Heymann, Jody

    2014-01-01

    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.

  4. Projecting future mortality in the Netherlands taking into account mortality delay and smoking

    NARCIS (Netherlands)

    Janssen, F.; de Beer, J.A.A.

    2016-01-01

    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

  5. EDITORIAL UNSAFE ABORTION AND MATERNAL MORTALITY: IS ...

    African Journals Online (AJOL)

    hi-tech

    February 2004. EAST AFRICAN MEDICAL JOURNAL. 61. EDITORIAL. UNSAFE ABORTION AND MATERNAL MORTALITY: IS AFRICA PREPARED. TO FACE THE REALITY? Sub-Saharan Africa has, by far, the highest maternal mortality ratio today. It is estimated that the risk of dying from pregnancy-related cause for a girl ...

  6. Mortality in patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Wermuth, L; Stenager, E; Stenager, E

    1995-01-01

    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...

  7. VSRR - Quarterly provisional estimates for infant mortality

    Data.gov (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...

  8. Mortality after trauma laparotomy in geriatric patients.

    Science.gov (United States)

    Joseph, Bellal; Zangbar, Bardiya; Pandit, Viraj; Kulvatunyou, Narong; Haider, Ansab; O'Keeffe, Terence; Khalil, Mazhar; Tang, Andrew; Vercruysse, Gary; Gries, Lynn; Friese, Randall S; Rhee, Peter

    2014-08-01

    Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy. A retrospective study was performed of all trauma patients undergoing a laparotomy at our level 1 trauma center over a 6-y period (2006-2012). Patients with age ≥55 y who underwent a trauma laparotomy were included. Patients with head abbreviated injury scale (AIS) score ≥ 3 or thorax AIS ≥ 3 were excluded. Our primary outcome measure was mortality. Significant factors in univariate regression model were used in multivariate regression analysis to evaluate the factors predicting mortality. A total of 1150 patients underwent a trauma laparotomy. Of which 90 patients met inclusion criteria. The mean age was 67 ± 10 y, 63% were male, and median abdominal AIS was 3 (2-4). Overall mortality rate was 23.3% (21/90) and progressively increased with age (P = 0.013). Age (P = 0.02) and lactate (P = 0.02) were the independent predictors of mortality in geriatric patients undergoing laparotomy. Mortality rate after trauma laparotomy increases with increasing age. Age and admission lactate were the predictors of mortality in geriatric population undergoing trauma laparotomies. Published by Elsevier Inc.

  9. Cancer mortality in Ireland, 1976-1986

    International Nuclear Information System (INIS)

    Seymour, C.; Herity, B.; Moriarty, M.J.

    1989-01-01

    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

  10. Maternal Mortality in the United States

    Science.gov (United States)

    Lee, Anne S.

    1977-01-01

    Figures from 1800 through 1973 are used to demonstrate that black women have had substantially higher rates of death in childbirth than white women. As mortality has declined, the relative difference between whites and blacks has actually increased. Factors affecting mortality and future prospects for reducing maternal deaths are discussed. (GC)

  11. 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.

    2004-01-01

    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.

  12. Maternal mortality among migrants in Western Europe

    DEFF Research Database (Denmark)

    Pedersen, Grete Skøtt; Grøntved, Anders; Mortensen, Laust Hvas

    2014-01-01

    To examine whether an excess risk of maternal mortality exists among migrant women in Western Europe. We searched electronic databases for studies published 1970 through 2013 for all observational studies comparing maternal mortality between the host country and a defined migrant population...

  13. Hospital volume and hospital mortality for esophagectomy

    NARCIS (Netherlands)

    van Lanschot, J. J.; Hulscher, J. B.; Buskens, C. J.; Tilanus, H. W.; ten Kate, F. J.; Obertop, H.

    2001-01-01

    Hospital mortality after esophagectomy has decreased from 29% to 7.5% over the last decades because of improved surgical techniques and better perioperative care. Suggestions have been made that a further decrease in hospital mortality may be achieved by centralization of esophagectomies in high

  14. Income related inequalities in avoidable mortality in Norway: A population-based study using data from 1994-2011.

    Science.gov (United States)

    Kinge, Jonas Minet; Vallejo-Torres, Laura; Morris, Stephen

    2015-07-01

    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.

  15. Territorial variation in mortality from causes amenable to medical care in Poland.

    Science.gov (United States)

    Wróblewska, Wiktoria

    2017-09-21

    This study examines the geographical variation of amenable mortality in Poland, focusing primarily on the role of health care resources at the level of administrative districts and regions, and selected area socioeconomic characteristics as explanatory factors. The concept was used of amenable mortality, based on the assumption that deaths from certain causes should not occur in the presence of timely and effective health care. Standardized death rates (SDR) from causes considered amenable to health care and, separately, for ischaemic heart disease (IHD), were calculated for each of 379 districts (NUTS 4 level) in Poland in 1991-1995 and 2006-2010, using unit mortality data from the National Causes of Death Register. The analytical procedure involved spatial analysis of the distribution of amenable mortality rates, selection of explanatory variables and fitting multilevel regression models using area-level and regional-level characteristics. The results indicate that mortality from conditions which have become amenable to medical intervention has generally decreased in all districts of Poland in the past two decades. Considerable territorial variation in mortality can be observed. Since the 1990s, these differences have been reduced for IHD-related mortality and have increased for amenable mortality. The presented analysis only partly confirms the correlation between variables reflecting the infrastructure of health care resources and the territorial variation in mortality from these two categories of causes of death. Significant correlations with variation in mortality are revealed for the number of primary care physicians (at district level) and the number of specialist practitioners (at regional level). However, after controlling for socioeconomic variables, such as education and low income, the effect of the health care infrastructure-related variables was considerably reduced. The multi-level models also revealed a substantial variation at the regional level

  16. Are the Poor Dying Younger in Malaysia? An Examination of the Socioeconomic Gradient in Mortality.

    Science.gov (United States)

    Mariapun, Jeevitha; Hairi, Noran N; Ng, Chiu-Wan

    2016-01-01

    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.

  17. Effects of temperature on mortality in Chiang Mai city, Thailand: a time series study.

    Science.gov (United States)

    Guo, Yuming; Punnasiri, Kornwipa; Tong, Shilu

    2012-07-09

    The association between temperature and mortality has been examined mainly in North America and Europe. However, less evidence is available in developing countries, especially in Thailand. In this study, we examined the relationship between temperature and mortality in Chiang Mai city, Thailand, during 1999-2008. A time series model was used to examine the effects of temperature on cause-specific mortality (non-external, cardiopulmonary, cardiovascular, and respiratory) and age-specific non-external mortality ( =85 years), while controlling for relative humidity, air pollution, day of the week, season and long-term trend. We used a distributed lag non-linear model to examine the delayed effects of temperature on mortality up to 21 days. We found non-linear effects of temperature on all mortality types and age groups. Both hot and cold temperatures resulted in immediate increase in all mortality types and age groups. Generally, the hot effects on all mortality types and age groups were short-term, while the cold effects lasted longer. The relative risk of non-external mortality associated with cold temperature (19.35°C, 1st percentile of temperature) relative to 24.7°C (25th percentile of temperature) was 1.29 (95% confidence interval (CI): 1.16, 1.44) for lags 0-21. The relative risk of non-external mortality associated with high temperature (31.7°C, 99th percentile of temperature) relative to 28°C (75th percentile of temperature) was 1.11 (95% CI: 1.00, 1.24) for lags 0-21. This study indicates that exposure to both hot and cold temperatures were related to increased mortality. Both cold and hot effects occurred immediately but cold effects lasted longer than hot effects. This study provides useful data for policy makers to better prepare local responses to manage the impact of hot and cold temperatures on population health.

  18. Pediatric acute kidney injury: Appraisal of predictors and prognostic indicators

    Directory of Open Access Journals (Sweden)

    Samuel Nkachukwu Uwaezuoke

    2017-01-01

    Full Text Available Acute kidney injury (AKI is a major contributor to childhood morbidity and mortality worldwide. In spite of the advances in renal replacement therapy, there has been a minimal reduction in AKI-related morbidity and mortality. Identifying the prognostic indicators and the risk factors that predict disease onset and progression, and instituting appropriate measures will lead to better survival outcomes. This narrative review seeks to appraise the predictors and prognostic indicators of pediatric AKI. Several biomarkers clearly stand out as predictors and prognostic indicators of the acute disease. Some of them are urine angiotensinogen, fibroblast growth factor-23, cystacin C, neutrophil gelatinase-associated lipocalin, tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7. Combining few of these biomarkers with clinical prediction models has improved their predictive and prognostic utility for AKI. Hemodynamic parameters such as indexed systemic oxygen delivery and mean arterial blood pressure have been proved to be reliable in predicting the occurrence and progression of the disease and its outcomes. Miscellaneous predictors and prognostic indicators like AKI definition criteria, presence of co-morbidities, and health-related quality of life assessment have also been documented from evidence-based studies. An understanding and application of these indices will obviously help to reduce AKI mortality in children.

  19. Recent trends in cancer mortality in Uruguay

    International Nuclear Information System (INIS)

    Garau, M.; Alonso, R.; Musetti, C.; Barrios, E.

    2010-01-01

    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

  20. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

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

    1993-01-01

    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...... livebirths. The neonatal and NNT mortality rates were higher in boys than in girls. Neonatal tetanus was not associated with mother's age, parity, or history of previous child death. The majority of the children (72%) were adequately protected at birth against NNT; in those with documented protection NNT...... mortality was 0, in those with undocumented protection 1.2 and in other children 8.5 per 1000 livebirths. Other risk factors for NNT included home delivery, untrained assistance during delivery, unhygienic cord cutting and application of potentially infectious substances on the umbilical stump. The survey...