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Sample records for death certificate based

  1. Certification of death.

    PubMed

    Chao, T C

    1990-04-01

    In Singapore, every deceased person must have a death certificate stating the cause of death. The death certificates are prepared from certificates of cause of death signed by medical practitioners, pathologists, coroners or inspectors of death. The death certificate is a legal document and the person who certifies the cause of death is responsible for the accuracy of the facts. Singapore has a Coroner's system and all deaths due to unnatural, violent, accidental, sudden and unknown causes must be reported to the coroner. These cases are usually subjected to post-mortem examination after which pathologist will sign the certificate of cause of death. Thus only pathologists are allowed to certify unnatural causes of death. All other categories of personnel are allowed to certify natural causes only. Any deviation will result in the certificate be rejected by the Registrar of Death and the matter referred to the Coroner. The offending doctor would be reprimanded by the court. Examples of wrong certification will be given and it is hoped that medical practitioners will not make similar mistakes. PMID:2371582

  2. Improving the accuracy of death certification

    PubMed Central

    Myers, K A; Farquhar, D R

    1998-01-01

    BACKGROUND: Population-based mortality statistics are derived from the information recorded on death certificates. This information is used for many important purposes, such as the development of public health programs and the allocation of health care resources. Although most physicians are confronted with the task of completing death certificates, many do not receive adequate training in this skill. Resulting inaccuracies in information undermine the quality of the data derived from death certificates. METHODS: An educational intervention was designed and implemented to improve internal medicine residents' accuracy in death certificate completion. A total of 229 death certificates (146 completed before and 83 completed after the intervention) were audited for major and minor errors, and the rates of errors before and after the intervention were compared. RESULTS: Major errors were identified on 32.9% of the death certificates completed before the intervention, a rate comparable to previously reported rates for internal medicine services in teaching hospitals. Following the intervention the major error rate decreased to 15.7% (p = 0.01). The reduction in the major error rate was accounted for by significant reductions in the rate of listing of mechanism of death without a legitimate underlying cause of death (15.8% v. 4.8%) (p = 0.01) and the rate of improper sequencing of death certificate information (15.8% v. 6.0%) (p = 0.03). INTERPRETATION: Errors are common in the completion of death certificates in the inpatient teaching hospital setting. The accuracy of death certification can be improved with the implementation of a simple educational intervention. PMID:9614825

  3. Mortality associated with neurofibromatosis type 1: A study based on Italian death certificates (1995-2006)

    PubMed Central

    2011-01-01

    Background Persons affected by neurofibromatosis type 1 (NF1) have a decreased survival, yet information on NF1-associated mortality is limited. Methods/Aim The National Mortality Database and individual Multiple-Causes-of-Death records were used to estimate NF1-associated mortality in Italy in the period 1995-2006, to compare the distribution of age at death (as a proxy of survival) to that of the general population and to evaluate the relation between NF1 and other medical conditions by determining whether the distribution of underlying causes of NF1-associated deaths differs from that of general population. Results Of the nearly 6.75 million deaths in the study period, 632 had a diagnosis of NF1, yet for nearly three-fourths of them the underlying cause was not coded as neurofibromatosis. The age distribution showed that NF1-associated deaths also occurred among the elderly, though mortality in early ages was high. The mean age for NF1-associated death was approximately 20 years lower than that for the general population. The gender differential may suggest that women are affected by more severe NF1-related complications, or they may simply reflect a greater tendency for NF1 to be reported on the death certificates of young women. Regarding the relation with other medical conditions, we found an excess, as the underlying cause of death, for malignant neoplasm of connective and other soft tissue and brain, but not for other sites. We also found an excess for obstructive chronic bronchitis and musculoskeletal system diseases among elderly persons. Conclusion This is the first nationally representative population-based study on NF1-associated mortality in Italy. It stresses the importance of the Multiple-Causes-of-Death Database in providing a more complete picture of mortality for conditions that are frequently not recorded as the underlying cause of death, or to study complex chronic diseases or diseases that have no specific International Classification of Diseases code, such as NF1. It also highlights the usefulness of already available data when a surveillance system is not fully operational. PMID:21439034

  4. Death certification of "suicide by cop".

    PubMed

    Neitzel, Amber R; Gill, James R

    2011-11-01

    Death certification of "suicide by cop" is controversial among some medical examiners and coroners. We present five such deaths that were certified as suicides and discuss the medico-legal issues involved with these certifications. To certify such a death as a suicide, certain criteria should be met. Suicide by cop is a circumstance that involves competing intentional acts that may result in dichotomous determinations of the manner of death. Despite the absence of direct self-infliction, there is overwhelming evidence that these five individuals intended to end their own lives. Their use of an unusual method to accomplish this goal may inappropriately result in a reflexive certification of homicide. All of the decedents possessed weapons or a facsimile of a weapon. We present five instances of suicide by cop and contend that these types of deaths are best certified as suicides. PMID:21827474

  5. An accessible method for teaching doctors about death certification.

    PubMed

    Walker, Sue; Rampatige, Rasika; Wainiqolo, Iris; Aumua, Audrey

    2012-01-01

    The World Health Organization (WHO) recommends that data on mortality in its member countries are collected utilising the Medical Certificate of Cause of Death published in the instruction volume of the ICD-10. However, investment in health information processes necessary to promote the use of this certificate and improve mortality information is lacking in many countries. An appeal for support to make improvements has been launched through the Health Metrics Network's MOVE-IT strategy (Monitoring of Vital Events Information Technology) (WHO 2011). Despite this international spotlight on the need for capture of mortality data and in the use of the ICD-10 to code the data reported on such certificates, there is little cohesion in the way that certifiers of deaths receive instruction in how to complete the death certificate, which is the main source document for mortality statistics. Complete and accurate documentation of the immediate, underlying and contributory causes of death of the decedent on the death certificate is a requirement to produce standardised statistical information and to the ability to produce cause-specific mortality statistics that can be compared between populations and across time. This paper reports on a research project conducted to determine the efficacy and accessibility of the certification module of the WHO's newly-developed web based training tool for coders and certifiers of deaths. Involving a population of medical students from the Fiji School of Medicine and a pre- and post-research design, the study entailed completion of death certificates based on vignettes before and after access to the training tool. The ability of the participants to complete the death certificates and analysis of the completeness and specificity of the ICD-10 coding of the reported causes of death were used to measure the effect of the students' learning from the training tool. The quality of death certificate completion was assessed using a Quality Index before and after the participants accessed the training tool. In addition, the views of the participants about accessibility and use of the training tool were elicited using a supplementary questionnaire. The results of the study demonstrated improvement in the ability of the participants to complete death certificates completely and accurately according to best practice. The training tool was viewed very positively and its implementation in the curriculum for medical students was encouraged. Participants also recommended that interactive discussions to examine the certification exercises would be an advantage. PMID:22408110

  6. Cause of death affects racial classification on death certificates.

    PubMed

    Noymer, Andrew; Penner, Andrew M; Saperstein, Aliya

    2011-01-01

    Recent research suggests racial classification is responsive to social stereotypes, but how this affects racial classification in national vital statistics is unknown. This study examines whether cause of death influences racial classification on death certificates. We analyze the racial classifications from a nationally representative sample of death certificates and subsequent interviews with the decedents' next of kin and find notable discrepancies between the two racial classifications by cause of death. Cirrhosis decedents are more likely to be recorded as American Indian on their death certificates, and homicide victims are more likely to be recorded as Black; these results remain net of controls for followback survey racial classification, indicating that the relationship we reveal is not simply a restatement of the fact that these causes of death are more prevalent among certain groups. Our findings suggest that seemingly non-racial characteristics, such as cause of death, affect how people are racially perceived by others and thus shape U.S. official statistics. PMID:21298093

  7. Principles and Pitfalls: a Guide to Death Certification

    PubMed Central

    Brooks, Erin G.; Reed, Kurt D.

    2015-01-01

    Death certificates serve the critical functions of providing documentation for legal/administrative purposes and vital statistics for epidemiologic/health policy purposes. In order to satisfy these functions, it is important that death certificates be filled out completely, accurately, and promptly. The high error rate in death certification has been documented in multiple prior studies, as has the effectiveness of educational training interventions at mitigating errors. The following guide to death certification is intended to illustrate some basic principles and common pitfalls in electronic death registration with the goal of improving death certification accuracy. PMID:26185270

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

    PubMed Central

    2012-01-01

    Background A growing body of scientific research is suggesting that end-of-life care and decision making may differ between age groups and that elderly patients may be the most vulnerable to exclusion of due care at the end of life. This study investigates age-related disparities in the rate of end-of-life decisions with a possible or certain life shortening effect (ELDs) and in the preceding decision making process in Flanders, Belgium in 2007, where euthanasia was legalised in 2002. Comparing with data from an identical survey in 1998 we also study the plausibility of the ‘slippery slope’ hypothesis which predicts a rise in the rate of administration of life ending drugs without patient request, especially among elderly patients, in countries where euthanasia is legal. Method We performed a post-mortem survey among physicians certifying a large representative sample (n = 6927) of death certificates in 2007, identical to a 1998 survey. Response rate was 58.4%. Results While the rates of non-treatment decisions (NTD) and administration of life ending drugs without explicit request (LAWER) did not differ between age groups, the use of intensified alleviation of pain and symptoms (APS) and euthanasia/assisted suicide (EAS), as well as the proportion of euthanasia requests granted, was bivariately and negatively associated with patient age. Multivariate analysis showed no significant effects of age on ELD rates. Older patients were less often included in decision making for APS and more often deemed lacking in capacity than were younger patients. Comparison with 1998 showed a decrease in the rate of LAWER in all age groups except in the 80+ age group where the rate was stagnant. Conclusion Age is not a determining factor in the rate of end-of-life decisions, but is in decision making as patient inclusion rates decrease with old age. Our results suggest there is a need to focus advance care planning initiatives on elderly patients. The slippery slope hypothesis cannot be confirmed either in general or among older people, as since the euthanasia law fewer LAWER cases were found. PMID:22708727

  9. Lawsuits against medical examiners or coroners arising from death certificates.

    PubMed

    Hanzlick, R

    1997-06-01

    A data base search through Westlaw was conducted to ascertain lawsuits in which a medical examiner or coroner (ME/C) was sued because of the cause or manner of death stated on the death certificate. Sixteen reported cases were found between 1948 and 1995, with 10 of the cases occurring since 1985. The frequency of reported cases is approximately 1/400,000 ME/C death certificates, but based on certain assumptions, the actual frequency may be estimated at 1/40,000 ME/C death certificates. Nine cases involved plaintiffs who contested when the manner of death was indicated as suicide. In 15 of the 16 cases, the lower court decision favored the ME/C viewpoint. Five of the 15 decisions were ultimately reversed by a higher court, but the ultimate outcomes of these cases were not available. Overall, it appears that most courts and decisions have recognized ME/C actions as discretionary or immune and that ME/Cs have been at low risk for such suits to date. This seems especially true if the ME/C position is defensible and the ME/C has acted in accordance with statute and without evidence of corruption, incompetence, arbitrariness, capriciousness, abuse of discretion, or outrageous conduct. PMID:9185925

  10. Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death

    PubMed Central

    Mieno, Makiko Naka; Tanaka, Noriko; Arai, Tomio; Kawahara, Takuya; Kuchiba, Aya; Ishikawa, Shizukiyo; Sawabe, Motoji

    2016-01-01

    Background Cause of death (COD) information taken from death certificates is often inaccurate and incomplete. However, the accuracy of Underlying CODs (UCODs) recorded on death certificates has not been comprehensively described when multiple diseases are present. Methods A total of 450 consecutive autopsies performed at a geriatric hospital in Japan between February 2000 and August 2002 were studied. We evaluated the concordance rate, sensitivity, and specificity of major UCODs (cancer, heart disease, and pneumonia) reported on death certificates compared with a reference standard of pathologist assessment based on autopsy data and clinical records. Logistic regression analysis was performed to assess the effect of sex, age, comorbidity, and UCODs on misclassification. Results The concordance rate was relatively high for cancer (81%) but low for heart disease (55%) and pneumonia (9%). The overall concordance rate was 48%. Sex and comorbidity did not affect UCOD misclassification rates, which tended to increase with patient age, although the association with age was also not significant. The strongest factor for misclassification was UCODs (P < 0.0001). Sensitivity and specificity for cancer were very high (80% and 96%, respectively), but sensitivity for heart disease and pneumonia was 60% and 46%, respectively. Specificity for each UCOD was more than 85%. Conclusions Researchers should be aware of the accuracy of COD data from death certificates used as research resources, especially for cases of elderly patients with pneumonia. PMID:26639750

  11. Performance Based Counselor Certification.

    ERIC Educational Resources Information Center

    Bernknopf, Stan; Ware, William B.

    For the past four years the Georgia Department of Education has been involved in a statewide effort to establish standards and procedures for certification of educational personnel based on competency demonstration. As part of this effort, a project was commissioned to develop a performance-based system for the certification of school counselors.…

  12. Inadequacies of death certification in Beirut: who is responsible?

    PubMed Central

    Sibai, Abla M.; Nuwayhid, Iman; Beydoun, May; Chaaya, Monique

    2002-01-01

    OBJECTIVE: To assess the completeness of data on death certificates over the past 25 years in Beirut, Lebanon, and to examine factors associated with the absence of certifiers' signatures and the non-reporting of the underlying cause of death. METHODS: A systematic 20% sample comprising 2607 death certificates covering the 1974, 1984, 1994, 1997 and 1998 registration periods was retrospectively reviewed for certification practices and missing data. FINDINGS: The information on the death certificates was almost complete in respect of all demographic characteristics of the deceased persons except for occupation and month of birth. Data relating to these variables were missing on approximately 95% and 78% of the certificates, respectively. Around half of the certificates did not carry a certifier's signature. Of those bearing such a signature, 21.6% lacked documentation of the underlying cause of death. The certifier's signature was more likely to be absent on: certificates corresponding to the younger and older age groups than on those of persons aged 15-44 years; those of females than on those of males; those of persons who had been living remotely from the registration governorate than on those of other deceased persons; and those for which there had been delays in registration exceeding six months than on certificates for which registration had been quicker. For certificates that carried the certifier's signature there was no evidence that any of the demographic characteristics of the deceased person was associated with decreased likelihood of reporting an underlying cause of death. CONCLUSION: The responsibility for failure to report causes of death in Beirut lies with families who lack an incentive to call for a physician and with certifying physicians who do not carry out this duty. The deficiencies in death certification are rectifiable. However, any changes should be sensitive to the constraints of the organizational and legal infrastructure governing death registration practices and the medical educational systems in the country. PMID:12163919

  13. An application of the Sentinel Health Event (Occupational) concept to death certificates.

    PubMed Central

    Lalich, N R; Schuster, L L

    1987-01-01

    This article describes a computer-based application of the Sentinel Health Event (Occupational) [SHE(O)] concept, developed in conjunction with five states, to monitor deaths which are occupationally related. The states have coded their state death certificate files for industry and occupation, using the decedent's usual occupation and industry as reported on the death certificate. From these files, the SHE(O) computer program selects deaths which are likely to be work-related, based on a previously published SHE(O) list of 50 disease rubrics and associated industries and occupations. The computer program matches the SHE(O) list with the recorded industry, occupation, and underlying cause of death. The program has been tested using 1984 death certificate data from Maine, upstate New York (excluding New York City), North Carolina, Pennsylvania, and Rhode Island. Approximately 1 to 2 per cent of all deaths were selected by the program, with lung cancer and coal workers' pneumoconiosis being the most frequent cause of death. The SHE(O) program may be useful for identifying deaths which are potentially occupationally related, but its utility and its application to death certificates needs further evaluation before recommending widespread use. Limitations are discussed, as well as plans for improving the application of the SHE(O) concept to death certificates. PMID:3631365

  14. Assessing the Awareness of Agents Involved in Issuance of Death Certificates About Death Registration Rules in Iran

    PubMed Central

    Mahdavi, Abdollah; Sedghi, Shahram; Sadoghi, Farahnaz; Azar, Farbod Ebadi Fard

    2015-01-01

    Introduction: In the death registration system, issuance of death certificate, as a binding rule, is considered among the major necessities of preparation of death statistics. In order to prepare death statistics that are adequately valid for subsequent applications, it is necessary to properly encode death certificates and fully follow rules on causes underlying death. This study aimed to assess the awareness and performance of agents involved in issuance of death certificate in the national death records system. Methods: It was a descriptive cross-sectional research, which was performed from September 2013 to March 2014 on 96 agents involved in issuance of death certificate Imam Khomeini, Alavi, Fatemi and BuAli education and treatment centers of Ardebil University of Medical Sciences. The population included faculty staff physicians, residents and health information management staffs. The research scale was also a researcher-made questionnaire that questioned the demographic information as well as awareness and performance of participants regarding death certificate coding rules. Research data was analyzed based on descriptive statistics and the chi-square test method in the SPSS software at a confidence level of 95%. Findings: A total of 34.42% of participants were aware of the general rules on issuance of death certificates while faculty staff higher specialists (41.67%) and clinical coders (38.34%) with five years of experience demonstrated the highest awareness levels. Only 23 participants (24.6%) were trained to issue death certificates. A total of 76 participants (79.3%) announced their need for learning how to complete death certificate forms on a constant basis. The awareness of participants about the general principle was assessed to be low (30.25%). Moreover, their awareness of selection rules and modification rules was low (27.75%) and moderate (45.25%), respectively. The chi-square test revealed a significant relationship between work experience and awareness of participants about coding rules (P=0.001), but no significant relationship was observed between education and awareness of coding rules (P=0.497). Conclusion: The awareness of participants about rules on coding death causes and their performance in this field was so satisfactory. That is to say, the awareness of faculty staff and health information management staffs was unexpectedly low. Seemingly, lack of adequate training is an international issue that causes mistakes in the recording of information on mortality. Hence, a short-term solution is to train faculty staff and residents and also revise the training provided to health information management staffs. As a long-term solution it is possible to provide related courses to general practitioner students. PMID:26156914

  15. Completeness of HIV reporting on death certificates for Floridians reported with HIV infection, 2000-2011.

    PubMed

    Trepka, Mary Jo; Sheehan, Diana M; Fennie, Kristopher P; Niyonsenga, Theophile; Lieb, Spencer; Maddox, Lorene M

    2016-01-01

    Human immunodeficiency virus (HIV) mortality is used as a key measure to monitor the impact of HIV throughout the world. It is important that HIV be correctly recorded on death certificates so that the burden of HIV mortality can be tracked accurately. The objective of this study was to determine the extent of failure to correctly report HIV on death certificates and examine patterns of incompleteness by demographic factors. Causes of death on death certificates of people infected with HIV reported to the Florida HIV surveillance system 2000-2011 were analyzed to determine the proportion without mention of HIV who had an underlying cause of death suggestive of HIV based on World Health Organization recommendations. Of the 11,989 deaths, 8089 (67.5%) had an HIV code (B20-B24, R75) as any of the causes of death, 3091 (25.8%) had no mention of HIV and the underlying cause was not suggestive of HIV, and 809 (6.7%) had no mention of HIV but the underlying cause was suggestive of HIV. Therefore, 9.1% (809/8898) of probable HIV-related deaths had no mention of HIV on the death certificate. Dying within 1 month of HIV diagnosis was the factor most strongly associated with no mention of HIV when the underlying cause was suggestive of HIV on the death certificate. The results suggest that HIV mortality using only vital records may underestimate actual HIV mortality by approximately 9%. Efforts to reduce incompleteness of reporting of HIV on death certificates could improve HIV-related mortality estimates. PMID:26273965

  16. Accuracy of Death Certificates in COPD: Analysis from the TORCH Trial

    PubMed Central

    Drummond, M. Bradley; Wise, Robert A.; John, Matthias; Zvarich, Michael T.; McGarvey, Lorcan P.

    2016-01-01

    The Towards a Revolution in COPD Health (TORCH) trial was an international clinical trial of chronic obstructive pulmonary disease (COPD) patients where cause of death was assigned by an independent committee. Comparison of death certificate data and adjudicated cause of death allows a unique opportunity to determine death certificate accuracy and frequency of COPD listing on death certificates of COPD patients. In this analysis, the authors determine the concordance between adjudicated cause of death and primary and secondary cause of death from death certificates. In 317 (80%) of informative deaths, the primary or secondary cause of death from certificates agreed with adjudicated cause of death. Only 229 (58%) of death certificates in these COPD patients listed COPD on the certificate. COPD was not listed on the death certificate in 21% of deaths adjudicated to be caused by COPD exacerbation. Compared with pulmonary causes, the listing of COPD on certificates occurred with less frequency than cardiovascular, cancer and other categories of death. The combined primary and secondary listing on death certificates has good concordance with actual cause of death. COPD is under-reported on death certificates, and this under-reporting is more frequent when the primary cause of death is not pulmonary. PMID:20486816

  17. Representativeness of deaths identified through the injury-at-work item on the death certificate: implications for surveillance.

    PubMed Central

    Russell, J; Conroy, C

    1991-01-01

    BACKGROUND. This research investigated the accuracy of the injury-at-work item on the death certificate for surveillance of occupational injury deaths in Oklahoma during 1985 and 1986. METHODS. Representativeness of occupational injury deaths identified by death certificates was assessed by comparing these deaths with all occupational injury deaths identified through death certificates, workers' compensation reports, medical examiner reports, and OSHA records for categories of occupation, industry, and external causes of death. RESULTS. Certain external causes of death (e.g., motor vehicle traffic deaths) and certain occupations (e.g., farming) and industries (agriculture and services) are more often underidentified through death certificates. CONCLUSIONS. The findings of this study support Baker's observation that no single data source contains all deaths or all the data elements necessary to describe occupational injury deaths. Data sources may be combined to improve representativeness through more complete case ascertainment. PMID:1836109

  18. Diagnosis on death certificates of sudden death due to ischemic heart disease.

    PubMed

    Najem, G R; Najem, A J; Najem, N H; Najem, F S; Najem, A J; Najem, A D

    1980-12-01

    This study was undertaken to evaluate the quality of diagnoses of sudden death (SD) caused by ischemic heart disease (IHD) on death certificates. A random sample of 10% (100 cases) was drawn from all such deaths which occurred in 1970 among Oklahoma City residents. The medical records of each case were reviewed and the quality of the diagnosis was rated, by the use of predetermined standard criteria, as confirmed and valid or unconfirmed and invalid. Among 100 IHD deaths, SD constitute 45%. Of these SDs, 18% were unobserved, without information as to the manifestations of the attack or the interval from onset of symptoms to death. According to criteria of the American Heart Association and WHO Expert Committee, the diagnosis in this 18% was unconfirmed and invalid. Thus there is insufficient quantitative evidence to justify the use of SD, as found on death certificates, as an indication of frequency of ischemic heart disease. PMID:7444553

  19. [The death certificate: how to draft and why?].

    PubMed

    Manaouil, C; Decourcelle, M; Gignon, M; Chatelain, D; Jardé, O

    2007-05-01

    The death certificate must be established within 24 hours following the death and handed to the mayor. The obligation to place in the coffin immediately is planned by a defined list of contagious diseases. Medicolegal obstacle must be ticked if there is a doubt on the cause of death. In order to look into the causes of the death, swabs can be asked by the physician. It is a medical or scientific autopsy to look into the causes of the death apart from a juridical procedure. The presence of a battery prosthesis (pacemaker) must be specified, so that it can be removed by a physician or a thanatopractionner before the placing in the coffin. Death certificate is passed on by the city hall to Insee, which updates the identification national register of physical people. Inserm receives anonymous data of the causes of death allowing to establish the mortality national statistics. In the absence of medicolegal obstacle or obligation to place in the coffin immediately, funeral operations can begin: preservation care, body transport, placing in the coffin and finally burial or cremation. PMID:17336488

  20. Varying Estimates of Sepsis Mortality Using Death Certificates and Administrative Codes - United States, 1999-2014.

    PubMed

    Epstein, Lauren; Dantes, Ray; Magill, Shelley; Fiore, Anthony

    2016-01-01

    Sepsis is a clinical syndrome caused by a dysregulated host response to infection (1). Because there is no confirmatory diagnostic test, the diagnosis of sepsis is based on evidence of infection and clinical judgement. Both death certificates and health services utilization data (administrative claims) have been used to assess sepsis incidence and mortality, but estimates vary depending on the surveillance definition and data source. To highlight the challenges and variability associated with estimating sepsis mortality, CDC compared national estimates of sepsis-related mortality based on death certificates using the CDC WONDER database with published sepsis mortality estimates generated using administrative claims data from hospital discharges reported in the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (2). During 2004-2009, using data rounded to thousands, the annual range of published sepsis-related mortality estimates based on administrative claims data was 15% to 140% higher (range = 168,000-381,000) than annual estimates generated using death certificate data (multiple causes) (range = 146,000-159,000). Differences in sepsis-related mortality reported using death certificates and administrative claims data might be explained by limitations inherent in each data source. These findings underscore the need for a reliable sepsis surveillance definition based on objective clinical data to more accurately track national sepsis trends and enable objective assessment of the impact of efforts to increase sepsis awareness and prevention. PMID:27054476

  1. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 4 2014-07-01 2014-07-01 false Death, disability, closed school, false certification... Programs by a Guaranty Agency § 682.402 Death, disability, closed school, false certification, unpaid..., attendance at a school that closes, false certification by a school of a borrower's eligibility for a...

  2. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 4 2013-07-01 2013-07-01 false Death, disability, closed school, false certification... Programs by a Guaranty Agency § 682.402 Death, disability, closed school, false certification, unpaid..., attendance at a school that closes, false certification by a school of a borrower's eligibility for a...

  3. Completing Death Certificates from an EMR: Analysis of a Novel Public-Private Partnership.

    PubMed

    Tripp, Jacob S; Duncan, Jeffrey D; Finch, Leisa; Huff, Stanley M

    2015-01-01

    With the objective of increasing electronic death registration, Intermountain Healthcare and the Utah Office of Vital Records and Statistics have developed a system enabling death certification from within Intermountain's electronic medical record (EMR), consisting of an EMR module and an HL7 interface. Comparison of post-intervention death certification at Intermountain Healthcare against a baseline study found a slight increase in the percentage of deaths certified electronically (73% pre vs. 77% post). Analysis of deaths certified using the EMR-module found that they were completed significantly sooner than those certified on paper or using the state's web-based electronic death registration system (EDRS) (Mean time: Paper = 114.72 hours, EDRS = 81.84 hours, EMR = 43.92 hours; p < 0.0001). EMR-certified deaths also contained significantly more causes of deaths than either alternative method (Mean number of causes: Paper = 3.9 causes, EDRS = 4.0 causes, EMR = 5.5 causes; p < 0.0001). PMID:26958261

  4. Completing Death Certificates from an EMR: Analysis of a Novel Public-Private Partnership

    PubMed Central

    Tripp, Jacob S.; Duncan, Jeffrey D.; Finch, Leisa; Huff, Stanley M.

    2015-01-01

    With the objective of increasing electronic death registration, Intermountain Healthcare and the Utah Office of Vital Records and Statistics have developed a system enabling death certification from within Intermountain’s electronic medical record (EMR), consisting of an EMR module and an HL7 interface. Comparison of post-intervention death certification at Intermountain Healthcare against a baseline study found a slight increase in the percentage of deaths certified electronically (73% pre vs. 77% post). Analysis of deaths certified using the EMR-module found that they were completed significantly sooner than those certified on paper or using the state’s web-based electronic death registration system (EDRS) (Mean time: Paper = 114.72 hours, EDRS = 81.84 hours, EMR = 43.92 hours; p < 0.0001). EMR-certified deaths also contained significantly more causes of deaths than either alternative method (Mean number of causes: Paper = 3.9 causes, EDRS = 4.0 causes, EMR = 5.5 causes; p < 0.0001). PMID:26958261

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

    PubMed

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

    2015-01-01

    Despite improvements to the Death Notification Form (DNF) used in South Africa (SA), the quality of cause-of-death information remains suboptimal. To address these inadequacies, the government ran a train-the-trainer programme on completion of the DNF, targeting doctors in public sector hospitals. Training materials were developed and workshops were held in all provinces. This article reflects on the lessons learnt from the training and highlights issues that need to be addressed to improve medical certification and cause-of-death data in SA. The DNF should be completed truthfully and accurately, and confidentiality of the information on the form should be maintained. The underlying cause of death should be entered on the lowest completed line in the cause-of-death section, and if appropriate, HIV should be entered here. Exclusion clauses for HIV in life insurance policies with Association of Savings and Investments South Africa companies were scrapped in 2005. Interactive workshops provide a good learning environment, but are logistically challenging. More use should be made of online training resources, particularly with continuing professional development accreditation and helpline support. In addition, training in the completion of the DNF should become part of the curriculum in all medical schools, and part of the orientation of interns and community service doctors in all facilities. PMID:26046158

  6. Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals

    PubMed Central

    2011-01-01

    Background In Mexico, the vital registration system relies on information collected from death certificates to generate official mortality figures. Although the death certificate has high coverage across the country, there is little information regarding its validity. The objective of this study was to assess the concordance between the underlying cause of death in official statistics obtained from death certificates and a gold standard diagnosis of the same deaths derived from medical records of hospitals. Methods The study sample consisted of 1,589 deaths that occurred in 34 public hospitals in the Federal District and the state of Morelos, Mexico in 2009. Neonatal, child, and adult cases were selected for causes of death that included infectious diseases, noncommunicable diseases, and injuries. We compared the underlying cause of death, obtained from medical death certificates, against a gold standard diagnosis derived from a review of medical records developed by the Population Health Metrics Research Consortium. We used chance-corrected concordance and accuracy as metrics to evaluate the quality of performance of the death certificate. Results Analysis considering only the underlying cause of death resulted in a median chance-corrected concordance between the cause of death in medical death certificates versus the gold standard of 54.3% (95% uncertainty interval [UI]: 52.2, 55.6) for neonates, 38.5% (37.0, 40.0) for children, and 66.5% (65.9, 66.9) for adults. The accuracy resulting from the same analysis was 0.756 (0.747, 0.769) for neonates, 0.683 (0.663, 0.701) for children, and 0.780 (0.774, 0.785) for adults. Median chance-corrected concordance and accuracy increased when considering the mention of any cause of death in the death certificate, not just the underlying cause. Concordance varied substantially depending on cause of death, and accuracy varied depending on the true cause-specific mortality fraction composition. Conclusions Although we cannot generalize our conclusions to Mexico as a whole, the results demonstrate important problems with the quality of the main source of information for causes of death used by decision-makers in settings with highly technological vital registration systems. It is necessary to improve death certification procedures, especially in the case of child and neonatal deaths. This requires an important commitment from the health system and health institutions. PMID:21816103

  7. Agreement on Cause of Death Between Proxies, Death Certificates, and Clinician Adjudicators in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

    PubMed Central

    Halanych, Jewell H.; Shuaib, Faisal; Parmar, Gaurav; Tanikella, Rajasekhar; Howard, Virginia J.; Roth, David L.; Prineas, Ronald J.; Safford, Monika M.

    2011-01-01

    Death certificates may lack accuracy and misclassify the cause of death. The validity of proxy-reported cause of death is not well established. The authors examined death records on 336 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a national cohort study of 30,239 community-dwelling US adults (2003–2010). Trained experts used study data, medical records, death certificates, and proxy reports to adjudicate causes of death. The authors computed agreement on cause of death from the death certificate, proxy, and adjudication, as well as sensitivity and specificity for certain diseases. Adjudicated cause of death had a higher rate of agreement with proxy reports (73%; Cohen's kappa (κ) statistic = 0.69) than with death certificates (61%; κ = 0.54). The agreement between proxy reports and adjudicators was better than agreement with death certificates for all disease-specific causes of death. Using the adjudicator assessments as the “gold standard,” for disease-specific causes of death, proxy reports had similar or higher specificity and higher sensitivity (sensitivity = 50%–89%) than death certificates (sensitivity = 31%–81%). Proxy reports may be more concordant with adjudicated causes of death than with the causes of death listed on death certificates. In many settings, proxy reports may represent a better strategy for determining cause of death than reliance on death certificates. PMID:21540327

  8. Occupation and bladder cancer: a death-certificate study.

    PubMed Central

    Dolin, P. J.; Cook-Mozaffari, P.

    1992-01-01

    Occupational statements on death certificates of 2,457 males aged 25-64 who died from bladder cancer in selected coastal and estaurine regions of England and Wales during 1965-1980 were studied. Excess mortality was found for deck and engine room crew of ships, railway workers, electrical and electronic workers, shoemakers and repairers, and tobacco workers. An excess of cases also occurred among food workers, particularly those employed in the bread and flour confectionary industry or involved in the extraction of animal and vegetable oils and fats. Use of a job-exposure matrix revealed elevated risk for occupations in which most workers were exposed to paints and pigments, benzene and cutting oils. PMID:1520596

  9. Death certification and epidemiological research. Medical Services Study Group of the Royal College of Physicians of London.

    PubMed Central

    1978-01-01

    The cause of death shown on 191 death certificates was compared with the cause indicated by the hospital case notes, the consultants' opinions, and the necropsy findings. All 191 deaths occurred among medical hospital patients aged under 50. In 39 cases there was a major discrepancy between the two sources over the cause of death and in another 54 ther was a minor but epidemiologically important difference. Death certificates are not primarily intended for epidemiological research, but researchers often rely on them. This and other studies have shown, however, that death certificates are often inaccurate records of the cause of death--even coroner's certificates issued after a coroner's necropsy. The accuracy of death certificates might be improved if coroners consulted clinicians more closely and if senior hospital staff completed hospital death certificates. PMID:709220

  10. Certification-Based Process Analysis

    NASA Technical Reports Server (NTRS)

    Knight, Russell L.

    2013-01-01

    Space mission architects are often challenged with knowing which investment in technology infusion will have the highest return. Certification-based analysis (CBA) gives architects and technologists a means to communicate the risks and advantages of infusing technologies at various points in a process. Various alternatives can be compared, and requirements based on supporting streamlining or automation can be derived and levied on candidate technologies. CBA is a technique for analyzing a process and identifying potential areas of improvement. The process and analysis products are used to communicate between technologists and architects. Process means any of the standard representations of a production flow; in this case, any individual steps leading to products, which feed into other steps, until the final product is produced at the end. This sort of process is common for space mission operations, where a set of goals is reduced eventually to a fully vetted command sequence to be sent to the spacecraft. Fully vetting a product is synonymous with certification. For some types of products, this is referred to as verification and validation, and for others it is referred to as checking. Fundamentally, certification is the step in the process where one insures that a product works as intended, and contains no flaws.

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

    PubMed Central

    2011-01-01

    Background Since most patients prefer out-of-hospital death, place of death can be considered an indicator of end-of-life care quality. The study of trends in place of death is necessary to examine causes of shifts, to evaluate efforts to alter place of death and develop future policies. This study aims to examine past trends and future projections of place of death. Methods Analysis of death certificates (decedents aged ≥ 1 year) in Belgium (Flanders and Brussels Capital region) 1998-2007. Trends in place of death were adjusted for cause of death, sociodemographic characteristics, environmental factors, numbers of hospital beds, and residential and skilled nursing beds in care homes. Future trends were based on age- and sex-specific mortality prognoses. Results Hospital deaths decreased from 55.1% to 51.7% and care home deaths rose from 18.3% to 22.6%. The percentage of home deaths remained stable. The odds of dying in a care home versus hospital increased steadily and was 1.65 (95%CI:1.53-1.78) in 2007 compared to 1998. This increase could be attributed to the replacement of residential beds by skilled nursing beds. Continuation of these trends would result in the more than doubling of deaths in care homes and a decrease in deaths at home and in hospital by 2040. Conclusions Additional end-of-life care resources in care homes largely explain the decrease in hospital deaths. Care homes will become the main locus of end-of-life care in the future. Governments should provide sufficient skilled nursing resources in care homes to fulfil the end-of-life care preferences and needs of patients. PMID:21489273

  12. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  13. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  14. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  15. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  16. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  17. Death certification practices of forensic physicians within the Strathclyde region of Scotland, UK.

    PubMed

    Stevenson, Richard

    2008-05-01

    Data relating to the perceived and actual cause of death, in those dying in the community is sparse. This in part is related to how each country deals with death investigations and certification of death. Under common law in Scotland, sudden unexpected deaths are referred to the Procurator Fiscal. Autopsy is not always the final arbiter of truth. While actual figures are not available at present, anecdotally the police indicate that general practitioners (GPs) are often declining to attend or certify in the vast majority of cases. The purpose of this prospective observational study was to examine the certification practice of the forensic physicians working for Strathclyde Police. In conclusion, the results from this short study indicate that in cases where the cause of death for an individual, who died suddenly in the community and where an autopsy is deemed necessary, forensic physicians are no better or worse than a pathologist in predicting the underlying reason. PMID:18423358

  18. Coroners and death certification law reform: the Coroners and Justice Act 2009 and its aftermath.

    PubMed

    Luce, Tom

    2010-10-01

    After considering various different options for half a decade, the last Government legislated in 2009 to reform the England and Wales coroner and death certification systems. The Coroners and Justice Act 2009 provides for the creation of a new Chief Coroner post to lead the jurisdiction and for local medical examiners to oversee a new death certification scheme applicable equally to burial and cremation cases. In October 2010 the new Government announced that it judges the main coroner reform to be unaffordable, will not proceed with it and plans to repeal the provisions. It intends to implement the new death certification arrangements, which is welcome. The decision to abort the main coroner reform in spite of longstanding and widespread recognition of the need for major change is deplorable though in line with other failures over the last century to properly modernise this neglected service. PMID:21539281

  19. Job strain, hypoxia and risk of amyotrophic lateral sclerosis: Results from a death certificate study.

    PubMed

    Vanacore, Nicola; Cocco, Pierluigi; Fadda, Domenica; Dosemeci, Mustafa

    2010-10-01

    Amyotrophic lateral sclerosis (ALS) most likely results from a multifactorial gene-environment interaction. Strenuous physical activity and occupational exposures have been suggested to play a role, and an abnormal response to hypoxia has been proposed in ALS pathogenesis. To test the hypothesis of an excess risk in occupations typically leading to intermittent hypoxia at the tissue level, we accessed a large publicly available database, including death certificates from 24 U.S. states in 1984-1998. We conducted a case-control analysis of 14,628 deaths due to ALS therein reported and 58,512 controls deceased from other selected causes of death, frequency matched by age, gender and broad geographic area. ALS risk associated with physical activity, and occupations leading to intermittent hypoxia, such as fire fighters and professional athletes, were calculated with unconditional logistic regression, adjusting by age, marital status, residence, and socioeconomic status. Physical activity in general did not show an association with ALS risk. Risk associated with occupation as a professional athlete was elevated (OR = 1.81, 99% CI 0.69-4.78), but not significantly so. Fire fighters showed a significant two-fold excess ALS risk (OR = 2.0; 99% CI 1.2-3.2). Based on our findings and the current clinical, epidemiological and experimental evidence, we suggest that occupational conditions typically leading to intermittent hypoxia, such as fire fighting, might be an ALS risk factor in subjects genetically prone to an abnormal response to hypoxia. PMID:20698805

  20. The suitability of using death certificates as a data source for cancer mortality assessment in Turkey

    PubMed Central

    Ulus, Tumer; Yurtseven, Eray; Cavdar, Sabanur; Erginoz, Ethem; Erdogan, M. Sarper

    2012-01-01

    Aim To compare the quality of the 2008 cancer mortality data of the Istanbul Directorate of Cemeteries (IDC) with the 2008 data of International Agency for Research on Cancer (IARC) and Turkish Statistical Institute (TUIK), and discuss the suitability of using this databank for estimations of cancer mortality in the future. Methods We used 2008 and 2010 death records of the IDC and compared it to TUIK and IARC data. Results According to the WHO statistics, in Turkey in 2008 there were 67 255 estimated cancer deaths. As the population of Turkey was 71 517 100, the cancer mortality rate was 9.4 per 10 000. According to the IDC statistics, the cancer mortality rate in Istanbul in 2008 was 5.97 per 10 000. Conclusion IDC estimates were higher than WHO estimates probably because WHO bases its estimates on a sample group and because of the restrictions of IDC data collection method. Death certificates could be a reliable and accurate data source for mortality statistics if the problems of data collection are solved. PMID:23100210

  1. 38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...; General § 10.24 Payment of death claim on lost, destroyed or mutilated adjusted service certificate with..., the adjusted service certificate was lost, destroyed, or so defaced as to impair its value and...

  2. Discrepancies in death certificates, public health registries, and judicial determinations in Italy.

    PubMed

    Minelli, Natalia; Marchetti, Daniela

    2013-05-01

    The death certificate is mandated by civil law and serves as a medical-scientific document useful for biostatistics and epidemiological research. For a variety of reasons, death certificates can be misclassified. We reviewed data from self-inflicted deaths collected over an 8-year period by the Forensic Institute of the University Sacro Cuore of Rome (Italy). Four hundred and thirty-five of 2904 were classified as self-inflicted deaths (15%). The comparison with death certificates processed by the local public health authority (ASL) and by the Italian National Census Bureau (Istat) and with the judicial investigation results available in the Italian Penal Court archive shows some discrepancies. One-hundred and twenty-four of 435 deaths were not considered to be self-inflicted but due to a crime (29% overrecording suicide) with a higher reduction for women, suggesting that it is easier to confuse a murder for suicide in female cases. Any discrepancies between the mortality and crime data are discussed in details. PMID:23488733

  3. Hyaline membrane disease is underreported in a linked birth-infant death certificate database.

    PubMed Central

    Hamvas, A; Kwong, P; DeBaun, M; Schramm, W; Cole, F S

    1998-01-01

    OBJECTIVE: This study compared the Missouri State Department of Health linked birth-infant death certificate database and medical records with respect to recording hyaline membrane disease in very low-birth-weight infants. METHODS: We reviewed the records for all 976 infants weighing 500 to 1500 g who were born to St. Louis, Mo, residents in 1989, 1991, and 1992. RESULTS: Eighteen percent of the birth certificates and 54% of the medical records documented hyaline membrane disease, resulting in 34% sensitivity and 99% specificity. CONCLUSIONS: The Missouri State Department of Health birth-infant death certificate database underestimates the incidence of hyaline membrane disease, which suggest that national statistics for the disease are also underestimated. PMID:9736884

  4. Comments on "Teen Suicide and Changing Cause-of-Death Certification, 1953-1987."

    ERIC Educational Resources Information Center

    Smith, Kim

    1991-01-01

    Responds to previous article by Males on teenage suicides and changing cause-of-death certification from 1953 through 1987. After closely examining Males' arguments, author comes to different conclusions concerning increase in teenage suicides during that time period. Concludes that increase in youth suicide is real and that increase is twice that…

  5. Comments on "Teen Suicide and Changing Cause-of-Death Certification, 1953-1987."

    ERIC Educational Resources Information Center

    Smith, Kim

    1991-01-01

    Responds to previous article by Males on teenage suicides and changing cause-of-death certification from 1953 through 1987. After closely examining Males' arguments, author comes to different conclusions concerning increase in teenage suicides during that time period. Concludes that increase in youth suicide is real and that increase is twice that

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

    PubMed

    Jalal, Kabir; Carter, Randy L

    2015-09-01

    For confidentiality reasons, US federal death certificate data are incomplete with regards to the dates of birth and death for the decedents, making calculation of total lifetime of a decedent impossible and thus estimation of mortality incidence difficult. This paper proposes the use of natality data and an imputation-based method to estimate age-specific mortality incidence rates in the face of this missing information. By utilizing previously determined probabilities of birth, a birth date and death date are imputed for every decedent in the dataset. Thus, the birth cohort of each individual is imputed, and the total on-study time can be calculated. This idea is implemented in two approaches for estimation of mortality incidence rates. The first is an extension of a person-time approach, while the second is an extension of a life table approach. Monte Carlo simulations showed that both approaches perform well in comparison to the ideal complete data methods, but that the person-time method is preferred. An application to Tay-Sachs disease is demonstrated. It is concluded that the imputation methods proposed provide valid estimates of the incidence of death from death certificate data without the need for additional assumptions under which usual mortality rates provide valid estimates. PMID:26080753

  7. Why are a quarter of all cancer deaths in south-east England registered by death certificate only? Factors related to death certificate only registrations in the Thames Cancer Registry between 1987 and 1989.

    PubMed Central

    Pollock, A. M.; Vickers, N.

    1995-01-01

    This paper describes the results of a study set up to investigate factors associated with the high proportions of 'death certificate only' registrations (DCOs) for all cancers registered in south-east England between 1987 and 1989 and to identify those which might be subject to registry intervention. DCOs as a proportion of all registrations (n = 162,131) were analysed by age, sex, district of residence, place of death and survival. DCO registration ratios (standardised for age and sex) were then derived for each of the 56 districts in the Thames Regions. A multiple logistic regression model was generated to estimate the effect of age at diagnosis, tumour survival and patient sex on final source of registration. To minimise the number of dummy variables needed, each of the 56 districts was ranked into quartiles: quartile 1 contained the 14 districts with the lowest age- and sex-standardised ratios for DCO registrations and quartile 4 comprised the 14 districts with the highest DCO ratios. Final source of registration was treated as a binomial trial (case notes or death certificates). The significance of associations was measured using the deviance difference as an approximate chi-square statistic. The effect of each variable on source of registration was estimated as an odds ratio. Interaction terms were also fitted. To estimate the effect of place of death on DCO registrations, a second model was generated for deceased patients only (n = 98,455, adding 'place of death' to the list of explanatory variables already used. A further interaction term was fitted to account for interaction between place of death and district quartile of residence. Around 24% of all patient deaths were registered as DCOs by the Thames Cancer Registry between 1987 and 1989. Of these, 40.9% died in an acute NHS hospital setting, 37.1% died at home, 10.4% died in hospices and 3.4% died in non-NHS hospitals. Increasing age, decreasing survival, district of residence and place of death were positively associated with death certificate registrations. The district effect was sustained in the regression model with significant positive associations shown for DHA quartile of residence. In the deceased group of patients, both district of residence and place of death were independent predictors of DCOs. Death occurring outside the acute NHS hospital setting increased the odds of being a DCO within and across district quartiles. DCOs could be reduced by better case ascertainment in some districts.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7880750

  8. Performance-Based Teacher Certification: A Survey of The States.

    ERIC Educational Resources Information Center

    Roth, Robert A.

    This report contains information on performance-based or competency-based teacher certification in each of the 50 states and the District of Columbia. The existing and/or planned requirements in each of the states for performance-based certification are listed. It is noted that a certification system is considered performance-based when it…

  9. State Variation in Underreporting of Alcohol Involvement on Death Certificates: Motor Vehicle Traffic Crash Fatalities as an Example

    PubMed Central

    Castle, I-Jen P; Yi, Hsiao-Ye; Hingson, Ralph W; White, Aaron M

    2014-01-01

    Objective: We used motor vehicle traffic (MVT) crash fatalities as an example to examine the extent of underreporting of alcohol involvement on death certificates and state variations. Method: We compared MVT-related death certificates identified from national mortality data (Multiple Cause of Death [MCoD] data) with deaths in national traffic census data from the Fatality Analysis Reporting System (FARS). Because MCoD data were not individually linked to FARS data, the comparisons were at the aggregate level. Reporting ratio of alcohol involvement on death certificates was thus computed as the prevalence of any mention of alcohol-related conditions among MVT deaths in MCoD, divided by the prevalence of decedents with blood alcohol concentration (BAC) test results (not imputed) of .08% or greater in FARS. Through bivariate analysis and multiple regression, we explored state characteristics correlated with state reporting ratios. Results: Both MCoD and FARS identified about 450,000 MVT deaths in 1999–2009. Reporting ratio was only 0.16 for all traffic deaths and 0.18 for driver deaths nationally, reflecting that death certificates captured only a small percentage of MVT deaths involving BAC of .08% or more. Reporting ratio did not improve over time, even though FARS indicated that the prevalence of BAC of at least .08% in MVT deaths increased from 19.9% in 1999 to 24.2% in 2009. State reporting ratios varied widely, from 0.02 (Nevada and New Jersey) to 0.81 (Delaware). Conclusions: The comparison of MCoD with FARS revealed a large discrepancy in reporting alcohol involvement in MVT deaths and considerable state variation in the magnitude of underreporting. We suspect similar underreporting and state variations in alcohol involvement in other types of injury deaths. PMID:24650824

  10. Complete republication: National Association of Medical Examiners position paper: Recommendations for the investigation, diagnosis, and certification of deaths related to opioid drugs.

    PubMed

    Davis, Gregory G

    2014-03-01

    The American College of Medical Toxicology and the National Association of Medical Examiners convened an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis, interpretation of toxicology findings, and death certification to improve the precision of death certificate data available for public health surveillance. The panel finds the following: 1. A complete autopsy is necessary for optimal interpretation of toxicology results, which must also be considered in the context of the circumstances surrounding death, medical history, and scene findings. 2. A complete scene investigation extends to reconciliation of prescription information and pill counts. 3. Blood, urine, and vitreous humor, when available, should be retained in all cases. Blood from the femoral vein is preferable to blood from other sites. 4. A toxicological panel should be comprehensive and include opioid and benzodiazepine analytes, as well as other potent depressant, stimulant, and anti-depressant medications. 5. Interpretation of postmortem opioid concentrations requires correlation with medical history, scene investigation, and autopsy findings. 6. If death is attributed to any drug or combination of drugs (whether as cause or contributing factor), the certifier should list all the responsible substances by generic name in the autopsy report and on the death certificate. 7. The best classification for manner of death in deaths due to the misuse or abuse of opioids without any apparent intent of self-harm is "accident." Reserve "undetermined" as the manner for the rare cases in which evidence exists to support more than one possible determination. PMID:24132519

  11. 25 CFR 15.104 - Does the agency need a death certificate to prepare a probate file?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does the agency need a death certificate to prepare a probate file? 15.104 Section 15.104 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR PROBATE PROBATE OF INDIAN ESTATES, EXCEPT FOR MEMBERS OF THE OSAGE NATION AND THE FIVE CIVILIZED TRIBES...

  12. 25 CFR 15.104 - Does the agency need a death certificate to prepare a probate file?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Does the agency need a death certificate to prepare a probate file? 15.104 Section 15.104 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR PROBATE PROBATE OF INDIAN ESTATES, EXCEPT FOR MEMBERS OF THE OSAGE NATION AND THE FIVE CIVILIZED TRIBES...

  13. Occupation and five cancers: a case-control study using death certificates.

    PubMed Central

    Magnani, C; Coggon, D; Osmond, C; Acheson, E D

    1987-01-01

    A case-control approach has been used to examine mortality from five cancers--oesophagus, pancreas, cutaneous melanoma, kidney, and brain--among young and middle aged men resident in three English counties. The areas studied were chosen because they include major centres of chemical manufacture. By combining data from 20 years it was possible to look at local industries with greater statistical power than is possible using routine national statistics. Each case was matched with up to four controls of similar age who died in the same year from other causes. The occupations and industries recorded on death certificates were coded to standard classifications and risk estimates derived for each job category. Where positive associations were found the records of the cases concerned were examined in greater detail to see whether the risk was limited to specific combinations of occupation and industry. The most interesting findings to emerge were risks of brain cancer associated with the production of meat and fish products (relative risk (RR) = 9.7, 95% confidence interval (CI) 2.6-36.8) and with mineral oil refining (RR = 2.9, CI 1.2-7.0), and a cluster of four deaths from melanoma among refinery workers (RR = 16.0, CI CI 1.8-143.2). A job-exposure matrix was applied to the data but gave no strong indications of further disease associations. Local analyses of occupational mortality such as this can usefully supplement national statistics. PMID:3689708

  14. Mandated Competency-Based Teacher Certification and the Public Interest.

    ERIC Educational Resources Information Center

    Spaulding, Robert L.

    Responding to the current lack of an empirical basis for competency-based teacher certification, Georgia has mandated studies leading to the establishment of empirical criteria. In the Carroll County Competency-Based Teacher Certification Project, the instructional behaviors of some 60 certified teachers and the classroom behaviors of the…

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

    ERIC Educational Resources Information Center

    Tyrer, F.; McGrother, C.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Tyrer, F.; McGrother, C.

    2009-01-01

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

  17. Alternative Certification and the Knowledge Base for Teachers.

    ERIC Educational Resources Information Center

    Marchant, Gregory J.

    This paper identifies areas within the teaching-learning process that need to be addressed by alternative teacher certification programs. One of the major strengths of alternative teacher certification programs rests in the subject matter knowledge of their participants. Beyond this, however, there is a growing knowledge base that includes…

  18. Accreditation and certification for evidence-based design.

    PubMed

    Stichler, Jaynelle F

    2010-04-01

    The Evidence-Based Design Accreditation and Certification (EDAC) is a professional certification that validates that individuals have a core body of knowledge and experience necessary to lead and engage in an evidence-based design process for healthcare facilities. This bimonthly department expands nurse leaders' knowledge and competencies in health facility design and enables them to lead in design efforts. In this article, the vision and mission of EDAC and specific content are shared to increase nurse leaders' awareness of the certification when interviewing prospective architectural firms or for nurse leaders who aspire to have a career in the healthcare design field. PMID:20305460

  19. Risk of multiple myeloma by occupation and industry among men and women: a 24-state death certificate study.

    PubMed

    Figgs, L W; Dosemeci, M; Blair, A

    1994-11-01

    This cancer surveillance investigation uses death certificates from 24 states for the period 1984-1989 to identify multiple myeloma and occupation associations and to stimulate hypotheses. A case-control study of multiple myeloma was created from 3,159,417 certificates in which 12,148 male and female cases were frequency matched by age, race, and gender with five controls per case. We screened 231 industries and 509 occupations. Women demonstrated significant excess risk among managers and administrators, post-secondary teachers, elementary teachers, social workers, other sales workers, waitresses, and hospital maids. Men showed significant risks among computer system scientists, veterinarians, elementary teachers, authors, engineering technicians, general office supervisors, insurance adjusters, barbers, electronic repairers, supervisors of extracting industries, production supervisors, photoengravers, and grader/dozer operators. Men and women elementary school teachers demonstrated the most consistent, statistically significant increased risk of multiple myeloma. PMID:7861265

  20. A post-mortem survey on end-of-life decisions using a representative sample of death certificates in Flanders, Belgium: research protocol

    PubMed Central

    Chambaere, Kenneth; Bilsen, Johan; Cohen, Joachim; Pousset, Geert; Onwuteaka-Philipsen, Bregje; Mortier, Freddy; Deliens, Luc

    2008-01-01

    Background Reliable studies of the incidence and characteristics of medical end-of-life decisions with a certain or possible life shortening effect (ELDs) are indispensable for an evidence-based medical and societal debate on this issue. This article presents the protocol drafted for the 2007 ELD Study in Flanders, Belgium, and outlines how the main aims and challenges of the study (i.e. making reliable incidence estimates of end-of-life decisions, even rare ones, and describing their characteristics; allowing comparability with past ELD studies; guaranteeing strict anonymity given the sensitive nature of the research topic; and attaining a sufficient response rate) are addressed in a post-mortem survey using a representative sample of death certificates. Study design Reliable incidence estimates are achievable by using large at random samples of death certificates of deceased persons in Flanders (aged one year or older). This entails the cooperation of the appropriate administrative authorities. To further ensure the reliability of the estimates and descriptions, especially of less prevalent end-of-life decisions (e.g. euthanasia), a stratified sample is drawn. A questionnaire is sent out to the certifying physician of each death sampled. The questionnaire, tested thoroughly and avoiding emotionally charged terms is based largely on questions that have been validated in previous national and European ELD studies. Anonymity of both patient and physician is guaranteed through a rigorous procedure, involving a lawyer as intermediary between responding physicians and researchers. To increase response we follow the Total Design Method (TDM) with a maximum of three follow-up mailings. Also, a non-response survey is conducted to gain insight into the reasons for lack of response. Discussion The protocol of the 2007 ELD Study in Flanders, Belgium, is appropriate for achieving the objectives of the study; as past studies in Belgium, the Netherlands, and other European countries have shown, strictly anonymous and thorough surveys among physicians using a large, stratified, and representative death certificate sample are most suitable in nationwide studies of incidence and characteristics of end-of-life decisions. There are however also some limitations to the study design. PMID:18752659

  1. Certificates.

    PubMed

    Fry, F

    1994-06-01

    The Concise Oxford English Dictionary defines 'dilemma' as "an argument forcing one to choose one of two alternatives both unfavourable to him (or her)". This is situation that frequently confronts the general practitioner. In this article a personal solution to the problem of 'certificates' is presented. Not every one will necessarily agree with the solutions presented and some may find them unacceptable, or have better solutions. The author warmly welcomes correspondence, either personal, or in the form of Letters to the Editor, as this is a subject in which consensus decisions are important. PMID:8053842

  2. A Program Certification Assistant Based on Fully Automated Theorem Provers

    NASA Technical Reports Server (NTRS)

    Denney, Ewen; Fischer, Bernd

    2005-01-01

    We describe a certification assistant to support formal safety proofs for programs. It is based on a graphical user interface that hides the low-level details of first-order automated theorem provers while supporting limited interactivity: it allows users to customize and control the proof process on a high level, manages the auxiliary artifacts produced during this process, and provides traceability between the proof obligations and the relevant parts of the program. The certification assistant is part of a larger program synthesis system and is intended to support the deployment of automatically generated code in safety-critical applications.

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

    ERIC Educational Resources Information Center

    Males, Mike

    1991-01-01

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

  4. The environmental impact statement: an important addition to the certification of early deaths.

    PubMed

    Pacy, H

    1978-05-20

    An environmental impact statement (EIS) has been made in conjunction with a prospective study of 56 consecutive deaths of persons under 60 years of age in a local population. EIS is the cheapest and the quickest means by which to continually highlight the weaknesses of a national health system. PMID:683064

  5. Windshear certification data base for forward-look detection systems

    NASA Technical Reports Server (NTRS)

    Switzer, George F.; Hinton, David A.; Proctor, Fred H.

    1994-01-01

    Described is an introduction to a comprehensive database that is to be used for certification testing of airborne forward-look windshear detection systems. The database was developed by NASA Langley Research Center, at the request of the Federal Aviation Administration (FAA), to support the industry initiative to certify and produce forward-looking windshear detection equipment. The database contains high-resolution three-dimensional fields for meteorological variables that may be sensed by forward-looking systems. The database is made up of seven case studies that are generated by the Terminal Area Simulation System, a state-of-the-art numerical system for the realistic modeling of windshear phenomena. The selected cases contained in the certification documentation represent a wide spectrum of windshear events. The database will be used with vendor-developed sensor simulation software and vendor-collected ground-clutter data to demonstrate detection performance in a variety of meteorological conditions using NASA/FAA pre-defined path scenarios for each of the certification cases. A brief outline of the contents and sample plots from the database documentation are included. These plots show fields of hazard factor, or F-factor (Bowles 1990), radar reflectivity, and velocity vectors on a horizontal plane overlayed with the applicable certification paths. For the plot of the F-factor field the region of 0.105 and above signify an area of hazardous, performance decreasing windshear, while negative values indicate regions of performance increasing windshear. The values of F-factor are based on 1-Km averaged segments along horizontal flight paths, assuming an air speed of 150 knots (approx. 75 m/s). The database has been released to vendors participating in the certification process. The database and associated document have been transferred to the FAA for archival storage and distribution.

  6. Efficient Certificate-Based Signcryption Secure against Public Key Replacement Attacks and Insider Attacks

    PubMed Central

    Li, Jiguo

    2014-01-01

    Signcryption is a useful cryptographic primitive that achieves confidentiality and authentication in an efficient manner. As an extension of signcryption in certificate-based cryptography, certificate-based signcryption preserves the merits of certificate-based cryptography and signcryption simultaneously. In this paper, we present an improved security model of certificate-based signcryption that covers both public key replacement attack and insider security. We show that an existing certificate-based signcryption scheme is insecure in our model. We also propose a new certificate-based signcryption scheme that achieves security against both public key replacement attacks and insider attacks. We prove in the random oracle model that the proposed scheme is chosen-ciphertext secure and existentially unforgeable. Performance analysis shows that the proposed scheme outperforms all the previous certificate-based signcryption schemes in the literature. PMID:24959606

  7. Space Based Range Demonstration and Certification (SBRDC)

    NASA Technical Reports Server (NTRS)

    Sakahara, Robert

    2005-01-01

    This viewgraph presentation describes the development, utilization and testing of technologies for range safety and range user systems. The contents include: 1) Space Based Range (SBR) Goals and Objectives; 2) Today s United States Range; 3) Future Range; 4) Another Vision for the Future Range; 5) STARS Project Goals; 6) STARS Content; 7) STARS Configuration Flight Demonstrations 1 & 2; 8) Spaceport And Range Technologies STARS Objectives and Results; 9) Spaceport And Range Technologies STARS FD2 Objectives; 10) Range Safety Hardware; 11) Range User Hardware; and 12) Past/Future Flight Demo Plans

  8. Reversal of English trend towards hospital death in dementia: a population-based study of place of death and associated individual and regional factors, 2001–2010

    PubMed Central

    2014-01-01

    Background England has one of the highest rates of hospital death in dementia in Europe. How this has changed over time is unknown. This study aimed to analyse temporal trends in place of death in dementia over a recent ten year period. Methods Population-based study linking Office for National Statistics mortality data with regional variables, in England 2001–2010. Participants were adults aged over 60 with a death certificate mention of dementia. Multivariable Poisson regression was used to determine the proportion ratio (PR) for death in care home (1) and home/hospice (1) compared to hospital (0). Explanatory variables included individual factors (age, gender, marital status, underlying cause of death), and regional variables derived at area level (deprivation, care home bed provision, urbanisation). Results 388,899 deaths were included. Most people died in care homes (55.3%) or hospitals (39.6%). A pattern of increasing hospital deaths reversed in 2006, with a subsequent decrease in hospital deaths (−0.93% per year, 95% CI −1.08 to −0.79 p < 0.001), and an increase in care home deaths (0.60% per year, 95% CI 0.45 to 0.75 p < 0.001). Care home death was more likely with older age (PR 1.11, 1.10 to 1.13), and in areas with greater care home bed provision (PR 1.82, 1.79 to 1.85) and affluence (PR 1.29, 1.26 to 1.31). Few patients died at home (4.8%) or hospice (0.3%). Home/hospice death was more likely in affluent areas (PR 1.23, 1.18 to 1.29), for women (PR 1.61, 1.56 to 1.65), and for those with cancer as underlying cause of death (PR 1.84, 1.77 to 1.91), and less likely in the unmarried (PRs 0.51 to 0.66). Conclusions Two in five people with dementia die in hospital. However, the trend towards increasing hospital deaths has reversed, and care home bed provision is key to sustain this. Home and hospice deaths are rare. Initiatives which aim to support the end of life preferences for people with dementia should be investigated. PMID:24666928

  9. GPS-based certification for the microwave landing system

    NASA Technical Reports Server (NTRS)

    Thornton, C. L.; Young, L. E.; Wu, S. C.; Thomas, J. B.

    1984-01-01

    An MLS (microwave landing system) certification system based on the Global Positioning System (GPS) is described. To determine the position history of the flight inspection aircraft during runway approach, signals from the GPS satellites, together with on-board radar altimetry, are used. It is shown that the aircraft position relative to a fixed point on the runway at threshold can be determined to about 30 cm vertically and 1 m horizontally. A requirement of the system is that the GPS receivers be placed on each flight inspection aircraft and at selected ground sites. The effects of different error sources on the determination of aircraft instantaneous position and its dynamics are analyzed.

  10. Rectal temperature-based death time estimation in infants.

    PubMed

    Igari, Yui; Hosokai, Yoshiyuki; Funayama, Masato

    2016-03-01

    In determining the time of death in infants based on rectal temperature, the same methods used in adults are generally used. However, whether the methods for adults are suitable for infants is unclear. In this study, we examined the following 3 methods in 20 infant death cases: computer simulation of rectal temperature based on the infinite cylinder model (Ohno's method), computer-based double exponential approximation based on Marshall and Hoare's double exponential model with Henssge's parameter determination (Henssge's method), and computer-based collinear approximation based on extrapolation of the rectal temperature curve (collinear approximation). The interval between the last time the infant was seen alive and the time that he/she was found dead was defined as the death time interval and compared with the estimated time of death. In Ohno's method, 7 cases were within the death time interval, and the average deviation in the other 12 cases was approximately 80min. The results of both Henssge's method and collinear approximation were apparently inferior to the results of Ohno's method. The corrective factor was set within the range of 0.7-1.3 in Henssge's method, and a modified program was newly developed to make it possible to change the corrective factors. Modification A, in which the upper limit of the corrective factor range was set as the maximum value in each body weight, produced the best results: 8 cases were within the death time interval, and the average deviation in the other 12 cases was approximately 80min. There was a possibility that the influence of thermal isolation on the actual infants was stronger than that previously shown by Henssge. We conclude that Ohno's method and Modification A are useful for death time estimation in infants. However, it is important to accept the estimated time of death with certain latitude considering other circumstances. PMID:26980252

  11. Certificate-based authorization policy in a PKI environment

    SciTech Connect

    Thompson, Mary R.; Essiari, Abdelilah; Mudumbai, Srilekha

    2003-02-15

    The major emphasis of Public Key Infrastructure has been to provide acryptographically secure means of authenticating identities. However, procedures for authorizing the holders of these identities to perform specific actions still need additional research and development. While there are a number of proposed standards for authorization structures and protocols such as KeyNote, SPKI and SAML based on X.509 or other key-based identities, none have been widely adopted. As part of an effort to use X.509 identities to provide authorization in highly distributed environments, we have developed and deployed an authorization service based on X.509 identified users and access policy contained in certificates signed by X.509 identified stakeholders. The major goal of this system, called Akenti, is to produce a usable authorization system for an environment consisting of distributed resources used by geographically and administratively distributed users. Akenti assumes communication between user s and resources over a secure protocol such as Transport Layer Security(TLS) to provide mutual authentication with X.509 certificates. This paper explains the authorization model and policy language used by Akenti, and how we have implemented an Apache authorization module to provide Akenti authorization.

  12. Ensuring that education, certification, and practice are evidence based.

    PubMed

    Fleming-Castaldy, Rita P; Gillen, Glen

    2013-01-01

    The occupational therapy profession has put forth a vision for evidence-based practice. Although many practitioners express a commitment to the provision of services informed by evidence, the reality that tradition still determines much of our education, certification, and practice cannot be ignored. In this article, we highlight the disconnect between the profession's aspirations and actual practices using neurophysiological models as an example. We describe actions to actualize the shift from traditional interventions to evidence-based approaches. We challenge readers to become agents of change and facilitate a culture shift to a profession informed by evidence. It is our hope that this article will provoke critical discourse among educators, practitioners, authors, and editors about why a reluctance to let go of unsubstantiated traditions and a hesitancy to embrace scientific evidence exist. A shift to providing evidence-based occupational therapy will enable us to meet the objectives of the Centennial Vision. PMID:23597695

  13. Community-based surveillance of maternal deaths in rural Ghana

    PubMed Central

    Adomako, Joseph; Asare, Gloria Q; Ofosu, Anthony; Iott, Bradley E; Anthony, Tiffany; Momoh, Andrea S; Warner, Elisa V; Idrovo, Judy P; Ward, Rachel

    2016-01-01

    Abstract Objective To examine the feasibility and effectiveness of community-based maternal mortality surveillance in rural Ghana, where most information on maternal deaths usually comes from retrospective surveys and hospital records. Methods In 2013, community-based surveillance volunteers used a modified reproductive age mortality survey (RAMOS 4+2) to interview family members of women of reproductive age (13–49 years) who died in Bosomtwe district in the previous five years. The survey comprised four yes–no questions and two supplementary questions. Verbal autopsies were done if there was a positive answer to at least one yes–no question. A mortality review committee established the cause of death. Findings Survey results were available for 357 women of reproductive age who died in the district. A positive response to at least one yes–no question was recorded for respondents reporting on the deaths of 132 women. These women had either a maternal death or died within one year of termination of pregnancy. Review of 108 available verbal autopsies found that 64 women had a maternal or late maternal death and 36 died of causes unrelated to childbearing. The most common causes of death were haemorrhage (15) and abortion (14). The resulting maternal mortality ratio was 357 per 100 000 live births, compared with 128 per 100 000 live births derived from hospital records. Conclusion The community-based mortality survey was effective for ascertaining maternal deaths and identified many deaths not included in hospital records. National surveys could provide the information needed to end preventable maternal mortality by 2030. PMID:26908958

  14. Statewide Systematic Evaluation of Sudden, Unexpected Infant Death Classification: Results from a National Pilot Project

    PubMed Central

    Kryscio, Richard; Holsinger, James W.; Krous, Henry F.

    2009-01-01

    The Centers for Disease Control and Prevention funded seven states, including Kentucky, to clarify statewide death certification practices in sudden, unexpected infant death and compare state performances with national expectations. Accurate assignment of the cause and manner of death in cases of sudden, unexpected infant death is critical for accurate vital statistics data to direct limited resources to appropriate targets, and to implement optimal and safe risk reduction strategies. The primary objectives are to (1) Compare SUID death certifications recommended by the KY medical examiners with the stated cause of death text field on the hard copy death electronic death certificates and (2) Compare KY and national SUID rates. Causes of death for SUID cases recommended by the medical examiners and those appearing on the hard copy and electronic death certificates in KY were collected retrospectively for 2004 and 2005. Medical examiner recommendations were based upon a classification scheme devised by them in 2003. Coroners hard copy death certificates and the cause of death rates in KY were compared to those occurring nationally. Eleven percent of infants dying suddenly and unexpectedly did not undergo autopsy during the study interval. The KY 2003 classification scheme for SIDS is at variance with the NICHD and San Diego SIDS definitions. Significant differences in causes of death recommended by medical examiners and those appearing on the hard copy and electronic death certificates were identified. SIDS rates increased in KY in contrast to decreasing rates nationally. Nationwide adoption of a widely used SIDS definition, such as that proposed in San Diego in 2004 as well as legislation by states to ensure autopsy in all cases of sudden unexpected infant death are recommended. Medical examiners’ recommendations for cause of death should appear on death certificates. Multidisciplinary pediatric death review teams prospectively evaluating cases before death certification is recommended. Research into other jurisdictions death certification process is encouraged. PMID:19771503

  15. Vocational Certification in Office Education through Competency-Based Performance

    ERIC Educational Resources Information Center

    Kruzel, Sandra

    1978-01-01

    A Vocational Certificate of Completion is given by the Ohio State Department of Education to each vocational student to verify that the student has satisfactorily completed a vocational program. The author describes a plan in the senior stenography program at her high school to match the certificate's employment skill levels with competency-based…

  16. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.20 Application for recognition based on certification. To apply for recognition and certification of a State home for adult day health care, a...

  17. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  18. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  19. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  20. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  1. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  2. Using a State Teacher Certification Test to Assess an Inquiry-Based Science Education Program

    ERIC Educational Resources Information Center

    Otto, Charlotte A.; Everett, Susan A.; Moyer, Richard H.; Zitzewitz, Paul W.

    2012-01-01

    In this study, we looked at the impact of our specially designed inquiry-based science courses for pre-service elementary teachers on their science content knowledge as measured by a high-stakes state certification test for elementary education. We conducted a pre/post-analysis of the certification test scores of 1,003 pre-service teachers. Cohort…

  3. The credentialing of a population-based health profession: lessons learned from health education certification.

    PubMed

    Livingood, W C; Auld, M E

    2001-07-01

    This article summarizes research and issues related to health education certification. Health education's experience with certification provides valuable insight for other public health professions because of the credential's population-based emphasis, its recent development, and its broadly defined cross-cutting skill set. Although data are still emerging on the outcomes of health education certification, most studies indicate that it has had a positive impact across multiple dimensions. Critical to this success has been providing profession-wide opportunities for input, communicating with key stakeholders, establishing an independent credentialing agency, and basing the credential on scientifically and legally defensible competencies that are linked to job responsibilities. PMID:11434038

  4. Coherent state quantum key distribution based on entanglement sudden death

    NASA Astrophysics Data System (ADS)

    Jaeger, Gregg; Simon, David; Sergienko, Alexander V.

    2016-03-01

    A method for quantum key distribution (QKD) using entangled coherent states is discussed which is designed to provide key distribution rates and transmission distances surpassing those of traditional entangled photon pair QKD by exploiting entanglement sudden death. The method uses entangled electromagnetic signal states of `macroscopic' average photon numbers rather than single photon or entangled photon pairs, which have inherently limited rate and distance performance as bearers of quantum key data. Accordingly, rather than relying specifically on Bell inequalities as do entangled photon pair-based methods, the security of this method is based on entanglement witnesses and related functions.

  5. Developing a University-Based Alternative Teacher Certification Program.

    ERIC Educational Resources Information Center

    Littleton, Mark

    Using guidelines established for alternative certification, Tarleton State University (Texas) has developed an accelerated teacher education program that allows nontraditional students to enter the teaching profession in an expedient and professional manner. The Tarleton Model for Accelerated Teacher Education (TMATE) was initiated and established…

  6. The effectiveness of market-based conservation in the tropics: forest certification in Ecuador and Bolivia.

    PubMed

    Ebeling, Johannes; Yasué, Maï

    2009-02-01

    During the last decade, forest certification has gained momentum as a market-based conservation strategy in tropical forest countries. Certification has been promoted to enhance forest management in countries where governance capacities are insufficient to adequately manage natural resources and enforce pertinent regulations, given that certification relies largely on non-governmental organisations and private businesses. However, at present there are few tropical countries with large areas of certified forests. In this study, we conducted semi-structured stakeholder interviews in Ecuador and Bolivia to identify key framework conditions that influence the costs and benefits for companies to switch from conventional to certified forestry operations. Bolivia has a much greater relative area under certified forest management than Ecuador and also significantly more certified producers. The difference in the success of certification between both countries is particularly notable because Bolivia is a poorer country with more widespread corruption, and is landlocked with less access to export routes. Despite these factors, several characteristics of the Bolivian forest industry contribute to lower additional costs of certified forest management compared to Ecuador. Bolivia has stronger government enforcement of forestry regulations a fact that increases the cost of illegal logging, management units are larger, and vertical integration in the process chain from timber extraction to markets is higher. Moreover, forestry laws in Bolivia are highly compatible with certification requirements, and the government provides significant tax benefits to certified producers. Results from this study suggest that certification can be successful in countries where governments have limited governance capacity. However, the economic incentives for certification do not only arise from favourable market conditions. Certification is likely to be more successful where governments enforce forestry laws, provide financial incentives for certified forestry, and provide land tenure security, and where large-scale and vertically integrated forestry operations are commercially feasible. For this reason, at present, there are few developing countries where forest certification is likely to achieve widespread success. PMID:18614273

  7. Early Childhood Injury Deaths in Washington State.

    ERIC Educational Resources Information Center

    Starzyk, Patricia M.

    This paper discusses data on the deaths of children aged 1-4 years in Washington State. A two-fold approach was used in the analysis. First, Washington State death certificate data for 1979-85 were used to characterize the deaths and identify hazardous situations. Second, death certificates were linked to birth certificates of children born in…

  8. 5 CFR 843.310 - Annuity based on death of an employee.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Annuity based on death of an employee... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.310 Annuity based on death of an employee. Except as provided...

  9. 5 CFR 843.310 - Annuity based on death of an employee.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Annuity based on death of an employee... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.310 Annuity based on death of an employee. Except as provided...

  10. PVDaCS - A prototype knowledge-based expert system for certification of spacecraft data

    NASA Technical Reports Server (NTRS)

    Wharton, Cathleen; Shiroma, Patricia J.; Simmons, Karen E.

    1989-01-01

    On-line data management techniques to certify spacecraft information are mandated by increasing telemetry rates. Knowledge-based expert systems offer the ability to certify data electronically without the need for time-consuming human interaction. Issues of automatic certification are explored by designing a knowledge-based expert system to certify data from a scientific instrument, the Orbiter Ultraviolet Spectrometer, on an operating NASA planetary spacecraft, Pioneer Venus. The resulting rule-based system, called PVDaCS (Pioneer Venus Data Certification System), is a functional prototype demonstrating the concepts of a larger system design. A key element of the system design is the representation of an expert's knowledge through the usage of well ordered sequences. PVDaCS produces a certification value derived from expert knowledge and an analysis of the instrument's operation. Results of system performance are presented.

  11. Certification Framework Based on Effective Trapping for Geologic Carbon Sequestration

    SciTech Connect

    Oldenburg, Curtis M.; Bryant, Steven L.; Nicot, Jean-Philippe

    2009-01-15

    We have developed a certification framework (CF) for certifying the safety and effectiveness of geologic carbon sequestration (GCS) sites. Safety and effectiveness are achieved if CO{sub 2} and displaced brine have no significant impact on humans, other living things, resources, or the environment. In the CF, we relate effective trapping to CO{sub 2} leakage risk which takes into account both the impact and probability of leakage. We achieve simplicity in the CF by using (1) wells and faults as the potential leakage pathways, (2) compartments to represent environmental resources that may be impacted by leakage, (3) CO{sub 2} fluxes and concentrations in the compartments as proxies for impact to vulnerable entities, (4) broad ranges of storage formation properties to generate a catalog of simulated plume movements, and (5) probabilities of intersection of the CO{sub 2} plume with the conduits and compartments. We demonstrate the approach on a hypothetical GCS site in a Texas Gulf Coast saline formation. Through its generality and flexibility, the CF can contribute to the assessment of risk of CO{sub 2} and brine leakage as part of the certification process for licensing and permitting of GCS sites around the world regardless of the specific regulations in place in any given country.

  12. Classifying undetermined poisoning deaths

    PubMed Central

    Donaldson, A E; Larsen, G Y; Fullerton‐Gleason, L; Olson, L M

    2006-01-01

    Objective To classify poisoning deaths of undetermined intent as either suicide or unintentional and to estimate the extent of underreported poisoning suicides. Methods Based on 2002 statewide death certificate and medical examiner data in Utah, the authors randomly selected one half of undetermined and unintentional poisoning deaths for data abstraction and included all suicides. Bivariate analyses assessed differences in demographics, death characteristics, forensic toxicology results, mental health history, and other potentially contributing factors. Classification and regression tree (CART) analysis used information from unintentional and suicide poisoning deaths to create a classification tree that was applied to undetermined poisoning deaths. Results The authors analyzed 41 unintentional, 87 suicide, and 84 undetermined poisonings. Undetermined and unintentional decedents were similar in the presence of opiates, physical health problems, and drug abuse. Although none of the undetermined decedents left a suicide note, previous attempt or intent to commit suicide was reported for 11 (13%) of these cases. CART analysis identified suicidal behavior, drug abuse, physical health problems, depressed mood, and age as discriminating between suicide and unintentional poisoning. It is estimated that suicide rates related to poisoning are underreported by approximately 30% and overall suicide rates by 10%. Unintentional poisoning death rates were underreported by 61%. Conclusions This study suggests that manner of death determination relies on circumstance dependent variables that may not be consistently captured by medical examiners. Underreporting of suicide rates has important implications in policy development, research funding, and evaluation of prevention programs. PMID:17018678

  13. The Impact of Competency-Based Teacher Education and Certification Programs in Utah.

    ERIC Educational Resources Information Center

    Mouritsen, Roger C.

    Utah is a member of a nine-state consortium to study competency-based teacher education and certification programs. This paper presents an overview of the nationwide movement for competency-based teacher education, followed by a description of the situation in Utah. The State Board of Education is making an effort through the Teacher Education and…

  14. Multiple cause of death mortality patterns among Californians

    SciTech Connect

    White, M.C.

    1989-11-28

    The purpose of this study was to describe mortality patterns among the elderly using single versus multiple cause of death data and examine ways that multiple cause of death data can best be processed, analyzed and presented. Deaths among white California aged 65 and older for the years 1970, 1975 and 1980 were analyzed. Overall, mortality rates decreased over time, at all ages and for both sexes but more so for females, although the number of causes of death increased with age. Underlying cause mortality rates were compared to rates based on any mention of a cause on the death certificate; diabetes and atherosclerosis were more frequent causes of both than would be indicated by single cause statistics, and heart diseases other than ischemic heart disease increased in mentions on the death certificated while ischemic heart disease underlying mortality rates decreased. Pairs of causes of death showed increased likelihood of occurrence of a number of combinations of chronic diseases. In all pair combinations studied, the addition of another serious chronic disease lowered the mean age of death resulted in an older mean age of death. This result combined with higher number of causes per death but lower mortality rates among females raised interesting questions about interpreting more causes on death certificates as an indication of a sicker person at time of death. This study confirmed morbidity and mortality work on other that mortality of older adults in decreasing but that the number of causes of death per person is increasing. 82 refs., 30 figs., 59 tabs.

  15. Characteristics of Belgian “life-ending acts without explicit patient request”: a large-scale death certificate survey revisited

    PubMed Central

    Chambaere, Kenneth; Bernheim, Jan L.; Downar, James; Deliens, Luc

    2014-01-01

    Background “Life-ending acts without explicit patient request,” as identified in robust international studies, are central in current debates on physician-assisted dying. Despite their contentiousness, little attention has been paid to their actual characteristics and to what extent they truly represent nonvoluntary termination of life. Methods We analyzed the 66 cases of life-ending acts without explicit patient request identified in a large-scale survey of physicians certifying a representative sample of deaths (n = 6927) in Flanders, Belgium, in 2007. The characteristics we studied included physicians’ labelling of the act, treatment course and doses used, and patient involvement in the decision. Results In most cases (87.9%), physicians labelled their acts in terms of symptom treatment rather than in terms of ending life. By comparing drug combinations and doses of opioids used, we found that the life-ending acts were similar to intensified pain and symptom treatment and were distinct from euthanasia. In 45 cases, there was at least 1 characteristic inconsistent with the common understanding of the practice: either patients had previously expressed a wish for ending life (16/66, 24.4%), physicians reported that the administered doses had not been higher than necessary to relieve suffering (22/66, 33.3%), or both (7/66, 10.6%). Interpretation Most of the cases we studied did not fit the label of “nonvoluntary life-ending” for at least 1 of the following reasons: the drugs were administered with a focus on symptom control; a hastened death was highly unlikely; or the act was taken in accordance with the patient’s previously expressed wishes. Thus, we recommend a more nuanced view of life-ending acts without explicit patient request in the debate on physician-assisted dying. PMID:25485252

  16. Summary of Actions Taken by Selected States Involved in Developing Competency-Based Certification Systems.

    ERIC Educational Resources Information Center

    Pitman, John C.

    This paper reviews actions taken by selected states as they move to implement competency-based teacher education and certification systems (CBTE-CBC). Following a brief discussion of the role of the state in developing CBTE-CBC, three major issues are presented: a) the type of consortium procedures used, b) the manner in which competencies are to…

  17. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Per diem based on recognition and certification. 52.10 Section 52.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes...

  18. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Application for recognition based on certification. 52.20 Section 52.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in...

  19. Scientifically Based Research in Educational Products: Vendors and Consumers on Filling the Certification Gap

    ERIC Educational Resources Information Center

    Caruthers, Bill J.

    2009-01-01

    The 2002 reauthorization of the Elementary and Secondary Education Act, or No Child Left Behind (NCLB) changed school law in the United States. Public schools can utilize federal funds to purchase only those educational products subject to scientifically based research. No dedicated certification intermediary (CI) exists to determine individual…

  20. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing adult day health care to eligible veterans in...

  1. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  2. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  3. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  4. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  5. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

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

    PubMed Central

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

    2014-01-01

    Background Centenarians are a rapidly growing demographic group worldwide, yet their health and social care needs are seldom considered. This study aims to examine trends in place of death and associations for centenarians in England over 10 years to consider policy implications of extreme longevity. Methods and Findings This is a population-based observational study using death registration data linked with area-level indices of multiple deprivations for people aged ?100 years who died 2001 to 2010 in England, compared with those dying at ages 80-99. We used linear regression to examine the time trends in number of deaths and place of death, and Poisson regression to evaluate factors associated with centenarians place of death. The cohort totalled 35,867 people with a median age at death of 101 years (range: 100115 years). Centenarian deaths increased 56% (95% CI 53.8%57.4%) in 10 years. Most died in a care home with (26.7%, 95% CI 26.3%27.2%) or without nursing (34.5%, 95% CI 34.0%35.0%) or in hospital (27.2%, 95% CI 26.7%27.6%). The proportion of deaths in nursing homes decreased over 10 years (?0.36% annually, 95% CI ?0.63% to ?0.09%, p?=?0.014), while hospital deaths changed little (0.25% annually, 95% CI ?0.06% to 0.57%, p?=?0.09). Dying with frailty was common with old age stated in 75.6% of death certifications. Centenarians were more likely to die of pneumonia (e.g., 17.7% [95% CI 17.3%18.1%] versus 6.0% [5.9%6.0%] for those aged 8084 years) and old age/frailty (28.1% [27.6%28.5%] versus 0.9% [0.9%0.9%] for those aged 8084 years) and less likely to die of cancer (4.4% [4.2%4.6%] versus 24.5% [24.6%25.4%] for those aged 8084 years) and ischemic heart disease (8.6% [8.3%8.9%] versus 19.0% [18.9%19.0%] for those aged 8084 years) than were younger elderly patients. More care home beds available per 1,000 population were associated with fewer deaths in hospital (PR 0.98, 95% CI 0.980.99, p<0.001). Conclusions Centenarians are more likely to have causes of death certified as pneumonia and frailty and less likely to have causes of death of cancer or ischemic heart disease, compared with younger elderly patients. To reduce reliance on hospital care at the end of life requires recognition of centenarians increased likelihood to acute decline, notably from pneumonia, and wider provision of anticipatory care to enable people to remain in their usual residence, and increasing care home bed capacity. Please see later in the article for the Editors' Summary PMID:24892645

  7. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.

    PubMed

    2015-10-16

    This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs. PMID:26477063

  8. Probabilistic thinking and death anxiety: a terror management based study.

    PubMed

    Hayslip, Bert; Schuler, Eric R; Page, Kyle S; Carver, Kellye S

    2014-01-01

    Terror Management Theory has been utilized to understand how death can change behavioral outcomes and social dynamics. One area that is not well researched is why individuals willingly engage in risky behavior that could accelerate their mortality. One method of distancing a potential life threatening outcome when engaging in risky behaviors is through stacking probability in favor of the event not occurring, termed probabilistic thinking. The present study examines the creation and psychometric properties of the Probabilistic Thinking scale in a sample of young, middle aged, and older adults (n = 472). The scale demonstrated adequate internal consistency reliability for each of the four subscales, excellent overall internal consistency, and good construct validity regarding relationships with measures of death anxiety. Reliable age and gender effects in probabilistic thinking were also observed. The relationship of probabilistic thinking as part of a cultural buffer against death anxiety is discussed, as well as its implications for Terror Management research. PMID:25273680

  9. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  10. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  11. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  12. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  13. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  14. ASNT central certification program

    NASA Astrophysics Data System (ADS)

    Spring, Robert W.; Snell, John R., Jr.

    1997-04-01

    The American Society of Nondestructive Testing (ASNT) has recently established a new central certification program. This program will allow individuals who meet the requirements to receive a 'portable' certificate. Augmenting the existing employer-based certification, this program will have significant impact on industries that may ultimately require nondestructive testing (NDT) personnel to have central certification. This paper explains show ASNT has structured central certification and when and how it will effect thermal/infrared thermography (T/IRT) personnel. The paper also discusses the industry specific certification process.

  15. Place of death for the ‘oldest old’: ≥85-year-olds in the CC75C population-based cohort

    PubMed Central

    Fleming, Jane; Zhao, Jun; Farquhar, Morag; Brayne, Carol; Barclay, Stephen

    2010-01-01

    Background Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce. Aim To examine the place of residence or care of ≥85 year-olds less than a year before death, and their place of death, and to map individual changes between the two. Design of study Population-based cohort study. Setting Cambridge City over-75s Cohort (CC75C) study, UK. Method Retrospective analysis of prospective data from males and females aged ≥85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage. Results Only 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes. Conclusion More than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old. PMID:20353663

  16. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study

    PubMed Central

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-01

    Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. Population 987 audited cases of maternal death. Main outcome measures Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. Results 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. Conclusions The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to inform corrective measures. PMID:26801466

  17. 5 CFR 843.311 - Annuity based on death of a separated employee.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Annuity based on death of a separated employee. 843.311 Section 843.311 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits...

  18. Cigarette Smoking as a Risk Factor for Sudden Infant Death Syndrome: A Population-Based Study.

    ERIC Educational Resources Information Center

    Haglund, Bengt; Cnattingius, Sven

    1990-01-01

    Examines risk factors for sudden infant death syndrome based on Swedish births between 1983 and 1985. Results indicate that maternal smoking doubles the risk of infant death, and infants of smokers also died sooner. The more the mother smoked the more likely her infant was to die. (JS)

  19. Development and Effectiveness Analysis of a Personalized Ubiquitous Multi-Device Certification Tutoring System Based on Bloom's Taxonomy of Educational Objectives

    ERIC Educational Resources Information Center

    Hwang, Gwo-Haur; Chen, Beyin; Huang, Cin-Wei

    2016-01-01

    In recent years, with the gradual increase in the importance of professional certificates, improvement in certification tutoring systems has become more important. In this study, we have developed a personalized ubiquitous multi-device certification tutoring system (PUMDCTS) based on "Bloom's Taxonomy of Educational Objectives," and

  20. Development and Effectiveness Analysis of a Personalized Ubiquitous Multi-Device Certification Tutoring System Based on Bloom's Taxonomy of Educational Objectives

    ERIC Educational Resources Information Center

    Hwang, Gwo-Haur; Chen, Beyin; Huang, Cin-Wei

    2016-01-01

    In recent years, with the gradual increase in the importance of professional certificates, improvement in certification tutoring systems has become more important. In this study, we have developed a personalized ubiquitous multi-device certification tutoring system (PUMDCTS) based on "Bloom's Taxonomy of Educational Objectives," and…

  1. Possible Prevention of Neonatal Death: A Regional Population-Based Study in Japan

    PubMed Central

    Yanagi, Takahide; Ono, Tetsuo; Tsuji, Shunichiro; Takahashi, Kentaro

    2016-01-01

    Purpose The neonatal mortality rate in Japan has currently been at the lowest level in the world. However, it is unclear whether there are still some potentially preventable neonatal deaths. We, therefore, aimed to examine the backgrounds of neonatal death and the possibilities of prevention in a region of Japan. Materials and Methods This is a population-based study of neonatal death in Shiga Prefecture of Japan. Results The 103 neonatal deaths in our prefecture between 2007 and 2011 were included. After reviewing by a peer-review team, we classified the backgrounds of these neonatal deaths and analyzed end-of-life care approaches associated with prenatal diagnosis. Furthermore, we evaluated the possibilities of preventable neonatal death, suggesting specific recommendations for its prevention. We analyzed 102 (99%) of the neonatal deaths. Congenital malformations and extreme prematurity were the first and the second most common causes of death, respectively. More than half of the congenital abnormalities (59%) including malformations and chromosome abnormality had been diagnosed before births. We had 22 neonates with non-intensive care including eighteen cases with congenital abnormality and four with extreme prematurity. Twenty three cases were judged to have had some possibility of prevention with one having had a strong possibility of prevention. Among specific recommendations of preventable neonatal death, more than half of them were for obstetricians. Conclusion There is room to reduce neonatal deaths in Japan. Prevention of neonatal death requires grater prenatal care by obstetricians before birth rather than improved neonatal care by neonatologists after birth. PMID:26847296

  2. A population-based study on deaths by drowning incidents in Turkey.

    PubMed

    Turgut, Adnan; Turgut, Tevfik

    2014-01-01

    The aim of this study is to find the numbers of deaths by drowning incidents by using online search engines and online newspaper reports for all age groups covering five years (2007-2011) in Turkey, in order to conduct a population-based study for the first time in Turkey and to identify the risk factors associated with deaths from drowning. This is a web-based, descriptive, retrospective study on the deaths caused by unintentional drowning incidents. In the period of the study, 3216 persons died from drowning in Turkey; 84.0% (2703 persons) were males, and 16.0% (513 persons) were females. Death rates from drowning in overall years were 0.89; 1.44 for males, and 0.28 for females per 100,000. For persons aged between 10-19 years, the death rate was the highest with 1.76 deaths per 100,000 people. The drowning rate in provinces and districts (1.01 per 100,000) was almost twice than that in towns and villages (0.53 per 100,000) and 75.7% of all deaths were in natural water environments such as fresh/still water, and the sea. As the first population-based study on drowning, this study presents vital information to build preventative strategies and policies against drowning incidents, which threaten public health in Turkey. PMID:23330832

  3. Identification of Modules Related to Programmed Cell Death in CHD Based on EHEN

    PubMed Central

    Jia, Xu; Miao, Zhengqiang; Feng, Chenchen; Liu, Zhe; He, Yuehan; Lv, Junjie; Du, Youwen; Hou, Min; He, Weiming; Li, Danbin

    2014-01-01

    The formation and death of macrophages and foam cells are one of the major factors that cause coronary heart disease (CHD). In our study, based on the Edinburgh Human Metabolic Network (EHMN) metabolic network, we built an enzyme network which was constructed by enzymes (nodes) and reactions (edges) called the Edinburgh Human Enzyme Network (EHEN). By integrating the subcellular location information for the reactions and refining the protein-reaction relationships based on the location information, we proposed a computational approach to select modules related to programmed cell death. The identified module was in the EHEN-mitochondria (EHEN-M) and was confirmed to be related to programmed cell death, CHD pathogenesis, and lipid metabolism in the literature. We expected this method could analyze CHD better and more comprehensively from the point of programmed cell death in subnetworks. PMID:25133163

  4. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and Lead..., see 40 CFR 745.225(f)(1) for details) Initial CourseInspector Risk assessor Supervisor Worker Project... Activities—Individual Certification Re-certification (every 3 years, see 40 CFR 745.226(e)(1) for...

  5. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., see 40 CFR 745.225(f)(1) for details) Initial CourseInspector Risk assessor Supervisor Worker Project... Activities—Individual Certification Re-certification (every 3 years, see 40 CFR 745.226(e)(1) for details...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  6. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., see 40 CFR 745.225(f)(1) for details) Initial CourseInspector Risk assessor Supervisor Worker Project... Activities—Individual Certification Re-certification (every 3 years, see 40 CFR 745.226(e)(1) for details...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  7. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., see 40 CFR 745.225(f)(1) for details) Initial CourseInspector Risk assessor Supervisor Worker Project... Activities—Individual Certification Re-certification (every 3 years, see 40 CFR 745.226(e)(1) for details...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  8. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., see 40 CFR 745.225(f)(1) for details) Initial CourseInspector Risk assessor Supervisor Worker Project... Activities—Individual Certification Re-certification (every 3 years, see 40 CFR 745.226(e)(1) for details...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  9. [A study on death: an analysis based on Vigotski's dialectical method].

    PubMed

    Combinato, Denise Stefanoni; Queiroz, Marcos de Souza

    2011-09-01

    This article focuses on the concept of death and, in particular, the social construction of its meaning for a professional healthcare team working in an intensive hospital care unit. Thirteen professionals (six physicians and seven nurses) participated in the research, through semi-structured interviews. Despite the fact that death is part of the human cycle and is present in the daily working life of these health professionals, the denial of its existence imposed by the culture of the modern western world prevents the development of specific strategies to address this problem. Based on the Vigotski's dialectical method, three main conceptions of death were extracted from the interviews: death as a natural consequence of life; death as a biological process and death as a divine blessing. In the absence of a proper space for a more systematical approach, the social representations from the professionals on this theme are restricted to subjective opinions. In the conclusion, the need for change in the institutional context and in health education is emphasized, with a specific focus directed on death and on the process of dying. PMID:21987332

  10. Development of the Knowledge-Based Standard for the Written Certification Examination of the American Board of Anesthesiology.

    ERIC Educational Resources Information Center

    Slogoff, Stephen; And Others

    1992-01-01

    Application of a knowledge-based standard in evaluating a written certification examination developed by the American Board of Anesthesiology established a standard of 57 percent correct over two years' examinations. This process is recommended for developing mastery-based (rather than normative-based) success criteria for evaluation of medical…

  11. Agricultural machine-related deaths.

    PubMed Central

    Etherton, J R; Myers, J R; Jensen, R C; Russell, J C; Braddee, R W

    1991-01-01

    Analysis of 1980-1985 death certificate data for the United States indicated that an average of 369 occupational deaths per year involved agricultural machinery as the external cause of death. Out of all agricultural machine-related deaths, tractors accounted for 69 percent. Over half of these tractor-related deaths were rollovers. There is a need for public health programs to affect greater use of rollover protective structures (ROPS) on farm tractors. PMID:2029052

  12. Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey

    PubMed Central

    Chambaere, Kenneth; Bilsen, Johan; Cohen, Joachim; Onwuteaka-Philipsen, Bregje D.; Mortier, Freddy; Deliens, Luc

    2010-01-01

    Background Legalization of euthanasia and physician-assisted suicide has been heavily debated in many countries. To help inform this debate, we describe the practices of euthanasia and assisted suicide, and the use of life-ending drugs without an explicit request from the patient, in Flanders, Belgium, where euthanasia is legal. Methods We mailed a questionnaire regarding the use of life-ending drugs with or without explicit patient request to physicians who certified a representative sample (n = 6927) of death certificates of patients who died in Flanders between June and November 2007. Results The response rate was 58.4%. Overall, 208 deaths involving the use of life-ending drugs were reported: 142 (weighted prevalence 2.0%) were with an explicit patient request (euthanasia or assisted suicide) and 66 (weighted prevalence 1.8%) were without an explicit request. Euthanasia and assisted suicide mostly involved patients less than 80 years of age, those with cancer and those dying at home. Use of life-ending drugs without an explicit request mostly involved patients 80 years of older, those with a disease other than cancer and those in hospital. Of the deaths without an explicit request, the decision was not discussed with the patient in 77.9% of cases. Compared with assisted deaths with the patient’s explicit request, those without an explicit request were more likely to have a shorter length of treatment of the terminal illness, to have cure as a goal of treatment in the last week, to have a shorter estimated time by which life was shortened and to involve the administration of opioids. Interpretation Physician-assisted deaths with an explicit patient request (euthanasia and assisted suicide) and without an explicit request occurred in different patient groups and under different circumstances. Cases without an explicit request often involved patients whose diseases had unpredictable end-of-life trajectories. Although opioids were used in most of these cases, misconceptions seem to persist about their actual life-shortening effects. PMID:20479044

  13. Meeting the community halfway to reduce maternal deaths? Evidence from a community-based maternal death review in Uttar Pradesh, India

    PubMed Central

    Raj, Sunil Saksena; Maine, Deborah; Sahoo, Pratap Kumar; Manthri, Suneedh; Chauhan, Kavita

    2013-01-01

    ABSTRACT Background: Uttar Pradesh (UP) is the most populous state in India with the second highest reported maternal mortality ratio in the country. In an effort to analyze the reasons for maternal deaths and implement appropriate interventions, the Government of India introduced Maternal Death Review guidelines in 2010. Methods: We assessed causes of and factors leading to maternal deaths in Unnao District, UP, through 2 methods. First, we conducted a facility gap assessment in 15 of the 16 block-level and district health facilities to collect information on the performance of the facilities in terms of treating obstetric complications. Second, teams of trained physicians conducted community-based maternal death reviews (verbal autopsies) in a sample of maternal deaths occurring between June 1, 2009, and May 31, 2010. Results: Of the 248 maternal deaths that would be expected in this district in a year, we identified 153 (62%) through community workers and conducted verbal autopsies with families of 57 of them. Verbal autopsies indicated that 23% and 30% of these maternal deaths occurred at home and on the way to a health facility, respectively. Most of the women who died had been taken to at least 2 health facilities. The facility assessment revealed that only the district hospital met the recommended criteria for either basic or comprehensive emergency obstetric and neonatal care. Conclusions: Life-saving treatment of obstetric complications was not offered at the appropriate level of government facilities in a representative district in UP, and an inadequate referral system provided fatal delays. Expensive transportation costs to get pregnant women to a functioning medical facility also contributed to maternal death. The maternal death review, coupled with the facility gap assessment, is a useful tool to address the adequacy of emergency obstetric and neonatal care services to prevent further maternal deaths. PMID:25276519

  14. A Computer-Based Private Pilot (Airplane) Certification Exam: A First Step Toward Nation-Wide Computer-Administration of FAA Certification Exams.

    ERIC Educational Resources Information Center

    Anderson, Richard I.; Trollip, Stanley R.

    1982-01-01

    To assess the feasibility of computer-assisted Federal Aviation Administration certification examinations, a system for administering the Private Pilot Certification Examination was implemented using PLATO. Characteristics, reactions, and guidelines for use of the test are included. (Author/JJD)

  15. Child Deaths in New Jersey: Social Characteristics.

    ERIC Educational Resources Information Center

    Crowley, Charles J.

    This report discusses trends in the causes of child deaths in New Jersey in recent years and closely examines child deaths in the state in 1974. Demographic data on child deaths are reported with an emphasis on types of deaths in which neglect or nonaccidental injury are likely to have been a factor. Death certificate data were obtained from the

  16. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Certification of individuals and firms engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures. 745.229 Section 745.229 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED...

  17. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Certification of individuals and firms engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures. 745.229 Section 745.229 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED...

  18. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... material handling devices covered by § 1917.50 of this chapter, safety and health regulations for marine... Shore-Based Equipment 1919.50 Eligibility for accreditation to certificate shore-based material handling devices covered by 1917.50 of this chapter, safety and health regulations for marine...

  19. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... material handling devices covered by § 1917.50 of this chapter, safety and health regulations for marine... Shore-Based Equipment 1919.50 Eligibility for accreditation to certificate shore-based material handling devices covered by 1917.50 of this chapter, safety and health regulations for marine...

  20. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... material handling devices covered by § 1917.50 of this chapter, safety and health regulations for marine... Shore-Based Equipment 1919.50 Eligibility for accreditation to certificate shore-based material handling devices covered by 1917.50 of this chapter, safety and health regulations for marine...

  1. Workshop-based methodology to understand the risks in grain export inspection and certification.

    PubMed

    Wilson, John R; Vaegen-Lloyd, Jo-Roxy; Caponecchia, Carlo

    2009-07-01

    Much of the human factors contribution in risk assessment and risk management has been focused on systems or product safety; the profession has a much smaller research base regarding risks to do with regulation, certification and public policy, for example. This paper discusses an explicitly human factors contribution to understanding and managing risk for the inspection and export certification of grain and plant products in Australia. Training and awareness workshops, incorporating elements of focus groups, were run for 12 groups of staff and managers from the government department concerned. As well as training in risk management the workshops were used to come to an understanding of the work of the inspectors and other staff, to identify the sources of risk to the successful completion of their work and to develop the basis for a risk assessment framework and tool. The paper is methodological in focus and describes the development and running of the workshops and explains how a human factors oriented risk register was developed on the basis of identification of potential threats and errors in the system. Whilst the contribution of ergonomics is increasingly important as regards safety risk assessment, professionals have been less active as regards business, public policy and even engineering risk. This paper describes an approach within which a new domain was studied and the risks of all kinds identified, preparatory to development of a risk assessment tool. PMID:19562588

  2. Infant mortality in southern Brazil: a population based study of causes of death.

    PubMed Central

    Barros, F C; Victora, C G; Vaughan, J P; Teixeira, A M; Ashworth, A

    1987-01-01

    The causes of 215 infant deaths occurring in a population based cohort of 5914 infants from southern Brazil were determined. Perinatal problems were responsible for 43% of these deaths and infectious diseases for 32%. In the group who died of infectious diseases, respiratory infections and diarrhoea were equally important, each accounting for 12% of all deaths. A total of 87% of the deaths occurred in the first six months of life, and this proportion remained high (77%) even after perinatal causes had been excluded. On the other hand, 53% of the infants who died were of low birth weight, as opposed to 7.9% of the survivors. This suggests that low birthweight infants need to be carefully followed by health workers at primary level, especially during the first six months. It was estimated that if the incidence of low birth weight was reduced from the present 8.8% to 5% the likely reduction in infant mortality would be 20%. This reduction would be 33% for deaths due to perinatal causes, 14% for respiratory infections, and only 5% for diarrhoea. Efforts for the prevention of infant deaths in southern Brazil are more likely to be effective if they concentrate on improving perinatal health care and environmental conditions. PMID:3606182

  3. Combined prediction model of death toll for road traffic accidents based on independent and dependent variables.

    PubMed

    Feng, Zhong-xiang; Lu, Shi-sheng; Zhang, Wei-hua; Zhang, Nan-nan

    2014-01-01

    In order to build a combined model which can meet the variation rule of death toll data for road traffic accidents and can reflect the influence of multiple factors on traffic accidents and improve prediction accuracy for accidents, the Verhulst model was built based on the number of death tolls for road traffic accidents in China from 2002 to 2011; and car ownership, population, GDP, highway freight volume, highway passenger transportation volume, and highway mileage were chosen as the factors to build the death toll multivariate linear regression model. Then the two models were combined to be a combined prediction model which has weight coefficient. Shapley value method was applied to calculate the weight coefficient by assessing contributions. Finally, the combined model was used to recalculate the number of death tolls from 2002 to 2011, and the combined model was compared with the Verhulst and multivariate linear regression models. The results showed that the new model could not only characterize the death toll data characteristics but also quantify the degree of influence to the death toll by each influencing factor and had high accuracy as well as strong practicability. PMID:25610454

  4. Combined Prediction Model of Death Toll for Road Traffic Accidents Based on Independent and Dependent Variables

    PubMed Central

    Zhong-xiang, Feng; Shi-sheng, Lu; Wei-hua, Zhang; Nan-nan, Zhang

    2014-01-01

    In order to build a combined model which can meet the variation rule of death toll data for road traffic accidents and can reflect the influence of multiple factors on traffic accidents and improve prediction accuracy for accidents, the Verhulst model was built based on the number of death tolls for road traffic accidents in China from 2002 to 2011; and car ownership, population, GDP, highway freight volume, highway passenger transportation volume, and highway mileage were chosen as the factors to build the death toll multivariate linear regression model. Then the two models were combined to be a combined prediction model which has weight coefficient. Shapley value method was applied to calculate the weight coefficient by assessing contributions. Finally, the combined model was used to recalculate the number of death tolls from 2002 to 2011, and the combined model was compared with the Verhulst and multivariate linear regression models. The results showed that the new model could not only characterize the death toll data characteristics but also quantify the degree of influence to the death toll by each influencing factor and had high accuracy as well as strong practicability. PMID:25610454

  5. Two New Reference Materials Based on Tobacco Leaves: Certification for over a Dozen of Toxic and Essential Elements

    PubMed Central

    Samczyński, Zbigniew; Dybczyński, Rajmund S.; Polkowska-Motrenko, Halina; Chajduk, Ewelina; Pyszynska, Marta; Danko, Bożena; Czerska, Elżbieta; Kulisa, Krzysztof; Doner, Katarzyna; Kalbarczyk, Paweł

    2012-01-01

    The preparation, certification, and characterization of two new biological certified reference materials for inorganic trace analysis have been presented. They are based on two different varieties of tobacco leaves, namely, Oriental Basma Tobacco Leaves (INCT-OBTL-5), grown in Greece, and Polish Virginia Tobacco Leaves (INCT-PVTL-6), grown in Poland. Certification of the materials was based on the statistical evaluation of results obtained in a worldwide interlaboratory comparison, in which 87 laboratories from 18 countries participated, providing 2568 laboratory averages on nearly 80 elements. It was possible to establish the certified values of concentration for many elements in the new materials, that is, 37 in INCT-OBTL-5 and 36 in INCT-PVTL-6, including several toxic ones like As, Cd, Hg, Pb, and so forth. The share and the role of instrumental analytical techniques used in the process of certification of the new CRMs are discussed. PMID:22536124

  6. Performance on Specific Cognitive Domains and Cause of Death: A Prospective Population-Based Study in Non-Demented Older Adults (NEDICES).

    PubMed

    Benito-León, Julián; Contador, Israel; Mitchell, Alex J; Domingo-Santos, Ángela; Bermejo-Pareja, Félix

    2016-02-01

    Evidence regarding the relationship between performance on specific cognitive domains and cause of death is scarce. We assessed whether specific cognitive domains predicted mortality and the presence of any association with specific causes of death in a population-dwelling sample of non-demented older adults. In this population-based, prospective study (NEDICES), 2,390 non-demented subjects ≥65 years completed a brief neuropsychological battery. Cox's proportional hazards models, adjusted by sociodemographic and comorbidity factors, global cognitive performance, educational level, and premorbid intelligence were used to assess the risk of death. Participants were followed for a median of 9.2 years (range 0.01-10.7), after which the death certificates of those who died were examined. 880 (36.8%) of 2,390 participants died over a median follow-up of 5.5 years (range 0.01-10.5). Using adjusted Cox regression models, we found that hazard ratios for mortality in participants within the lowest tertiles (worse performance) were 1.31 (speed of cognitive processing, p = 0.03); 1.22 (semantic fluency, p = 0.04), 1.32 (delayed free recall, p = 0.003), and 1.23 (delayed logical memory, p = 0.03). Poor performance on delayed recall and speed of cognitive processing tests were associated with dementia and cerebrovascular disease mortality, respectively. Further, poor performance on semantic fluency was associated with decreased cancer mortality. In this study of community dwelling non-demented older adults, worse neuropsychological performance was associated with increased risk of mortality. Performance on specific cognitive domains were related to different causes of death. Of particular note there appears to be an inverse association between poor semantic fluency and cancer mortality. PMID:26890757

  7. PRESENT CONDITION OF FOOD WASTE RECYCLING LOOP BASED ON RECYCLING PROJECT CERTIFICATION OF THE FOOD WASTE RECYCLING LAW

    NASA Astrophysics Data System (ADS)

    Kita, Tomoko; Kanaya, Ken

    Purpose of this research is to clear present condition of food waste recycling loops based on recycling project certification of the Food Waste Recycling Law. Method of this research is questionnaire survey to companies constituting the loops. Findings of this research are as follows: 1. Proponents of the loop is most often the recycling companies. 2. Food waste recycling rate is 61% for the food retailing industry and 81% for the food service industry. These values are higher than the national average in 2006. The effect of the revision of recycling project certification is suggested.

  8. The Issue of Death and Dying: Employing Problem-Based Learning in Nursing Education.

    ERIC Educational Resources Information Center

    Mok, Esther; Lee, Wai Man; Wong, Frances Kam-yuet

    2002-01-01

    Hong Kong nursing students used journals to problem-based learning (PBL) related to dying patients. Increased self-awareness, positive attitude toward death, and culturally sensitive care resulted. PBL methods included information searches, interviews with experts and patients, and tutorials for sharing feelings and information. (Contains 21…

  9. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Certification of individuals and firms engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures. 745...: public and commercial buildings, bridges and superstructures....

  10. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Certification of individuals and firms engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures. 745...: public and commercial buildings, bridges and superstructures....

  11. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Eligibility for accreditation to certificate shore-based material handling devices covered by § 1917.50 of this chapter, safety and health regulations for marine terminals. 1919.50 Section 1919.50 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT...

  12. A Perspective Evaluation of Problem-Based Learning in ESL Classroom in the Malaysian Higher School Certificate Program

    ERIC Educational Resources Information Center

    Rashid, Radzuwan Ab.

    2011-01-01

    This study was initiated to explore how pre-university students who enrolled in the Malaysian Higher School Certificate program perceived their experiences in learning ESL through Problem-Based Learning (PBL). This small scale study involved 35 pre-university students in an upper sixth form in a secondary school in Kelantan, Malaysia. Participants…

  13. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Certification of individuals and firms engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures. 745...: public and commercial buildings, bridges and superstructures....

  14. Predictive Power of School Based Assessment Scores on Students' Achievement in Junior Secondary Certificate Examination (JSCE) in English and Mathematics

    ERIC Educational Resources Information Center

    Opara, Ijeoma M.; Onyekuru, Bruno U.; Njoku, Joyce U.

    2015-01-01

    The study investigated the predictive power of school based assessment scores on students' achievement in Junior Secondary Certificate Examination (JSCE) in English and Mathematics. Two hypotheses tested at 0.05 level of significance guided the study. The study adopted an ex-post facto research design. A sample of 250 students were randomly drawn…

  15. 40 CFR 94.912 - Optional certification to land-based standards for auxiliary marine engines.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... certified to the requirements that apply to compression-ignition engines under 40 CFR part 89 or 1039 for... certificate issued under 40 CFR part 86 or 1039 for each engine to also be a valid certificate of conformity... applicable requirements from 40 CFR part 89 or 1039. This paragraph (c) applies to engine manufacturers,...

  16. Information Technology Student-Based Certification in Formal Education Settings: Who Benefits and What Is Needed

    ERIC Educational Resources Information Center

    Randall, Michael H.; Zirkle, Christopher J.

    2005-01-01

    There is a growing trend within secondary and post-secondary institutions to offer information technology (IT) certification programs as instructional vehicles to provide students with viable skills needed by the workforce, to satisfy state skill standards, and to prepare students for post-secondary IT studies. The use of IT certification programs…

  17. Ceramide, sphingoid bases, and sphingoid base metabolites as lipid mediators in signaling pathways leading to cell death and disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Increased ceramide generation de novo is known to be involved in the mechanism of action of many chemotherapeutic agents and conditions which disrupt cell cycle progression and induce cell death. Conversely, the metabolism of ceramide to sphingoid bases and and sphingoid base 1-phosphates has been i...

  18. The Determinants of Place of Death: An Evidence-Based Analysis

    PubMed Central

    Costa, V

    2014-01-01

    Background According to a conceptual model described in this analysis, place of death is determined by an interplay of factors associated with the illness, the individual, and the environment. Objectives Our objective was to evaluate the determinants of place of death for adult patients who have been diagnosed with an advanced, life-limiting condition and are not expected to stabilize or improve. Data Sources A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews, for studies published from January 1, 2004, to September 24, 2013. Review Methods Different places of death are considered in this analysis—home, nursing home, inpatient hospice, and inpatient palliative care unit, compared with hospital. We selected factors to evaluate from a list of possible predictors—i.e., determinants—of death. We extracted the adjusted odds ratios and 95% confidence intervals of each determinant, performed a meta-analysis if appropriate, and conducted a stratified analysis if substantial heterogeneity was observed. Results From a literature search yielding 5,899 citations, we included 2 systematic reviews and 29 observational studies. Factors that increased the likelihood of home death included multidisciplinary home palliative care, patient preference, having an informal caregiver, and the caregiver's ability to cope. Factors increasing the likelihood of a nursing home death included the availability of palliative care in the nursing home and the existence of advance directives. A cancer diagnosis and the involvement of home care services increased the likelihood of dying in an inpatient palliative care unit. A cancer diagnosis and a longer time between referral to palliative care and death increased the likelihood of inpatient hospice death. The quality of the evidence was considered low. Limitations Our results are based on those of retrospective observational studies. Conclusions The results obtained were consistent with previously published systematic reviews. The analysis identified several factors that are associated with place of death. PMID:26351550

  19. Modular Certification

    NASA Technical Reports Server (NTRS)

    Rushby, John; Miner, Paul S. (Technical Monitor)

    2002-01-01

    Airplanes are certified as a whole: there is no established basis for separately certifying some components, particularly software-intensive ones, independently of their specific application in a given airplane. The absence of separate certification inhibits the development of modular components that could be largely "precertified" and used in several different contexts within a single airplane, or across many different airplanes. In this report, we examine the issues in modular certification of software components and propose an approach based on assume-guarantee reasoning. We extend the method from verification to certification by considering behavior in the presence of failures. This exposes the need for partitioning, and separation of assumptions and guarantees into normal and abnormal cases. We then identify three classes of property that must be verified within this framework: safe function, true guarantees, and controlled failure. We identify a particular assume-guarantee proof rule (due to McMillan) that is appropriate to the applications considered, and formally verify its soundness in PVS.

  20. School-Based Initial Vocational Education in the Republic of Ireland: The Parity of Esteem and Fitness for Purpose of the Leaving Certificate Applied

    ERIC Educational Resources Information Center

    Gleeson, Jim; O'Flaherty, Joanne

    2013-01-01

    The Irish Leaving Certificate Applied (LCA) is a school-based, pre-vocational alternative to the "high stakes" established Leaving Certificate. Its origins lie in European Union funded "school to work" initiatives and it is currently taken to completion by some 5% of Irish senior cycle students. Since it was designed 20 years…

  1. School-Based Initial Vocational Education in the Republic of Ireland: The Parity of Esteem and Fitness for Purpose of the Leaving Certificate Applied

    ERIC Educational Resources Information Center

    Gleeson, Jim; O'Flaherty, Joanne

    2013-01-01

    The Irish Leaving Certificate Applied (LCA) is a school-based, pre-vocational alternative to the "high stakes" established Leaving Certificate. Its origins lie in European Union funded "school to work" initiatives and it is currently taken to completion by some 5% of Irish senior cycle students. Since it was designed 20 years

  2. Psychiatric disorders following fetal death: a population-based cohort study

    PubMed Central

    Munk-Olsen, Trine; Bech, Bodil Hammer; Vestergaard, Mogens; Li, Jiong; Olsen, Jørn; Laursen, Thomas Munk

    2014-01-01

    Objectives Women have increased risks of severe mental disorders after childbirth and death of a child, but it remains unclear whether this association also applies to fetal loss and, if so, to which extent. We studied the risk of any inpatient or outpatient psychiatric treatment during the time period from 12 months before to 12 months after fetal death. Design Cohort study using Danish population-based registers. Setting Denmark. Participants A total of 1 112 831 women born in Denmark from 1960 to 1995 were included. In total, 87 687cases of fetal death (International Classification of Disease-10 codes for spontaneous abortion or stillbirth) were recorded between 1996 and 2010. Primary and secondary outcome measures The main outcome measures were incidence rate ratios (risk of first psychiatric inpatient or outpatient treatment). Results A total of 1379 women had at least one psychiatric episode during follow-up from the year before fetal death to the year after. Within the first few months after the loss, women had an increased risk of psychiatric contact, IRR: 1.51 (95% CI 1.15 to 1.99). In comparison, no increased risk of psychiatric contact was found for the period before fetal death. The risk of experiencing a psychiatric episode was highest for women with a loss occurring after 20 weeks of gestation (12 month probability: 1.95%, 95% CI 1.50 to 2.39). Conclusions Fetal death was associated with a transient increased risk of experiencing a first-time episode of a psychiatric disorder, primarily adjustment disorders. The risk of psychiatric episodes tended to increase with increasing gestational age at the time of the loss. PMID:24907247

  3. NATIONAL VITAL STATISTICS SYSTEM - LINKED BIRTH AND INFANT DEATH DATA

    EPA Science Inventory

    In 1983, NCHS established a research data set comprised of linked birth and death certificates for infants born in the United States who died before reaching one year of age. In this data set, information from the death certificate is linked with information from the birth certif...

  4. Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis

    PubMed Central

    Carson, E Ann; Krueger, Patrick M; Mueller, Shane R; Steiner, John F; Sabol, William J

    2014-01-01

    Objective To determine the mortality attributable to smoking and years of potential life lost from smoking among people in prison and whether bans on smoking in prison are associated with reductions in smoking related deaths. Design Analysis of cross sectional survey data with the smoking attributable mortality, morbidity, and economic costs system; population based time series analysis. Setting All state prisons in the United States. Main outcome measures Prevalence of smoking from cross sectional survey of inmates in state correctional facilities. Data on state prison tobacco policies from web based searches of state policies and legislation. Deaths and causes of death in US state prisons from the deaths in custody reporting program of the Bureau of Justice Statistics for 2001-11. Smoking attributable mortality and years of potential life lost was assessed from the smoking attributable mortality, morbidity, and economic costs system of the Centers for Disease Control and Prevention. Multivariate Poisson models quantified the association between bans and smoking related cancer, cardiovascular and pulmonary deaths. Results The most common causes of deaths related to smoking among people in prison were lung cancer, ischemic heart disease, other heart disease, cerebrovascular disease, and chronic airways obstruction. The age adjusted smoking attributable mortality and years of potential life lost rates were 360 and 5149 per 100 000, respectively; these figures are higher than rates in the general US population (248 and 3501, respectively). The number of states with any smoking ban increased from 25 in 2001 to 48 by 2011. In prisons the mortality rate from smoking related causes was lower during years with a ban than during years without a ban (110.4/100 000 v 128.9/100 000). Prisons that implemented smoking bans had a 9% reduction (adjusted incidence rate ratio 0.91, 95% confidence interval 0.88 to 0.95) in smoking related deaths. Bans in place for longer than nine years were associated with reductions in cancer mortality (adjusted incidence rate ratio 0.81, 95% confidence interval 0.74 to 0.90). Conclusions Smoking contributes to substantial mortality in prison, and prison tobacco control policies are associated with reduced mortality. These findings suggest that smoking bans have health benefits for people in prison, despite the limits they impose on individual autonomy and the risks of relapse after release. PMID:25097186

  5. Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates.

    PubMed

    Farooqui, Habib; Jit, Mark; Heymann, David L; Zodpey, Sanjay

    2015-01-01

    The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3-3.9 million) episodes of severe pneumonia and 0.35 million (0.31-0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49-0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92-119 thousand) pneumococcal deaths occurred in India. The top contributors to India's pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our results highlight the need to improve access to care and increase coverage and equity of pneumonia preventing vaccines in states with high pneumonia burden. PMID:26086700

  6. Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates

    PubMed Central

    Farooqui, Habib; Jit, Mark; Heymann, David L.; Zodpey, Sanjay

    2015-01-01

    The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3–3.9 million) episodes of severe pneumonia and 0.35 million (0.31–0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49–0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92–119 thousand) pneumococcal deaths occurred in India. The top contributors to India’s pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our results highlight the need to improve access to care and increase coverage and equity of pneumonia preventing vaccines in states with high pneumonia burden. PMID:26086700

  7. Prediction of proapoptotic anticancer therapeutic response in vivo based on cell death visualization and TRAIL death ligand-receptor interaction.

    PubMed

    Zhou, LanLan; Wang, Wenge; Dicker, David T; Humphreys, Robin C; El-Deiry, Wafik S

    2011-08-15

    Tumor growth is often associated with insufficient apoptosis. The Tumor Necrosis Factor (TNF)-Related Apoptosis-Inducing Ligand (TRAIL) and its proapoptotic receptors death receptor 4 (DR4) and DR5 agonistic monoclonal antibodies are being developed as targeted therapeutics because they kill cancer cells while sparing normal cells. A challenge to targeted therapeutics is the selection of patients who are most likely to benefit from targeted drugs because of the heterogeneity of cancer. Molecular imaging may be useful in targeted drug development by assessing the target expression and drug-target interaction, and for predicting therapeutic response. We hypothesized that the cell surface expression level of DR4/5 may predict the proapoptotic targeted therapeutic response if the signaling pathway downstream is intact. The goal of this proof-of-concept study was to develop a molecular imaging strategy to predict proapoptotic anti-cancer therapy response at an early stage of treatment. TRAIL and the DR5 agonistic monoclonal antibody HGS-ETR2 (Lexatumumab, TRM-2) were labeled with a near-infrared dye and these were used to image the TRAIL receptors on cultured TRAIL sensitive and TRAIL resistant human tumor cells as well as tumor xenografts. Imaging of cells and tumor-bearing animals was conducted with near infrared fluorescence imagers and apoptosis in cells was assessed by western blots of PARP-cleavage and flow cytometry of sub-G1 content. Apoptosis in tumors was evaluated by imaging near-infrared dye-labeled Annexin V and tumor tissue activated caspase-3 staining. Both in vitro and in vivo studies showed that imaging of death inducing ligand-receptor interaction was consistent with the apoptosis readout. Thus TRAIL sensitive tumors that express TRAIL receptors underwent cell death following treatment whereas tumors lacking TRAIL receptor expression were shown to be TRAIL resistant. In vivo molecular imaging of TRAIL receptor expression correlated with response to TRAIL therapy and an apoptotic response in vivo. PMID:21785270

  8. Record-linkage comparison of verbal autopsy and routine civil registration death certification in rural north-east South Africa: 2006–09

    PubMed Central

    Joubert, Jané; Bradshaw, Debbie; Kabudula, Chodziwadziwa; Rao, Chalapati; Kahn, Kathleen; Mee, Paul; Tollman, Stephen; Lopez, Alan D; Vos, Theo

    2014-01-01

    Background: South African civil registration (CR) provides a key data source for local health decision making, and informs the levels and causes of mortality in data-lacking sub-Saharan African countries. We linked mortality data from CR and the Agincourt Health and Socio-demographic Surveillance System (Agincourt HDSS) to examine the quality of rural CR data. Methods: Deterministic and probabilistic techniques were used to link death data from 2006 to 2009. Causes of death were aggregated into the WHO Mortality Tabulation List 1 and a locally relevant short list of 15 causes. The matching rate was compared with informant-reported death registration. Using the VA diagnoses as reference, misclassification patterns, sensitivity, positive predictive values and cause-specific mortality fractions (CSMFs) were calculated for the short list. Results: A matching rate of 61% [95% confidence interval (CI): 59.2 to 62.3] was attained, lower than the informant-reported registration rate of 85% (CI: 83.4 to 85.8). For the 2264 matched cases, cause agreement was 15% (kappa 0.1083, CI: 0.0995 to 0.1171) for the WHO list, and 23% (kappa 0.1631, CI: 0.1511 to 0.1751) for the short list. CSMFs were significantly different for all but four (tuberculosis, cerebrovascular disease, other heart disease, and ill-defined natural) of the 15 causes evaluated. Conclusion: Despite data limitations, it is feasible to link official CR and HDSS verbal autopsy data. Data linkage proved a promising method to provide empirical evidence about the quality and utility of rural CR mortality data. Agreement of individual causes of death was low but, at the population level, careful interpretation of the CR data can assist health prioritization and planning. PMID:25146564

  9. Does Marital Status Predict the Odds of Suicidal Death in Taiwan? A Seven-Year Population-Based Study

    ERIC Educational Resources Information Center

    Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

    2008-01-01

    Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups--total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly

  10. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... work, or construction); or (3) Certification as an industrial hygienist, professional engineer... welfare warrants immediate action to suspend the certification of any individual or firm prior to...

  11. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... work, or construction); or (3) Certification as an industrial hygienist, professional engineer... welfare warrants immediate action to suspend the certification of any individual or firm prior to...

  12. Patterns in Place of Cancer Death in the State of Qatar: A Population-Based Study

    PubMed Central

    Mohsen, Hassan; Haddad, Pascale; Allam, Ayman; Hassan, Azza

    2014-01-01

    Background International studies show that most people prefer to die at home; however, hospitals remain the most common place of death (PoD). This study aims to investigate the patterns in PoD and the associated factors, which are crucial for end-of-life cancer care enhancement. Method This retrospective, population-based study analyzed all registered cancer deaths in Qatar between January 1, 2006 and December 31, 2012 (n = 1,224). The main outcome measures were patient characteristics: age, gender, nationality, cancer diagnosis, year of death, and PoD. Time trends for age-standardized proportions of death in individual PoDs were evaluated using chi-square analysis. Odds ratio (OR) were determined for variables associated with the most preferred (acute palliative care unit [APCU] and hematology/oncology ward) versus least preferred (ICU and general medicine ward) PoDs in Qatar, stratified by nationality. Results The hematology/oncology ward was the most common PoD (32.4%; 95% CI 26.7–35.3%) followed by ICU (31.4%; 95% CI 28.7–34.3%), APCU (26.9%; 95% CI 24.3–29.6%), and general medicine ward (9.2%; 95% CI 7.6–11.1%). APCU trended upward (+0.057/year; p<0.001), while the hematology/oncology ward trended downward (−0.055/year; p<0.001). No statistically significant changes occurred in the other PoDs; home deaths remained low (0.4%; 95% Cl 0.38–0.42). Qataris who died from liver cancer (OR 0.23) and aged 65 or older (OR 0.64) were less likely to die in the APCU or hematology/oncology ward (p<0.05). Non-Qataris who died from pancreatic cancer (OR 3.12) and female (OR 2.05) were more likely to die in the APCU or hematology/oncology ward (p<0.05). Both Qataris and non-Qataris who died from hematologic malignancy (OR 0.18 and 0.41, respectively) were more likely to die in the ICU or general medicine ward (p<0.05). Conclusion A high percentage of cancer deaths in Qatar occur in hospital. As home was the preferred PoD for most people, effective home care and hospice programs are needed to improve end-of-life cancer care. PMID:25536076

  13. Maintenance of Certification Part 4 Credit and Recruitment for Practice-Based Research

    PubMed Central

    Klein, Jonathan D.; Harris, Donna L.; Kaseeska, Kristen R.; Whitmore Shaefer, Regina M.; Bocian, Alison B.; Davis, James B.; Gotlieb, Edward M.; Wasserman, Richard C.

    2014-01-01

    BACKGROUND: Competing priorities in pediatric practice have created challenges for practice-based research. To increase recruitment success, researchers must design studies that provide added value to participants. This study evaluates recruitment of pediatricians into a study, before and after the development and addition of a quality improvement (QI) curriculum approved for American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Credit as an enrollment incentive. METHODS: Researchers implemented multiple outreach methods to enroll pediatric practices over 28 months. Field note review revealed that many physicians declined enrollment, stating that they prioritized MOC Part 4 projects over research studies. A QI curriculum meeting standards for MOC Part 4 Credit was developed and added to the study protocol as an enrollment incentive. Enrollment rates and characteristics of practitioners enrolled pre- and post-MOC were compared. RESULTS: Pre-MOC enrollment contributed 48% of practices in 22 months; post-MOC enrollment contributed 49% of practices in 6 months. An average of 3.5 practices enrolled per month pre-MOC, compared with 13.1 per month post-MOC (P < .001). Clinicians in pre- and post-MOC groups were similar in age, gender, race, and time spent on patient care; practices enrolled post-MOC were more likely to be located in federally designated Medically Underserved Areas than those enrolled pre-MOC (28.6% vs 12%, P = .03). CONCLUSIONS: Addition of MOC Part 4 Credit increased recruitment success and increased enrollment of pediatricians working in underserved areas. Including QI initiatives meeting MOC Part 4 criteria in practice-based research protocols may enhance participation and aid in recruiting diverse practice and patient populations. PMID:25180282

  14. Cell death following BNCT: a theoretical approach based on Monte Carlo simulations.

    PubMed

    Ballarini, F; Bakeine, J; Bortolussi, S; Bruschi, P; Cansolino, L; Clerici, A M; Ferrari, C; Protti, N; Stella, S; Zonta, A; Zonta, C; Altieri, S

    2011-12-01

    In parallel to boron measurements and animal studies, investigations on radiation-induced cell death are also in progress in Pavia, with the aim of better characterisation of the effects of a BNCT treatment down to the cellular level. Such studies are being carried out not only experimentally but also theoretically, based on a mechanistic model and a Monte Carlo code. Such model assumes that: (1) only clustered DNA strand breaks can lead to chromosome aberrations; (2) only chromosome fragments within a certain threshold distance can undergo misrejoining; (3) the so-called "lethal aberrations" (dicentrics, rings and large deletions) lead to cell death. After applying the model to normal cells exposed to monochromatic fields of different radiation types, the irradiation section of the code was purposely extended to mimic the cell exposure to a mixed radiation field produced by the (10)B(n,α) (7)Li reaction, which gives rise to alpha particles and Li ions of short range and high biological effectiveness, and by the (14)N(n,p)(14)C reaction, which produces 0.58 MeV protons. Very good agreement between model predictions and literature data was found for human and animal cells exposed to X- or gamma-rays, protons and alpha particles, thus allowing to validate the model for cell death induced by monochromatic radiation fields. The model predictions showed good agreement also with experimental data obtained by our group exposing DHD cells to thermal neutrons in the TRIGA Mark II reactor of the University of Pavia; this allowed to validate the model also for a BNCT exposure scenario, providing a useful predictive tool to bridge the gap between irradiation and cell death. PMID:21481595

  15. Towards FAA Certification of UAVs

    NASA Technical Reports Server (NTRS)

    Nelson, Stacy

    2003-01-01

    As of June 30, 2003, all Unmanned Aerial Vehicles (UAV), no matter how small, must adhere to the same FAA regulations as human-piloted aircraft. These regulations include certification for flying in controlled airspace and certification of flight software based on RTCA DO-178B. This paper provides an overview of the steps necessary to obtain certification, as well as a discussion about the challenges UAV's face when trying to meet these requirements. It is divided into two parts: 1) Certifications for Flying in Controlled Airspace; 2) Certification of Flight Software per RTCA DO-178B.

  16. An Open Letter to Deans of Teacher Education and Directors of Teacher Certification on Performance-Based Teacher Education/Certification (Is It a "No Exit" Syndrome?) AFT QuEST Paper No. 14.

    ERIC Educational Resources Information Center

    Bhaerman, Robert D.

    This open letter focuses on performance-based teacher education and certification (PBTE/C). The first section of the letter deals with anxieties about PBTE/C and about some of the people who have brought about this innovation. It comprises a survey. The second part of the paper makes various recommendations: a) the establishment of an independent…

  17. An Exploration of Initial Certification Candidates' TPACK and Mathematics-Based Applications Using Touch Device Technology

    ERIC Educational Resources Information Center

    McCrory, Michael Ray

    2010-01-01

    This qualitative research study employed a multiple-case study approach to describe the experiences of a group of Initial Certification Candidates (ICCs) as they participated in explorations of readings and third-party applications (apps) run on touch screen technology devices. The group of ICCs was comprised of two Undergraduate Teacher

  18. Getting Started on Assessment: Developing a Voluntary System of Assessment and Certification Based on Skill Standards.

    ERIC Educational Resources Information Center

    National Skill Standards Board (DOL/ETA), Washington, DC.

    This manual provides practical advice for voluntary partnerships that, since 1994, are part of the effort to build a voluntary national system of skill standards, assessment, and certification. Intended to be used with guidance from the National Skill Standards Board, it is designed for the voluntary partnerships that have completed the standards…

  19. An Exploration of Initial Certification Candidates' TPACK and Mathematics-Based Applications Using Touch Device Technology

    ERIC Educational Resources Information Center

    McCrory, Michael Ray

    2010-01-01

    This qualitative research study employed a multiple-case study approach to describe the experiences of a group of Initial Certification Candidates (ICCs) as they participated in explorations of readings and third-party applications (apps) run on touch screen technology devices. The group of ICCs was comprised of two Undergraduate Teacher…

  20. 28 CFR 26.23 - Certification process.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....23 Judicial Administration DEPARTMENT OF JUSTICE DEATH SENTENCES PROCEDURES Certification Process for... state that it has provided notice of its request for certification to the chief or presiding justice or judge of the state's highest court with jurisdiction over criminal matters. (c) Upon receipt of a...

  1. Developing Competency-Based Preparation and Performance-Based Certification in Georgia.

    ERIC Educational Resources Information Center

    Solomon, Lester M.

    The state of Georgia has been moving toward competency/performance-based education since the late 1960's. All of the groups concerned with education and the preparation of teachers (higher education institutions, the Georgia Teacher Education Council, professional organizations, and the Georgia Department of Education) have been involved. In…

  2. Estimated incidence and risk factors of sudden unexpected death

    PubMed Central

    Lin, Feng-Chang; Mehta, Neil; Mounsey, Louisa; Nwosu, Anthony; Pursell, Irion; Chung, Eugene H; Mounsey, J Paul; Simpson, Ross J

    2016-01-01

    Objective In this manuscript, we estimate the incidence and identify risk factors for sudden unexpected death in a socioeconomically and racially diverse population in one county in North Carolina. Estimates of the incidence and risk factors contributing to sudden death vary widely. The Sudden Unexpected Death in North Carolina (SUDDEN) project is a population-based investigation of the incidence and potential causes of sudden death. Methods From 3 March 2013 to 2 March 2014, all out-of-hospital deaths in Wake County, North Carolina, were screened to identify presumed sudden unexpected death among free-living residents between the ages of 18 and 64 years. Death certificate, public and medical records were reviewed and adjudicated to confirm sudden unexpected death cases. Results Following adjudication, 190 sudden unexpected deaths including 122 men and 68 women were identified. Estimated incidence was 32.1 per 100 000 person-years overall: 42.7 among men and 22.4 among women. The majority of victims were white, unmarried men over age 55 years, with unwitnessed deaths at home. Hypertension and dyslipidaemia were common in men and women. African-American women dying from sudden unexpected death were over-represented. Women who were under age 55 years with coronary disease accounted for over half of female participants with coronary artery disease. Conclusions The overall estimated incidence of sudden unexpected death may account for approximately 10% of all deaths classified as ‘natural’. Women have a lower estimated incidence of sudden unexpected death than men. However, we found no major differences in age or comorbidities between men and women. African-Americans and young women with coronary disease are at risk for sudden unexpected death. PMID:27042316

  3. Predictors of Death among Patients Who Completed Tuberculosis Treatment: A Population-Based Cohort Study

    PubMed Central

    Millet, Juan-Pablo; Orcau, Angels; Rius, Cristina; Casals, Marti; de Olalla, Patricia Garcia; Moreno, Antonio; Nelson, Jeanne L.; Caylà, Joan A.

    2011-01-01

    Background Mortality among patients who complete tuberculosis (TB) treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. Methods A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995–1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR) with 95% confidence intervals (CI). Results Among the 762 included patients, the median age was 36 years, 520 (68.2%) were male, 178 (23.4%) HIV-infected, and 208 (27.3%) were alcohol abusers. Of the 134 (17.6%) injecting drug users (IDU), 123 (91.8%) were HIV-infected. A total of 30 (3.9%) recurrences and 173 deaths (22.7%) occurred (mortality rate: 3.4/100 person-years of follow-up). The predictors of death were: age between 41–60 years old (HR: 3.5; CI:2.1–5.7), age greater than 60 years (HR: 14.6; CI:8.9–24), alcohol abuse (HR: 1.7; CI:1.2–2.4) and HIV-infected IDU (HR: 7.9; CI:4.7–13.3). Conclusions The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival. PMID:21980423

  4. Verbal Autopsy Methods to Ascertain Birth Asphyxia Deaths in a Community-based Setting in Southern Nepal

    PubMed Central

    Lee, Anne CC; Mullany, Luke C.; Tielsch, James M.; Katz, Joanne; Khatry, Subarna K.; LeClerq, Steven C.; Adhikari, Ramesh K.; Shrestha, Shardaram R.; Darmstadt, Gary L.

    2008-01-01

    OBJECTIVES 1) Develop an approach to ascertain birth asphyxia deaths using verbal autopsy data from a community-based setting in Nepal, and 2) explore variations in birth asphyxia mortality fractions using different birth asphyxia case definitions and hierarchal classifications. PATIENTS AND METHODS Data were prospectively collected during a cluster-randomized, community-based trial of health interventions on neonatal mortality in Sarlahi, Nepal from 2002-2006. To assign cause of death, four computer-assigned, symptom-based asphyxia case definitions; Nepali physician classification; and our independent review of verbal autopsy open narratives were used. Varying hierarchal classification approaches to assign cause of death were also explored. RESULTS Birth asphyxia specific mortality ranged from 26%-54% depending on the computer case definition used. There was poor agreement between computer and physician classification of birth asphyxia (kappa 0.15). By comparing computer, physician, and our independent ascertainment of cause of death, we identified 246 cases of birth asphyxia (32% of neonatal deaths). Allowing for more than one cause of death, 30% and 42% of asphyxia cases also met criteria for prematurity and serious infection, respectively. When a hierarchy was used to assign a single cause of death, the birth asphyxia proportionate mortality was reduced to 12% when identification of deaths due to congenital anomalies, prematurity, and serious infections preceded birth asphyxia. CONCLUSIONS Use of varying verbal autopsy definitions and hierarchal approaches to assign cause of death may substantially affect estimates of birth asphyxia-specific mortality and analyses of risk factors. Verbal autopsy methods need to be standardized and validated in order to generate accurate global estimates to direct policy and resource allocation in low-middle income countries. PMID:18450880

  5. Healthcare teams over the Internet: towards a certificate-based approach.

    PubMed

    Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

    2002-01-01

    Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modem healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has therefore become a major concern for healthcare applications over the Internet. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security policy is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided. PMID:15460685

  6. Performance-based regulation: enterprise responsibility for reducing death, injury, and disease caused by consumer products.

    PubMed

    Sugarman, Stephen D

    2009-12-01

    This article offers a bold new idea for confronting the staggering level of death, injury, and disease caused by five consumer products: cigarettes, alcohol, guns, junk food, and motor vehicles. Business leaders try to frame these negative outcomes as "collateral damage" that is someone else's problem. That framing not only is morally objectionable but also overlooks the possibility that, with proper prodding, industry could substantially lessen these public health disasters. I seek to reframe the public perception of who is responsible and propose to deploy a promising approach called "performance-based regulation" to combat the problem. Performance-based regulation would impose on manufacturers a legal obligation to reduce the negative social costs of their products. Rather than involving them in litigation or forcing them to operate differently (as "command-and-control" regimes do), performance-based regulation allows the firms to determine how best to decrease bad public health consequences. Like other public health strategies, performance-based regulation focuses on those who are far more likely than individual consumers to achieve real gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good. PMID:20018990

  7. Facility-based maternal death reviews: effects on maternal mortality in a district hospital in Senegal.

    PubMed Central

    Dumont, Alexandre; Gaye, Alioune; de Bernis, Luc; Chaillet, Nils; Landry, Anne; Delage, Joanne; Bouvier-Colle, Marie-Hélène

    2006-01-01

    OBJECTIVE: The improvement of obstetric services is one of the key components of the Safe Motherhood Programme. Reviewing maternal deaths and complications is one method that may make pregnancy safer, but there is no evidence about the effectiveness of this strategy. The objective of our before and after study is to assess the effect of facility-based maternal deaths reviews (MDR) on maternal mortality rates in a district hospital in Senegal that provides primary and referral maternity services. METHODS: We included all women who were admitted to the maternity unit for childbirth, or within 24 hours of delivery. We recorded maternal mortality during a 1-year baseline period from January to December 1997, and during a 3-year period from January 1998 to December 2000 after MDR had been implemented. Effects of MDR on organization of care were qualitatively evaluated. FINDINGS: The MDR strategy led to changes in organizational structure that improved life-saving interventions with a relatively large financial contribution from the community. Overall mortality significantly decreased from 0.83 (95% CI (confidence interval) = 0.60 -1.06) in baseline period to 0.41 (95% CI = 0.25 -0.56) per 100 women 3 years later. CONCLUSION: MDR had a marked effect on resources, management and maternal outcomes in this facility. However, given the design of our study and the local specific context, further research is needed to confirm the feasibility of MDR in other settings and to confirm the benefits of this approach for maternal health in developing countries. PMID:16583081

  8. Certification trails for data structures

    NASA Technical Reports Server (NTRS)

    Sullivan, Gregory F.; Masson, Gerald M.

    1993-01-01

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

  9. Increased risk of maternal deaths associated with foreign origin in Spain: a population based case-control study.

    PubMed

    Luque Fernández, Miguel Ángel; Gutiérrez Garitano, Ignacio; Cavanillas, Aurora Bueno

    2011-06-01

    In Europe, different studies have identified immigrant women coming from developing countries as a risk group for maternal death. In Spain, an ecological study showed higher maternal mortality rates among foreign mothers compared with Spanish mothers during 2003-04. To examine whether the maternal death risk among foreign mothers in Spain is increased, we performed a population-based matched case-control study. Each case of maternal death during 1999-2006 was matched with four mothers who had given birth during the same year the case occurred. The National Statistics Institute provided the data. The variables in the study were maternal age and country of origin. We used a conditional logistic regression analysis. Adjusted by age, the risk of maternal death was 87% higher among foreign mothers. This study confirms that there is an increased risk of maternal death among foreign mothers in Spain. It would be desirable to analyse the socio-economic and healthcare circumstances surrounding the deaths. PMID:20570961

  10. Co-trimoxazole and sudden death in patients receiving inhibitors of renin-angiotensin system: population based study

    PubMed Central

    Fralick, Michael; Macdonald, Erin M; Gomes, Tara; Antoniou, Tony; Hollands, Simon; Mamdani, Muhammad M

    2014-01-01

    Objective To determine whether the prescription of co-trimoxazole with an angiotensin converting enzyme inhibitor or angiotensin receptor blocker is associated with sudden death. Design Population based nested case-control study. Setting Ontario, Canada, from 1 April 1994 to 1 January 2012. Participants Ontario residents aged 66 years or older treated with an angiotensin converting enzyme inhibitor or angiotensin receptor blocker. Cases were those who died suddenly shortly after receiving an outpatient prescription for one of co-trimoxazole, amoxicillin, ciprofloxacin, norfloxacin, or nitrofurantoin. Each case was matched with up to four controls on age, sex, chronic kidney disease, and diabetes. Main outcome measure Odds ratio for the association between sudden death and exposure to each antibiotic relative to amoxicillin, after adjustment for predictors of sudden death according to a disease risk index. Results Of 39?879 sudden deaths, 1027 occurred within seven days of exposure to an antibiotic and were matched to 3733 controls. Relative to amoxicillin, co-trimoxazole was associated with an increased risk of sudden death (adjusted odds ratio 1.38, 95% confidence interval 1.09 to 1.76). The risk was marginally higher at 14 days (adjusted odds ratio 1.54, 1.29 to 1.84). This corresponds to approximately three sudden deaths within 14 days per 1000 co-trimoxazole prescriptions. Ciprofloxacin (a known cause of QT interval prolongation) was also associated with an increased risk of sudden death (adjusted odds ratio 1.29, 1.03 to 1.62), but no such risk was observed with nitrofurantoin or norfloxacin. Conclusions In older patients receiving angiotensin converting enzyme inhibitors or angiotensin receptor blockers, co-trimoxazole is associated with an increased risk of sudden death. Unrecognized severe hyperkalemia may underlie this finding. When appropriate, alternative antibiotics should be considered in such patients. PMID:25359996

  11. Brain death: the Asian perspective.

    PubMed

    Chua, Hoe Chin; Kwek, Tong Kiat; Morihara, Hirofumi; Gao, Daiquan

    2015-04-01

    Asia is the largest and most populous continent in the world with people from many diverse ethnic groups, religions and government systems. The authors surveyed 14 countries accounting for the majority of Asia's population and found that, although the concept of brain death is widely accepted, there is wide variability in the criteria for certification. Although most Asian countries have adopted the "whole-brain" concept of brain death, most countries with past colonial links to the United Kingdom follow the UK "brainstem" concept of brain death. Despite this difference, most countries require only neurologic testing of irreversible coma and absent brainstem reflexes as criteria for certification of brain death. Variability exists in the number of personnel required, qualifications of certifying doctors, need for repeat examination, minimum time interval between examinations, and requirement for and choice of confirmatory tests. PMID:25839724

  12. A district-based audit of the causes and circumstances of maternal deaths in South Kalimantan, Indonesia.

    PubMed Central

    Supratikto, Gunawan; Wirth, Meg E.; Achadi, Endang; Cohen, Surekha; Ronsmans, Carine

    2002-01-01

    A district-based audit of maternal and perinatal mortality began during 1994 in three provinces of South Kalimantan, Indonesia. Both medical and non-medical factors were documented and an effort was made to progress from merely assessing substandard care to recommending improvements in access to care and the quality of care. Extensive discussions of cases of maternal death were held during regular meetings with providers, policy-makers and community members. The sources of information included verbal autopsies with family members and medical records. Between 1995 and 1999 the audit reviewed 130 maternal deaths. The leading causes of death were haemorrhage (41%) and hypertensive diseases (32%). Delays in decision-making and poor quality of care in health facilities were seen as contributory factors in 77% and 60% of the deaths, respectively. Economic constraints were believed to have contributed to 37% of the deaths. The distance between a patient's home and a health provider or facility did not appear to have a significant influence, nor did transport problems. The audit led to changes in the quality of obstetric care in the district. Its success was particularly attributable to the process of accountability of both health providers and policy-makers and to improved working relationships between health providers at different levels and between providers and the community. With a view to the continuation and further expansion of the audit it may be necessary to reconsider the role of the provincial team, the need of health providers for confidentiality, the added benefit of facility-based audits, the need to incorporate scientific evidence into the review process, and the possible consideration of severe complications as well as deaths. It may also be necessary to recognize that village midwives are not solely responsible for maternal deaths. PMID:11984609

  13. Infant Maltreatment-Related Mortality in Alaska: Correcting the Count and Using Birth Certificates to Predict Mortality

    ERIC Educational Resources Information Center

    Parrish, Jared W.; Gessner, Bradford D.

    2010-01-01

    Objectives: To accurately count the number of infant maltreatment-related fatalities and to use information from the birth certificates to predict infant maltreatment-related deaths. Methods: A population-based retrospective cohort study of infants born in Alaska for the years 1992 through 2005 was conducted. Risk factor variables were ascertained…

  14. Infant Maltreatment-Related Mortality in Alaska: Correcting the Count and Using Birth Certificates to Predict Mortality

    ERIC Educational Resources Information Center

    Parrish, Jared W.; Gessner, Bradford D.

    2010-01-01

    Objectives: To accurately count the number of infant maltreatment-related fatalities and to use information from the birth certificates to predict infant maltreatment-related deaths. Methods: A population-based retrospective cohort study of infants born in Alaska for the years 1992 through 2005 was conducted. Risk factor variables were ascertained

  15. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  16. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  17. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  18. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  19. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  20. Rotavirus mortality in India: estimates based on a nationally representative survey of diarrhoeal deaths

    PubMed Central

    Awasthi, Shally; Khera, Ajay; Bassani, Diego G; Kang, Gagandeep; Parashar, Umesh D; Kumar, Rajesh; Shet, Anita; Glass, Roger I; Jha, Prabhat

    2012-01-01

    Abstract Objective To estimate the number of rotavirus-associated deaths among Indian children younger than five years. Methods We surveyed more than 23 000 child deaths from a nationally representative survey of 1.1 million Indian households during 2001–2003. Diarrhoeal deaths were characterized by region, age and sex and were combined with the proportion of deaths attributable to rotavirus, as determined by hospital microbiologic data collected by the Indian Rotavirus Strain Surveillance Network from December 2005 to November 2007. Rotavirus vaccine efficacy data from clinical trials in developing countries were used to estimate the number of deaths preventable by a national vaccination programme. Data were analysed using Stata SE version 10. Findings Rotavirus caused an estimated 113 000 deaths (99% confidence interval, CI: 86 000–155 000); 50% (54 700) and 75% (85 400) occurred before one and two years of age, respectively. One child in 242 died from rotavirus infection before five years of age. Rotavirus-associated mortality rates overall, among girls and among boys were 4.14 (99% CI: 3.14–5.68), 4.89 (99% CI: 3.75–6.79) and 3.45 (99% CI: 2.58–4.66) deaths per 1000 live births, respectively. Rates were highest in Bihar, Uttar Pradesh and Madhya Pradesh, which together accounted for > 50% of deaths (64 400) nationally. Rotavirus vaccine could prevent 41 000–48 000 deaths among children aged 3–59 months. Conclusion The burden of rotavirus-associated mortality is high among Indian children, highlighting the potential benefits of rotavirus vaccination. PMID:23109739

  1. Reflection on family consent: based on a pregnant death in a Beijing hospital.

    PubMed

    Zhang, Xinqing

    2012-12-01

    The 'family consent' process has been placed at the centre of Chinese clinical practice. Although there has been critical analysis of how the process functions in relation to the autonomy and rights of patients, there has been little examination of the perceptions and attitude of patients and their families and the medical professionals, in relation to moral dilemmas that arise in real cases in the bioethical discourse. When faced with a consent form in an emergency situation, the family member's capacity to act is reduced, as he/she becomes enmeshed in the hospital structure of tacit, socially-imposed rules. In a questionnaires based on a real death case in 2008, 70.9% of the surveyed medical professionals (n = 3,665) disagreed with performing surgery without the consent of the family even if the patient's life was in danger, while 36.6% of the surveyed patients (n = 1,198) hold the same position. This work demonstrates the weakness of the family consent process as a safeguard of patient's autonomy. Finally, I argue that saving the patient's life should be the overriding obligation rather than the respect for the surrogate's autonomous choice at such a decisive moment. PMID:21266002

  2. Hospital-based study of severe malaria and associated deaths in Myanmar.

    PubMed Central

    Ejov, M. N.; Tun, T.; Aung, S.; Lwin, S.; Sein, K.

    1999-01-01

    The present study identifies factors that contribute to malaria deaths in township hospitals reporting large numbers of such deaths in Myanmar. Between July and December 1995, we identified a total of 101 patients with severe and complicated malaria by screening the cases admitted to hospital with a primary diagnosis of falciparum malaria. Unrousable coma and less marked impairment of consciousness with or without other severe malaria complications, in contrast to severe malaria anaemia, were associated with all malaria deaths. Adult patients with severe malaria were 2.8 times more likely to die than child patients, with the higher risk of death among adults probably being associated with previous exposure to malaria, delay in seeking treatment and severity of the illness before admission. In view of this, we consider that malaria mortality could be reduced by improving peripheral facilities for the management of severe malaria and providing appropriate education to communities, without stepping up vector control activities. PMID:10327709

  3. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the adequacy of the certification activity performed. (c) Accreditation to conduct such nondestructive... wire rope tests, nondestructive examinations, and heat treatments may be carried out by...

  4. Predictors of Place of Death for Seniors in Ontario: A Population-Based Cohort Analysis

    ERIC Educational Resources Information Center

    Motiwala, Sanober S.; Croxford, Ruth; Guerriere, Denise N.; Coyte, Peter C.

    2006-01-01

    Place of death was determined for all 58,689 seniors (age greater than or equal to 66 years) in Ontario who died during fiscal year 2001/2002. The relationship of place of death to medical and socio-demographic characteristics was examined using a multinomial logit model. Half (49.2 %) of these individuals died in hospital, 30.5 per cent died in a…

  5. Predictors of Place of Death for Seniors in Ontario: A Population-Based Cohort Analysis

    ERIC Educational Resources Information Center

    Motiwala, Sanober S.; Croxford, Ruth; Guerriere, Denise N.; Coyte, Peter C.

    2006-01-01

    Place of death was determined for all 58,689 seniors (age greater than or equal to 66 years) in Ontario who died during fiscal year 2001/2002. The relationship of place of death to medical and socio-demographic characteristics was examined using a multinomial logit model. Half (49.2 %) of these individuals died in hospital, 30.5 per cent died in a

  6. Does marital status predict the odds of suicidal death in taiwan? A seven-year population-based study.

    PubMed

    Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

    2008-06-01

    Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds. PMID:18611128

  7. Parity, Age at First Birth, and Risk of Death from Non-Hodgkin’s Lymphoma: A Population-Based Cohort Study in Taiwan

    PubMed Central

    Chen, Brian K.; Yang, Chun-Yuh

    2015-01-01

    We undertook this study to examine whether there exists an association between parity and age at first birth and risk of death from non-Hodgkin’s lymphoma (NHL). Our sample included a total of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We followed each subject from their first childbirth to 31 December 2009, and determined their vital status by merging natality data with Taiwan’s national death certificate database. Hazard ratios (HR) of death from NHL associated with parity and age at first birth were estimated using Cox proportional hazard regression models. In all, 412 NHL deaths were recorded during 34,980,246 person-years of follow-up. NHL mortality rate was 1.18 cases per 100,000 person-years. Older age at first birth (>23 vs. ≤23 years) was linked to an increased risk of death from NHL (adjusted HR = 1.41; 95% CI = 1.13–1.75). Controlling for age at first birth, the adjusted HR were 0.74 (95% CI = 0.55–0.98) for women with 2 births, and 0.71 (95% CI = 0.53–0.95) for women with 3 births or more, respectively, when compared with women with only 1 birth. A statistically significant downward trend in the adjusted HR for NHL death was detected with increasing parity (p for trend = 0.05). The HR of death from NHL was decreased by 7% (HR = 0.93; 95% CI = 0.87–0.99) for each additional parity. Our findings are consistent with reproductive factors (parity and early age at first birth) conferring a protective effect against the risk of NHL death. PMID:26251917

  8. A Feasibility Study for a Comprehensive Competency-Based Training and Certification System for Child Care Personnel in the Commonwealth of Pennsylvania. Annotated Bibliography. Appendix A. Final Report.

    ERIC Educational Resources Information Center

    Educational Projects, Inc., Washington, DC.

    This 196-item annotated bibliography contains components of a competency-based training and certification system for teachers serving children in Pennsylvania day care programs. It is the appendix of a final report sponsored by the Pennsylvania Department of Public Welfare, Bureau of Child Development. The organizational topics and number of…

  9. "We Brought It upon Ourselves": University-Based Teacher Education and the Emergence of Boot-Camp-Style Routes to Teacher Certification

    ERIC Educational Resources Information Center

    Friedrich, Daniel

    2014-01-01

    The proliferation of boot-camp-style routes to teacher certification in the last two decades is seen by many university-based teacher educators as the result of the advancement of conservative interests aimed at de-professionalizing teaching. This essay argues that this view only accounts for one piece of the answer, the other one being that some…

  10. PREPARING FOR A SUCCESSFUL EVMS CERTIFICATION

    SciTech Connect

    CROWE SL; BASCHE AD

    2011-02-09

    The client, a government agency, requires its contractor to obtain an Earned Value Management System (EVMS) certification that meets the intent of ANSI/EIA-748-B, Earned Value Management Systems. The contractor has extensive experience with certification preparation, having completed two certifications within two years. Information from a previous EVMS certification and internal system surveillances are used to prepare for client-based EVMS certifications and bi-annual surveillances. The contractor also sent members of its group to assist other companies preparing for surveillances and certifications to perform 'Black Hat Reviews.' This paper is a lessons learned on preparing a team for EVMS certification. The information is also applicable for surveillances, since the contractor prepares its team for the surveillance in the same manner as the initial certification. Some of the areas covered include required documents, tracing the data through the systems, Control Account Manager (CAM) preparation, and system verification.

  11. A CRISPR-Based Screen Identifies Genes Essential for West-Nile-Virus-Induced Cell Death.

    PubMed

    Ma, Hongming; Dang, Ying; Wu, Yonggan; Jia, Gengxiang; Anaya, Edgar; Zhang, Junli; Abraham, Sojan; Choi, Jang-Gi; Shi, Guojun; Qi, Ling; Manjunath, N; Wu, Haoquan

    2015-07-28

    West Nile virus (WNV) causes an acute neurological infection attended by massive neuronal cell death. However, the mechanism(s) behind the virus-induced cell death is poorly understood. Using a library containing 77,406 sgRNAs targeting 20,121 genes, we performed a genome-wide screen followed by a second screen with a sub-library. Among the genes identified, seven genes, EMC2, EMC3, SEL1L, DERL2, UBE2G2, UBE2J1, and HRD1, stood out as having the strongest phenotype, whose knockout conferred strong protection against WNV-induced cell death with two different WNV strains and in three cell lines. Interestingly, knockout of these genes did not block WNV replication. Thus, these appear to be essential genes that link WNV replication to downstream cell death pathway(s). In addition, the fact that all of these genes belong to the ER-associated protein degradation (ERAD) pathway suggests that this might be the primary driver of WNV-induced cell death. PMID:26190106

  12. A CRISPR-based screen identifies genes essential for West Nile virus-induced cell death

    PubMed Central

    Ma, Hongming; Dang, Ying; Wu, Yonggan; Jia, Gengxiang; Anaya, Edgar; Zhang, Junli; Abraham, Sojan; Choi, Jang-Gi; Shi, Guojun; Qi, Ling; Manjunath, N.; Wu, Haoquan

    2015-01-01

    Summary West Nile virus (WNV) causes an acute neurological infection attended by massive neuronal cell death. However, the mechanism(s) behind the virus-induced cell death is poorly understood. Using a library containing 77,406 sgRNAs targeting 20,121 genes, we performed a genome-wide screen followed by a second screen with a sub-library. Among the genes identified, seven genes, EMC2, EMC3, SEL1L, DERL2, UBE2G2, UBE2J1, and HRD1, stood out as having the strongest phenotype, whose knockout conferred strong protection against WNV-induced cell death with two different WNV strains and in three cell lines. Interestingly, knockout of these genes did not block WNV replication. Thus, these appear to be essential genes that link WNV replication to downstream cell death pathway(s). In addition, the fact that all of these genes belong to the endoplasmic reticulum-associated protein degradation (ERAD) pathway suggests that this might be the primary driver of WNV-induced cell death. PMID:26190106

  13. The Effects of "High Stakes" Certification Demands on the Generalizability and Dependability of a Classroom-Based Teacher Assessment System.

    ERIC Educational Resources Information Center

    Ellett, Chad D.; And Others

    This paper presents the results of ongoing analyses of the reliability of the System for Teaching and Learning Assessment and Review (STAR) as a comprehensive measure of classroom teaching and learning for making teacher certification decisions. Focus was on the effects of high stakes assessment conditions for certification on the generalizability…

  14. Organ donation after death in Ontario: a population-based cohort study

    PubMed Central

    Redelmeier, Donald A.; Markel, Frank; Scales, Damon C.

    2013-01-01

    Background: Shortfalls in deceased organ donation lead to shortages of solid organs available for transplantation. We assessed rates of deceased organ donation and compared hospitals that had clinical services for transplant recipients (transplant hospitals) to those that did not (general hospitals). Methods: We conducted a population-based cohort analysis involving patients who died from traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage or other catastrophic neurologic conditions in Ontario, Canada, between Apr. 1, 1994, and Mar. 31, 2011. We distinguished between acute care hospitals with and without transplant services. The primary outcome was actual organ donation determined through the physician database for organ procurement procedures. Results: Overall, 87 129 patients died from catastrophic neurologic conditions during the study period, of whom 1930 became actual donors. Our primary analysis excluded patients from small hospitals, reducing the total to 79 746 patients, of whom 1898 became actual donors. Patients who died in transplant hospitals had a distribution of demographic characteristics similar to that of patients who died in other large general hospitals. Transplant hospitals had an actual donor rate per 100 deaths that was about 4 times the donor rate at large general hospitals (5.0 v. 1.4, p < 0.001). The relative reduction in donations at general hospitals was accentuated among older patients, persisted among patients who were the most eligible candidates and amounted to about 121 fewer actual donors per year (adjusted odds ratio 0.58, 95% confidence interval 0.36–0.92). Hospital volumes were only weakly correlated with actual organ donation rates. Interpretation: Optimizing organ donation requires greater attention to large general hospitals. These hospitals account for most of the potential donors and missed opportunities for deceased organ donation. PMID:23549970

  15. Certification Reform.

    ERIC Educational Resources Information Center

    Klagholz, Leo; Cooperman, Saul

    Two major problems of state certification of teachers are decline in the quality of teacher candidates and the inability of qualified applicants to be certified without majoring in education. With improved knowledge about how good teachers teach and what is essential for beginning teachers to know, teacher education programs are likely to remain

  16. Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort

    PubMed Central

    Miró, Josep M.; Ocaña, Inma; Knobel, Hernando; Barberá, Maria Jesús; Humet, Victoria; Domingo, Pere; Gatell, Josep M.; Ribera, Esteve; Gurguí, Mercè; Marco, Andrés

    2015-01-01

    Introduction Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0–16.1/1000 py], 81.3% of them had a known cause of death. Mortality rate by HIV-related causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7–6.1/1000 py), external was lower [1.7/1000 py; (1.0–2.4/1000 py)]. Survival Results Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5–7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3–5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4–1.7) and heterosexual female (sHR:2.8; CI:1.1–7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7–123.2) and heterosexual male (sHR:11.8; CI:2.5–56.4) versus MSM. Conclusion and Recommendation There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males. PMID:26716982

  17. [Collecting and rearing necrophagous insects, important in determining date of death, base on the entomological method].

    PubMed

    Kaczorowska, Elzbieta

    2002-01-01

    The entomological method of determining date of death is used in police investigation more frequently. In order for correct determination of this date, the entomologist must correctly collect and rear the necrophagous insects, feeding and breeding on the corpse. Therefore, in this paper, methods of collecting, rearing and preservation of flies, water insects and beetles are described. PMID:14669680

  18. 20 CFR 410.679 - Finality of findings with respect to other claims for benefits based on the disability or death...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... claims for benefits based on the disability or death of a miner. 410.679 Section 410.679 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK... claims for benefits based on the disability or death of a miner. Findings of fact made in a...

  19. 20 CFR 410.679 - Finality of findings with respect to other claims for benefits based on the disability or death...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... claims for benefits based on the disability or death of a miner. 410.679 Section 410.679 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK... claims for benefits based on the disability or death of a miner. Findings of fact made in a...

  20. The Global Burden of Snakebite: A Literature Analysis and Modelling Based on Regional Estimates of Envenoming and Deaths

    PubMed Central

    Kasturiratne, Anuradhani; Wickremasinghe, A. Rajitha; de Silva, Nilanthi; Gunawardena, N. Kithsiri; Pathmeswaran, Arunasalam; Premaratna, Ranjan; Savioli, Lorenzo; Lalloo, David G; de Silva, H. Janaka

    2008-01-01

    Background Envenoming resulting from snakebites is an important public health problem in many tropical and subtropical countries. Few attempts have been made to quantify the burden, and recent estimates all suffer from the lack of an objective and reproducible methodology. In an attempt to provide an accurate, up-to-date estimate of the scale of the global problem, we developed a new method to estimate the disease burden due to snakebites. Methods and Findings The global estimates were based on regional estimates that were, in turn, derived from data available for countries within a defined region. Three main strategies were used to obtain primary data: electronic searching for publications on snakebite, extraction of relevant country-specific mortality data from databases maintained by United Nations organizations, and identification of grey literature by discussion with key informants. Countries were grouped into 21 distinct geographic regions that are as epidemiologically homogenous as possible, in line with the Global Burden of Disease 2005 study (Global Burden Project of the World Bank). Incidence rates for envenoming were extracted from publications and used to estimate the number of envenomings for individual countries; if no data were available for a particular country, the lowest incidence rate within a neighbouring country was used. Where death registration data were reliable, reported deaths from snakebite were used; in other countries, deaths were estimated on the basis of observed mortality rates and the at-risk population. We estimate that, globally, at least 421,000 envenomings and 20,000 deaths occur each year due to snakebite. These figures may be as high as 1,841,000 envenomings and 94,000 deaths. Based on the fact that envenoming occurs in about one in every four snakebites, between 1.2 million and 5.5 million snakebites could occur annually. Conclusions Snakebites cause considerable morbidity and mortality worldwide. The highest burden exists in South Asia, Southeast Asia, and sub-Saharan Africa. PMID:18986210

  1. Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics

    PubMed Central

    2010-01-01

    Background Incomplete information on death certificates makes recorded cause-of-death data less useful for public health monitoring and planning. Certifying physicians sometimes list only the mode of death without indicating the underlying disease or diseases that led to the death. Inconsistent cause-of-death assignment among cardiovascular causes of death is of particular concern. This can prevent valid epidemiologic comparisons across countries and over time. Methods We propose that coarsened exact matching be used to infer the underlying causes of death where only the mode of death is known. We focus on the case of heart failure in US, Mexican, and Brazilian death records. Results Redistribution algorithms derived using this method assign the largest proportion of heart failure deaths to ischemic heart disease in all three countries (53%, 26%, and 22% respectively), with larger proportions assigned to hypertensive heart disease and diabetes in Mexico and Brazil (16% and 23% vs. 7% for hypertensive heart disease, and 13% and 9% vs. 6% for diabetes). Reassigning these heart failure deaths increases the US ischemic heart disease mortality rate by 6%. Conclusions The frequency with which physicians list heart failure in the causal chain for various underlying causes of death allows for inference about how physicians use heart failure on the death certificate in different settings. This easy-to-use method has the potential to reduce bias and increase comparability in cause-of-death data, thereby improving the public health utility of death records. PMID:20388206

  2. Sepsis-associated mortality in England: an analysis of multiple cause of death data from 2001 to 2010

    PubMed Central

    McPherson, Duncan; Griffiths, Clare; Williams, Matthew; Baker, Allan; Klodawski, Ed; Jacobson, Bobbie; Donaldson, Liam

    2013-01-01

    Objectives To quantify mortality associated with sepsis in the whole population of England. Design Descriptive statistics of multiple cause of death data. Setting England between 2001 and 2010. Participants All people whose death was registered in England between 2001 and 2010 and whose certificate contained a sepsis-associated International Classification of Diseases, 10th Revision (ICD-10) code. Data sources Multiple cause of death data extracted from Office for National Statistics mortality database. Statistical methods Age-specific and sex-specific death rates and direct age-standardised death rates. Results In 2010, 5.1% of deaths in England were definitely associated with sepsis. Adding those that may be associated with sepsis increases this figure to 7.7% of all deaths. Only 8.6% of deaths definitely associated with sepsis in 2010 had a sepsis-related condition as the underlying cause of death. 99% of deaths definitely associated with sepsis have one of the three ICD-10 codes—A40, A41 and P36—in at least one position on the death certificate. 7% of deaths definitely associated with sepsis in 2001–2010 did not occur in hospital. Conclusions Sepsis is a major public health problem in England. In attempting to tackle the problem of sepsis, it is not sufficient to rely on hospital-based statistics, or methods of intervention, alone. A robust estimate of the burden of sepsis-associated mortality in England can be made by identifying deaths with one of the three ICD-10 codes in multiple cause of death data. These three codes could be used for future monitoring of the burden of sepsis-associated mortality. PMID:23913771

  3. Cot Deaths.

    ERIC Educational Resources Information Center

    Tyrrell, Shelagh

    1985-01-01

    Addresses the tragedy of crib deaths, giving particular attention to causes, prevention, and medical research on Sudden Infant Death Syndrome (SIDS). Gives anecdotal accounts of coping strategies used by parents and families of SIDS infants. (DT)

  4. The epidemiological transition in Antananarivo, Madagascar: an assessment based on death registers (1900–2012)

    PubMed Central

    Masquelier, Bruno; Waltisperger, Dominique; Ralijaona, Osée; Pison, Gilles; Ravélo, Arsène

    2014-01-01

    Background Madagascar today has one of the highest life expectancies in sub-Saharan Africa, despite being among the poorest countries in the continent. There are relatively few detailed accounts of the epidemiological transition in this country due to the lack of a comprehensive death registration system at the national level. However, in Madagascar’s capital city, death registration was established around the start of the 20th century and is now considered virtually complete. Objective We provide an overview of trends in all-cause and cause-specific mortality in Antananarivo to document the timing and pace of the mortality decline and the changes in the cause-of-death structure. Design Death registers covering the period 1976–2012 were digitized and the population at risk of dying was estimated from available censuses and surveys. Trends for the period 1900–1976 were partly reconstructed from published sources. Results The crude death rate stagnated around 30‰ until the 1940s in Antananarivo. Mortality declined rapidly after the World War II and then resurged again in the 1980s as a result of the re-emergence of malaria and the collapse of Madagascar’s economy. Over the past 30 years, impressive gains in life expectancy have been registered thanks to the unabated decline in child mortality, despite political instability, a lasting economic crisis and the persistence of high rates of chronic malnutrition. Progress in adult survival has been more modest because reductions in infectious diseases and diseases of the respiratory system have been partly offset by increases in cardiovascular diseases, neoplasms, and other diseases, particularly at age 50 years and over. Conclusions The transition in Antananarivo has been protracted and largely dependent on anti-microbial and anti-parasitic medicine. The capital city now faces a double burden of communicable and non-communicable diseases. The ongoing registration of deaths in the capital generates a unique database to evaluate the performance of the health system and measure intervention impacts. PMID:24848650

  5. Immunogenic Cell Death Induced by Ginsenoside Rg3: Significance in Dendritic Cell-based Anti-tumor Immunotherapy.

    PubMed

    Son, Keum-Joo; Choi, Ki Ryung; Lee, Seog Jae; Lee, Hyunah

    2016-02-01

    Cancer is one of the leading causes of morbidity and mortality worldwide; therefore there is a need to discover new therapeutic modules with improved efficacy and safety. Immune-(cell) therapy is a promising therapeutic strategy for the treatment of intractable cancers. The effectiveness of certain chemotherapeutics in inducing immunogenic tumor cell death thus promoting cancer eradication has been reported. Ginsenoside Rg3 is a ginseng saponin that has antitumor and immunomodulatory activity. In this study, we treated tumor cells with Rg3 to verify the significance of inducing immunogenic tumor cell death in antitumor therapy, especially in DC-based immunotherapy. Rg3 killed the both immunogenic (B16F10 melanoma cells) and non-immunogenic (LLC: Lewis Lung Carcinoma cells) tumor cells by inducing apoptosis. Surface expression of immunogenic death markers including calreticulin and heat shock proteins and the transcription of relevant genes were increased in the Rg3-dying tumor. Increased calreticulin expression was directly related to the uptake of dying tumor cells by dendritic cells (DCs): the proportion of CRT(+) CD11c(+) cells was increased in the Rg3-treated group. Interestingly, tumor cells dying by immunogenic cell death secreted IFN-γ, an effector molecule for antitumor activity in T cells. Along with the Rg3-induced suppression of pro-angiogenic (TNF-α) and immunosuppressive cytokine (TGF-β) secretion, IFN-γ production from the Rg3-treated tumor cells may also indicate Rg3 as an effective anticancer immunotherapeutic strategy. The data clearly suggests that Rg3-induced immunogenic tumor cell death due its cytotoxic effect and its ability to induce DC function. This indicates that Rg3 may be an effective immunotherapeutic strategy. PMID:26937234

  6. Immunogenic Cell Death Induced by Ginsenoside Rg3: Significance in Dendritic Cell-based Anti-tumor Immunotherapy

    PubMed Central

    Son, Keum-joo; Choi, Ki ryung; Lee, Seog Jae

    2016-01-01

    Cancer is one of the leading causes of morbidity and mortality worldwide; therefore there is a need to discover new therapeutic modules with improved efficacy and safety. Immune-(cell) therapy is a promising therapeutic strategy for the treatment of intractable cancers. The effectiveness of certain chemotherapeutics in inducing immunogenic tumor cell death thus promoting cancer eradication has been reported. Ginsenoside Rg3 is a ginseng saponin that has antitumor and immunomodulatory activity. In this study, we treated tumor cells with Rg3 to verify the significance of inducing immunogenic tumor cell death in antitumor therapy, especially in DC-based immunotherapy. Rg3 killed the both immunogenic (B16F10 melanoma cells) and non-immunogenic (LLC: Lewis Lung Carcinoma cells) tumor cells by inducing apoptosis. Surface expression of immunogenic death markers including calreticulin and heat shock proteins and the transcription of relevant genes were increased in the Rg3-dying tumor. Increased calreticulin expression was directly related to the uptake of dying tumor cells by dendritic cells (DCs): the proportion of CRT+ CD11c+ cells was increased in the Rg3-treated group. Interestingly, tumor cells dying by immunogenic cell death secreted IFN-γ, an effector molecule for antitumor activity in T cells. Along with the Rg3-induced suppression of pro-angiogenic (TNF-α) and immunosuppressive cytokine (TGF-β) secretion, IFN-γ production from the Rg3-treated tumor cells may also indicate Rg3 as an effective anticancer immunotherapeutic strategy. The data clearly suggests that Rg3-induced immunogenic tumor cell death due its cytotoxic effect and its ability to induce DC function. This indicates that Rg3 may be an effective immunotherapeutic strategy. PMID:26937234

  7. Infant death scene investigation.

    PubMed

    Tabor, Pamela D; Ragan, Krista

    2015-01-01

    The sudden unexpected death of an infant is a tragedy to the family, a concern to the community, and an indicator of national health. To accurately determine the cause and manner of the infant's death, a thorough and accurate death scene investigation by properly trained personnel is key. Funding and resources are directed based on autopsy reports, which are only as accurate as the scene investigation. The investigation should include a standardized format, body diagrams, and a photographed or videotaped scene recreation utilizing doll reenactment. Forensic nurses, with their basic nursing knowledge and additional forensic skills and abilities, are optimally suited to conduct infant death scene investigations as well as train others to properly conduct death scene investigations. Currently, 49 states have child death review teams, which is an idea avenue for a forensic nurse to become involved in death scene investigations. PMID:25642921

  8. A population-based post mortem study of sudden unexpected death in epilepsy.

    PubMed

    Clark, Damian; Riney, Kate

    2016-01-01

    The aim of this study was to review population autopsy data on epilepsy-related deaths (ERD) in Queensland, Australia, to establish the incidence of autopsy-confirmed sudden unexpected death in epilepsy (SUDEP), explore factors associated with SUDEP, and determine if complete autopsy examinations of SUDEP were performed. All autopsy reports for a 5year period in Queensland were electronically searched for the terms 'epilepsy' or 'seizure'. The identified reports were reviewed, and data were extracted for all ERD. In the study period, 175 ERD were identified from autopsy records (123 SUDEP, 34 accident-related, 3 due to status epilepticus). From data available on the prevalence of epilepsy in Queensland (National Health Survey), the incidence of autopsy-confirmed SUDEP was 0.7 per 1000 person years (95% confidence interval 0.5-1.2 per 1000 person years). The factors associated with SUDEP were male sex (for those >18 years) and subtherapeutic anticonvulsant medication levels (found in 55%). Where recorded, the majority of deaths happened in the person's usual residence (90%), were overnight (70%) and unwitnessed (87%), with the person found prone (74%), in or adjacent to their bed (49%) and with signs of proximate seizure (60%). A complete autopsy was undertaken for only 59% of cases, the majority in urban locations. This study provides support for an unwitnessed overnight seizure being a key factor in autopsy-confirmed SUDEP in Queensland. PMID:26387918

  9. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes

    PubMed Central

    França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; de Morais, Otaliba Libânio; Szwarcwald, Célia Landman

    2014-01-01

    OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes. PMID:25210826

  10. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes.

    PubMed

    França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; Morais Neto, Otaliba Libânio de; Szwarcwald, Célia Landman

    2014-08-01

    OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes. PMID:25210826

  11. Maternal risk factors for potential maltreatment deaths among healthy singleton and twin infants.

    PubMed

    Luke, Barbara; Brown, Morton B

    2007-10-01

    Our aim was to evaluate the risk of death among healthy infants due to maltreatment, using national linked vital statistics data. The study population included all nonanomalous, full-term (> or = 37 weeks), non-low birthweight (> 2500 grams) infants born between 1995 and 2000 and their linked death certificates: 18,673,439 singleton pregnancies (36,864 deaths) and 77,800 twin pregnancies (356 pregnancies with a death). The underlying cause of death was characterized as due to maltreatment, sudden infant death syndrome (SIDS), and other causes, based on ICD-9 and ICD-10 codes, and modeled by maternal age using multinomial logistic regression; mothers aged 25 to 29 were the reference group. The highest risk for infant mortality was among the youngest mothers for maltreatment (AOR 2.45 and 1.95 for singleton mothers < 20 and aged 20 to 24, respectively; AOR 4.34 and 2.25 for twin mothers < 20 and aged 20 to 24, respectively). The risk of death overall and for each category was modeled by maternal age < 20, aged 20 to 24, and > or = 25, with and without the father's age present on the birth certificate, with mothers > or = 25 and father's age present as the reference group. All risks of death were significantly increased for mothers younger than age 25, with the highest risks among the youngest mothers and missing father's age. The pattern for twins was similar, with elevated risks among younger mothers with or without father's age present on the birth certificate. These results add to the body of knowledge regarding risk factors for infant mortality among healthy singletons and twins. PMID:17903121

  12. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    PubMed Central

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality. PMID:25590598

  13. 20 CFR 655.204 - Determinations based on temporary labor certification applications.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the bases of the OFLC Administrator's determination in accordance with the DHS regulation at 8 CFR 214... for Logging Employment and Non-H-2A Agricultural Employment § 655.204 Determinations based...

  14. 20 CFR 655.204 - Determinations based on temporary labor certification applications.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the bases of the OFLC Administrator's determination in accordance with the DHS regulation at 8 CFR 214... for Logging Employment and Non-H-2A Agricultural Employment § 655.204 Determinations based...

  15. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Internet-based TRS provider and TRS program... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 Internet-based TRS... including notification in the Federal Register. (2) Internet-based TRS provider. Any entity desiring...

  16. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Internet-based TRS provider and TRS program... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 Internet-based TRS... including notification in the Federal Register. (2) Internet-based TRS provider. Any entity desiring...

  17. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Internet-based TRS provider and TRS program... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 Internet-based TRS... including notification in the Federal Register. (2) Internet-based TRS provider. Any entity desiring...

  18. Single base substitution in OsCDC48 is responsible for premature senescence and death phenotype in rice.

    PubMed

    Huang, Qi-Na; Shi, Yong-Feng; Zhang, Xiao-Bo; Song, Li-Xin; Feng, Bao-Hua; Wang, Hui-Mei; Xu, Xia; Li, Xiao-Hong; Guo, Dan; Wu, Jian-Li

    2016-01-01

    A premature senescence and death 128 (psd128) mutant was isolated from an ethyl methane sulfonate-induced rice IR64 mutant bank. The premature senescence phenotype appeared at the six-leaf stage and the plant died at the early heading stage. psd128 exhibited impaired chloroplast development with significantly reduced photosynthetic ability, chlorophyll and carotenoid contents, root vigor, soluble protein content and increased malonaldehyde content. Furthermore, the expression of senescence-related genes was significantly altered in psd128. The mutant trait was controlled by a single recessive nuclear gene. Using map-based strategy, the mutation Oryza sativa cell division cycle 48 (OsCDC48) was isolated and predicted to encode a putative AAA-type ATPase with 809 amino-acid residuals. A single base substitution at position C2347T in psd128 resulted in a premature stop codon. Functional complementation could rescue the mutant phenotype. In addition, RNA interference resulted in the premature senescence and death phenotype. OsCDC48 was expressed constitutively in the root, stem, leaf and panicle. Subcellular analysis indicated that OsCDC48:YFP fusion proteins were located both in the cytoplasm and nucleus. OsCDC48 was highly conserved with more than 90% identity in the protein levels among plant species. Our results indicated that the impaired function of OsCDC48 was responsible for the premature senescence and death phenotype. PMID:26040493

  19. Assessment of Computer-based Geologic Mapping of Rock Units in the LANDSAT-4 Scene of Northern Death Valley, California

    NASA Technical Reports Server (NTRS)

    Short, N. M.

    1984-01-01

    Results from a series of geologic classifications conducted on a thematic mapper subscene of the northern Death Valley, California are reported. Measurements of accuracy are made through comparison with the 1977 edition of the Death Valley geologic sheet. This employs a simplified map version which is registered by computer to the image data base, allowing a pixel by pixel match with the classified scene. The results show accuracy ranges from 36 to 79% depending on the type of classifier used and the statistical adjustments made to the data. Accuracy values in identifying geologic units were 2 to 3 times higher for those in the relatively flat valleys than for units in the rugged mountainous terrain. Improvements in accuracy will be sought by correcting for slope/aspect variations in mountainous terrain using topographic data recorded in Defense Mapping Agency (DMA) tapes. The above classification results will also be compared with ratio and principal component image classifications made from the same scene.

  20. Cardiovascular Deaths among Alaskan Natives, 1980-86.

    ERIC Educational Resources Information Center

    Middaugh, John P.

    1990-01-01

    Analyzes death certificate data to discover the number of deaths of Alaskan natives caused by cardiovascular disease. Rates from cardiovascular diseases and atherosclerosis from 1980-86 among Alaskan natives were lower than rates among other Alaskans, while death rates from other causes were higher. Discusses the possible impact of diet. (JS)

  1. [The medical certificate--contents, form, deficiencies, fees].

    PubMed

    Schulz, E

    1996-02-01

    The medical certificate ist a written health certificate based on the results of a medical diagnosis or examination. It does not contain scientifically base conclusions. The various forms of the certificate can be, for example, certificates of unfitness for work, certificates for insurance companies, certificates for exemption from school sports, diet certificates for tax returns, confirmation of a stable diabetes condition for driving licence authorities, certificates as proof of unfitness to plead in the process of criminal law. It is an offence (section 278 German Penal Code) to issue false health certificates for use with a public authority or insurance company contrary to one's knowledge. The form of some certificates is free, in some cases forms are used. "Standard form certificates" for insurance company are extended certificates. Certificates, especially free-form certificates, often have deficiencies: the purpose or addressee is not quoted; the date of the examination has not been entered; it is not apparent whether the statement is based on objective results; "catchword" like diagnostic terms are used: the necessary form ist not adhered to. The "Law concerning Compensation for Witnesses and Experts" (ZSEG) and the Scale of Medical Fees (GOA) set the standards for assessing the fee for a certificate. PMID:8852073

  2. Competency-Based Teacher Education and Certification Definitions: Synthesis and Schema.

    ERIC Educational Resources Information Center

    Roth, Robert A.

    This document is divided into an introduction and two sections. Each section is divided into two parts: definition and synthesis. Section 1 is devoted to competency-based teacher education. The "definition" part presents 14 definitions of competency-based teacher education that have been culled from various authorities. The "synthesis" part lists…

  3. Early deaths in bloodstream infections: a population-based case series.

    PubMed

    Kontula, Keiju S K; Skogberg, Kirsi; Ollgren, Jukka; Järvinen, Asko; Lyytikäinen, Outi

    2016-05-01

    A notable portion of deaths in bloodstream infections (BSI) have previously been shown to occur within 2 days after taking the first positive blood culture specimen. The aim of this study was to analyse patients' characteristics and causative pathogens of BSIs, leading to early deaths in order to explore possibilities for prevention. Patients with BSI in Helsinki and Uusimaa region (population = 1.5 million) in 2007 were identified from the National Infectious Disease Register (n = 2181) and their deaths within 2 days after the first positive blood culture from the Population Information System (n = 76). Of the early fatal BSIs, 42 (55%) were community-acquired (CA-BSI) and 34 (45%) healthcare-associated (HA-BSI). Charlson comorbidity index was moderate-to-high (index ≥ 3) in 71% of HA-BSIs and 60% of CA-BSIs. The most common pathogens in CA-BSIs were Streptococcus pneumoniae (29%) and Escherichia coli (24%) and in HA-BSIs Pseudomonas aeruginosa (24%) and Staphylococcus aureus (18%). The respiratory tract (50%) was the most common focus of infection. Empiric antimicrobial treatment was more often appropriate in CA-BSIs vs HA-BSIs (81% vs 41%, p < 0.001), but treatment delays were longer in CA-BSIs. The majority of the BSI patients who died early had severe comorbidities. S. pneumoniae accounted for one third of CA-BSIs, highlighting the potential role of pneumococcal vaccines in prevention. Early recognition of BSI and its origin (CA-BSI vs HA-BSI) is crucial. Continuous surveillance data on causative microbes and resistance trends in hospitals is needed to propose guidelines for empiric antimicrobial therapy of BSIs. PMID:26763410

  4. Excess Deaths Associated With Tigecycline After Approval Based on Noninferiority Trials

    PubMed Central

    Prasad, Paritosh; Sun, Junfeng; Danner, Robert L.; Natanson, Charles

    2012-01-01

    Background. On the basis of noninferiority trials, tigecycline received Food and Drug Administration (FDA) approval in 2005. In 2010, the FDA warned in a safety communication that tigecycline was associated with an increased risk of death. Methods. PubMed, EMBASE, Scopus, and ClinicalTrials.gov were searched using the terms “tigecycline” and “randomized controlled trial (RCT)” through April 2011. Excess deaths and noncure rates for both approved and nonapproved indications were examined using meta-analysis. Results. Ten published and 3 unpublished studies met inclusion criteria (N = 7434). No significant heterogeneity was seen for mortality (I2 = 0%; P = .99) or noncure rates (I2 = 25%; P = .19). Across randomized controlled trials, tigecycline was associated with increased mortality (risk difference [RD], 0.7%; 95% confidence interval [CI], 0.1%–1.2%; P = .01) and noncure rates (RD, 2.9%; 95% CI, 0.6%–5.2%; P = .01). Effects were not isolated to type of infection or comparator antibiotic regimen, and the impact on survival remained significant when limited to trials of approved indications (I2 = 0%; RD, 0.6%; P = .04). A pooled analysis of the 5 trials completed by early 2005 before tigecycline was approved would have demonstrated a similar harmful effect of tigecycline on survival (I2 = 0%; RD, 0.7%; P = .06). Conclusions. Pooling noninferiority studies to examine survival may help ensure the safety and efficacy of new antibiotics. The association of tigecycline with excess deaths and noncure includes indications for which it is approved and marketed. Tigecycline cannot be relied on in serious infections. PMID:22467668

  5. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010)

    PubMed Central

    Braggion-Santos, Maria Fernanda; Volpe, Gustavo Jardim; Pazin-Filho, Antonio; Maciel, Benedito Carlos; Marin-Neto, José Antonio; Schmidt, André

    2015-01-01

    Background Sudden cardiac death (SCD) is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents) according to Coroners’ Office autopsy reports. Methods We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR) was attempted were collected. Results We identified 899 cases of SCD (20%); the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD) (64%) and occurred in men (67%), between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3%) and CPR was attempted in almost half of victims (49.7%). The most prevalent comorbidity was systemic hypertension (57.3%). Chagas’ disease was present in 49 cases (5.5%). Conclusion The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases. PMID:25424162

  6. Using multiple cause-of-death data to improve surveillance of drug-related mortality

    PubMed Central

    Nordstrom, David L.; Yokoi-Shelton, Mieko L.; Zosel, Amy

    2015-01-01

    Context Many state and local areas are affected by the national epidemic of drug-related mortality, which recently has shown signs of a rising licit-to-illicit drug death ratio. Appropriate local public health surveillance can help to monitor and control this epidemic. Objective Using our state as an example, we sought to illustrate how to describe the changes in drug death rates, causes, and circumstances. In contrast to most other surveillance reports, our approach includes both drug-induced and drug-related deaths and both demographic and socioeconomic decedent characteristics. Design Cross-sectional study. Setting All residents of the State of Wisconsin. Participants Decedents from 1999–2008. Main outcome measure Annual numbers and population-based rates of deaths due to drugs, including both identified and unidentified drugs. Information was obtained from death certificates with any of approximately 270 underlying, immediate, or contributing cause of death codes from the International Classification of Diseases 10th Revision. Results Drug-related death rates increased during much of the 10-year study period, and the ratio of male to female deaths rose. The median age at death from drug-related causes was 43 years. Opioid analgesic poisoning surpassed cocaine and heroin poisoning as the most frequent type of fatal drug poisoning. Of all 4828 deaths from drug-related causes--virtually all of which were certified by a county medical examiner or coroner--3,410 (71%) were unintentional, and 1,053 (22%) were suicide. The unintentional-to-suicide death rate ratio grew from 1.6 to 3.5 during the study period. Methadone-related deaths increased from 10 in 1999 to 118 in 2008 (1080%), while benzodiazepine-related deaths rose from 23 to 106 (361%). Conclusions Although premature deaths from drug use and abuse continue to rise, in some states even surpassing motor vehicle crash deaths, multiple cause of death information from death certificates is available to monitor their occurrence and nature and to inform selection of prevention strategies. PMID:23266754

  7. A study in causal discovery from population-based infant birth and death records.

    PubMed Central

    Mani, S.; Cooper, G. F.

    1999-01-01

    In the domain of medicine, identification of the causal factors of diseases and outcomes, helps us formulate better management, prevention and control strategies for the improvement of health care. With the goal of exploring, evaluating and refining techniques to learn causal relationships from observational data, such as data routinely collected in healthcare settings, we focused on investigating factors that may contribute causally to infant mortality in the United States. We used the U.S. Linked Birth/Infant Death dataset for 1991 with more than four million records and about 200 variables for each record. Our sample consisted of 41,155 records randomly selected from the whole dataset. Each record had maternal, paternal and child factors and the outcome at the end of the first year--whether the infant survived or not. For causal discovery we used a modified Local Causal Discovery (LCD2) algorithm, which uses the framework of causal Bayesian Networks to represent causal relationships among model variables. LCD2 takes as input a dataset and outputs causes of the form variable X causes variable Y. Using the infant birth and death dataset as input, LCD2 output nine purported causal relationships. Eight out of the nine relationships seem plausible. Even though we have not yet discovered a clinically novel causal link, we plan to look for novel causal pathways using the full sample after refining the algorithm and developing a more efficient implementation. PMID:10566372

  8. Autoerotic death: incidence and age of victims--a population-based study.

    PubMed

    Byard, Roger W; Winskog, Calle

    2012-01-01

    Review of the Australian National Coronial Information System and the Swedish National Forensic Database was undertaken over a 7-year period from 2001 to 2007 for all cases where death had been attributed to autoerotic death or sexual asphyxia. In Australia, there were 44 cases (M:F = 42:2) with the majority of victims aged >30 years (77%)-a yearly national rate of approximately 0.3/million. In Sweden, there were nine cases (M:F = 9:0) with the majority of cases aged <30 years (55%)-a yearly national rate of approximately 0.14/million. The usual male predominance was present in both populations, although the Australian victims were older than is usually reported. Lethal sexual asphyxia is uncommon in both the Australian and Swedish populations, with a lower rate than has been cited for North America. Whether this is because of different kinds of paraphilic activities in different populations or of differences in methods of central data collection is uncertain. PMID:21827479

  9. Certification/enforcement analysis

    SciTech Connect

    1980-06-01

    Industry compliance with minimum energy efficiency standards will be assured through a two-part program approach of certification and enforcement activities. The technical support document (TSD) presents the analyses upon which the proposed rule for assuring that consumer product comply with applicable energy efficiency standards is based. Much of the TSD is based upon support provided DOE by Vitro Laboratories. The OAO Corporation provided additional support in the development of the sampling plan incorporated in the proposed rule. Vitro's recommended approach to appliance certification and enforcement, developed after consideration of various program options, benefits, and impacts, establishes the C/E program framework, general criteria, and procedures for assuring a specified level of energy efficiency performance of covered consumer products. The results of the OAO analysis are given in Volume II of the TSD.

  10. Causes of Deaths in Children under-Five Years Old at a Tertiary Hospital in Limpopo Province of South Africa

    PubMed Central

    Ntuli, Sam Thembelihle; Malangu, Ntambwe; Alberts, Marianne

    2013-01-01

    Objective: Accurate and timely information on the causes of child deaths is essential in guiding efforts to improve child survival, by providing data from which health profiles can be constructed and relevant health policies formulated. The purpose of this study was to identify causes of death in children younger than 5 years-old in a tertiary hospital in South Africa. Methods: Death certificates from the Pietersburg/Mankweng hospital complex, for the period of January 1, 2008 through December 31, 2010, were obtained for all patients younger than 5 years and were retrospectively reviewed. Data were collected using a data collection form designed for the study. Information abstracted included: date of death, age, sex, and cause of death. Results: A total of 1266 deaths were recorded, the sex ratio was 1.26 boys per girl. About 611 (48%) of deaths were listed as neonatal deaths (0-28 days), 387 (31%) were listed as infant deaths (29 days-11 months), and 268 (21%) as children’s death (1-4 years). For neonates the leading causes of death were: prematurity/low birth weight, birth asphyxia and pneumonia. For the infant death group, the leading causes of death were pneumonia, diarrhea, and HIV/AIDS; and in the children’s group, the leading causes were injuries, diarrhea and pneumonia. There was no statistical significant difference in the proportions of causes of death based on the sex of children. Conclusion: The top 10 leading causes of death in children under-5 years old treated at Pietersburg/Mankweng Hospital Complex were in descending order: prematurity/low birth weight, pneumonia, diarrheal diseases, birth asphyxia, and severe malnutrition, HIV/AIDS, hydrocephalus, unintentional injuries, meningitis and other infections. These ten conditions represent 73.9% of causes of death at this facility. A mix of multi-faceted interventions is needed to address these causes of death in children. PMID:23618479

  11. 78 FR 35115 - Listing of Color Additives Exempt From Certification; Mica-Based Pearlescent Pigments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ... FR 16784), FDA announced that a color additive petition (CAP 2C0294) had been filed by E. & J. Gallo... of mica-based pearlescent pigments in food (Sec. 73.350) and ingested drugs (Sec. 73.1350) (71 FR... and at the 90th percentile, respectively, for the subgroup of children aged 2 to 5 years (71 FR...

  12. Fetal deaths in Brazil: a systematic review

    PubMed Central

    Barbeiro, Fernanda Morena dos Santos; Fonseca, Sandra Costa; Tauffer, Mariana Girão; Ferreira, Mariana de Souza Santos; da Silva, Fagner Paulo; Ventura, Patrícia Mendonça; Quadros, Jesirée Iglesias

    2015-01-01

    OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners. RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history. CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary. PMID:25902565

  13. Network-based survival-associated module biomarker and its crosstalk with cell death genes in ovarian cancer

    PubMed Central

    Jin, Nana; Wu, Hao; Miao, Zhengqiang; Huang, Yan; Hu, Yongfei; Bi, Xiaoman; Wu, Deng; Qian, Kun; Wang, Liqiang; Wang, Changliang; Wang, Hongwei; Li, Kongning; Li, Xia; Wang, Dong

    2015-01-01

    Ovarian cancer remains a dismal disease with diagnosing in the late, metastatic stages, therefore, there is a growing realization of the critical need to develop effective biomarkers for understanding underlying mechanisms. Although existing evidences demonstrate the important role of the single genetic abnormality in pathogenesis, the perturbations of interactors in the complex network are often ignored. Moreover, ovarian cancer diagnosis and treatment still exist a large gap that need to be bridged. In this work, we adopted a network-based survival-associated approach to capture a 12-gene network module based on differential co-expression PPI network in the advanced-stage, high-grade ovarian serous cystadenocarcinoma. Then, regulatory genes (protein-coding genes and non-coding genes) direct interacting with the module were found to be significantly overlapped with cell death genes. More importantly, these overlapping genes tightly clustered together pointing to the module, deciphering the crosstalk between network-based survival-associated module and cell death in ovarian cancer. PMID:26099452

  14. Certificates in General Education for Adults. Certificate I (Foundation). Certificate II & Certificate II (Further Study).

    ERIC Educational Resources Information Center

    National Languages and Literacy Inst. of Australia, Melbourne. Adult Education Resource and Information Service.

    This document is intended for adult education providers in Victoria, Australia, who intend to deliver courses leading to one or more of the following certificates in general education for adults: Certificate I in General Education for Adults (Foundation); Certificate II in General Education for Adults; and Certificate II in General Education for

  15. Building secure wireless access point based on certificate authentication and firewall captive portal

    NASA Astrophysics Data System (ADS)

    Soewito, B.; Hirzi

    2014-03-01

    Wireless local area network or WLAN more vulnerability than wired network even though WLAN has many advantages over wired. Wireless networks use radio transmissions to carry data between end users and access point. Therefore, it is possible for someone to sit in your office building's lobby or parking lot or parking lot to eavesdrop on the wireless network communication. This paper discussed securing wires local area network used WPA2 Enterprise based PEAP MS-CHAP and Captive portal firewall. We also divided the network for employer and visitor to increase the level of security. Our experiment showed that the WLAN could be broken using the attacker tool such as airodump, aireply, and aircrack.

  16. End-of-life medical decisions in France: a death certificate follow-up survey 5 years after the 2005 act of parliament on patients’ rights and end of life

    PubMed Central

    2012-01-01

    Background The “Patients’ Rights and End of Life Care” Act came into force in France in 2005. It allows withholding/withdrawal of life-support treatment, and intensified use of medications that may hasten death through a double effect, as long as hastening death is not the purpose of the decision. It also specifies the requirements of the decision-making process. This study assesses the situation by examining the frequency of end-of-life decisions by patients’ and physicians’ characteristics, and describes the decision-making processes. Methods We conducted a nationwide retrospective study of a random sample of adult patients who died in December 2009. Questionnaires were mailed to the physicians who certified/attended these deaths. Cases were weighted to adjust for response rate bias. Bivariate analyses and logistic regressions were performed for each decision. Results Of all deaths, 16.9% were sudden deaths with no information about end of life, 12.2% followed a decision to do everything possible to prolong life, and 47.7% followed at least one medical decision that may certainly or probably hasten death: withholding (14.6%) or withdrawal (4.2%) of treatments, intensified use of opioids and/or benzodiazepines (28.1%), use of medications to deliberately hasten death (i.e. not legally authorized) (0.8%), at the patient’s request (0.2%) or not (0.6%). All other variables held constant, cause of death, patient's age, doctor’s age and specialty, and place of death, influenced the frequencies of decisions. When a decision was made, 20% of the persons concerned were considered to be competent. The decision was discussed with the patient if competent in 40% (everything done) to 86% (intensification of alleviation of symptoms) of cases. Legal requirements regarding decision-making for incompetent patients were frequently not complied with. Conclusions This study shows that end-of-life medical decisions are common in France. Most are in compliance with the 2005 law (similar to some other European countries). Nonetheless, the study revealed cases where not all legal obligations were met or where the decision was totally illegal. There is still a lot to be done through medical education and population awareness-raising to ensure that the decision-making process is compatible with current legislation, the physician's duty of care and the patient’s rights. PMID:23206428

  17. The "Last Mile" in Standards-Based Reform: Conducting a Match Study Linking Teacher-Certification Tests to Student Standards

    ERIC Educational Resources Information Center

    Murphy, Edward J.

    2006-01-01

    States have invested significant resources in developing student academic standards. Mr. Murphy argues that, for these standards to be effective, teacher preparation and certification must be aligned with them. He proposes "match studies" as a way to ensure this alignment. (Contains 3 endnotes.)

  18. Work-related deaths in children.

    PubMed

    Suruda, A; Halperin, W

    1991-01-01

    An analysis of OSHA fatality investigations for 1984-1987 found 104 work-related deaths in children. The largest category (30%) involved industrial vehicles and equipment, followed by electrocution (17%) and falls (11%). Forty-three deaths (41%) occurred while engaged in types of work prohibited for children by the Fair Labor Standards Act (FLSA). Three deaths involved work with conveyors, an activity currently permitted for child workers under FLSA. OSHA issued citations for safety violations in 70% of deaths. Since OSHA investigates only some work-related deaths, the actual number of child labor fatalities during the four year period was probably higher. Using information from OSHA and from death certificate data, we estimate that there are at least 100 work-related deaths in the United States in children under 18 each year. Hazardous child labor continues to occur even in industries regulated by OSHA and FLSA. PMID:1882852

  19. An ostracode based paleolimnologic and paleohydrologic history of Death Valley: 200 to 0 ka

    USGS Publications Warehouse

    Forester, R.M.; Lowenstein, T.K.; Spencer, R.J.

    2005-01-01

    Death Valley, a complex tectonic and hydrologic basin, was cored from its lowest surface elevation to a depth of 186 m. The sediments range from bedded primary halite to black muds. Continental ostracodes found in the black muds indicate that those sediments were deposited in a variety of hydrologic settings ranging from deep, relatively fresh water to shallow saline lakes to spring discharge supported wetlands. The alkaline-enriched, calcium-depleted paleolake waters indicate extrabasinal streamflow and basin-margin spring discharge. The alkaline-depleted, calcium-enriched paleowetland waters indicate intrabasinal spring discharge. During Marine Isotope Stage 6 (MIS 6, ca. 180-140 ka) the hydrologic settings were highly variable, implying that complex relations existed between climate and basin hydrology. Termination II (MIS 6 to MIS 5E) was a complex multicyclic sequence of paleoenvironments, implying that climates oscillated between high and low effective moisture. MIS 4 (ca. 73-61 ka) was a spring discharge supported wetland complex. During MIS 2 (ca. 20-12 ka) the hydrologic settings were variable, although they are not fully understood because some black muds deposited during that time were lost during coring. ?? 2005 Geological Society of America.

  20. The changing demographics of inpatient hospice death: Population-based cross-sectional study in England, 1993–2012

    PubMed Central

    Sleeman, Katherine E; Davies, Joanna M; Verne, Julia; Gao, Wei; Higginson, Irene J

    2016-01-01

    Background: Studies in the United Kingdom and elsewhere have suggested inequality of hospice provision with respect to factors such as age, diagnosis and socio-economic position. How this has changed over time is unknown. Aim: To describe the factors associated with inpatient hospice death in England and examine how these have changed over time. Design: Population-based study. Multivariable Poisson regression compared 1998–2002, 2003–2007 and 2008–2012, with 1993–1997. Explanatory variables included individual factors (age, gender, marital status, underlying cause of death) and area-based measures of deprivation. Setting: Adults aged 25 years and over who died in inpatient hospice units in England between 1993 and 2002 (n = 446,615). Results: The annual number of hospice deaths increased from 17,440 in 1993 to 26,032 in 2012, accounting for 3.4% of all deaths in 1993 and 6.0% in 2012. A total of 50.6% of hospice decedents were men; the mean age was 69.9 (standard deviation: 12.4) years. The likelihood of hospice decedents being in the oldest age group (>85 years) increased over time (proportion ratio: 1.43, 95% confidence interval: 1.39 to 1.48 for 2008–2012 compared to 1993–1997). Just 5.2% of all hospice decedents had non-cancer diagnoses, though the likelihood of non-cancer conditions increased over time (proportion ratio: 1.41, 95% confidence interval: 1.37 to 1.46 for 2008–2012 compared to 1993–1997). The likelihood of hospice decedents being resident in the least deprived quintile increased over time (proportion ratio: 1.25, 95% confidence interval: 1.22 to 1.29 for 2008–2012 compared to 1993–1997). Conclusion: The increase in non-cancer conditions among hospice decedents is encouraging although absolute numbers remain very small. Deprivation trends are concerning and require further exploration. PMID:25991729

  1. Certificates: Gateway to Gainful Employment and College Degrees

    ERIC Educational Resources Information Center

    Carnevale, Anthony P.; Rose, Stephen J.; Hanson, Andrew R.

    2012-01-01

    Certificates are recognition of completion of a course of study based on a specific field, usually associated with a limited set of occupations. Certificates differ from other kinds of labor market credentials such as industry-based certifications and licenses, which typically involve passing an examination to prove a specific competency,…

  2. The national review of asthma deaths: what did we learn and what needs to change?

    PubMed Central

    2015-01-01

    Key points The 2014 UK National Review of Asthma Deaths identified potentially preventable factors in two-thirds of the medical records of cases scrutinised 45% of people who died from asthma did not call for or receive medical assistance in their final fatal attack Overall asthma management, acute and chronic, in primary and secondary care was judged to be good in less than one-fifth of those who died There was a failure by doctors and nurses to identify and act on risk factors for asthma attacks and asthma death The rationale for diagnosing asthma was not evident in a considerable number of cases, and there were inaccuracies related to the completion of medical certificates of the cause of death in over half of the cases considered for the UK National Review of Asthma Deaths Educational aims To increase awareness of some of the findings of the recent UK National Review of Asthma Deaths and previous similar studies To emphasise the need for accurate diagnosis of asthma, and of the requirements for completion of medical certificates of the cause of death To consider areas for improving asthma care and prevention of attacks and avoidable deaths Summary Despite the development and publication of evidence-based asthma guidelines nearly three decades ago, potentially preventable factors are repeatedly identified in studies of the care provided for patients who die from asthma. The UK National Review of Asthma Deaths (NRAD), a confidential enquiry, was no exception: major preventable factors were identified in two-thirds of asthma deaths. Most of these factors, such as inappropriate prescription and failure to provide patients with personal asthma action plans (PAAPs), could possibly have been prevented had asthma guidelines been implemented. NRAD involved in-depth scrutiny by clinicians of the asthma care for 276 people who were classified with asthma as the underlying cause of death in real-life. A striking finding was that a third of these patients did not actually die from asthma, and many had no recorded rationale for an asthma diagnosis. The apparent complacency with respect to asthma care, highlighted in NRAD, serves as a wake-up call for health professionals, patients and their carers to take asthma more seriously. Based on the NRAD evidence, the report made 19 recommendations for change. The author has selected six areas related to the NRAD findings for discussion and provides suggestions for change in the provision of asthma care. The six areas are: systems for provision and optimisation of asthma care, diagnosis, identifying risk, implementation of guidelines, improved patient education and self-management, and improved quality of completion of medical certificates of the cause of death. PMID:26306100

  3. Rates of readmission and death associated with leaving hospital against medical advice: a population-based study

    PubMed Central

    Garland, Allan; Ramsey, Clare D.; Fransoo, Randy; Olafson, Kendiss; Chateau, Daniel; Yogendran, Marina; Kraut, Allen

    2013-01-01

    Background: Leaving hospital against medical advice may have adverse consequences. Previous studies have been limited by evaluating specific types of patients, small sample sizes and incomplete determination of outcomes. We hypothesized that leaving hospital against medical advice would be associated with increases in subsequent readmission and death. Methods: In a population-based analysis involving all adults admitted to hospital and discharged alive in Manitoba from Apr. 1, 1990, to Feb. 28, 2009, we evaluated all-cause 90-day mortality and 30-day hospital readmission. We used multivariable regression, adjusted for age, sex, socioeconomic status, year of hospital admission, patient comorbidities, hospital diagnosis, past frequency of admission to hospital, having previously left hospital against medical advice and data clustering (patients with multiple admissions). For readmission, we assessed both between-person and within-person effects of leaving hospital against medical advice. Results: Leaving against medical advice occurred in 21 417 of 1 916 104 index hospital admissions (1.1%), and was associated with higher adjusted rates of 90-day mortality (odds ratio [OR] 2.51, 95% confidence interval [CI] 2.18–2.89), and 30-day hospital readmission (within-person OR 2.10, CI 1.99–2.21; between-person OR 3.04, CI 2.79–3.30). In our additional analyses, elevated rates of readmission and death associated with leaving against medical advice were manifest within 1 week and persisted for at least 180 days after discharge. Interpretation: Adults who left the hospital against medical advice had higher rates of hospital readmission and death. The persistence of these effects suggests that they are not solely a result of incomplete treatment of acute illness. Interventions aimed at reducing these effects may need to include longitudinal interventions extending beyond admission to hospital. PMID:23979869

  4. Detachment-Based Equilibrium of Anoikic Cell Death and Autophagic Cell Survival Through Adaptor Protein p66(Shc).

    PubMed

    Cai, Zeyuan; Zhao, Dan; Sun, Yanan; Gao, Dan; Li, Xia; Yang, Jie; Ma, Zhenyi

    2016-03-01

    Anoikis (detachment-induced cell death) confers a tumor-suppressive function in metastatic cancer cells. Autophagy, a conserved self-degradative process, enhances the anoikis resistance of detached cancer cells by maintaining cellular homeostasis. However, the mechanism of regulating cell fate-decision by balancing anoikis and autophagy has been poorly understood. Our previous studies have shown that the adaptor protein p66(Shc) mediates anoikis through RhoA activation and inhibits tumor metastasis in vivo. We also found that p66(Shc) depletion mitigates nutrient-deprivation-induced autophagy. These findings suggest p66(Shc) may coordinately regulate these two processes. To verify this hypothesis, we investigated the effect of p66(Shc) on the cell death of detached lung cancer cells, and measured autophagy markers and autophagic flux. Results showed that p66(Shc) depletion significantly inhibited anoikis, and reduced the formation of LC3B-II and the degradation of Sequestosome 1 (SQSTM1, p62) in detachment-induced cells. Using monodansylcadaverine (MDC)-LysoTracker double staining and monomeric Cherry (mCherry)-GFP-LC3 assay, we found that the autophagic flux was also mitigated by p66(Shc) depletion. In addition, p66(Shc) knockdown increased the formation of full-length X-linked inhibitor of apoptosis (XIAP)-associated factor 1 (XAF1), which enhances anoikis sensitivity. In conclusion, p66(Shc) plays an essential role in detachment-based equilibrium of anoikic cell death and autophagic cell survival. Anat Rec, 299:325-333, 2016. © 2015 Wiley Periodicals, Inc. PMID:26643258

  5. Diagnosis of causes of childhood deaths in developing countries by verbal autopsy: suggested criteria. The SEARCH Team.

    PubMed Central

    Bang, A. T.; Bang, R. A.

    1992-01-01

    In the absence of medical certification of deaths in developing countries, lay reporting and verbal autopsy have emerged as useful alternative methods for collecting data on causes of death. Of these, verbal autopsy offers advantages and is widely used in field studies and child survival programmes. However, because uniform and valid criteria for the diagnosis of common causes of death are lacking, comparison of the results of different studies becomes meaningless. This article proposes such a set of criteria for the cause of death among neonates and for those aged 1-59 months. The criteria are based on the findings of earlier validation studies, a Delphi survey and the experience gained from performing 1000 verbal autopsies in Gadchiroli, India. The emergence of such standardized criteria of causes of death should be of immense value for health planning, monitoring and evaluation purposes and for interregional comparisons. PMID:1394784

  6. Aerosol delivery of programmed cell death protein 4 using polysorbitol-based gene delivery system for lung cancer therapy.

    PubMed

    Kim, You-Kyoung; Xing, Lei; Chen, Bao-An; Xu, Fengguo; Jiang, Hu-Lin; Zhang, Can

    2014-11-01

    The development of a safe and effective gene delivery system is the most challenging obstacle to the broad application of gene therapy in the clinic. In this study, we report the development of a polysorbitol-based gene delivery system as an alternative gene carrier for lung cancer therapy. The copolymer was prepared by a Michael addition reaction between sorbitol diacrylate (SD) and spermine (SPE); the SD-SPE copolymer effectively condenses with DNA on the nanoscale and protects it from nucleases. SD-SPE/DNA complexes showed excellent transfection with low toxicity both in vitro and in vivo, and aerosol delivery of SD-SPE complexes with programmed cell death protein 4 DNA significantly suppressed lung tumorigenesis in K-ras(LA1) lung cancer model mice. These results demonstrate that SD-SPE has great potential as a gene delivery system based on its excellent biocompatibility and high gene delivery efficiency for lung cancer gene therapy. PMID:24983766

  7. Eighth Amendment & Death Penalty.

    ERIC Educational Resources Information Center

    Shortall, Joseph M.; Merrill, Denise W.

    1987-01-01

    Presents a lesson on capital punishment for juveniles based on three hypothetical cases. The goal of the lesson is to have students understand the complexities of decisions regarding the death penalty for juveniles. (JDH)

  8. Causes of death and associated risk factors among climacteric women from Southern Brazil: a population based-study

    PubMed Central

    2014-01-01

    Background Aging and menopause are particular cardiovascular risk factors for women, due to estrogen deprivation at the time of menopause. Studies show that diabetes mellitus (DM), smoking, hypertension, high body mass index (BMI), and serum lipids are associated with increased risk of cardiovascular disease (CVD), the main cause of female mortality in Brazil. The aim of this study was to assess the mortality rate, causes of death and associated risk factors in a cohort of women from Brazil. Methods A longitudinal population-based study of menopausal status is currently underway in a city in South Brazil. In 2010, a third follow-up of this population was performed to assess cardiovascular risk and mortality rate between 1995 and 2011. For this analysis, 358 participants were studied. At baseline, participants had completed a standardized questionnaire including demographic, lifestyle, medical and reproductive characteristics. In addition to the contacts with relatives, mortality data were obtained through review of medical records in all city hospitals and the Center for Health Information (NIS/RS-SES). Multivariate-adjusted hazard risk (HR) and 95% confidence intervals (CI95%) were estimated using Cox proportional hazards regression. Survival curves were estimated using the Kaplan-Meier curve. Results There were 17 (4.7%) deaths from all causes during the study period. Seven (41.2%) deaths were caused by CVD, including four cases of stroke and three cases of myocardial infarction. Six (35.3%) deaths were due to cancer, and four (23.5%) were due to other reasons. In the age and smoking-adjusted multivariate models, diabetes (HR 6.645, 95% CI: 1.938–22.79, p = 0.003), alcohol intake (HR 1.228, 95% CI: 1.014-1.487, p = 0.035) and postmenopausal status (HR = 6.216, 95% CI: 0.963–40.143, p = 0.055) were associated with all-cause mortality. A significant association was found between abdominal obesity (WHR ≥ 0.85) and mortality even after the adjustment for BMI (HR = 9.229, 95% IC: 2.083–41.504, p = 0.003). Conclusion CVD was an important cause of mortality in this cohort and DM and/or central adiposity were associated with all-cause mortality. Lifestyle and dietary factors seem to be related to risk of mortality in middle-aged women. PMID:24559309

  9. Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study

    PubMed Central

    McAvay, Gail; Trentalange, Mark; Cohen, Andrew B; Allore, Heather G

    2015-01-01

    Objective To estimate the association between guideline recommended drugs and death in older adults with multiple chronic conditions. Design Population based cohort study. Setting Medicare Current Beneficiary Survey cohort, a nationally representative sample of Americans aged 65 years or more. Participants 8578 older adults with two or more study chronic conditions (atrial fibrillation, coronary artery disease, chronic kidney disease, depression, diabetes, heart failure, hyperlipidemia, hypertension, and thromboembolic disease), followed through 2011. Exposures Drugs included β blockers, calcium channel blockers, clopidogrel, metformin, renin-angiotensin system (RAS) blockers; selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs); statins; thiazides; and warfarin. Main outcome measure Adjusted hazard ratios for death among participants with a condition and taking a guideline recommended drug relative to participants with the condition not taking the drug and among participants with the most common combinations of four conditions. Results Over 50% of participants with each condition received the recommended drugs regardless of coexisting conditions; 1287/8578 (15%) participants died during the three years of follow-up. Among cardiovascular drugs, β blockers, calcium channel blockers, RAS blockers, and statins were associated with reduced mortality for indicated conditions. For example, the adjusted hazard ratio for β blockers was 0.59 (95% confidence interval 0.48 to 0.72) for people with atrial fibrillation and 0.68 (0.57 to 0.81) for those with heart failure. The adjusted hazard ratios for cardiovascular drugs were similar to those with common combinations of four coexisting conditions, with trends toward variable effects for β blockers. None of clopidogrel, metformin, or SSRIs/SNRIs was associated with reduced mortality. Warfarin was associated with a reduced risk of death among those with atrial fibrillation (adjusted hazard ratio 0.69, 95% confidence interval 0.56 to 0.85) and thromboembolic disease (0.44, 0.30 to 0.62). Attenuation in the association with reduced risk of death was found with warfarin in participants with some combinations of coexisting conditions. Conclusions Average effects on survival, particularly for cardiovascular study drugs, were comparable to those reported in randomized controlled trials but varied for some drugs according to coexisting conditions. Determining treatment effects in combinations of conditions may guide prescribing in people with multiple chronic conditions. PMID:26432468

  10. [Drug deaths].

    PubMed

    Gerber, A

    1976-01-01

    In the Federal Republic of Germany there exist no statistical datas concerning death related to drug dependence until now. We propose to define death in connexion with drug dependence as the death of a drug dependent person caused by direct or indirect effect of the drug used. We first report on several international investigations; then the results of our own investigation in 40 cases of death in connexion with drug dependence in the district of Nordbaden are presented in detail. As a result it seems necessary to register drug dependent persons and to isolate those who are resistent to any therapy and thus represent a focus for further expansion of drug consuming. PMID:962461

  11. Neonatal Death

    MedlinePlus

    ... story First Candle Centering Corporation The Compassionate Friends Star Legacy Foundation Last reviewed: November, 2015 Neonatal death ... story First Candle Centering Corporation The Compassionate Friends Star Legacy Foundation Last reviewed: November, 2015 Complications & Loss ...

  12. Preventing Fire Death and Injury, Conducting a Fire Drill in a Group Home [and] When You Need a Fire Safety Expert. National Fire Safety Certification System. Continuing Education Program. Volume 1, Numbers 1-3.

    ERIC Educational Resources Information Center

    Walker, Bonnie

    Three booklets provide fire safety information for staff of residential facilities serving people with developmental disabilities. Booklets focus on: (1) preventing fire death and injury, (2) conducting a fire drill in a group home, and (3) the role of fire safety experts. The first booklet stresses the elimination of the following dangers:…

  13. Comparison of Prevalence- and Smoking Impact Ratio-Based Methods of Estimating Smoking-Attributable Fractions of Deaths

    PubMed Central

    Kong, Kyoung Ae; Jung-Choi, Kyung-Hee; Lim, Dohee; Lee, Hye Ah; Lee, Won Kyung; Baik, Sun Jung; Park, Su Hyun; Park, Hyesook

    2016-01-01

    Background Smoking is a major modifiable risk factor for premature mortality. Estimating the smoking-attributable burden is important for public health policy. Typically, prevalence- or smoking impact ratio (SIR)-based methods are used to derive estimates, but there is controversy over which method is more appropriate for country-specific estimates. We compared smoking-attributable fractions (SAFs) of deaths estimated by these two methods. Methods To estimate SAFs in 2012, we used several different prevalence-based approaches using no lag and 10- and 20-year lags. For the SIR-based method, we obtained lung cancer mortality rates from the Korean Cancer Prevention Study (KCPS) and from the United States-based Cancer Prevention Study-II (CPS-II). The relative risks for the diseases associated with smoking were also obtained from these cohort studies. Results For males, SAFs obtained using KCPS-derived SIRs were similar to those obtained using prevalence-based methods. For females, SAFs obtained using KCPS-derived SIRs were markedly greater than all prevalence-based SAFs. Differences in prevalence-based SAFs by time-lag period were minimal among males, but SAFs obtained using longer-lagged prevalence periods were significantly larger among females. SAFs obtained using CPS-II-based SIRs were lower than KCPS-based SAFs by >15 percentage points for most diseases, with the exceptions of lung cancer and chronic obstructive pulmonary disease. Conclusions SAFs obtained using prevalence- and SIR-based methods were similar for males. However, neither prevalence-based nor SIR-based methods resulted in precise SAFs among females. The characteristics of the study population should be carefully considered when choosing a method to estimate SAF. PMID:26477995

  14. A Death in the Family: Death as a Zen Concept

    ERIC Educational Resources Information Center

    Black, Helen K.; Rubinstein, Robert L.

    2013-01-01

    This study is based on original research that explored family reaction to the death of an elderly husband and father. We interviewed 34 families (a family included a widow and two adult biological children) approximately 6 to 10 months after the death. In one-on-one interviews, we discussed family members' initial reaction to the death, how the…

  15. A Death in the Family: Death as a Zen Concept

    ERIC Educational Resources Information Center

    Black, Helen K.; Rubinstein, Robert L.

    2013-01-01

    This study is based on original research that explored family reaction to the death of an elderly husband and father. We interviewed 34 families (a family included a widow and two adult biological children) approximately 6 to 10 months after the death. In one-on-one interviews, we discussed family members' initial reaction to the death, how the

  16. Software Certification and Software Certificate Management Systems

    NASA Technical Reports Server (NTRS)

    Denney, Ewen; Fischer, Bernd

    2005-01-01

    Incremental certification and re-certification of code as it is developed and modified is a prerequisite for applying modem, evolutionary development processes, which are especially relevant for NASA. For example, the Columbia Accident Investigation Board (CAIB) report 121 concluded there is "the need for improved and uniform statistical sampling, audit, and certification processes". Also, re-certification time has been a limiting factor in making changes to Space Shuttle code close to launch time. This is likely to be an even bigger problem with the rapid turnaround required in developing NASA s replacement for the Space Shuttle, the Crew Exploration Vehicle (CEV). Hence, intelligent development processes are needed which place certification at the center of development. If certification tools provide useful information, such as estimated time and effort, they are more likely to be adopted. The ultimate impact of such a tool will be reduced effort and increased reliability.

  17. Brain Death and Islam

    PubMed Central

    Ziad-Miller, Amna; Elamin, Elamin M.

    2014-01-01

    How one defines death may vary. It is important for clinicians to recognize those aspects of a patient’s religious beliefs that may directly influence medical care and how such practices may interface with local laws governing the determination of death. Debate continues about the validity and certainty of brain death criteria within Islamic traditions. A search of PubMed, Scopus, EMBASE, Web of Science, PsycNet, Sociological Abstracts, DIALOGUE ProQuest, Lexus Nexus, Google, and applicable religious texts was conducted to address the question of whether brain death is accepted as true death among Islamic scholars and clinicians and to discuss how divergent opinions may affect clinical care. The results of the literature review inform this discussion. Brain death has been acknowledged as representing true death by many Muslim scholars and medical organizations, including the Islamic Fiqh Academies of the Organization of the Islamic Conference and the Muslim World League, the Islamic Medical Association of North America, and other faith-based medical organizations as well as legal rulings by multiple Islamic nations. However, consensus in the Muslim world is not unanimous, and a sizable minority accepts death by cardiopulmonary criteria only. PMID:25287999

  18. 16 CFR 1204.14 - Certification tests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Certification tests. 1204.14 Section 1204.14... tests. (a) General. As explained in § 1204.11 of this subpart, certificates of compliance required by section 14(a) of the act must be based on either a test of each item or on a reasonable testing...

  19. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property Renovation § 745.89 Firm certification. (a)...

  20. 14 CFR 13.19 - Certificate action.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INVESTIGATIVE AND ENFORCEMENT PROCEDURES Legal Enforcement Actions § 13.19 Certificate action. (a) Under section... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Certificate action. 13.19 Section 13.19... Administrator bases the proposed action and, except in an emergency, allows the holder to answer any charges...

  1. 14 CFR 13.19 - Certificate action.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INVESTIGATIVE AND ENFORCEMENT PROCEDURES Legal Enforcement Actions § 13.19 Certificate action. (a) Under section... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Certificate action. 13.19 Section 13.19... charges or other reasons upon which the Administrator bases the proposed action and, except in...

  2. Changing Breton Responses to Death.

    ERIC Educational Resources Information Center

    Badone, Ellen

    1988-01-01

    Based on fieldwork conducted in Brittany, France, during 1983 and 1984, discusses changes in Breton responses to death which have accompanied modernization and economic development. Suggests that familiarity with death and acceptance of it are being replaced by the "denial of death" characteristic of contemporary Western culture. Notes parallel…

  3. Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

    PubMed

    Werren, Julia; Yuksel, Necef; Smith, Saxon

    2012-09-01

    The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia. PMID:23156656

  4. Looking at: Competency-Based Teacher Education, Public Doublespeak, Oral History, Death and Dying.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse for Social Studies/Social Science Education, Boulder, CO.

    Four issues of a current awareness bulletin published occasionally by the ERIC Clearinghouse for Social Studies for use by elementary and secondary social studies teachers are combined in this document. The first issue deals with the application of competency-based curriculum to teacher education, focusing on teacher growth and evidence of pupil…

  5. Certificate Production and the Race toward Higher Degree Attainment

    ERIC Educational Resources Information Center

    State Higher Education Executive Officers, 2010

    2010-01-01

    Complete College America and FutureWorks conducted an analysis of certificate production, the value of the certificate program, and the economic benefit it provides to the region and nation. The conclusion, based on labor market demand and both personal and economic returns, is that certificates count and the policy and trends around certificates…

  6. Young Children's Probability of Dying Before and After Their Mother's Death: A Rural South African Population-Based Surveillance Study

    PubMed Central

    Clark, Samuel J.; Kahn, Kathleen; Houle, Brian; Arteche, Adriane; Collinson, Mark A.; Tollman, Stephen M.; Stein, Alan

    2013-01-01

    Background There is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after her death. Therefore we investigated the relationship between young children's likelihood of dying and the timing of their mother's death and, in particular, the existence of a critical period of increased risk. Methods and Findings Data from a health and socio-demographic surveillance system in rural South Africa were collected on children 0–5 y of age from 1 January 1994 to 31 December 2008. Discrete time survival analysis was used to estimate children's probability of dying before and after their mother's death, accounting for moderators. 1,244 children (3% of sample) died from 1994 to 2008. The probability of child death began to rise 6–11 mo prior to the mother's death and increased markedly during the 2 mo immediately before the month of her death (odds ratio [OR] 7.1 [95% CI 3.9–12.7]), in the month of her death (OR 12.6 [6.2–25.3]), and during the 2 mo following her death (OR 7.0 [3.2–15.6]). This increase in the probability of dying was more pronounced for children whose mothers died of AIDS or tuberculosis compared to other causes of death, but the pattern remained for causes unrelated to AIDS/tuberculosis. Infants aged 0–6 mo at the time of their mother's death were nine times more likely to die than children aged 2–5 y. The limitations of the study included the lack of knowledge about precisely when a very ill mother will die, a lack of information about child nutrition and care, and the diagnosis of AIDS deaths by verbal autopsy rather than serostatus. Conclusions Young children in lower income settings are more likely to die not only after their mother's death but also in the months before, when she is seriously ill. Interventions are urgently needed to support families both when the mother becomes very ill and after her death. Please see later in the article for the Editors' Summary PMID:23555200

  7. Supporting nurse manager certification.

    PubMed

    Rees, Susan; Glynn, Michele; Moore, Rebecca; Rankin, Rebecca; Stevens, Linda

    2014-06-01

    Professional certification is desirable for nursing staff and leaders to demonstrate high levels of knowledge and expertise. Nurse managers can be role models for staff by attaining certification. The organization highlighted in this article developed a process that included an in-house nurse manager certification review course resulting in increased certification rates from 33% to 50% for nurse managers in a 14-month period. PMID:24853798

  8. Differential risk of death in older residents in nursing homes prescribed specific antipsychotic drugs: population based cohort study

    PubMed Central

    2012-01-01

    Objective To assess risks of mortality associated with use of individual antipsychotic drugs in elderly residents in nursing homes. Design Population based cohort study with linked data from Medicaid, Medicare, the Minimum Data Set, the National Death Index, and a national assessment of nursing home quality. Setting Nursing homes in the United States. Participants 75?445 new users of antipsychotic drugs (haloperidol, aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone). All participants were aged ?65, were eligible for Medicaid, and lived in a nursing home in 2001-5. Main outcome measures Cox proportional hazards models were used to compare 180 day risks of all cause and cause specific mortality by individual drug, with propensity score adjustment to control for potential confounders. Results Compared with risperidone, users of haloperidol had an increased risk of mortality (hazard ratio 2.07, 95% confidence interval 1.89 to 2.26) and users of quetiapine a decreased risk (0.81, 0.75 to 0.88). The effects were strongest shortly after the start of treatment, remained after adjustment for dose, and were seen for all causes of death examined. No clinically meaningful differences were observed for the other drugs. There was no evidence that the effect measure modification in those with dementia or behavioural disturbances. There was a dose-response relation for all drugs except quetiapine. Conclusions Though these findings cannot prove causality, and we cannot rule out the possibility of residual confounding, they provide more evidence of the risk of using these drugs in older patients, reinforcing the concept that they should not be used in the absence of clear need. The data suggest that the risk of mortality with these drugs is generally increased with higher doses and seems to be highest for haloperidol and least for quetiapine. PMID:22362541

  9. Alternative Teacher Certification.

    ERIC Educational Resources Information Center

    Newman, Carol; Thomas, Kay

    This paper examines issues related to alternative teacher certification, discussing teacher certification in Texas and noting that most researchers agree that both traditional and alternative routes to teacher preparation need improvement. For over a decade, alternative certification has become increasingly available in Texas. This paper…

  10. Hypericin-based photodynamic therapy: antitumor activity, accumulation potential, and induced cell death pathway

    NASA Astrophysics Data System (ADS)

    Luksiene, Zivile; Vaitkuviene, Aurelija

    2004-09-01

    In this study the main interest was focused on the to investigation the photodynamic efficacy of hypericin, three other photosensitizers and 5 aminolevulinic acid-induced protopofirin IX in their ability to block the growth of rather aggressive tumor - Ehrlich ascite carcinoma in mice as well as Reh cells in humans (B-leukemia). Hypericin was found to exhibit the highest phototoxicity and antitumor activity in treating Ehrlich ascite carcinoma. The different photosensitizers were ranked as follows: Hypericin > hematoporphyrin dimethyl ether > Photofrin II > meso-tetra (para-sulfophenyl)porphin > 5-aminolevulinic acid. The most important is that just after Hyp-based photodynamic therapy 75% of mice survived a 4 month-period, and no recurrence of tumor within this period was detected in 25% of the treated mice. The clear cut correlation observed between intracellular dye concentration in the tumor cells and efficiency of photodynamic therapy, supports the idea that the intracellular accumulation of the photosensitizer is one of the most important factors in determining the benefit of photodynamic therapy. Hence, the accumulation of the photosensitizer in the tumor cells should be considered as one of the prognostic factors for the determination of the therapeutic outcome. Eventually, one of the most significant result is that hypericin is effective photosensitizer for human B-leukemia cells and induces apoptosis after photosensitization.

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

    NASA Astrophysics Data System (ADS)

    Nonaka, K.; Imaizumi, Y.

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

  12. Certification and recertification.

    PubMed

    Scheiber, S C

    1991-01-01

    The American Board of Psychiatry and Neurology issues certificates for psychiatrists in general psychiatry, child and adolescent psychiatry, and added qualification in geriatric psychiatry. It will issue a certificate in added qualification in clinical neurophysiology in 1992. An application for a certificate in added qualification in addiction psychiatry is currently under review by the American Board of Medical Specialties. The American Psychiatric Association has requested that the ABPN consider forensic psychiatry for an added qualification. All new subspecialty certificates will have a ten year time limit. Beginning on October 1, 1994, all certificates will be time-limited. Time-limited certificates will lead to the requirement for recertification. Current requirements for certification are reviewed and strategies for planing for recertification are discussed. PMID:1780385

  13. Dig1 protects against cell death provoked by glyphosate-based herbicides in human liver cell lines

    PubMed Central

    2010-01-01

    Background Worldwide used pesticides containing different adjuvants like Roundup formulations, which are glyphosate-based herbicides, can provoke some in vivo toxicity and in human cells. These pesticides are commonly found in the environment, surface waters and as food residues of Roundup tolerant genetically modified plants. In order to know their effects on cells from liver, a major detoxification organ, we have studied their mechanism of action and possible protection by precise medicinal plant extracts called Dig1. Methods The cytotoxicity pathways of four formulations of glyphosate-based herbicides were studied using human hepatic cell lines HepG2 and Hep3B, known models to study xenobiotic effects. We monitored mitochondrial succinate dehydrogenase activity and caspases 3/7 for cell mortality and protection by Dig1, as well as cytochromes P450 1A1, 1A2, 3A4 and 2C9 and glutathione-S-transferase to approach the mechanism of actions. Results All the four Roundup formulations provoke liver cell death, with adjuvants having stronger effects than glyphosate alone. Hep3B are 3-5 times more sensitive over 48 h. Caspases 3/7 are greatly activated in HepG2 by Roundup at non-cytotoxic levels, and some apoptosis induction by Roundup is possible together with necrosis. CYP3A4 is specifically enhanced by Roundup at doses 400 times less than used in agriculture (2%). CYP1A2 is increased to a lesser extent together with glutathione-S-transferase (GST) down-regulation. Dig 1, non cytotoxic and not inducing caspases by itself, is able to prevent Roundup-induced cell death in a time-dependant manner with an important efficiency of up to 89%, within 48 h. In addition, we evidenced that it prevents Caspases 3/7 activation and CYP3A4 enhancement, and not GST reduction, but in turn it slightly inhibited CYP2C9 when added before Roundup. Conclusion Roundup is able to provoke intracellular disruption in hepatic cell lines at different levels, but a mixture of medicinal plant extracts Dig1 can protect to some extent human cell lines against this pollutants. All this system constitutes a tool for studying liver intoxication and detoxification. PMID:20979644

  14. Maintenance of Certification for Radiation Oncology

    SciTech Connect

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

    2005-06-01

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

  15. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Renovator certification and dust sampling technician certification. 745.90 Section 745.90 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential...

  16. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Renovator certification and dust sampling technician certification. 745.90 Section 745.90 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential...

  17. IR spectroscopic characteristics of cell cycle and cell death probed by synchrotron radiation based Fourier transform IR spectromicroscopy

    NASA Technical Reports Server (NTRS)

    Holman, H. Y.; Martin, M. C.; Blakely, E. A.; Bjornstad, K.; McKinney, W. R.

    2000-01-01

    Synchrotron radiation based Fourier transform IR (SR-FTIR) spectromicroscopy allows the study of individual living cells with a high signal to noise ratio. Here we report the use of the SR-FTIR technique to investigate changes in IR spectral features from individual human lung fibroblast (IMR-90) cells in vitro at different points in their cell cycle. Clear changes are observed in the spectral regions corresponding to proteins, DNA, and RNA as a cell changes from the G(1)-phase to the S-phase and finally into mitosis. These spectral changes include markers for the changing secondary structure of proteins in the cell, as well as variations in DNA/RNA content and packing as the cell cycle progresses. We also observe spectral features that indicate that occasional cells are undergoing various steps in the process of cell death. The dying or dead cell has a shift in the protein amide I and II bands corresponding to changing protein morphologies, and a significant increase in the intensity of an ester carbonyl C===O peak at 1743 cm(-1) is observed. Copyright John Wiley & Sons, Inc. Biopolymers (Biospectroscopy) 57: 329-335, 2000.

  18. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property Renovation... current certification will remain in effect until its expiration date or until EPA has made a...

  19. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property Renovation... current certification will remain in effect until its expiration date or until EPA has made a...

  20. Cesarean birth in the border region: a descriptive analysis based on US Hispanic and Mexican birth certificates.

    PubMed

    McDonald, Jill A; Mojarro Davila, Octavio; Sutton, Paul D; Ventura, Stephanie J

    2015-01-01

    Cesarean birth (CB) is more prevalent in the US-Mexico border region than among all US Hispanics. Comparable data from US and Mexican birth certificates can be used to compare prevalence and identify risk factors on either side of the border. Using 2009 US and Mexican birth certificates, we compared the characteristics of US Hispanic and Mexican CBs in six geographic subgroups: US and Mexican border counties/municipios, US and Mexican non-border counties/municipios and the US and Mexico overall. We also explored cesarean prevalence over time. During 2000-2009, CB rates increased from 22.1 to 31.6 % among US Hispanics and from 25.9 to 37.9 % among Hispanics in the US border region. 2009 rates were 44.5 % in Mexico and 43.1 % in the Mexican border region. In both countries, CB rates were similar for primiparas and multiparas. Higher education, being married and parity >4 were associated with CB in Mexico; being married was associated in the US. Hispanic rates were higher in the US border than non-border region for all age groups. Along the border, cesarean rates for Hispanics were highest in Texas (43.5 %) and neighboring Tamaulipas (49.8 %). Higher cesarean prevalence in Mexico than in US Hispanics, while unexplained, is consistent with high prevalence in some Latin American countries. Higher cesarean prevalence among Hispanics in the US border region than among Hispanics nationwide cannot be explained by maternal age or parity. Medical indications are also unlikely to explain such high rates, which are undesirable for mothers and infants. PMID:24791973

  1. Reliability of cause of death coding: an international comparison.

    PubMed

    Antini, Carmen; Rajs, Danuta; Muoz-Quezada, Mara Teresa; Mondaca, Boris Andrs Lucero; Heiss, Gerardo

    2015-07-01

    This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ? 60, issued in 2008 in the Valparaso and Metropolitan regions, Chile. All causes of death were converted to ICD-10 codes in parallel by both coders. Concordance was analyzed with inter-coder agreement and Cohen's kappa coefficient by level of specification ICD-10 code for the underlying cause and the total causes of death coding. Inter-coder agreement was 76.4% for all causes of death and 80.6% for the underlying cause (agreement at the four-digit level), with differences by the level of specification of the ICD-10 code, by line of the death certificate, and by number of causes of death per certificate. Cohen's kappa coefficient was 0.76 (95%CI: 0.68-0.84) for the underlying cause and 0.75 (95%CI: 0.74-0.77) for the total causes of death. In conclusion, causes of death coding and inter-coder agreement for cardiovascular diseases in two regions of Chile are comparable to an external benchmark and with reports from other countries. PMID:26248102

  2. Population‐Based Incidence of Sudden Cardiac and Unexpected Death Before and After the 2011 Earthquake and Tsunami in Iwate, Northeast Japan

    PubMed Central

    Niiyama, Masanobu; Tanaka, Fumitaka; Nakajima, Satoshi; Itoh, Tomonori; Matsumoto, Tatsuya; Kawakami, Mikio; Naganuma, Yujiro; Omama, Shinichi; Komatsu, Takashi; Onoda, Toshiyuki; Sakata, Kiyomi; Ichikawa, Takashi; Nakamura, Motoyuki

    2014-01-01

    Background The aim of this study was to evaluate the temporal impact of the 2011 Japan earthquake and tsunami on the incidence of sudden cardiac and unexpected death (SCUD). Methods and Results We surveyed the impact of the disaster on the incidence and clinical characteristics of SCUD in Iwate. To perform complete identification of SCUD for 8 weeks before and 40 weeks after the disaster, medical records and death certificates relevant to SCUD were surveyed in the study area. Compared with the previous year's rate, the incidence (per 10 000 person‐year) of SCUD for the initial 4 weeks after the disaster (acute phase) was double (33.5 vs 18.9), and thereafter the rate returned to the previous level. Significant relationships were found between weekly numbers of SCUD and seismic activity (intensity, r=0.43; P<0.005: frequency, r=0.46; P<0.002). The standardized incidence ratio (SIR) of SCUD in the acute phase was significantly increased compared with that of previous years (1.71, 95% CI 1.33 to 2.16). Increased SIRs were predominantly found in female subjects (1.73, 95% CI 1.22 to 2.37), the elderly (1.73, 95% CI 1.29 to 2.27), and residents living in the tsunami‐stricken area (1.83, 95% CI 1.33 to 2.46). In addition, SIRs for weekdays (1.71, 95% CI 1.28 to 2.24) and nights‐mornings (2.09, 95% CI 1.48 to 2.86) were amplified. Conclusions The present results suggest that the magnitude of a disaster, related stress, and population aging may cause a temporary increase in the incidence of SCUD with amplification of ordinary weekly and circadian variations. PMID:24811614

  3. The dynamics of certification.

    PubMed

    Reid, Jerry

    2012-01-01

    All of the Registry's certification requirements are monitored and evaluated on a continuous basis. The ARRT Board of Trustees routinely sets aside time to review the requirements in depth and determine how they can be improved. This supports a dynamic system of certification requirements that keep pace with evolving roles and technology. The bottom line is that ARRT's certification programs are never on cruise control. PMID:22563616

  4. [Accompany death].

    PubMed

    Salvador Borrell, Montserrat

    2010-11-01

    One of the roles of nursing is to take care of the patients in terminal situation. The time, the experience, the formation, and the personal and professional attitudes that the nurse has will propitiate that taking care of moribund patients might turn into one of the more rewarding human experiences in life. There for, it is indispensable that nurses assume death as a natural and inevitable reality to achieve. The principal aim of the study is to evaluate the competence of confrontation and the autoefficiency of the welfare among nurses who work with adult patients at the end of the life. Descriptive study realized in the units of Oncology, Hametology and Palliative Care of the following centers: La Fe, Clínico, Dr. Peset, H. General, Arnau de Vilanova and Dr. Moliner de Portacoelli in Valencia (Spain). The following instruments were used: the Bugen Scale of confrontation of the Death (1980-1981) and the Robbins Scale of Autoefficiency (1992). Data suggests that major coping gives major autoeffciency and vice versa. The realized study opens numerous questions, specially related with training and the burden of preparation along the whole professional career, in order to achieve competence for coping and autoefficiency. PMID:21188869

  5. Certification report for the CALMAC solar powered pump

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The certification of the CALMAC solar powered thermopump is presented. Each element of the specification is delineated, together with the verification, based on analysis, similarity, inspection, or testing.

  6. [Deaths in hotels].

    PubMed

    Risse, Manfred; Weilbcher, Nadine; Birngruber, Christoph; Verhoff, Marcel A

    2010-01-01

    There are no verified statistics about deaths occurring in hotels, and only a few cases have been described in the literature. A recent case induced us to conduct a systematic search for deaths in hotels in the autopsy reports of the Institute of Legal Medicine in Giessen for the period from 1968 to 2009. This search yielded 22 evaluable cases in which persons had been found dead or had died in hotels. Data evaluated in the study were sex and age of the deceased, reason for the stay in the hotel and cause of death. Among the deaths, 18 were males and 4 females and the average age was 41 and 40 years respectively. 6 of the male guests had died from a natural and 10 from a non-natural cause. In the remaining two cases, the cause of death could not be determined, but as there was no evidence that another party had been involved, the cases were not further investigated. Of the 4 female guests, 3 had died of a natural cause; in one case, the cause of death remained unclear even after morphological and toxicological investigations. Surprisingly, a third of the men were found to be temporarily living in hotels due to social circumstances. This was not true for any of the women. Our retrospective analysis is based on a comparatively small number of deaths in what were mostly hotels in small to medium-sized towns. Interestingly, the gender ratio of 18:4 for deceased men and women was significantly higher than the usual gender ratio of 2:1 found for forensic autopsies. To be able to draw further conclusions, a greater number of cases would have to be analysed, for example by recruiting additional case files from other institutes of legal medicine. This would also open up the option of investigating possible regional variations. PMID:20642257

  7. The Debate in Cuba's Scientific Community on Sudden Cardiac Death.

    PubMed

    Vilches, Ernesto; Ochoa, Luis A; Ramos, Lianne

    2015-10-01

    Sudden cardiac death poses a challenge to modern medicine because of its high incidence, the unexpected and dramatic nature of the event, and years of potential life lost. What's more, despite modest decreases in global mortality attributed to cardiovascular diseases, incidence of sudden cardiac death has not declined. Cuba, like most of the Americas, suffers from knowledge gaps that hamper adequate strategies to address sudden cardiac death as a population health problem. We suggest that a generally accepted operational definition of sudden cardiac death be agreed upon, and a national registry developed that recognizes this cause of death on death certificates. These two actions will enable Cuba's public health authorities to assess the extent of the problem and to design intervention strategies for the population with intermediate and lower cardiovascular risk, the group in which most cases occur. KEYWORDS Sudden cardiac death, cardiovascular disease, sudden death, sudden cardiac arrest, risk reduction, prevention and control, Cuba. PMID:26947282

  8. [Near death experiences].

    PubMed

    Rubia Vila, Francisco José

    2012-01-01

    Near Death Experiences are those accounted by people who after being clinically dead return to life spontaneously or after reanimation. These experiences have been used traditionally to support the belief in the existence of the soul and of life after death. However, today neuroscience tries to explain these experiences from the scientific point of view, i.e. explaining them based on their brain substrates. Their resemblance to mystic experiences and to altered states of consciousness seems to indicate that they may be produced by hyperactivity of limbic structures caused by anoxia or hypercapnia. PMID:24294729

  9. The Impact of Follow-up Type and Missed Deaths on Population-Based Cancer Survival Studies for Hispanics and Asians

    PubMed Central

    Morris, Cyllene R.; Liu, Lihua; Bungum, Timothy J.; Altekruse, Sean F.

    2014-01-01

    Background The accuracy of cancer survival statistics relies on the quality of death linkages and follow-up information collected by population-based cancer registries. Methodological issues on survival data by race-ethnicity in the United States, in particular for Hispanics and Asians, have not been well studied and may undermine our understanding of survival disparities. Methods Based on Surveillance, Epidemiology, and End Results (SEER)-18 data, we analyzed existing biases in survival statistics when comparing the four largest racial-ethnic groups in the United States, whites, blacks, Hispanics and Asians. We compared the “reported alive” method for calculation of survival, which is appropriate when date of last alive contact is available for all cases, with the “presumed alive” method used when dates of last contact are unavailable. Cox regression was applied to calculate the likelihood of incomplete follow-up (those with less than 5 years of vital status information) according to racial-ethnic group and stage of diagnosis. Finally, potentially missed deaths were estimated based on the numbers of cases with incomplete follow-up for highly fatal cancers. Results The presumed alive method overestimated survival compared with the reported alive method by as much as 0.9–6.2 percentage points depending on the cancer site among Hispanics and by 0.4–2.7 percentage points among Asians. In SEER data, Hispanics and Asians are more likely to have incomplete follow-up than whites or blacks. The assumption of random censoring across race-ethnicity is not met, as among non-white cases, those who have a worse prognosis are more likely to have incomplete follow-up than those with a better prognosis (P < .05). Moreover, death ascertainment is not equal across racial-ethnic groups. Overall, 3% of cancer deaths were missed among Hispanics and Asians compared with less than 0.5% among blacks and whites. Conclusions Cancer survival studies involving Hispanics and Asians should be interpreted with caution because the current available data overtly inflates survival in these populations. Censoring is clearly nonrandom across race-ethnicity meaning that findings of Hispanic and Asian survival advantages may be biased. Problematic death linkages among Hispanics and Asians contribute to missing deaths and overestimated survival. More complete follow-up with at least 5 years of information on vital status as well as improved death linkages will decisively increase the validity of survival estimates for these growing populations. PMID:25417234

  10. Determining 'age at death' for forensic purposes using human bone by a laboratory-based biomechanical analytical method.

    PubMed

    Zioupos, P; Williams, A; Christodoulou, G; Giles, R

    2014-05-01

    Determination of age-at-death (AAD) is an important and frequent requirement in contemporary forensic science and in the reconstruction of past populations and societies from their remains. Its estimation is relatively straightforward and accurate (±3yr) for immature skeletons by using morphological features and reference tables within the context of forensic anthropology. However, after skeletal maturity (>35yr) estimates become inaccurate, particularly in the legal context. In line with the general migration of all the forensic sciences from reliance upon empirical criteria to those which are more evidence-based, AAD determination should rely more-and-more upon more quantitative methods. We explore here whether well-known changes in the biomechanical properties of bone and the properties of bone matrix, which have been seen to change with age even after skeletal maturity in a traceable manner, can be used to provide a reliable estimate of AAD. This method charts a combination of physical characteristics some of which are measured at a macroscopic level (wet & dry apparent density, porosity, organic/mineral/water fractions, collagen thermal degradation properties, ash content) and others at the microscopic level (Ca/P ratios, osteonal and matrix microhardness, image analysis of sections). This method produced successful age estimates on a cohort of 12 donors of age 53-85yr (7 male, 5 female), where the age of the individual could be approximated within less than ±1yr. This represents a vastly improved level of accuracy than currently extant age estimation techniques. It also presents: (1) a greater level of reliability and objectivity as the results are not dependent on the experience and expertise of the observer, as is so often the case in forensic skeletal age estimation methods; (2) it is purely laboratory-based analytical technique which can be carried out by someone with technical skills and not the specialised forensic anthropology experience; (3) it can be applied worldwide following stringent laboratory protocols. As such, this technique contributes significantly to improving age estimation and therefore identification methods for forensic and other purposes. PMID:24286969

  11. Encountering Death: Structured Activities for Death Awareness.

    ERIC Educational Resources Information Center

    Welch, Ira David; And Others

    This book is intended to be used as a supplement to standard textbooks on death and dying for college students. Chapter 1 "Encountering Death in the Self" builds the foundation for increased self-awareness for the study of death and dying. Chapter 2 "Encountering Death in the Family" provides activities which are appropriate for a wide variety of…

  12. Teacher Certification in Manitoba.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg.

    This booklet provides information for teachers wishing to qualify for certification in the Canadian province of Manitoba. Written in French and English, the booklet's topics include: (1) requirements for types of teaching certificates (provisional teaching; permanent teaching; special, vocational-industrial, and vocational-business education;…

  13. Certification Programs for Citrus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Citrus certification programs designed to ensure that healthy plants of the highest genetic potential are being planted in the field are the basic building block of an integrated pest management program. Certification programs began for citrus began with the discovery that the diseases were graft t...

  14. EDR2 NEGATIVELY REGULATES SALICYLIC ACID-BASED DEFENSES AND CELL DEATH DURING POWDERY MILDEW INFECTIONS OF ARABIDOPSIS THALIANA

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The hypersensitive necrosis response (HR) of resistant plants to avirulent pathogens is a form of programmed cell death in which the plant sacrifices a few cells under attack, restricting pathogen growth into adjacent healthy tissues. In spite of the importance of this defense response, relatively l...

  15. Sex-Based Differences in Rates, Causes, and Predictors of Death Among Injection Drug Users in Vancouver, Canada.

    PubMed

    Hayashi, Kanna; Dong, Huiru; Marshall, Brandon D L; Milloy, Michael-John; Montaner, Julio S G; Wood, Evan; Kerr, Thomas

    2016-03-15

    In the present study, we sought to identify rates, causes, and predictors of death among male and female injection drug users (IDUs) in Vancouver, British Columbia, Canada, during a period of expanded public health interventions. Data from prospective cohorts of IDUs in Vancouver were linked to the provincial database of vital statistics to ascertain rates and causes of death between 1996 and 2011. Mortality rates were analyzed using Poisson regression and indirect standardization. Predictors of mortality were identified using multivariable Cox regression models stratified by sex. Among the 2,317 participants, 794 (34.3%) of whom were women, there were 483 deaths during follow-up, with a rate of 32.1 (95% confidence interval (CI): 29.3, 35.0) deaths per 1,000 person-years. Standardized mortality ratios were 7.28 (95% CI: 6.50, 8.14) for men and 15.56 (95% CI: 13.31, 18.07) for women. During the study period, mortality rates related to infection with human immunodeficiency virus (HIV) declined among men but remained stable among women. In multivariable analyses, HIV seropositivity was independently associated with mortality in both sexes (all P < 0.05). The excess mortality burden among IDUs in our cohorts was primarily attributable to HIV infection; compared with men, women remained at higher risk of HIV-related mortality, indicating a need for sex-specific interventions to reduce mortality among female IDUs in this setting. PMID:26865265

  16. Young People's Risk of Suicide Attempts in Relation to Parental Death: A Population-Based Register Study

    ERIC Educational Resources Information Center

    Jakobsen, Ida Skytte; Christiansen, Erik

    2011-01-01

    Background: The objective of this study was to examine the association between the death of a biological parent and subsequent suicide attempts by young people (aged 10-22 years), and to explore sociodemographic factors as modifying factors in the process. Methods: The study used a nested case-control design. The full study population was obtained…

  17. Long-term mortality risk by cause of death in newly diagnosed patients with epilepsy in Finland: a nationwide register-based study.

    PubMed

    Nevalainen, Olli; Raitanen, Jani; Ansakorpi, Hanna; Artama, Miia; Isojrvi, Jouko; Auvinen, Anssi

    2013-12-01

    To estimate long-term mortality by cause of death in a nationwide, register-based cohort of newly diagnosed patients with epilepsy (PWE). All noninstitutionalized Finnish PWE aged 10-74 years (n = 10,818) eligible for reimbursement for antiepileptic medication for the first time between 1990 and 1994 were identified in the database of Social Insurance Institution of Finland. Mortality was compared against a population-based reference cohort (n = 43,894). Hazard ratios (HR) and their 95 % confidence intervals (95 % CI) during a follow-up of 18 years were estimated using proportional hazards modeling. Potential years of life lost (PYLL) and excess fraction of causes of death attributable to epilepsy were estimated. PWE contributed 137,610 person-years of observation and there were 3,558 deaths. Mortality remained elevated up to 18 years post-diagnosis (HR 3.21, 95 % CI 3.07-3.35). Ischemic heart disease mortality in PWE was two-fold (HR 2.31, 95 % CI 2.09-2.54), and remained constantly elevated during entire follow-up in both men and women. Most premature mortality in terms of PYLL was attributable to brain cancer (17 %), other cancers (15 %), ischemic heart disease (11 %), as well as cerebrovascular diseases (10 %). The percentage of deaths in PWE statistically attributable to epilepsy was 3.9 % for accidents, 3.4 % for alcohol-related diseases, and 1.6 % for suicides. PWE had substantial excess mortality from non-communicable diseases, which did not disappear by 18 years. Diseases of the circulatory system and cancers, especially brain cancer, were the most important causes of death almost regardless of the mortality indicator. PMID:24072507

  18. Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study

    PubMed Central

    Mlqvist, Mats; Eriksson, Leif; Nga, Nguyen Thu; Fagerland, Linn Irene; Hoa, Dinh Phuong; Wallin, Lars; Ewald, Uwe; Persson, Lars-ke

    2008-01-01

    Background In order to improve child survival there is a need to target neonatal mortality. In this pursuit, valid local and national statistics on child health are essential. We analyze to what extent births and neonatal deaths are unreported in a low-income country and discuss the consequences at local and international levels for efforts to save newborn lives. Methods Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam in 2005 was ascertained by systematic inventory through group interviews with key informants, questionnaires and examination of health facility records. Health care staff at 187 Community Health Centers (CHC) and 18 hospitals, in addition to 1372 Village Health Workers (VHW), were included in the study. Results were compared with the official reports of the Provincial Health Bureau. Results The neonatal mortality rate (NMR) was 16/1000 (284 neonatal deaths/17 519 births), as compared to the official rate of 4.2/1000. The NMR varied between 44/1000 and 10/1000 in the different districts of the province. The under-reporting was mainly attributable to a dysfunctional reporting system and the fact that families, not the health system, were made responsible to register births and deaths. This under-reporting has severe consequences at local, national and international levels. At a local level, it results in a lack of awareness of the magnitude and differentials in NMR, leading to an indifference towards the problem. At a national and international level the perceived low mortality rate is manifested in a lack of investments in perinatal health programs. Conclusion This example of a faulty health information system is reportedly not unique in low and middle income countries where needs for neonatal health reforms are greatest. Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality in order to reach the fourth millennium goal. PMID:18373839

  19. Parental bereavement after the death of an offspring in a motor vehicle collision: a population-based study.

    PubMed

    Bolton, James M; Au, Wendy; Walld, Randy; Chateau, Dan; Martens, Patricia J; Leslie, William D; Enns, Murray W; Sareen, Jitender

    2014-01-15

    Motor vehicle collisions (MVCs) are the leading cause of death in young people in North America. The effects of such deaths on parents have not been systematically studied. Administrative data sets were used to identify all parents (n = 1,458) who had an offspring die in a MVC between 1996 and 2008 in the province of Manitoba, Canada. They were matched to general population control parents who had not had offspring die from any sudden cause during the study period. Generalized estimating equations were used to compare the rates of physician-diagnosed mental and physical disorders, social factors, and treatment utilization in the 2 parent groups in the 2 years before and after offspring death, with adjustment for confounding factors. The risk of depression among bereaved parents almost tripled (adjusted prevalence ratio = 2.85, 95% confidence interval: 2.44, 3.33; P < 0.001) during the 2 years after death of an offspring. Significant increases in the risk of anxiety disorders (adjusted prevalence ratio = 1.45, 95% confidence interval: 1.26, 1.67; P < 0.001) were also observed. When compared with nonbereaved parents, bereaved parents had significant increases in the risks of depression (P < 0.001), anxiety disorders (P < 0.001), marital break-up (P = 0.015), and physician visits for mental illness (P < 0.001) in the post-death period. In conclusion, parents who lose an offspring in a MVC experience considerable mental illness and marital disruption. PMID:24186971

  20. Causes of death in osteogenesis imperfecta.

    PubMed Central

    McAllion, S J; Paterson, C R

    1996-01-01

    AIMS: To determine the causes of death in patients with osteogenesis imperfecta, excluding infants with the perinatal lethal form (type II). METHODS: Seventy nine patients with known osteogenesis imperfecta were identified, 37 of whom had been seen clinically in life. Causes of death were identified from death certificates, postmortem reports, medical records, hospital consultants, relatives, and the Brittle Bone Society's records. RESULTS: Patients with the milder types of osteogenesis imperfecta, I and IV, often had a normal lifespan and died of unrelated illnesses such as myocardial infarction and malignancy. In some of these patients and in many patients with the more severe type III disease, it was clear that osteogenesis imperfecta contributed significantly to death, almost certainly to many of the respiratory deaths and to deaths from cardiac failure due to kyphoscoliosis. Osteogenesis imperfecta also caused six deaths, directly or indirectly, due to basilar invagination of the skull. Osteogenesis imperfecta may have contributed to deaths from intracranial bleeding. Apparently minor traumatic incidents may have disastrous consequences in patients with this disorder. CONCLUSIONS: Prompt care for respiratory infections and prevention of trauma in patients with osteogenesis imperfecta is essential. Images PMID:8881910

  1. Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

    PubMed Central

    2011-01-01

    Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+). The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83). No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07). The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour was higher in several subgroups of asylum seekers than that in the reference population. We conclude that measures to prevent suicide and suicidal behaviour among asylum seekers in the Netherlands are indicated. PMID:21693002

  2. Parity, age at first birth, and risk of death from brain cancer: a population-based cohort study in Taiwan

    PubMed Central

    2012-01-01

    Background This study was undertaken to examine whether there is an association between parity and age at first birth and risk of death from brain cancer. Methods The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between Jan. 1, 1978 and Dec. 31, 1987. We tracked each woman from the time of their first childbirth to December 31, 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from brain cancer associated with parity and age at first birth. Results There were 316 brain cancer deaths during 34,980,246 person-years of follow-up. The mortality rate of brain cancer was 0.90 cases per 100,000 person-years. The adjusted HR was 1.35 (95% CI= 0.91-2.01) for women who gave birth between 21 and 25, 1.61 (95% CI=1.05-2.45) for women who gave birth after 25 years of age, respectively, when compared with women who gave birth less than 20 years. A trend of increasing risk of brain cancer was seen with increasing age at first birth. The adjusted HR were 0.73 (95% CI= 0.53-0.99) for women who had 2 children, and 0.60 (95% CI =0.43-0.83) for women with 3 or more births, respectively, when compared with women who had given birth to only 1 child. There was a significant decreasing trend in the HRs of brain cancer with increasing parity. Conclusions This study provides evidence that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of death from brain cancer. PMID:23046716

  3. Consumption of PCB-contaminated sport fish and risk of spontaneous fetal death.

    PubMed Central

    Mendola, P; Buck, G M; Vena, J E; Zielezny, M; Sever, L E

    1995-01-01

    Spontaneous fetal death has been observed among various mammalian species after exposure to polychlorinated biphenyls (PCBs). Our exposure-based cohort study assessed the relationship between consumption of PCB-contaminated Lake Ontario sport fish and spontaneous fetal death using 1820 multigravid fertile women from the 1990-1991 New York State Angler Cohort Study. Fish consumption data were obtained from food frequency questionnaires and history of spontaneous fetal death from live birth certificates. Analyses were stratified by number of prior pregnancies and controlled for smoking and maternal age. No significant increases in risk for fetal death were observed across four measures of exposure: a lifetime estimate of PCB exposure based on species-specific PCB levels; the number of years of fish consumption; kilograms of sport fish consumed in 1990-1991; and a lifetime estimate of kilograms eaten. A slight risk reduction was seen for women with two prior pregnancies at the highest level of PCB exposure (odds ratio = 0.36; 95% CI, 0.14-0.92) and for women with three or more prior pregnancies with increasing years of fish consumption (odds ratio = 0.97; 95% CI, 0.94-0.99). These findings suggest that consumption of PCB-contaminated sport fish does not increase the risk of spontaneous fetal death. PMID:7656880

  4. Consumption of PCB-contaminated sport fish and risk of spontaneous fetal death

    SciTech Connect

    Mendola, P.; Buck, G.M.; Vena, J.E.; Zielezny, M.; Sever, L.E.

    1995-05-01

    Spontaneous fetal death has been observed among various mammalian species after exposure to polychlorinated biphenyls (PCBs). Our exposure-based cohort study assessed the relationship between consumption of PCB-contaminated Lake Ontario sport fish and spontaneous fetal death using 1820 multigravid fertile women from the 1990-1991 New York State Angler Cohort Study. Fish consumption data were obtained from food frequency questionnaires and history of spontaneous fetal death from live birth certificates. Analyses were stratified by number of prior pregnancies and controlled for smoking and maternal age. No significant increases in risk for fetal death were observed across four measures of exposure: a lifetime estimate of PCB exposure based on species-specific PCB levels; the number of years of fish consumption; kilograms of sport fish consumed in 1990-1991; and a lifetime estimate of kilograms eaten. A slight risk reduction was seen for women with two prior pregnancies at the highest level of PCB exposure (odds ratio = 0.36; 95% CI, 0.14-0.92) and for women with three or more prior pregnancies with increasing years of fish consumption (odds ratio = 0.97; 95% CI, 0.94-0.99). These findings suggest that consumption of PCB-contaminated sport fish does not increase the risk of spontaneous fetal death. 50 refs., 2 tabs.

  5. Acute traumatic death of a 17th century general based on examination of mummified remains found in Korea.

    PubMed

    Lee, In Sun; Lee, Eun-Joo; Park, Jun Bum; Baek, Seung Hee; Oh, Chang Seok; Lee, Soong Deok; Kim, Yi-Suk; Bok, Gi Dae; Hong, Jung Won; Lim, Do-Sun; Shin, Myung Ho; Seo, Min; Shin, Dong Hoon

    2009-06-01

    Recently, we examined one of the most perfectly preserved mummies of the Joseon Dynasty (1392-1910) ever found in Korea. The individual was an elderly man and a high-ranking general who had lived sometime during the 16th or 17th century in Korea. When computerized tomography (CT) radiographs were taken, a fracture line was observed on the left side of the mandible. A post-factum dissection also provided crucial clues to the cause of death. First of all, blood clots were still evident at the fracture site, indicating that the mandibular fracture had occurred just before death. Second, we also found feces exclusively in the sigmoid colon or rectum, but not in the stomach, small intestine or colon. This told us that our subject had not eaten anything during his final 2 days (even though there was no indication that he would have had any difficulty eating during that time). Therefore, we presume that this case might not be one of chronic or wasting disease, but rather a case of sudden death. By virtue of the varied specialties of the researchers involved in this study, we were able to piece together a partly very clear and partly very plausible story for our 17th century mummy subject. Considering the high level of preservation of remains and artifacts found in lime soil mixture barrier (LSMB) tombs, not to mention the rich supplementary information available from historical documents, similarly successful studies are promised in forthcoming days and years. PMID:19345566

  6. Guidelines for the verification and validation of expert system software and conventional software: Evaluation of knowledge base certification methods. Volume 4

    SciTech Connect

    Miller, L.A.; Hayes, J.E.; Mirsky, S.M.

    1995-03-01

    This report presents the results of the Knowledge Base Certification activity of the expert systems verification and validation (V&V) guideline development project which is jointly funded by the US Nuclear Regulatory Commission and the Electric Power Research Institute. The ultimate objective is the formulation of guidelines for the V&V of expert systems for use in nuclear power applications. This activity is concerned with the development and testing of various methods for assuring the quality of knowledge bases. The testing procedure used was that of behavioral experiment, the first known such evaluation of any type of V&V activity. The value of such experimentation is its capability to provide empirical evidence for -- or against -- the effectiveness of plausible methods in helping people find problems in knowledge bases. The three-day experiment included 20 participants from three nuclear utilities, the Nuclear Regulatory Commission`s Technical training Center, the University of Maryland, EG&G Idaho, and SAIC. The study used two real nuclear expert systems: a boiling water reactor emergency operating procedures tracking system and a pressurized water reactor safety assessment systems. Ten participants were assigned to each of the expert systems. All participants were trained in and then used a sequence of four different V&V methods selected as being the best and most appropriate for study on the basis of prior evaluation activities. These methods either involved the analysis and tracing of requirements to elements in the knowledge base (requirements grouping and requirements tracing) or else involved direct inspection of the knowledge base for various kinds of errors. Half of the subjects within each system group used the best manual variant of the V&V methods (the control group), while the other half were supported by the results of applying real or simulated automated tools to the knowledge bases (the experimental group).

  7. Value, Challenges, and Satisfaction of Certification for Multiple Sclerosis Specialists

    PubMed Central

    Halper, June

    2014-01-01

    Background: Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. Methods: A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Results: Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS specialists perceived significantly greater value and satisfaction than lapsed-certification MS specialists in terms of employer and peer recognition, validation of MS knowledge, and empowering MS patients. Lapsed-certification MS specialists reported increased confidence and caring for MS patients using evidence-based practice. Both currently certified and lapsed-certification groups reported dissatisfaction with MSCS recognition and pay/salary rewards. Conclusions: The results of this study can be used in efforts to encourage initial certification and recertification of interdisciplinary MS team members. PMID:25061432

  8. Building Intercultural Competence through Intercultural Competency Certification of Undergraduate Students

    ERIC Educational Resources Information Center

    Janeiro, Maria G. Fabregas; Fabre, Ricardo Lopez; Nuno de la Parra, Jose Pablo

    2014-01-01

    The Intercultural Competency Certificate (CCI in Spanish) designed for the Universidad Popular Autonoma del Estado de Puebla (UPAEP University) is a theory based comprehensive plan to develop undergraduate students' intercultural competence. This Certificate is based in the Developmental Model of Intercultural Sensitivity (DMIS) developed by

  9. Building Intercultural Competence through Intercultural Competency Certification of Undergraduate Students

    ERIC Educational Resources Information Center

    Janeiro, Maria G. Fabregas; Fabre, Ricardo Lopez; Nuno de la Parra, Jose Pablo

    2014-01-01

    The Intercultural Competency Certificate (CCI in Spanish) designed for the Universidad Popular Autonoma del Estado de Puebla (UPAEP University) is a theory based comprehensive plan to develop undergraduate students' intercultural competence. This Certificate is based in the Developmental Model of Intercultural Sensitivity (DMIS) developed by…

  10. Spontaneous fetal death among multigravid fertile women in relation to sport fish consumption and PCB exposure, New York State Angler Study

    SciTech Connect

    Mendola, P.

    1994-01-01

    Spontaneous fetal death, a sentinel event for environmental reproductive toxicity, has been observed among various mammalian species following polychlorinated biphenyl (PCB) exposure. This exposure-based cohort study assessed the relationship between PCB exposure due to consumption of contaminated Lake Ontario sport fish and spontaneous fetal death. Using 1,820 women from the 1990-1991 New York State Angler Study, fish consumption data were obtained from food frequency questionnaires and reproductive histories from live birth certificates. A reliability study demonstrated an excellent level of agreement between the exact number of spontaneous fetal deaths recorded on the birth certificate compared with telephone interview data (kappa = 0.83). Women who had never eaten Lake Ontario sport fish were unexposed (n = 979) and 841 women reported various levels of exposure. Analyses were stratified by maternal gravidity and controlled for smoking status and maternal age. No significant increases in risk for spontaneous fetal death were seen for any estimate of PCB exposure including lifetime estimate of PCB exposure based on species-specific PCB levels, years of fish consumption, and kilograms of fish consumed, either in the 1990-1991 season or in a lifetime estimate. The only significant finding was a slight risk reduction for women of gravidity three or more with years of fish consumption (odds ratio = 0.97; p = 0.03; 95% confidence interval = 0.94-0.99). These findings suggest that PCB exposure from contaminated sport fish does not increase the risk of spontaneous fetal death.

  11. PEM public key certificate cache server

    NASA Astrophysics Data System (ADS)

    Cheung, T.

    1993-12-01

    Privacy Enhanced Mail (PEM) provides privacy enhancement services to users of Internet electronic mail. Confidentiality, authentication, message integrity, and non-repudiation of origin are provided by applying cryptographic measures to messages transferred between end systems by the Message Transfer System. PEM supports both symmetric and asymmetric key distribution. However, the prevalent implementation uses a public key certificate-based strategy, modeled after the X.509 directory authentication framework. This scheme provides an infrastructure compatible with X.509. According to RFC 1422, public key certificates can be stored in directory servers, transmitted via non-secure message exchanges, or distributed via other means. Directory services provide a specialized distributed database for OSI applications. The directory contains information about objects and then provides structured mechanisms for accessing that information. Since directory services are not widely available now, a good approach is to manage certificates in a centralized certificate server. This document describes the detailed design of a centralized certificate cache serve. This server manages a cache of certificates and a cache of Certificate Revocation Lists (CRL's) for PEM applications. PEMapplications contact the server to obtain/store certificates and CRL's. The server software is programmed in C and ELROS. To use this server, ISODE has to be configured and installed properly. The ISODE library 'libisode.a' has to be linked together with this library because ELROS uses the transport layer functions provided by 'libisode.a.' The X.500 DAP library that is included with the ELROS distribution has to be linked in also, since the server uses the DAP library functions to communicate with directory servers.

  12. Studies on time of death estimation in the early post mortem period -- application of a method based on eyeball temperature measurement to human bodies.

    PubMed

    Kaliszan, Michał

    2013-09-01

    This paper presents a verification of the thermodynamic model allowing an estimation of the time of death (TOD) by calculating the post mortem interval (PMI) based on a single eyeball temperature measurement at the death scene. The study was performed on 30 cases with known PMI, ranging from 1h 35min to 5h 15min, using pin probes connected to a high precision electronic thermometer (Dostmann-electronic). The measured eye temperatures ranged from 20.2 to 33.1°C. Rectal temperature was measured at the same time and ranged from 32.8 to 37.4°C. Ambient temperatures which ranged from -1 to 24°C, environmental conditions (still air to light wind) and the amount of hair on the head were also recorded every time. PMI was calculated using a formula based on Newton's law of cooling, previously derived and successfully tested in comprehensive studies on pigs and a few human cases. Thanks to both the significantly faster post mortem decrease of eye temperature and a residual or nonexistent plateau effect in the eye, as well as practically no influence of body mass, TOD in the human death cases could be estimated with good accuracy. The highest TOD estimation error during the post mortem intervals up to around 5h was 1h 16min, 1h 14min and 1h 03min, respectively in three cases among 30, while for the remaining 27 cases it was not more than 47min. The mean error for all 30 cases was ±31min. All that indicates that the proposed method is of quite good precision in the early post mortem period, with an accuracy of ±1h for a 95% confidence interval. On the basis of the presented method, TOD can be also calculated at the death scene with the use of a proposed portable electronic device (TOD-meter). PMID:23879937

  13. Certification of training

    NASA Technical Reports Server (NTRS)

    Gibson, Richard S.

    1994-01-01

    Training has been around as an informal process for countless years. Most higher order animals require some level of training in hunting, social skills, or other survival related skills to continue their existence beyond early infancy. Much of the training is accomplished through imitation, trial and error, and good luck. In some ways the essentials of training in aviation have not deviated from this original formula a great deal. One of the major changes in aviation and other technical areas is that more complex response chains based on a broader base of knowledge are now required. 'To certify' means many things according to the American Heritage dictionary of the English Language. These meanings range from 'to guarantee as meeting a standard' to 'to declare legally insane'. For this discussion, we will use the definition 'an action taken by some authoritative body that essentially guarantees that the instruction meets some defined standard'. In order to make this certification, the responsible body subjects the educational process, training, training device, or simulator to some type of examination to determine its adequacy or validity.

  14. [Unnatural deaths must be investigated better--risk of crimes being missed. Examination of the police and the health care system management of deaths in three counties].

    PubMed

    Pettersson, Gisela; Eriksson, Anders

    In 2008 only 55 % of all deaths not deemed to be natural in Sweden underwent a medicolegal autopsy. In the present study we describe and compare the characteristics of unnatural deaths in three counties through review of death certificates for unnatural deaths and, when applicable, corresponding police reports. The majority of unnatural deaths that were not reported to the police were among elderly decedents, with the deaths most often resulting from a fall-related fracture or head injury. One subgroup among these deaths that were not recognized as reportable by the involved physician, estimated by extrapolation to a total of approximately 300 annually, nationwide, was considered to be at elevated risk for a criminal death (homicide). The causes of death in this group were due to, for example, high energy or sharp force trauma, gunshot injury, asphyxia, and drug and/or alcohol intoxication. We conclude that additional training in the handling of unnatural deaths is indicated for Swedish physicians. PMID:25423339

  15. Operator Certification Study Guide.

    ERIC Educational Resources Information Center

    American Water Works Association, Denver, CO.

    This study guide contains typical questions and answers that all levels of water treatment plant operators might expect to find on a certification examination. The manual covers the basic sciences, treatment techniques, testing procedures, and federal legislation. (Author/SB)

  16. An A+ Certification Program.

    ERIC Educational Resources Information Center

    Rubenstein, Charles

    2003-01-01

    Describes the computer technology program at Thomas A. Edison Vocational and Technical High School in Queens, New York, all of whose graduates go on to specialty secondary schools for additional certification or to postsecondary education programs. (JOW)

  17. Waterfront Certification Changes.

    ERIC Educational Resources Information Center

    O'Brien, Laurie

    1995-01-01

    Overviews certification changes affecting lifeguard training, progressive swimming instructors, CPR and first aid training, canoeing and kayaking instructors, sailing instructors, water skiing instructors, and instructor trainers. Addresses how changes impact American Camping Association standards. Provides addresses of training organizations. (LP)

  18. Laminar Flow Aircraft Certification

    NASA Technical Reports Server (NTRS)

    Williams, Louis J. (Compiler)

    1986-01-01

    Various topics telative to laminar flow aircraft certification are discussed. Boundary layer stability, flaps for laminar flow airfoils, computational wing design studies, manufacturing requirements, windtunnel tests, and flow visualization are among the topics covered.

  19. Certification Exams. Let's Proceed.

    ERIC Educational Resources Information Center

    McKinney, William R.; Pope, Michael S.

    1986-01-01

    The authors discuss why certification examinations for park, recreation, and leisure professionals are needed and highlight specific concerns now being addressed by the Test Development Management Committee of the National Recreation and Park Association. (MT)

  20. Expressing death risk as condensed life experience and death intensity.

    PubMed

    Ioannidis, John P A

    2013-08-01

    Some risk exposures, including many medical and surgical procedures, typically carry hazards of death that are difficult to convey and appreciate in absolute terms. I propose presenting the death risk as a condensed life experience (i.e., the equivalent amount of life T that would carry the same cumulative mortality hazard for a person of the same age and sex based on life tables). For example, if the risk of death during an elective 1-hour procedure is 0.01%, and same-age and same-sex people have a 0.01% death risk over 1 month, one can inform the patient that "this procedure carries the same death risk as living 1 month of normal life." Comparative standards from other risky activities or from a person with the same disease at the same stage and same predictive profile could also be used. A complementary metric that may be useful to consider is the death intensity. The death intensity λ is the hazard function that shows the fold-risk estimate of dying compared with the reference person. The death intensity can vary substantially for different phases of the event, operation, or procedure (e.g., intraoperative, early postoperative, late postoperative), and this variability may also be useful to convey. T will vary depending on the time window for which it is computed. I present examples for calculating T and λ using literature data on accidents, ascent to Mount Everest, and medical and surgical procedures. PMID:23579043

  1. Sex Differences in Dose Escalation and Overdose Death during Chronic Opioid Therapy: A Population-Based Cohort Study

    PubMed Central

    Kaplovitch, Eric; Gomes, Tara; Camacho, Ximena; Dhalla, Irfan A.; Mamdani, Muhammad M.; Juurlink, David N.

    2015-01-01

    Background The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually. The patients at greatest risk of death are those receiving high doses of opioids. Whether sex influences the risk of dose escalation or opioid-related mortality is unknown. Methods and Findings We conducted a cohort study using healthcare records of 32,499 individuals aged 15 to 64 who commenced chronic opioid therapy for noncancer pain between April 1, 1997 and December 31, 2010 in Ontario, Canada. Patients were followed from their first opioid prescription until discontinuation of therapy, death from any cause or the end of the study period. Among patients receiving chronic opioid therapy, 589 (1.8%) escalated to high dose therapy and n = 59 (0.2%) died of opioid-related causes while on treatment. After multivariable adjustment, men were more likely than women to escalate to high-dose opioid therapy (adjusted hazard ratio 1.44; 95% confidence interval 1.21 to 1.70) and twice as likely to die of opioid-related causes (adjusted hazard ratio 2.04; 95% confidence interval 1.18 to 3.53). These associations were maintained in a secondary analysis of 285,520 individuals receiving any opioid regardless of the duration of therapy. Conclusions Men are at higher risk than women for escalation to high-dose opioid therapy and death from opioid-related causes. Both outcomes were more common than anticipated. PMID:26291716

  2. Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)

    PubMed Central

    Kayaba, Kazunori; Nakahara, Ken-ichi; Matsushita, Satoru

    2012-01-01

    Background Experimental studies support the anti-neoplastic effect of apo(a), but several clinical studies have reported contradictory results. The purpose of this study was to determine whether a low lipoprotein(a) [Lp(a)] concentration is related to mortality from major causes of death, especially cancer. Methods The subjects were 10,413 participants (4,005 men and 6,408 women) from a multi-center population-based cohort study in Japan (The Jichi Medical School cohort study). The average age at registration was 55.0 years, and the median observation period was 4,559 days. As the estimated hazard ratio was high for both the low and very high Lp(a) levels, we defined two Lp(a) groups: a low Lp(a) group [Lp(a)<80 mg/L] and an intermediate-to-high Lp(a) group [Lp(a)?80]. Participants who died from malignant neoplasms (n?=?316), cardiovascular disease (202), or other causes (312) during the observation period were examined. Results Cumulative incidence plots showed higher cumulative death rates for the low Lp(a) group than for the intermediate-to-high Lp(a) group for all-cause, cancer, and miscellaneous-cause deaths (p<0.001, p?=?0.03, and p?=?0.03, respectively). Cox proportional hazards analyses with the sex and age of the participants, body mass index, and smoking and drinking histories as covariates showed that a low Lp(a) level was a significant risk for all-cause, cancer, and miscellaneous-cause deaths (p<0.001, p?=?0.003, and p?=?0.01, respectively). The hazard ratio (95% CI) [1.48, 1.151.92] of a low Lp(a) level for cancer deaths was almost the same as that for a male sex (1.46, 1.002.13). Conclusions This is the first report to describe the association between a low Lp(a) level and all-cause or cancer death, supporting the anti-neoplastic effect of Lp(a). Further epidemiological studies are needed to confirm the present results. PMID:22485129

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

    PubMed Central

    Wahlberg, Anna; Källestål, Carina; Lundgren, AnnaCarin; Essén, Birgitta

    2014-01-01

    Background Undocumented migrants are one of the most vulnerable groups in Swedish society, where they generally suffer from poor health and limited health care access. Due to their irregular status, such migrants are an under-researched group and are not included in the country’s Cause of Death Register (CDR). Objective To determine the causes of death among undocumented migrants in Sweden and to ascertain whether there are patterns in causes of death that differ between residents and undocumented migrants. Design This is a cross-sectional study of death certificates issued from 1997 to 2010 but never included in the CDR from which we established our study sample of undocumented migrants. As age adjustments could not be performed due to lack of data, comparisons between residents and undocumented migrants were made at specific age intervals, based on the study sample’s mean age at death±a half standard deviation. Results Out of 7,925 individuals surveyed, 860 were classified as likely to have been undocumented migrants. External causes (49.8%) were the most frequent cause of death, followed by circulatory system diseases, and then neoplasms. Undocumented migrants had a statistically significant increased risk of dying from external causes (odds ratio [OR] 3.57, 95% confidence interval [CI]: 2.83–4.52) and circulatory system diseases (OR 2.20, 95% CI: 1.73–2.82) compared to residents, and a lower risk of dying from neoplasms (OR 0.07, 95% CI: 0.04–0.14). Conclusions We believe our study is the first to determine national figures on causes of death of undocumented migrants. We found inequity in health as substantial differences in causes of death between undocumented migrants and residents were seen. Legal ambiguities regarding health care provision must be addressed if equity in health is to be achieved in a country otherwise known for its universal health coverage. PMID:24909409

  4. Classification of perinatal deaths.

    PubMed

    Wigglesworth, J S

    1994-01-01

    Accurate classification of perinatal deaths is instrumental in efforts to improve the perinatal mortality rate (PNMR). Accurate records should be maintained on birth weight, gestational age, a simple classification of cause of death (possibly the "Wigglesworth" or the author's system), a classification system correlated with birth weight/gestation of dead and live births, and, where possible, detailed coding such as the International Classification of Diseases (ICD) or the Systematized Nomenclature of Medicine (SNOMED). The fetal loss rate in Great Britain is reported as a minimum of 0.1% per week for pregnancies from 22 weeks until term. Obstetric or neonatal management can affect the level of mortality. Terminations due to malformations performed before the 24th week are found to account for a 50% decline in the PNMR. PNMR is affected also by birth weight and the occurrence of multiple births. Neonatal care that prolongs the survival of sick or malformed neonates may decrease PNMR or increase infant death rates. Analysis of trends in PNMR must consider demographic changes such as an increase in preterm multiple births due to fertility treatment. Perinatal deaths may be classified by cause with a variety of systems. The ICD system is a single axis classification which uses three digit codes for primary causes and a fourth and fifth digit for detailed subcategories, which can be accessed in a alphabetically-organized index. SNOMED provides six different fields of information, including topography, morphology, aetiology, function, disease, and procedure. Five subordinate fields are identified and linked to topographic body sites. Choice of classification systems is considered to be based on availability of information and the needs for subsequent analysis. Two other systems of classification are available in the UK. The Aberdeen system is based on maternal factors, but the disadvantage is the high number of unexplained deaths. The Hey et al. system codes by fetal and neonatal factors and does not require modern investigative techniques, but the detail is highly variables from case-to-case and hospital-to-hospital. The author's system is based on routine autopsies of external conditions. Four groupings are identified, including macerated normally-formed stillborn infants, congenital anomalies (stillbirth or neonatal death), conditions associated with prematurity, and fresh stillbirths presumed asphyxiated. A fifth category groups infants dying of specific conditions such as toxoplasmosis. PMID:8147106

  5. Certification of computational results

    NASA Technical Reports Server (NTRS)

    Sullivan, Gregory F.; Wilson, Dwight S.; Masson, Gerald M.

    1993-01-01

    A conceptually novel and powerful technique to achieve fault detection and fault tolerance in hardware and software systems is described. When used for software fault detection, this new technique uses time and software redundancy and can be outlined as follows. In the initial phase, a program is run to solve a problem and store the result. In addition, this program leaves behind a trail of data called a certification trail. In the second phase, another program is run which solves the original problem again. This program, however, has access to the certification trail left by the first program. Because of the availability of the certification trail, the second phase can be performed by a less complex program and can execute more quickly. In the final phase, the two results are compared and if they agree the results are accepted as correct; otherwise an error is indicated. An essential aspect of this approach is that the second program must always generate either an error indication or a correct output even when the certification trail it receives from the first program is incorrect. The certification trail approach to fault tolerance is formalized and realizations of it are illustrated by considering algorithms for the following problems: convex hull, sorting, and shortest path. Cases in which the second phase can be run concurrently with the first and act as a monitor are discussed. The certification trail approach are compared to other approaches to fault tolerance.

  6. Sudden infant death syndrome

    MedlinePlus

    Crib death; SIDS ... However, SIDS is still a major cause of death in infants under 1 year old. Thousands of ... affects boys more often than girls. Most SIDS deaths occur in the winter. The following may increase ...

  7. Death: 'nothing' gives insight.

    PubMed

    Ettema, Eric J

    2013-08-01

    According to a widely accepted belief, we cannot know our own death--death means 'nothing' to us. At first sight, the meaning of 'nothing' just implies the negation or absence of 'something'. Death then simply refers to the negation or absence of life. As a consequence, however, death has no meaning of itself. This leads to an ontological paradox in which death is both acknowledged and denied: death is … nothing. In this article, I investigate whether insight into the ontological paradox of the nothingness of death can contribute to a good end-of-life. By analysing Aquinas', Heidegger's and Derrida's understanding of death as nothingness, I explore how giving meaning to death on different ontological levels connects to, and at the same time provides resistance against, the harsh reality of death. By doing so, I intend to demonstrate that insight into the nothingness of death can count as a framework for a meaningful dealing with death. PMID:23054426

  8. Atomic oxygen interaction with spacecraft materials: Relationship between orbital and ground-based testing for materials certification

    NASA Technical Reports Server (NTRS)

    Cross, Jon B.; Koontz, Steven L.; Lan, Esther H.

    1993-01-01

    The effects of atomic oxygen on boron nitride (BN), silicon nitride (Si3N4), Intelsat 6 solar cell interconnects, organic polymers, and MoS2 and WS2 dry lubricant, were studied in Low Earth Orbit (LEO) flight experiments and in a ground based simulation facility. Both the inflight and ground based experiments employed in situ electrical resistance measurements to detect penetration of atomic oxygen through materials and Electron Spectroscopy for Chemical Analysis (ESCA) analysis to measure chemical composition changes. Results are given. The ground based results on the materials studied to date show good qualitative correlation with the LEO flight results, thus validating the simulation fidelity of the ground based facility in terms of reproducing LEO flight results. In addition it was demonstrated that ground based simulation is capable of performing more detailed experiments than orbital exposures can presently perform. This allows the development of a fundamental understanding of the mechanisms involved in the LEO environment degradation of materials.

  9. Spatial analysis of deaths from pulmonary tuberculosis in the city of São Luís, Brazil*

    PubMed Central

    Santos-Neto, Marcelino; Yamamura, Mellina; Garcia, Maria Concebida da Cunha; Popolin, Marcela Paschoal; Silveira, Tatiane Ramos dos Santos; Arcêncio, Ricardo Alexandre

    2014-01-01

    OBJECTIVE: To characterize deaths from pulmonary tuberculosis, according to sociodemographic and operational variables, in the city of São Luís, Brazil, and to describe their spatial distribution. METHODS: This was an exploratory ecological study based on secondary data from death certificates, obtained from the Brazilian Mortality Database, related to deaths from pulmonary tuberculosis. We included all deaths attributed to pulmonary tuberculosis that occurred in the urban area of São Luís between 2008 and 2012. We performed univariate and bivariate analyses of the sociodemographic and operational variables of the deaths investigated, as well as evaluating the spatial distribution of the events by kernel density estimation. RESULTS: During the study period, there were 193 deaths from pulmonary tuberculosis in São Luís. The median age of the affected individuals was 52 years. Of the 193 individuals who died, 142 (73.60%) were male, 133 (68.91%) were Mulatto, 102 (53.13%) were single, and 64 (33.16%) had completed middle school. There was a significant positive association between not having received medical care prior to death and an autopsy having been performed (p = 0.001). A thematic map by density of points showed that the spatial distribution of those deaths was heterogeneous and that the density was as high as 8.12 deaths/km2. CONCLUSIONS: The sociodemographic and operational characteristics of the deaths from pulmonary tuberculosis evaluated in this study, as well as the identification of priority areas for control and surveillance of the disease, could promote public health policies aimed at reducing health inequities, allowing the optimization of resources, as well as informing decisions regarding the selection of strategies and specific interventions targeting the most vulnerable populations. PMID:25410843

  10. Viking site selection and certification

    NASA Technical Reports Server (NTRS)

    Masursky, H.; Crabill, N. L.

    1981-01-01

    The landing site selection and certification effort for the Viking mission to Mars is reviewed from the premission phase through the acquisition of data and decisions during mission operations and the immediate postlanding evaluation. The utility and limitations of the orbital television and infrared data and ground based radar observation of candidate and actual landing sites are evaluated. Additional instruments and types of observations which would have been useful include higher resolution cameras, radar altimeters, and terrain hazard avoidance capability in the landing system. Suggestions based on this experience that might be applied to future missions are included.

  11. USING RISK-BASED CORRECTIVE ACTION (RBCA) TO ASSESS (THEORETICAL) CANCER DEATHS AVERTED COMPARED TO THE (REAL) COST OF ENVIRONMENTAL REMEDIATION

    SciTech Connect

    Miller, M. L.; Hylko, J. M.

    2002-02-25

    In 1978, on the basis of existing health studies at the time, the Uranium Mill Tailings Remedial Action (UMTRA) Project legislation was proposed that would authorize remedial action at inactive uranium processing sites and vicinity properties. The cost of the program to the Federal Government was expected to be $180 million. With the completion of this project, approximately 1300 theoretical cancer deaths were prevented in the next 100 years at a cost of $1.45 billion, based on the Fiscal Year 1998 Federal UMTRA budget. The individual site costs ranged from $0.2 million up to $18 billion spent per theoretical cancer death averted over the next 100 years. Resources required to sustain remediation activities such as this are subject to reduction over time, and are originally based on conservative assumptions that tend to overestimate risks to the general public. This evaluation used a process incorporating risk-based corrective action (RBCA); a three-tiered, decision-making process tailoring corrective action activities according to site-specific conditions and risks. If RBCA had been applied at the start of the UMTRA Project, and using a criterion of >1 excess cancer death prevented as justification to remediate the site, only 50% of the existing sites would have been remediated, yielding a cost savings of $303.6 million to the Federal Government and affected States, which share 10% of the cost. This cost savings equates to 21% of the overall project budget. In addition, only 22% of the vicinity properties had structural contamination contributing to elevated interior gamma exposure and radon levels. Focusing only on these particular properties could have saved an additional $269.3 million, yielding a total savings of $573 million; 40% of the overall project budget. As operational experience is acquired, including greater understanding of the radiological and nonradiological risks, decisions should be based on the RBCA process, rather than relying on conservative assumptions that tend to overestimate risks to the general public.

  12. Death Education for the Health Professional.

    ERIC Educational Resources Information Center

    Benoliel, Jeanne Quint, Ed.

    The perspectives of a number of health professionals based on their experiences in providing death education courses are presented in essays. In "Interdisciplinary Death Education in a Nursing School" (Helen L. Swain and Kathleen V. Cowles), the development of an undergraduate elective course in death, dying, and bereavement at the University of…

  13. Assessment of a sudden death case due to coronary artery disease based on the PMCT and forensic autopsy.

    PubMed

    Wan, Lei; Zhang, Jian-hua; Huang, Ping; Ying, Chong-liang; Liu, Ning-guo; Zhu, Guang-you

    2012-10-01

    It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT). This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan. The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR), and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software. The results showed that CAC was conspicuous; the total calcium score was 640.3, considerably higher than 400. The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found. The imaging results confirmed those of autopsy. In addition, the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure. PMID:23213791

  14. In vitro study of cell death with 5-aminolevulinic acid based photodynamic therapy to improve the efficiency of cancer treatment

    NASA Astrophysics Data System (ADS)

    Firdous, S.; Nawaz, M.; Ikram, M.; Ahmed, M.

    2012-03-01

    Photodynamic therapy (PDT) is a kind of photochemo therapeutic treatment that exerts its effect mainly through the induction of cell death. Distinct types of cell death may be elicited by different PDT regimes. In this study, efforts are underway to optimize PDT protocols for improved efficacy and combination of all three PDT mechanisms involved in the different human carcinomas cell narcosis. Our in vitro cell culture experiments with 5-aminolevulanic acid (ALA) a clinically approved photiosensitizer (PS) and 635 nm laser light have yielded promising results, as follow: (1) (human cervical cancer (HeLa) cell line incubated, for 18 h, with 30 μg/ml of 5-ALA, treated with laser light dose of 50 J/cm2 can produce 85% of cell killing (2) human larynx carcinoma (Hep2c) cell line incubated, for 7 h, with 55 μg/ml of 5-ALA, treated with laser light dose of 85 J/cm2 can produce 75% of cell killing (3) human liver cancer (HepG2) cell line incubated, for 22-48 h, with 262 μg/ml of 5-ALA, treated with laser light dose of 120 J/cm2 can produce 95% of cell killing (4) human muscle cancer (RD) cell line incubated, for 47 h, with 250 μg/ml of 5-ALA, treated with laser light dose of 80 J/cm2 can produce 76% of cell killing (5) Human embryonic kidney (HEK293T) cell line incu-bated, for 18 h, with 400 μg/ml of 5-ALA, treated with laser light dose of 40 J/cm2 can produce 82% of cell killing confirming the efficacy of photodynamic therapy.

  15. A Parallel Universe: Certification in the Information Technology Guild.

    ERIC Educational Resources Information Center

    Adelman, Clifford

    2000-01-01

    Discusses the growing importance of transnational, competency-based training in information technology and considers implications for traditional institutions of higher education. Considers the awarding of certificates rather than degrees; the types of providers offering training; the role of testing companies in the certification process; and the

  16. Problem Solving Abilities and Perceptions in Alternative Certification Mathematics Teachers

    ERIC Educational Resources Information Center

    Evans, Brian R.

    2012-01-01

    It is important for teacher educators to understand new alternative certification middle and high school teachers' mathematical problem solving abilities and perceptions. Teachers in an alternative certification program in New York were enrolled in a proof-based algebra course. At the beginning and end of a semester participants were given a…

  17. Subspecialty Certification by the American Board of Psychiatry and Neurology

    ERIC Educational Resources Information Center

    Juul, Dorthea; Scheiber, Stephen C.; Kramer, Thomas A. M.

    2004-01-01

    Objective: The authors describe the approval processes for subspecialties and the mechanisms for certification and recertification and review the status of training programs and numbers of diplomates with subspecialty certification. Methods: Published information and relevant data bases were reviewed. To date, 5,327 child and adolescent…

  18. 40 CFR 270.280 - What are the certification requirements?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... compliance with 40 CFR part 267. (a) Your certification must read: I certify under penalty of law that: (1) I... of my facility's compliance status with 40 CFR part 267, which supports this certification. Based on... existing facility complies with all applicable requirements of 40 CFR part 267 and will continue to...

  19. Postsecondary Certificates and Degrees in the State of Alaska.

    ERIC Educational Resources Information Center

    Alaska State Commission on Postsecondary Education, Juneau.

    The number of certificate and degree programs offered and awarded at public and private nonproprietary, postsecondary institutions in Alaska is listed statewide and by institution. Programs that may be underproductive based on the number of formal awards over a four-year period are also identified. A total of 252 unduplicated certificate and…

  20. 40 CFR 91.118 - Certification procedure-testing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Certification procedure-testing. 91.118 Section 91.118 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... certificate of conformity; or (ii) Model year 2003 based on good engineering judgement. (2) Upon request...

  1. 40 CFR 91.118 - Certification procedure-testing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Certification procedure-testing. 91.118 Section 91.118 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... certificate of conformity; or (ii) Model year 2003 based on good engineering judgement. (2) Upon request...

  2. 40 CFR 91.118 - Certification procedure-testing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Certification procedure-testing. 91.118 Section 91.118 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... certificate of conformity; or (ii) Model year 2003 based on good engineering judgement. (2) Upon request...

  3. 40 CFR 91.118 - Certification procedure-testing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certification procedure-testing. 91.118 Section 91.118 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... certificate of conformity; or (ii) Model year 2003 based on good engineering judgement. (2) Upon request...

  4. 40 CFR 91.118 - Certification procedure-testing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Certification procedure-testing. 91.118 Section 91.118 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... certificate of conformity; or (ii) Model year 2003 based on good engineering judgement. (2) Upon request...

  5. A Parallel Universe: Certification in the Information Technology Guild.

    ERIC Educational Resources Information Center

    Adelman, Clifford

    2000-01-01

    Discusses the growing importance of transnational, competency-based training in information technology and considers implications for traditional institutions of higher education. Considers the awarding of certificates rather than degrees; the types of providers offering training; the role of testing companies in the certification process; and the…

  6. Developing an Online Certification Program for Nutrition Education Assistants

    ERIC Educational Resources Information Center

    Christofferson, Debra; Christensen, Nedra; LeBlanc, Heidi; Bunch, Megan

    2012-01-01

    Objective: To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses. Design: An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and…

  7. The Assessment of Alternative Certification Practices. Panel Presentations.

    ERIC Educational Resources Information Center

    Allegro, Annalisa

    This panel discussion focuses on alternative teacher certification. Alternative certification is a way of becoming a bilingual education or English-as-a-Second-Language (ESL) teacher without completing a preservice college program. It has three areas: formal instruction, school-based supervision, and evaluation. It serves the purpose of more…

  8. 30 CFR 35.9 - Certificates of approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... APPROVAL OF MINING PRODUCTS FIRE-RESISTANT HYDRAULIC FLUIDS General Provisions § 35.9 Certificates of approval. (a) Upon completion of an investigation of a hydraulic fluid MSHA will issue to the applicant... hydraulic fluid upon which the certificate of approval is based. In addition to the applicant's record...

  9. Developing an Online Certification Program for Nutrition Education Assistants

    ERIC Educational Resources Information Center

    Christofferson, Debra; Christensen, Nedra; LeBlanc, Heidi; Bunch, Megan

    2012-01-01

    Objective: To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses. Design: An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and

  10. Certification of damage tolerant composite structure

    NASA Technical Reports Server (NTRS)

    Rapoff, Andrew J.; Dill, Harold D.; Sanger, Kenneth B.; Kautz, Edward F.

    1990-01-01

    A reliability based certification testing methodology for impact damage tolerant composite structure was developed. Cocured, adhesively bonded, and impact damaged composite static strength and fatigue life data were statistically analyzed to determine the influence of test parameters on the data scatter. The impact damage resistance and damage tolerance of various structural configurations were characterized through the analysis of an industry wide database of impact test results. Realistic impact damage certification requirements were proposed based on actual fleet aircraft data. The capabilities of available impact damage analysis methods were determined through correlation with experimental data. Probabilistic methods were developed to estimate the reliability of impact damaged composite structures.

  11. Personnel Issues in School-Based Physical Therapy: A Look at Supply and Demand, Professional Preparation, Licensure, and Certification

    ERIC Educational Resources Information Center

    Rapport, Mary Jane K.; Effgen, Susan K.

    2004-01-01

    Physical therapy in school settings focuses on outcomes and is based on meeting the educational needs of the child or student. Despite the expansion in delivery models beyond direct one-to-one intervention, and the use of multiple team members, to achieve outcomes for students in educational environments, there continue to be shortages of physical…

  12. Computer Certification Updates for Technical Educators.

    ERIC Educational Resources Information Center

    Evans, Candy Duncan; Henry, Janice Schoen

    2000-01-01

    Discusses the importance of providing students with information about certification. Included advantages of certification for employers, employees, and others and discusses certifications sponsored by professional associations. Includes certification resources such as websites, books, and organizations. (JOW)

  13. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  14. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  15. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  16. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  17. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  18. Child deaths of unknown cause: review of 7 years' experience.

    PubMed

    Bowen, Kathryn A; Marshall, William N

    2004-01-01

    Using data from the Pima County (Arizona) Child Fatality Review Team, we sought to describe the nature of unknown cause pediatric deaths. Of 1,150 total deaths (1995-2001), 22 were unknown cause and 3 had only a mode of death on the death certificate. There were 15 infants <6 months, 4 children 1-4 years, 2 children 5-9 years, 1 preteen (10-14 years), and 3 aged 15-17 years. Four patterns were seen: those resembling SIDS but with confounding history, autopsy, or scene investigation; sleeping toddlers with respiratory symptoms; children with underlying conditions not expected to cause death; and deaths without complete investigation. PMID:15583775

  19. Council on Certification Professional Practice Analysis.

    PubMed

    Zaglaniczny, K L

    1993-06-01

    The CCNA has completed a PPA and will begin implementing its recommendations with the December 1993 certification examination. The results of the PPA provide content validation for the CCNA certification examination. The certification examination is reflective of the knowledge and skill required for entry-level practice. Assessment of this knowledge is accomplished through the use of questions that are based on the areas represented in the content outline. Analysis of the PPA has resulted in changes in the examination content outline and percentages of questions in each area to reflect current entry-level nurse anesthesia practice. The new outline is based on the major domains of knowledge required for nurse anesthesia practice. These changes are justified by the consistency in the responses of the practitioners surveyed. There was overall agreement as to the knowledge and skills related to patient conditions, procedures, agents, techniques, and equipment that an entry-level CRNA must have to practice. Members of the CCNA and Examination Committee will use the revised outline to develop questions for the certification examination. The questions will be focused on the areas identified as requiring high levels of expertise and those that appeared higher in frequency. The PPA survey will be used as a basis for subsequent content validation studies. It will be revised to reflect new knowledge, technology, and techniques related to nurse anesthesia practice. The CCNA has demonstrated its commitment to the certification process through completion of the PPA and implementation of changes in the structure of the examination. PMID:8291387

  20. Death and the Oldest Old: Attitudes and Preferences for End-of-Life Care - Qualitative Research within a Population-Based Cohort Study

    PubMed Central

    Fleming, Jane; Farquhar, Morag; Brayne, Carol; Barclay, Stephen

    2016-01-01

    Introduction Increasing longevity means more people will be dying in very old age, but little is known about the preferences of the ‘oldest old’ regarding their care at the end of life. Aims To understand very old people’s preferences regarding care towards the end of life and attitudes towards dying, to inform policy and practice. Methods Qualitative data collection for n = 42 population-based cohort study participants aged 95–101 (88% women, 42% in long-term-care): topic-guided interviews with n = 33 participants and n = 39 proxy informants, most with both (n = 30: 4 jointly + separate interviews for 26 dyads). Results Death was a part of life: these very old people mainly live day-to-day. Most were ready to die, reflecting their concerns regarding quality of life, being a nuisance, having nothing to live for and having lived long enough. Contrasting views were rare exceptions but voiced firmly. Most were not worried about death itself, but concerned more about the dying process and impacts on those left behind; a peaceful and pain-free death was a common ideal. Attitudes ranged from not wanting to think about death, through accepting its inevitable approach to longing for its release. Preferring to be made comfortable rather than have life-saving treatment if seriously ill, and wishing to avoid hospital, were commonly expressed views. There was little or no future planning, some consciously choosing not to. Uncertainty hampered end-of-life planning even when death was expected soon. Some stressed circumstances, such as severe dependency and others’ likely decision-making roles, would influence choices. Carers found these issues harder to raise but felt they would know their older relatives’ preferences, usually palliative care, although we found two discrepant views. Conclusions This study’s rare data show ≥95-year-olds are willing to discuss dying and end-of-life care but seldom do. Formal documentation of wishes is extremely rare and may not be welcome. Although being “ready to die” and preferring a palliative approach predominated, these preferences cannot be assumed. PMID:27045734

  1. Facility Death Review of Maternal and Neonatal Deaths in Bangladesh

    PubMed Central

    Biswas, Animesh; Rahman, Fazlur; Eriksson, Charli; Halim, Abdul; Dalal, Koustuv

    2015-01-01

    Objectives To explore the experiences, acceptance, and effects of conducting facility death review (FDR) of maternal and neonatal deaths and stillbirths at or below the district level in Bangladesh. Methods This was a qualitative study with healthcare providers involved in FDRs. Two districts were studied: Thakurgaon district (a pilot district) and Jamalpur district (randomly selected from three follow-on study districts). Data were collected between January and November 2011. Data were collected from focus group discussions, in-depth interviews, and document review. Hospital administrators, obstetrics and gynecology consultants, and pediatric consultants and nurses employed in the same departments of the respective facilities participated in the study. Content and thematic analyses were performed. Results FDR for maternal and neonatal deaths and stillbirths can be performed in upazila health complexes at sub-district and district hospital levels. Senior staff nurses took responsibility for notifying each death and conducting death reviews with the support of doctors. Doctors reviewed the FDRs to assign causes of death. Review meetings with doctors, nurses, and health managers at the upazila and district levels supported the preparation of remedial action plans based on FDR findings, and interventions were planned accordingly. There were excellent examples of improved quality of care at facilities as a result of FDR. FDR also identified gaps and challenges to overcome in the near future to improve maternal and newborn health. Discussion FDR of maternal and neonatal deaths is feasible in district and upazila health facilities. FDR not only identifies the medical causes of a maternal or neonatal death but also explores remediable gaps and challenges in the facility. FDR creates an enabled environment in the facility to explore medical causes of deaths, including the gaps and challenges that influence mortality. FDRs mobilize health managers at upazila and district levels to forward plan and improve healthcare delivery. PMID:26540233

  2. Certification et equivalence

    NASA Astrophysics Data System (ADS)

    Colardyn, Danielle

    1992-11-01

    The new economic and social equilibrium which is gradually coming about in Europe has significant consequences in terms of mobility, recognition of qualifications and certification. Specifically in the educational arena, questions are raised as to the social and vocational value of certificates, and the recognition of vocational skills. These skills are part of the wealth of the particular countries in the Community, and of each of the individuals who are now confronted by the enlarged economic and social space, in its varying forms. In this European context, what is examined here is more particularly the French situation, from the point of view of the evolution of the notion of certification and recognition of skills, and of policies both of qualification, and of initial and continuing training of the work force.

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

    ERIC Educational Resources Information Center

    Klevens, Joanne; Leeb, Rebecca T.

    2010-01-01

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

  4. Atomic oxygen interaction with spacecraft materials: Relationship between orbital and ground-based testing for materials certification

    SciTech Connect

    Cross, J.B. ); Koontz, S.L. . Lyndon B. Johnson Space Center); Lan, E.H. )

    1991-01-01

    The effects of atomic oxygen on boron nitride, silicon nitride, solar cell interconnects used on the Intelsat 6 satellite, organic polymers, and MoS{sub 2} and WS{sub 2} dry lubricant have been studied in low Earth orbit (LEO) flight experiments and in our ground-based simulation facility at Los Alamos National Laboratory. Both the in-flight and ground-based experiments employed in situ electrical resistance measurements to detect penetration of atomic oxygen through materials and ESCA analysis to measure chemical composition changes. In the presence of atomic oxygen, silver oxidizes to form silver oxide, which has a much higher electrical resistance than pure silver. Permeation of atomic oxygen through BN overcoated on thin silver was observed. No permeation of atomic oxygen through Si{sub 3}N{sub 4} was observed. Test results on the Intelsat 6 satellite interconnects used on its photovoltaic array indicate that more than 60--80% of the original thickness of silver should remain after completion of the proposed Space Shuttle rescue/reboost mission. Gas phase reaction products produced by the interaction of high kinetic energy atomic oxygen (AO) with Kapton were found to be H{sub 2}, H{sub 2}O, CO, and CO{sub 2} with NO being a possible secondary product. Hydrogen abstraction at high AO kinetic energy is postulated to be the key reaction controlling the erosion rate of Kapton. An Arrhenius-like expression having an activation barrier of 0.4 eV can be fit to the data, which suggests that the rate limiting step in the AO/Kapton reaction mechanism can be overcome by translational energy. Oxidation of MoS{sub 2} and WS{sub 2} dry lubricants in both ground-based and orbital exposures indicated the formation of MoO{sub 3} and WO{sub 3} respectively. A protective oxide layer is formed {approx}30 monolayers thick which has a high initial friction coefficient until the layer is worn off.

  5. Comprehensive review of sleep-related sudden unexpected infant deaths and their investigations: Florida 2008.

    PubMed

    Sauber-Schatz, Erin K; Sappenfield, William M; Shapiro-Mendoza, Carrie K

    2015-02-01

    To describe 2008 Florida sleep-related sudden unexpected infant deaths (SUIDs) by describing (a) percentage distribution of medical examiner (ME) cause-of-death determinations; (b) mortality rates by maternal and infant characteristics; (c) prevalence of selected suffocation or sudden infant death syndrome (SIDS) risk and protective factors; (d) frequency of selected scene investigation and autopsy components (including extent of missing data); and (e) percentage with public health program contact. In this population-based study, we identified sleep-related SUIDs occurring among Florida residents from the 2008-linked Florida infant death and birth certificates. Information about the circumstances of death was abstracted from ME, law enforcement, and hospital records. We used frequencies and percentages to describe characteristics of sleep-related SUID cases. Of 215 sleep-related SUID cases, MEs identified 47.9% as accidental suffocation and strangulation in bed, 35.4% as unknown or undetermined cause, and 16.7% as SIDS. Sleep-related SUID most frequently occurred in an adult bed (n = 108; 50.2%). At death, 82.4% of sleep-related SUIDs had ?1 suffocation or SIDS risk factor with 54.4% infants sharing a sleep surface, 38.1% placed nonsupine, 24.2% placed on a pillow, and 10.2% having head covering. Missing data frequently resulted from incomplete scene investigation and autopsy components. SUID contributed to ?1 in seven Florida infant deaths in 2008. Approximately 80% of sleep-related SUIDs were reported among infants placed in unsafe sleeping environments. Effective interventions are needed to promote safe sleep among caregivers of Florida infants. These interventions must reach infant caregivers at highest risk and change unsafe sleep practices. The substantial percentage of missing investigation data reinforces the need for standardized reporting. PMID:24898690

  6. Assessment of Computer-based Geologic Mapping of Rock Units in the LANDSAT-4 Scene of Northern Death Valley, California

    NASA Technical Reports Server (NTRS)

    Short, N. M.

    1985-01-01

    Geologists obtain low accuracy levels when maps derived from LANDSAT MSS data are compared with those made by conventional methods. Procedures developed for the IDIMS computer system and used to classify a subset of a TM image of the Death Valley, California - Nevada border are described. Despite the superior resolution, broader spectral coverage, and greater sensitivity inherent to the TM, the actual recorded measured accuracy was in the same narrow range (30 to 60%) recorded for MSS data from earlier LANDSATs. The supervised classification approach appears to be superior to the unsupervised approach when applied to vegetation-sparse surfaces composed of spectrally contrasting rock/soil units distributed in relatively flat to low relief terrain. As spatial resolution improves and optimal spectral bands for identifying rock materials are specified, use of classified multispectral remote sensing data from air and space when coupled with supporting field calibration and checks should become the dominant way in which geologic mapping is carried out in future decades.

  7. Role of connexin-based gap junction channels and hemichannels in ischemia-induced cell death in nervous tissue

    PubMed Central

    Contreras, Jorge E.; Snchez, Helmuth A.; Vliz, Loreto P.; Bukauskas, Feliksas F.; Bennett, Michael V.L.; Sez, Juan C.

    2013-01-01

    Gap junction channels and hemichannels formed of connexin subunits are found in most cell types in vertebrates. Gap junctions connect cells via channels not open to the extracellular space and permit the passage of ions and molecules of ~1 kDa. Single connexin hemichannels, which are connexin hexamers, are present in the surface membrane before docking with a hemichannel in an apposed membrane. Because of their high conductance and permeability in cellcell channels, it had been thought that connexin hemichannels remained closed until docking to form a cellcell channel. Now it is clear that at least some hemichannels can open to allow passage of molecules between the cytoplasm and extracellular space. Here we review evidence that gap junction channels may allow intercellular diffusion of necrotic or apoptotic signals, but may also allow diffusion of ions and substances from healthy to injured cells, thereby contributing to cell survival. Moreover, opening of gap junction hemichannels may exacerbate cell injury or mediate paracrine or autocrine signaling. In addition to the cell specific features of an ischemic insult, propagation of cell damage and death within affected tissues may be affected by expression and regulation of gap junction channels and hemichannels formed by connexins. PMID:15572178

  8. Brainstem death: A comprehensive review in Indian perspective

    PubMed Central

    Dhanwate, Anant Dattatray

    2014-01-01

    With the advent of cardiopulmonary resuscitation techniques, the cardiopulmonary definition of death lost its significance in favor of brain death. Brain death is a permanent cessation of all functions of the brain in which though individual organs may function but lack of integrating function of the brain, lack of respiratory drive, consciousness, and cognition confirms to the definition that death is an irreversible cessation of functioning of the organism as a whole. In spite of medical and legal acceptance globally, the concept of brain death and brain-stem death is still unclear to many. Brain death is not promptly declared due to lack of awareness and doubts about the legal procedure of certification. Many brain dead patients are kept on life supporting systems needlessly. In this comprehensive review, an attempt has been made to highlight the history and concept of brain death and brain-stem death; the anatomical and physiological basis of brain-stem death, and criteria to diagnose brain-stem death in India. PMID:25249744

  9. The Revolution in Teacher Certification.

    ERIC Educational Resources Information Center

    Erbes, Robert L.

    1984-01-01

    Survey results concerning each state's procedures for music teacher certification are examined; future directions for certification are discussed. Testing and evaluation of teaching will become an integral part of future certification practices. Additional methods for improving educational quality, e.g., field experiences before student teaching…

  10. Board Certification in Counseling Psychology

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  11. Deaths in World Trade Center terrorist attacks--New York City, 2001.

    PubMed

    2002-09-11

    On September 11, 2001, terrorists flew two hijacked airplanes into the World Trade Center (WTC) in lower Manhattan in New York City (NYC), destroying both towers of the WTC. This report presents preliminary vital statistics on the deaths caused by the terrorist attacks and describes the procedures developed by the New York City Department of Health and Mental Hygiene (NYCDOHMH) to issue death certificates in response to the attacks. These data underscore the need for legal mechanisms to expedite the issuance of death certificates in the absence of human remains and the need for vital registration systems that can be relocated in case of emergency. PMID:12238537

  12. Expert system-based mineral mapping in northern Death Valley, California/Nevada, using the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS)

    NASA Technical Reports Server (NTRS)

    Kruse, F. A.; Lefkoff, A. B.; Dietz, J. B.

    1993-01-01

    Integrated analysis of imaging spectrometer data and field spectral measurements were used in conjunction with conventional geologic field mapping to characterize bedrock and surficial geology at the northern end of Death Valley, California and Nevada. A knowledge-based expert system was used to automatically produce image maps showing the principal surface mineralogy from Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data. Linear spectral unmixing of the AVIRIS data allowed further determination of relative mineral, abundances and identification of mineral assemblages and mixtures. The imaging spectrometer data show the spatial distribution of spectrally distinct minerals occurring both as primary rockforming minerals and as alteration and weathering products. Field spectral measurements were used to verify the mineral maps and field mapping was used to extend the remote sensing results. Geographically referenced image maps produced from these data form new base maps from which to develop improved understanding of the processes of deposition and erosion affecting the present land surface.

  13. Occupational injury deaths of 16 and 17 year olds in the US: trends and comparisons with older workers.

    PubMed Central

    Castillo, D. N.; Malit, B. D.

    1997-01-01

    OBJECTIVE: To examine patterns of occupational injury deaths of 16 and 17 year olds in the United States for the three year period 1990-2, examine trends since the 1980s, and compare fatality rates with those of older workers. METHODS: Occupational injury deaths were analyzed using the death certificate based National Traumatic Occupational Fatalities (NTOF) surveillance system. Fatality rates were calculated using estimates of full time equivalent (FTE) workers based on data from the Current Population Survey, a monthly household survey. RESULTS: There were 111 deaths of 16 and 17 year olds for the years 1990-2. The average yearly rate was 3.5 deaths/100,000 FTE. The leading causes of death were motor vehicle related, homicide, and machinery related. All causes occupational injury fatality rates for 16 and 17 year olds were lower than for adults for 1990-2. Rates for the leading causes of death (motor vehicle related, homicide, and machinery related) were comparable or slightly higher than the rates for young and middle aged adult workers. Although rates decreased dramatically from 1980 to 1983, the decreasing trend attenuated in later years. CONCLUSIONS: Comparisons of youth fatality rates to those of adult workers should address differences in patterns of employment, most importantly hours of work. Comparisons to narrow age groupings of adults is preferable to a single category of all workers 18 years and older. Increasing compliance with federal child labor regulations could help reduce work related deaths of youth. Other measures are needed, however, as there are many work hazards, including those associated with homicides, that are not addressed by United States federal child labor law regulations. PMID:9493624

  14. A hospital-based estimate of major causes of death among under-five children from a health facility in Lagos, Southwest Nigeria: possible indicators of health inequality

    PubMed Central

    2012-01-01

    Introduction Current evidence on the root-causes of deaths among children younger than 5years is critical to direct international efforts to improve child survival, focus on health promotion and achieve Millennium Development Goal 4. We report a hospital-based estimate for 2005-2007 of the major causes of death in children in this age-group in south-west Nigeria. Methods We used retrospective data from the intensive care unit of a second-tier health facility to extract the presenting complaints, clinical diagnosis, treatment courses, prognosis and outcome among children aged 6—59months. SPSS-19 was used for data analysis. Results Of the 301 children (58% males, 42% females) admitted into the ICU within the period of study, 173 (26%) presented with complaints related to the gastrointestinal system, 138 (21%) with respiratory symptoms and 196 (29%) with complaints of fever. Overall, 708 investigations were requested for among which were full blood count (215, 30%) and blood slides for malaria parasite (166, 23%). Infection ranked highest (181, 31%) in clinicians’ diagnosis, followed by haematological health problems (109, 19%) and respiratory illnesses (101, 17%). There were negative correlations between outcome of the illness and patient’s weight (r=-0.195, p=0.001) and a strong positive correlation between prognosis and outcome of admission (r=0.196, p=0.001). Of the 59 (20%) children that died, presentation of respiratory tract illnesses were significantly higher in females (75%) than in males (39%) (χ²=7.06; p=0.008) and diagnoses related to gastrointestinal pathology were significantly higher in males (18%) than in females (0%) (χ²=4.07; p=0.05). Majority of the deaths (21%) occurred among children aged 1.0 to 1.9years old and among weight group of 5.1-15.0kg. Conclusion The major causes of deaths among under-five years old originate from respiratory, gastrointestinal and infectious diseases – diseases that were recognized as major causes of childhood mortality about half a century earlier. Realization of MDG4 - to reduce child mortality by two-thirds – is only possible if the government and donor agencies look beyond the health sector to find hidden causative factors such as education and housing and within the health sector such as vibrant maternal, new-born, and child health interventions. PMID:22873746

  15. A Collaborative, Alternative Teacher Certification Program.

    ERIC Educational Resources Information Center

    Securro, Samuel, Jr.; And Others

    In the summer of 1986, three institutions (West Virginia State College, West Virigina College of Graduate Studies, and West Virgina Institute of Technology) consorted to design an alternative teacher certification program to attract and retain a qualified pool of mathematics and science teachers. Known as the Field-Based Training Program (FBTP),…

  16. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  17. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  18. 40 CFR 85.1406 - Certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CFR part 86, provided the equipment is properly installed. (2) Emission test engine selection. (i) The... urban bus engines. (c) Test equipment selection. Certification shall be based upon tests utilizing...-use engine that is newly rebuilt to its original configuration. (b) Diesel test fuel....

  19. 40 CFR 85.1406 - Certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CFR part 86, provided the equipment is properly installed. (2) Emission test engine selection. (i) The... urban bus engines. (c) Test equipment selection. Certification shall be based upon tests utilizing...-use engine that is newly rebuilt to its original configuration. (b) Diesel test fuel....

  20. Professional Certification: Will It Become a Reality?

    ERIC Educational Resources Information Center

    Bratton, Barry

    1984-01-01

    Discussion of the development of a list of certification competencies for instructional designers by National Society for Performance and Instruction's Standards Committee and Association for Educational Communications and Technology's Division of Instructional Development includes precepts on which competencies are based, ways list will be

  1. 40 CFR 85.2108 - Dealer certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... manufacturer. The visual inspection required by this subsection is limited to those emission control devices or...) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Emissions Control System Performance Warranty Regulations and... the vehicle is covered by an EPA Certificate of Conformity; (2) Based upon a visual inspection...

  2. Rethinking Teacher Certification.

    ERIC Educational Resources Information Center

    Kirkpatrick, David W.

    The original rationale for state teacher certification regulations was that they afforded the public a measure of protection against frauds and incompetents and against the capriciousness or low standards of local school boards. However, recent evidence (1985) shows that there is not much difference in quality and effectiveness between certified…

  3. School Nursing Certification Review

    ERIC Educational Resources Information Center

    Selekman, Janice; Wolfe, Linda C.

    2010-01-01

    The 2010 update to the resource you have been waiting for to help you prepare to take the National School Nurse Certification Exam. Dr. Janice Selekman DNSc, RN, NCSN, a recognized expert in pediatric nursing, and NASN Past President Linda C. Wolfe MEd, BSN, RN, NCSN, FNASN are the authors. This text was created in response to many years of…

  4. Standards and Certification. Symposium.

    ERIC Educational Resources Information Center

    2002

    This document contains three papers from a symposium on standards and certification in human resource development (HRD). "Implementing Management Standards in the UK" (Jonathan Winterton, Ruth Winterton) reports on a study that explored the implementation of management standards in 16 organizations and identified 36 key themes and strategic issues…

  5. Certificates in Adult Education.

    ERIC Educational Resources Information Center

    Deutscher Volkshochschul-Verband, Frankfurt (West Germany).

    Certificates are awarded to adult candidates who satisfy the examiners that their standard of ability in everyday English is adequate for them to express themselves in writing and to take an active part in conversations about everyday topics. The examination, which makes use of the techniques of objective testing, is set by a central Examining…

  6. Boat Operator Certification

    On September 16, 2014 staff from the Maine Office headed to the Kennebec River in Gardiner for their boat operator re-certification. The USGS routinely uses manned boats for discharge measurements on rivers throughout the state and after our initial training, are re-certified every 5 years. In this...

  7. Certification/Licensure Dictionary.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus.

    This document helps districts implement the new teacher licensure standards and ensure that staff are assigned to classes they are qualified to teach. It identifies both the existing certification areas and the new licensure areas that are required for teaching specific courses. The areas included are: agriculture; business; career-based…

  8. Kentucky's Automotive Certification Program.

    ERIC Educational Resources Information Center

    Kentucky State Dept. of Education, Frankfort. Office of Vocational Education.

    The state of Kentucky recognized a need to standardize automotive mechanics training throughout the state and to establish minimum guidelines for the quality of instruction in such programs. To meet these needs, the Office of Vocational Education selected the National Institute for Automotive Service Excellence (ASE) and began the certification

  9. What is organic certification?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Certified organic crop production is a holistic approach to sustainable and healthy food production to enhance the well being of the consumer, while protecting natural resources. Organic certification was implemented by the National Organic Program (NOP) in 2002 in recognition of the necessity for c...

  10. Postoperative myocardial infarction and cardiac death. Predictive value of dipyridamole-thallium imaging and five clinical scoring systems based on multifactorial analysis

    SciTech Connect

    Lette, J.; Waters, D.; Lassonde, J.; Dube, S.; Heyen, F.; Picard, M.; Morin, M. )

    1990-01-01

    Sixty-six patients unable to complete a standard preoperative exercise test because of physical limitations were studied to determine the predictive value of individual clinical parameters, of clinical scoring systems based on multifactorial analysis, and of dipyridamole-thallium imaging before major general and vascular surgery. Study endpoints were limited to postoperative myocardial infarction or cardiac death before hospital discharge. There were nine postoperative cardiac events (seven deaths and two nonfatal infarctions). There was no statistical correlation between cardiac events and preoperative clinical descriptors, including individual clinical parameters, the Dripps-American Surgical Association score, the Goldman Cardiac Risk Index score, the Detsky Modified Cardiac Risk Index score, Eagle's clinical markers of low surgical risk, and the probability of postoperative events as determined by Cooperman's equation. There were no cardiac events in 30 patients with normal dipyridamole-thallium scans or in nine patients with fixed myocardial perfusion defects. Of 21 patients with reversible perfusion defects who underwent surgery, nine had a postoperative cardiac event (sensitivity, 100%; specificity, 43%). In the six other patients with reversible defects, preoperative angiography showed severe coronary disease or cardiomyopathy. Thus in patients unable to complete a standard exercise stress test, postoperative outcome cannot be predicted clinically before major general and vascular surgery, whereas dipyridamole-thallium imaging successfully identified all patients who sustained a postoperative cardiac event.

  11. The death watch: certifying death using cardiac criteria.

    PubMed

    DeVita, M A

    2001-03-01

    In the past, inadequate diagnostic instruments sometimes led to incorrect diagnoses of death, so careful and prolonged observation--the "death watch"--was required. Diagnostic instruments are now accurate and determining the presence or absence of circulation and cerebral function is easy in virtually all cases. Still, ambiguity and controversy in diagnosing death persists because the current criteria, irreversible cessation of cardiac or whole brain function, are ambiguous. Recent reintroduction of non-heart-beating organ donation has highlighted the controversy. Data on the ability to achieve restoration of spontaneous circulation are quite consistent, but they support several different sets of reasonable death criteria. This article concludes with a rejection of a fixed notion of "irreversibility" because it does not conform to current practice, is potentially deleterious to social events at the time of death, and the reversibility of cardiopulmonary arrest is dependent on available means of resuscitation. Finally, the time required to ensure irreversible cessation of cardiac function despite potential intervention is too broad to be clinically applicable and is unreasonable. Diagnosis of death should be based on the context in which it occurs because the medical means available determine what is irreversible. PMID:11357558

  12. Cell death proteomics database: consolidating proteomics data on cell death.

    PubMed

    Arntzen, Magnus Ø; Bull, Vibeke H; Thiede, Bernd

    2013-05-01

    Programmed cell death is a ubiquitous process of utmost importance for the development and maintenance of multicellular organisms. More than 10 different types of programmed cell death forms have been discovered. Several proteomics analyses have been performed to gain insight in proteins involved in the different forms of programmed cell death. To consolidate these studies, we have developed the cell death proteomics (CDP) database, which comprehends data from apoptosis, autophagy, cytotoxic granule-mediated cell death, excitotoxicity, mitotic catastrophe, paraptosis, pyroptosis, and Wallerian degeneration. The CDP database is available as a web-based database to compare protein identifications and quantitative information across different experimental setups. The proteomics data of 73 publications were integrated and unified with protein annotations from UniProt-KB and gene ontology (GO). Currently, more than 6,500 records of more than 3,700 proteins are included in the CDP. Comparing apoptosis and autophagy using overrepresentation analysis of GO terms, the majority of enriched processes were found in both, but also some clear differences were perceived. Furthermore, the analysis revealed differences and similarities of the proteome between autophagosomal and overall autophagy. The CDP database represents a useful tool to consolidate data from proteome analyses of programmed cell death and is available at http://celldeathproteomics.uio.no. PMID:23537399

  13. Certification Considerations for Adaptive Systems

    NASA Technical Reports Server (NTRS)

    Bhattacharyya, Siddhartha; Cofer, Darren; Musliner, David J.; Mueller, Joseph; Engstrom, Eric

    2015-01-01

    Advanced capabilities planned for the next generation of aircraft, including those that will operate within the Next Generation Air Transportation System (NextGen), will necessarily include complex new algorithms and non-traditional software elements. These aircraft will likely incorporate adaptive control algorithms that will provide enhanced safety, autonomy, and robustness during adverse conditions. Unmanned aircraft will operate alongside manned aircraft in the National Airspace (NAS), with intelligent software performing the high-level decision-making functions normally performed by human pilots. Even human-piloted aircraft will necessarily include more autonomy. However, there are serious barriers to the deployment of new capabilities, especially for those based upon software including adaptive control (AC) and artificial intelligence (AI) algorithms. Current civil aviation certification processes are based on the idea that the correct behavior of a system must be completely specified and verified prior to operation. This report by Rockwell Collins and SIFT documents our comprehensive study of the state of the art in intelligent and adaptive algorithms for the civil aviation domain, categorizing the approaches used and identifying gaps and challenges associated with certification of each approach.

  14. Midcourse Space Experiment Data Certification and Technology Transfer

    NASA Technical Reports Server (NTRS)

    Pollock, David B.

    1998-01-01

    The Midcourse Space Experiment spacecraft, launched April 24, 1996, is expected to have a 5 year useful lifetime with a 12 month lifetime for the cryogenically cooled IR sensor. A pre-launch, ground based calibration of the instruments provided a basis for the pre-launch certification of the Level 2 data base these instruments produce. With the spacecraft in-orbit the certification of the instrument's Level 2 data base is being extended to the in-orbit environment.

  15. Look at the inside the American Society for Nondestructive Testing (ASNT) Level III certification program

    NASA Astrophysics Data System (ADS)

    Schaufler, Edward R.

    1995-03-01

    The American Society for Nondestructive Testing (ASNT) has historically provided guidelines to qualify NDT personnel for employer certification. In recent years, ASNT has provided certification of Level III NDT personnel by qualification based on experience, training, and examination. This certification program is administered by the National Certification Board (NCB). Guidelines for certification are available for ten (10) test methods, including thermal/infrared (TIR). ASNT certification requires qualification based on experience, training, and examination. The written examination consists of multiple choice questions developed by volunteers in the Personnel Qualification Council and utilized by the NCB. The examination data base is confidentially controlled with ParTEST computer software. Recently, a major task for the NCB has been the development of the Generic Practical Examination, which is available in 1995. This examination tests the ability of the Level III to prepare written test methods. This paper describes the mechanics of the ASNT Level III certification program with emphasis on the examination process.

  16. Opportunities for prevention of alcohol-related death in primary care: results from a population-based cross-sectional study.

    PubMed

    Morris, Margaret; Johnson, David; Morrison, David S

    2012-11-01

    The mortality rate from alcohol-related conditions has risen sharply in the United Kingdom and it is not known whether opportunities for preventive interventions could be improved. The purpose of our study was to identify opportunities to detect, assess, and manage alcohol problems in primary care according to evidence-based guidelines. We carried out a cross-sectional study on patients who died from alcohol-related conditions in the calendar year 2003 within National Health Service Greater Glasgow Health Board area, Scotland (population 920,000). We described patient characteristics and care recorded in health service records, comparing it with best evidence-based practice in Scottish Intercollegiate Guidelines Network and Health Technology Board for Scotland recommendations on the management of harmful drinking and alcohol dependence. 501 deaths occurred from an alcohol-related cause. The mean age at death was 57.5 years and 72% were male. The most common causes of death, recorded by the International Classification of Diseases, revision 10, excluding accidents, were alcoholic liver disease (290, 57.9%) and mental and behavioural disorders due to alcohol (70, 14.0%). Lifetime mean consultations at primary care general practitioner and hospital outpatient departments were 24 in males and 5 in females. All individuals who died from an alcohol-related cause had at least one biochemical or physical indicator suggestive of alcohol misuse. 21% (95% CI 13-33%) had no record of having been advised to abstain from alcohol and 23% (95% CI 15-35%) had received brief interventions. 58% (95% CI 46-70%) had been referred to specialist alcohol services but a third of them did not attend. The majority of patients (83%, 95% CI 72-90%) had no evidence of shared health service and social work care. We concluded that individuals who died from alcohol-related conditions were usually in contact with statutory and voluntary services but further efforts were required to use these opportunities to detect, assess, and manage serious alcohol problems according to evidence-based guidelines. PMID:22840815

  17. Monitoring Cell Death in Regorafenib-Treated Experimental Colon Carcinomas Using Annexin-Based Optical Fluorescence Imaging Validated by Perfusion MRI

    PubMed Central

    Kazmierczak, Philipp M.; Burian, Egon; Eschbach, Ralf; Hirner-Eppeneder, Heidrun; Moser, Matthias; Havla, Lukas; Eisenblätter, Michel; Reiser, Maximilian F.; Nikolaou, Konstantin; Cyran, Clemens C.

    2015-01-01

    Objective To investigate annexin-based optical fluorescence imaging (OI) for monitoring regorafenib-induced early cell death in experimental colon carcinomas in rats, validated by perfusion MRI and multiparametric immunohistochemistry. Materials and Methods Subcutaneous human colon carcinomas (HT-29) in athymic rats (n = 16) were imaged before and after a one-week therapy with regorafenib (n = 8) or placebo (n = 8) using annexin-based OI and perfusion MRI at 3 Tesla. Optical signal-to-noise ratio (SNR) and MRI tumor perfusion parameters (plasma flow PF, mL/100mL/min; plasma volume PV, %) were assessed. On day 7, tumors underwent immunohistochemical analysis for tumor cell apoptosis (TUNEL), proliferation (Ki-67), and microvascular density (CD31). Results Apoptosis-targeted OI demonstrated a tumor-specific probe accumulation with a significant increase of tumor SNR under therapy (mean Δ +7.78±2.95, control: -0.80±2.48, p = 0.021). MRI detected a significant reduction of tumor perfusion in the therapy group (mean ΔPF -8.17±2.32 mL/100 mL/min, control -0.11±3.36 mL/100 mL/min, p = 0.036). Immunohistochemistry showed significantly more apoptosis (TUNEL; 11392±1486 vs. 2921±334, p = 0.001), significantly less proliferation (Ki-67; 1754±184 vs. 2883±323, p = 0.012), and significantly lower microvascular density (CD31; 107±10 vs. 182±22, p = 0.006) in the therapy group. Conclusions Annexin-based OI allowed for the non-invasive monitoring of regorafenib-induced early cell death in experimental colon carcinomas, validated by perfusion MRI and multiparametric immunohistochemistry. PMID:26393949

  18. A new hierarchical classification of causes of infant deaths in England and Wales.

    PubMed Central

    Alberman, E; Botting, B; Blatchley, N; Twidell, A

    1994-01-01

    In 1986 The Office of Population Censuses and Surveys (OPCS) introduced new certificates for stillbirths and neonatal deaths. This allowed certifiers more flexibility in the completion of the certificate, and the number and ordering of the causes given. Tabulations have been published of the fetal and maternal causes of death mentioned on the certificates for every year from 1986 to 1991 in annual reference volumes. It has not been possible either to derive a single cause group for each death, however, or to compare the information available on neonatal deaths with that on postneonatal deaths, which are still derived from the standard death certificate. The aim of the work described here was to adapt previous classifications to derive a single cause grouping for stillbirths and infant deaths which would provide the maximum information about preventability and yet meet the national and international responsibilities of OPCS. The methods used and the tests carried out on the validity and consistency of the chosen classification are described. PMID:8017962

  19. Evidence for a heritable predisposition to death due to influenza.

    PubMed

    Albright, Frederick S; Orlando, Patricia; Pavia, Andrew T; Jackson, George G; Cannon Albright, Lisa A

    2008-01-01

    Animal model studies and human epidemiological studies have shown that some infectious diseases develop primarily in individuals with an inherited predisposition. A heritable contribution to the development of severe influenza virus infection (i.e., that which results in death) has not previously been hypothesized or tested. Evidence for a heritable contribution to death due to influenza was examined using a resource consisting of a genealogy of the Utah population linked to death certificates in Utah over a period of 100 years. The relative risks of death due to influenza were estimated for the relatives of 4,855 individuals who died of influenza. Both close and distant relatives of individuals who died of influenza were shown to have a significantly increased risk of dying of influenza, consistent with a combination of shared exposure and genetic effects. These data provide strong support for a heritable contribution to predisposition to death due to influenza. PMID:18171280

  20. Attitude Toward Death, Fear of Being Declared Dead Too Soon, and Donation of Organs After Death.

    ERIC Educational Resources Information Center

    Hessing, Dick J.; Elffers, Henk

    1987-01-01

    Describes a study of willingness to donate organs for transplantation after death based on Weyant's cost-benefit model for altruistic behavior. Two death anxieties (the attitude toward death and the fear of being declared dead too soon) were introduced to help explain the discrepancy between attitudes and behavior in the matter of organ donation.…

  1. Autoerotic death. A definition.

    PubMed

    Byard, R W; Bramwell, N H

    1991-03-01

    A definition of autoerotic death is suggested that restricts the use of this term to accidental deaths that occur during individual, usually solitary, sexual activity in which a device, apparatus, or prop that was employed to enhance the sexual stimulation of the deceased in some way caused unintended death. The case of the autoerotic asphyxial death of a 48-year-old man is reported in order to demonstrate the application of this definition. PMID:2063822

  2. Religious characteristics and the death penalty.

    PubMed

    Miller, Monica K; Hayward, R David

    2008-04-01

    Using one mock trial scenario, this study investigated whether religious and demographic factors were related to death penalty attitudes and sentencing verdicts. Those who favored the death penalty differed from those who had doubts about the penalty in gender, affiliation, fundamentalism, evangelism, literal Biblical interpretism, beliefs about God's attitudes toward murders, and perceptions of how their religious groups felt about the death penalty. These relationships generally held after mock jurors were death qualified. Gender, fundamentalism, literal interpretism, beliefs about God's death penalty position, and perceptions of how one's religious group felt about the death penalty predicted death penalty sentencing verdicts. Future research could determine whether using peremptory challenges to exclude potential jurors based on religion can help lawyers choose a more favorable jury. PMID:17546480

  3. The association of maternal smoking with age and cause of infant death.

    PubMed

    Malloy, M H; Kleinman, J C; Land, G H; Schramm, W F

    1988-07-01

    Linked birth certificate and infant death certificate data from Missouri for 1979-1983 were used to explore the association of maternal smoking with age and cause of infant death. The data included 305,730 singleton white livebirths, of which 2,720 resulted in infant deaths. Using multiple logistic regression to control for the confounding effects of maternal age, parity, marital status, and education, the authors found that smoking was associated with both neonatal and post-neonatal mortality and with each cause of death except congenital anomalies. The adjusted odds ratio for smoking was higher for postneonatal deaths than neonatal deaths and was particularly high for two causes: respiratory disease (odds ratio = 3.4) and sudden infant death syndrome (odds ratio = 1.9). A moderate odds ratio (about 1.4) was found for causes attributed to the International Classification of Diseases, 9th Revision Perinatal Conditions Chapter. Although the associations for neonatal deaths and perinatal conditions were partially attributable to the effect of maternal smoking in lowering birth weight, virtually none of the excess respiratory mortality and sudden infant death syndrome mortality among the offspring of smokers was attributable to birth weight differences between the infants of smokers and nonsmokers. This suggests that respiratory deaths and sudden infant death syndrome deaths may be related to the effect of passive exposure of the infant to smoke after birth. PMID:3381835

  4. Dreams of Death.

    ERIC Educational Resources Information Center

    Barrett, Deirdre

    1989-01-01

    Examined frequency and characteristics of overt dreams of dying among healthy young adults. Dreams of dying were found to be rare but distinctive content category, representing overwhelmingly pleasant dreams. Over one-half of death dreams involved lengthy afterlife sequence, remainder focused on process of death. Death dreams of these healthy…

  5. Sudden Cardiac Death

    PubMed Central

    Weinberg, Marc

    1978-01-01

    Over the past decade, there has been a significant decrease in the hospital mortality of patients with coronary artery disease. However, sudden cardiac death, which accounts for the majority of deaths from coronary artery disease, hasbeen little affected. This report reviews the pathology, electrophysiology, demographics and clinical presentation of sudden cardiac death. Emergency care and possible preventative measures are examined. PMID:356435

  6. Death Education: An Overview.

    ERIC Educational Resources Information Center

    Eddy, James M.; St. Pierre, Richard W.

    A review of the literature of death education reveals a lack of consensus among authors concerning the exact scope and sequence of an ideal death education program. Most authors feel, however, that death education should be a subject of immediate concern to all health educators, and that it is important to determine how children respond to various…

  7. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property Renovation § 745.90 Renovator certification and dust sampling... renovator. (3) Individuals who have successfully completed an accredited lead-based paint inspector or...

  8. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property Renovation § 745.90 Renovator certification and dust sampling... certified renovator. (3) Individuals who have successfully completed an accredited lead-based...

  9. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property Renovation § 745.90 Renovator certification and dust sampling... certified renovator. (3) Individuals who have successfully completed an accredited lead-based...

  10. Association of Holter-Based Measures Including T-wave Alternans with Risk of Sudden Cardiac Death in the Community-Dwelling Elderly: The Cardiovascular Health Study

    PubMed Central

    Stein, Phyllis K.; Sanghavi, Devang; Sotoodehnia, Nona; Siscovick, David S; Gottdiener, John

    2010-01-01

    Background Sudden cardiac death (SCD) can be the first manifestation of cardiovascular disease. Development of screening methods for higher / lower risk is critical. Methods The Cardiovascular Healthy Study (CHS) is a population-based study of risk factors for coronary heart disease and stroke those ≥65 years. N=49 (of 1649) with usable Holters and in normal sinus rhythm, suffered SCD during follow up and were matched with 2 controls, alive at the time of death of the case and not suffering SCD on follow up. Univariate and multivariate conditional logistic regression determined the association of Holter-based information and SCD. Results In univariate models, the upper half of VPC counts, abnormal heart rate turbulence, decreased normalized low frequency power, increased T-wave alternans (TWA) and decreased DFA1 (short-term fractal scaling exponent) were associated with SCD, but time domain HRV was not. In multivariate models, the upper half of VPC counts (OR=6.6) and having TWA ≥37µV on Ch2 (OR=4.8) were independently associated with SCD. Also, the upper half of VPC counts (OR=6.9) and having DFA1 <1.05 (OR=5.0) were independently associated with SCD. When additive effects were explored: having both higher VPCs and higher TWA was associated with an OR of 8.2 for SCD compared to 2.6 for having either. Also, having both higher VPCs and lower DFA1 was associated with an OR of 9.6 for SCD compared to 3.1 for having either. Conclusions Results support a potential role for 24-hour Holter recordings to identify older adults at increased or lower risk of SCD. PMID:20096853

  11. SU-B-213-00: Education Council Symposium: Accreditation and Certification: Establishing Educational Standards and Evaluating Candidates Based on these Standards

    SciTech Connect

    2015-06-15

    The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

  12. Mitigating Circumstances in Death Penalty Decisions: Using Evidence-Based Research to Inform Social Work Practice in Capital Trials

    ERIC Educational Resources Information Center

    Schroeder, Julie; Guin, Cecile C.; Pogue, Rene; Bordelon, Danna

    2006-01-01

    Providing an effective defense for individuals charged with capital crimes requires a diligent, thorough investigation by a mitigation specialist. However, research suggests that mitigation often plays a small role in the decision for life. Jurors often make sentencing decisions prematurely, basing those decisions on their personal reactions to…

  13. Ventricular fibrillation and sudden cardiac death during myocardial infarction.

    PubMed

    Jabbari, Reza

    2016-05-01

    In this PhD thesis, we report that VF is still a common complication of STEMI, with an incidence of 11.6% in the population of Danish STEMI patients who survive to reach the hospital. In this STEMI population, we identified several risk factors associated with VF independent of MI. We identified and confirmed findings from several previous studies and found several risk factors, such as younger age, a family history of sudden death, a TIMI flow grade of 0, the absence of angina, anterior infarction (i.e., VF before PPCI), and inferior infarction (i.e., VF during PPCI) that were associated with VF in a Danish cohort. Furthermore, a history of atrial fibrillation and alcohol intake were identified as novel risk factors for VF. To the best of our knowledge, this study contains data on the largest VF cohort with the longest reported follow-up published; we found that VF mortality is significantly higher within the first 30 days for patients who experience VF before and during PPCI compared with STEMI patients without VF. However, the long-term mortality rates of the three groups are the same. Importantly, our results contradict the previous understanding that VF during PPCI is "benign"; the mortality rate within the first 30 days was as high for patients with VF during PPCI as the mortality rate of patients with VF before PPCI. Finally, although it is difficult to draw clinical implications from a descriptive study, due to the comprehensiveness of Danish death certificates, we reported a high incidence of cardiac symptoms and contact with healthcare professionals based on cardiac symptoms in young SCD patients who died due to CAD, although death was not avoided. PMID:27127021

  14. Mitigating circumstances in death penalty decisions: using evidence-based research to inform social work practice in capital trials.

    PubMed

    Schroeder, Julie; Guin, Cecile C; Pogue, Rene; Bordelon, Danna

    2006-10-01

    Providing an effective defense for individuals charged with capital crimes requires a diligent, thorough investigation by a mitigation specialist. However, research suggests that mitigation often plays a small role in the decision for life. Jurors often make sentencing decisions prematurely, basing those decisions on their personal reactions to the defendant (for example, fear, anger), their confusion about the rules of law, and their lack of understanding regarding their role and responsibilities. This article proposes an evidence-based conceptual model of the complicating problems surrounding mitigation practice and a focused discussion about how traditional social work mitigation strategies might be evolved to a set of best practices that more effectively ensure jurors' careful consideration of mitigation evidence. PMID:17152633

  15. Black-White differences in the effect of baseline depressive symptoms on deaths due to renal diseases: 25 year follow up of a nationally representative community sample

    PubMed Central

    Assari, Shervin; Burgard, Sarah

    2015-01-01

    Introduction: More studies are needed to examine whether race moderates the effect of baseline depressive symptoms on cause-specific mortality including deaths due to renal diseases in the United States. Objectives: The present longitudinal study compared Blacks and Whites for the effect of baseline depressive symptoms on deaths due to renal diseases over a 25-year period in a nationally representative community sample. Patients and Methods: Data came from the Americans’ Changing Lives (ACL) study, a nationally representative cohort that followed 3361 Black (n = 1156) or White (n = 2205) adults 25 and older for up to 25 years from 1986 to 2011. Month, year and cause of death were extracted from death certificates or national death index reports and coded based on ICD-9 or ICD-10 codes, depending on the year of death. We used Cox proportional hazards models for data analysis. Time to death due to renal diseases over a 25-year period was the outcome, baseline depressive symptoms (11-item Center for Epidemiological Studies-Depression [CES-D]) was the predictor, demographic characteristics, socio-economic status and chronic medical conditions (CMC) (hypertension, diabetes, chronic lung disease, heart disease, stroke, cancer, and arthritis) at baseline were controls, and race was the focal moderator. Results: In the pooled sample, race and baseline depressive symptoms showed a significant interaction, suggesting a stronger effect of baseline depressive symptoms on deaths due to renal diseases for Whites compared to Blacks. In race-specific models, high depressive symptoms at baseline increased risk of death due to renal diseases among Whites but not Blacks. Conclusion: The Black-White difference in the predictive role of baseline depressive symptoms on deaths due to renal diseases over a 25-year period found here provides support for the Black-White health paradox. PMID:26693500

  16. 14 CFR 21.191 - Experimental certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Experimental certificates. 21.191 Section... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Airworthiness Certificates § 21.191 Experimental certificates. Experimental certificates are issued for the following purposes: (a) Research and development. Testing...

  17. 14 CFR 21.191 - Experimental certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Experimental certificates. 21.191 Section... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Airworthiness Certificates § 21.191 Experimental certificates. Experimental certificates are issued for the following purposes: (a) Research and development. Testing...

  18. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Crane certification. 107.258 Section 107.258 Shipping... CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept current certificates issued by approved organizations as evidence of condition and suitability of cranes. The...

  19. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Crane certification. 107.258 Section 107.258 Shipping... CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept current certificates issued by approved organizations as evidence of condition and suitability of cranes. The...

  20. 7 CFR 205.404 - Granting certification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Granting certification. 205.404 Section 205.404... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.404 Granting certification. (a) Within a reasonable... agent shall grant certification. The certification may include requirements for the correction of...

  1. 7 CFR 205.404 - Granting certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Granting certification. 205.404 Section 205.404... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.404 Granting certification. (a) Within a reasonable... agent shall grant certification. The certification may include requirements for the correction of...

  2. 14 CFR 21.191 - Experimental certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Airworthiness Certificates § 21.191 Experimental certificates. Experimental certificates are issued for the following purposes: (a) Research and development. Testing new... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Experimental certificates. 21.191...

  3. Combinatorial DNA damage pairing model based on X-ray-induced foci predicts the dose and LET dependence of cell death in human breast cells.

    PubMed

    Vadhavkar, Nikhil; Pham, Christopher; Georgescu, Walter; Deschamps, Thomas; Heuskin, Anne-Catherine; Tang, Jonathan; Costes, Sylvain V

    2014-09-01

    In contrast to the classic view of static DNA double-strand breaks (DSBs) being repaired at the site of damage, we hypothesize that DSBs move and merge with each other over large distances (μm). As X-ray dose increases, the probability of having DSB clusters increases as does the probability of misrepair and cell death. Experimental work characterizing the X-ray dose dependence of radiation-induced foci (RIF) in nonmalignant human mammary epithelial cells (MCF10A) is used here to validate a DSB clustering model. We then use the principles of the local effect model (LEM) to predict the yield of DSBs at the submicron level. Two mechanisms for DSB clustering, namely random coalescence of DSBs versus active movement of DSBs into repair domains are compared and tested. Simulations that best predicted both RIF dose dependence and cell survival after X-ray irradiation favored the repair domain hypothesis, suggesting the nucleus is divided into an array of regularly spaced repair domains of ∼1.55 μm sides. Applying the same approach to high-linear energy transfer (LET) ion tracks, we are able to predict experimental RIF/μm along tracks with an overall relative error of 12%, for LET ranging between 30-350 keV/μm and for three different ions. Finally, cell death was predicted by assuming an exponential dependence on the total number of DSBs and of all possible combinations of paired DSBs within each simulated RIF. Relative biological effectiveness (RBE) predictions for cell survival of MCF10A exposed to high-LET showed an LET dependence that matches previous experimental results for similar cell types. Overall, this work suggests that microdosimetric properties of ion tracks at the submicron level are sufficient to explain both RIF data and survival curves for any LET, similarly to the LEM assumption. Conversely, high-LET death mechanism does not have to infer linear-quadratic dose formalism as done in the LEM. In addition, the size of repair domains derived in our model are based on experimental RIF and are three times larger than the hypothetical LEM voxel used to fit survival curves. Our model is therefore an alternative to previous approaches that provides a testable biological mechanism (i.e., RIF). In addition, we propose that DSB pairing will help develop more accurate alternatives to the linear cancer risk model (LNT) currently used for regulating exposure to very low levels of ionizing radiation. PMID:25076115

  4. Combinatorial DNA Damage Pairing Model Based on X-Ray-Induced Foci Predicts the Dose and LET Dependence of Cell Death in Human Breast Cells

    SciTech Connect

    Vadhavkar, Nikhil; Pham, Christopher; Georgescu, Walter; Deschamps, Thomas; Heuskin, Anne-Catherine; Tang, Jonathan; Costes, Sylvain V.

    2014-09-01

    In contrast to the classic view of static DNA double-strand breaks (DSBs) being repaired at the site of damage, we hypothesize that DSBs move and merge with each other over large distances (m). As X-ray dose increases, the probability of having DSB clusters increases as does the probability of misrepair and cell death. Experimental work characterizing the X-ray dose dependence of radiation-induced foci (RIF) in nonmalignant human mammary epithelial cells (MCF10A) is used here to validate a DSB clustering model. We then use the principles of the local effect model (LEM) to predict the yield of DSBs at the submicron level. Two mechanisms for DSB clustering, namely random coalescence of DSBs versus active movement of DSBs into repair domains are compared and tested. Simulations that best predicted both RIF dose dependence and cell survival after X-ray irradiation favored the repair domain hypothesis, suggesting the nucleus is divided into an array of regularly spaced repair domains of ~;;1.55 m sides. Applying the same approach to high-linear energy transfer (LET) ion tracks, we are able to predict experimental RIF/m along tracks with an overall relative error of 12percent, for LET ranging between 30 350 keV/m and for three different ions. Finally, cell death was predicted by assuming an exponential dependence on the total number of DSBs and of all possible combinations of paired DSBs within each simulated RIF. Relative biological effectiveness (RBE) predictions for cell survival of MCF10A exposed to high-LET showed an LET dependence that matches previous experimental results for similar cell types. Overall, this work suggests that microdosimetric properties of ion tracks at the submicron level are sufficient to explain both RIF data and survival curves for any LET, similarly to the LEM assumption. Conversely, high-LET death mechanism does not have to infer linear-quadratic dose formalism as done in the LEM. In addition, the size of repair domains derived in our model are based on experimental RIF and are three times larger than the hypothetical LEM voxel used to fit survival curves. Our model is therefore an alternative to previous approaches that provides a testable biological mechanism (i.e., RIF). In addition, we propose that DSB pairing will help develop more accurate alternatives to the linear cancer risk model (LNT) currently used for regulating exposure to very low levels of ionizing radiation.

  5. Cause of death as a contemporary problem.

    PubMed

    Rosenberg, H M

    1999-04-01

    Four characteristics have been identified that affect the contemporary analysis of cause of death: (1) the increasing use of cause-of-death data for public policy; (2) the growing disjuncture between cause of death and cause of poor health; (3) the problem of specifying cause of death for the elderly, who constitute a growing proportion of the population and, accordingly, of mortality; and (4) the impact of technology and medical science on the temporal comparability of mortality statistics. With regard to the first issue, statistical data in general are being used with increasing sophistication throughout society. The public is exposed to all types of data by the media,and is increasingly educated in how to interpret statistics. Government at all levels increasingly uses data to help to help identify priorities, to choose among policy options, and to evaluate outcomes of decision making. Cause-of-death data are but a specific subset of information that are being used to understand social, economic, and health issues and to make more informed private and public choices regarding these issues. Increasing use of any data set is likely to result in better data simply because greater use results in closer scrutiny of data quality with resultant emphasis on evaluation and systematic efforts to improve quality. This is happening to cause-of-death data in the United States. The National Center for Health Statistics (NCHS) initiated major efforts through two national workshops in 1989 and 1991 to improve the quality of medical certification of death through better training of physicians, medical examiners, and coroners. While there is no clear evidence that the initiatives resulting from these workshops alone resulted in data quality improvement, the indicators used by NCHS to measure quality of medical certification point to continued gradual improvement in completeness and specificity in cause-of-death data. The gap between causes of morbidity and causes of mortality is growing because advances in medical science has essentially eliminated many infectious and communicable diseases that previously caused premature death and have considerably reduced the lethality of chronic conditions that previously caused death at earlier ages. As acute conditions have moved into the background, so to speak, a variety of disabilities and impairments have moved forward as sources of illness,pain, and diminished quality of life. As a consequence, the previously clear etching in mortality statistics of a society's health has become blurred by advances in medicine, healthcare, and prevention. Mortality data continue to have value per set and are important to social and medical knowledge because of their availability as a uniquely continuous data set. However, increasingly, a complete and contemporary profile of the health of a society requires data on both morbidity and mortality as complimentary indicators of health and social development. Not only do we need to know of what causes people to die, but also what health conditions aggravate and diminish their lives and, at an aggregate level, that conditions impose the greatest health costs on the community. Increasingly, these are debilitating conditions of the elderly that may diminish life but may not cause death. Medical description of the cause of death of an elderly person has probably never been easy; however, the contemporary extension of life has made the problem more visible and substantial than in earlier times. It is likely that the relatively few octogenarians of centuries past were also afflicted by concurrent medical conditions, and that even younger persons were prematurely afflicted by conditions that are now identified with advanced age. For these population groups, the description of cause of death, as a single and singular initiating event, is problematic. PMID:10453679

  6. Clinical Profiles Related to Timing of Death, Including In-Hospital Deaths Before Admission, in Patients With ST-Elevation Myocardial Infarction.

    PubMed

    Bogaty, Peter; L'Allier, Philippe L; Segal, Eli; Rinfret, Stéphane; Racine, Normand; Harvey, Richard; Ross, Dave; Maire, Sébastien; Kouz, Simon; Carroll, Céline; Boothroyd, Lucy J; Kezouh, Abbas; Azzi, Leila; Brown, Kevin A; Nasmith, James; Lambert, Laurie J

    2016-02-01

    Patients with ST-elevation myocardial infarction (STEMI) who die in hospital before inpatient admission are generally not included in clinical studies and registries, and the clinical profiles of patients who die earlier versus later are not well defined. We aimed to characterize all patients with STEMI who arrived at emergency departments in the province of Quebec (Canada) based on inpatient admission status and when they died. All patients who presented with symptoms and core laboratory-confirmed STEMI or left bundle branch block during 6 months in 82 hospitals in Quebec were included. Death certificates were used to identify nonadmitted deaths. Of the 2017 patients with STEMI, 340 (16.9%) died within 1 year. Of the latter, 63 (18.5%) were nonadmitted deaths (group A), 179 (52.6%) were deaths after admission but within 30 days (group B), and 98 (28.8%) were deaths after 30 days to 1 year (group C). Group A was younger and most often hemodynamically unstable, followed for both features by B then C. Earliest presentation from symptom onset and most frequent ambulance use were found in group A, followed by B, then C. Presenting electrocardiogram (ECG) features were most severe in A, then B, then C (more arrhythmias, more anterior STEMI, more leads with ST elevation, and higher ST elevation). Patients who died earliest had the least frequency of previous myocardial infarction, coronary revascularization, vascular disease, and heart failure, and the least noncardiac co-morbidity. In conclusion, patients with STEMI dying in hospital before inpatient admission contributed substantially to overall STEMI mortality. Although dying patients who presented earlier had severer presenting clinical profiles, they were paradoxically younger and had less co-morbidity. Previous co-morbidities may favor adaptive protective mechanisms on initial presentation with STEMI. PMID:26721650

  7. Certification plan for safety and PRA codes

    SciTech Connect

    Toffer, H.; Crowe, R.D. ); Ades, M.J. )

    1990-05-01

    A certification plan for computer codes used in Safety Analyses and Probabilistic Risk Assessment (PRA) for the operation of the Savannah River Site (SRS) reactors has been prepared. An action matrix, checklists, and a time schedule have been included in the plan. These items identify what is required to achieve certification of the codes. A list of Safety Analysis and Probabilistic Risk Assessment (SA PRA) computer codes covered by the certification plan has been assembled. A description of each of the codes was provided in Reference 4. The action matrix for the configuration control plan identifies code specific requirements that need to be met to achieve the certification plan's objectives. The checklist covers the specific procedures that are required to support the configuration control effort and supplement the software life cycle procedures based on QAP 20-1 (Reference 7). A qualification checklist for users establishes the minimum prerequisites and training for achieving levels of proficiency in using configuration controlled codes for critical parameter calculations.

  8. Certification plan for safety and PRA codes

    SciTech Connect

    Toffer, H.; Crowe, R.D.; Ades, M.J.

    1990-05-01

    A certification plan for computer codes used in Safety Analyses and Probabilistic Risk Assessment (PRA) for the operation of the Savannah River Site (SRS) reactors has been prepared. An action matrix, checklists, and a time schedule have been included in the plan. These items identify what is required to achieve certification of the codes. A list of Safety Analysis and Probabilistic Risk Assessment (SA&PRA) computer codes covered by the certification plan has been assembled. A description of each of the codes was provided in Reference 4. The action matrix for the configuration control plan identifies code specific requirements that need to be met to achieve the certification plan`s objectives. The checklist covers the specific procedures that are required to support the configuration control effort and supplement the software life cycle procedures based on QAP 20-1 (Reference 7). A qualification checklist for users establishes the minimum prerequisites and training for achieving levels of proficiency in using configuration controlled codes for critical parameter calculations.

  9. Comparative thorax morphology of death-feigning flightless cryptorhynchine weevils (Coleoptera: Curculionidae) based on 3D reconstructions.

    PubMed

    van de Kamp, Thomas; Cecilia, Angelica; dos Santos Rolo, Tomy; Vagovič, Patrik; Baumbach, Tilo; Riedel, Alexander

    2015-11-01

    The thorax morphology, especially the muscles and the tracheal system of three flightless species of Cryptorhynchinae is examined by digital 3D reconstructions based on synchrotron X-ray microtomography and compared to other Curculionidae. Wings, metanepisternites, and muscles functional in flight are fully reduced in the species examined: Kyklioacalles roboris (Curtis), Trigonopterus scharfi Riedel and Trigonopterus vandekampi Riedel. All three share the same set of thoracic muscles, but differences exist in the shape and size of muscles. Both Trigonopterus species examined have a conspicuous fan-shaped branch of Musculus mesosterni primus contracting pro- and mesothorax, interpreted as an adaption to their thanatosis defense strategy. Trigonopterus vandekampi furthermore shows a marked increase in the size of two metacoxal muscles, which may be functional in this species' thanatosis blocking mechanisms. The metathoracic spiracle of all Trigonopterus species is located at the side of the metaventrite externally and not in the subelytral space as in other beetles. It is hypothesized that this translocation was triggered by the need to improve oxygen supply during thanatosis, when both the mesothoracic spiracle and the subelytral cavity are tightly sealed from the outside. PMID:26259678

  10. Mortality and causes of death among violent offenders and victims-a Swedish population based longitudinal study

    PubMed Central

    2012-01-01

    Background Most previous studies on mortality in violent offenders or victims are based on prison or hospital samples, while this study analyzed overall and cause specific mortality among violent offenders, victims, and individuals who were both offenders and victims in a general sample of 48,834 18-20 year-old men conscripted for military service in 1969/70 in Sweden. Methods Each person completed two non-anonymous questionnaires concerning family, psychological, and behavioral factors. The cohort was followed for 35 years through official registers regarding violent offenses, victimization, and mortality. The impact of violence, victimization, early risk factors and hospitalization for psychiatric diagnosis or alcohol and drug misuse during follow up on mortality was investigated using Cox proportional hazard regression analyses. Results Repeat violent offenses were associated with an eleven fold higher hazard of dying from a substance-related cause and nearly fourfold higher hazard of dying from suicide. These figures remained significantly elevated also in multivariate analyses, with a 3.03 and 2.39 hazard ratio (HR), respectively. Participants with experience of violence and inpatient care for substance abuse or psychiatric disorder had about a two to threefold higher risk of dying compared to participants with no substance use or psychiatric disorder. Conclusions Violent offending and being victimized are associated with excess mortality and a risk of dying from an alcohol or drug-related cause or suicide. Consequently, prevention of violent behavior might have an effect on overall mortality and suicide rates. Prevention of alcohol and drug use is also warranted. PMID:22251445

  11. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  12. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  13. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  14. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  15. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  16. Decisions on sick leave certifications for acute airways infections based on vignettes: A cross-sectional survey of GPs in Norway and Poland

    PubMed Central

    Halvorsen, Peder A.; Wennevold, Katrine; Fleten, Nils; Muras, Magdalena; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Melbye, Hasse

    2011-01-01

    Objective To explore whether frequency and duration of sick-leave certification for acute airway infections differ between general practitioners (GPs) in Poland and Norway. Design Cross-sectional survey. Setting Educational courses for GPs. Intervention We used a questionnaire with four vignettes presenting patients with symptoms consistent with pneumonia, sinusitis, common cold, and exacerbation of chronic obstructive pulmonary disease (COPD), respectively. For each vignette GPs were asked whether they would offer a sick-leave note, and if so, for how many days. Subjects Convenience samples of GPs in Poland (n = 216) and Norway (n = 171). Main outcome measures Proportion of GPs offering a sick-leave certificate. Duration of sick-leave certification. Results In Poland 100%, 95%, 87%, and 94% of GPs would offer sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, respectively. Corresponding figures in Norway were 97%, 83%, 60%, and 90%. Regression analysis adjusting for the GPs' sex, speciality, experience, and workload indicated that relative risks for offering sick leave (Poland versus Norway) were 1.16 (95% CI 1.071.26) for sinusitis and 1.50 (1.281.75) for common cold. Among GPs who offered sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, mean duration was 8.9, 7.5, 5.1, and 6.9 days (Poland) versus 6.6, 4.3, 3.1, and 6.1 days (Norway), respectively. In regression analyses the differences between the Polish and Norwegian samples in duration of sick leave were statistically significant for all vignettes. A pattern of offering sick leave for three, five, seven, 10, or 14 days was observed in both countries. Conclusion In the Polish sample GPs were more likely to offer sick-leave notes for sinusitis and common cold. GPs in Poland offered sick leaves of longer duration for pneumonia, sinusitis, common colds, and exacerbation of COPD compared with GPs in the Norwegian sample. PMID:21323635

  17. Dendritic cell vaccines based on immunogenic cell death elicit danger signals and T cell-driven rejection of high-grade glioma.

    PubMed

    Garg, Abhishek D; Vandenberk, Lien; Koks, Carolien; Verschuere, Tina; Boon, Louis; Van Gool, Stefaan W; Agostinis, Patrizia

    2016-03-01

    The promise of dendritic cell (DC)-based immunotherapy has been established by two decades of translational research. Of the four malignancies most targeted with clinical DC immunotherapy, high-grade glioma (HGG) has shown the highest susceptibility. HGG-induced immunosuppression is a roadblock to immunotherapy, but may be overcome by the application of T helper 1 (TH1) immunity-biased, next-generation, DC immunotherapy. To this end, we combined DC immunotherapy with immunogenic cell death (ICD; a modality shown to induce TH1 immunity) induced by hypericin-based photodynamic therapy. In an orthotopic HGG mouse model involving prophylactic/curative setups, both biologically and clinically relevant versions of ICD-based DC vaccines provided strong anti-HGG survival benefit. We found that the ability of DC vaccines to elicit HGG rejection was significantly blunted if cancer cell-associated reactive oxygen species and emanating danger signals were blocked either singly or concomitantly, showing hierarchical effect on immunogenicity, or if DCs, DC-associated MyD88 signal, or the adaptive immune system (especially CD8(+) T cells) were depleted. In a curative setting, ICD-based DC vaccines synergized with standard-of-care chemotherapy (temozolomide) to increase survival of HGG-bearing mice by ~300%, resulting in ~50% long-term survivors. Additionally, DC vaccines also induced an immunostimulatory shift in the brain immune contexture from regulatory T cells to TH1/cytotoxic T lymphocyte/TH17 cells. Analysis of the The Cancer Genome Atlas glioblastoma cohort confirmed that increased intratumor prevalence of TH1/cytotoxic T lymphocyte/TH17 cells linked genetic signatures was associated with good patient prognosis. Therefore, pending final preclinical checks, ICD-based vaccines can be clinically translated for glioma treatment. PMID:26936504

  18. Suicide Among Veterans in 16 States, 2005 to 2008: Comparisons Between Utilizers and Nonutilizers of Veterans Health Administration (VHA) Services Based on Data From the National Death Index, the National Violent Death Reporting System, and VHA Administrative Records

    PubMed Central

    Katz, Ira R.; Ignacio, Rosalinda V.; Kemp, Janet

    2012-01-01

    Objectives. We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Methods. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Results. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. Conclusions.The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide. PMID:22390582

  19. What is the Safest Way to Cross the Valley of Death: Wisdom gained from Making a Satellite based Flood Forecasting System Operational and Owned by Stakeholders

    NASA Astrophysics Data System (ADS)

    Hossain, F.

    2013-12-01

    More than a decade ago, the National Research Council report popularized the term 'Valley of Death' to describe the region where research on Weather Satellites had struggled to survive before reaching maturity for societal applications. For example, the space vantage of earth observing satellites can solve some of the world's otherwise fundamentally intractable operational problems on water resources. However, recent experiences show that many of the potential beneficiaries, who are not as familiar with water cycle remote sensing missions or anthropogenic climate studies, referred here as the ';non-traditional consumers,' may have a more skeptical view based on their current practices. This talk will focus on one such non-traditional consumer group: the water resources managers/staff in developing nations of South Asia. Using real-world examples on applications and hands-on-training to make a satellite based flood forecasting system operational, the talk will dissect the view that is shared by many water managers of Bangladesh on satellite remote sensing for day to day decision making. The talk will share the experience and wisdom generated in the successful capacity building of emerging satellite technology for water management. It will end with an overview of initiatives for more effective promotion of the value of planned water cycle satellite missions for water resources management community in the developing world.

  20. Ground-based observations of the long-term evolution and death of Saturn's 2010 Great White Spot

    NASA Astrophysics Data System (ADS)

    Sánchez-Lavega, Agustín; del Río-Gaztelurrutia, Teresa; Delcroix, Marc; Legarreta, Jon J.; Gómez-Forrellad, Josep M.; Hueso, Ricardo; García-Melendo, Enrique; Pérez-Hoyos, Santiago; Barrado-Navascués, David; Lillo, Jorge; International Outer Planet Watch Team IOPW-PVOL

    2012-08-01

    We report on the long-term evolution of Saturn's sixth Great White Spot (GWS) event that initiated at northern mid-latitudes of the planet on December 5th, 2010 (Fletcher, L. et al. [2011]. Science 332, 1413-1417; Sánchez-Lavega, A. et al. [2011]. Nature 475, 71-74; Fischer, G. et al. [2011]. Nature 475, 75-77). We find from ground-based observations that the GWS formed a planetary-scale disturbance that encircled the planet in 50 days, covering the latitude band between 24.6° and 44.8°N (planetographic) or about 22,000 km in meridional extent and 280,000 km in full zonal circumference length. The head of the GWS was located at an averaged latitude of 40.8 ± 1°N in the peak of a westward jet and showed a mean linear drift in System III longitude of 2.793 deg/day, equivalent to a mean zonal velocity of u = -27.9 m s-1, with maximum speed fluctuations around this mean of -5.3 to +2.7 m s-1. The difference between the undisturbed jet peak velocity and the GWS head was Δu = -12 m s-1. Assuming the GWS has a deep origin at the water cloud a vertical extent of Δz ˜ 250 km is expected and we can derive a vertical shear of the zonal winds ∂u/∂z ˜ 5 × 10-5 s-1. The cloud morphology of the disturbance was sculpted by the winds at this latitude and their latitudinal shears, showing several distinct features: (1) A long-lived Dark Spot (DS, anticyclone vortex) placed at 41.5 ± 1.1°N with a speed u = -11.0 ± 0.1 m s-1 and a size of 7800 km (East-West) per 6000 km (North-South). (2) Two branches of zonally periodic features at both sides of the jet peak, a northern branch at 44.4°N (anticyclonic) and a southern branch at 32°N (cyclonic), with wavelengths in the range ˜ 5000-14,000 km. Precise long-term cloud tracking of disturbance features shows that they moved with speeds close to those of the prevailing winds, although differences up to ˜-45 m s-1 were measured, probably due to wave motion or to real wind changes produced by momentum transfers induced by the disturbance. Vortex DS and the GWS head encountered between the 15th and 19th of June 2011, disappearing within the resolution of our images. We present and discuss two simple hypothesis to explain the nature of this phenomenon. Taking into account our results together with previous historical events, we summarize the mysteries of GWS phenomena: seasonal forcing, occurrence at preferred latitudes only in the Northern hemisphere, no relation of the outbreaks with the wind profile structure and the existence of a continuous deep moist convection source to feed the disturbance.

  1. Deadly pluralism? Why death-concept, death-definition, death-criterion and death-test pluralism should be allowed, even though it creates some problems.

    PubMed

    Zeiler, Kristin

    2009-10-01

    Death concept, death definition, death criterion and death test pluralism has been described by some as a problematic approach. Others have claimed it to be a promising way forward within modern pluralistic societies. This article describes the New Jersey Death Definition Law and the Japanese Transplantation Law. Both of these laws allow for more than one death concept within a single legal system. The article discusses a philosophical basis for these laws starting from John Rawls' understanding of comprehensive doctrines, reasonable pluralism and overlapping consensus. It argues for the view that a certain legal pluralism in areas of disputed metaphysical, philosophical and/or religious questions should be allowed, as long as the disputed questions concern the individual and the resulting policy, law or acts based on the policy/law, do not harm the lives of other individuals to an intolerable extent. However, while this death concept, death definition, death criterion and death test pluralism solves some problems, it creates others. PMID:18554277

  2. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  3. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  4. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  5. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  6. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  7. Performance or marketing benefits? The case of LEED certification.

    PubMed

    Matisoff, Daniel C; Noonan, Douglas S; Mazzolini, Anna M

    2014-01-01

    Green building adoption is driven by both performance-based benefits and marketing based benefits. Performance based benefits are those that improve performance or lower operating costs of the building or of building users. Marketing benefits stem from the consumer response to green certification. This study illustrates the relative importance of the marketing based benefits that accrue to Leadership in Energy and Environmental Design (LEED) buildings due to green signaling mechanisms, specifically related to the certification itself are identified. Of course, all participants in the LEED certification scheme seek marketing benefits. But even among LEED participants, the interest in green signaling is pronounced. The green signaling mechanism that occurs at the certification thresholds shifts building patterns from just below to just above the threshold level, and motivates builders to cluster buildings just above each threshold. Results are consistent across subsamples, though nonprofit organizations appear to build greener buildings and engage in more green signaling than for-profit entities. Using nonparametric regression discontinuity, signaling across different building types is observed. Marketing benefits due to LEED certification drives organizations to build "greener" buildings by upgrading buildings at the thresholds to reach certification levels. PMID:24392820

  8. The Effects of Death Education.

    ERIC Educational Resources Information Center

    Freitag, Carl B.; Hassler, Shawn David

    Although fear of death is recorded in the writings of the oldest major religions, the study of death and the fear of death have only occurred for the last few decades. Death education courses have grown in number since the early 1970's. College students participated in an investigation of the effects of death education on death anxiety by…

  9. The Effects of Death Education.

    ERIC Educational Resources Information Center

    Freitag, Carl B.; Hassler, Shawn David

    Although fear of death is recorded in the writings of the oldest major religions, the study of death and the fear of death have only occurred for the last few decades. Death education courses have grown in number since the early 1970's. College students participated in an investigation of the effects of death education on death anxiety by

  10. 76 FR 48833 - Notice of Filings of Self-Certifications of Coal Capability Under the Powerplant and Industrial...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... of Filings of Self-Certifications of Coal Capability Under the Powerplant and Industrial Fuel Use Act... owners of three new base load electric powerplants submitted coal capability self-certifications to the... publish a notice of receipt of self-certifications in the Federal Register. ADDRESSES: Copies of...

  11. The Effectiveness of Texas Teacher Certification Programs as Evidenced through Pass Rates on TExES PPR 160 Exam

    ERIC Educational Resources Information Center

    Clouse, Scarlet

    2013-01-01

    The purpose of this study was to investigate the differences between alternative certification pathways, specifically those offered through a university-based, post baccalaureate certification program and a regional education service center certification program. A quantitative research design was implemented and archived scores on the TExES PPR…

  12. Counterfactual quantum certificate authorization

    NASA Astrophysics Data System (ADS)

    Shenoy H., Akshata; Srikanth, R.; Srinivas, T.

    2014-05-01

    We present a multipartite protocol in a counterfactual paradigm. In counterfactual quantum cryptography, secure information is transmitted between two spatially separated parties even when there is no physical travel of particles transferring the information between them. We propose here a tripartite counterfactual quantum protocol for the task of certificate authorization. Here a trusted third party, Alice, authenticates an entity Bob (e.g., a bank) that a client Charlie wishes to securely transact with. The protocol is counterfactual with respect to either Bob or Charlie. We prove its security against a general incoherent attack, where Eve attacks single particles.

  13. [Brain death: biological and ethical aspects].

    PubMed

    Roczeń, R; Bohatyrewicz, R

    2001-01-01

    The article presents briefly historical development of death criteria from the modern times to the present. The criteria which are used for identification and diagnosing death on the base of respiratory and circulatory death definition are described. This work underlines the inadequacy of the definition of the brain death in relation to patients with persistent vegetative state and in relation to anencephalic newborns. The author describes the pathology and clinical and laboratory evidence of the brain stem death, which gave the possibility to justify the thesis that in case of the brain stem death ontological arguments are sufficient for diagnosing the death of a human being. The attention of the ethic of the life sanctity (on the base of halachic's law) and its opposing influence on the evolution of the medical definition of death has been paid. The recognition of the brain as the death of an individual is a cultural shock, which from scientific point of view changed the ways of thinking, almost immediately but did not in the awareness of the society. The work also underlies the fact that utilitarian argumentation can not be a criterion for making a decision concerning the life of an individual. PMID:12094808

  14. Cause of Death in Women of Reproductive Age in Rural Nepal Obtained Through Community-Based Surveillance: Is Reducing Maternal Mortality the Right Priority for Women's Health Programs?

    PubMed

    Pyakurel, Ram; Sharma, Nirmala; Paudel, Deepak; Coghill, Anna; Sinden, Laura; Bost, Liberty; Larkin, Melissa; Burrus, Carla Jean; Roy, Khrist

    2015-01-01

    We used a community surveillance system to gather information regarding pregnancy outcomes and the cause of death for women of reproductive age (WRA) in Kanchanpur, Nepal. A total of 784 mother groups participated in the collection of pregnancy outcomes and mortality data. Of the 273 deaths among WRA, the leading causes of death reported were chronic diseases (94, 34.4%) poisoning, snake bites, and suicide (grouped together; 55, 20.1%), and accidents (29, 10.6%), while maternal mortality accounted for 7%. Nevertheless, the calculated maternal mortality ratio was quite high (259.3 per 100,000 live births). PMID:24690028

  15. DEATH, DYING AND NEAR DEATH EXPERIENCE

    PubMed Central

    Singh, Ajai R.; Bagadia, V.N.; Pradhan, P.V.; Acharya, V.N.

    1988-01-01

    SUMMARY Psychology of deaths due to acute medical emergencies is under-researched. Most studies till now have concentrated on extended-death situations like malignancy. This open pilot study of twenty five patients examines the psychological state of patients during a life threatening acute medical illness (Group A, ten patients) and of those who survive such an experience (Group B, fifteen patients). The study finds psychological exploration both possible and necessary if carried out in a discreet manner. Salient features of the interview technique are discussed. The study finds out whether patients are aware of the possibility of terminality. The psychological disturbances manifest and nature of care expected are also discussed. Near Death Experiences of those who acknowledge their occurence are reported. Some nuances of thanatological research are high-lighted: What are the abilities needed in an interviewer? Can such exploration increase psychological distress in a patient already prone to it because of serious medical sickness? What impact such research can have on the interviewer himself? The paper answers some of these common questions while developing the method of thanatological study in acute medical death-situations. PMID:21927325

  16. Alternative Teacher Certification in Texas.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    This publication describes alternative teacher certification programs in Texas that train interns who are generally mature, mid-career individuals. The document is organized into seven sections: (1) "Alternative Certification in Texas" discusses the history and background of the programs including legislation, the first alternative teacher

  17. Are you considering organic certification?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Organic certification was developed in recognition of the necessity for consistent standards across the U.S. for the benefit of producers, processors, wholesalers, retailers, and consumers. Prior to establishment of federal guidelines (National Organic Program) for organic certification in 2002, a ...

  18. The ABCs of Certification Use

    ERIC Educational Resources Information Center

    Lualhati, Joselito C.

    2006-01-01

    Educators continue to show interest in the topic of certification use, which is not surprising. Certifications provide educators access to "de facto" content standards that define expectations of what students need to know and be able to do; teaching materials and resources that make it easier for educators to teach the knowledge and skills…

  19. Alternative Teacher Certification in Texas.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    This publication describes alternative teacher certification programs in Texas that train interns who are generally mature, mid-career individuals. The document is organized into seven sections: (1) "Alternative Certification in Texas" discusses the history and background of the programs including legislation, the first alternative teacher…

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

    PubMed

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

    2014-01-01

    Easter Island is a small island of 180 km2, located 3,800 km from the Chilean coast and one of the most isolated inhabited places in the world. Since the mid-twentieth century, it has been undergoing an epidemiological transition in relation to the causes of death, from a predominance of infectious to non-communicable diseases (NCDs) such as cardiovascular ailments and cancer. The aim of this study is to describe the causes of death to Easter Island between 2000 and 2012, so the statistical records of Hanga Roa Hospital and death certificates were reviewed. The period under review of 13 years there was a total of 252 deaths, an average to 19.3 deaths per year. The most frequent causes of death found in the general population of Easter Island were cardiovascular diseases (25.4%), followed by neoplasms (23.4%), accidents (18.6%). Related to Rapa Nui people, cardiovascular and neoplastic diseases (both 26.7%) predominate, while in the population without belonging to the ethnic group the main causes were traumatic (25%) and cardiovascular (22.2%). Comparing the leading causes of death of Easter Island with mainland Chile, it can be seen how they resemble. Taking the island death profile, it is necessary to work on public health strategies aimed to this, considering that some of the causes are completely preventable. PMID:25556431

  1. A prognostic model predicts the risk of distant metastasis and death for patients with nasopharyngeal carcinoma based on pre-treatment interleukin 6 and clinical stage.

    PubMed

    Ke, Liangru; Xiang, Yanqun; Xia, Weixiong; Yang, Jing; Yu, Yahui; Ye, Yanfang; Liang, Hu; Guo, Xiang; Lv, Xing

    2016-03-01

    Because inflammation plays a critical role in nasopharyngeal carcinoma (NPC), this study aims to investigate the correlation between the pro-inflammation cytokine interleukin-6 (IL6) and the prognosis of NPC and develop a new prognostic model. IL6 levels were measured in the serum of 290 NPC patients by ELISA and the correlation between IL6 and prognosis of NPC was evaluated by Kaplan-Meier analysis and multivariate analysis. The results showed that elevated IL6 levels were positively correlated with poorer 9-year overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and lung metastasis-free survival (lung-MFS). IL6 level was an independent prognostic factor for OS, DFS, DMFS and lung-MFS. The CI-model based on TNM stage and IL6 level could better predict the OS, DFS, DMFS and lung-MFS of NPC patients. Here, the newly developed prognostic CI-model for predicting distant metastasis and death of NPC patients could facilitate patients consulting and individualized immunotherapy. PMID:26780676

  2. National Trends in Pharmaceutical Opioid Related Overdose Deaths Compared to other Substance Related Overdose Deaths: 1999-2009

    PubMed Central

    Calcaterra, Susan; Glanz, Jason; Binswanger, Ingrid A.

    2014-01-01

    Background: Pharmaceutical opioid related deaths have increased. This study aimed to place pharmaceutical opioid overdose deaths within the context of heroin, cocaine, psychostimulants, and pharmaceutical sedative hypnotics, examine demographic trends, and describe common combinations of substances involved in opioid related deaths. Methods: We reviewed deaths among 15-64 year olds in the US from 1999-2009 using death certificate data available through the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Database. We identified International Classification of Disease-10 codes describing accidental overdose deaths, including poisonings related to stimulants, pharmaceutical drugs, and heroin. We used crude and age adjusted death rates (deaths/100,000 person years [p-y] and 95% confidence interval [CI] and multivariable Poisson regression models, yielding incident rate ratios (IRRs), for analysis. Results: The age adjusted death rate related to pharmaceutical opioids increased almost 4-fold from 1999 to 2009 (1.54/100,000 p-y [95% CI 1.49-1.60] to 6.05/100,000 p-y [95% CI 5.95-6.16; p<0.001). From 1999 to 2009, pharmaceutical opioids were responsible for the highest relative increase in overdose death rates (IRR 4.22, 95% CI 3.03-5.87) followed by sedative hypnotics (IRR 3.53, 95% CI 2.11-5.90). Heroin related overdose death rates increased from 2007 to 2009 (1.05/100,000 persons [95% CI 1.00-1.09] to 1.43/100,000 persons [95% CI 1.38-1.48; p<0.001). From 2005-2009 the combination of pharmaceutical opioids and benzodiazepines was the most common cause of polysubstance overdose deaths (1.27/100,000 p-y (95% CI 1.25-1.30). Conclusion: Strategies, such as wider implementation of naloxone, expanded access to treatment, and development of new interventions are needed to curb the pharmaceutical opioid overdose epidemic. PMID:23294765

  3. Smoking and Risk of All-cause Deaths in Younger and Older Adults: A Population-based Prospective Cohort Study Among Beijing Adults in China.

    PubMed

    Li, Kuibao; Yao, Chonghua; Di, Xuan; Yang, Xinchun; Dong, Lei; Xu, Li; Zheng, Meili

    2016-01-01

    Cigarette smoking is the leading preventable cause of death worldwide. Few studies, however, have examined the modified effects of age on the association between smoking and all-cause mortality.In the current study, the authors estimated the association between smoking and age-specific mortality in adults from Beijing, China. This is a large community-based prospective cohort study comprising of 6209 Beijing adults (aged ≥40 years) studied for approximately 8 years (1991-1999). Hazard ratios (HRs) and attributable fractions associated with smoking were estimated by Cox proportional hazard models, adjusting for age, sex, alcohol intake, body mass index, systolic blood pressure, hypertension, and heart rate.The results showed, compared with nonsmokers, the multivariable-adjusted HRs for all-cause mortality were 2.7(95% confidence interval (CI):1.56-4.69) in young adult smokers (40-50 years) and 1.31 (95% CI: 1.13-1.52) in old smokers (>50 years); and the interaction term between smoking and age was significant (P = 0.026). Attributable fractions for all-cause mortality in young and old adults were 63% (95% CI: 41%-85%) and 24% (95% CI: 12%-36%), respectively. The authors estimated multivariate adjusted absolute risk (mortality) by Poisson regression and calculated risk differences and 95% CI by bootstrap estimation. Mortality differences (/10,000 person-years) were 15.99 (95% CI: 15.34-16.64) in the young and 74.61(68.57-80.65) in the old. Compared with current smokers, the HRs of all-cause deaths for former smokers in younger and older adults were 0.57 (95% CI: 0.23-1.42) and 0.96 (95% CI: 0.73-1.26), respectively.The results indicate smoking significantly increases the risks of all-cause mortality in both young and old Beijing adults from the relative and absolute risk perspectives. Smoking cessation could also reduce the excess risk of mortality caused by continuing smoking in younger adults compared with older individuals. PMID:26817876

  4. Software Certification for Temporal Properties With Affordable Tool Qualification

    NASA Technical Reports Server (NTRS)

    Xia, Songtao; DiVito, Benedetto L.

    2005-01-01

    It has been recognized that a framework based on proof-carrying code (also called semantic-based software certification in its community) could be used as a candidate software certification process for the avionics industry. To meet this goal, tools in the "trust base" of a proof-carrying code system must be qualified by regulatory authorities. A family of semantic-based software certification approaches is described, each different in expressive power, level of automation and trust base. Of particular interest is the so-called abstraction-carrying code, which can certify temporal properties. When a pure abstraction-carrying code method is used in the context of industrial software certification, the fact that the trust base includes a model checker would incur a high qualification cost. This position paper proposes a hybrid of abstraction-based and proof-based certification methods so that the model checker used by a client can be significantly simplified, thereby leading to lower cost in tool qualification.

  5. Near-death experiences.

    PubMed

    Blackmore, S J

    1996-02-01

    Reactions to claims of near-death experiences (NDE) range from the popular view that this must be evidence for life after death, to outright rejection of the experiences as, at best, drug induced hallucinations or, at worse, pure invention. Twenty years, and much research, later, it is clear that neither extreme is correct. PMID:8683504

  6. Programmed cell death

    SciTech Connect

    1995-12-31

    The purpose of this conference to provide a multidisciplinary forum for exchange of state-of-the-art information on the role programmed cell death plays in normal development and homeostasis of many organisms. This volume contains abstracts of papers in the following areas: invertebrate development; immunology/neurology; bcl-2 family; biochemistry; programmed cell death in viruses; oncogenesis; vertebrate development; and diseases.

  7. The Psychology of Death

    ERIC Educational Resources Information Center

    Fields, B. Celestine

    1976-01-01

    Forty-eight black men and women living and/or attending school in the St. Louis and Washington, D.C. areas responded to questionnaires concerning feelings, attitudes, emotions, etc. towards death and dying. It is concluded that blacks see death as a very significant happening; and that although in some areas blacks have become Americanized in…

  8. Conflicting Thoughts about Death

    ERIC Educational Resources Information Center

    Harris, Paul L.

    2011-01-01

    Most research on children's conception of death has probed their understanding of its biological aspects: its inevitability, irreversibility and terminal impact. Yet many adults subscribe to a religious conception implying that death marks the beginning of a new life. Two recent empirical studies confirm that in the course of development, children…

  9. Death Acceptance through Ritual

    ERIC Educational Resources Information Center

    Reeves, Nancy C.

    2011-01-01

    This article summarizes the author's original research, which sought to discover the elements necessary for using death-related ritual as a psychotherapeutic technique for grieving people who experience their grief as "stuck," "unending," "maladaptive," and so on. A "death-related ritual" is defined as a ceremony, directly involving at least 1…

  10. Facing Up to Death

    ERIC Educational Resources Information Center

    Ross, Elizabeth Kubler

    1972-01-01

    Doctor urges that Americans accept death as a part of life and suggests ways of helping dying patients and their families face reality calmly, with peace. Dying children and their siblings, as well as children's feelings about relatives' deaths, are also discussed. (PD)

  11. Physician-assisted death.

    PubMed Central

    1995-01-01

    Physician-assisted death includes both euthanasia and assistance in suicide. The CMA urges its members to adhere to the principles of palliative care. It does not support euthanasia and assisted suicide. The following policy summary includes definitions of euthanasia and assisted suicide, background information, basic ethical principles and physician concerns about legalization of physician-assisted death. PMID:7632208

  12. Death Acceptance through Ritual

    ERIC Educational Resources Information Center

    Reeves, Nancy C.

    2011-01-01

    This article summarizes the author's original research, which sought to discover the elements necessary for using death-related ritual as a psychotherapeutic technique for grieving people who experience their grief as "stuck," "unending," "maladaptive," and so on. A "death-related ritual" is defined as a ceremony, directly involving at least 1

  13. SUICIDE ON DEATH ROW.

    PubMed

    Tartaro, Christine; Lester, David

    2015-12-01

    For the period 1976-2011, the suicide rate on death rows in the United States was only weakly (and non-significantly) associated with the marriage, birth, divorce, and unemployment rates in the general population. Possible explanations for why social indicators in the larger society might be associated with the behavior of prisoners on death row were discussed. PMID:26595302

  14. Death Obsession in Palestinians

    ERIC Educational Resources Information Center

    Abdel-Khalek, Ahmed M.; Al-Arja, Nahida S.; Abdalla, Taysir

    2006-01-01

    The authors explored death obsession level and correlates among a sample (N=601) of Palestinians living in the city of Beit Jala, the village of Al-Khader, and the Aida refugee camp in the Bethlehem area. They live in war conditions; the houses of half of them have been demolished. The Death Obsession Scale (DOS) was administered. Its alpha…

  15. Near-death experiences.

    PubMed Central

    Blackmore, S J

    1996-01-01

    Reactions to claims of near-death experiences (NDE) range from the popular view that this must be evidence for life after death, to outright rejection of the experiences as, at best, drug induced hallucinations or, at worse, pure invention. Twenty years, and much research, later, it is clear that neither extreme is correct. PMID:8683504

  16. Death Writ Large

    ERIC Educational Resources Information Center

    Kastenbaum, Robert

    2004-01-01

    Mainstream thanatology has devoted its efforts to improving the understanding, care, and social integration of people who are confronted with life-threatening illness or bereavement. This article suggests that it might now be time to expand the scope and mission to include large-scale death and death that occurs through complex and multi-domain…

  17. The association of cerebral palsy and death with small-for-gestational age birth weight in preterm neonates by individualized and population-based percentiles

    PubMed Central

    Grobman, William A.; Lai, Yinglei; Rouse, Dwight J.; Spong, Catherine Y.; Varner, Michael W.; Mercer, Brian M.; Leveno, Kenneth J.; Iams, Jay D.; Wapner, Ronald J.; Sorokin, Yoram; Thorp, John M.; Ramin, Susan M.; Malone, Fergal D.; O'sullivan, Mary J.; Hankins, Gary D. V.; Caritis, Steve N.

    2013-01-01

    OBJECTIVE To determine whether an individualized growth standard (IS) improves identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death. STUDY DESIGN Secondary analysis of data from a randomized trial of MgSO4 for prevention of CP or death among anticipated preterm births. Singleton non-anomalous liveborns delivered before 34 weeks’ were classified as SGA (< 10th % for their GA) by a population standard (PS) or an IS (incorporating maternal age, height, weight, parity, race/ethnicity, and neonatal gender). The primary outcome was prediction of moderate or severe CP or death by age 2. RESULTS Of 1588 eligible newborns, 143 (9.4%) experienced CP (N=33) or death (N=110). Forty-four (2.8%) were SGA by the PS and 364 (22.9%) by the IS. All PS-SGA newborns also were identified as IS-SGA. SGA newborns by either standard had a similarly increased risk of CP or death (PS: RR 2.4, 95% CI 1.3–4.3 vs. IS: RR 1.8, 95% CI 1.3–2.5, respectively). The similarity of RRs remained after stratification by MgSO4 treatment group. The IS was more sensitive (36% vs. 6%, p <.001), but less specific (78% vs. 98%, p <.001) for CP or death. ROC curve analysis revealed a statistically lower AUC for the PS, although the ability of either method to predict which neonates would subsequently develop CP or death was poor (PS: 0.55, 95% CI 0.49–0.60 vs. IS: 0.59, 95% CI 0.54–0.64, p<.001). CONCLUSION An individualized SGA growth standard does not improve the association with, or prediction of, CP or death by age 2. PMID:23770470

  18. Death in Denmark.

    PubMed Central

    Evans, M

    1990-01-01

    Does it matter that the hearts of 'brainstem dead' patients may persist in beating spontaneously? Hostile reactions, to the Danish inclusion of cardiac criteria in the determination of death, betray reductionist views of human life at the core of 'brainstem' conceptions of death. Such views (whether centred on neurological function or on abstractions concerning 'personhood') supplant the richness of human life and death with the poverty of essentialism: and mask the lethal nature of beating-heart organ retrieval. The affirmation of cardiac criteria for death is not an alternative form of essentialism as some critics suppose, but part of an understanding of human life and death which rejects essentialism altogether. The spontaneously persistent heartbeat does not constitute human life, but most certainly counts for it. PMID:2287015

  19. [Brain death, bioethics and organ transplantation].

    PubMed

    Flores, Juan Carlos; Pérez, Manuel; Thambo, Sergio; Valdivieso, Andrés

    2004-01-01

    The concept of death has evolved medically, legally and culturally since the introduction of life support technologies in the middle of the 20th century. The traditional cardiopulmonary and the new neurologically based brain death criterions of death are examined. We conclude that brain death, defined as total and irreversible loss of function of the whole brain, fulfills better "the permanent cessation of functioning of the organism as a whole" definition of death. Brain death diagnosis, based on standard neurologic clinical examination performed accurately, is unequivocal. Transplantation medicine, mostly based on organ donation of brain dead people, has become a routine and universally accepted therapeutic intervention nowadays, which benefits many people. Ethics foundations of organ transplantation are reviewed. Even though brain death and organ donation are widely accepted in medical, legal, religious and public opinion today, the whole society and medical community need to be further educated about these matters, so that unavoidable changes of traditional concepts might be better understood. Permanent education should be the best way to dissipate social fears and distrust towards organ donation and brain death. PMID:15379061

  20. Certificates of Confidentiality and the Compelled Disclosure of Research Data

    PubMed Central

    Beskow, Laura M.; Dame, Lauren; Costello, E. Jane

    2009-01-01

    Certificates of Confidentiality have gained prominence in the context of efforts to build large-scale research platforms and new requirements for an unprecedented degree of data sharing. There is, however, a remarkable paucity of evidence upon which to base conclusions about the strength, applicability, and durability of the legal protections a Certificate affords. Here we describe a recent legal challenge in which a research participant’s data, collected under a Certificate, were subpoenaed as part of a criminal case that reached the North Carolina Court of Appeals. We show how, despite the legal protections ostensibly afforded by the Certificate and the vigorous objections of the Principal Investigator and institutional counsel, the research subject’s confidentiality was ultimately compromised in the course of the legal proceedings; further, we discuss the broader implications of this case for the research enterprise as a whole. PMID:19008431