Sample records for national mortality database

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

    PubMed

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

    2016-02-01

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

  2. In-hospital mortality and morbidity of pediatric scoliosis surgery in Japan: Analysis using a national inpatient database.

    PubMed

    Taniguchi, Yuki; Oichi, Takeshi; Ohya, Junichi; Chikuda, Hirotaka; Oshima, Yasushi; Matsubayashi, Yoshitaka; Matsui, Hiroki; Fushimi, Kiyohide; Tanaka, Sakae; Yasunaga, Hideo

    2018-04-01

    Several previous reports have elucidated the mortality and incidence of complications after pediatric scoliosis surgery using nationwide databases. However, all of these studies were conducted in North America. Hence, this study aimed to identify the incidence and risk factors for in-hospital mortality and morbidity in pediatric scoliosis surgery, utilizing the Diagnosis Procedure Combination database, a national inpatient database in Japan.We retrospectively extracted data for patients aged less than 19 years who were admitted between 01 June 2010 and 31 March 2013 and underwent scoliosis surgery with fusion. The primary outcomes were in-hospital death and postoperative complications, including surgical site infection, ischemic heart disease, acute renal failure, pneumonia, stroke, disseminated intravascular coagulation, pulmonary embolism, and urinary tract infection.We identified 1,703 eligible patients (346 males and 1,357 females) with a mean age of 14.1 years. There were no deaths among the patients. At least one postoperative complication was found in 49 patients (2.9%). The most common complication was surgical site infection (1.4%). The multivariable logistic regression analysis showed that male sex (odds ratio, 2.22; 95% confidence interval, 1.28-3.70), comorbid diabetes (7.00; 1.56-31.51), and use of allogeneic blood transfusion (3.43; 1.86-6.41) were associated with the occurrence of postoperative complications. The present nationwide study elucidated the incidence and risk factors for in-hospital mortality and morbidity following surgery for pediatric scoliosis in an area other than North America. Diabetes was identified for the first time as a risk factor for postoperative complications in pediatric scoliosis surgery.

  3. National and regional breast cancer incidence and mortality trends in Mexico 2001-2011: Analysis of a population-based database.

    PubMed

    Soto-Perez-de-Celis, Enrique; Chavarri-Guerra, Yanin

    2016-04-01

    Breast cancer is the most common malignancy in Mexican women since 2006. However, due to a lack of cancer registries, data is scarce. We sought to describe breast cancer trends in Mexico using population-based data from a national database and to analyze geographical and age-related differences in incidence and mortality rates. All incident breast cancer cases reported to the National Epidemiological Surveillance System and all breast cancer deaths registered by the National Institute of Statistics and Geography in Mexico from 2001 to 2011 were included. Incidence and mortality rates were calculated for each age group and for 3 geographic regions of the country. Joinpoint regression analysis was performed to examine trends in BC incidence and mortality. We estimated annual percentage change (APC) using weighted least squares log-linear regression. We found an increase in the reported national incidence, with an APC of 5.9% (95% CI 4.1-7.7, p<0.05). Women aged 60-65 had the highest increase in incidence (APC 7.89%; 95% CI 5.5 -10.3, p<0.05). Reported incidence rates were significantly increased in the Center and in the South of the country, while in the North they remained stable. Mortality rates also showed a significant increase, with an APC of 0.4% (95% CI 0.1-0.7, p<0.05). Women 85 and older had the highest increase in mortality (APC 2.99%, 95% CI 1.9-4.1; p<0.05). The reporting of breast cancer cases in Mexico had a continuous increase, which could reflect population aging, increased availability of screening, an improvement in the number of clinical facilities and better reporting of cases. Although an improvement in the detection of cases is the most likely explanation for our findings, our results point towards an epidemiological transition in Mexico and should help in guiding national policy in developing countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Database documentation of marine mammal stranding and mortality: current status review and future prospects.

    PubMed

    Chan, Derek K P; Tsui, Henry C L; Kot, Brian C W

    2017-11-21

    Databases are systematic tools to archive and manage information related to marine mammal stranding and mortality events. Stranding response networks, governmental authorities and non-governmental organizations have established regional or national stranding networks and have developed unique standard stranding response and necropsy protocols to document and track stranded marine mammal demographics, signalment and health data. The objectives of this study were to (1) describe and review the current status of marine mammal stranding and mortality databases worldwide, including the year established, types of database and their goals; and (2) summarize the geographic range included in the database, the number of cases recorded, accessibility, filter and display methods. Peer-reviewed literature was searched, focussing on published databases of live and dead marine mammal strandings and mortality and information released from stranding response organizations (i.e. online updates, journal articles and annual stranding reports). Databases that were not published in the primary literature or recognized by government agencies were excluded. Based on these criteria, 10 marine mammal stranding and mortality databases were identified, and strandings and necropsy data found in these databases were evaluated. We discuss the results, limitations and future prospects of database development. Future prospects include the development and application of virtopsy, a new necropsy investigation tool. A centralized web-accessed database of all available postmortem multimedia from stranded marine mammals may eventually support marine conservation and policy decisions, which will allow the use of marine animals as sentinels of ecosystem health, working towards a 'One Ocean-One Health' ideal.

  5. Low oxygen saturation is associated with pre-hospital mortality among non-traumatic patients using emergency medical services: A national database of Thailand.

    PubMed

    Sittichanbuncha, Yuwares; Savatmongkorngul, Sorrawit; Jawroongrit, Puchong; Sawanyawisuth, Kittisak

    2015-09-01

    Pre-hospital emergency medical services are an important network for Emergency Medicine. It has been shown to reduce morbidity and mortality of patients by medical procedures. The Thai government established pre-hospital emergency medical services in 2008 to improve emergency medical care. Since then, there are limited data at the national level on mortality rates with pre-hospital care and the risk factors associated with mortality in non-traumatic patients. To study the pre-hospital mortality rate and factors associated with mortality in non-traumatic patients using the emergency medical service in Thailand. This study retrieved medical data from the National Institute for Emergency Medicine, NIEMS. The inclusion criteria were adult patients above the age of 15 who received medical services by the emergency medical services in Thailand (except Bangkok) from April 1st, 2011 to March 31st, 2012. Patients were excluded if there was no treatment during pre-hospital period, if they were trauma patients, or if their medical data was incomplete. Patients were categorized as either in the survival or non-survival group. Factors associated with mortality were examined by multivariate logistic regression analysis. During the study period, there were 127,602 non-traumatic patients who used pre-hospital emergency medical services in Thailand. Of those, 98,587 patients met the study criteria. For the statistical analyses, there were 66,760 patients who had complete clinical investigations. The mortality rate in this group was 1.89%. Only oxygen saturation was associated with mortality by multivariate logistic regression analysis. The adjusted OR was 0.922 (95% CI 0.8550.994). Low oxygen saturation is significantly associated with pre-hospital mortality in a national database of non-traumatic patients using emergency medical services in Thailand. During pre-hospital care, oxygen level should be monitored and promptly treated. Pulse oximetry devices should be available in all

  6. Pediatric burns: Kids' Inpatient Database vs the National Burn Repository.

    PubMed

    Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hartman, Brett C; Hadad, Ivan; Tholpady, Sunil S

    2016-04-01

    Burn injuries are one of the leading causes of morbidity and mortality in young children. The Kids' Inpatient Database (KID) and National Burn Repository (NBR) are two large national databases that can be used to evaluate outcomes and help quality improvement in burn care. Differences in the design of the KID and NBR could lead to differing results affecting resultant conclusions and quality improvement programs. This study was designed to validate the use of KID for burn epidemiologic studies, as an adjunct to the NBR. Using the KID (2003, 2006, and 2009), a total of 17,300 nonelective burn patients younger than 20 y old were identified. Data from 13,828 similar patients were collected from the NBR. Outcome variables were compared between the two databases. Comparisons revealed similar patient distribution by gender, race, and burn size. Inhalation injury was more common among the NBR patients and was associated with increased mortality. The rates of respiratory failure, wound infection, cellulitis, sepsis, and urinary tract infection were higher in the KID. Multiple regression analysis adjusting for potential confounders demonstrated similar mortality rate but significantly longer length of stay for patients in the NBR. Despite differences in the design and sampling of the KID and NBR, the overall demographic and mortality results are similar. The differences in complication rate and length of stay should be explored by further studies to clarify underlying causes. Investigations into these differences should also better inform strategies to improve burn prevention and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Impact of HIV on inpatient mortality and complications in stroke in Thailand: a National Database Study.

    PubMed

    Cumming, K; Tiamkao, S; Kongbunkiat, K; Clark, A B; Bettencourt-Silva, J H; Sawanyawisuth, K; Kasemsap, N; Mamas, M A; Seeley, J A; Myint, P K

    2017-04-01

    The co-existence of stroke and HIV has increased in recent years, but the impact of HIV on post-stroke outcomes is poorly understood. We examined the impact of HIV on inpatient mortality, length of acute hospital stay and complications (pneumonia, respiratory failure, sepsis and convulsions), in hospitalized strokes in Thailand. All hospitalized strokes between 1 October 2004 and 31 January 2013 were included. Data were obtained from a National Insurance Database. Characteristics and outcomes for non-HIV and HIV patients were compared and multivariate logistic and linear regression models were constructed to assess the above outcomes. Of 610 688 patients (mean age 63·4 years, 45·4% female), 0·14% (866) had HIV infection. HIV patients were younger, a higher proportion were male and had higher prevalence of anaemia (P < 0·001) compared to non-HIV patients. Traditional cardiovascular risk factors, hypertension and diabetes, were more common in the non-HIV group (P < 0·001). After adjusting for age, sex, stroke type and co-morbidities, HIV infection was significantly associated with higher odds of sepsis [odds ratio (OR) 1·75, 95% confidence interval (CI) 1·29-2·4], and inpatient mortality (OR 2·15, 95% CI 1·8-2·56) compared to patients without HIV infection. The latter did not attenuate after controlling for complications (OR 2·20, 95% CI 1·83-2·64). HIV infection is associated with increased odds of sepsis and inpatient mortality after acute stroke.

  8. Uses of tuberculosis mortality surveillance to identify programme errors and improve database reporting.

    PubMed

    Selig, L; Guedes, R; Kritski, A; Spector, N; Lapa E Silva, J R; Braga, J U; Trajman, A

    2009-08-01

    In 2006, 848 persons died from tuberculosis (TB) in Rio de Janeiro, Brazil, corresponding to a mortality rate of 5.4 per 100 000 population. No specific TB death surveillance actions are currently in place in Brazil. Two public general hospitals with large open emergency rooms in Rio de Janeiro City. To evaluate the contribution of TB death surveillance in detecting gaps in TB control. We conducted a survey of TB deaths from September 2005 to August 2006. Records of TB-related deaths and deaths due to undefined causes were investigated. Complementary data were gathered from the mortality and TB notification databases. Seventy-three TB-related deaths were investigated. Transmission hazards were identified among firefighters, health care workers and in-patients. Management errors included failure to isolate suspected cases, to confirm TB, to correct drug doses in underweight patients and to trace contacts. Following the survey, 36 cases that had not previously been notified were included in the national TB notification database and the outcome of 29 notified cases was corrected. TB mortality surveillance can contribute to TB monitoring and evaluation by detecting correctable and specific programme- and hospital-based care errors, and by improving the accuracy of TB database reporting. Specific local and programmatic interventions can be proposed as a result.

  9. The Dutch Hospital Standardised Mortality Ratio (HSMR) method and cardiac surgery: benchmarking in a national cohort using hospital administration data versus a clinical database

    PubMed Central

    Siregar, S; Pouw, M E; Moons, K G M; Versteegh, M I M; Bots, M L; van der Graaf, Y; Kalkman, C J; van Herwerden, L A; Groenwold, R H H

    2014-01-01

    Objective To compare the accuracy of data from hospital administration databases and a national clinical cardiac surgery database and to compare the performance of the Dutch hospital standardised mortality ratio (HSMR) method and the logistic European System for Cardiac Operative Risk Evaluation, for the purpose of benchmarking of mortality across hospitals. Methods Information on all patients undergoing cardiac surgery between 1 January 2007 and 31 December 2010 in 10 centres was extracted from The Netherlands Association for Cardio-Thoracic Surgery database and the Hospital Discharge Registry. The number of cardiac surgery interventions was compared between both databases. The European System for Cardiac Operative Risk Evaluation and hospital standardised mortality ratio models were updated in the study population and compared using the C-statistic, calibration plots and the Brier-score. Results The number of cardiac surgery interventions performed could not be assessed using the administrative database as the intervention code was incorrect in 1.4–26.3%, depending on the type of intervention. In 7.3% no intervention code was registered. The updated administrative model was inferior to the updated clinical model with respect to discrimination (c-statistic of 0.77 vs 0.85, p<0.001) and calibration (Brier Score of 2.8% vs 2.6%, p<0.001, maximum score 3.0%). Two average performing hospitals according to the clinical model became outliers when benchmarking was performed using the administrative model. Conclusions In cardiac surgery, administrative data are less suitable than clinical data for the purpose of benchmarking. The use of either administrative or clinical risk-adjustment models can affect the outlier status of hospitals. Risk-adjustment models including procedure-specific clinical risk factors are recommended. PMID:24334377

  10. Variability in Standard Outcomes of Posterior Lumbar Fusion Determined by National Databases.

    PubMed

    Joseph, Jacob R; Smith, Brandon W; Park, Paul

    2017-01-01

    National databases are used with increasing frequency in spine surgery literature to evaluate patient outcomes. The differences between individual databases in relationship to outcomes of lumbar fusion are not known. We evaluated the variability in standard outcomes of posterior lumbar fusion between the University HealthSystem Consortium (UHC) database and the Healthcare Cost and Utilization Project National Inpatient Sample (NIS). NIS and UHC databases were queried for all posterior lumbar fusions (International Classification of Diseases, Ninth Revision code 81.07) performed in 2012. Patient demographics, comorbidities (including obesity), length of stay (LOS), in-hospital mortality, and complications such as urinary tract infection, deep venous thrombosis, pulmonary embolism, myocardial infarction, durotomy, and surgical site infection were collected using specific International Classification of Diseases, Ninth Revision codes. Analysis included 21,470 patients from the NIS database and 14,898 patients from the UHC database. Demographic data were not significantly different between databases. Obesity was more prevalent in UHC (P = 0.001). Mean LOS was 3.8 days in NIS and 4.55 in UHC (P < 0.0001). Complications were significantly higher in UHC, including urinary tract infection, deep venous thrombosis, pulmonary embolism, myocardial infarction, surgical site infection, and durotomy. In-hospital mortality was similar between databases. NIS and UHC databases had similar demographic patient populations undergoing posterior lumbar fusion. However, the UHC database reported significantly higher complication rate and longer LOS. This difference may reflect academic institutions treating higher-risk patients; however, a definitive reason for the variability between databases is unknown. The inability to precisely determine the basis of the variability between databases highlights the limitations of using administrative databases for spinal outcome analysis. Copyright

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

    PubMed

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

    2013-01-01

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

  12. Comparison of pediatric cardiac surgical mortality rates from national administrative data to contemporary clinical standards.

    PubMed

    Welke, Karl F; Diggs, Brian S; Karamlou, Tara; Ungerleider, Ross M

    2009-01-01

    Despite the superior coding and risk adjustment of clinical data, the ready availability, national scope, and perceived unbiased nature of administrative data make it the choice of governmental agencies and insurance companies for evaluating quality and outcomes. We calculated pediatric cardiac surgery mortality rates from administrative data and compared them with widely quoted standards from clinical databases. Pediatric cardiac surgical operations were retrospectively identified by ICD-9-CM diagnosis and procedure codes from the Nationwide Inpatient Sample (NIS) 1988-2005 and the Kids' Inpatient Database (KID) 2003. Cases were grouped into Risk Adjustment for Congenital Heart Surgery, version 1 (RACHS-1) categories. In-hospital mortality rates and 95% confidence intervals were calculated. A total of 55,164 operations from the NIS and 10,945 operations from the KID were placed into RACHS-1 categories. During the 18-year period, the overall NIS mortality rate for pediatric cardiac surgery decreased from 8.7% (95% confidence interval, 8.0% to 9.3%) to 4.6% (95% confidence interval, 4.3% to 5.0%). Mortality rates by RACHS-1 category decreased significantly as well. The KID and NIS mortality rates from comparable years were similar. Overall mortality rates derived from administrative data were higher than those from contemporary national clinical data, The Society of Thoracic Surgeons Congenital Heart Surgery Database, or published data from pediatric cardiac specialty centers. Although category-specific mortality rates were higher in administrative data than in clinical data, a minority of the relationships reached statistical significance. Despite substantial improvement, mortality rates from administrative data remain higher than those from clinical data. The discrepancy may be attributable to several factors: differences in database design and composition, differences in data collection and reporting structures, and variation in data quality.

  13. National Transportation Atlas Databases : 1999

    DOT National Transportation Integrated Search

    1999-01-01

    The National Transportation Atlas Databases -- 1999 (NTAD99) is a set of national : geographic databases of transportation facilities. These databases include geospatial : information for transportation modal networks and intermodal terminals, and re...

  14. National Transportation Atlas Databases : 2001

    DOT National Transportation Integrated Search

    2001-01-01

    The National Transportation Atlas Databases-2001 (NTAD-2001) is a set of national geographic databases of transportation facilities. These databases include geospatial information for transportation modal networks and intermodal terminals and related...

  15. National Transportation Atlas Databases : 1996

    DOT National Transportation Integrated Search

    1996-01-01

    The National Transportation Atlas Databases -- 1996 (NTAD96) is a set of national : geographic databases of transportation facilities. These databases include geospatial : information for transportation modal networks and intermodal terminals, and re...

  16. National Transportation Atlas Databases : 2000

    DOT National Transportation Integrated Search

    2000-01-01

    The National Transportation Atlas Databases-2000 (NTAD-2000) is a set of national geographic databases of transportation facilities. These databases include geospatial information for transportation modal networks and intermodal terminals and related...

  17. National Transportation Atlas Databases : 1997

    DOT National Transportation Integrated Search

    1997-01-01

    The National Transportation Atlas Databases -- 1997 (NTAD97) is a set of national : geographic databases of transportation facilities. These databases include geospatial : information for transportation modal networks and intermodal terminals, and re...

  18. Surgical research using national databases

    PubMed Central

    Leland, Hyuma; Heckmann, Nathanael

    2016-01-01

    Recent changes in healthcare and advances in technology have increased the use of large-volume national databases in surgical research. These databases have been used to develop perioperative risk stratification tools, assess postoperative complications, calculate costs, and investigate numerous other topics across multiple surgical specialties. The results of these studies contain variable information but are subject to unique limitations. The use of large-volume national databases is increasing in popularity, and thorough understanding of these databases will allow for a more sophisticated and better educated interpretation of studies that utilize such databases. This review will highlight the composition, strengths, and weaknesses of commonly used national databases in surgical research. PMID:27867945

  19. Surgical research using national databases.

    PubMed

    Alluri, Ram K; Leland, Hyuma; Heckmann, Nathanael

    2016-10-01

    Recent changes in healthcare and advances in technology have increased the use of large-volume national databases in surgical research. These databases have been used to develop perioperative risk stratification tools, assess postoperative complications, calculate costs, and investigate numerous other topics across multiple surgical specialties. The results of these studies contain variable information but are subject to unique limitations. The use of large-volume national databases is increasing in popularity, and thorough understanding of these databases will allow for a more sophisticated and better educated interpretation of studies that utilize such databases. This review will highlight the composition, strengths, and weaknesses of commonly used national databases in surgical research.

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

    PubMed

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

    2017-11-01

    Stroke is the leading cause of death in women and the third leading cause in men in France. In young adults (ie, <65 years old), an increase in the incidence of ischemic stroke was observed at a local scale between 1985 and 2011. After the implementation of the 2010 to 2014 National Stroke Action Plan, this study investigates national trends in patients hospitalized by stroke subtypes, in-hospital mortality, and stroke mortality between 2008 and 2014. Hospitalization data were extracted from the French national hospital discharge databases and mortality data from the French national medical causes of death database. Time trends were tested using a Poisson regression model. From 2008 to 2014, the age-standardized rates of patients hospitalized for ischemic stroke increased by 14.3% in patients <65 years old and decreased by 1.5% in those aged ≥65 years. The rate of patients hospitalized for hemorrhagic stroke was stable (+2.0%), irrespective of age and sex. The proportion of patients hospitalized in stroke units substantially increased. In-hospital mortality decreased by 17.1% in patients with ischemic stroke. From 2008 to 2013, stroke mortality decreased, except for women between 45 and 64 years old and for people aged ≥85 years. An increase in cardiovascular risk factors and improved stroke management may explain the increase in the rates of patients hospitalized for ischemic stroke. The decrease observed for in-hospital stroke mortality may be because of recent improvements in acute-phase management. © 2017 American Heart Association, Inc.

  1. A comparison of the surgical mortality due to colorectal perforation at different hospitals with data from 10,090 cases in the Japanese National Clinical Database.

    PubMed

    Ohki, Takeshi; Yamamoto, Masakazu; Miyata, Hiroaki; Sato, Yasuto; Saida, Yoshihisa; Morimoto, Tsuyoshi; Konno, Hiroyuki; Seto, Yasuyuki; Hirata, Koichi

    2017-01-01

    Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted. The primary outcome measures included the 30-day postsurgery mortality and surgical mortality of colorectal perforation. We analyzed differences in the observed-to-expected mortality (O/E) ratio between the two groups of hospitals, that is, specialized and non-specialized, using the logistic regression analysis forward selection method.There were 10,090 cases of disease-induced colorectal perforation during the study period. The annual average postoperative fatality rate was 11.36%. There were 3884 patients in the specialized hospital group and 6206 in the non-specialized hospital group. The O/E ratio (0.9106) was significantly lower in the specialized hospital group than in the non-specialized hospital group (1.0704). The experience level of hospitals in treating cases of colorectal perforation negatively correlated with the O/E ratio.We conducted the first study investigating differences among hospitals with respect to their fatality rate of colorectal perforation on the basis of data from a nationwide database. Our data suggest that patients with colorectal perforation should choose to be treated at a specialized hospital or a hospital that treats five or more cases of colorectal perforation per year. The results of this study indicate that specialized hospitals may provide higher quality medical care, which in turn proves that government policy on healthcare is effective at improving the medical system in Japan.

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

    PubMed

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

    2017-08-31

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

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

    PubMed Central

    Winslow, Ksenia; Ho, Andrew; Fortney, Kristen; Morgen, Eric

    2017-01-01

    Biomarkers of all-cause mortality are of tremendous clinical and research interest. Because of the long potential duration of prospective human lifespan studies, such biomarkers can play a key role in quantifying human aging and quickly evaluating any potential therapies. Decades of research into mortality biomarkers have resulted in numerous associations documented across hundreds of publications. Here, we present MortalityPredictors.org, a manually-curated, publicly accessible database, housing published, statistically-significant relationships between biomarkers and all-cause mortality in population-based or generally healthy samples. To gather the information for this database, we searched PubMed for appropriate research papers and then manually curated relevant data from each paper. We manually curated 1,576 biomarker associations, involving 471 distinct biomarkers. Biomarkers ranged in type from hematologic (red blood cell distribution width) to molecular (DNA methylation changes) to physical (grip strength). Via the web interface, the resulting data can be easily browsed, searched, and downloaded for further analysis. MortalityPredictors.org provides comprehensive results on published biomarkers of human all-cause mortality that can be used to compare biomarkers, facilitate meta-analysis, assist with the experimental design of aging studies, and serve as a central resource for analysis. We hope that it will facilitate future research into human mortality and aging. PMID:28858850

  4. Mortality in hepatectomy: Model for End-Stage Liver Disease as a predictor of death using the National Surgical Quality Improvement Program database.

    PubMed

    Ross, Samuel W; Seshadri, Ramanathan; Walters, Amanda L; Augenstein, Vedra A; Heniford, B Todd; Iannitti, David A; Martinie, John B; Vrochides, Dionisios; Swan, Ryan Z

    2016-03-01

    The predictive value of the Model for End-stage Liver Disease (MELD) for mortality after hepatectomy is unclear. This study aimed to evaluate whether MELD score predicts death after hepatectomy and to identify the most useful score type for predicting mortality. We hypothesized that an increase in this score is correlated with 30-day mortality in patients undergoing hepatic resection. The American College of Surgeons National Surgical Quality Improvement Program database was queried for hepatectomy. Original MELD, United Network of Organ Sharing-modified MELD (uMELD), integrated MELD (i-MELD), and sodium-corrected MELD (MELD-Na) scores were calculated. Mortality was analyzed by multivariate logistic regression. MELD types were compared using receiver operating characteristic (ROC) curves. From 2005 to 2011, 11,933 hepatic resections were performed, including 7,519 partial, 2,104 right, and 1,210 left resections, and 1,100 trisectionectomies. The mean duration of stay was 8.4 ± 22.0 days, and there were 275 deaths (2.4%). The 30-day mortality rates were 1.8%, 6.9%, 15.4%, and 25% according to uMELD strata of 0-9, 10-19, 20-29, and ≥ 30, respectively. Multivariate analysis revealed that increasing MELD stratum was independently associated with higher mortality (P < .001) for all MELD types. The uMELD had the largest effect size (odds ratio [OR], 1.16; 95% CI, 1.10-1.20), whereas i-MELD had the narrowest CI (OR, 1.13; 95% CI, 1.10-1.17) and largest area under the ROC curve. The postoperative 30-day mortality after hepatectomy increases with increasing MELD score across all MELD types. There is a 16% increase in the odds of mortality for each point increase in uMELD. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. A national database of incidence and treatment outcomes of status epilepticus in Thailand.

    PubMed

    Tiamkao, Somsak; Pranbul, Sineenard; Sawanyawisuth, Kittisak; Thepsuthammarat, Kaewjai

    2014-06-01

    Status epilepticus (SE) is a serious neurological condition. The national database of SE in Thailand and other developing countries is limited in terms of incidence and treatment outcomes. This study was conducted on the prevalence of status epilepticus (SE). The study group comprised of adult inpatients (over 18 years old) with SE throughout Thailand. SE patients were diagnosed and searched based on ICD 10 (G41) from the national database. The database used was from reimbursement documents submitted by the hospitals under the three health insurance systems, namely, the universal health coverage insurance, social security, and government health welfare system during the fiscal year 2010. We found 2190 SE patients receiving treatment at hospitals (5.10/100 000 population). The average age was 50.5 years and 1413 patients were males (64.5%). Mortality rate was 0.6 death/100 000 population or 11.96% of total patients. Significant factors associated with death or a nonimproved status at discharge were type of insurance, hospital level, chronic kidney disease, having pneumonia, having shock, on mechanical ventilator, and having cardiopulmonary resuscitation. In conclusion, the incidence of SE in Thailand was 5.10/100 000 population with mortality rate of 0.6/100 000 population.

  6. Predictors of in-hospital mortality for patients admitted with ST-elevation myocardial infarction: a real-world study using the Myocardial Infarction National Audit Project (MINAP) database.

    PubMed

    Gale, C P; Manda, S O M; Batin, P D; Weston, C F; Birkhead, J S; Hall, A S

    2008-11-01

    Although early thrombolysis reduces the risk of death in STEMI patients, mortality remains high. We evaluated factors predicting inpatient mortality for patients with STEMI in a "real-world" population. Analysis of the Myocardial Infarction National Audit Project (MINAP) database using multivariate logistic regression and area under the receiver operating curve analysis. All acute hospitals in England and Wales. 34 722 patients with STEMI from 1 January 2003 to 31 March 2005. Inpatient mortality was 10.6%. The highest odds ratios for inpatient survival were aspirin therapy given acutely and out-of-hospital thrombolysis, independently associated with a mortality risk reduction of over half. A 10-year increase in age doubled inpatient mortality risk, whereas cerebrovascular disease increased it by 1.7. The risk model comprised 14 predictors of mortality, C index = 0.82 (95% CI 0.82 to 0.83, p<0.001). A simple model comprising age, systolic blood pressure (SBP) and heart rate (HR) offered a C index of 0.80 (0.79 to 0.80, p<0.001). The strongest predictors of in-hospital survival for STEMI were aspirin therapy given acutely and out-of-hospital thrombolysis, Previous STEMI models have focused on age, SBP and HR We have confirmed the importance of these predictors in the discrimination of death after STEMI, but also demonstrated that other potentially modifiable variables impact upon the prediction of short-term mortality.

  7. National mortality rates: the impact of inequality?

    PubMed

    Wilkinson, R G

    1992-08-01

    Although health is closely associated with income differences within each country there is, at best, only a weak link between national mortality rates and average income among the developed countries. On the other hand, there is evidence of a strong relationship between national mortality rates and the scale of income differences within each society. These three elements are coherent if health is affected less by changes in absolute material standards across affluent populations than it is by relative income or the scale of income differences and the resulting sense of disadvantage within each society. Rather than socioeconomic mortality differentials representing a distribution around given national average mortality rates, it is likely that the degree of income inequality indicates the burden of relative deprivation on national mortality rates.

  8. National mortality rates: the impact of inequality?

    PubMed Central

    Wilkinson, R G

    1992-01-01

    Although health is closely associated with income differences within each country there is, at best, only a weak link between national mortality rates and average income among the developed countries. On the other hand, there is evidence of a strong relationship between national mortality rates and the scale of income differences within each society. These three elements are coherent if health is affected less by changes in absolute material standards across affluent populations than it is by relative income or the scale of income differences and the resulting sense of disadvantage within each society. Rather than socioeconomic mortality differentials representing a distribution around given national average mortality rates, it is likely that the degree of income inequality indicates the burden of relative deprivation on national mortality rates. PMID:1636827

  9. National Vulnerability Database (NVD)

    National Institute of Standards and Technology Data Gateway

    National Vulnerability Database (NVD) (Web, free access)   NVD is a comprehensive cyber security vulnerability database that integrates all publicly available U.S. Government vulnerability resources and provides references to industry resources. It is based on and synchronized with the CVE vulnerability naming standard.

  10. The Society of Thoracic Surgeons General Thoracic Surgery Database: establishing generalizability to national lung cancer resection outcomes.

    PubMed

    LaPar, Damien J; Bhamidipati, Castigliano M; Lau, Christine L; Jones, David R; Kozower, Benjamin D

    2012-07-01

    The Society of Thoracic Surgeons General Thoracic Surgery Database (GTDB) has demonstrated outstanding results for lung cancer resection. However, whether the GTDB results are generalizable nationwide is unknown. The purpose of this study was to establish the generalizability of the GTDB by comparing lung cancer resection results with those of the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient database in the United States. From 2002 to 2008, primary lung cancer resection outcomes were compared between the GTDB (n = 19,903) and the NIS (n = 246,469). Primary outcomes were the proportion of procedures performed nationally that were captured in the GTDB and differences in mortality rates and hospital length of stay. Observed differences in patient characteristics, operative procedures, and postoperative events were also analyzed. Annual GTDB lung cancer resection volume has increased over time but only captures an estimated 8% of resections performed nationally. The GTDB and NIS databases had similar median patient age (67 vs 68 years) and female sex (50% vs 49%), lobectomy was the most common procedure (64.7% vs 79.7%; p < 0.001), and pneumonectomies were uncommon (6.3% vs 7.2%; p < 0.001). Compared with NIS, the GTDB had significantly lower unadjusted discharge mortality rates (1.8% vs 3.0%), median length of stay (5.0 vs 7.0 days; p < 0.001), and postoperative pulmonary complication rates (18.5% vs 23.6%, p < 0.001). The GTDB represents a small percentage of the lung cancer resections performed nationally and reports significantly lower mortality rates and shorter hospital length of stay than national results. The GTDB is not broadly generalizable. These results establish a benchmark for future GTDB comparisons and highlight the importance of increasing participation in the database. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Biological age as a health index for mortality and major age-related disease incidence in Koreans: National Health Insurance Service – Health screening 11-year follow-up study

    PubMed Central

    Kang, Young Gon; Suh, Eunkyung; Lee, Jae-woo; Kim, Dong Wook; Cho, Kyung Hee; Bae, Chul-Young

    2018-01-01

    Purpose A comprehensive health index is needed to measure an individual’s overall health and aging status and predict the risk of death and age-related disease incidence, and evaluate the effect of a health management program. The purpose of this study is to demonstrate the validity of estimated biological age (BA) in relation to all-cause mortality and age-related disease incidence based on National Sample Cohort database. Patients and methods This study was based on National Sample Cohort database of the National Health Insurance Service – Eligibility database and the National Health Insurance Service – Medical and Health Examination database of the year 2002 through 2013. BA model was developed based on the National Health Insurance Service – National Sample Cohort (NHIS – NSC) database and Cox proportional hazard analysis was done for mortality and major age-related disease incidence. Results For every 1 year increase of the calculated BA and chronological age difference, the hazard ratio for mortality significantly increased by 1.6% (1.5% in men and 2.0% in women) and also for hypertension, diabetes mellitus, heart disease, stroke, and cancer incidence by 2.5%, 4.2%, 1.3%, 1.6%, and 0.4%, respectively (p<0.001). Conclusion Estimated BA by the developed BA model based on NHIS – NSC database is expected to be used not only as an index for assessing health and aging status and predicting mortality and major age-related disease incidence, but can also be applied to various health care fields. PMID:29593385

  12. National Transportation Atlas Databases : 2002

    DOT National Transportation Integrated Search

    2002-01-01

    The National Transportation Atlas Databases 2002 (NTAD2002) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  13. National Transportation Atlas Databases : 2010

    DOT National Transportation Integrated Search

    2010-01-01

    The National Transportation Atlas Databases 2010 (NTAD2010) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  14. National Transportation Atlas Databases : 2006

    DOT National Transportation Integrated Search

    2006-01-01

    The National Transportation Atlas Databases 2006 (NTAD2006) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  15. National Transportation Atlas Databases : 2005

    DOT National Transportation Integrated Search

    2005-01-01

    The National Transportation Atlas Databases 2005 (NTAD2005) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  16. National Transportation Atlas Databases : 2008

    DOT National Transportation Integrated Search

    2008-01-01

    The National Transportation Atlas Databases 2008 (NTAD2008) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  17. National Transportation Atlas Databases : 2003

    DOT National Transportation Integrated Search

    2003-01-01

    The National Transportation Atlas Databases 2003 (NTAD2003) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  18. National Transportation Atlas Databases : 2004

    DOT National Transportation Integrated Search

    2004-01-01

    The National Transportation Atlas Databases 2004 (NTAD2004) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  19. National Transportation Atlas Databases : 2009

    DOT National Transportation Integrated Search

    2009-01-01

    The National Transportation Atlas Databases 2009 (NTAD2009) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  20. National Transportation Atlas Databases : 2007

    DOT National Transportation Integrated Search

    2007-01-01

    The National Transportation Atlas Databases 2007 (NTAD2007) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  1. National Transportation Atlas Databases : 2012

    DOT National Transportation Integrated Search

    2012-01-01

    The National Transportation Atlas Databases 2012 (NTAD2012) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  2. National Transportation Atlas Databases : 2011

    DOT National Transportation Integrated Search

    2011-01-01

    The National Transportation Atlas Databases 2011 (NTAD2011) is a set of nationwide geographic databases of transportation facilities, transportation networks, and associated infrastructure. These datasets include spatial information for transportatio...

  3. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan.

    PubMed

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

    2017-03-01

    Myxedema coma is a life-threatening and emergency presentation of hypothyroidism. However, the clinical features and outcomes of this condition have been poorly defined because of its rarity. We conducted a retrospective observational study of patients diagnosed with myxedema coma from July 2010 through March 2013 using a national inpatient database in Japan. We investigated characteristics, comorbidities, treatments, and in-hospital mortality of patients with myxedema coma. We identified 149 patients diagnosed with myxedema coma out of approximately 19 million inpatients in the database. The mean (standard deviation) age was 77 (12) years, and two-thirds of the patients were female. The overall proportion of in-hospital mortality among cases was 29.5%. The number of patients was highest in the winter season. Patients treated with steroids, catecholamines, or mechanical ventilation showed higher in-hospital mortality than those without. Variations in type and dosage of thyroid hormone replacement were not associated with in-hospital mortality. The most common comorbidity was cardiovascular diseases (40.3%). The estimated incidence of myxedema coma was 1.08 per million people per year in Japan. Multivariable logistic regression analysis revealed that higher age and use of catecholamines (with or without steroids) were significantly associated with higher in-hospital mortality. The present study identified the clinical characteristics and outcomes of patients with myxedema coma using a large-scale database. Myxedema coma mortality was independently associated with age and severe conditions requiring treatment with catecholamines. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  4. Critical Infrastructure: The National Asset Database

    DTIC Science & Technology

    2007-07-16

    Infrastructure: The National Asset Database 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...upon which federal resources, including infrastructure protection grants , are allocated. According to DHS, both of those assumptions are wrong. DHS...assets that it has determined are critical to the nation. Also, while the National Asset Database has been used to support federal grant -making

  5. National Transportation Atlas Databases : 1995

    DOT National Transportation Integrated Search

    1995-01-01

    BTS has compiled the initial version of a geographic atlas : database to support research, analysis, and decision making : across all modes of transportation. The atlas databases are : designed primarily to meet the needs of DOT at the national : lev...

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

    PubMed

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

    2017-10-01

    The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality. Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P < 0.0001). A similar decrease was seen in all regions. The mortality reduction was overwhelmingly observed in elderly patients admitted as an emergency. The commencement of this nation-wide mortality audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes. © 2017 Royal Australasian College of Surgeons.

  7. 47 CFR 54.404 - The National Lifeline Accountability Database.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false The National Lifeline Accountability Database... National Lifeline Accountability Database. (a) State certification. An eligible telecommunications carrier... within 90 days of filing. (b) The National Lifeline Accountability Database. In order to receive Lifeline...

  8. 47 CFR 54.404 - The National Lifeline Accountability Database.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false The National Lifeline Accountability Database... National Lifeline Accountability Database. (a) State certification. An eligible telecommunications carrier... within 90 days of filing. (b) The National Lifeline Accountability Database. In order to receive Lifeline...

  9. 47 CFR 54.404 - The National Lifeline Accountability Database.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false The National Lifeline Accountability Database... National Lifeline Accountability Database. (a) State certification. An eligible telecommunications carrier... within 90 days of filing. (b) The National Lifeline Accountability Database. In order to receive Lifeline...

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

    PubMed

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

    2016-01-01

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

  11. Diabetes, Frequency of Exercise, and Mortality Over 12 Years: Analysis of the National Health Insurance Service-Health Screening (NHIS-HEALS) Database.

    PubMed

    Shin, Woo Young; Lee, Taehee; Jeon, Da Hye; Kim, Hyeon Chang

    2018-02-19

    The goal of this study was to analyze the relationship between exercise frequency and all-cause mortality for individuals diagnosed with and without diabetes mellitus (DM). We analyzed data for 505,677 participants (53.9% men) in the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort. The study endpoint variable was all-cause mortality. Frequency of exercise and covariates including age, sex, smoking status, household income, blood pressure, fasting glucose, body mass index, total cholesterol, and Charlson comorbidity index were determined at baseline. Cox proportional hazard regression models were developed to assess the effects of exercise frequency (0, 1-2, 3-4, 5-6, and 7 days per week) on mortality, separately in individuals with and without DM. We found a U-shaped association between exercise frequency and mortality in individuals with and without DM. However, the frequency of exercise associated with the lowest risk of all-cause mortality was 3-4 times per week (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.65-0.73) in individuals without DM, and 5-6 times per week in those with DM (HR, 0.93; 95% CI, 0.78-1.10). A moderate frequency of exercise may reduce mortality regardless of the presence or absence of DM; however, when compared to those without the condition, people with DM may need to exercise more often. © 2018 The Korean Academy of Medical Sciences.

  12. Diabetes, Frequency of Exercise, and Mortality Over 12 Years: Analysis of the National Health Insurance Service-Health Screening (NHIS-HEALS) Database

    PubMed Central

    2018-01-01

    Background The goal of this study was to analyze the relationship between exercise frequency and all-cause mortality for individuals diagnosed with and without diabetes mellitus (DM). Methods We analyzed data for 505,677 participants (53.9% men) in the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort. The study endpoint variable was all-cause mortality. Results Frequency of exercise and covariates including age, sex, smoking status, household income, blood pressure, fasting glucose, body mass index, total cholesterol, and Charlson comorbidity index were determined at baseline. Cox proportional hazard regression models were developed to assess the effects of exercise frequency (0, 1–2, 3–4, 5–6, and 7 days per week) on mortality, separately in individuals with and without DM. We found a U-shaped association between exercise frequency and mortality in individuals with and without DM. However, the frequency of exercise associated with the lowest risk of all-cause mortality was 3–4 times per week (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.65–0.73) in individuals without DM, and 5–6 times per week in those with DM (HR, 0.93; 95% CI, 0.78–1.10). Conclusion A moderate frequency of exercise may reduce mortality regardless of the presence or absence of DM; however, when compared to those without the condition, people with DM may need to exercise more often. PMID:29441753

  13. EPA U.S. NATIONAL MARKAL DATABASE: DATABASE DOCUMENTATION

    EPA Science Inventory

    This document describes in detail the U.S. Energy System database developed by EPA's Integrated Strategic Assessment Work Group for use with the MARKAL model. The group is part of the Office of Research and Development and is located in the National Risk Management Research Labor...

  14. National Transportation Atlas Databases : 2014

    DOT National Transportation Integrated Search

    2014-01-01

    The National Transportation Atlas Databases 2014 : (NTAD2014) is a set of nationwide geographic datasets of : transportation facilities, transportation networks, associated : infrastructure, and other political and administrative entities. : These da...

  15. National Transportation Atlas Databases : 2015

    DOT National Transportation Integrated Search

    2015-01-01

    The National Transportation Atlas Databases 2015 : (NTAD2015) is a set of nationwide geographic datasets of : transportation facilities, transportation networks, associated : infrastructure, and other political and administrative entities. : These da...

  16. New Zealand's National Landslide Database

    NASA Astrophysics Data System (ADS)

    Rosser, B.; Dellow, S.; Haubrook, S.; Glassey, P.

    2016-12-01

    Since 1780, landslides have caused an average of about 3 deaths a year in New Zealand and have cost the economy an average of at least NZ$250M/a (0.1% GDP). To understand the risk posed by landslide hazards to society, a thorough knowledge of where, when and why different types of landslides occur is vital. The main objective for establishing the database was to provide a centralised national-scale, publically available database to collate landslide information that could be used for landslide hazard and risk assessment. Design of a national landslide database for New Zealand required consideration of both existing landslide data stored in a variety of digital formats, and future data, yet to be collected. Pre-existing databases were developed and populated with data reflecting the needs of the landslide or hazard project, and the database structures of the time. Bringing these data into a single unified database required a new structure capable of storing and delivering data at a variety of scales and accuracy and with different attributes. A "unified data model" was developed to enable the database to hold old and new landslide data irrespective of scale and method of capture. The database contains information on landslide locations and where available: 1) the timing of landslides and the events that may have triggered them; 2) the type of landslide movement; 3) the volume and area; 4) the source and debris tail; and 5) the impacts caused by the landslide. Information from a variety of sources including aerial photographs (and other remotely sensed data), field reconnaissance and media accounts has been collated and is presented for each landslide along with metadata describing the data sources and quality. There are currently nearly 19,000 landslide records in the database that include point locations, polygons of landslide source and deposit areas, and linear features. Several large datasets are awaiting upload which will bring the total number of landslides to

  17. National Transportation Atlas Databases : 2013

    DOT National Transportation Integrated Search

    2013-01-01

    The National Transportation Atlas Databases 2013 (NTAD2013) is a set of nationwide geographic datasets of transportation facilities, transportation networks, associated infrastructure, and other political and administrative entities. These datasets i...

  18. National Databases for Neurosurgical Outcomes Research: Options, Strengths, and Limitations.

    PubMed

    Karhade, Aditya V; Larsen, Alexandra M G; Cote, David J; Dubois, Heloise M; Smith, Timothy R

    2017-08-05

    Quality improvement, value-based care delivery, and personalized patient care depend on robust clinical, financial, and demographic data streams of neurosurgical outcomes. The neurosurgical literature lacks a comprehensive review of large national databases. To assess the strengths and limitations of various resources for outcomes research in neurosurgery. A review of the literature was conducted to identify surgical outcomes studies using national data sets. The databases were assessed for the availability of patient demographics and clinical variables, longitudinal follow-up of patients, strengths, and limitations. The number of unique patients contained within each data set ranged from thousands (Quality Outcomes Database [QOD]) to hundreds of millions (MarketScan). Databases with both clinical and financial data included PearlDiver, Premier Healthcare Database, Vizient Clinical Data Base and Resource Manager, and the National Inpatient Sample. Outcomes collected by databases included patient-reported outcomes (QOD); 30-day morbidity, readmissions, and reoperations (National Surgical Quality Improvement Program); and disease incidence and disease-specific survival (Surveillance, Epidemiology, and End Results-Medicare). The strengths of large databases included large numbers of rare pathologies and multi-institutional nationally representative sampling; the limitations of these databases included variable data veracity, variable data completeness, and missing disease-specific variables. The improvement of existing large national databases and the establishment of new registries will be crucial to the future of neurosurgical outcomes research. Copyright © 2017 by the Congress of Neurological Surgeons

  19. Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems.

    PubMed

    Anazawa, Takayuki; Paruch, Jennifer L; Miyata, Hiroaki; Gotoh, Mitsukazu; Ko, Clifford Y; Cohen, Mark E; Hirahara, Norimichi; Zhou, Lynn; Konno, Hiroyuki; Wakabayashi, Go; Sugihara, Kenichi; Mori, Masaki

    2015-12-01

    International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD).Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population.We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACS-NSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries.We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement.

  20. 2008 rural national transit database

    DOT National Transportation Integrated Search

    2008-01-01

    This spreadsheet includes the following data from the 2008 Rural National Transit Database: : > Sub-Recipient Information : > Service Data : > Revenue Vehicle Inventory : > Counties Served : Each one of the categories above are in worksheets within t...

  1. The National Land Cover Database

    USGS Publications Warehouse

    Homer, Collin G.; Fry, Joyce A.; Barnes, Christopher A.

    2012-01-01

    The National Land Cover Database (NLCD) serves as the definitive Landsat-based, 30-meter resolution, land cover database for the Nation. NLCD provides spatial reference and descriptive data for characteristics of the land surface such as thematic class (for example, urban, agriculture, and forest), percent impervious surface, and percent tree canopy cover. NLCD supports a wide variety of Federal, State, local, and nongovernmental applications that seek to assess ecosystem status and health, understand the spatial patterns of biodiversity, predict effects of climate change, and develop land management policy. NLCD products are created by the Multi-Resolution Land Characteristics (MRLC) Consortium, a partnership of Federal agencies led by the U.S. Geological Survey. All NLCD data products are available for download at no charge to the public from the MRLC Web site: http://www.mrlc.gov.

  2. Comparison of the Mortality Probability Admission Model III, National Quality Forum, and Acute Physiology and Chronic Health Evaluation IV hospital mortality models: implications for national benchmarking*.

    PubMed

    Kramer, Andrew A; Higgins, Thomas L; Zimmerman, Jack E

    2014-03-01

    To examine the accuracy of the original Mortality Probability Admission Model III, ICU Outcomes Model/National Quality Forum modification of Mortality Probability Admission Model III, and Acute Physiology and Chronic Health Evaluation IVa models for comparing observed and risk-adjusted hospital mortality predictions. Retrospective paired analyses of day 1 hospital mortality predictions using three prognostic models. Fifty-five ICUs at 38 U.S. hospitals from January 2008 to December 2012. Among 174,001 intensive care admissions, 109,926 met model inclusion criteria and 55,304 had data for mortality prediction using all three models. None. We compared patient exclusions and the discrimination, calibration, and accuracy for each model. Acute Physiology and Chronic Health Evaluation IVa excluded 10.7% of all patients, ICU Outcomes Model/National Quality Forum 20.1%, and Mortality Probability Admission Model III 24.1%. Discrimination of Acute Physiology and Chronic Health Evaluation IVa was superior with area under receiver operating curve (0.88) compared with Mortality Probability Admission Model III (0.81) and ICU Outcomes Model/National Quality Forum (0.80). Acute Physiology and Chronic Health Evaluation IVa was better calibrated (lowest Hosmer-Lemeshow statistic). The accuracy of Acute Physiology and Chronic Health Evaluation IVa was superior (adjusted Brier score = 31.0%) to that for Mortality Probability Admission Model III (16.1%) and ICU Outcomes Model/National Quality Forum (17.8%). Compared with observed mortality, Acute Physiology and Chronic Health Evaluation IVa overpredicted mortality by 1.5% and Mortality Probability Admission Model III by 3.1%; ICU Outcomes Model/National Quality Forum underpredicted mortality by 1.2%. Calibration curves showed that Acute Physiology and Chronic Health Evaluation performed well over the entire risk range, unlike the Mortality Probability Admission Model and ICU Outcomes Model/National Quality Forum models. Acute

  3. [National Database of Genotypes--ethical and legal issues].

    PubMed

    Franková, Vera; Tesínová, Jolana; Brdicka, Radim

    2011-01-01

    National Database of Genotypes--ethical and legal issues The aim of the project National Database of Genotypes is to outline structure and rules for the database operation collecting information about genotypes of individual persons. The database should be used entirely for health care. Its purpose is to enable physicians to gain quick and easy access to the information about persons requiring specialized care due to their genetic constitution. In the future, another introduction of new genetic tests into the clinical practice can be expected thus the database of genotypes facilitates substantial financial savings by exclusion of duplicates of the expensive genetic testing. Ethical questions connected with the creating and functioning of such database concern mainly privacy protection, confidentiality of personal sensitive data, protection of database from misuse, consent with participation and public interests. Due to necessity of correct interpretation by qualified professional (= clinical geneticist), particular categorization of genetic data within the database is discussed. The function of proposed database has to be governed in concordance with the Czech legislation together with solving ethical problems.

  4. Mortality experience of the 1986-2000 National Health Interview Survey Linked Mortality Files participants.

    PubMed

    Ingram, Deborah D; Lochner, Kimberly A; Cox, Christine S

    2008-10-01

    The National Center for Health Statistics (NCHS) has produced the 1986-2000 National Health Interview Survey (NHIS) Linked Mortality Files by linking eligible adults in the 1986-2000 NHIS cohorts through probabilistic record linkage to the National Death Index to obtain mortality follow-up through December 31, 2002. The resulting files contain more than 120,000 deaths and an average of 9 years of survival time. To assess how well mortality was ascertained in the linked mortality files, NCHS has conducted a comparison of the mortality experience of the 1986-2000 NHIS cohorts with that of the U.S. population. This report presents the results of this comparative mortality assessment. Methods The survival of each annual NHIS cohort was compared with that of the U.S. population during the same period. Cumulative survival probabilities for each annual NHIS cohort were derived using the Kaplan-Meier product limit method, and corresponding cumulative survival probabilities were computed for the U.S. population using information from annual U.S. life tables. The survival probabilities were calculated at various lengths of follow-up for each age-race-sex group of each NHIS cohort and for the U.S. population. Results As expected, mortality tended to be underestimated in the NHIS cohorts because the sample includes only civilian, noninstitutionalized persons, but this underestimation generally was not statistically significant. Statistically significant differences increased with length of follow-up, occurred more often for white females than for the other race-sex groups, and occurred more often in the oldest age groups. In general, the survival experience of the age-race-sex groups of each NHIS cohort corresponds quite closely to that of the U.S. population, providing support that the ascertainment of mortality through the probabilistic record linkage accurately reflects the mortality experience of the NHIS cohorts.

  5. The National Hospital Discharge Survey and Nationwide Inpatient Sample: the databases used affect results in THA research.

    PubMed

    Bekkers, Stijn; Bot, Arjan G J; Makarawung, Dennis; Neuhaus, Valentin; Ring, David

    2014-11-01

    The National Hospital Discharge Survey (NHDS) and the Nationwide Inpatient Sample (NIS) collect sample data and publish annual estimates of inpatient care in the United States, and both are commonly used in orthopaedic research. However, there are important differences between the databases, and because of these differences, asking these two databases the same question may result in different answers. The degree to which this is true for arthroplasty-related research has, to our knowledge, not been characterized. We tested the following null hypotheses: (1) there are no differences between the NHDS and NIS in patient characteristics, comorbidities, and adverse events in patients with hip osteoarthritis treated with THA, and (2) there are no differences between databases in factors associated with inpatient mortality, adverse events, and length of hospital stay after THA. The NHDS and NIS databases use different methods of data collection and weighting to provide data representative of all nonfederal hospital discharges in the United States. In 2006 the NHDS database contained 203,149 patients with hip arthritis treated with hip arthroplasty, and the NIS database included 193,879 patients. Multivariable analyses for factors associated with inpatient mortality, adverse events, and days of care were constructed for each database. We found that 26 of 42 of the factors in demographics, comorbidities, and adverse events after THA in the NIS and NHDS databases differed more than 10%. Age and days of care were associated with inpatient mortality with the NHDS and the NIS although the effect rates differ more than 10%. The NIS identified seven other factors not identified by the NHDS: wound complications, congestive heart failure, new mental disorder, chronic pulmonary disease, dementia, geographic region Northeast, acute postoperative anemia, and sex, that were associated with inpatient mortality even after controlling for potentially confounding variables. For inpatient

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

    PubMed

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

    2015-08-01

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

  7. The National Solar Radiation Database (NSRDB)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sengupta, Manajit; Habte, Aron; Lopez, Anthony

    This presentation provides a high-level overview of the National Solar Radiation Database (NSRDB), including sensing, measurement and forecasting, and discusses observations that are needed for research and product development.

  8. Analysis of mortality in colorectal surgery in the Bi-National Colorectal Cancer Audit.

    PubMed

    Teloken, Patrick Ely; Spilsbury, Katrina; Platell, Cameron

    2016-06-01

    In the last decade, there has been a significant increase in interest for public reporting of outcome data and performance comparison across institutions and surgeons. This study aims at comparing postoperative mortality after colorectal cancer surgery across units and individual consultants in Australia and New Zealand using funnel plots. The Bi-National Colorectal Cancer Audit database was used. Unadjusted and adjusted funnel plots of inpatient mortality were constructed. Risk adjustment was based upon multivariable logistic regression models using purposeful covariate selection. A total of 10 008 patients undergoing surgery for colorectal cancer from 56 surgical units and 90 consultants were identified. Overall inpatient mortality was 1.51%, corresponding to 1.1% for elective and 3.9% for urgent cases. Logistic regression identified age, American Society of Anesthesiologists score, urgent surgery and open surgery to be independently associated with inpatient mortality. Unadjusted and adjusted funnel plot analysis identified three (5.3%) units exceeding the inner limit and none exceeding the outer limit. Six (6.6%) consultants had inpatient mortality between the upper inner and outer limits and one (1.1%) between the inferior inner and outer limits. Upon adjustment, seven (7.7%) consultants had inpatient mortality between the inner and outer limit. Potential limitations of this study include: residual confounding being responsible for the association of open surgery and mortality; incomplete case-mix adjustment resulting in outlier identification; and bias towards inclusion of larger institutions. Mortality figures in Australia and New Zealand are comparable to recently reported international data. The vast majority of units and consultants are performing within the expected boundaries. © 2016 Royal Australasian College of Surgeons.

  9. Traumatic colorectal injuries in children: The National Trauma Database experience.

    PubMed

    Choi, Pamela M; Wallendorf, Michael; Keller, Martin S; Vogel, Adam M

    2017-10-01

    We sought to utilize a nationwide database to characterize colorectal injuries in pediatric trauma. The National Trauma Database (NTDB) was queried for all patients (age≤14years) with colorectal injuries from 2013 to 2014. We stratified patients by demographics and measured outcomes. We analyzed groups based on mechanism, colon vs rectal injury, as well as colostomy creation. Statistical analysis was conducted using t-test and ANOVA for continuous variables as well as chi-square for continuous variables. There were 534 pediatric patients who sustained colorectal trauma. The mean ISS was 15.6±0.6 with an average LOS of 8.5±0.5days. 435 (81.5%) were injured by blunt mechanism while 99 (18.5%) were injured by penetrating mechanism. There were no differences between age, ISS, complications, mortality, LOS, ICU LOS, and ventilator days between blunt and penetrating groups. Significantly more patients in the penetrating group had associated small intestine and hepatic injuries as well as underwent colostomies. Patients with rectal injuries (25.7%) were more likely to undergo colonic diversion (p<0.0001), but also had decreased mortality (p=0.001) and decreased LOS (p=0.01). Patients with colostomies (9.9%) had no differences in age, ISS, GCS, transfusion of blood products, and complications compared to patients who did not receive a colostomy. Despite this, colostomy patients had significantly increased hospital LOS (12.1±1.8 vs 8.2±0.5days, p=0.02) and ICU LOS (9.0±1.7 vs 5.4±0.3days, p=0.02). Although infrequent, colorectal injuries in children are associated with considerable morbidity regardless of mechanism and may be managed without fecal diversion. III. Epidemiology. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. National Water Quality Standards Database (NWQSD)

    EPA Pesticide Factsheets

    The National Water Quality Standards Database (WQSDB) provides access to EPA and state water quality standards (WQS) information in text, tables, and maps. This data source was last updated in December 2007 and will no longer be updated.

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

    PubMed

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

    2016-10-01

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

  12. Unintentional Child and Adolescent Drowning Mortality from 2000 to 2013 in 21 Countries: Analysis of the WHO Mortality Database.

    PubMed

    Wu, Yue; Huang, Yun; Schwebel, David C; Hu, Guoqing

    2017-08-04

    Limited research considers change over time for drowning mortality among individuals under 20 years of age, or the sub-cause (method) of those drownings. We assessed changes in under-20 drowning mortality from 2000 to 2013 among 21 countries. Age-standardized drowning mortality data were obtained through the World Health Organization (WHO) Mortality Database. Twenty of the 21 included countries experienced a reduction in under-20 drowning mortality rate between 2000 and 2013, with decreases ranging from -80 to -13%. Detailed analysis by drowning method presented large variations in the cause of drowning across countries. Data were missing due to unspecified methods in some countries but, when known, drowning in natural bodies of water was the primary cause of child and adolescent drowning in Poland (56-92%), Cuba (53-81%), Venezuela (43-56%), and Japan (39-60%), while drowning in swimming pools and bathtubs was common in the United States (26-37%) and Japan (28-39%), respectively. We recommend efforts to raise the quality of drowning death reporting systems and discuss prevention strategies that may reduce child and adolescent drowning risk, both in individual countries and globally.

  13. The National Nonindigenous Aquatic Species Database

    USGS Publications Warehouse

    Neilson, Matthew E.; Fuller, Pamela L.

    2012-01-01

    The U.S. Geological Survey (USGS) Nonindigenous Aquatic Species (NAS) Program maintains a database that monitors, records, and analyzes sightings of nonindigenous aquatic plant and animal species throughout the United States. The program is based at the USGS Wetland and Aquatic Research Center in Gainesville, Florida.The initiative to maintain scientific information on nationwide occurrences of nonindigenous aquatic species began with the Aquatic Nuisance Species Task Force, created by Congress in 1990 to provide timely information to natural resource managers. Since then, the NAS database has been a clearinghouse of information for confirmed sightings of nonindigenous, also known as nonnative, aquatic species throughout the Nation. The database is used to produce email alerts, maps, summary graphs, publications, and other information products to support natural resource managers.

  14. 45 CFR 1356.80 - Scope of the National Youth in Transition Database.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Scope of the National Youth in Transition Database... REQUIREMENTS APPLICABLE TO TITLE IV-E § 1356.80 Scope of the National Youth in Transition Database. The requirements of the National Youth in Transition Database (NYTD) §§ 1356.81 through 1356.86 of this part apply...

  15. 45 CFR 1356.80 - Scope of the National Youth in Transition Database.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Scope of the National Youth in Transition Database... REQUIREMENTS APPLICABLE TO TITLE IV-E § 1356.80 Scope of the National Youth in Transition Database. The requirements of the National Youth in Transition Database (NYTD) §§ 1356.81 through 1356.86 of this part apply...

  16. 45 CFR 1356.80 - Scope of the National Youth in Transition Database.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Scope of the National Youth in Transition Database... REQUIREMENTS APPLICABLE TO TITLE IV-E § 1356.80 Scope of the National Youth in Transition Database. The requirements of the National Youth in Transition Database (NYTD) §§ 1356.81 through 1356.86 of this part apply...

  17. 45 CFR 1356.80 - Scope of the National Youth in Transition Database.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Scope of the National Youth in Transition Database... REQUIREMENTS APPLICABLE TO TITLE IV-E § 1356.80 Scope of the National Youth in Transition Database. The requirements of the National Youth in Transition Database (NYTD) §§ 1356.81 through 1356.86 of this part apply...

  18. 45 CFR 1356.80 - Scope of the National Youth in Transition Database.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Scope of the National Youth in Transition Database... REQUIREMENTS APPLICABLE TO TITLE IV-E § 1356.80 Scope of the National Youth in Transition Database. The requirements of the National Youth in Transition Database (NYTD) §§ 1356.81 through 1356.86 of this part apply...

  19. Database Dictionary for Ethiopian National Ground-Water DAtabase (ENGDA) Data Fields

    USGS Publications Warehouse

    Kuniansky, Eve L.; Litke, David W.; Tucci, Patrick

    2007-01-01

    Introduction This document describes the data fields that are used for both field forms and the Ethiopian National Ground-water Database (ENGDA) tables associated with information stored about production wells, springs, test holes, test wells, and water level or water-quality observation wells. Several different words are used in this database dictionary and in the ENGDA database to describe a narrow shaft constructed in the ground. The most general term is borehole, which is applicable to any type of hole. A well is a borehole specifically constructed to extract water from the ground; however, for this data dictionary and for the ENGDA database, the words well and borehole are used interchangeably. A production well is defined as any well used for water supply and includes hand-dug wells, small-diameter bored wells equipped with hand pumps, or large-diameter bored wells equipped with large-capacity motorized pumps. Test holes are borings made to collect information about the subsurface with continuous core or non-continuous core and/or where geophysical logs are collected. Test holes are not converted into wells. A test well is a well constructed for hydraulic testing of an aquifer in order to plan a larger ground-water production system. A water-level or water-quality observation well is a well that is used to collect information about an aquifer and not used for water supply. A spring is any naturally flowing, local, ground-water discharge site. The database dictionary is designed to help define all fields on both field data collection forms (provided in attachment 2 of this report) and for the ENGDA software screen entry forms (described in Litke, 2007). The data entered into each screen entry field are stored in relational database tables within the computer database. The organization of the database dictionary is designed based on field data collection and the field forms, because this is what the majority of people will use. After each field, however, the

  20. Risk factors for 30-day postoperative complications and mortality after below-knee amputation: a study of 2,911 patients from the national surgical quality improvement program.

    PubMed

    Belmont, Philip J; Davey, Shaunette; Orr, Justin D; Ochoa, Leah M; Bader, Julia O; Schoenfeld, Andrew J

    2011-09-01

    This investigation sought to evaluate risk factors for morbidity and mortality from a large series of below-knee amputees prospectively entered in a national database. All patients undergoing below-knee amputations in the years 2005-2008 were identified in the database of the National Surgical Quality Improvement Program (NSQIP). Demographic data, medical comorbidities, and medical history were obtained. Mortality and postoperative complications within 30 days of the below-knee amputation were also documented. Chi-square test, univariate, and multivariate logistic regression analyses were used to assess the effect of specific risk factors on mortality, as well as the likelihood of developing major, minor, or any complications developing. Below-knee amputations were performed in 2,911 patients registered in the NSQIP database between 2005 and 2008. The average age of patients was 65.8 years old and 64.3% were male. There was a 7.0% 30-day mortality rate and 1,627 complications occurred in 1,013 patients (34.4%). Multivariate logistic regression analysis identified renal insufficiency, cardiac issues, history of sepsis, steroid use, COPD, and increased patient age as independent predictors of mortality. The most common major complications were return to the operating room (15.6%), wound infection (9.3%), and postoperative sepsis (9.3%). History of sepsis, alcohol use, steroid use, cardiac issues, renal insufficiency, and contaminated/infected wounds were independent predictors of one or more complications developing. Renal disease, cardiac issues, history of sepsis, steroid use, COPD, and increased patient age were identified as predictors of mortality after below-knee amputation. Renal disease, cardiac issues, history of sepsis, steroid use, contaminated/infected wounds, and alcohol use were also found to be predictors of postoperative complications. Published by Elsevier Inc.

  1. Neonatal Mortality and Inequalities in Bangladesh: Differential Progress and Sub-national Developments.

    PubMed

    Minnery, Mark; Firth, Sonja; Hodge, Andrew; Jimenez-Soto, Eliana

    2015-09-01

    A rapid reduction in under-five mortality has put Bangladesh on-track to reach Millennium Development Goal 4. Little research, however, has been conducted into neonatal reductions and sub-national rates in the country, with considerable disparities potentially masked by national reductions. The aim of this paper is to estimate national and sub-national rates of neonatal mortality to compute relative and absolute inequalities between sub-national groups and draw comparisons with rates of under-five mortality. Mortality rates for under-five children and neonates were estimated directly for 1980-1981 to 2010-2011 using data from six waves of the Demographic and Health Survey. Rates were stratified by levels of rural/urban location, household wealth and maternal education. Absolute and relative inequalities within these groups were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. National mortality was shown to have decreased dramatically although at differential rates for under-fives and neonates. Across all equity markers, a general pattern of declining absolute but constant relative inequalities was found. For mortality rates stratified by education and wealth mixed evidence suggests that relative inequalities may have also fallen. Although disparities remain, Bangladesh has achieved a rare combination of substantive reductions in mortality levels without increases in relative inequalities. A coalescence of substantial increases in coverage and equitable distribution of key child and neonatal interventions with widespread health sectoral and policy changes over the last 30 years may in part explain this exceptional pattern.

  2. The National State Policy Database. Quick Turn Around (QTA).

    ERIC Educational Resources Information Center

    Ahearn, Eileen; Jackson, Terry

    This paper describes the National State Policy Database (NSPD), a full-text searchable database of state and federal education regulations for special education. It summarizes the history of the NSPD and reports on a survey of state directors or their designees as to their use of the database and their suggestions for its future expansion. The…

  3. Forecasting sex differences in mortality in high income nations: The contribution of smoking

    PubMed Central

    Pampel, Fred

    2011-01-01

    To address the question of whether sex differences in mortality will in the future rise, fall, or stay the same, this study uses relative smoking prevalence among males and females to forecast future changes in relative smoking-attributed mortality. Data on 21 high income nations from 1975 to 2000 and a lag between smoking prevalence and mortality allow forecasts up to 2020. Averaged across nations, the results for logged male/female ratios in smoking mortality reveal equalization of the sex differential. However, continued divergence in non-smoking mortality rates would counter convergence in smoking mortality rates and lead to future increases in the female advantage overall, particularly in nations at late stages of the cigarette epidemic (such as the United States and the United Kingdom). PMID:21874120

  4. National Administrative Databases in Adult Spinal Deformity Surgery: A Cautionary Tale.

    PubMed

    Buckland, Aaron J; Poorman, Gregory; Freitag, Robert; Jalai, Cyrus; Klineberg, Eric O; Kelly, Michael; Passias, Peter G

    2017-08-15

    Comparison between national administrative databases and a prospective multicenter physician managed database. This study aims to assess the applicability of National Administrative Databases (NADs) in adult spinal deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement. These databases utilize billing codes, not clinical inclusion criteria, and have not been validated against PMDs in ASD surgery. The NIS was searched for years 2002 to 2012 and NSQIP for years 2006 to 2013 using validated spinal deformity diagnostic codes. Procedural codes (ICD-9 and CPT) were then applied to each database. A multicenter PMD including years 2008 to 2015 was used for comparison. Databases were assessed for levels fused, osteotomies, decompressed levels, and invasiveness. Database comparisons for surgical details were made in all patients, and also for patients with ≥ 5 level spinal fusions. Approximately, 37,368 NIS, 1291 NSQIP, and 737 PMD patients were identified. NADs showed an increased use of deformity billing codes over the study period (NIS doubled, 68x NSQIP, P < 0.001), but ASD remained stable in the PMD.Surgical invasiveness, levels fused and use of 3-column osteotomy (3-CO) were significantly lower for all patients in the NIS (11.4-13.7) and NSQIP databases (6.4-12.7) compared with PMD (27.5-32.3). When limited to patients with ≥5 levels, invasiveness, levels fused, and use of 3-CO remained significantly higher in the PMD compared with NADs (P < 0.001). National databases NIS and NSQIP do not capture the same patient population as is captured in PMDs in ASD. Physicians should remain cautious in interpreting conclusions drawn from these databases

  5. Perioperative Mortality, 2010 to 2014: A Retrospective Cohort Study Using the National Anesthesia Clinical Outcomes Registry.

    PubMed

    Whitlock, Elizabeth L; Feiner, John R; Chen, Lee-Lynn

    2015-12-01

    The National Anesthesia Clinical Outcomes Registry collects demographic and outcome data from anesthesia cases, with the goal of improving safety and quality across the specialty. The authors present a preliminary analysis of the National Anesthesia Clinical Outcomes Registry database focusing on the rates of and associations with perioperative mortality (within 48 h of anesthesia induction). The authors retrospectively analyzed 2,948,842 cases performed between January 1, 2010, and May 31, 2014. Cases without procedure information and vaginal deliveries were excluded. Mortality and other outcomes were reported by the anesthesia provider. Hierarchical logistic regression was performed on cases with complete information for patient age group, sex, American Society of Anesthesiologists physical status, emergency case status, time of day, and surgery type, controlling for random effects within anesthesia practices. The final analysis included 2,866,141 cases and 944 deaths (crude mortality rate, 33 per 100,000). Increasing American Society of Anesthesiologists physical status, emergency case status, cases beginning between 4:00 PM and 6:59 AM, and patient age less than 1 yr or greater than or equal to 65 yr were independently associated with higher perioperative mortality. A post hoc subgroup analysis of 279,154 patients limited to 22 elective case types, post hoc models incorporating either more granular estimate of surgical risk or work relative value units, and a post hoc propensity score-matched cohort confirmed the association with time of day. Several factors were associated with increased perioperative mortality. A case start time after 4:00 PM was associated with an adjusted odds ratio of 1.64 (95% CI, 1.22 to 2.21) for perioperative death, which suggests a potentially modifiable target for perioperative risk reduction. Limitations of this study include nonstandardized mortality reporting and limited ability to adjust for missing data.

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

    PubMed

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

    2017-02-02

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

  7. WHipple-ABACUS, a simple, validated risk score for 30-day mortality after pancreaticoduodenectomy developed using the ACS-NSQIP database.

    PubMed

    Gleeson, Elizabeth M; Shaikh, Mohammad F; Shewokis, Patricia A; Clarke, John R; Meyers, William C; Pitt, Henry A; Bowne, Wilbur B

    2016-11-01

    Pancreaticoduodenectomy needs simple, validated risk models to better identify 30-day mortality. The goal of this study is to develop a simple risk score to predict 30-day mortality after pancreaticoduodenectomy. We reviewed cases of pancreaticoduodenectomy from 2005-2012 in the American College of Surgeons-National Surgical Quality Improvement Program databases. Logistic regression was used to identify preoperative risk factors for morbidity and mortality from a development cohort. Scores were created using weighted beta coefficients, and predictive accuracy was assessed on the validation cohort using receiver operator characteristic curves and measuring area under the curve. The 30-day mortality rate was 2.7% for patients who underwent pancreaticoduodenectomy (n = 14,993). We identified 8 independent risk factors. The score created from weighted beta coefficients had an area under the curve of 0.71 (95% confidence interval, 0.66-0.77) on the validation cohort. Using the score WHipple-ABACUS (hypertension With medication + History of cardiac surgery + Age >62 + 2 × Bleeding disorder + Albumin <3.5 g/dL + 2 × disseminated Cancer + 2 × Use of steroids + 2 × Systemic inflammatory response syndrome), mortality rates increase with increasing score (P < .001). While other risk scores exist for 30-day mortality after pancreaticoduodenectomy, we present a simple, validated score developed using exclusively preoperative predictors surgeons could use to identify patients at risk for this procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Brief Report: Rheumatoid Arthritis as the Underlying Cause of Death in Thirty-One Countries, 1987-2011: Trend Analysis of World Health Organization Mortality Database.

    PubMed

    Kiadaliri, Aliasghar A; Felson, David T; Neogi, Tuhina; Englund, Martin

    2017-08-01

    To examine trends in rheumatoid arthritis (RA) as an underlying cause of death (UCD) in 31 countries across the world from 1987 to 2011. Data on mortality and population were collected from the World Health Organization mortality database and from the United Nations Population Prospects database. Age-standardized mortality rates (ASMRs) were calculated by means of direct standardization. We applied joinpoint regression analysis to identify trends. Between-country disparities were examined using between-country variance and the Gini coefficient. Due to low numbers of deaths, we smoothed the ASMRs using a 3-year moving average. Changes in the number of RA deaths between 1987 and 2011 were decomposed using 2 counterfactual scenarios. The absolute number of deaths with RA registered as the UCD decreased from 9,281 (0.12% of all-cause deaths) in 1987 to 8,428 (0.09% of all-cause deaths) in 2011. The mean ASMR decreased from 7.1 million person-years in 1987-1989 to 3.7 million person-years in 2009-2011 (48.2% reduction). A reduction of ≥25% in the ASMR occurred in 21 countries, while a corresponding increase was observed in 3 countries. There was a persistent reduction in RA mortality, and on average, the ASMR declined by 3.0% per year. The absolute and relative between-country disparities decreased during the study period. The rates of mortality attributable to RA have declined globally. However, we observed substantial between-country disparities in RA mortality, although these disparities decreased over time. Population aging combined with a decline in RA mortality may lead to an increase in the economic burden of disease that should be taken into consideration in policy-making. © 2017, American College of Rheumatology.

  9. Cross-National Trends in Mortality Rates among the Elderly.

    ERIC Educational Resources Information Center

    Myers, GeorgeC.

    1978-01-01

    An examination of death rates among the elderly and trends over the period 1950-1975 and 1970-1975 for selected developed nations provides evidence of continued strong mortality declines for females and somewhat mixed results for males. Implications of these trends for forecasting the mortality component of U.S. population projections are…

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

    PubMed

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

    2016-05-01

    Little is known about the risk factors of suicide mortality among multiple attempters. This study aims to investigate the predictors of suicidal mortality in a prospective cohort of attempters in Taiwan, focusing on the time interval and suicide method change between the last two nonfatal attempts. The representative data retrieved from the National Suicide Surveillance System (NSSS) was linked with National Mortality Database to identify the causes of death in multiple attempters during 2006-2008. Cox-proportional hazard models were applied to calculate the hazard ratios for the predictors of suicide. Among the 55,560 attempters, 6485 (11.7%) had survived attempts ranging from one to 11 times; 861 (1.5%) eventually died by suicide. Multiple attempters were characterized by female (OR = 1.56, p < 0.0001), nonrecipient of national aftercare service (OR = 1.62, p < 0.0001), and current contact with mental health services (OR = 3.17, p < 0.0001). Most multiple attempters who survived from hanging (68.1%) and gas poisoning (61.9%) chose the same method in the following fatal episode. Predictors of suicidal death were identified as male, older age (≥ 45 years), shorter interval and not maintaining methods of low lethality in the last two nonfatal attempts. Receipt of nationwide aftercare was associated with lower risk of suicide but the effect was insignificant. The time interval of the last two nonfatal attempts and alteration in the lethality of suicide method were significant factors for completed suicide. Risk assessment involving these two factors may be necessary for multiple attempters in different clinical settings. Effective strategies for suicide prevention emphasizing this high risk population should be developed in the future. Copyright © 2015. Published by Elsevier B.V.

  11. Clinical features and practice patterns of gastroschisis: a retrospective analysis using a Japanese national inpatient database.

    PubMed

    Fujiogi, Michimasa; Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Fujishiro, Jun

    2018-05-16

    The number of infants with gastroschisis is increasing worldwide, but advances in neonatal intensive care and parenteral nutrition have reduced gastroschisis mortality. Recent clinical data on gastroschisis are often from Western nations. This study aimed to examine clinical features and practice patterns of gastroschisis in Japan. We examined treatment options, outcomes, and discharge status among inpatients with simple gastroschisis (SG) and complex gastroschisis (CG), 2010-2016, using a national inpatient database in Japan. The 247 eligible patients (222 with SG) had average birth weight of 2102 g and average gestational age of 34 weeks; 30% had other congenital anomalies. Digestive anomalies were most common, followed by circulatory anomalies. In-hospital mortality was 8.1%. The median age at start of full enteral feeding was 30 days. The median length of stay was 46 days. There were no significant differences in outcomes except for length of stay, starting full enteral feeding and total hospitalization costs between the SG and CG groups. About 80% of patients were discharged to home without home medical care. The readmission rate was 28%. This study's findings on the clinical characteristics and outcomes of gastroschisis are useful for the clinical management of gastroschisis.

  12. Effects of employment and education on preterm and full-term infant mortality in Korea.

    PubMed

    Ko, Y-J; Shin, S-H; Park, S M; Kim, H-S; Lee, J-Y; Kim, K H; Cho, B

    2014-03-01

    The infant mortality rate is a sensitive and commonly used indicator of the socio-economic status of a population. Generally, studies investigating the relationship between infant mortality and socio-economic status have focused on full-term infants in Western populations. This study examined the effects of education level and employment status on full-term and preterm infant mortality in Korea. Data were collected from the National Birth Registration Database and merged with data from the National Death Certification Database. Prospective cohort study. In total, 1,316,184 singleton births registered in Korea's National Birth Registration Database between January 2004 and December 2006 were included in the study. Multivariate logistic regression analysis was performed. Paternal and maternal education levels were inversely related to infant mortality in preterm and full-term infants following multivariate adjusted logistic models. Parental employment status was not associated with infant mortality in full-term infants, but was associated with infant mortality in preterm infants, after adjusting for place of birth, gender, marital status, paternal age, maternal age and parity. Low paternal and maternal education levels were found to be associated with infant mortality in both full-term and preterm infants. Low parental employment status was found to be associated with infant mortality in preterm infants but not in full-term infants. In order to reduce inequalities in infant mortality, public health interventions should focus on providing equal access to education. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. Disparities in suicide mortality trends between United States of America and 25 European countries: retrospective analysis of WHO mortality database

    PubMed Central

    Fond, Guillaume; Llorca, Pierre-Michel; Boucekine, Mohamed; Zendjidjian, Xavier; Brunel, Lore; Lancon, Christophe; Auquier, Pascal; Boyer, Laurent

    2016-01-01

    The objective was to examine changes in temporal trends in suicide mortality in 26 Western countries by retrospective trend analysis of the WHO mortality database on causes of deaths. From 1990 to 2010, there was a median reduction in suicide mortality of 22.7%, ranging from a 46% reduction in Estonia to a 26.2% increase in Romania. Suicide mortality decreased by ≥20% in 15 countries, and the reduction tended to be greater in countries with higher mortality in 1990. In most of the central European countries mortality strongly declined. The median changes in the age groups were −25.3% (range −62.9% to 72.6%) in people aged 15–24 years, −36.9% (−60.5% to 32.4%) in 25–34 years, −3.6% (−57.1% to 92%) in 35–54 years, −12.2% (−37% to 65,7%) in 55–74 years and −16.1% (−54.5% to 166.7%) in ≥75 years. Suicide prevention programs in youths and in the elderly seem to be effective (at least in females for the elderly) and efforts should be pursued in this way. However, suicide mortality of the people aged 35–54 years has increased in half of the studied countries between 1990 and 2010. Public policies should further orientate their efforts toward this population. PMID:26883796

  14. Variations in data collection methods between national databases affect study results: a comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures.

    PubMed

    Bohl, Daniel D; Russo, Glenn S; Basques, Bryce A; Golinvaux, Nicholas S; Fu, Michael C; Long, William D; Grauer, Jonathan N

    2014-12-03

    There has been an increasing use of national databases to conduct orthopaedic research. Questions regarding the validity and consistency of these studies have not been fully addressed. The purpose of this study was to test for similarity in reported measures between two national databases commonly used for orthopaedic research. A retrospective cohort study of patients undergoing lumbar spinal fusion procedures during 2009 to 2011 was performed in two national databases: the Nationwide Inpatient Sample and the National Surgical Quality Improvement Program. Demographic characteristics, comorbidities, and inpatient adverse events were directly compared between databases. The total numbers of patients included were 144,098 from the Nationwide Inpatient Sample and 8434 from the National Surgical Quality Improvement Program. There were only small differences in demographic characteristics between the two databases. There were large differences between databases in the rates at which specific comorbidities were documented. Non-morbid obesity was documented at rates of 9.33% in the Nationwide Inpatient Sample and 36.93% in the National Surgical Quality Improvement Program (relative risk, 0.25; p < 0.05). Peripheral vascular disease was documented at rates of 2.35% in the Nationwide Inpatient Sample and 0.60% in the National Surgical Quality Improvement Program (relative risk, 3.89; p < 0.05). Similarly, there were large differences between databases in the rates at which specific inpatient adverse events were documented. Sepsis was documented at rates of 0.38% in the Nationwide Inpatient Sample and 0.81% in the National Surgical Quality Improvement Program (relative risk, 0.47; p < 0.05). Acute kidney injury was documented at rates of 1.79% in the Nationwide Inpatient Sample and 0.21% in the National Surgical Quality Improvement Program (relative risk, 8.54; p < 0.05). As database studies become more prevalent in orthopaedic surgery, authors, reviewers, and readers should

  15. Belgian health-related data in three international databases

    PubMed Central

    2011-01-01

    Aims of the study This study wants to examine the availability of Belgian healthcare data in the three main international health databases: the World Health Organization European Health for All Database (WHO-HFA), the Organisation for Economic Co-operation and Development Health Data 2009 and EUROSTAT. Methods For the indicators present in the three databases, the availability of Belgian data and the source of these data were checked. Main findings The most important problem concerning the availability of Belgian health-related data in the three major international databases is the lack of recent data. Recent data are available for 27% of the indicators of the WHO-HFA database, 73% of the OECD Health Data, and for half of the Eurostat indicators. Especially recent data about health status (including mortality-based indicators) are lacking. Discussion Only the availability of the health-related data is studied in this article. The quality of the Belgian data is however also important to examine. The main problem concerning the availability of health data is the timeliness. One of the causes of this lack of (especially mortality) data is the reform of the Belgian State. Nowadays mortality data are provided by the communities. This results in a delay in the delivery of national mortality data. However several efforts are made to catch up. PMID:22958554

  16. 76 FR 30997 - National Transit Database: Amendments to Urbanized Area Annual Reporting Manual

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... Transit Database: Amendments to Urbanized Area Annual Reporting Manual AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice of Amendments to 2011 National Transit Database Urbanized Area Annual... Administration's (FTA) 2011 National Transit Database (NTD) Urbanized Area Annual Reporting Manual (Annual Manual...

  17. A pancreaticoduodenectomy risk model derived from 8575 cases from a national single-race population (Japanese) using a web-based data entry system: the 30-day and in-hospital mortality rates for pancreaticoduodenectomy.

    PubMed

    Kimura, Wataru; Miyata, Hiroaki; Gotoh, Mitsukazu; Hirai, Ichiro; Kenjo, Akira; Kitagawa, Yuko; Shimada, Mitsuo; Baba, Hideo; Tomita, Naohiro; Nakagoe, Tohru; Sugihara, Kenichi; Mori, Masaki

    2014-04-01

    To create a mortality risk model after pancreaticoduodenectomy (PD) using a Web-based national database system. PD is a major gastroenterological surgery with relatively high mortality. Many studies have reported factors to analyze short-term outcomes. After initiation of National Clinical Database, approximately 1.2 million surgical cases from more than 3500 Japanese hospitals were collected through a Web-based data entry system. After data cleanup, 8575 PD patients (mean age, 68.2 years) recorded in 2011 from 1167 hospitals were analyzed using variables and definitions almost identical to those of American College of Surgeons-National Surgical Quality Improvement Program. The 30-day postoperative and in-hospital mortality rates were 1.2% and 2.8% (103 and 239 patients), respectively. Thirteen significant risk factors for in-hospital mortality were identified: age, respiratory distress, activities of daily living within 30 days before surgery, angina, weight loss of more than 10%, American Society of Anesthesiologists class of greater than 3, Brinkman index of more than 400, body mass index of more than 25 kg/m, white blood cell count of more than 11,000 cells per microliter, platelet count of less than 120,000 per microliter, prothrombin time/international normalized ratio of more than 1.1, activated partial thromboplastin time of more than 40 seconds, and serum creatinine levels of more than 3.0 mg/dL. Five variables, including male sex, emergency surgery, chronic obstructive pulmonary disease, bleeding disorders, and serum urea nitrogen levels of less than 8.0 mg/dL, were independent variables in the 30-day mortality group. The overall PD complication rate was 40.0%. Grade B and C pancreatic fistulas in the International Study Group on Pancreatic Fistula occurred in 13.2% cases. The 30-day and in-hospital mortality rates for pancreatic cancer were significantly lower than those for nonpancreatic cancer. We conducted the reported risk stratification study for PD

  18. Mortality in a teaching hospital during junior doctor changeover: a regional and national comparison.

    PubMed

    Sharma, Vijay; Proctor, Ian; Winstanley, Alison

    2013-03-01

    Concerns about whether the junior doctor changeover in the UK is associated with an increased risk of death have been reawakened by a retrospective study (Jen et al, 2009). Examination of overall mortality data has consistently failed to demonstrate any increase in mortality during the changeover. However, regional and national trends may mask this increase, so a study was undertaken to compare mortality in a busy London teaching hospital with regional and national trends. No evidence of an increase in mortality in August was found for any of the time periods examined, even after comparison with regional and national trends. The authors conclude that examination of overall mortality data is a blunt and impractical instrument for settling the question of whether an increase in morbidity and mortality occurs. Preventable morbidity and mortality should be audited.

  19. Subsequent mortality after hyperglycemic crisis episode in the non-elderly: a national population-based cohort study.

    PubMed

    Kao, Yuan; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2016-01-01

    Hyperglycemic crisis episodes (HCEs)-diabetic ketoacidosis and the hyperosmolar hyperglycemic state-are the most serious acute metabolic complications of diabetes. We aimed to investigate the subsequent mortality after HCE in the non-elderly diabetic which is still unclear. This retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 23,079 non-elder patients (≤65 years) with new-onset diabetes between 2000 and 2002: 7693 patients with HCE and 15,386 patients without HCE (1:2). Both groups were compared, and follow-up prognoses were done until 2011. One thousand eighty-five (14.1%) patients with HCE and 725 (4.71%) patients without HCE died (P < 0.0001) during follow-up. Incidence rate ratios (IRR) of mortality were 3.24 times higher in patients with HCE than in patients without HCE (P < 0.0001). Individual analysis of diabetic ketoacidosis and hyperosmolar hyperglycemic state also showed the similar result with combination of both. After stratification by age, mortality was significant higher in the middle age (40-64 years) [IRR 3.29; 95% confidence interval (CI) 2.98-3.64] and young adult (18-39 years) (IRR 3.91; 95% CI 3.28-4.66), but not in the pediatric subgroup (<18 years) (IRR 1.28; 95% CI 0.21-7.64). The mortality risk was highest in the first month (IRR 54.43; 95% CI 27.98-105.89), and still high after 8 years (IRR 2.05; 95% CI 1.55-2.71). After adjusting for age, gender, and selected comorbidities, the mortality hazard ratio for patients with HCE was still four times higher than for patients without HCE. Moreover, older age, male gender, stroke, cancer, chronic obstructive pulmonary disease, congestive heart failure, and liver disease were independent mortality predictors. HCE significantly increases the subsequent mortality risk in the non-elderly with diabetes. Strategies for prevention and control of comorbidities are needed as soon as possible.

  20. Database Software Selection for the Egyptian National STI Network.

    ERIC Educational Resources Information Center

    Slamecka, Vladimir

    The evaluation and selection of information/data management system software for the Egyptian National Scientific and Technical (STI) Network are described. An overview of the state-of-the-art of database technology elaborates on the differences between information retrieval and database management systems (DBMS). The desirable characteristics of…

  1. An Audit of the Irish National Intellectual Disability Database

    ERIC Educational Resources Information Center

    Dodd, Philip; Craig, Sarah; Kelly, Fionnola; Guerin, Suzanne

    2010-01-01

    This study describes a national data audit of the National Intellectual Disability Database (NIDD). The NIDD is a national information system for intellectual disability (ID) for Ireland. The purpose of this audit was to assess the overall accuracy of information contained on the NIDD, as well as collecting qualitative information to support the…

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

    PubMed

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

    2012-12-01

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

  3. NATIONAL URBAN DATABASE AND ACCESS PROTAL TOOL

    EPA Science Inventory

    Current mesoscale weather prediction and microscale dispersion models are limited in their ability to perform accurate assessments in urban areas. A project called the National Urban Database with Access Portal Tool (NUDAPT) is beginning to provide urban data and improve the para...

  4. Data tables for the 1993 National Transit Database section 15 report year

    DOT National Transportation Integrated Search

    1994-12-01

    The Data Tables For the 1993 National Transit Database Section 15 Report Year is one of three publications comprising the 1993 Annual Report. Also referred to as the National Transit Database Reporting System, it is administered by the Federal Transi...

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

    PubMed

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

    2006-07-01

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

  6. Tuberous Sclerosis Complex National Database

    DTIC Science & Technology

    2005-10-01

    monotherapy LIAED dosage reduction ElDiscontinuation of AED LURemoval of VNS device O1Discontinuation of Ketogenic Diet U Seizure remission Surgical...34* Treatments "* VNS "* Ketogenic Diet "* AEDs W81XWH-04-1-0896 Annual Report 10/05 Tuberous Sclerosis Complex National Database App. H - Page 1 of 3 PI: Steven P...Page 20 of 29 Date last modified 7/14/05 Subject name: First, Middle, Last DOB: LiKetogenic diet LiEpilepsy surgery (if checked, complete the separate

  7. Association of Preoperative Anemia With Postoperative Mortality in Neonates.

    PubMed

    Goobie, Susan M; Faraoni, David; Zurakowski, David; DiNardo, James A

    2016-09-01

    Neonates undergoing noncardiac surgery are at risk for adverse outcomes. Preoperative anemia is a strong independent risk factor for postoperative mortality in adults. To our knowledge, this association has not been investigated in the neonatal population. To assess the association between preoperative anemia and postoperative mortality in neonates undergoing noncardiac surgery in a large sample of US hospitals. Using data from the 2012 and 2013 pediatric databases of the American College of Surgeons National Surgical Quality Improvement Program, we conducted a retrospective study of neonates undergoing noncardiac surgery. Analysis of the data took place between June 2015 and December 2015. All neonates (0-30 days old) with a recorded preoperative hematocrit value were included. Anemia defined as hematocrit level of less than 40%. Receiver operating characteristics analysis was used to assess the association between preoperative hematocrit and mortality, and the Youden J Index was used to determine the specific hematocrit cutoff point to define anemia in the neonatal population. Demographic and postoperative outcomes variables were compared between anemic and nonanemic neonates. Univariate and multivariable logistic regression analyses were used to determine factors associated with postoperative neonatal mortality. An external validation was performed using the 2014 American College of Surgeons National Surgical Quality Improvement Program database. Neonates accounted for 2764 children (6%) in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program databases. Neonates inlcuded in the study were predominately male (64.5%), white (66.3%), and term (69.9% greater than 36 weeks' gestation) and weighed more than 2 kg (85.0%). Postoperative in-hospital mortality was 3.4% in neonates and 0.6% in all age groups (0-18 years). A preoperative hematocrit level of less than 40% was the optimal cutoff (Youden) to predict in-hospital mortality

  8. Pediatric malignant hyperthermia: risk factors, morbidity, and mortality identified from the Nationwide Inpatient Sample and Kids' Inpatient Database.

    PubMed

    Salazar, Jose H; Yang, Jingyan; Shen, Liang; Abdullah, Fizan; Kim, Tae W

    2014-12-01

    Malignant Hyperthermia (MH) is a potentially fatal metabolic disorder. Due to its rarity, limited evidence exists about risk factors, morbidity, and mortality especially in children. Using the Nationwide Inpatient Sample and the Kid's Inpatient Database (KID), admissions with the ICD-9 code for MH (995.86) were extracted for patients 0-17 years of age. Demographic characteristics were analyzed. Logistic regression was performed to identify patient and hospital characteristics associated with mortality. A subset of patients with a surgical ICD-9 code in the KID was studied to calculate the prevalence of MH in the dataset. A total of 310 pediatric admissions were seen in 13 nonoverlapping years of data. Patients had a mortality of 2.9%. Male sex was predominant (64.8%), and 40.5% of the admissions were treated at centers not identified as children's hospitals. The most common associated diagnosis was rhabdomyolysis, which was present in 26 cases. Regression with the outcome of mortality did not yield significant differences between demographic factors, age, sex race, or hospital type, pediatric vs nonpediatric. Within a surgical subset of 530,449 admissions, MH was coded in 55, giving a rate of 1.04 cases per 10,000 cases. This study is the first to combine two large databases to study MH in the pediatric population. The analysis provides an insight into the risk factors, comorbidities, mortality, and prevalence of MH in the United States population. Until more methodologically rigorous, large-scale studies are done, the use of databases will continue to be the optimal method to study rare diseases. © 2014 John Wiley & Sons Ltd.

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

    PubMed

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

    2006-08-01

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

  10. Estimation of the global burden of mesothelioma deaths from incomplete national mortality data.

    PubMed

    Odgerel, Chimed-Ochir; Takahashi, Ken; Sorahan, Tom; Driscoll, Tim; Fitzmaurice, Christina; Yoko-O, Makoto; Sawanyawisuth, Kittisak; Furuya, Sugio; Tanaka, Fumihiro; Horie, Seichi; Zandwijk, Nico van; Takala, Jukka

    2017-12-01

    Mesothelioma is increasingly recognised as a global health issue and the assessment of its global burden is warranted. To descriptively analyse national mortality data and to use reported and estimated data to calculate the global burden of mesothelioma deaths. For the study period of 1994 to 2014, we grouped 230 countries into 59 countries with quality mesothelioma mortality data suitable to be used for reference rates, 45 countries with poor quality data and 126 countries with no data, based on the availability of data in the WHO Mortality Database. To estimate global deaths, we extrapolated the gender-specific and age-specific mortality rates of the countries with quality data to all other countries. The global numbers and rates of mesothelioma deaths have increased over time. The 59 countries with quality data recorded 15 011 mesothelioma deaths per year over the 3 most recent years with available data (equivalent to 9.9 deaths per million per year). From these reference data, we extrapolated the global mesothelioma deaths to be 38 400 per year, based on extrapolations for asbestos use. Although the validity of our extrapolation method depends on the adequate identification of quality mesothelioma data and appropriate adjustment for other variables, our estimates can be updated, refined and verified because they are based on commonly accessible data and are derived using a straightforward algorithm. Our estimates are within the range of previously reported values but higher than the most recently reported values. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Mortality and comorbidities in patients with multiple sclerosis compared with a population without multiple sclerosis: An observational study using the US Department of Defense administrative claims database.

    PubMed

    Capkun, Gorana; Dahlke, Frank; Lahoz, Raquel; Nordstrom, Beth; Tilson, Hugh H; Cutter, Gary; Bischof, Dorina; Moore, Alan; Simeone, Jason; Fraeman, Kathy; Bancken, Fabrice; Geissbühler, Yvonne; Wagner, Michael; Cohan, Stanley

    2015-11-01

    Data are limited for mortality and comorbidities in patients with multiple sclerosis (MS). Compare mortality rates and event rates for comorbidities in MS (n=15,684) and non-MS (n=78,420) cohorts from the US Department of Defense (DoD) database. Comorbidities and all-cause mortality were assessed using the database. Causes of death (CoDs) were assessed through linkage with the National Death Index. Cohorts were compared using mortality (MRR) and event (ERR) rate ratios. All-cause mortality was 2.9-fold higher in the MS versus non-MS cohort (MRR, 95% confidence interval [CI]: 2.9, 2.7-3.2). Frequent CoDs in the MS versus non-MS cohort were infectious diseases (6.2, 4.2-9.4), diseases of the nervous (5.8, 3.7-9.0), respiratory (5.0, 3.9-6.4) and circulatory (2.1, 1.7-2.7) systems and suicide (2.6, 1.3-5.2). Comorbidities including sepsis (ERR, 95% CI: 5.7, 5.1-6.3), ischemic stroke (3.8, 3.5-4.2), attempted suicide (2.4, 1.3-4.5) and ulcerative colitis (2.0, 1.7-2.3), were higher in the MS versus non-MS cohort. The rate of cancers was also higher in the MS versus the non-MS cohort, including lymphoproliferative disorders (2.2, 1.9-2.6) and melanoma (1.7, 1.4-2.0). Rates of mortality and several comorbidities are higher in the MS versus non-MS cohort. Early recognition and management of comorbidities may reduce premature mortality and improve quality of life in patients with MS. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

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

    PubMed

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

    2015-01-01

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

  13. Effect of anaesthesia type on postoperative mortality and morbidities: a matched analysis of the NSQIP database.

    PubMed

    Saied, N N; Helwani, M A; Weavind, L M; Shi, Y; Shotwell, M S; Pandharipande, P P

    2017-01-01

    The anaesthetic technique may influence clinical outcomes, but inherent confounding and small effect sizes makes this challenging to study. We hypothesized that regional anaesthesia (RA) is associated with higher survival and fewer postoperative organ dysfunctions when compared with general anaesthesia (GA). We matched surgical procedures and type of anaesthesia using the US National Surgical Quality Improvement database, in which 264,421 received GA and 64,119 received RA. Procedures were matched according to Current Procedural Terminology (CPT) and ASA physical status classification. Our primary outcome was 30-day postoperative mortality and secondary outcomes were hospital length of stay, and postoperative organ system dysfunction. After matching, multiple regression analysis was used to examine associations between anaesthetic type and outcomes, adjusting for covariates. After matching and adjusting for covariates, type of anaesthesia did not significantly impact 30-day mortality. RA was significantly associated with increased likelihood of early discharge (HR 1.09; P< 0.001), 47% lower odds of intraoperative complications, and 24% lower odds of respiratory complications. RA was also associated with 16% lower odds of developing deep vein thrombosis and 15% lower odds of developing any one postoperative complication (OR 0.85; P < 0.001). There was no evidence of an effect of anaesthesia technique on postoperative MI, stroke, renal complications, pulmonary embolism or peripheral nerve injury. After adjusting for clinical and patient characteristic confounders, RA was associated with significantly lower odds of several postoperative complications, decreased hospital length of stay, but not mortality when compared with GA. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. National Geochronological Database

    USGS Publications Warehouse

    Revised by Sloan, Jan; Henry, Christopher D.; Hopkins, Melanie; Ludington, Steve; Original database by Zartman, Robert E.; Bush, Charles A.; Abston, Carl

    2003-01-01

    The National Geochronological Data Base (NGDB) was established by the United States Geological Survey (USGS) to collect and organize published isotopic (also known as radiometric) ages of rocks in the United States. The NGDB (originally known as the Radioactive Age Data Base, RADB) was started in 1974. A committee appointed by the Director of the USGS was given the mission to investigate the feasibility of compiling the published radiometric ages for the United States into a computerized data bank for ready access by the user community. A successful pilot program, which was conducted in 1975 and 1976 for the State of Wyoming, led to a decision to proceed with the compilation of the entire United States. For each dated rock sample reported in published literature, a record containing information on sample location, rock description, analytical data, age, interpretation, and literature citation was constructed and included in the NGDB. The NGDB was originally constructed and maintained on a mainframe computer, and later converted to a Helix Express relational database maintained on an Apple Macintosh desktop computer. The NGDB and a program to search the data files were published and distributed on Compact Disc-Read Only Memory (CD-ROM) in standard ISO 9660 format as USGS Digital Data Series DDS-14 (Zartman and others, 1995). As of May 1994, the NGDB consisted of more than 18,000 records containing over 30,000 individual ages, which is believed to represent approximately one-half the number of ages published for the United States through 1991. Because the organizational unit responsible for maintaining the database was abolished in 1996, and because we wanted to provide the data in more usable formats, we have reformatted the data, checked and edited the information in some records, and provided this online version of the NGDB. This report describes the changes made to the data and formats, and provides instructions for the use of the database in geographic

  15. Data tables for the 1994 National Transit Database report year

    DOT National Transportation Integrated Search

    1995-12-01

    The Data Tables For the 1994 National Transit Database Report Year is one of three publications also referred to as the National Transit Databse Reporting System. The report provides detailed summaries of financial and operating data submitted to FTA...

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

    PubMed

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

    2016-07-20

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

  17. National Solar Radiation Database 1991-2010 Update: User's Manual

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wilcox, S. M.

    This user's manual provides information on the updated 1991-2010 National Solar Radiation Database. Included are data format descriptions, data sources, production processes, and information about data uncertainty.

  18. The National NeuroAIDS Tissue Consortium (NNTC) Database: an integrated database for HIV-related studies

    PubMed Central

    Cserhati, Matyas F.; Pandey, Sanjit; Beaudoin, James J.; Baccaglini, Lorena; Guda, Chittibabu; Fox, Howard S.

    2015-01-01

    We herein present the National NeuroAIDS Tissue Consortium-Data Coordinating Center (NNTC-DCC) database, which is the only available database for neuroAIDS studies that contains data in an integrated, standardized form. This database has been created in conjunction with the NNTC, which provides human tissue and biofluid samples to individual researchers to conduct studies focused on neuroAIDS. The database contains experimental datasets from 1206 subjects for the following categories (which are further broken down into subcategories): gene expression, genotype, proteins, endo-exo-chemicals, morphometrics and other (miscellaneous) data. The database also contains a wide variety of downloadable data and metadata for 95 HIV-related studies covering 170 assays from 61 principal investigators. The data represent 76 tissue types, 25 measurement types, and 38 technology types, and reaches a total of 33 017 407 data points. We used the ISA platform to create the database and develop a searchable web interface for querying the data. A gene search tool is also available, which searches for NCBI GEO datasets associated with selected genes. The database is manually curated with many user-friendly features, and is cross-linked to the NCBI, HUGO and PubMed databases. A free registration is required for qualified users to access the database. Database URL: http://nntc-dcc.unmc.edu PMID:26228431

  19. Epidemiology and mortality of liver abscess in end-stage renal disease dialysis patients: Taiwan national cohort study.

    PubMed

    Hong, Chon-Seng; Chung, Kun-Ming; Huang, Po-Chang; Wang, Jhi-Joung; Yang, Chun-Ming; Chu, Chin-Chen; Chio, Chung-Ching; Chang, Fu-Lin; Chien, Chih-Chiang

    2014-01-01

    To determine the incidence rates and mortality of liver abscess in ESRD patients on dialysis. Using Taiwan's National Health Insurance Research Database, we collected data from all ESRD patients who initiated dialysis between 2000 and 2006. Patients were followed until death, end of dialysis, or December 31, 2008. Predictors of liver abscess and mortality were identified using Cox models. Of the 53,249 incident dialysis patients identified, 447 were diagnosed as having liver abscesses during the follow-up period (224/100,000 person-years). The cumulative incidence rate of liver abscess was 0.3%, 1.1%, and 1.5% at 1 year, 5 years, and 7 years, respectively. Elderly patients and patients on peritoneal dialysis had higher incidence rates. The baseline comorbidities of diabetes mellitus, polycystic kidney disease, malignancy, chronic liver disease, biliary tract disease, or alcoholism predicted development of liver abscess. Overall in-hospital mortality was 10.1%. The incidence of liver abscess is high among ESRD dialysis patients. In addition to the well known risk factors of liver abscess, two other important risk factors, peritoneal dialysis and polycystic kidney disease, were found to predict liver abscess in ESRD dialysis patients.

  20. Critical Infrastructure: The National Asset Database

    DTIC Science & Technology

    2006-09-14

    NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION...that, in its current form, it is being used inappropriately as the basis upon which federal resources, including infrastructure protection grants , are...National Asset Database has been used to support federal grant -making decisions, according to a DHS official, it does not drive those decisions. In July

  1. National, regional, and global levels and trends in maternal mortality between 1990 and 2015 with scenario-based projections to 2030: a systematic analysis by the United Nations Maternal Mortality Estimation Inter-Agency Group

    PubMed Central

    Alkema, Leontine; Chou, Doris; Hogan, Daniel; Zhang, Sanqian; Moller, Ann-Beth; Gemmill, Alison; Fat, Doris Ma; Boerma, Ties; Temmerman, Marleen; Mathers, Colin; Say, Lale; Ahmed, Saifuddin; Ali, Mohamed; Amouzou, Agbessi; Braunholtz, David; Byass, Peter; Carvajal-Velez, Liliana; Gaigbe-Togbe, Victor; Gerland, Patrick; Loaiza, Edilberto; Mills, Samuel; Mutombo, Namuunda; Newby, Holly; Pullum, Thomas W.; Suzuki, Emi

    2017-01-01

    Summary Background Millennium Development Goal (MDG) 5 calls for a reduction of 75% in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed scenario-based projections to highlight the accelerations needed to accomplish the Sustainable Development Goal (SDG) global target of less than 70 maternal deaths per 100,000 live births globally by 2030. Methods We updated the open access UN Maternal Mortality Estimation Inter-agency Group (MMEIG) database. Based upon nationally-representative data for 171 countries, we generated estimates of maternal mortality and related indicators with uncertainty intervals using a Bayesian model, which extends and refines the previous UN MMEIG estimation approach. The model combines the rate of change implied by a multilevel regression model with a time series model to capture data-driven changes in country-specific MMRs, and includes a data model to adjust for systematic and random errors associated with different data sources. Results The global MMR declined from 385 deaths per 100,000 live births (80% uncertainty interval ranges from 359 to 427) in 1990 to 216 (207 to 249) in 2015, corresponding to a relative decline of 43.9% (34.0 to 48.7) during the 25-year period, with 303,000 (291,000 to 349,000) maternal deaths globally in 2015. Regional progress in reducing the MMR since 1990 ranged from an annual rate of reduction of 1.8% (0 to 3.1) in the Caribbean to 5.0% (4.0 to 6.0) for Eastern Asia. Regional MMRs for 2015 range from 12 (11 to 14) for developed regions to 546 (511 to 652) for sub-Saharan Africa. Accelerated progress will be needed to achieve the SDG goal; countries will need to reduce their MMRs at an annual rate of reduction of at least 7.5%. Interpretation Despite global progress in reducing maternal mortality, immediate action is required to begin making progress towards the

  2. Application of China's National Forest Continuous Inventory database.

    PubMed

    Xie, Xiaokui; Wang, Qingli; Dai, Limin; Su, Dongkai; Wang, Xinchuang; Qi, Guang; Ye, Yujing

    2011-12-01

    The maintenance of a timely, reliable and accurate spatial database on current forest ecosystem conditions and changes is essential to characterize and assess forest resources and support sustainable forest management. Information for such a database can be obtained only through a continuous forest inventory. The National Forest Continuous Inventory (NFCI) is the first level of China's three-tiered inventory system. The NFCI is administered by the State Forestry Administration; data are acquired by five inventory institutions around the country. Several important components of the database include land type, forest classification and ageclass/ age-group. The NFCI database in China is constructed based on 5-year inventory periods, resulting in some of the data not being timely when reports are issued. To address this problem, a forest growth simulation model has been developed to update the database for years between the periodic inventories. In order to aid in forest plan design and management, a three-dimensional virtual reality system of forest landscapes for selected units in the database (compartment or sub-compartment) has also been developed based on Virtual Reality Modeling Language. In addition, a transparent internet publishing system for a spatial database based on open source WebGIS (UMN Map Server) has been designed and utilized to enhance public understanding and encourage free participation of interested parties in the development, implementation, and planning of sustainable forest management.

  3. The National NeuroAIDS Tissue Consortium (NNTC) Database: an integrated database for HIV-related studies.

    PubMed

    Cserhati, Matyas F; Pandey, Sanjit; Beaudoin, James J; Baccaglini, Lorena; Guda, Chittibabu; Fox, Howard S

    2015-01-01

    We herein present the National NeuroAIDS Tissue Consortium-Data Coordinating Center (NNTC-DCC) database, which is the only available database for neuroAIDS studies that contains data in an integrated, standardized form. This database has been created in conjunction with the NNTC, which provides human tissue and biofluid samples to individual researchers to conduct studies focused on neuroAIDS. The database contains experimental datasets from 1206 subjects for the following categories (which are further broken down into subcategories): gene expression, genotype, proteins, endo-exo-chemicals, morphometrics and other (miscellaneous) data. The database also contains a wide variety of downloadable data and metadata for 95 HIV-related studies covering 170 assays from 61 principal investigators. The data represent 76 tissue types, 25 measurement types, and 38 technology types, and reaches a total of 33,017,407 data points. We used the ISA platform to create the database and develop a searchable web interface for querying the data. A gene search tool is also available, which searches for NCBI GEO datasets associated with selected genes. The database is manually curated with many user-friendly features, and is cross-linked to the NCBI, HUGO and PubMed databases. A free registration is required for qualified users to access the database. © The Author(s) 2015. Published by Oxford University Press.

  4. A 30-meter spatial database for the nation's forests

    Treesearch

    Raymond L. Czaplewski

    2002-01-01

    The FIA vision for remote sensing originated in 1992 with the Blue Ribbon Panel on FIA, and it has since evolved into an ambitious performance target for 2003. FIA is joining a consortium of Federal agencies to map the Nation's land cover. FIA field data will help produce a seamless, standardized, national geospatial database for forests at the scale of 30-m...

  5. A blue carbon soil database: Tidal wetland stocks for the US National Greenhouse Gas Inventory

    NASA Astrophysics Data System (ADS)

    Feagin, R. A.; Eriksson, M.; Hinson, A.; Najjar, R. G.; Kroeger, K. D.; Herrmann, M.; Holmquist, J. R.; Windham-Myers, L.; MacDonald, G. M.; Brown, L. N.; Bianchi, T. S.

    2015-12-01

    Coastal wetlands contain large reservoirs of carbon, and in 2015 the US National Greenhouse Gas Inventory began the work of placing blue carbon within the national regulatory context. The potential value of a wetland carbon stock, in relation to its location, soon could be influential in determining governmental policy and management activities, or in stimulating market-based CO2 sequestration projects. To meet the national need for high-resolution maps, a blue carbon stock database was developed linking National Wetlands Inventory datasets with the USDA Soil Survey Geographic Database. Users of the database can identify the economic potential for carbon conservation or restoration projects within specific estuarine basins, states, wetland types, physical parameters, and land management activities. The database is geared towards both national-level assessments and local-level inquiries. Spatial analysis of the stocks show high variance within individual estuarine basins, largely dependent on geomorphic position on the landscape, though there are continental scale trends to the carbon distribution as well. Future plans including linking this database with a sedimentary accretion database to predict carbon flux in US tidal wetlands.

  6. Landscape features, standards, and semantics in U.S. national topographic mapping databases

    USGS Publications Warehouse

    Varanka, Dalia

    2009-01-01

    The objective of this paper is to examine the contrast between local, field-surveyed topographical representation and feature representation in digital, centralized databases and to clarify their ontological implications. The semantics of these two approaches are contrasted by examining the categorization of features by subject domains inherent to national topographic mapping. When comparing five USGS topographic mapping domain and feature lists, results indicate that multiple semantic meanings and ontology rules were applied to the initial digital database, but were lost as databases became more centralized at national scales, and common semantics were replaced by technological terms.

  7. Database resources of the National Center for Biotechnology

    PubMed Central

    Wheeler, David L.; Church, Deanna M.; Federhen, Scott; Lash, Alex E.; Madden, Thomas L.; Pontius, Joan U.; Schuler, Gregory D.; Schriml, Lynn M.; Sequeira, Edwin; Tatusova, Tatiana A.; Wagner, Lukas

    2003-01-01

    In addition to maintaining the GenBank(R) nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides data analysis and retrieval resources for the data in GenBank and other biological data made available through NCBI's Web site. NCBI resources include Entrez, PubMed, PubMed Central (PMC), LocusLink, the NCBITaxonomy Browser, BLAST, BLAST Link (BLink), Electronic PCR (e-PCR), Open Reading Frame (ORF) Finder, References Sequence (RefSeq), UniGene, HomoloGene, ProtEST, Database of Single Nucleotide Polymorphisms (dbSNP), Human/Mouse Homology Map, Cancer Chromosome Aberration Project (CCAP), Entrez Genomes and related tools, the Map Viewer, Model Maker (MM), Evidence Viewer (EV), Clusters of Orthologous Groups (COGs) database, Retroviral Genotyping Tools, SAGEmap, Gene Expression Omnibus (GEO), Online Mendelian Inheritance in Man (OMIM), the Molecular Modeling Database (MMDB), the Conserved Domain Database (CDD), and the Conserved Domain Architecture Retrieval Tool (CDART). Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of the resources can be accessed through the NCBI home page at: http://www.ncbi.nlm.nih.gov. PMID:12519941

  8. Trends and outcomes of valve surgery: 16-year results of Netherlands Cardiac Surgery National Database.

    PubMed

    Siregar, Sabrina; de Heer, Frederiek; Groenwold, Rolf H H; Versteegh, Michel I M; Bekkers, Jos A; Brinkman, Emile S; Bots, Michiel L; van der Graaf, Yolanda; van Herwerden, Lex A

    2014-09-01

    The aim was to describe procedural volumes, patient risk profile and outcomes of heart valve surgery in the past 16 years in Netherlands. The Dutch National Database for Cardio-Thoracic Surgery includes approximately 200 000 cardiac operations performed between 1995 and 2010. Information on all valve surgeries (56 397 operations) was extracted. We determined trends for changes in procedural volume, demographics, risk profile and in-hospital mortality of valve operations. Because of incomplete data in the first years of registration, the total number of operations in those years was estimated using Poisson regression. For a subset from 2007 to 2010, follow-up data were available. Survival status was obtained through linkage with the national Cause of Death Registry, and survival analysis was performed using Kaplan-Meier method. Information on discharge and readmissions was obtained from the National Hospital Discharge Registry. The annual volume of heart valve operations increased by more than 100% from an estimated 2431 in 1995 to 5906 in 2010. Adjusted for population size in Netherlands, the number of operations per 100 000 adults increased from 20 in 1995 to 43 in 2010. In 2010, frequently performed valve surgery included the following: 34.6% isolated aortic valve (AoV) replacement, 21.8% AoV replacement and coronary artery bypass grafting (CABG), 14.6% isolated mitral valve surgery (repair or replacement) and 9.1% mitral valve and CABG. In AoV surgery, an increasing use of bioprostheses in all age categories is observed. In mitral valve surgery, 75.4% was performed by repair rather than replacement in 2010. In-hospital mortality for all valve surgery decreased significantly from 4.6% in 2007 to 3.6% in 2010, whereas the mean logistic EuroSCORE remained stable (median 5.8, P = 1.000). Thirty-day mortality after all valve surgery was 3.9% and 120-day mortality was 6.5%. At 1 year, survival after all valve surgery was 91.6% and a reoperation had been performed in 1

  9. National Solar Radiation Database 1991-2005 Update: User's Manual

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wilcox, S.

    2007-04-01

    This manual describes how to obtain and interpret the data products from the updated 1991-2005 National Solar Radiation Database (NSRDB). This is an update of the original 1961-1990 NSRDB released in 1992.

  10. Decreasing incidence and mortality among hospitalized patients suffering a ventilator-associated pneumonia: Analysis of the Spanish national hospital discharge database from 2010 to 2014.

    PubMed

    de Miguel-Díez, Javier; López-de-Andrés, Ana; Hernández-Barrera, Valentín; Jiménez-Trujillo, Isabel; Méndez-Bailón, Manuel; Miguel-Yanes, José M de; Del Rio-Lopez, Benito; Jiménez-García, Rodrigo

    2017-07-01

    The aim of this study was to describe trends in the incidence and outcomes of ventilator-associated pneumonia (VAP) among hospitalized patients in Spain (2010-2014).This is a retrospective study using the Spanish national hospital discharge database from year 2010 to 2014. We selected all hospital admissions that had an ICD-9-CM code: 997.31 for VAP in any diagnosis position. We analyzed incidence, sociodemographic and clinical characteristics, procedures, pathogen isolations, and hospital outcomes.We identified 9336 admissions with patients suffering a VAP. Incidence rates of VAP decreased significantly over time (from 41.7 cases/100,000 inhabitants in 2010 to 40.55 in 2014). The mean Charlson comorbidity index (CCI) was 1.08 ± 0.98 and it did not change significantly during the study period. The most frequent causative agent was Pseudomonas and there were not significant differences in the isolation of this microorganism over time. Time trend analyses showed a significant decrease in in-hospital mortality (IHM), from 35.74% in 2010 to 32.81% in 2014. Factor associated with higher IHM included male sex, older age, higher CCI, vein or artery occlusion, pulmonary disease, cancer, undergone surgery, emergency room admission, and readmission.This study shows that the incidence of VAP among hospitalized patients has decreased in Spain from 2010 to 2014. The IHM has also decreased over the study period. Further investigations are needed to improve the prevention and control of VAP.

  11. Child mortality estimation 2013: an overview of updates in estimation methods by the United Nations Inter-agency Group for Child Mortality Estimation.

    PubMed

    Alkema, Leontine; New, Jin Rou; Pedersen, Jon; You, Danzhen

    2014-01-01

    In September 2013, the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) published an update of the estimates of the under-five mortality rate (U5MR) and under-five deaths for all countries. Compared to the UN IGME estimates published in 2012, updated data inputs and a new method for estimating the U5MR were used. We summarize the new U5MR estimation method, which is a Bayesian B-spline Bias-reduction model, and highlight differences with the previously used method. Differences in UN IGME U5MR estimates as published in 2012 and those published in 2013 are presented and decomposed into differences due to the updated database and differences due to the new estimation method to explain and motivate changes in estimates. Compared to the previously used method, the new UN IGME estimation method is based on a different trend fitting method that can track (recent) changes in U5MR more closely. The new method provides U5MR estimates that account for data quality issues. Resulting differences in U5MR point estimates between the UN IGME 2012 and 2013 publications are small for the majority of countries but greater than 10 deaths per 1,000 live births for 33 countries in 2011 and 19 countries in 1990. These differences can be explained by the updated database used, the curve fitting method as well as accounting for data quality issues. Changes in the number of deaths were less than 10% on the global level and for the majority of MDG regions. The 2013 UN IGME estimates provide the most recent assessment of levels and trends in U5MR based on all available data and an improved estimation method that allows for closer-to-real-time monitoring of changes in the U5MR and takes account of data quality issues.

  12. Birth Outcomes and Infant Mortality by the Degree of Rural Isolation among First Nations and Non-First Nations in Manitoba, Canada

    ERIC Educational Resources Information Center

    Luo, Zhong-Cheng; Wilkins, Russell; Heaman, Maureen; Martens, Patricia; Smylie, Janet; Hart, Lyna; Simonet, Fabienne; Wassimi, Spogmai; Wu, Yuquan; Fraser, William D.

    2010-01-01

    Context: It is unknown whether rural isolation may affect birth outcomes and infant mortality differentially for Indigenous versus non-Indigenous populations. We assessed birth outcomes and infant mortality by the degree of rural isolation among First Nations (North American Indians) and non-First Nations populations in Manitoba, Canada, a setting…

  13. Income Inequality and Child Mortality in Wealthy Nations.

    PubMed

    Collison, David

    2016-01-01

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

  14. A National Virtual Specimen Database for Early Cancer Detection

    NASA Technical Reports Server (NTRS)

    Crichton, Daniel; Kincaid, Heather; Kelly, Sean; Thornquist, Mark; Johnsey, Donald; Winget, Marcy

    2003-01-01

    Access to biospecimens is essential for enabling cancer biomarker discovery. The National Cancer Institute's (NCI) Early Detection Research Network (EDRN) comprises and integrates a large number of laboratories into a network in order to establish a collaborative scientific environment to discover and validate disease markers. The diversity of both the institutions and the collaborative focus has created the need for establishing cross-disciplinary teams focused on integrating expertise in biomedical research, computational and biostatistics, and computer science. Given the collaborative design of the network, the EDRN needed an informatics infrastructure. The Fred Hutchinson Cancer Research Center, the National Cancer Institute,and NASA's Jet Propulsion Laboratory (JPL) teamed up to build an informatics infrastructure creating a collaborative, science-driven research environment despite the geographic and morphology differences of the information systems that existed within the diverse network. EDRN investigators identified the need to share biospecimen data captured across the country managed in disparate databases. As a result, the informatics team initiated an effort to create a virtual tissue database whereby scientists could search and locate details about specimens located at collaborating laboratories. Each database, however, was locally implemented and integrated into collection processes and methods unique to each institution. This meant that efforts to integrate databases needed to be done in a manner that did not require redesign or re-implementation of existing system

  15. Has TRISS become an anachronism? A comparison of mortality between the National Trauma Data Bank and Major Trauma Outcome Study databases.

    PubMed

    Rogers, Frederick B; Osler, Turner; Krasne, Margaret; Rogers, Amelia; Bradburn, Eric H; Lee, John C; Wu, Daniel; McWilliams, Nathan; Horst, Michael A

    2012-08-01

    The Trauma and Injury Severity Score (TRISS) has been the approach to trauma outcome prediction during the past 20 years and has been adopted by many commercial registries. Unfortunately, its survival predictions are based upon coefficients that were derived from a data set collected in the 1980s and updated only once using a data set collected in the early 1990s. We hypothesized that the improvements in trauma care during the past 20 years would lead to improved survival in a large database, thus making the TRISS biased. The TRISSs from the Pennsylvania statewide trauma registry (Collector, Digital Innovations) for the years 1990 to 2010. Observed-to-expected mortality ratios for each year of the study were calculated by taking the ratio of actual deaths (observed deaths, O) to the summation of the probability of mortality predicted by the TRISS taken over all patients (expected deaths, E). For reference, O/E ratio should approach 1 if the TRISS is well calibrated (i.e., has predictive accuracy). There were 408,489 patients with complete data sufficient to calculate the TRISSs. There was a significant trend toward improved outcome (i.e., decreasing O/E ratio; nonparametric test of trend, p < 0.001) over time in both the total population and the blunt trauma subpopulation. In the penetrating trauma population, there was a trend toward improved outcome (decreasing O/E ratio), but it did not quite reach significance (nonparametric test of trend p = 0.073). There is a steady trend toward improved O/E survival in the Pennsylvania database with each passing year, suggesting that the TRISS is drifting out of calibration. It is likely that improvements in care account for these changes. For the TRISS to remain an accurate outcome prediction model, new coefficients would need to be calculated periodically to keep up with trends in trauma care. This requirement for occasional updating is likely to be a requirement of any trauma prediction model, but because many other

  16. A national analysis of the relationship between hospital factors and post-cardiac arrest mortality.

    PubMed

    Carr, Brendan G; Goyal, Munish; Band, Roger A; Gaieski, David F; Abella, Benjamin S; Merchant, Raina M; Branas, Charles C; Becker, Lance B; Neumar, Robert W

    2009-03-01

    We sought to generate national estimates for post-cardiac arrest mortality, to assess trends, and to identify hospital factors associated with survival. We used a national sample of US hospitals to identify patients resuscitated after cardiac arrest from 2000 to 2004 to describe the association between hospital factors (teaching status, location, size) and mortality, length of stay, and hospital charges. Analyses were performed using logistic regression. A total of 109,739 patients were identified. In-hospital mortality was 70.6%. A 2% decrease in unadjusted mortality from 71.6% in 2000 to 69.6% in 2004 (OR 0.96, P < 0.001) was observed. Mortality was lower at teaching hospitals (OR 0.58, P = 0.001), urban hospitals (OR 0.63, P = 0.004), and large hospitals (OR 0.55, P < 0.001). Mortality after in-hospital cardiac arrest decreased over 5 years. Mortality was lower at urban, teaching, and large hospitals. There are implications for dissemination of best practices or regionalization of post-cardiac arrest care.

  17. The landslide database for Germany: Closing the gap at national level

    NASA Astrophysics Data System (ADS)

    Damm, Bodo; Klose, Martin

    2015-11-01

    The Federal Republic of Germany has long been among the few European countries that lack a national landslide database. Systematic collection and inventory of landslide data still has a long research history in Germany, but one focussed on the development of databases with local or regional coverage. This has changed in recent years with the launch of a database initiative aimed at closing the data gap existing at national level. The present paper reports on this project that is based on a landslide database which evolved over the last 15 years to a database covering large parts of Germany. A strategy of systematic retrieval, extraction, and fusion of landslide data is at the heart of the methodology, providing the basis for a database with a broad potential of application. The database offers a data pool of more than 4,200 landslide data sets with over 13,000 single data files and dates back to the 12th century. All types of landslides are covered by the database, which stores not only core attributes, but also various complementary data, including data on landslide causes, impacts, and mitigation. The current database migration to PostgreSQL/PostGIS is focused on unlocking the full scientific potential of the database, while enabling data sharing and knowledge transfer via a web GIS platform. In this paper, the goals and the research strategy of the database project are highlighted at first, with a summary of best practices in database development providing perspective. Next, the focus is on key aspects of the methodology, which is followed by the results of three case studies in the German Central Uplands. The case study results exemplify database application in the analysis of landslide frequency and causes, impact statistics, and landslide susceptibility modeling. Using the example of these case studies, strengths and weaknesses of the database are discussed in detail. The paper concludes with a summary of the database project with regard to previous

  18. TAPIR--Finnish national geochemical baseline database.

    PubMed

    Jarva, Jaana; Tarvainen, Timo; Reinikainen, Jussi; Eklund, Mikael

    2010-09-15

    In Finland, a Government Decree on the Assessment of Soil Contamination and Remediation Needs has generated a need for reliable and readily accessible data on geochemical baseline concentrations in Finnish soils. According to the Decree, baseline concentrations, referring both to the natural geological background concentrations and the diffuse anthropogenic input of substances, shall be taken into account in the soil contamination assessment process. This baseline information is provided in a national geochemical baseline database, TAPIR, that is publicly available via the Internet. Geochemical provinces with elevated baseline concentrations were delineated to provide regional geochemical baseline values. The nationwide geochemical datasets were used to divide Finland into geochemical provinces. Several metals (Co, Cr, Cu, Ni, V, and Zn) showed anomalous concentrations in seven regions that were defined as metal provinces. Arsenic did not follow a similar distribution to any other elements, and four arsenic provinces were separately determined. Nationwide geochemical datasets were not available for some other important elements such as Cd and Pb. Although these elements are included in the TAPIR system, their distribution does not necessarily follow the ones pre-defined for metal and arsenic provinces. Regional geochemical baseline values, presented as upper limit of geochemical variation within the region, can be used as trigger values to assess potential soil contamination. Baseline values have also been used to determine upper and lower guideline values that must be taken into account as a tool in basic risk assessment. If regional geochemical baseline values are available, the national guideline values prescribed in the Decree based on ecological risks can be modified accordingly. The national geochemical baseline database provides scientifically sound, easily accessible and generally accepted information on the baseline values, and it can be used in various

  19. Aortic dissection in pregnancy in England: an incidence study using linked national databases

    PubMed Central

    Banerjee, Amitava; Begaj, Irena; Thorne, Sara

    2015-01-01

    Objectives To conduct the first population-level incidence study of aortic dissection in pregnancy using linked hospital-based data in England. Setting Hospital-based data (Hospital Episode Statistics (HES) linked with mortality data from the Office of National Statistics), national enquiries (Confidential Enquiries into Maternal Mortality) and surveys (UK Obstetric Surveillance System; UKOSS) of aortic dissection in pregnancy from 2003 to 2011 in England. Participants Between 2003 and 2011, all female patients admitted with diagnoses of aortic dissection (not necessarily as the primary cause of admission) and of pregnancy, childbirth and puerperium, were included. Outcome measures Diagnosis of aortic dissection during pregnancy, operated or not operated, with outcome of death or live patient from 2003 to 2011 in England. Results There were significant differences in characteristics of databases with respect to study population, time of study, recorded event and follow-up of outcomes. On the basis of HES, annual incidence of aortic dissection was 1.23 (95% CI 1.22 to 1.24) per 100 000 maternities. Incidence of aortic dissection with death within 1 year was 0.30 (0.29 to 0.31) per 100 000 maternities. Incidence of aortic dissection increased from 0.74 (0.73 to 0.75) per 100 000 maternities in 2003–2005 to 1.52 (1.51 to 1.53) per 100 000 maternities in 2009–2011. In the Confidential Enquiries into Maternal Deaths, incidence of deaths was highest for 2003–2005 (0.43/100 000 maternities) and lowest for 1997–1999 (0.21/100 000 maternities). In the UK Obstetric Surveillance System, national incidence of aortic dissection was 0.80 (0.50 to 1.50) per 100 000 maternities between 2009 and 2011. Conclusions The case of aortic dissection in pregnancy illustrates data limitations regarding complications in pregnancy from different sources in the UK, even for a diagnosis with seemingly few alternative coding and diagnostic possibilities. These limitations should be

  20. National cancer incidence and mortality in China, 2012.

    PubMed

    Chen, Wanqing; Zheng, Rongshou; Zuo, Tingting; Zeng, Hongmei; Zhang, Siwei; He, Jie

    2016-02-01

    Population-based cancer registration data in 2012 from all available cancer registries were collected by the National Central Cancer Registry (NCCR). NCCR estimated the numbers of new cancer cases and cancer deaths in China with compiled cancer incidence and mortality rates. In 2015, there were 261 cancer registries submitted cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the NCCR criteria of data quality. Qualified data from 193 registries were used for cancer statistics analysis as national estimation. The pooled data were stratified by area (urban/rural), gender, age group [0, 1-4, 5-9, 10-14, …, 85+] and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding national population in 2012. The Chinese census data in 2000 and Segi's population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year. Qualified 193 cancer registries (74 urban and 119 rural registries) covered 198,060,406 populations (100,450,109 in urban and 97,610,297 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 69.13% and 2.38%, respectively, and the mortality to incidence rate ratio (M/I) was 0.62. A total of 3,586,200 new cancer cases and 2,186,600 cancer deaths were estimated in China in 2012. The incidence rate was 264.85/100,000 (289.30/100,000 in males, 239.15/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 191.89/100,000 and 187.83/100,000 with the cumulative incidence rate (0-74 age years old) of 21.82%. The cancer incidence, ASIRC and ASIRW in urban areas were 277.17/100,000, 195.56/100,000 and 190.88/100,000 compared to 251.20/100,000, 187.10/100,000 and 183.91/100,000 in rural areas, respectively. The cancer mortality was 161.49/100,000 (198.99/100,000 in males, 122.06/100,000 in females), the

  1. Report to Congress : review of the National Transit Database

    DOT National Transportation Integrated Search

    2000-05-30

    This report presents the findings and recommendations of the evaluation of the Federal Transit Administration (FTA) National Transit Database (NTD), conducted in accordance with the direction of the House and Senate Committees of Appropriations, as s...

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

    PubMed

    2017-09-16

    -specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised

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

    PubMed

    Fuse, Kana; Crenshaw, Edward M

    2006-01-01

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

  4. Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan.

    PubMed

    Kao, Wei-Heng; Hong, Ji-Hong; See, Lai-Chu; Yu, Huang-Ping; Hsu, Jun-Te; Chou, I-Jun; Chou, Wen-Chi; Chiou, Meng-Jiun; Wang, Chun-Chieh; Kuo, Chang-Fu

    2017-08-16

    We aimed to evaluate the validity of cancer diagnosis in the National Health Insurance (NHI) database, which has routinely collected the health information of almost the entire Taiwanese population since 1995, compared with the Taiwan National Cancer Registry (NCR). There were 26,542,445 active participants registered in the NHI database between 2001 and 2012. National Cancer Registry and NHI database records were compared for cancer diagnosis; date of cancer diagnosis; and 1, 2, and 5 year survival. In addition, the 10 leading causes of cancer deaths in Taiwan were analyzed. There were 908,986 cancer diagnoses in NCR and NHI database and 782,775 (86.1%) in both, with 53,192 (5.9%) in the NHI database only and 73,019 (8.0%) in the NCR only. The positive predictive value of the NHI database cancer diagnoses was 94% for all cancers; the positive predictive value of the 10 specific cancers ranged from 95% (lung cancer) to 82% (cervical cancer). The date of diagnosis in the NHI database was generally delayed by a median of 15 days (interquartile range 8-18) compared with the NCR. The 1, 2, and 5 year survival rates were 71.21%, 60.85%, and 47.44% using the NHI database and were 71.18%, 60.17%, and 46.09% using NCR data. Recording of cancer diagnoses and survival estimates based on these diagnosis codes in the NHI database are generally consistent with the NCR. Studies using NHI database data must pay careful attention to eligibility and record linkage; use of both sources is recommended. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Expanded national database collection and data coverage in the FINDbase worldwide database for clinically relevant genomic variation allele frequencies

    PubMed Central

    Viennas, Emmanouil; Komianou, Angeliki; Mizzi, Clint; Stojiljkovic, Maja; Mitropoulou, Christina; Muilu, Juha; Vihinen, Mauno; Grypioti, Panagiota; Papadaki, Styliani; Pavlidis, Cristiana; Zukic, Branka; Katsila, Theodora; van der Spek, Peter J.; Pavlovic, Sonja; Tzimas, Giannis; Patrinos, George P.

    2017-01-01

    FINDbase (http://www.findbase.org) is a comprehensive data repository that records the prevalence of clinically relevant genomic variants in various populations worldwide, such as pathogenic variants leading mostly to monogenic disorders and pharmacogenomics biomarkers. The database also records the incidence of rare genetic diseases in various populations, all in well-distinct data modules. Here, we report extensive data content updates in all data modules, with direct implications to clinical pharmacogenomics. Also, we report significant new developments in FINDbase, namely (i) the release of a new version of the ETHNOS software that catalyzes development curation of national/ethnic genetic databases, (ii) the migration of all FINDbase data content into 90 distinct national/ethnic mutation databases, all built around Microsoft's PivotViewer (http://www.getpivot.com) software (iii) new data visualization tools and (iv) the interrelation of FINDbase with DruGeVar database with direct implications in clinical pharmacogenomics. The abovementioned updates further enhance the impact of FINDbase, as a key resource for Genomic Medicine applications. PMID:27924022

  6. Mortality Trends in Pediatric and Congenital Heart Surgery: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

    PubMed

    Jacobs, Jeffrey P; He, Xia; Mayer, John E; Austin, Erle H; Quintessenza, James A; Karl, Tom R; Vricella, Luca; Mavroudis, Constantine; O'Brien, Sean M; Pasquali, Sara K; Hill, Kevin D; Husain, S Adil; Overman, David M; St Louis, James D; Han, Jane M; Shahian, David M; Cameron, Duke; Jacobs, Marshall L

    2016-10-01

    Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Database (STS CHSD) was queried to assess multiinstitutional trends over time in discharge mortality and postoperative length of stay (PLOS). Since 2009, operations in the STS CHSD have been classified according to STAT (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery) Congenital Heart Surgery Mortality Categories. The five STAT Mortality Categories were chosen to be optimal with respect to minimizing variation within categories and maximizing variation between categories. For this study, all index cardiac operations from 1998 to 2014, inclusive, were grouped by STAT Mortality Category (exclusions: patent ductus arteriosus ligation in patients weighing less than or equal to 2.5 kg and operations that could not be assigned to a STAT Mortality Category). End points were discharge mortality and PLOS in survivors for the entire period and for 4-year epochs. The Cochran-Armitage trend test was used to test the null hypothesis that the mortality was the same across epochs, by STAT Mortality Category. The analysis encompassed 202,895 index operations at 118 centers. The number of centers participating in STS CHSD increased in each epoch. Overall discharge mortality was 3.4% (6,959 of 202,895) for 1998 to 2014 and 3.1% (2,308 of 75,337) for 2011 to 2014. Statistically significant improvement in discharge mortality was seen in STAT Mortality Categories 2, 3, 4, and 5 (p values for STAT Mortality Categories 1 through 5 are 0.060, <0.001, 0.015, <0.001, and <0.001, respectively). PLOS in survivors was relatively unchanged over the same time intervals. Sensitivity analyses reveal that the finding of declining risk-stratified rates of discharge mortality over time is not simply attributable to the addition

  7. Epidemiology and Mortality of Liver Abscess in End-Stage Renal Disease Dialysis Patients: Taiwan National Cohort Study

    PubMed Central

    Huang, Po-Chang; Wang, Jhi-Joung; Yang, Chun-Ming; Chu, Chin-Chen; Chio, Chung-Ching; Chang, Fu-Lin; Chien, Chih-Chiang

    2014-01-01

    Background and Objectives To determine the incidence rates and mortality of liver abscess in ESRD patients on dialysis. Design, Setting, Participants, & Measurements Using Taiwan’s National Health Insurance Research Database, we collected data from all ESRD patients who initiated dialysis between 2000 and 2006. Patients were followed until death, end of dialysis, or December 31, 2008. Predictors of liver abscess and mortality were identified using Cox models. Results Of the 53,249 incident dialysis patients identified, 447 were diagnosed as having liver abscesses during the follow-up period (224/100,000 person-years). The cumulative incidence rate of liver abscess was 0.3%, 1.1%, and 1.5% at 1 year, 5 years, and 7 years, respectively. Elderly patients and patients on peritoneal dialysis had higher incidence rates. The baseline comorbidities of diabetes mellitus, polycystic kidney disease, malignancy, chronic liver disease, biliary tract disease, or alcoholism predicted development of liver abscess. Overall in-hospital mortality was 10.1%. Conclusions The incidence of liver abscess is high among ESRD dialysis patients. In addition to the well known risk factors of liver abscess, two other important risk factors, peritoneal dialysis and polycystic kidney disease, were found to predict liver abscess in ESRD dialysis patients. PMID:24551077

  8. Database resources of the National Center for Biotechnology Information

    PubMed Central

    2015-01-01

    The National Center for Biotechnology Information (NCBI) provides a large suite of online resources for biological information and data, including the GenBank® nucleic acid sequence database and the PubMed database of citations and abstracts for published life science journals. Additional NCBI resources focus on literature (Bookshelf, PubMed Central (PMC) and PubReader); medical genetics (ClinVar, dbMHC, the Genetic Testing Registry, HIV-1/Human Protein Interaction Database and MedGen); genes and genomics (BioProject, BioSample, dbSNP, dbVar, Epigenomics, Gene, Gene Expression Omnibus (GEO), Genome, HomoloGene, the Map Viewer, Nucleotide, PopSet, Probe, RefSeq, Sequence Read Archive, the Taxonomy Browser, Trace Archive and UniGene); and proteins and chemicals (Biosystems, COBALT, the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART), the Molecular Modeling Database (MMDB), Protein Clusters, Protein and the PubChem suite of small molecule databases). The Entrez system provides search and retrieval operations for many of these databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of these resources can be accessed through the NCBI home page at http://www.ncbi.nlm.nih.gov. PMID:25398906

  9. Database resources of the National Center for Biotechnology Information

    PubMed Central

    2016-01-01

    The National Center for Biotechnology Information (NCBI) provides a large suite of online resources for biological information and data, including the GenBank® nucleic acid sequence database and the PubMed database of citations and abstracts for published life science journals. Additional NCBI resources focus on literature (PubMed Central (PMC), Bookshelf and PubReader), health (ClinVar, dbGaP, dbMHC, the Genetic Testing Registry, HIV-1/Human Protein Interaction Database and MedGen), genomes (BioProject, Assembly, Genome, BioSample, dbSNP, dbVar, Epigenomics, the Map Viewer, Nucleotide, Probe, RefSeq, Sequence Read Archive, the Taxonomy Browser and the Trace Archive), genes (Gene, Gene Expression Omnibus (GEO), HomoloGene, PopSet and UniGene), proteins (Protein, the Conserved Domain Database (CDD), COBALT, Conserved Domain Architecture Retrieval Tool (CDART), the Molecular Modeling Database (MMDB) and Protein Clusters) and chemicals (Biosystems and the PubChem suite of small molecule databases). The Entrez system provides search and retrieval operations for most of these databases. Augmenting many of the web applications are custom implementations of the BLAST program optimized to search specialized datasets. All of these resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov. PMID:26615191

  10. Database resources of the National Center for Biotechnology Information

    PubMed Central

    Wheeler, David L.; Barrett, Tanya; Benson, Dennis A.; Bryant, Stephen H.; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M.; DiCuccio, Michael; Edgar, Ron; Federhen, Scott; Feolo, Michael; Geer, Lewis Y.; Helmberg, Wolfgang; Kapustin, Yuri; Khovayko, Oleg; Landsman, David; Lipman, David J.; Madden, Thomas L.; Maglott, Donna R.; Miller, Vadim; Ostell, James; Pruitt, Kim D.; Schuler, Gregory D.; Shumway, Martin; Sequeira, Edwin; Sherry, Steven T.; Sirotkin, Karl; Souvorov, Alexandre; Starchenko, Grigory; Tatusov, Roman L.; Tatusova, Tatiana A.; Wagner, Lukas; Yaschenko, Eugene

    2008-01-01

    In addition to maintaining the GenBank(R) nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data available through NCBI's web site. NCBI resources include Entrez, the Entrez Programming Utilities, My NCBI, PubMed, PubMed Central, Entrez Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link, Electronic PCR, OrfFinder, Spidey, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, Cancer Chromosomes, Entrez Genome, Genome Project and related tools, the Trace, Assembly, and Short Read Archives, the Map Viewer, Model Maker, Evidence Viewer, Clusters of Orthologous Groups, Influenza Viral Resources, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus, Entrez Probe, GENSAT, Database of Genotype and Phenotype, Online Mendelian Inheritance in Man, Online Mendelian Inheritance in Animals, the Molecular Modeling Database, the Conserved Domain Database, the Conserved Domain Architecture Retrieval Tool and the PubChem suite of small molecule databases. Augmenting the web applications are custom implementations of the BLAST program optimized to search specialized data sets. These resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov. PMID:18045790

  11. The National Landslide Database of Great Britain: Acquisition, communication and the role of social media

    NASA Astrophysics Data System (ADS)

    Pennington, Catherine; Freeborough, Katy; Dashwood, Claire; Dijkstra, Tom; Lawrie, Kenneth

    2015-11-01

    The British Geological Survey (BGS) is the national geological agency for Great Britain that provides geoscientific information to government, other institutions and the public. The National Landslide Database has been developed by the BGS and is the focus for national geohazard research for landslides in Great Britain. The history and structure of the geospatial database and associated Geographical Information System (GIS) are explained, along with the future developments of the database and its applications. The database is the most extensive source of information on landslides in Great Britain with over 17,000 records of landslide events to date, each documented as fully as possible for inland, coastal and artificial slopes. Data are gathered through a range of procedures, including: incorporation of other databases; automated trawling of current and historical scientific literature and media reports; new field- and desk-based mapping technologies with digital data capture, and using citizen science through social media and other online resources. This information is invaluable for directing the investigation, prevention and mitigation of areas of unstable ground in accordance with Government planning policy guidelines. The national landslide susceptibility map (GeoSure) and a national landslide domains map currently under development, as well as regional mapping campaigns, rely heavily on the information contained within the landslide database. Assessing susceptibility to landsliding requires knowledge of the distribution of failures, an understanding of causative factors, their spatial distribution and likely impacts, whilst understanding the frequency and types of landsliding present is integral to modelling how rainfall will influence the stability of a region. Communication of landslide data through the Natural Hazard Partnership (NHP) and Hazard Impact Model contributes to national hazard mitigation and disaster risk reduction with respect to weather and

  12. Dynamic delivery of the National Transit Database Sampling Manual.

    DOT National Transportation Integrated Search

    2013-02-01

    This project improves the National Transit Database (NTD) Sampling Manual and develops an Internet-based, WordPress-powered interactive Web tool to deliver the new NTD Sampling Manual dynamically. The new manual adds guidance and a tool for transit a...

  13. Dynamic delivery of the National Transit Database sampling manual.

    DOT National Transportation Integrated Search

    2013-02-01

    This project improves the National Transit Database (NTD) Sampling Manual and develops an Internet-based, WordPress-powered interactive Web tool to deliver the new NTD Sampling Manual dynamically. The new manual adds guidance and a tool for transit a...

  14. [Demographic characteristics and mortality among indigenous peoples in Mato Grosso do Sul State, Brazil].

    PubMed

    Ferreira, Maria Evanir Vicente; Matsuo, Tiemi; Souza, Regina Kazue Tanno de

    2011-12-01

    The present study aimed to assess mortality rates and related demographic factors among indigenous peoples in the State of Mato Grosso do Sul, Central-West Brazil, compared to the State's general population. Mortality rates were estimated based on data obtained from the Health Care Database for Indigenous Peoples and monthly patient care records as well as demographic data from the Brazilian Unified National Health System (SUS) and mortality data from the SUS Mortality Database. Compared to the overall population, among indigenous peoples there were proportionally more individuals under 15 years of age and fewer elderly, besides higher mortality rates at early ages and from infectious and parasitic diseases. Indigenous men showed significantly higher mortality rates from external causes and respiratory and infectious diseases, while among women the mortality rates from external causes and infectious diseases were higher. Suicide rates among young indigenous individuals were also particularly alarming. Indigenous people's health conditions are worse than those of the general population in Mato Grosso do Sul.

  15. Database resources of the National Center for Biotechnology Information

    PubMed Central

    Wheeler, David L.; Barrett, Tanya; Benson, Dennis A.; Bryant, Stephen H.; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M.; DiCuccio, Michael; Edgar, Ron; Federhen, Scott; Geer, Lewis Y.; Helmberg, Wolfgang; Kapustin, Yuri; Kenton, David L.; Khovayko, Oleg; Lipman, David J.; Madden, Thomas L.; Maglott, Donna R.; Ostell, James; Pruitt, Kim D.; Schuler, Gregory D.; Schriml, Lynn M.; Sequeira, Edwin; Sherry, Stephen T.; Sirotkin, Karl; Souvorov, Alexandre; Starchenko, Grigory; Suzek, Tugba O.; Tatusov, Roman; Tatusova, Tatiana A.; Wagner, Lukas; Yaschenko, Eugene

    2006-01-01

    In addition to maintaining the GenBank(R) nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data made available through NCBI's Web site. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central, Entrez Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link (BLink), Electronic PCR, OrfFinder, Spidey, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, Cancer Chromosomes, Entrez Genomes and related tools, the Map Viewer, Model Maker, Evidence Viewer, Clusters of Orthologous Groups, Retroviral Genotyping Tools, HIV-1, Human Protein Interaction Database, SAGEmap, Gene Expression Omnibus, Entrez Probe, GENSAT, Online Mendelian Inheritance in Man, Online Mendelian Inheritance in Animals, the Molecular Modeling Database, the Conserved Domain Database, the Conserved Domain Architecture Retrieval Tool and the PubChem suite of small molecule databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized datasets. All of the resources can be accessed through the NCBI home page at: . PMID:16381840

  16. Database resources of the National Center for Biotechnology Information

    PubMed Central

    Wheeler, David L.; Church, Deanna M.; Lash, Alex E.; Leipe, Detlef D.; Madden, Thomas L.; Pontius, Joan U.; Schuler, Gregory D.; Schriml, Lynn M.; Tatusova, Tatiana A.; Wagner, Lukas; Rapp, Barbara A.

    2001-01-01

    In addition to maintaining the GenBank® nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides data analysis and retrieval resources that operate on the data in GenBank and a variety of other biological data made available through NCBI’s Web site. NCBI data retrieval resources include Entrez, PubMed, LocusLink and the Taxonomy Browser. Data analysis resources include BLAST, Electronic PCR, OrfFinder, RefSeq, UniGene, HomoloGene, Database of Single Nucleotide Polymorphisms (dbSNP), Human Genome Sequencing, Human MapViewer, GeneMap’99, Human–Mouse Homology Map, Cancer Chromosome Aberration Project (CCAP), Entrez Genomes, Clusters of Orthologous Groups (COGs) database, Retroviral Genotyping Tools, Cancer Genome Anatomy Project (CGAP), SAGEmap, Gene Expression Omnibus (GEO), Online Mendelian Inheri­tance in Man (OMIM), the Molecular Modeling Database (MMDB) and the Conserved Domain Database (CDD). Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of the resources can be accessed through the NCBI home page at: http://www.ncbi.nlm.nih.gov. PMID:11125038

  17. Analysis of Diagnoses Associated with Multiple Sclerosis-Related In-Hospital Mortality Using the Premier Hospital Database.

    PubMed

    Ernst, Frank R; Pocoski, Jennifer; Cutter, Gary; Kaufman, David W; Pleimes, Dirk

    2016-01-01

    We sought to compare mortality rates and related diagnoses in hospitalized patients with multiple sclerosis (MS), those with diabetes mellitus (DM), and the general hospitalized population (GHP). Patients who died between 2007 and 2011 were identified in the US hospital-based Premier Healthcare Database. Demographic information was collected, mortality rates calculated, and principal diagnoses categorized. Of 55,152 unique patients with MS identified, 1518 died. Mean age at death was 10 years younger for the MS group (63.4 years) than for the DM (73.3 years) and GHP (73.1 years) groups. Age-adjusted mortality rates, based on the 2000 US Standard Million Population, were 1077, 1248, and 1133 per 100,000, respectively. Infection was the most common principal diagnosis at the hospital stay during which the patient died in the MS cohort (43.1% vs. 26.3% and 24.0% in the DM and GHP groups, respectively). Other common principal diagnoses in the MS group included pulmonary (17.5%) and cardiovascular (12.1%) disease. Septicemia/sepsis/septic shock was a secondary diagnosis for 50.7% of patients with MS versus 36.0% and 31.0% of patients in the DM and GHP cohorts, respectively. Patients with MS had a shorter life span than patients with DM or the GHP and were more likely to have a principal diagnosis of infection at their final hospital stay. However, the database was limited to codes recorded in the hospital; diagnoses received outside the hospital were not captured.

  18. [The role of supply-side characteristics of services in AIDS mortality in Mexico].

    PubMed

    Bautista-Arredondo, Sergio; Serván-Mori, Edson; Silverman-Retana, Omar; Contreras-Loya, David; Romero-Martínez, Martín; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Lozano, Rafael

    2015-01-01

    To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

  19. Use of national clinical databases for informing and for evaluating health care policies.

    PubMed

    Black, Nick; Tan, Stefanie

    2013-02-01

    Policy-makers and analysts could make use of national clinical databases either to inform or to evaluate meso-level (organisation and delivery of health care) and macro-level (national) policies. Reviewing the use of 15 of the best established databases in England, we identify and describe four published examples of each use. These show that policy-makers can either make use of the data itself or of research based on the database. For evaluating policies, the major advantages are the huge sample sizes available, the generalisability of the data, its immediate availability and historic information. The principal methodological challenges involve the need for risk adjustment and time-series analysis. Given their usefulness in the policy arena, there are several reasons why national clinical databases have not been used more, some due to a lack of 'push' by their custodians and some to the lack of 'pull' by policy-makers. Greater exploitation of these valuable resources would be facilitated by policy-makers' and custodians' increased awareness, minimisation of legal restrictions on data use, improvements in the quality of databases and a library of examples of applications to policy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Progress on Updating the 1961-1990 National Solar Radiation Database

    NASA Technical Reports Server (NTRS)

    Renne, D.; Wilcox, S.; Marion, B.; George, R.; Myers, D.

    2003-01-01

    The 1961-1990 National Solar Radiation Data Base (NSRDB) provides a 30-year climate summary and solar characterization of 239 locations throughout the United States. Over the past several years, the National Renewable Energy Laboratory (NREL) has received numerous inquiries from a range of constituents as to whether an update of the database to include the 1990s will be developed. However, there are formidable challenges to creating an update of the serially complete station-specific database for the 1971-2000 period. During the 1990s, the National Weather Service changed its observational procedures from a human-based to an automated system, resulting in the loss of important input variables to the model used to complete the 1961-1990 NSRDB. As a result, alternative techniques are required for an update that covers the 1990s. This paper examines several alternative approaches for creating this update and describes preliminary NREL plans for implementing the update.

  1. Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database.

    PubMed

    Feng, Mengling; McSparron, Jakob I; Kien, Dang Trung; Stone, David J; Roberts, David H; Schwartzstein, Richard M; Vieillard-Baron, Antoine; Celi, Leo Anthony

    2018-06-01

    While the use of transthoracic echocardiography (TTE) in the ICU is rapidly expanding, the contribution of TTE to altering patient outcomes among ICU patients with sepsis has not been examined. This study was designed to examine the association of TTE with 28-day mortality specifically in that population. The MIMIC-III database was employed to identify patients with sepsis who had and had not received TTE. The statistical approaches utilized included multivariate regression, propensity score analysis, doubly robust estimation, the gradient boosted model, and an inverse probability-weighting model to ensure the robustness of our findings. Significant benefit in terms of 28-day mortality was observed among the TTE patients compared to the control (no TTE) group (odds ratio = 0.78, 95% CI 0.68-0.90, p < 0.001). The amount of fluid administered (2.5 vs. 2.1 L on day 1, p < 0.001), use of dobutamine (2% vs. 1%, p = 0.007), and the maximum dose of norepinephrine (1.4 vs. 1 mg/min, p = 0.001) were significantly higher for the TTE patients. Importantly, the TTE patients were weaned off vasopressors more quickly than those in the no TTE group (vasopressor-free days on day 28 of 21 vs. 19, p = 0.004). In a general population of critically ill patients with sepsis, use of TTE is associated with an improvement in 28-day mortality.

  2. 77 FR 66622 - Submission for OMB Review; Comment Request: National Database for Autism Research (NDAR) Data...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review; Comment Request: National Database for Autism Research (NDAR) Data Access Request SUMMARY: Under the... currently valid OMB control number. Proposed Collection: Title: National Database for Autism Research (NDAR...

  3. Safe working in a 7-day service. Experience of hip fracture care as documented by the UK National Hip Fracture Database.

    PubMed

    Neuburger, Jenny; Currie, Colin; Wakeman, Robert; Georghiou, Theo; Boulton, Chris; Johansen, Antony; Tsang, Carmen; Wilson, Helen; Cromwell, David A; Jan van der Meulen

    2018-05-22

    to describe differences in care and 30-day mortality of patients admitted with hip fracture on weekends (Saturday-Sunday) compared to weekdays (Monday-Friday), and their relationship to the organisation of care. data came from the National Hip Fracture Database (NHFD) linked to ONS mortality data on 52,599 patients presenting to 162 units in England between 1 January and 31 December 2014. This was combined with information on geriatrician staffing and major trauma centre (MTC) status. 30-day mortality and care were compared for patients admitted at weekends and weekdays; separately for patients treated in units grouped by the mean level of input by geriatricians, weekend geriatrician clinical cover and MTC status. Differences were adjusted for variation in patients' characteristics. there was no evidence of differences in 30-day mortality between patients admitted at weekends compared to weekdays (7.2 vs 7.5%, P = 0.3) before or after adjusting for patient characteristics in either MTCs or general hospitals. The proportion receiving a preoperative geriatrician assessment was lower at weekends (42.8 vs 60.7%, P < 0.001). 30-day mortality was lower in units with higher levels of geriatrician input, but there was no weekend mortality effect associated with lower levels of input or absence of weekend cover. there was no evidence of a weekend mortality effect among patients treated for hip fracture in the English NHS. It appears that clinical teams provide comparably safe and effective care throughout the week. However, greater geriatrician involvement in teams was associated with overall lower mortality.

  4. THE NATIONAL EXPOSURE RESEARCH LABORATORY'S COMPREHENSIVE HUMAN ACTIVITY DATABASE

    EPA Science Inventory

    EPA's National Exposure Research Laboratory (NERL) has combined data from nine U.S. studies related to human activities into one comprehensive data system that can be accessed via the world-wide web. The data system is called CHAD-Consolidated Human Activity Database-and it is ...

  5. THE NATIONAL EXPOSURE RESEARCH LABORATORY'S CONSOLIDATED HUMAN ACTIVITY DATABASE

    EPA Science Inventory

    EPA's National Exposure Research Laboratory (NERL) has combined data from 12 U.S. studies related to human activities into one comprehensive data system that can be accessed via the Internet. The data system is called the Consolidated Human Activity Database (CHAD), and it is ...

  6. The Israeli National Genetic database: a 10-year experience.

    PubMed

    Zlotogora, Joël; Patrinos, George P

    2017-03-16

    The Israeli National and Ethnic Mutation database ( http://server.goldenhelix.org/israeli ) was launched in September 2006 on the ETHNOS software to include clinically relevant genomic variants reported among Jewish and Arab Israeli patients. In 2016, the database was reviewed and corrected according to ClinVar ( https://www.ncbi.nlm.nih.gov/clinvar ) and ExAC ( http://exac.broadinstitute.org ) database entries. The present article summarizes some key aspects from the development and continuous update of the database over a 10-year period, which could serve as a paradigm of successful database curation for other similar resources. In September 2016, there were 2444 entries in the database, 890 among Jews, 1376 among Israeli Arabs, and 178 entries among Palestinian Arabs, corresponding to an ~4× data content increase compared to when originally launched. While the Israeli Arab population is much smaller than the Jewish population, the number of pathogenic variants causing recessive disorders reported in the database is higher among Arabs (934) than among Jews (648). Nevertheless, the number of pathogenic variants classified as founder mutations in the database is smaller among Arabs (175) than among Jews (192). In 2016, the entire database content was compared to that of other databases such as ClinVar and ExAC. We show that a significant difference in the percentage of pathogenic variants from the Israeli genetic database that were present in ExAC was observed between the Jewish population (31.8%) and the Israeli Arab population (20.6%). The Israeli genetic database was launched in 2006 on the ETHNOS software and is available online ever since. It allows querying the database according to the disorder and the ethnicity; however, many other features are not available, in particular the possibility to search according to the name of the gene. In addition, due to the technical limitations of the previous ETHNOS software, new features and data are not included in the

  7. 75 FR 61553 - National Transit Database: Amendments to the Urbanized Area Annual Reporting Manual and to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... Transit Database: Amendments to the Urbanized Area Annual Reporting Manual and to the Safety and Security... the 2011 National Transit Database Urbanized Area Annual Reporting Manual and Announcement of... Transit Administration's (FTA) National Transit Database (NTD) reporting requirements, including...

  8. Paleontologic Database for the Guadalupe Peak 1:100,000 Quadrangle: A Prototype for the National Paleontologic Database, Paleodata

    USGS Publications Warehouse

    Wardlaw, Bruce R.

    2008-01-01

    This report is a compilation of most of the known fossil locality data from Guadalupe Peak 1:100,000 quadrangle, West Texas. The data represent several major collection efforts over the past century by the Smithsonian Institution, the American Museum of Natural History, and the U.S. Geological Survey. This dataset is not meant to be all inclusive but instead is an attempt to pull together the vast amount of paleontologic data originally collected by Girty (1908) and King (1948), much of which is unpublished and (or) poorly located. The author visited most of the major fossil collection sites to collect for conodonts on a ten-year program funded by the Smithsonian Institution for collaborative research with Richard E. Grant. Guadalupe Mountains National Park occupies the northern part of the quadrangle, and the Park Service has been very helpful over the years in compiling the data and relocating the collection sites. This dataset serves as the prototype for the National Paleontologic Database, part of the National Geologic Map Database Project. The database is intended to be indexed to 1:100,000 quadrangles of the U.S. The minimum number of fields and information within those fields is shown in the report.

  9. The National Landslide Database and GIS for Great Britain: construction, development, data acquisition, application and communication

    NASA Astrophysics Data System (ADS)

    Pennington, Catherine; Dashwood, Claire; Freeborough, Katy

    2014-05-01

    The National Landslide Database has been developed by the British Geological Survey (BGS) and is the focus for national geohazard research for landslides in Great Britain. The history and structure of the geospatial database and associated Geographical Information System (GIS) are explained, along with the future developments of the database and its applications. The database is the most extensive source of information on landslides in Great Britain with over 16,500 records of landslide events, each documented as fully as possible. Data are gathered through a range of procedures, including: incorporation of other databases; automated trawling of current and historical scientific literature and media reports; new field- and desk-based mapping technologies with digital data capture, and crowd-sourcing information through social media and other online resources. This information is invaluable for the investigation, prevention and mitigation of areas of unstable ground in accordance with Government planning policy guidelines. The national landslide susceptibility map (GeoSure) and a national landslide domain map currently under development rely heavily on the information contained within the landslide database. Assessing susceptibility to landsliding requires knowledge of the distribution of failures and an understanding of causative factors and their spatial distribution, whilst understanding the frequency and types of landsliding present is integral to modelling how rainfall will influence the stability of a region. Communication of landslide data through the Natural Hazard Partnership (NHP) contributes to national hazard mitigation and disaster risk reduction with respect to weather and climate. Daily reports of landslide potential are published by BGS through the NHP and data collected for the National Landslide Database is used widely for the creation of these assessments. The National Landslide Database is freely available via an online GIS and is used by a

  10. Social inclusion affects elderly suicide mortality.

    PubMed

    Yur'yev, Andriy; Leppik, Lauri; Tooding, Liina-Mai; Sisask, Merike; Värnik, Peeter; Wu, Jing; Värnik, Airi

    2010-12-01

    National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared. For each country, mean age-adjusted, gender-specific elderly suicide rates in the last five years for which data had been available were obtained from the WHO European Mortality Database. Questions about citizens' attitudes towards the elderly were taken from the European Social Survey. Correlations between attitudes and suicide rates were analyzed using Pearson's test. Differences between mean scores for Western and Eastern European attitudes were calculated, and data on labor-market exit ages were obtained from the EUROSTAT database. Perception of the elderly as having higher status, recognition of their economic contribution and higher moral standards, and friendly feelings towards and admiration of them are inversely correlated with suicide mortality. Suicide rates are lower in countries where the elderly live with their families more often. Elderly suicide mortality and labor-market exit age are inversely correlated. In Eastern European countries, elderly people's status and economic contribution are seen as less important. Western Europeans regard the elderly with more admiration, consider them more friendly and more often have elderly relatives in the family. The data also show gender differences. Society's attitudes influence elderly suicide mortality; attitudes towards the elderly are more favorable among Western European citizens; and extended labor-market inclusion of the elderly is a suicide-protective factor.

  11. Database resources of the National Center for Biotechnology Information

    PubMed Central

    Sayers, Eric W.; Barrett, Tanya; Benson, Dennis A.; Bolton, Evan; Bryant, Stephen H.; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M.; DiCuccio, Michael; Federhen, Scott; Feolo, Michael; Fingerman, Ian M.; Geer, Lewis Y.; Helmberg, Wolfgang; Kapustin, Yuri; Krasnov, Sergey; Landsman, David; Lipman, David J.; Lu, Zhiyong; Madden, Thomas L.; Madej, Tom; Maglott, Donna R.; Marchler-Bauer, Aron; Miller, Vadim; Karsch-Mizrachi, Ilene; Ostell, James; Panchenko, Anna; Phan, Lon; Pruitt, Kim D.; Schuler, Gregory D.; Sequeira, Edwin; Sherry, Stephen T.; Shumway, Martin; Sirotkin, Karl; Slotta, Douglas; Souvorov, Alexandre; Starchenko, Grigory; Tatusova, Tatiana A.; Wagner, Lukas; Wang, Yanli; Wilbur, W. John; Yaschenko, Eugene; Ye, Jian

    2012-01-01

    In addition to maintaining the GenBank® nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data made available through the NCBI Website. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central (PMC), Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link (BLink), Primer-BLAST, COBALT, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, dbVar, Epigenomics, Genome and related tools, the Map Viewer, Model Maker, Evidence Viewer, Trace Archive, Sequence Read Archive, BioProject, BioSample, Retroviral Genotyping Tools, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus (GEO), Probe, Online Mendelian Inheritance in Animals (OMIA), the Molecular Modeling Database (MMDB), the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART), Biosystems, Protein Clusters and the PubChem suite of small molecule databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of these resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov. PMID:22140104

  12. Database resources of the National Center for Biotechnology Information.

    PubMed

    Sayers, Eric W; Barrett, Tanya; Benson, Dennis A; Bolton, Evan; Bryant, Stephen H; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M; Dicuccio, Michael; Federhen, Scott; Feolo, Michael; Fingerman, Ian M; Geer, Lewis Y; Helmberg, Wolfgang; Kapustin, Yuri; Krasnov, Sergey; Landsman, David; Lipman, David J; Lu, Zhiyong; Madden, Thomas L; Madej, Tom; Maglott, Donna R; Marchler-Bauer, Aron; Miller, Vadim; Karsch-Mizrachi, Ilene; Ostell, James; Panchenko, Anna; Phan, Lon; Pruitt, Kim D; Schuler, Gregory D; Sequeira, Edwin; Sherry, Stephen T; Shumway, Martin; Sirotkin, Karl; Slotta, Douglas; Souvorov, Alexandre; Starchenko, Grigory; Tatusova, Tatiana A; Wagner, Lukas; Wang, Yanli; Wilbur, W John; Yaschenko, Eugene; Ye, Jian

    2012-01-01

    In addition to maintaining the GenBank® nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data made available through the NCBI Website. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central (PMC), Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link (BLink), Primer-BLAST, COBALT, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, dbVar, Epigenomics, Genome and related tools, the Map Viewer, Model Maker, Evidence Viewer, Trace Archive, Sequence Read Archive, BioProject, BioSample, Retroviral Genotyping Tools, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus (GEO), Probe, Online Mendelian Inheritance in Animals (OMIA), the Molecular Modeling Database (MMDB), the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART), Biosystems, Protein Clusters and the PubChem suite of small molecule databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of these resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov.

  13. Database resources of the National Center for Biotechnology Information

    PubMed Central

    2013-01-01

    In addition to maintaining the GenBank® nucleic acid sequence database, the National Center for Biotechnology Information (NCBI, http://www.ncbi.nlm.nih.gov) provides analysis and retrieval resources for the data in GenBank and other biological data made available through the NCBI web site. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central, Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link (BLink), Primer-BLAST, COBALT, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, dbVar, Epigenomics, the Genetic Testing Registry, Genome and related tools, the Map Viewer, Model Maker, Evidence Viewer, Trace Archive, Sequence Read Archive, BioProject, BioSample, Retroviral Genotyping Tools, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus, Probe, Online Mendelian Inheritance in Animals, the Molecular Modeling Database, the Conserved Domain Database, the Conserved Domain Architecture Retrieval Tool, Biosystems, Protein Clusters and the PubChem suite of small molecule databases. Augmenting many of the web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of these resources can be accessed through the NCBI home page. PMID:23193264

  14. Database resources of the National Center for Biotechnology Information.

    PubMed

    Sayers, Eric W; Barrett, Tanya; Benson, Dennis A; Bryant, Stephen H; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M; DiCuccio, Michael; Edgar, Ron; Federhen, Scott; Feolo, Michael; Geer, Lewis Y; Helmberg, Wolfgang; Kapustin, Yuri; Landsman, David; Lipman, David J; Madden, Thomas L; Maglott, Donna R; Miller, Vadim; Mizrachi, Ilene; Ostell, James; Pruitt, Kim D; Schuler, Gregory D; Sequeira, Edwin; Sherry, Stephen T; Shumway, Martin; Sirotkin, Karl; Souvorov, Alexandre; Starchenko, Grigory; Tatusova, Tatiana A; Wagner, Lukas; Yaschenko, Eugene; Ye, Jian

    2009-01-01

    In addition to maintaining the GenBank nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data made available through the NCBI web site. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central, Entrez Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link (BLink), Electronic PCR, OrfFinder, Spidey, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, Cancer Chromosomes, Entrez Genomes and related tools, the Map Viewer, Model Maker, Evidence Viewer, Clusters of Orthologous Groups (COGs), Retroviral Genotyping Tools, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus (GEO), Entrez Probe, GENSAT, Online Mendelian Inheritance in Man (OMIM), Online Mendelian Inheritance in Animals (OMIA), the Molecular Modeling Database (MMDB), the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART) and the PubChem suite of small molecule databases. Augmenting many of the web applications is custom implementation of the BLAST program optimized to search specialized data sets. All of the resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov.

  15. Database resources of the National Center for Biotechnology Information

    PubMed Central

    Acland, Abigail; Agarwala, Richa; Barrett, Tanya; Beck, Jeff; Benson, Dennis A.; Bollin, Colleen; Bolton, Evan; Bryant, Stephen H.; Canese, Kathi; Church, Deanna M.; Clark, Karen; DiCuccio, Michael; Dondoshansky, Ilya; Federhen, Scott; Feolo, Michael; Geer, Lewis Y.; Gorelenkov, Viatcheslav; Hoeppner, Marilu; Johnson, Mark; Kelly, Christopher; Khotomlianski, Viatcheslav; Kimchi, Avi; Kimelman, Michael; Kitts, Paul; Krasnov, Sergey; Kuznetsov, Anatoliy; Landsman, David; Lipman, David J.; Lu, Zhiyong; Madden, Thomas L.; Madej, Tom; Maglott, Donna R.; Marchler-Bauer, Aron; Karsch-Mizrachi, Ilene; Murphy, Terence; Ostell, James; O'Sullivan, Christopher; Panchenko, Anna; Phan, Lon; Pruitt, Don Preussm Kim D.; Rubinstein, Wendy; Sayers, Eric W.; Schneider, Valerie; Schuler, Gregory D.; Sequeira, Edwin; Sherry, Stephen T.; Shumway, Martin; Sirotkin, Karl; Siyan, Karanjit; Slotta, Douglas; Soboleva, Alexandra; Soussov, Vladimir; Starchenko, Grigory; Tatusova, Tatiana A.; Trawick, Bart W.; Vakatov, Denis; Wang, Yanli; Ward, Minghong; John Wilbur, W.; Yaschenko, Eugene; Zbicz, Kerry

    2014-01-01

    In addition to maintaining the GenBank® nucleic acid sequence database, the National Center for Biotechnology Information (NCBI, http://www.ncbi.nlm.nih.gov) provides analysis and retrieval resources for the data in GenBank and other biological data made available through the NCBI Web site. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central, PubReader, Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link, Primer-BLAST, COBALT, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, dbVar, Epigenomics, the Genetic Testing Registry, Genome and related tools, the Map Viewer, Trace Archive, Sequence Read Archive, BioProject, BioSample, ClinVar, MedGen, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus, Probe, Online Mendelian Inheritance in Animals, the Molecular Modeling Database, the Conserved Domain Database, the Conserved Domain Architecture Retrieval Tool, Biosystems, Protein Clusters and the PubChem suite of small molecule databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All these resources can be accessed through the NCBI home page. PMID:24259429

  16. Analysis of Diagnoses Associated with Multiple Sclerosis–Related In-Hospital Mortality Using the Premier Hospital Database

    PubMed Central

    Pocoski, Jennifer; Cutter, Gary; Kaufman, David W.; Pleimes, Dirk

    2016-01-01

    Background: We sought to compare mortality rates and related diagnoses in hospitalized patients with multiple sclerosis (MS), those with diabetes mellitus (DM), and the general hospitalized population (GHP). Methods: Patients who died between 2007 and 2011 were identified in the US hospital–based Premier Healthcare Database. Demographic information was collected, mortality rates calculated, and principal diagnoses categorized. Results: Of 55,152 unique patients with MS identified, 1518 died. Mean age at death was 10 years younger for the MS group (63.4 years) than for the DM (73.3 years) and GHP (73.1 years) groups. Age-adjusted mortality rates, based on the 2000 US Standard Million Population, were 1077, 1248, and 1133 per 100,000, respectively. Infection was the most common principal diagnosis at the hospital stay during which the patient died in the MS cohort (43.1% vs. 26.3% and 24.0% in the DM and GHP groups, respectively). Other common principal diagnoses in the MS group included pulmonary (17.5%) and cardiovascular (12.1%) disease. Septicemia/sepsis/septic shock was a secondary diagnosis for 50.7% of patients with MS versus 36.0% and 31.0% of patients in the DM and GHP cohorts, respectively. Conclusions: Patients with MS had a shorter life span than patients with DM or the GHP and were more likely to have a principal diagnosis of infection at their final hospital stay. However, the database was limited to codes recorded in the hospital; diagnoses received outside the hospital were not captured. PMID:27252603

  17. BioData: a national aquatic bioassessment database

    USGS Publications Warehouse

    MacCoy, Dorene

    2011-01-01

    BioData is a U.S. Geological Survey (USGS) web-enabled database that for the first time provides for the capture, curation, integration, and delivery of bioassessment data collected by local, regional, and national USGS projects. BioData offers field biologists advanced capabilities for entering, editing, and reviewing the macroinvertebrate, algae, fish, and supporting habitat data from rivers and streams. It offers data archival and curation capabilities that protect and maintain data for the long term. BioData provides the Federal, State, and local governments, as well as the scientific community, resource managers, the private sector, and the public with easy access to tens of thousands of samples collected nationwide from thousands of stream and river sites. BioData also provides the USGS with centralized data storage for delivering data to other systems and applications through automated web services. BioData allows users to combine data sets of known quality from different projects in various locations over time. It provides a nationally aggregated database for users to leverage data from many independent projects that, until now, was not feasible at this scale. For example, from 1991 to 2011, the USGS Idaho Water Science Center collected more than 816 bioassessment samples from 63 sites for the National Water Quality Assessment (NAWQA) Program and more than 477 samples from 39 sites for a cooperative USGS and State of Idaho Statewide Water Quality Network (fig. 1). Using BioData, 20 years of samples collected for both of these projects can be combined for analysis. BioData delivers all of the data using current taxonomic nomenclature, thus relieving users of the difficult and time-consuming task of harmonizing taxonomy among samples collected during different time periods. Fish data are reported using the Integrated Taxonomic Information Service (ITIS) Taxonomic Serial Numbers (TSN's). A simple web-data input interface and self-guided, public data

  18. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation.

    PubMed

    You, Danzhen; Hug, Lucia; Ejdemyr, Simon; Idele, Priscila; Hogan, Daniel; Mathers, Colin; Gerland, Patrick; New, Jin Rou; Alkema, Leontine

    2015-12-05

    In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. We aimed to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030. We updated the UN Inter-agency Group for Child Mortality Estimation (UN IGME) database with 5700 country-year datapoints. As of July, 2015, the database contains about 17 000 country-year datapoints for mortality of children younger than 5 years for 195 countries, and includes all available nationally-representative data from vital registration systems, population censuses, household surveys, and sample registration systems. We used these data to generate estimates, with uncertainty intervals, of under-5 (age 0-4 years) mortality using a Bayesian B-spline bias-reduction model (B3 model). This model includes a data model to adjust for systematic biases associated with different types of data sources. To provide insights into the global and regional burden of under-5 deaths associated with post-2015 targets, we constructed five scenario-based projections for under-5 mortality from 2016 to 2030 and estimated national, regional, and global under-5 mortality rates up to 2030 for each scenario. The global under-5 mortality rate has fallen from 90·6 deaths per 1000 livebirths (90% uncertainty interval 89·3-92·2) in 1990 to 42·5 (40·9-45·6) in 2015. During the same period, the annual number of under-5 deaths worldwide dropped from 12·7 million (12·6 million-13·0 million) to 5·9 million (5·7 million-6·4 million). The global under-5 mortality rate reduced by 53% (50-55%) in the past 25 years and therefore missed the MDG 4 target. Based on point estimates, two regions-east Asia and the Pacific, and Latin America and the Caribbean

  19. Educational inequalities in mortality by cause of death: first national data for the Netherlands.

    PubMed

    Kulhánová, Ivana; Hoffmann, Rasmus; Eikemo, Terje A; Menvielle, Gwenn; Mackenbach, Johan P

    2014-10-01

    Using new facilities for linking large databases, we aimed to evaluate for the first time the magnitude of relative and absolute educational inequalities in mortality by sex and cause of death in the Netherlands. We analyzed data from Dutch Labour Force Surveys (1998-2002) with mortality follow-up 1998-2007 among people aged 30-79 years. We calculated hazard ratios using Cox proportional hazards model, age-standardized mortality rates and partial life expectancy by education. We compared results for the Netherlands with those for other European countries. The relative risk of dying was about two times higher among primary educated men and women as compared to their tertiary educated counterparts, leading to a gap in partial life expectancy of 3.4 years (men) and 2.4 years (women). Inequalities in mortality are similar to those in other countries in North-Western Europe, but inequalities in lung cancer mortality are substantially larger in the Netherlands, particularly among men. The Netherlands has large inequalities in mortality, especially for smoking-related causes of death. These large inequalities require the urgent attention of policy makers.

  20. The Identification of People with Disabilities in National Databases: A Failure to Communicate. Technical Report 6.

    ERIC Educational Resources Information Center

    McGrew, Kevin; And Others

    This research analyzes similarities and differences in how students with disabilities are identified in national databases, through examination of 19 national data collection programs in the U.S. Departments of Education, Commerce, Justice, and Health and Human Services, as well as databases from the National Science Foundation. The study found…

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

    PubMed Central

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

    2015-01-01

    Background Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. Objectives To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. Research design We performed a multi-center retrospective case-control study using 2001–2010 Medicare claims data linked to a national survey identifying United States hospitals adopting ICU telemedicine. We matched each adopting hospital (cases) to up to 3 non-adopting hospitals (controls) based on size, case-mix and geographic proximity during the year of adoption. Using ICU admissions from 2 years before and after the adoption date, we compared outcomes between case and control hospitals using a difference-in-differences approach. Results 132 adopting case hospitals were matched to 389 similar non-adopting control hospitals. The pre- and post-adoption unadjusted 90-day mortality was similar in both case hospitals (24.0% vs. 24.3%, p=0.07) and control hospitals (23.5% vs. 23.7%, p<0.01). In the difference-in-differences analysis, ICU telemedicine adoption was associated with a small relative reduction in 90-day mortality (ratio of odds ratios: 0.96, 95% CI = 0.95–0.98, p<0.001). However, there was wide variation in the ICU telemedicine effect across individual hospitals (median ratio of odds ratios: 1.01; interquartile range 0.85–1.12; range 0.45–2.54). Only 16 case hospitals (12.2%) experienced statistically significant mortality reductions post-adoption. Hospitals with a significant mortality reduction were more likely to have large annual admission volumes (p<0.001) and be located in urban areas (p=0.04) compared to other hospitals. Conclusions Although ICU telemedicine adoption resulted in a small relative overall mortality reduction, there was heterogeneity in effect across adopting hospitals, with large-volume urban hospitals

  2. Incidence of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Nationwide Population-Based Study Using National Health Insurance Database in Korea.

    PubMed

    Yang, Min-Suk; Lee, Jin Yong; Kim, Jayeun; Kim, Gun-Woo; Kim, Byung-Keun; Kim, Ju-Young; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

    2016-01-01

    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases; however, it is hard to estimate their incidence due to the rarity of these diseases. We evaluated the incidence of SJS and TEN using a nationwide administrative database. We used a national medical insurance review system (Health Insurance Review and Assessment) database which contained the claim data of the entire nation from 2009 to 2013 to estimate the accurate incidence of SJS and TEN in Korea. The diagnostic codes of L511 (SJS) or L512 (TEN) from the International Classification of Diseases-10th revision were used to define the target study population. We also retrospectively followed up a 2011 SJS and TEN cohort for 24 months in order to assess the in-hospital mortality, related complications and total claims cost due to SJS and TEN. A total of 1,167 (938 SJS and 229 TEN) cases were newly diagnosed from 2010 to 2013. The age- and sex-standardized annual incidences estimated in this study were 3.96 to 5.03 in SJS and 0.94 to 1.45 in TEN per million. There was no significant change in annual incidence throughout the study periods. When analyzed by 10-year age groups, the annual incidence was the lowest in group 20-29 years and the highest in group 70 for both SJS and TEN. Based on the 2011 cohort analysis, the in-hospital mortality were 5.7 and 15.1% for SJS and TEN, respectively. The mortality increased with age, particularly, after 40 years of age. Among the complications related with SJS or TEN, ocular sequelae was the most common (43.1 and 43.4% of SJS and TEN patients, respectively) followed by urethral sequelae (5.7 and 9.4% of SJS and TEN patients, respectively). Overall, our data suggest that SJS, and TEN are infrequent but constantly arise throughout the years.

  3. Database resources of the National Center for Biotechnology Information.

    PubMed

    2016-01-04

    The National Center for Biotechnology Information (NCBI) provides a large suite of online resources for biological information and data, including the GenBank(®) nucleic acid sequence database and the PubMed database of citations and abstracts for published life science journals. Additional NCBI resources focus on literature (PubMed Central (PMC), Bookshelf and PubReader), health (ClinVar, dbGaP, dbMHC, the Genetic Testing Registry, HIV-1/Human Protein Interaction Database and MedGen), genomes (BioProject, Assembly, Genome, BioSample, dbSNP, dbVar, Epigenomics, the Map Viewer, Nucleotide, Probe, RefSeq, Sequence Read Archive, the Taxonomy Browser and the Trace Archive), genes (Gene, Gene Expression Omnibus (GEO), HomoloGene, PopSet and UniGene), proteins (Protein, the Conserved Domain Database (CDD), COBALT, Conserved Domain Architecture Retrieval Tool (CDART), the Molecular Modeling Database (MMDB) and Protein Clusters) and chemicals (Biosystems and the PubChem suite of small molecule databases). The Entrez system provides search and retrieval operations for most of these databases. Augmenting many of the web applications are custom implementations of the BLAST program optimized to search specialized datasets. All of these resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov. Published by Oxford University Press on behalf of Nucleic Acids Research 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Database resources of the National Center for Biotechnology Information.

    PubMed

    2015-01-01

    The National Center for Biotechnology Information (NCBI) provides a large suite of online resources for biological information and data, including the GenBank(®) nucleic acid sequence database and the PubMed database of citations and abstracts for published life science journals. Additional NCBI resources focus on literature (Bookshelf, PubMed Central (PMC) and PubReader); medical genetics (ClinVar, dbMHC, the Genetic Testing Registry, HIV-1/Human Protein Interaction Database and MedGen); genes and genomics (BioProject, BioSample, dbSNP, dbVar, Epigenomics, Gene, Gene Expression Omnibus (GEO), Genome, HomoloGene, the Map Viewer, Nucleotide, PopSet, Probe, RefSeq, Sequence Read Archive, the Taxonomy Browser, Trace Archive and UniGene); and proteins and chemicals (Biosystems, COBALT, the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART), the Molecular Modeling Database (MMDB), Protein Clusters, Protein and the PubChem suite of small molecule databases). The Entrez system provides search and retrieval operations for many of these databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of these resources can be accessed through the NCBI home page at http://www.ncbi.nlm.nih.gov. Published by Oxford University Press on behalf of Nucleic Acids Research 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. USGS launches online database: Lichens in National Parks

    USGS Publications Warehouse

    Bennett, Jim

    2005-01-01

    If you are interested in lichens and National Parks, now you can query a lichen database that combines these two elements. Using pull-down menus you can: search by park, specifying either species list or the references used for that area; search by species (a report will show the parks in which species are found); and search by reference codes, which are available from the first query. The reference code search allows you to obtain the complete citation for each lichen species listed in a National Park.The result pages from these queries can be printed directly from the web browser, or can be copied and pasted into a word processor.

  6. Variation in Risk-Standardized Mortality of Stroke among Hospitals in Japan.

    PubMed

    Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

    2015-01-01

    Despite recent advances in care, stroke remains a life-threatening disease. Little is known about current hospital mortality with stroke and how it varies by hospital in a national clinical setting in Japan. Using the Diagnosis Procedure Combination database (a national inpatient database in Japan), we identified patients aged ≥ 20 years who were admitted to the hospital with a primary diagnosis of stroke within 3 days of stroke onset from April 2012 to March 2013. We constructed a multivariable logistic regression model to predict in-hospital death for each patient with patient-level factors, including age, sex, type of stroke, Japan Coma Scale, and modified Rankin Scale. We defined risk-standardized mortality ratio as the ratio of the actual number of in-hospital deaths to the expected number of such deaths for each hospital. A hospital-level multivariable linear regression was modeled to analyze the association between risk-standardized mortality ratio and hospital-level factors. We performed a patient-level Cox regression analysis to examine the association of in-hospital death with both patient-level and hospital-level factors. Of 176,753 eligible patients from 894 hospitals, overall in-hospital mortality was 10.8%. The risk-standardized mortality ratio for stroke varied widely among the hospitals; the proportions of hospitals with risk-standardized mortality ratio categories of ≤ 0.50, 0.51-1.00, 1.01-1.50, 1.51-2.00, and >2.00 were 3.9%, 47.9%, 41.4%, 5.2%, and 1.5%, respectively. Academic status, presence of a stroke care unit, higher hospital volume and availability of endovascular therapy had a significantly lower risk-standardized mortality ratio; distance from the patient's residence to the hospital was not associated with the risk-standardized mortality ratio. Our results suggest that stroke-ready hospitals play an important role in improving stroke mortality in Japan.

  7. Changes in U.S. Hospitalization and Mortality Rates following Smoking Bans

    ERIC Educational Resources Information Center

    Shetty, Kanaka D.; DeLeire, Thomas; White, Chapin; Bhattacharya, Jayanta

    2011-01-01

    U.S. state and local governments have increasingly adopted restrictions on smoking in public places. This paper analyzes nationally representative databases, including the Nationwide Inpatient Sample, to compare short-term changes in mortality and hospitalization rates in smoking-restricted regions with control regions. In contrast with smaller…

  8. USDA National Nutrient Database for Standard Reference, release 28

    USDA-ARS?s Scientific Manuscript database

    The USDA National Nutrient Database for Standard Reference, Release 28 contains data for nearly 8,800 food items for up to 150 food components. SR28 replaces the previous release, SR27, originally issued in August 2014. Data in SR28 supersede values in the printed handbooks and previous electronic...

  9. USDA National Nutrient Database for Standard Reference, Release 25

    USDA-ARS?s Scientific Manuscript database

    The USDA National Nutrient Database for Standard Reference, Release 25(SR25)contains data for over 8,100 food items for up to 146 food components. It replaces the previous release, SR24, issued in September 2011. Data in SR25 supersede values in the printed handbooks and previous electronic releas...

  10. Health care access and poverty do not explain the higher esophageal cancer mortality in African Americans.

    PubMed

    Miller, Jordan A G; Rege, Robert V; Ko, Clifford Y; Livingston, Edward H

    2004-07-01

    Esophageal cancer mortality is increased in African Americans relative to white patients. The reasons for this are unknown but are thought to be related to inadequate access to health care secondary to a higher poverty rate in African American populations. The National Health Interview Survey database for years 1986 to 1994 were combined and linked to the National Death Index. Individuals who died from esophageal carcinoma were assessed in the combined database, thus enabling detailed analysis of their socioeconomic status, race, and health care access. Poverty was 4-fold more frequent in African Americans who died from esophageal carcinoma than whites. Despite poverty, African American patients' access to health care was good and was not statistically related to increased mortality. Although the esophageal carcinoma mortality rate is higher in African Americans than in whites, it is not clearly related to the presence of poverty or to limited health care access. The higher mortality may be related to lifestyle differences, environmental exposure, or difference in disease biology, but it is not related exclusively to socioeconomic factors.

  11. Mortality associated with bone fractures in COPD patients.

    PubMed

    Yamauchi, Yasuhiro; Yasunaga, Hideo; Sakamoto, Yukiyo; Hasegawa, Wakae; Takeshima, Hideyuki; Urushiyama, Hirokazu; Jo, Taisuke; Matsui, Hiroki; Fushimi, Kiyohide; Nagase, Takahide

    2016-01-01

    COPD is well known to frequently coexist with osteoporosis. Bone fractures often occur and may affect mortality in COPD patients. However, in-hospital mortality related to bone fractures in COPD patients has been poorly studied. This retrospective study investigated in-hospital mortality of COPD patients with bone fractures using a national inpatient database in Japan. Data of COPD patients admitted with bone fractures, including hip, vertebra, shoulder, and forearm fractures to 1,165 hospitals in Japan between July 2010 and March 2013, were extracted from the Diagnosis Procedure Combination database. The clinical characteristics and mortalities of the patients were determined. Multivariable logistic regression analysis was also performed to determine the factors associated with in-hospital mortality of COPD patients with hip fractures. Among 5,975 eligible patients, those with hip fractures (n=4,059) were older, had lower body mass index (BMI), and had poorer general condition than those with vertebral (n=1,477), shoulder (n=281), or forearm (n=158) fractures. In-hospital mortality was 7.4%, 5.2%, 3.9%, and 1.3%, respectively. Among the hip fracture group, surgical treatment was significantly associated with lower mortality (adjusted odds ratio, 0.43; 95% confidence interval, 0.32-0.56) after adjustment for patient backgrounds. Higher in-hospital mortality was associated with male sex, lower BMI, lower level of consciousness, and having several comorbidities, including pneumonia, lung cancer, congestive heart failure, chronic liver disease, and chronic renal failure. COPD patients with hip fractures had higher mortality than COPD patients with other types of fracture. Surgery for hip fracture was associated with lower mortality than conservative treatment.

  12. Child Mortality Estimation 2013: An Overview of Updates in Estimation Methods by the United Nations Inter-Agency Group for Child Mortality Estimation

    PubMed Central

    Alkema, Leontine; New, Jin Rou; Pedersen, Jon; You, Danzhen

    2014-01-01

    Background In September 2013, the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) published an update of the estimates of the under-five mortality rate (U5MR) and under-five deaths for all countries. Compared to the UN IGME estimates published in 2012, updated data inputs and a new method for estimating the U5MR were used. Methods We summarize the new U5MR estimation method, which is a Bayesian B-spline Bias-reduction model, and highlight differences with the previously used method. Differences in UN IGME U5MR estimates as published in 2012 and those published in 2013 are presented and decomposed into differences due to the updated database and differences due to the new estimation method to explain and motivate changes in estimates. Findings Compared to the previously used method, the new UN IGME estimation method is based on a different trend fitting method that can track (recent) changes in U5MR more closely. The new method provides U5MR estimates that account for data quality issues. Resulting differences in U5MR point estimates between the UN IGME 2012 and 2013 publications are small for the majority of countries but greater than 10 deaths per 1,000 live births for 33 countries in 2011 and 19 countries in 1990. These differences can be explained by the updated database used, the curve fitting method as well as accounting for data quality issues. Changes in the number of deaths were less than 10% on the global level and for the majority of MDG regions. Conclusions The 2013 UN IGME estimates provide the most recent assessment of levels and trends in U5MR based on all available data and an improved estimation method that allows for closer-to-real-time monitoring of changes in the U5MR and takes account of data quality issues. PMID:25013954

  13. Long-term Mortality Risk After Hyperglycemic Crisis Episodes in Geriatric Patients With Diabetes: A National Population-Based Cohort Study.

    PubMed

    Huang, Chien-Cheng; Weng, Shih-Feng; Tsai, Kang-Ting; Chen, Ping-Jen; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Chou, Willy; Guo, How-Ran; Hsu, Chien-Chin

    2015-05-01

    Hyperglycemic crisis is one of the most serious diabetes-related complications. The increase in the prevalence of diabetes in the geriatric population leads to a large disease burden, but previous studies of geriatric hyperglycemic crisis were focused on acute hyperglycemic crisis episode (HCE). This study aimed to delineate the long-term mortality risk after HCE. This retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 13,551 geriatric patients with new-onset diabetes between 2000 and 2002, including 4,517 with HCE (case subjects) (ICD-9 code 250.1 or 250.2) and 9,034 without HCE (control subjects). The groups were compared and followed until 2011. One thousand six hundred thirty-four (36.17%) case and 1,692 (18.73%) control subjects died (P < 0.0001) during follow-up. Incidence rate ratios (IRRs) of death were 2.82 times higher in case subjects (P < 0.0001). The mortality risk was highest in the first month (IRR 26.56; 95% CI 17.97-39.27) and remained higher until 4-6 years after the HCE (IRR 1.49; 95% CI 1.23-1.81). After adjustment for age, sex, selected comorbidities, and monthly income, the mortality hazard ratio was still 2.848 and 4.525 times higher in case subjects with one episode and two or more episodes of hyperglycemic crisis, respectively. Older age, male sex, renal disease, stroke, cancer, chronic obstructive pulmonary disease, and congestive heart failure were independent mortality predictors. Patients with diabetes had a higher mortality risk after HCE during the first 6 years of follow-up. Referral for proper education, better access to medical care, effective communication with a health care provider, and control of comorbidities should be done immediately after HCE. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  14. Characteristics and external validity of the German Health Risk Institute (HRI) Database.

    PubMed

    Andersohn, Frank; Walker, Jochen

    2016-01-01

    The aim of this study was to describe characteristics and external validity of the German Health Risk Institute (HRI) Database. The HRI Database is an anonymized healthcare database with longitudinal data from approximately six Mio Germans. In addition to demographic information (gender, age, region of residence), data on persistence of insurants over time, hospitalization rates, mortality rates and drug prescription rates were extracted from the HRI database for 2013. Corresponding national reference data were obtained from official sources. The proportion of men and women was similar in the HRI Database and Germany, but the database population was slightly younger (mean 40.4 vs 43.7 years). The proportion of insurants living in the eastern part of Germany was lower in the HRI Database (10.1% vs 19.7%). There was good accordance to German reference data with respect to hospitalization rates, overall mortality rate and prescription rates for the 20 most often reimbursed drug classes, with the overall burden of morbidity being slightly lower in the HRI database. From insurants insured on 1 January 2009 (N = 6.2 Mio), a total of 70.6% survived and remained continuously insured with the same statutory health insurance until 31 December 2013. This proportion increased to 77.5% if only insurants ≥40 years were considered. There was good overall accordance of the HRI database and the German population in terms of measures of morbidity, mortality and drug usage. Persistence of insurants with the database over time was high, indicating suitability of the data source for longitudinal epidemiological analyses. Copyright © 2015 John Wiley & Sons, Ltd.

  15. Database resources of the National Center for Biotechnology Information.

    PubMed

    Sayers, Eric W; Barrett, Tanya; Benson, Dennis A; Bolton, Evan; Bryant, Stephen H; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M; DiCuccio, Michael; Federhen, Scott; Feolo, Michael; Fingerman, Ian M; Geer, Lewis Y; Helmberg, Wolfgang; Kapustin, Yuri; Landsman, David; Lipman, David J; Lu, Zhiyong; Madden, Thomas L; Madej, Tom; Maglott, Donna R; Marchler-Bauer, Aron; Miller, Vadim; Mizrachi, Ilene; Ostell, James; Panchenko, Anna; Phan, Lon; Pruitt, Kim D; Schuler, Gregory D; Sequeira, Edwin; Sherry, Stephen T; Shumway, Martin; Sirotkin, Karl; Slotta, Douglas; Souvorov, Alexandre; Starchenko, Grigory; Tatusova, Tatiana A; Wagner, Lukas; Wang, Yanli; Wilbur, W John; Yaschenko, Eugene; Ye, Jian

    2011-01-01

    In addition to maintaining the GenBank® nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data made available through the NCBI Web site. NCBI resources include Entrez, the Entrez Programming Utilities, MyNCBI, PubMed, PubMed Central (PMC), Entrez Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link (BLink), Primer-BLAST, COBALT, Electronic PCR, OrfFinder, Splign, ProSplign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, dbVar, Epigenomics, Cancer Chromosomes, Entrez Genomes and related tools, the Map Viewer, Model Maker, Evidence Viewer, Trace Archive, Sequence Read Archive, Retroviral Genotyping Tools, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus (GEO), Entrez Probe, GENSAT, Online Mendelian Inheritance in Man (OMIM), Online Mendelian Inheritance in Animals (OMIA), the Molecular Modeling Database (MMDB), the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART), IBIS, Biosystems, Peptidome, OMSSA, Protein Clusters and the PubChem suite of small molecule databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of these resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov.

  16. Database resources of the National Center for Biotechnology Information.

    PubMed

    Wheeler, David L; Barrett, Tanya; Benson, Dennis A; Bryant, Stephen H; Canese, Kathi; Chetvernin, Vyacheslav; Church, Deanna M; DiCuccio, Michael; Edgar, Ron; Federhen, Scott; Geer, Lewis Y; Kapustin, Yuri; Khovayko, Oleg; Landsman, David; Lipman, David J; Madden, Thomas L; Maglott, Donna R; Ostell, James; Miller, Vadim; Pruitt, Kim D; Schuler, Gregory D; Sequeira, Edwin; Sherry, Steven T; Sirotkin, Karl; Souvorov, Alexandre; Starchenko, Grigory; Tatusov, Roman L; Tatusova, Tatiana A; Wagner, Lukas; Yaschenko, Eugene

    2007-01-01

    In addition to maintaining the GenBank nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides analysis and retrieval resources for the data in GenBank and other biological data made available through NCBI's Web site. NCBI resources include Entrez, the Entrez Programming Utilities, My NCBI, PubMed, PubMed Central, Entrez Gene, the NCBI Taxonomy Browser, BLAST, BLAST Link(BLink), Electronic PCR, OrfFinder, Spidey, Splign, RefSeq, UniGene, HomoloGene, ProtEST, dbMHC, dbSNP, Cancer Chromosomes, Entrez Genome, Genome Project and related tools, the Trace and Assembly Archives, the Map Viewer, Model Maker, Evidence Viewer, Clusters of Orthologous Groups (COGs), Viral Genotyping Tools, Influenza Viral Resources, HIV-1/Human Protein Interaction Database, Gene Expression Omnibus (GEO), Entrez Probe, GENSAT, Online Mendelian Inheritance in Man (OMIM), Online Mendelian Inheritance in Animals (OMIA), the Molecular Modeling Database (MMDB), the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART) and the PubChem suite of small molecule databases. Augmenting many of the Web applications are custom implementations of the BLAST program optimized to search specialized data sets. These resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov.

  17. The contribution of national disparities to international differences in mortality between the United States and 7 European countries.

    PubMed

    van Hedel, Karen; Avendano, Mauricio; Berkman, Lisa F; Bopp, Matthias; Deboosere, Patrick; Lundberg, Olle; Martikainen, Pekka; Menvielle, Gwenn; van Lenthe, Frank J; Mackenbach, Johan P

    2015-04-01

    This study examined to what extent the higher mortality in the United States compared to many European countries is explained by larger social disparities within the United States. We estimated the expected US mortality if educational disparities in the United States were similar to those in 7 European countries. Poisson models were used to quantify the association between education and mortality for men and women aged 30 to 74 years in the United States, Belgium, Denmark, Finland, France, Norway, Sweden, and Switzerland for the period 1989 to 2003. US data came from the National Health Interview Survey linked to the National Death Index and the European data came from censuses linked to national mortality registries. If people in the United States had the same distribution of education as their European counterparts, the US mortality disadvantage would be larger. However, if educational disparities in mortality within the United States equaled those within Europe, mortality differences between the United States and Europe would be reduced by 20% to 100%. Larger educational disparities in mortality in the United States than in Europe partly explain why US adults have higher mortality than their European counterparts. Policies to reduce mortality among the lower educated will be necessary to bridge the mortality gap between the United States and European countries.

  18. A VBA Desktop Database for Proposal Processing at National Optical Astronomy Observatories

    NASA Astrophysics Data System (ADS)

    Brown, Christa L.

    National Optical Astronomy Observatories (NOAO) has developed a relational Microsoft Windows desktop database using Microsoft Access and the Microsoft Office programming language, Visual Basic for Applications (VBA). The database is used to track data relating to observing proposals from original receipt through the review process, scheduling, observing, and final statistical reporting. The database has automated proposal processing and distribution of information. It allows NOAO to collect and archive data so as to query and analyze information about our science programs in new ways.

  19. Cross-temporal and cross-national poverty and mortality rates among developed countries.

    PubMed

    Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

    2013-01-01

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

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

    PubMed Central

    Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

    2013-01-01

    A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes. PMID:23840235

  1. Multimedia Database at National Museum of Ethnology

    NASA Astrophysics Data System (ADS)

    Sugita, Shigeharu

    This paper describes the information management system at National Museum of Ethnology, Osaka, Japan. This museum is a kind of research center for cultural anthropology, and has many computer systems such as IBM 3090, VAX11/780, Fujitu M340R, etc. With these computers, distributed multimedia databases are constructed in which not only bibliographic data but also artifact image, slide image, book page image, etc. are stored. The number of data is now about 1.3 million items. These data can be retrieved and displayed on the multimedia workstation which has several displays.

  2. Creating a model to detect dairy cattle farms with poor welfare using a national database.

    PubMed

    Krug, C; Haskell, M J; Nunes, T; Stilwell, G

    2015-12-01

    The objective of this study was to determine whether dairy farms with poor cow welfare could be identified using a national database for bovine identification and registration that monitors cattle deaths and movements. The welfare of dairy cattle was assessed using the Welfare Quality(®) protocol (WQ) on 24 Portuguese dairy farms and on 1930 animals. Five farms were classified as having poor welfare and the other 19 were classified as having good welfare. Fourteen million records from the national cattle database were analysed to identify potential welfare indicators for dairy farms. Fifteen potential national welfare indicators were calculated based on that database, and the link between the results on the WQ evaluation and the national cattle database was made using the identification code of each farm. Within the potential national welfare indicators, only two were significantly different between farms with good welfare and poor welfare, 'proportion of on-farm deaths' (p<0.01) and 'female/male birth ratio' (p<0.05). To determine whether the database welfare indicators could be used to distinguish farms with good welfare from farms with poor welfare, we created a model using the classifier J48 of Waikato Environment for Knowledge Analysis. The model was a decision tree based on two variables, 'proportion of on-farm deaths' and 'calving-to-calving interval', and it was able to correctly identify 70% and 79% of the farms classified as having poor and good welfare, respectively. The national cattle database analysis could be useful in helping official veterinary services in detecting farms that have poor welfare and also in determining which welfare indicators are poor on each particular farm. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Education and mortality in Spain: a national study supports local findings.

    PubMed

    Regidor, Enrique; Reques, Laura; Belza, María J; Kunst, Anton E; Mackenbach, Johan P; de la Fuente, Luis

    2016-01-01

    To estimate educational inequalities in mortality in Spain and in three Spanish areas: Madrid, Barcelona, and the Basque country. A national prospective study was carried out including all persons aged 25-74 years living in Spain in 2001 and followed up for mortality over 7 years. The mortality rate ratio and difference from all causes and from leading causes of death were estimated for the entire Spanish population and for the above three geographical areas. With respect to people with the highest education, the mortality rate ratios in the entire population of Spain in people with the second highest, second lowest and lowest education were, respectively, 1.09, 1.10, 1.39 in women and 1.19, 1.27 and 1.54 in men. The mortality rate differences per 100,000 person-years were, respectively, 24.8, 28.3, 108.2 in women and 116.7, 162.5 and 319.1 in men. These estimates were intermediate in magnitude compared to those seen in the three geographical areas. The results provide further evidence that educational inequalities in mortality are smaller in the south of Europe than in other European countries.

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

    PubMed

    Khang, Young-Ho; Kim, Hye-Ryun

    2016-03-22

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

  5. Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

    PubMed

    Lloyd, Belinda; Zahnow, Renee; Barratt, Monica J; Best, David; Lubman, Dan I; Ferris, Jason

    2017-11-01

    Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Using a relational database to improve mortality and length of stay for a department of surgery: a comparative review of 5200 patients.

    PubMed

    Ang, Darwin N; Behrns, Kevin E

    2013-07-01

    The emphasis on high-quality care has spawned the development of quality programs, most of which focus on broad outcome measures across a diverse group of providers. Our aim was to investigate the clinical outcomes for a department of surgery with multiple service lines of patient care using a relational database. Mortality, length of stay (LOS), patient safety indicators (PSIs), and hospital-acquired conditions were examined for each service line. Expected values for mortality and LOS were derived from University HealthSystem Consortium regression models, whereas expected values for PSIs were derived from Agency for Healthcare Research and Quality regression models. Overall, 5200 patients were evaluated from the months of January through May of both 2011 (n = 2550) and 2012 (n = 2650). The overall observed-to-expected (O/E) ratio of mortality improved from 1.03 to 0.92. The overall O/E ratio for LOS improved from 0.92 to 0.89. PSIs that predicted mortality included postoperative sepsis (O/E:1.89), postoperative respiratory failure (O/E:1.83), postoperative metabolic derangement (O/E:1.81), and postoperative deep vein thrombosis or pulmonary embolus (O/E:1.8). Mortality and LOS can be improved by using a relational database with outcomes reported to specific service lines. Service line quality can be influenced by distribution of frequent reports, group meetings, and service line-directed interventions.

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

    PubMed

    Singh, Rajvir; Tripathi, Vrijesh

    2015-01-01

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

  8. A national database for essential drugs in South Africa.

    PubMed

    Zweygarth, M; Summers, R S

    2000-06-01

    In the process of drafting standard treatment guidelines for adults and children at hospital level, the Secretariat of the National Essential Drugs List Committee made use of a database designed with technical support from the School of Pharmacy, MEDUNSA. The database links the current 697 drugs on the Essential Drugs List with Standard Treatment Guidelines for over 400 conditions. It served to streamline the inclusion of different drugs and dosage forms in the various guidelines, and provided concise, updated information to other departments involved in drug procurement. From information on drug prices and morbidity, it can also be used to calculate drug consumption and cost estimates and compare them with actual figures.

  9. Advanced Neonatal Medicine in China: A National Baseline Database.

    PubMed

    Liao, Xiang-Peng; Chipenda-Dansokho, Selma; Lewin, Antoine; Abdelouahab, Nadia; Wei, Shu-Qin

    2017-01-01

    Previous surveys of neonatal medicine in China have not collected comprehensive information on workforce, investment, health care practice, and disease expenditure. The goal of the present study was to develop a national database of neonatal care units and compare present outcomes data in conjunction with health care practices and costs. We summarized the above components by extracting data from the databases of the national key clinical subspecialty proposals issued by national health authority in China, as well as publicly accessible databases. Sixty-one newborn clinical units from provincial or ministerial hospitals at the highest level within local areas in mainland China, were included for the study. Data were gathered for three consecutive years (2008-2010) in 28 of 31 provincial districts in mainland China. Of the 61 newborn units in 2010, there were 4,948 beds (median = 62 [IQR 43-110]), 1,369 physicians (median = 22 [IQR 15-29]), 3,443 nurses (median = 52 [IQR 33-81]), and 170,159 inpatient discharges (median = 2,612 [IQR 1,436-3,804]). During 2008-2010, the median yearly investment for a single newborn unit was US$344,700 (IQR 166,100-585,800), median length of hospital stay for overall inpatient newborns 9.5 (IQR 8.2-10.8) days, median inpatient antimicrobial drug use rate 68.7% (IQR 49.8-87.0), and median nosocomial infection rate 3.2% (IQR1.7-5.4). For the common newborn diseases of pneumonia, sepsis, respiratory distress syndrome, and very low birth weight (<1,500 grams) infants, their lengths of hospital stay, daily costs, hospital costs, ratios of hospital cost to per-capita disposable income, and ratios of hospital cost to per-capita health expenditure, were all significantly different across regions (North China, Northeast China, East China, South Central China, Southwest China, and Northwest China). The survival rate of extremely low birth weight (ELBW) infants (Birth weight <1,000 grams) was 76.0% during 2008-2010 in the five hospitals where

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

    PubMed Central

    2012-01-01

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

  11. Assessment of COPD-related outcomes via a national electronic medical record database.

    PubMed

    Asche, Carl; Said, Quayyim; Joish, Vijay; Hall, Charles Oaxaca; Brixner, Diana

    2008-01-01

    The technology and sophistication of healthcare utilization databases have expanded over the last decade to include results of lab tests, vital signs, and other clinical information. This review provides an assessment of the methodological and analytical challenges of conducting chronic obstructive pulmonary disease (COPD) outcomes research in a national electronic medical records (EMR) dataset and its potential application towards the assessment of national health policy issues, as well as a description of the challenges or limitations. An EMR database and its application to measuring outcomes for COPD are described. The ability to measure adherence to the COPD evidence-based practice guidelines, generated by the NIH and HEDIS quality indicators, in this database was examined. Case studies, before and after their publication, were used to assess the adherence to guidelines and gauge the conformity to quality indicators. EMR was the only source of information for pulmonary function tests, but low frequency in ordering by primary care was an issue. The EMR data can be used to explore impact of variation in healthcare provision on clinical outcomes. The EMR database permits access to specific lab data and biometric information. The richness and depth of information on "real world" use of health services for large population-based analytical studies at relatively low cost render such databases an attractive resource for outcomes research. Various sources of information exist to perform outcomes research. It is important to understand the desired endpoints of such research and choose the appropriate database source.

  12. The Contribution of National Disparities to International Differences in Mortality Between the United States and 7 European Countries

    PubMed Central

    Avendano, Mauricio; Berkman, Lisa F.; Bopp, Matthias; Deboosere, Patrick; Lundberg, Olle; Martikainen, Pekka; Menvielle, Gwenn; van Lenthe, Frank J.; Mackenbach, Johan P.

    2015-01-01

    Objectives. This study examined to what extent the higher mortality in the United States compared to many European countries is explained by larger social disparities within the United States. We estimated the expected US mortality if educational disparities in the United States were similar to those in 7 European countries. Methods. Poisson models were used to quantify the association between education and mortality for men and women aged 30 to 74 years in the United States, Belgium, Denmark, Finland, France, Norway, Sweden, and Switzerland for the period 1989 to 2003. US data came from the National Health Interview Survey linked to the National Death Index and the European data came from censuses linked to national mortality registries. Results. If people in the United States had the same distribution of education as their European counterparts, the US mortality disadvantage would be larger. However, if educational disparities in mortality within the United States equaled those within Europe, mortality differences between the United States and Europe would be reduced by 20% to 100%. Conclusions. Larger educational disparities in mortality in the United States than in Europe partly explain why US adults have higher mortality than their European counterparts. Policies to reduce mortality among the lower educated will be necessary to bridge the mortality gap between the United States and European countries. PMID:25713947

  13. Preoperative Myocardial Injury as a Predictor of Mortality in Emergency General Surgery: An Analysis Using the American College of Surgeons NSQIP Database.

    PubMed

    Zimmerman, Asha M; Marwaha, Jayson; Nunez, Hector; Harrington, David; Heffernan, Daithi; Monaghan, Sean; Adams, Charles; Stephen, Andrew

    2016-08-01

    Recent studies have linked postoperative serum troponin elevation to mortality in a range of different clinical scenarios. To date, there has been no investigation into the significance of preoperative troponin elevation in emergency general surgery (EGS) patients. We define this as preoperative myocardial injury (PMI). We hypothesize that PMI seen in EGS patients may predict postoperative morbidity and mortality. Using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of all EGS cases between 2008 and 2014. Patients with preoperative troponin I drawn were compared. There were 464 EGS patients who had troponin I measurements preoperatively. Eighty-two (18%) had preoperative troponin elevations. Patients with PMI were more likely to have the following preoperative physiologic derangements: acute renal failure (18% vs 4%; p = 0.002) and septic shock (40% vs 13%; p < 0.001). Patient comorbidities associated with PMI included congestive heart failure (13% vs 3%; p = 0.007), dialysis dependence (16% vs 3%; p = 0.002), and American Society of Anesthesiologists (ASA) class ≥ 4 (52% vs 29%; p < 0.001). Compared with controls, patients with PMI had higher rates of postoperative events (77% vs 52%; p < 0.001) and mortality (34% vs 13%; p = 0.009). Univariate analysis showed that patients with PMI had an increased risk of postoperative events (odds ratio [OR] 3.02; 95% CI 1.74 to 5.25) and mortality (OR 3.53; 95% CI 1.66 to 7.47). Multivariate analysis revealed preoperative troponin I elevation was an independent predictor of mortality (OR 3.03; 95% CI 1.19 to 7.72, p = 0.020). Emergency general surgery patients with PMI are at increased risk for postoperative events and death. Preoperative myocardial injury is an independent predictor of mortality and has prognostic utility that can prepare surgical teams for adverse events so that they can be recognized, evaluated, and treated

  14. Using multi-year national survey cohorts for period estimates: an application of weighted discrete Poisson regression for assessing annual national mortality in US adults with and without diabetes, 2000-2006.

    PubMed

    Cheng, Yiling J; Gregg, Edward W; Rolka, Deborah B; Thompson, Theodore J

    2016-12-15

    Monitoring national mortality among persons with a disease is important to guide and evaluate progress in disease control and prevention. However, a method to estimate nationally representative annual mortality among persons with and without diabetes in the United States does not currently exist. The aim of this study is to demonstrate use of weighted discrete Poisson regression on national survey mortality follow-up data to estimate annual mortality rates among adults with diabetes. To estimate mortality among US adults with diabetes, we applied a weighted discrete time-to-event Poisson regression approach with post-stratification adjustment to national survey data. Adult participants aged 18 or older with and without diabetes in the National Health Interview Survey 1997-2004 were followed up through 2006 for mortality status. We estimated mortality among all US adults, and by self-reported diabetes status at baseline. The time-varying covariates used were age and calendar year. Mortality among all US adults was validated using direct estimates from the National Vital Statistics System (NVSS). Using our approach, annual all-cause mortality among all US adults ranged from 8.8 deaths per 1,000 person-years (95% confidence interval [CI]: 8.0, 9.6) in year 2000 to 7.9 (95% CI: 7.6, 8.3) in year 2006. By comparison, the NVSS estimates ranged from 8.6 to 7.9 (correlation = 0.94). All-cause mortality among persons with diabetes decreased from 35.7 (95% CI: 28.4, 42.9) in 2000 to 31.8 (95% CI: 28.5, 35.1) in 2006. After adjusting for age, sex, and race/ethnicity, persons with diabetes had 2.1 (95% CI: 2.01, 2.26) times the risk of death of those without diabetes. Period-specific national mortality can be estimated for people with and without a chronic condition using national surveys with mortality follow-up and a discrete time-to-event Poisson regression approach with post-stratification adjustment.

  15. Ethnicity and mortality from systemic lupus erythematosus in the US.

    PubMed

    Krishnan, E; Hubert, H B

    2006-11-01

    To study ethnic differences in mortality from systemic lupus erythematosus (lupus) in two large, population-based datasets. We analysed the national death data (1979-98) from the National Center for Health Statistics (Hyattsville, Maryland, USA) and hospitalisation data (1993-2002) from the Nationwide Inpatient Sample (NIS), the largest hospitalisation database in the US. The overall, unadjusted, lupus mortality in the National Center for Health Statistics data was 4.6 per million, whereas the proportion of in-hospital mortality from the NIS was 2.9%. African-Americans had disproportionately higher mortality risk than Caucasians (all-cause mortality relative risk adjusted for age = 1.24 (women), 1.36 (men); lupus mortality relative risk = 3.91 (women), 2.40 (men)). Excess risk was found among in-hospital deaths (odds ratio adjusted for age = 1.4 (women), 1.3 (men)). Lupus death rates increased overall from 1979 to 98 (p<0.001). The proportional increase was greatest among African-Americans. Among Caucasian men, death rates declined significantly (p<0.001), but rates did not change substantially for African-American men. The African-American:Caucasian mortality ratio rose with time among men, but there was little change among women. In analyses of the NIS data adjusted for age, the in-hospital mortality risk decreased with time among Caucasian women (p<0.001). African-Americans with lupus have 2-3-fold higher lupus mortality risk than Caucasians. The magnitude of the risk disparity is disproportionately higher than the disparity in all-cause mortality. A lupus-specific biological factor, as opposed to socioeconomic and access-to-care factors, may be responsible for this phenomenon.

  16. Correlation of antidepressive agents and the mortality of end-stage renal disease.

    PubMed

    Tsai, Chia-Jui; Loh, El-Wui; Lin, Ching-Heng; Yu, Tung-Min; Chan, Chin-Hong; Lan, Tsuo-Hung

    2012-05-01

    Depression is one of the most common psychological disorders in end-stage renal disease (ESRD) patients and is associated with impaired quality of life and increased mortality and rate of hospitalization. We aimed to examine the contributions of depression and the use of antidepressive agents in the mortality of ESRD patients. A retrospective observatory study was conducted using the National Health Insurance Research Database in Taiwan. Patients with newly diagnosed as ESRD during the year 2001 to 2007 were collected. A total of 2312 ESRD patients were identified in the database. Statistical analyses were conducted to examine the contributions of depression and exposure of antidepressive agents in mortality rates of ESRD patients. Diagnosis of depression did not influence mortality rate (mortality rate in patients with depression: 26.5%; mortality rate in patients without depression: 26.2%; P= 1.000). Those who had antidepressive agents exposure had significantly higher mortality rate (mortality rate: 32.3%) than those who did not (mortality rate: 24.5%) (P < 0.001). Our findings suggest that (i) the mortality rate of ESRD patients was not affected by the diagnosis of depression, and (ii) exposure of antidepressive agents in ESRD patients was associated with a higher mortality rate. The high mortality rate in ESRD patients exposed to antidepressive agents can be a bias by indication. Equally, a true contribution of the antidepressive agents cannot be ruled out and this needs clarification. © 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.

  17. Successful linking of the Society of Thoracic Surgeons Database to Social Security data to examine the accuracy of Society of Thoracic Surgeons mortality data.

    PubMed

    Jacobs, Jeffrey P; O'Brien, Sean M; Shahian, David M; Edwards, Fred H; Badhwar, Vinay; Dokholyan, Rachel S; Sanchez, Juan A; Morales, David L; Prager, Richard L; Wright, Cameron D; Puskas, John D; Gammie, James S; Haan, Constance K; George, Kristopher M; Sheng, Shubin; Peterson, Eric D; Shewan, Cynthia M; Han, Jane M; Bongiorno, Phillip A; Yohe, Courtney; Williams, William G; Mayer, John E; Grover, Frederick L

    2013-04-01

    The Society of Thoracic Surgeons Adult Cardiac Surgery Database has been linked to the Social Security Death Master File to verify "life status" and evaluate long-term surgical outcomes. The objective of this study is explore practical applications of the linkage of the Society of Thoracic Surgeons Adult Cardiac Surgery Database to Social Securtiy Death Master File, including the use of the Social Securtiy Death Master File to examine the accuracy of the Society of Thoracic Surgeons 30-day mortality data. On January 1, 2008, the Society of Thoracic Surgeons Adult Cardiac Surgery Database began collecting Social Security numbers in its new version 2.61. This study includes all Society of Thoracic Surgeons Adult Cardiac Surgery Database records for operations with nonmissing Social Security numbers between January 1, 2008, and December 31, 2010, inclusive. To match records between the Society of Thoracic Surgeons Adult Cardiac Surgery Database and the Social Security Death Master File, we used a combined probabilistic and deterministic matching rule with reported high sensitivity and nearly perfect specificity. Between January 1, 2008, and December 31, 2010, the Society of Thoracic Surgeons Adult Cardiac Surgery Database collected data for 870,406 operations. Social Security numbers were available for 541,953 operations and unavailable for 328,453 operations. According to the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the 30-day mortality rate was 17,757/541,953 = 3.3%. Linkage to the Social Security Death Master File identified 16,565 cases of suspected 30-day deaths (3.1%). Of these, 14,983 were recorded as 30-day deaths in the Society of Thoracic Surgeons database (relative sensitivity = 90.4%). Relative sensitivity was 98.8% (12,863/13,014) for suspected 30-day deaths occurring before discharge and 59.7% (2120/3551) for suspected 30-day deaths occurring after discharge. Linkage to the Social Security Death Master File confirms the accuracy of

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

    PubMed

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

    2017-11-01

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

  19. Mortality among workers at Oak Ridge National Laboratory.

    PubMed

    Richardson, David B; Wing, Steve; Keil, Alexander; Wolf, Susanne

    2013-07-01

    Workers employed at the Oak Ridge National Laboratory (ORNL) were potentially exposed to a range of chemical and physical hazards, many of which are poorly characterized. We compared the observed deaths among workers to expectations based upon US mortality rates. The cohort included 22,831 workers hired between January 1, 1943 and December 31, 1984. Vital status and cause of death information were ascertained through December 31, 2008. Standardized mortality ratios (SMRs) were computed separately for males and females using US and Tennessee mortality rates; SMRs for men were tabulated separately for monthly-, weekly-, and hourly-paid workers. Hourly-paid males had more deaths due to cancer of the pleura (SMR = 12.09, 95% CI: 4.44, 26.32), cancer of the bladder (SMR = 1.89, 95% CI: 1.26, 2.71), and leukemia (SMR = 1.33, 95% CI: 0.87, 1.93) than expected based on US mortality rates. Female workers also had more deaths than expected from cancer of the bladder (SMR = 2.20, 95% CI: 1.20, 3.69) and leukemia (SMR = 1.64, 95% CI: 1.09, 2.36). The pleural cancer excess has only appeared since the 1980s, approximately 40 years after the start of operations. The bladder cancer excess was larger among workers who also had worked at other Oak Ridge nuclear weapons facilities, while the leukemia excess was among people who had not worked at other DOE facilities. Occupational hazards including asbestos and ionizing radiation may contribute to these excesses. Copyright © 2013 Wiley Periodicals, Inc.

  20. Evaluation of cardiac surgery mortality rates: 30-day mortality or longer follow-up?

    PubMed

    Siregar, Sabrina; Groenwold, Rolf H H; de Mol, Bas A J M; Speekenbrink, Ron G H; Versteegh, Michel I M; Brandon Bravo Bruinsma, George J; Bots, Michiel L; van der Graaf, Yolanda; van Herwerden, Lex A

    2013-11-01

    The aim of our study was to investigate early mortality after cardiac surgery and to determine the most adequate follow-up period for the evaluation of mortality rates. Information on all adult cardiac surgery procedures in 10 of 16 cardiothoracic centres in Netherlands from 2007 until 2010 was extracted from the database of Netherlands Association for Cardio-Thoracic Surgery (n = 33 094). Survival up to 1 year after surgery was obtained from the national death registry. Survival analysis was performed using Kaplan-Meier and Cox regression analysis. Benchmarking was performed using logistic regression with mortality rates at different time points as dependent variables, the logistic EuroSCORE as covariate and a random intercept per centre. In-hospital mortality was 2.94% (n = 972), 30-day mortality 3.02% (n = 998), operative mortality 3.57% (n = 1181), 60-day mortality 3.84% (n = 1271), 6-month mortality 5.16% (n = 1707) and 1-year mortality 6.20% (n = 2052). The survival curves showed a steep initial decline followed by stabilization after ∼60-120 days, depending on the intervention performed, e.g. 60 days for isolated coronary artery bypass grafting (CABG) and 120 days for combined CABG and valve surgery. Benchmark results were affected by the choice of the follow-up period: four hospitals changed outlier status when the follow-up was increased from 30 days to 1 year. In the isolated CABG subgroup, benchmark results were unaffected: no outliers were found using either 30-day or 1-year follow-up. The course of early mortality after cardiac surgery differs across interventions and continues up to ∼120 days. Thirty-day mortality reflects only a part of early mortality after cardiac surgery and should only be used for benchmarking of isolated CABG procedures. The follow-up should be prolonged to capture early mortality of all types of interventions.

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

    PubMed

    Ward, Joseph L; Viner, Russell M

    2017-05-11

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

  2. The National Solar Radiation Database (NSRDB): A Brief Overview

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Habte, Aron M; Sengupta, Manajit; Lopez, Anthony

    This poster presents a high-level overview of the National Solar Radiation Database (NSRDB). The NSRDB uses the physics-based model (PSM), which was developed using: adapted PATMOS-X model for cloud identification and properties, REST-2 model for clear-sky conditions, and NREL's Fast All-sky Radiation Model for Solar Applications (FARMS) for cloudy-sky Global Horizontal Irradiance (GHI) solar irradiance calculations.

  3. Cancer mortality trends in Spain: 1980-2007.

    PubMed

    Cabanes, A; Vidal, E; Aragonés, N; Pérez-Gómez, B; Pollán, M; Lope, V; López-Abente, G

    2010-05-01

    Since the 1990s, there has been a downturn in mortality for specific types of tumour in Spain and other European countries. This article reports on the current situation of cancer mortality in Spain, as well as mortality trends over the period 1980-2007, and provides an overview of cancer mortality trends in Europe in recent years. Data were sourced from the National Statistics Institute (Instituto Nacional de Estadística - INE) and the World Health Organization mortality database. Mortality trends were studied using change-point Poisson regression models. All-cancer mortality decreased in both sexes from 1980 to 2007, owing to the fact that the tumours responsible for the highest number of deaths registered declining trends from the mid-1990s onwards. In men, mortality due to stomach and prostate cancer fell by >3% per annum in the last 10 years of the study period. In women, the largest contributions to the fall in cancer mortality were due to breast and colorectal cancers. In contrast, female mortality due to smoking-related cancers rose significantly. Within the European context, Spain's estimated 2005 mortality rates were intermediate for men and low for women. Cancer control is progressing in the right direction in Spain. Further interventions directed to reduce tobacco-related cancer mortality remain a priority, particularly for women.

  4. The effect of Taiwan's national health insurance on mortality of the elderly: revisited.

    PubMed

    Chang, Simon

    2012-11-01

    A recent paper estimates the effects of Taiwan's National Health Insurance (NHI) on the elderly and concludes that NHI greatly increased the medical care utilization of the elderly but did not reduce their mortality. Using more recent and more accurate mortality data of the same group of elderly, this note re-estimates the NHI effect on mortality and finds that the mortality hazard of the previously uninsured elderly in the post-NHI period was on average 24% lower than it would have been in the absence of NHI. However, the NHI effect on the mortality hazard is only evident in the first 6 years following the enactment of NHI, suggesting that it may be difficult to undo the damage caused by the lack of insurance in early life. Copyright © 2011 John Wiley & Sons, Ltd.

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

    PubMed

    Pannwitz, Gunter

    2015-03-01

    In a retrospective cohort study of national register data, 1946 randomly selected holdings, with 286,912 individual cattle accumulating 170,416 animal-years were analyzed. The sample was considered to represent the national herd in Germany 2012. Within each holding, individual cattle records were stratified by current age (≤21 days, 3-6 weeks, 6-12 weeks, 3-6 months, 6-12 months, 1-2, 2-4, 4-8, and >8 years), sex, breed (intensive milk, less intensive milk, and beef), and mean monthly air temperature (<10°C and ≥10°C). Holdings were categorized by size (<100 and ≥100 animal-years), calving rate, slaughter rate, and federal state. 8027 on-site deaths (excluding slaughter for human consumption) were recorded, with cattle aged <6 months, 6-24 months, and >2 years contributing 50.0%, 15.4%, and 34.6% of deaths, respectively. Poisson regression and generalized estimating equations (gee) accounting for intra-herd clustering were used to model the number of deaths. In both models, most age bands differed significantly, with highest rates in calves ≤21 days, falling to lowest rates in 1-2 year olds, and rising again thereafter in females. Males exhibited higher mortality than females from birth to 2 years. All breed categories differed significantly with lowest rates in beef and highest in intensive milk breeds. Larger holdings, temperatures ≤10°C, calving rates >0-0.5 per animal year were all associated with higher mortality. Via interaction, intensive and less intensive milk breed cattle aging 6 weeks to 6 months and intensive milk breed females >4 years were associated with higher mortality. There were no significant differences between federal states and slaughter rates. The standardized deviations of modeled dead cattle numbers from occurred deaths per calendar year per holding were calculated and a 95% reference range of deviations constructed. This approach makes a standardized active monitoring and surveillance system regardless of herd size possible

  6. Human health risk assessment database, "the NHSRC toxicity value database": supporting the risk assessment process at US EPA's National Homeland Security Research Center.

    PubMed

    Moudgal, Chandrika J; Garrahan, Kevin; Brady-Roberts, Eletha; Gavrelis, Naida; Arbogast, Michelle; Dun, Sarah

    2008-11-15

    The toxicity value database of the United States Environmental Protection Agency's (EPA) National Homeland Security Research Center has been in development since 2004. The toxicity value database includes a compilation of agent property, toxicity, dose-response, and health effects data for 96 agents: 84 chemical and radiological agents and 12 biotoxins. The database is populated with multiple toxicity benchmark values and agent property information from secondary sources, with web links to the secondary sources, where available. A selected set of primary literature citations and associated dose-response data are also included. The toxicity value database offers a powerful means to quickly and efficiently gather pertinent toxicity and dose-response data for a number of agents that are of concern to the nation's security. This database, in conjunction with other tools, will play an important role in understanding human health risks, and will provide a means for risk assessors and managers to make quick and informed decisions on the potential health risks and determine appropriate responses (e.g., cleanup) to agent release. A final, stand alone MS ACESSS working version of the toxicity value database was completed in November, 2007.

  7. HIV mortality and infection in India: estimates from nationally representative mortality survey of 1.1 million homes.

    PubMed

    Jha, Prabhat; Kumar, Rajesh; Khera, Ajay; Bhattacharya, Madhulekha; Arora, Paul; Gajalakshmi, Vendhan; Bhatia, Prakash; Kam, Derek; Bassani, Diego G; Sullivan, Ashleigh; Suraweera, Wilson; McLaughlin, Catherine; Dhingra, Neeraj; Nagelkerke, Nico

    2010-02-23

    To determine the rates of death and infection from HIV in India. Nationally representative survey of deaths. 1.1 million homes in India. Population 123,000 deaths at all ages from 2001 to 2003. HIV mortality and infection. HIV accounted for 8.1% (99% confidence interval 5.0% to 11.2%) of all deaths among adults aged 25-34 years. In this age group, about 40% of deaths from HIV were due to AIDS, 26% were due to tuberculosis, and the rest were attributable to other causes. Nationally, HIV infection accounted for about 100,000 (59,000 to 140,000) deaths or 3.2% (1.9% to 4.6%) of all deaths among people aged 15-59 years. Deaths from HIV were concentrated in the states and districts with higher HIV prevalence and in men. The mortality results imply an HIV prevalence at age 15-49 years of 0.26% (0.13% to 0.39%) in 2004, comparable to results from a 2005/6 household survey that tested for HIV (0.28%). Collectively, these data suggest that India had about 1.4-1.6 million HIV infected adults aged 15-49 years in 2004-6, about 40% lower than the official estimate of 2.3 million for 2006. All cause mortality increased in men aged 25-34 years between 1997 and 2002 in the states with higher HIV prevalence but declined after that. HIV prevalence in young pregnant women, a proxy measure of incidence in the general population, fell between 2000 and 2007. Thus, HIV mortality and prevalence may have fallen further since our study. HIV attributable death and infection in India is substantial, although it is lower than previously estimated.

  8. Handbook of automated data collection methods for the National Transit Database

    DOT National Transportation Integrated Search

    2003-10-01

    In recent years, with the increasing sophistication and capabilities of information processing technologies, there has been a renewed interest on the part of transit systems to tap the rich information potential of the National Transit Database (NTD)...

  9. Investigating the association of alerts from a national mortality surveillance system with subsequent hospital mortality in England: an interrupted time series analysis.

    PubMed

    Cecil, Elizabeth; Bottle, Alex; Esmail, Aneez; Wilkinson, Samantha; Vincent, Charles; Aylin, Paul P

    2018-05-04

    To investigate the association between alerts from a national hospital mortality surveillance system and subsequent trends in relative risk of mortality. There is increasing interest in performance monitoring in the NHS. Since 2007, Imperial College London has generated monthly mortality alerts, based on statistical process control charts and using routinely collected hospital administrative data, for all English acute NHS hospital trusts. The impact of this system has not yet been studied. We investigated alerts sent to Acute National Health Service hospital trusts in England in 2011-2013. We examined risk-adjusted mortality (relative risk) for all monitored diagnosis and procedure groups at a hospital trust level for 12 months prior to an alert and 23 months post alert. We used an interrupted time series design with a 9-month lag to estimate a trend prior to a mortality alert and the change in trend after, using generalised estimating equations. On average there was a 5% monthly increase in relative risk of mortality during the 12 months prior to an alert (95% CI 4% to 5%). Mortality risk fell, on average by 61% (95% CI 56% to 65%), during the 9-month period immediately following an alert, then levelled to a slow decline, reaching on average the level of expected mortality within 18 months of the alert. Our results suggest an association between an alert notification and a reduction in the risk of mortality, although with less lag time than expected. It is difficult to determine any causal association. A proportion of alerts may be triggered by random variation alone and subsequent falls could simply reflect regression to the mean. Findings could also indicate that some hospitals are monitoring their own mortality statistics or other performance information, taking action prior to alert notification. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless

  10. Outcomes of operations for benign foregut disease in elderly patients: a National Surgical Quality Improvement Program database analysis.

    PubMed

    Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Feinberg, Richard L; Lidor, Anne O

    2014-08-01

    The development of minimally invasive operative techniques and improvement in postoperative care has made surgery a viable option to a greater number of elderly patients. Our objective was to evaluate the outcomes of laparoscopic and open foregut operation in relation to the patient age. Patients who underwent gastric fundoplication, paraesophageal hernia repair, and Heller myotomy were identified via the National Surgical Quality Improvement Program (NSQIP) database (2005-2011). Patient characteristics and outcomes were compared between five age groups (group I: ≤65 years, II: 65-69 years; III: 70-74 years; IV: 75-79 years; and V: ≥80 years). Multivariable logistic regression analysis was used to predict the impact of age and operative approach on the studied outcomes. A total of 19,388 patients were identified. Advanced age was associated with increased rate of 30-day mortality, overall morbidity, serious morbidity, and extended length of stay, regardless of the operative approach. After we adjusted for other variables, advanced age was associated with increased odds of 30-day mortality compared with patients <65 years (III: odds ratio 2.70, 95% confidence interval 1.34-5.44, P = .01; IV: 2.80, 1.35-5.81, P = .01; V: 6.12, 3.41-10.99, P < .001). Surgery for benign foregut disease in elderly patients carries a burden of mortality and morbidity that needs to be acknowledged. Copyright © 2014 Mosby, Inc. All rights reserved.

  11. Quantifying the individual-level association between income and mortality risk in the United States using the National Longitudinal Mortality Study.

    PubMed

    Brodish, Paul Henry; Hakes, Jahn K

    2016-12-01

    Policy makers would benefit from being able to estimate the likely impact of potential interventions to reverse the effects of rapidly rising income inequality on mortality rates. Using multiple cohorts of the National Longitudinal Mortality Study (NLMS), we estimate the absolute income effect on premature mortality in the United States. A multivariate Poisson regression using the natural logarithm of equivilized household income establishes the magnitude of the absolute income effect on mortality. We calculate mortality rates for each income decile of the study sample and mortality rate ratios relative to the decile containing mean income. We then apply the estimated income effect to two kinds of hypothetical interventions that would redistribute income. The first lifts everyone with an equivalized household income at or below the U.S. poverty line (in 2000$) out of poverty, to the income category just above the poverty line. The second shifts each family's equivalized income by, in turn, 10%, 20%, 30%, or 40% toward the mean household income, equivalent to reducing the Gini coefficient by the same percentage in each scenario. We also assess mortality disparities of the hypothetical interventions using ratios of mortality rates of the ninth and second income deciles, and test sensitivity to the assumption of causality of income on mortality by halving the mortality effect per unit of equivalized household income. The estimated absolute income effect would produce a three to four percent reduction in mortality for a 10% reduction in the Gini coefficient. Larger mortality reductions result from larger reductions in the Gini, but with diminishing returns. Inequalities in estimated mortality rates are reduced by a larger percentage than overall estimated mortality rates under the same hypothetical redistributions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Epidemiology, microbiology and mortality associated with community-acquired bacteremia in northeast Thailand: a multicenter surveillance study.

    PubMed

    Kanoksil, Manas; Jatapai, Anchalee; Peacock, Sharon J; Limmathurotsakul, Direk

    2013-01-01

    National statistics in developing countries are likely to underestimate deaths due to bacterial infections. Here, we calculated mortality associated with community-acquired bacteremia (CAB) in a developing country using routinely available databases. Information was obtained from the microbiology and hospital database of 10 provincial hospitals in northeast Thailand, and compared with the national death registry from the Ministry of Interior, Thailand for the period between 2004 and 2010. CAB was defined in patients who had pathogenic organisms isolated from blood taken within 2 days of hospital admission without a prior inpatient episode in the preceding 30 days. A total of 15,251 CAB patients identified, of which 5,722 (37.5%) died within 30 days of admission. The incidence rate of CAB between 2004 and 2010 increased from 16.7 to 38.1 per 100,000 people per year, and the mortality rate associated with CAB increased from 6.9 to 13.7 per 100,000 people per year. In 2010, the mortality rate associated with CAB was lower than that from respiratory tract infection, but higher than HIV disease or tuberculosis. The most common causes of CAB were Escherichia coli (23.1%), Burkholderia pseudomallei (19.3%), and Staphylococcus aureus (8.2%). There was an increase in the proportion of Extended-Spectrum Beta-Lactamases (ESBL) producing E. coli and Klebsiella pneumoniae over time. This study has demonstrated that national statistics on causes of death in developing countries could be improved by integrating information from readily available databases. CAB is neglected as an important cause of death, and specific prevention and intervention is urgently required to reduce its incidence and mortality.

  13. Epidemiology, Microbiology and Mortality Associated with Community-Acquired Bacteremia in Northeast Thailand: A Multicenter Surveillance Study

    PubMed Central

    Kanoksil, Manas; Jatapai, Anchalee; Peacock, Sharon J.; Limmathurotsakul, Direk

    2013-01-01

    Background National statistics in developing countries are likely to underestimate deaths due to bacterial infections. Here, we calculated mortality associated with community-acquired bacteremia (CAB) in a developing country using routinely available databases. Methods/Principal Findings Information was obtained from the microbiology and hospital database of 10 provincial hospitals in northeast Thailand, and compared with the national death registry from the Ministry of Interior, Thailand for the period between 2004 and 2010. CAB was defined in patients who had pathogenic organisms isolated from blood taken within 2 days of hospital admission without a prior inpatient episode in the preceding 30 days. A total of 15,251 CAB patients identified, of which 5,722 (37.5%) died within 30 days of admission. The incidence rate of CAB between 2004 and 2010 increased from 16.7 to 38.1 per 100,000 people per year, and the mortality rate associated with CAB increased from 6.9 to 13.7 per 100,000 people per year. In 2010, the mortality rate associated with CAB was lower than that from respiratory tract infection, but higher than HIV disease or tuberculosis. The most common causes of CAB were Escherichia coli (23.1%), Burkholderia pseudomallei (19.3%), and Staphylococcus aureus (8.2%). There was an increase in the proportion of Extended-Spectrum Beta-Lactamases (ESBL) producing E. coli and Klebsiella pneumoniae over time. Conclusions This study has demonstrated that national statistics on causes of death in developing countries could be improved by integrating information from readily available databases. CAB is neglected as an important cause of death, and specific prevention and intervention is urgently required to reduce its incidence and mortality. PMID:23349954

  14. Liver cancer mortality rate model in Thailand

    NASA Astrophysics Data System (ADS)

    Sriwattanapongse, Wattanavadee; Prasitwattanaseree, Sukon

    2013-09-01

    Liver Cancer has been a leading cause of death in Thailand. The purpose of this study was to model and forecast liver cancer mortality rate in Thailand using death certificate reports. A retrospective analysis of the liver cancer mortality rate was conducted. Numbering of 123,280 liver cancer causes of death cases were obtained from the national vital registration database for the 10-year period from 2000 to 2009, provided by the Ministry of Interior and coded as cause-of-death using ICD-10 by the Ministry of Public Health. Multivariate regression model was used for modeling and forecasting age-specific liver cancer mortality rates in Thailand. Liver cancer mortality increased with increasing age for each sex and was also higher in the North East provinces. The trends of liver cancer mortality remained stable in most age groups with increases during ten-year period (2000 to 2009) in the Northern and Southern. Liver cancer mortality was higher in males and increase with increasing age. There is need of liver cancer control measures to remain on a sustained and long-term basis for the high liver cancer burden rate of Thailand.

  15. Advanced Neonatal Medicine in China: A National Baseline Database

    PubMed Central

    Chipenda-Dansokho, Selma; Lewin, Antoine; Abdelouahab, Nadia; Wei, Shu-Qin

    2017-01-01

    Previous surveys of neonatal medicine in China have not collected comprehensive information on workforce, investment, health care practice, and disease expenditure. The goal of the present study was to develop a national database of neonatal care units and compare present outcomes data in conjunction with health care practices and costs. We summarized the above components by extracting data from the databases of the national key clinical subspecialty proposals issued by national health authority in China, as well as publicly accessible databases. Sixty-one newborn clinical units from provincial or ministerial hospitals at the highest level within local areas in mainland China, were included for the study. Data were gathered for three consecutive years (2008–2010) in 28 of 31 provincial districts in mainland China. Of the 61 newborn units in 2010, there were 4,948 beds (median = 62 [IQR 43–110]), 1,369 physicians (median = 22 [IQR 15–29]), 3,443 nurses (median = 52 [IQR 33–81]), and 170,159 inpatient discharges (median = 2,612 [IQR 1,436–3,804]). During 2008–2010, the median yearly investment for a single newborn unit was US$344,700 (IQR 166,100–585,800), median length of hospital stay for overall inpatient newborns 9.5 (IQR 8.2–10.8) days, median inpatient antimicrobial drug use rate 68.7% (IQR 49.8–87.0), and median nosocomial infection rate 3.2% (IQR1.7–5.4). For the common newborn diseases of pneumonia, sepsis, respiratory distress syndrome, and very low birth weight (<1,500 grams) infants, their lengths of hospital stay, daily costs, hospital costs, ratios of hospital cost to per-capita disposable income, and ratios of hospital cost to per-capita health expenditure, were all significantly different across regions (North China, Northeast China, East China, South Central China, Southwest China, and Northwest China). The survival rate of extremely low birth weight (ELBW) infants (Birth weight <1,000 grams) was 76.0% during 2008–2010 in the

  16. In-hospital mortality among electroconvulsive therapy recipients: A 17-year nationwide population-based retrospective study.

    PubMed

    Liang, C-S; Chung, C-H; Tsai, C-K; Chien, W-C

    2017-05-01

    Electroconvulsive therapy (ECT) remains irreplaceable in the treatment of several psychiatric conditions. However, evidence derived using data from a national database to support its safety is limited. The aim of this study was to investigate in-hospital mortality among patients with psychiatric conditions treated with and without ECT. Using data from the Taiwan National Health Insurance Research Database from 1997 to 2013, we identified 828,899 inpatients with psychiatric conditions, among whom 0.19% (n=1571) were treated with ECT. We found that ECT recipients were more frequently women, were younger and physically healthier, lived in more urbanized areas, were treated in medical centers, and had longer hospital stays. ECT recipients had lower odds of in-hospital mortality than did those who did not receive ECT. Moreover, no factor was identified as being able to predict mortality in patients who underwent ECT. Among all patients, ECT was not associated with in-hospital mortality after controlling for potential confounders. ECT was indicated to be safe and did not increase the odds of in-hospital mortality. However, ECT appeared to be administered only on physically healthy but psychiatrically compromised patients, a pattern that is in opposition with the scientific evidence supporting its safety. Moreover, our data suggest that ECT is still used as a treatment of last resort in the era of modern psychiatry. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. On pump versus off pump coronary artery bypass grafting in patients with end-stage renal disease and coronary artery disease - A nation-wide, propensity score matched database analyses.

    PubMed

    Chen, Jien-Jiun; Lin, Lian-Yu; Yang, Yao-Hsu; Hwang, Juey-Jen; Chen, Pau-Chung; Lin, Jiunn-Lee; Chi, Nai-Hsin

    2017-01-15

    The usage of on or off cardiopulmonary bypass in patients with coronary artery disease receiving coronary artery bypass grafting (CABG) surgery had been debated and had not yet been investigated thoroughly in patients with end-stage renal disease (ESRD). We aimed to study cardiovascular outcomes and total mortality in these patients by using our National Health Insurance (NHI) database. By using our NHI ESRD claim database, we searched ESRD patients aged more than 18years, who received CABG and divided them into on pump and off pump groups. Baseline characteristics and underlying comorbidities were identified from the database. Propensity score (PS) method was used to match all the potential confounders between patients. Outcomes including mortality, myocardial infarction, stroke and repeat revascularization within 30days, 1year and whole follow-up period were also obtained. A total of 134,410 ESRD patients were identified in the database. We included 341 patients and 543 patients who received off pump and on pump CABG respectively. The hazard ratios of different outcomes at 30days, 1year and a median of 745days after CABG did not show significant different between on, or off pump groups before and after PS match. ESRD patients with CAD undergoing either on pump or off pump CABG surgery showed similar outcomes in 30days, 1year and whole follow-up period. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Database resources of the National Center for Biotechnology Information: 2002 update

    PubMed Central

    Wheeler, David L.; Church, Deanna M.; Lash, Alex E.; Leipe, Detlef D.; Madden, Thomas L.; Pontius, Joan U.; Schuler, Gregory D.; Schriml, Lynn M.; Tatusova, Tatiana A.; Wagner, Lukas; Rapp, Barbara A.

    2002-01-01

    In addition to maintaining the GenBank nucleic acid sequence database, the National Center for Biotechnology Information (NCBI) provides data analysis and retrieval resources that operate on the data in GenBank and a variety of other biological data made available through NCBI’s web site. NCBI data retrieval resources include Entrez, PubMed, LocusLink and the Taxonomy Browser. Data analysis resources include BLAST, Electronic PCR, OrfFinder, RefSeq, UniGene, HomoloGene, Database of Single Nucleotide Polymorphisms (dbSNP), Human Genome Sequencing, Human MapViewer, Human¡VMouse Homology Map, Cancer Chromosome Aberration Project (CCAP), Entrez Genomes, Clusters of Orthologous Groups (COGs) database, Retroviral Genotyping Tools, SAGEmap, Gene Expression Omnibus (GEO), Online Mendelian Inheritance in Man (OMIM), the Molecular Modeling Database (MMDB) and the Conserved Domain Database (CDD). Augmenting many of the web applications are custom implementations of the BLAST program optimized to search specialized data sets. All of the resources can be accessed through the NCBI home page at http://www.ncbi.nlm.nih.gov. PMID:11752242

  19. Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study.

    PubMed

    Iacobelli, Silvia; Combier, Evelyne; Roussot, Adrien; Cottenet, Jonathan; Gouyon, Jean-Bernard; Quantin, Catherine

    2017-01-18

    Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA). This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32-43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 - 28), post-neonatal hospitalization (day of life 29 - 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used. The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 - 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3-3.9] at 32 and 1.5 [95% CI: 1.1-1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4-5.8] at 32 and 6.6 [95% CI: 2.1-20.9] at 43, compared to 40 weeks. There's a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality.

  20. Socioeconomic differentials in the immediate mortality effects of the national Irish smoking ban.

    PubMed

    Stallings-Smith, Sericea; Goodman, Pat; Kabir, Zubair; Clancy, Luke; Zeka, Ariana

    2014-01-01

    Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000-2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring that a differentiated analytical approach

  1. A critical assessment of outcomes in emergency versus nonemergency general surgery using the American College of Surgeons National Surgical Quality Improvement Program database.

    PubMed

    Becher, Robert D; Hoth, J Jason; Miller, Preston R; Mowery, Nathan T; Chang, Michael C; Meredith, J Wayne

    2011-07-01

    Emergent operations are thought to carry higher morbidity and mortality than nonemergent cases. However, there is a lack of specific outcomes data for emergent general surgery procedures. The objective of our study was to assess and quantify postoperative morbidity and mortality for emergency versus nonemergency general surgery operations. All general surgery inpatients were identified in the American College of Surgeons National Surgical Quality Improvement Program 2008 database. Preoperative, intraoperative, and postoperative clinical metrics and occurrences were assessed. A total of 25,770 emergent and 98,867 nonemergent cases were identified. Postoperative morbidity was significantly worse in the emergent group, including ventilation more than 48 hours, bleeding requiring transfusion, deep vein thrombosis, renal failure, and need for reoperation. Overall, emergent cases had significantly more postoperative complications (22.8% vs 14.2%) and higher mortality rates (6.5% vs 1.4%). General surgery patients who undergo emergent operations have significantly poorer outcomes when compared with nonemergent patients; our analysis has quantified these differences. Emergent patients seem to manifest unique clinical, pathophysiologic, and inflammatory responses to their surgical disease. This data suggests that there is a need for improvement in both methods and systems of care for the emergent population.

  2. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

    PubMed Central

    2012-01-01

    Background While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery (< 2 days from admission) and in-hospital mortality, controlling for several confounding factors. Results Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%). However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not. PMID:22257790

  3. Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: a prospective database study in Italy.

    PubMed

    Marmo, Riccardo; Del Piano, Mario; Rotondano, Gianluca; Koch, Maurizio; Bianco, Maria Antonia; Zambelli, Alessandro; Di Matteo, Giovanni; Grossi, Enzo; Cipolletta, Livio; Prometeo Investigators

    2012-02-01

    Nonulcer causes of bleeding are often regarded as minor, ie, associated with a lower risk of mortality. To assess the risk of death from nonulcer causes of upper GI bleeding (UGIB). Secondary analysis of prospectively collected data from 3 national databases. Community and teaching hospitals. Consecutive patients admitted for acute nonvariceal UGIB. Early endoscopy, medical and endoscopic treatment as appropriate. Thirty-day mortality, recurrent bleeding, and need for surgery. A total of 3207 patients (65.8% male), mean (standard deviation) age 68.3 (16.4) years, were analyzed. Overall mortality was 4.45% (143 patients). According to the source of bleeding, mortality was 9.8% for neoplasia, 4.8% for Mallory-Weiss tears, 4.8% for vascular lesions, 4.4% for gastroduodenal erosions, 4.4% for duodenal ulcer, and 3.1% for gastric ulcer. Frequency of death was not different among benign endoscopic diagnoses (overall P = .567). Risk of death was significantly higher in patients with neoplasia compared with benign conditions (odds ratio 2.50; 95% CI, 1.32-4.46; P < .0001). Gastric or duodenal ulcer significantly increased the risk of death, but this was not related to the presence of high-risk stigmata (P = .368). The strongest predictor of mortality for all causes of nonvariceal UGIB was the overall physical status of the patient measured with the American Society of Anesthesiologists score (1-2 vs 3-4, P < .001). No data on the American Society of Anesthesiologists class score in the Prometeo study. Nonulcer causes of nonvariceal UGIB have a risk of death, similar to bleeding peptic ulcers in the clinical context of a high-risk patient. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  4. A hierarchical spatial framework and database for the national river fish habitat condition assessment

    USGS Publications Warehouse

    Wang, L.; Infante, D.; Esselman, P.; Cooper, A.; Wu, D.; Taylor, W.; Beard, D.; Whelan, G.; Ostroff, A.

    2011-01-01

    Fisheries management programs, such as the National Fish Habitat Action Plan (NFHAP), urgently need a nationwide spatial framework and database for health assessment and policy development to protect and improve riverine systems. To meet this need, we developed a spatial framework and database using National Hydrography Dataset Plus (I-.100,000-scale); http://www.horizon-systems.com/nhdplus). This framework uses interconfluence river reaches and their local and network catchments as fundamental spatial river units and a series of ecological and political spatial descriptors as hierarchy structures to allow users to extract or analyze information at spatial scales that they define. This database consists of variables describing channel characteristics, network position/connectivity, climate, elevation, gradient, and size. It contains a series of catchment-natural and human-induced factors that are known to influence river characteristics. Our framework and database assembles all river reaches and their descriptors in one place for the first time for the conterminous United States. This framework and database provides users with the capability of adding data, conducting analyses, developing management scenarios and regulation, and tracking management progresses at a variety of spatial scales. This database provides the essential data needs for achieving the objectives of NFHAP and other management programs. The downloadable beta version database is available at http://ec2-184-73-40-15.compute-1.amazonaws.com/nfhap/main/.

  5. Screening Program Reduced Melanoma Mortality at the Lawrence Livermore National Laboratory, 1984-1996

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schneider, MD, J S; II, PhD, D; MD, PhD, M

    Worldwide incidence of cutaneous malignant melanoma has increased substantially, and no screening program has yet demonstrated reduction in mortality. We evaluated the education, self examination and targeted screening campaign at the Lawrence Livermore National Laboratory (LLNL) from its beginning in July 1984 through 1996. The thickness and crude incidence of melanoma from the years before the campaign were compared to those obtained during the 13 years of screening. Melanoma mortality during the 13-year period was based on a National Death Index search. Expected yearly deaths from melanoma among LLNL employees were calculated by using California mortality data matched by age,more » sex, and race/ethnicity and adjusted to exclude deaths from melanoma diagnosed before the program began or before employment at LLNL. After the program began, crude incidence of melanoma thicker than 0.75 mm decreased from 18 to 4 cases per 100,000 person-years (p = 0.02), while melanoma less than 0.75mm remained stable and in situ melanoma increased substantially. No eligible melanoma deaths occurred among LLNL employees during the screening period compared with a calculated 3.39 expected deaths (p = 0.034). Education, self examination and selective screening for melanoma at LLNL significantly decreased incidence of melanoma thicker than 0.75 mm and reduced the melanoma-related mortality rate to zero. This significant decrease in mortality rate persisted for at least 3 yr after employees retired or otherwise left the laboratory.« less

  6. Factors Associated With Mortality of Thyroid Storm

    PubMed Central

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

    2016-01-01

    Abstract Thyroid storm is a life-threatening and emergent manifestation of thyrotoxicosis. However, predictive features associated with fatal outcomes in this crisis have not been clearly defined because of its rarity. The objective of this study was to investigate the associations of patient characteristics, treatments, and comorbidities with in-hospital mortality. We conducted a retrospective observational study of patients diagnosed with thyroid storm using a national inpatient database in Japan from April 1, 2011 to March 31, 2014. Of approximately 21 million inpatients in the database, we identified 1324 patients diagnosed with thyroid storm. The mean (standard deviation) age was 47 (18) years, and 943 (71.3%) patients were female. The overall in-hospital mortality was 10.1%. The number of patients was highest in the summer season. The most common comorbidity at admission was cardiovascular diseases (46.6%). Multivariable logistic regression analyses showed that higher mortality was significantly associated with older age (≥60 years), central nervous system dysfunction at admission, nonuse of antithyroid drugs and β-blockade, and requirement for mechanical ventilation and therapeutic plasma exchange combined with hemodialysis. The present study identified clinical features associated with mortality of thyroid storm using large-scale data. Physicians should pay special attention to older patients with thyrotoxicosis and coexisting central nervous system dysfunction. Future prospective studies are needed to clarify treatment options that could improve the survival outcomes of thyroid storm. PMID:26886648

  7. Wildlife mortality investigation and disease research: contributions of the USGS National Wildlife Health Center to endangered species management and recovery

    USGS Publications Warehouse

    Brand, Christopher J.

    2013-01-01

    The U.S. Geological Survey—National Wildlife Health Center (NWHC) provides diagnostic services, technical assistance, applied research, and training to federal, state, territorial, and local government agencies and Native American tribes on wildlife diseases and wildlife health issues throughout the United States and its territories, commonwealth, and freely associated states. Since 1975, >16,000 carcasses and specimens from vertebrate species listed under the Endangered Species Act have been submitted to NWHC for determination of causes of morbidity or mortality or assessment of health/disease status. Results from diagnostic investigations, analyses of the diagnostic database, technical assistance and consultation, field investigation of epizootics, and wildlife disease research by NWHC wildlife disease specialists have contributed importantly to the management and recovery of listed species.

  8. Wildlife mortality investigation and disease research: contributions of the USGS National Wildlife Health Center to endangered species management and recovery.

    PubMed

    Brand, Christopher J

    2013-12-01

    The U.S. Geological Survey-National Wildlife Health Center (NWHC) provides diagnostic services, technical assistance, applied research, and training to federal, state, territorial, and local government agencies and Native American tribes on wildlife diseases and wildlife health issues throughout the United States and its territories, commonwealth, and freely associated states. Since 1975, >16,000 carcasses and specimens from vertebrate species listed under the Endangered Species Act have been submitted to NWHC for determination of causes of morbidity or mortality or assessment of health/disease status. Results from diagnostic investigations, analyses of the diagnostic database, technical assistance and consultation, field investigation of epizootics, and wildlife disease research by NWHC wildlife disease specialists have contributed importantly to the management and recovery of listed species.

  9. Completion of the National Land Cover Database (NLCD) 1992-2001 Land Cover Change Retrofit Product

    EPA Science Inventory

    The Multi-Resolution Land Characteristics Consortium has supported the development of two national digital land cover products: the National Land Cover Dataset (NLCD) 1992 and National Land Cover Database (NLCD) 2001. Substantial differences in imagery, legends, and methods betwe...

  10. Thematic Accuracy Assessment of the 2011 National Land Cover Database (NLCD)

    EPA Science Inventory

    Accuracy assessment is a standard protocol of National Land Cover Database (NLCD) mapping. Here we report agreement statistics between map and reference labels for NLCD 2011, which includes land cover for ca. 2001, ca. 2006, and ca. 2011. The two main objectives were assessment o...

  11. Hospital volume and mortality due to preterm patent ductus arteriosus.

    PubMed

    Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

    2016-11-01

    Preterm patent ductus arteriosus (PDA) requires neonatal intensive care. The relationship between hospital volume and mortality of PDA remains poorly understood. This was a retrospective observational study, using a national inpatient database in Japan. We identified patients who were diagnosed with PDA; exclusion criteria were as follows: (i) other cardiac complications; (ii) mild PDA treated without oral/i.v. indomethacin, surgery, or catheter intervention; (iii) age >1 year at admission; (iv) gestational age ≥32 weeks; (v) death within 3 days of admission; and (vi) transferal to other hospitals. Information was collected using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2013. Hospital volume was defined as the average annual number of neonates with gestational age <32 weeks at each hospital. The outcome measure was in-hospital mortality. A total of 2437 eligible patients treated at 199 hospitals were included. Low, medium, and high volume were defined as average annual number of preterm infants <34, 34-65, and >65, respectively. There were no significant differences in in-hospital mortality according to hospital volume. In-hospital mortality was identical in patients who received indomethacin alone, surgical or catheter intervention, or both after adjustment for patient background. There was no significant relationship between hospital volume and in-hospital mortality due to preterm PDA. Centralization of patients with this condition may not be necessary. © 2016 Japan Pediatric Society.

  12. Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010

    PubMed Central

    Xiao, Lin; Zhang, Dan-Li; Torrie, Jill; Auger, Nathalie; McHugh, Nancy Gros-Louis; Luo, Zhong-Cheng

    2016-01-01

    Background Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related. Methods This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996–2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality. Results Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age). Conclusions Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities. PMID:27517613

  13. Comparative study for surgical management of thymectomy for non-thymomatous myasthenia gravis from the French national database EPITHOR.

    PubMed

    Orsini, Bastien; Santelmo, Nicola; Pages, Pierre Benoit; Baste, Jean Marc; Dahan, Marcel; Bernard, Alain; Thomas, Pascal Alexandre

    2016-09-01

    Thymectomy may be part of the therapeutic strategy in patients with myasthenia gravis (MG) without thymoma. Median sternotomy is still considered as the gold standard, but during the last 15 years, several groups have demonstrated the non-inferiority of cervicotomy with upper sternotomy and minimally invasive techniques. To date, there is no consensus on surgical procedure choice. The aim of our study was to compare the morbidity and mortality of three techniques [cervicotomy with upper sternotomy versus sternotomy versus video-assisted thoracic surgery (VATS)/robotic-assisted thoracic surgery (RATS)] from the national database EPITHOR and to analyse French epidemiology. From the national thoracic surgery database EPITHOR, we have extracted all the details regarding thymectomies performed for non-thymomatous MG. We have divided thymectomy into three groups: A-sternotomy; B-cervicotomy with upper sternotomy; C-VATS/RATS. We investigated the postoperative morbidity and mortality without analysis of the long-term evolution of the disease not available on EPITHOR. From 2005 to 2013, 278 patients were included: 131 (47%) in Group A, 31 (11%) in Group B and 116 (42%) in Group C. The sex ratio F/M was 2.3. The mean age was, respectively, 42 ± 17, 42 ± 16, 35 ± 14 years old (P < 0.01). The number of patients without comorbidities was 63 (48%), 25 (81%) and 78 (65%), respectively (P < 0.01). The operative time was 94 ± 37, 79 ± 42 and 112 ± 59 min, respectively (P < 0.01). The number of patients who presented at least one postoperative complication was 12 (14%), 0 and 3 (9%) (P= 0.03), respectively. The postoperative lengths of stay were 7.7 ± 4.5, 5 ± 1.7 and 4.5 ± 2 days, respectively (P < 0.01). There was no death. In our study, we were unable to prove the superiority of minimally invasive techniques due to the important differences between the groups. However, this study shows us major changes in French surgical procedures during the last decade with an

  14. Development of a 2001 National Land Cover Database for the United States

    USGS Publications Warehouse

    Homer, Collin G.; Huang, Chengquan; Yang, Limin; Wylie, Bruce K.; Coan, Michael

    2004-01-01

    Multi-Resolution Land Characterization 2001 (MRLC 2001) is a second-generation Federal consortium designed to create an updated pool of nation-wide Landsat 5 and 7 imagery and derive a second-generation National Land Cover Database (NLCD 2001). The objectives of this multi-layer, multi-source database are two fold: first, to provide consistent land cover for all 50 States, and second, to provide a data framework which allows flexibility in developing and applying each independent data component to a wide variety of other applications. Components in the database include the following: (1) normalized imagery for three time periods per path/row, (2) ancillary data, including a 30 m Digital Elevation Model (DEM) derived into slope, aspect and slope position, (3) perpixel estimates of percent imperviousness and percent tree canopy, (4) 29 classes of land cover data derived from the imagery, ancillary data, and derivatives, (5) classification rules, confidence estimates, and metadata from the land cover classification. This database is now being developed using a Mapping Zone approach, with 66 Zones in the continental United States and 23 Zones in Alaska. Results from three initial mapping Zones show single-pixel land cover accuracies ranging from 73 to 77 percent, imperviousness accuracies ranging from 83 to 91 percent, tree canopy accuracies ranging from 78 to 93 percent, and an estimated 50 percent increase in mapping efficiency over previous methods. The database has now entered the production phase and is being created using extensive partnering in the Federal government with planned completion by 2006.

  15. Online Searching of Bibliographic Databases: Microcomputer Access to National Information Systems.

    ERIC Educational Resources Information Center

    Coons, Bill

    This paper describes the range and scope of various information databases available for technicians, researchers, and managers employed in forestry and the forest products industry. Availability of information on reports of field and laboratory research, business trends, product prices, and company profiles through national distributors of…

  16. Effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease based on a national administrative database.

    PubMed

    Murata, Atsuhiko; Mayumi, Toshihiko; Muramatsu, Keiji; Ohtani, Makoto; Matsuda, Shinya

    2015-10-01

    Little information is available on the effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease at the population level. This study aimed to investigate the effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer based on a national administrative database. A total of 14,569 elderly patients (≥80 years) who were treated by endoscopic hemostasis for hemorrhagic peptic ulcer were referred to 1073 hospitals between 2010 and 2012 in Japan. We collected patients' data from the administrative database to compare clinical and medical economic outcomes of elderly patients with hemorrhagic peptic ulcers. Patients were divided into two groups according to the presence of dementia: patients with dementia (n = 695) and those without dementia (n = 13,874). There were no significant differences in in-hospital mortality within 30 days and overall mortality between the groups (odds ratio; OR 1.00, 95 % confidence interval; CI 0.68-1.46, p = 0.986 and OR 1.02, 95 % CI 0.74-1.41, p = 0.877). However, the length of stay (LOS) and medical costs during hospitalization were significantly higher in patients with dementia compared with those without dementia. The unstandardized coefficient for LOS was 3.12 days (95 % CI 1.58-4.67 days, p < 0.001), whereas that for medical costs was 1171.7 US dollars (95 % CI 533.8-1809.5 US dollars, p < 0.001). Length of stay and medical costs during hospitalization are significantly increased in elderly patients with dementia undergoing endoscopic hemostasis for hemorrhagic peptic ulcer disease.

  17. POVERTY, INFANT MORTALITY, AND HOMICIDE RATES IN CROSS-NATIONAL PERPSECTIVE: ASSESSMENTS OF CRITERION AND CONSTRUCT VALIDITY*

    PubMed Central

    Messner, Steven F.; Raffalovich, Lawrence E.; Sutton, Gretchen M.

    2011-01-01

    This paper assesses the extent to which the infant mortality rate might be treated as a “proxy” for poverty in research on cross-national variation in homicide rates. We have assembled a pooled, cross-sectional time-series dataset for 16 advanced nations over the 1993–2000 period that includes standard measures of infant mortality and homicide and also contains information on two commonly used “income-based” poverty measures: a measure intended to reflect “absolute” deprivation and a measure intended to reflect “relative” deprivation. With these data, we are able to assess the criterion validity of the infant mortality rate with reference to the two income-based poverty measures. We are also able to estimate the effects of the various indicators of disadvantage on homicide rates in regression models, thereby assessing construct validity. The results reveal that the infant mortality rate is more strongly correlated with “relative poverty” than with “absolute poverty,” although much unexplained variance remains. In the regression models, the measure of infant mortality and the relative poverty measure yield significant positive effects on homicide rates, while the absolute poverty measure does not exhibit any significant effects. Our analyses suggest that it would be premature to dismiss relative deprivation in cross-national research on homicide, and that disadvantage is best conceptualized and measured as a multidimensional construct. PMID:21643432

  18. Levelling and merging of two discrete national-scale geochemical databases: A case study showing the surficial expression of metalliferous black shales

    USGS Publications Warehouse

    Smith, Steven M.; Neilson, Ryan T.; Giles, Stuart A.

    2015-01-01

    Government-sponsored, national-scale, soil and sediment geochemical databases are used to estimate regional and local background concentrations for environmental issues, identify possible anthropogenic contamination, estimate mineral endowment, explore for new mineral deposits, evaluate nutrient levels for agriculture, and establish concentration relationships with human or animal health. Because of these different uses, it is difficult for any single database to accommodate all the needs of each client. Smith et al. (2013, p. 168) reviewed six national-scale soil and sediment geochemical databases for the United States (U.S.) and, for each, evaluated “its appropriateness as a national-scale geochemical database and its usefulness for national-scale geochemical mapping.” Each of the evaluated databases has strengths and weaknesses that were listed in that review.Two of these U.S. national-scale geochemical databases are similar in their sample media and collection protocols but have different strengths—primarily sampling density and analytical consistency. This project was implemented to determine whether those databases could be merged to produce a combined dataset that could be used for mineral resource assessments. The utility of the merged database was tested to see whether mapped distributions could identify metalliferous black shales at a national scale.

  19. The impact of a national clinician-led audit initiative on care and mortality after hip fracture in England: an external evaluation using time trends in non-audit data.

    PubMed

    Neuburger, Jenny; Currie, Colin; Wakeman, Robert; Tsang, Carmen; Plant, Fay; De Stavola, Bianca; Cromwell, David A; van der Meulen, Jan

    2015-08-01

    Hip fracture is the most common serious injury of older people. The UK National Hip Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve the quality of hip fracture care, but has not yet been externally evaluated. We used routinely collected data on 471,590 older people (aged 60 years and older) admitted with a hip fracture to National Health Service (NHS) hospitals in England between 2003 and 2011. The main variables of interest were the use of early surgery (on day of admission, or day after) and mortality at 30 days from admission. We compared time trends in the periods 2003-2007 and 2007-2011 (before and after the launch of the NHFD), using Poisson regression models to adjust for demographic changes. The number of hospitals participating in the NHFD increased from 11 in 2007 to 175 in 2011. From 2007 to 2011, the rate of early surgery increased from 54.5% to 71.3%, whereas the rate had remained stable over the period 2003-2007. Thirty-day mortality fell from 10.9% to 8.5%, compared with a small reduction from 11.5% to 10.9% previously. The annual relative reduction in adjusted 30-day mortality was 1.8% per year in the period 2003-2007, compared with 7.6% per year over 2007-2011 (P<0.001 for the difference). The launch of a national clinician-led audit initiative was associated with substantial improvements in care and survival of older people with hip fracture in England.

  20. The North American Forest Database: going beyond national-level forest resource assessment statistics.

    PubMed

    Smith, W Brad; Cuenca Lara, Rubí Angélica; Delgado Caballero, Carina Edith; Godínez Valdivia, Carlos Isaías; Kapron, Joseph S; Leyva Reyes, Juan Carlos; Meneses Tovar, Carmen Lourdes; Miles, Patrick D; Oswalt, Sonja N; Ramírez Salgado, Mayra; Song, Xilong Alex; Stinson, Graham; Villela Gaytán, Sergio Armando

    2018-05-21

    Forests cannot be managed sustainably without reliable data to inform decisions. National Forest Inventories (NFI) tend to report national statistics, with sub-national stratification based on domestic ecological classification systems. It is becoming increasingly important to be able to report statistics on ecosystems that span international borders, as global change and globalization expand stakeholders' spheres of concern. The state of a transnational ecosystem can only be properly assessed by examining the entire ecosystem. In global forest resource assessments, it may be useful to break national statistics down by ecosystem, especially for large countries. The Inventory and Monitoring Working Group (IMWG) of the North American Forest Commission (NAFC) has begun developing a harmonized North American Forest Database (NAFD) for managing forest inventory data, enabling consistent, continental-scale forest assessment supporting ecosystem-level reporting and relational queries. The first iteration of the database contains data describing 1.9 billion ha, including 677.5 million ha of forest. Data harmonization is made challenging by the existence of definitions and methodologies tailored to suit national circumstances, emerging from each country's professional forestry development. This paper reports the methods used to synchronize three national forest inventories, starting with a small suite of variables and attributes.

  1. The Primate Life History Database: A unique shared ecological data resource

    PubMed Central

    Strier, Karen B.; Altmann, Jeanne; Brockman, Diane K.; Bronikowski, Anne M.; Cords, Marina; Fedigan, Linda M.; Lapp, Hilmar; Liu, Xianhua; Morris, William F.; Pusey, Anne E.; Stoinski, Tara S.; Alberts, Susan C.

    2011-01-01

    Summary The importance of data archiving, data sharing, and public access to data has received considerable attention. Awareness is growing among scientists that collaborative databases can facilitate these activities.We provide a detailed description of the collaborative life history database developed by our Working Group at the National Evolutionary Synthesis Center (NESCent) to address questions about life history patterns and the evolution of mortality and demographic variability in wild primates.Examples from each of the seven primate species included in our database illustrate the range of data incorporated and the challenges, decision-making processes, and criteria applied to standardize data across diverse field studies. In addition to the descriptive and structural metadata associated with our database, we also describe the process metadata (how the database was designed and delivered) and the technical specifications of the database.Our database provides a useful model for other researchers interested in developing similar types of databases for other organisms, while our process metadata may be helpful to other groups of researchers interested in developing databases for other types of collaborative analyses. PMID:21698066

  2. Effects of impairment in activities of daily living on predicting mortality following hip fracture surgery in studies using administrative healthcare databases

    PubMed Central

    2014-01-01

    Background Impairment in activities of daily living (ADL) is an important predictor of outcomes although many administrative databases lack information on ADL function. We evaluated the impact of ADL function on predicting postoperative mortality among older adults with hip fractures in Ontario, Canada. Methods Sociodemographic and medical correlates of ADL impairment were first identified in a population of older adults with hip fractures who had ADL information available prior to hip fracture. A logistic regression model was developed to predict 360-day postoperative mortality and the predictive ability of this model were compared when ADL impairment was included or omitted from the model. Results The study sample (N = 1,329) had a mean age of 85.2 years, were 72.8% female and the majority resided in long-term care (78.5%). Overall, 36.4% of individuals died within 360 days of surgery. After controlling for age, sex, medical comorbidity and medical conditions correlated with ADL impairment, addition of ADL measures improved the logistic regression model for predicting 360 day mortality (AIC = 1706.9 vs. 1695.0; c -statistic = 0.65 vs 0.67; difference in - 2 log likelihood ratios: χ2 = 16.9, p = 0.002). Conclusions Direct measures of ADL impairment provides additional prognostic information on mortality for older adults with hip fractures even after controlling for medical comorbidity. Observational studies using administrative databases without measures of ADLs may be potentially prone to confounding and bias and case-mix adjustment for hip fracture outcomes should include ADL measures where these are available. PMID:24472282

  3. Morbidity and mortality from a propensity score-matched, prospective cohort study of laparoscopic versus open total gastrectomy for gastric cancer: data from a nationwide web-based database.

    PubMed

    Etoh, Tsuyoshi; Honda, Michitaka; Kumamaru, Hiraku; Miyata, Hiroaki; Yoshida, Kazuhiro; Kodera, Yasuhiro; Kakeji, Yoshihiro; Inomata, Masafumi; Konno, Hiroyuki; Seto, Yasuyuki; Kitano, Seigo; Hiki, Naoki

    2018-06-01

    Controversy persists regarding the technical feasibility of laparoscopic total gastrectomy (LTG), and to our knowledge, no prospective study with a sample size sufficient to investigate its safety has been reported. We aimed to compare the postoperative morbidity and mortality rates in patients undergoing LTG and open total gastrectomy (OTG) for gastric cancer in prospectively enrolled cohort using nationwide web-based registry. From August 2014 to July 2015, consecutive patients undergoing LTG or OTG (925 and 1569 patients, respectively) at the participating institutions were enrolled prospectively into the National Clinical Database registration system. We constructed propensity score (PS) models separately in four facility yearly case-volume groups, and evaluated the postoperative morbidity and mortality in PS-matched 1024 patients undergoing LTG or OTG. The incidence of overall morbidity were 84 (16.4%) in the OTG and 54 (10.3%) in the LTG groups (p = 0.01).The incidence of anastomotic leakage and pancreatic fistula grade B or above were not significantly different between the two groups (LTG 5.3% vs. OTG 6.1%, p = 0.59, LTG 2.7% vs. OTG 3.7%, p = 0.38, respectively). There were also no significant differences in the 30-day and in-hospital mortality rates between the two groups (LTG 0.2% vs. OTG 0.4%, p = 0.56; LTG 0.4% vs. OTG 0.4%, p = 1.00, respectively). The results from our nationally representative data analysis showed that LTG could be a safe procedure to treat gastric cancer compared to OTG. The indication for LTG should be considered carefully in a clinical setting.

  4. Genetics and Forensics: Making the National DNA Database

    PubMed Central

    Johnson, Paul; Williams, Robin; Martin, Paul

    2005-01-01

    This paper is based on a current study of the growing police use of the epistemic authority of molecular biology for the identification of criminal suspects in support of crime investigation. It discusses the development of DNA profiling and the establishment and development of the UK National DNA Database (NDNAD) as an instance of the ‘scientification of police work’ (Ericson and Shearing 1986) in which the police uses of science and technology have a recursive effect on their future development. The NDNAD, owned by the Association of Chief Police Officers of England and Wales, is the first of its kind in the world and currently contains the genetic profiles of more than 2 million people. The paper provides a framework for the examination of this socio-technical innovation, begins to tease out the dense and compact history of the database and accounts for the way in which changes and developments across disparate scientific, governmental and policing contexts, have all contributed to the range of uses to which it is put. PMID:16467921

  5. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006.

    PubMed

    Rogers, William J; Frederick, Paul D; Stoehr, Edna; Canto, John G; Ornato, Joseph P; Gibson, C Michael; Pollack, Charles V; Gore, Joel M; Chandra-Strobos, Nisha; Peterson, Eric D; French, William J

    2008-12-01

    Although ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (AMI) have been the focus of intense clinical investigation, limited information exists on characteristics and hospital mortality of patients not enrolled in clinical trials. Previous large databases have reported declining mortality of patients with STEMI but have not noted substantial mortality change among those with NSTEMI. The National Registry of Myocardial Infarction enrolled 2,515,106 patients at 2,157 US hospitals from 1990 to 2006. Of these, we evaluated 1,950,561 with diagnoses reflecting acute myocardial ischemia on admission. From 1990 to 2006, the proportion of NSTEMI increased from 14.2% to 59.1% (P < .0001), whereas the proportion of STEMI decreased. Mean age increased (from 64.1 to 66.4 years, P < .0001) as did the proportion of females (from 32.4% to 37.0%, P < .0001). Patients were less likely to report prior angina, prior AMI, or family history of coronary artery disease but more likely to report history of diabetes, hypertension, current smoking, heart failure, prior revascularization, stroke, and hyperlipidemia. From 1994 to 2006, hospital mortality fell among all patients (10.4% to 6.3%), STEMI (11.5% to 8.0%), and NSTEMI (7.1% to 5.2%), (all P < .0001). After adjustment for baseline covariates, hospital mortality fell among all patients by 23.6% (odds ratio [OR] 0.764, 95% CI 0.744-0.785), STEMI by 24.2% (OR 0.758, 0.732-0.784), and NSTEMI by 22.6% (OR 0.774, 0.741-0.809), all P < .001. This large, observational database from 1990 to 2006 shows increasing prevalence of NSTEMI and, despite higher risk profile on presentation, falling risk-adjusted hospital mortality in patients with either STEMI or NSTEMI.

  6. [Mortality and survival analysis of liver cancer in China].

    PubMed

    Zheng, Rongshou; Zuo, Tingting; Zeng, Hongmei; Zhang, Siwei; Chen, Wanqing

    2015-09-01

    Based on the cancer registry data to analyze the mortality and survival of liver cancer in China. Liver cancer data of 2011 were retrieved from the National Cancer Registry Database.Liver cancer deaths were estimated using age-specific rate by areas and gender according to the national population in 2011. Mortality data from 22 cancer registries during 2000-2011 were used to analyze the mortality trend, and data from 17 cancer registries during 2003-2005 were used for survival analysis. The estimates of liver cancer deaths were about 322 thousand in 2011 with a crude mortality rate of 23.93/10(5).There was an increasing trend of crude mortality rate of liver cancer during 2000-2011 in 22 Chinese cancer registries with an average annual percentage change of 0.7% (95%CI: 0.2%-1.2%), 1.1% in urban and 0.4% in rural areas. After age standardization with Segi's population, the mortality rate was significantly decreased, with an APC of -2.3%, -1.9% in urban and -2.2% in rural populations. The 5-year age standardized relative survival was 10.1% (95%CI: 9.5% to 10.7%), and the 1-, 3- and the 5-year observed survival rates were 27.2%, 12.7%, and 8.9%, respectively. Liver cancer is a major cancer threatening people's lives and health in China, and the liver cancer burden is still high.

  7. Socioeconomic Differentials in the Immediate Mortality Effects of the National Irish Smoking Ban

    PubMed Central

    Stallings-Smith, Sericea; Goodman, Pat; Kabir, Zubair; Clancy, Luke; Zeka, Ariana

    2014-01-01

    Background Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Methods Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000–2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Conclusions Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring

  8. Occupational hierarchy, economic sector, and mortality from cardiovascular disease among men and women. Findings from the National Longitudinal Mortality Study.

    PubMed

    Muntaner, C; Sorlie, P; O'Campo, P; Johnson, N; Backlund, E

    2001-04-01

    Although socioeconomic position has been identified as a determinant of cardiovascular disease among employed men and women in the U.S., the role of economic sector in shaping this relationship has yet to be examined. We sought to estimate the combined effects of economic sector-one of the three major sectors of the economy: finance, government and production-and socioeconomic position on cardiovascular mortality among employed men and women. Approximately 375,000 men and women 25 years of age or more were identified from selected Current Population Surveys between 1979 and 1985. These persons were followed for cardiovascular mortality through use of the National Death Index for the years 1979 through 1989. In men, the lowest cardiovascular mortality was found for professionals in the finance sector (76/100,000 person/years). The highest cardiovascular mortality was found among male non-professional workers in the production sector (192/100,000 person years). A different pattern was observed among women. Professional women in the finance sector had the highest rates of cardiovascular mortality (133/100,000 person years). For both men and women, the professional/non-professional gap in cardiovascular mortality was lower in the government sector than in the production and finance sectors. These associations were strong even after adjustment for age, race and income. Characteristics of government, finance and production work differentially influence the risk of cardiovascular disease mortality. Men, women, professionals and non-professionals experience this risk differently.

  9. The Impact of Metastatic Spinal Tumor Location on 30-Day Perioperative Mortality and Morbidity After Surgical Decompression.

    PubMed

    Hussain, Awais K; Vig, Khushdeep S; Cheung, Zoe B; Phan, Kevin; Lima, Mauricio C; Kim, Jun S; Kaji, Deepak A; Arvind, Varun; Cho, Samuel Kang-Wook

    2018-06-01

    A retrospective cohort study from 2011 to 2014 was performed using the American College of Surgeons National Surgical Quality Improvement Program database. The purpose of this study was to assess the impact of tumor location in the cervical, thoracic, or lumbosacral spine on 30-day perioperative mortality and morbidity after surgical decompression of metastatic extradural spinal tumors. Operative treatment of metastatic spinal tumors involves extensive procedures that are associated with significant complication rates and healthcare costs. Past studies have examined various risk factors for poor clinical outcomes after surgical decompression procedures for spinal tumors, but few studies have specifically investigated the impact of tumor location on perioperative mortality and morbidity. We identified 2238 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent laminectomy for excision of metastatic extradural tumors in the cervical, thoracic, or lumbosacral spine. Baseline patient characteristics were collected from the database. Univariate and multivariate regression analyses were performed to examine the association between spinal tumor location and 30-day perioperative mortality and morbidity. On univariate analysis, cervical spinal tumors were associated with the highest rate of pulmonary complications. Multivariate regression analysis demonstrated that cervical spinal tumors had the highest odds of multiple perioperative complications. However, thoracic spinal tumors were associated with the highest risk of intra- or postoperative blood transfusion. In contrast, patients with metastatic tumors in the lumbosacral spine had lower odds of perioperative mortality, pulmonary complications, and sepsis. Tumor location is an independent risk factor for perioperative mortality and morbidity after surgical decompression of metastatic spinal tumors. The addition of tumor location to existing prognostic scoring

  10. The Spanish National Reference Database for Ionizing Radiations (BANDRRI)

    PubMed

    Los Arcos JM; Bailador; Gonzalez; Gonzalez; Gorostiza; Ortiz; Sanchez; Shaw; Williart

    2000-03-01

    The Spanish National Reference Database for Ionizing Radiations (BANDRRI) is being implemented by a reasearch team in the frame of a joint project between CIEMAT (Unidad de Metrologia de Radiaciones Ionizantes and Direccion de Informatica) and the Universidad Nacional de Educacion a Distancia (UNED, Departamento de Mecanica y Departamento de Fisica de Materiales). This paper presents the main objectives of BANDRRI, its dynamic and relational data base structure, interactive Web accessibility and its main radionuclide-related contents at this moment.

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

    PubMed

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

    2013-01-01

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

  12. Hypothyroidism is associated with all-cause mortality in a national cohort of chronic haemodialysis patients.

    PubMed

    Lin, Hsuan-Jen; Lin, Chung-Chih; Lin, Hsuan Ming; Chen, Hsuan-Ju; Lin, Che-Chen; Chang, Chiz-Tzung; Chou, Che-Yi; Huang, Chiu-Ching

    2018-06-01

    The prevalence of hypothyroidism is high in haemodialysis (HD) patients and hypothyroidism increases all-cause mortality in HD patients. Comorbidities are common in HD patients and are associated with both mortality and hypothyroidism. The aim of the study is to explore the effect of the interactions of comorbidities and hypothyroidism on all-cause mortality in HD patients. Patients with hypothyroidism (ICD-9-CM 244.0, 244.1, and 244.9) and matched patients without hypothyroidism in the Registry for Catastrophic Illness Patient Database of Taiwan Health Insurance from 2000 to 2010 were analyzed. The association of hypothyroidism and risk of all-cause mortality was analyzed using Cox proportional hazard regression. Nine hundred and eight HD patients with hypothyroidism and 3632 sex-, age-, gender- matched HD patients without hypothyroidism were analyzed. Hypothyroidism was associated with increased all-cause mortality with an adjusted hazard ratio of 1.22 [95% confidence interval (CI): 1.10-1.36, P < 0.001]. TRT may decrease mortality associated with hypothyroidism (P < 0.001). There was a significant interaction (P = 0.04) between diabetes and hypothyroidism. There was no significant interaction found in hypothyroidism and the following comorbidities: hyperlipidaemia, hypertension, chronic obstructive pulmonary disease, coronary artery disease, stroke, peripheral arterial disease, asthma, congestive heart failure and cancer. Hypothyroidism is associated with increased all-cause mortality in chronic HD patients. The interaction of hypothyroidism and diabetes, but not other common comorbidities in HD patients, has an effect on mortality risks. © 2017 Asian Pacific Society of Nephrology.

  13. Global variance in female population height: the influence of education, income, human development, life expectancy, mortality and gender inequality in 96 nations.

    PubMed

    Mark, Quentin J

    2014-01-01

    Human height is a heritable trait that is known to be influenced by environmental factors and general standard of living. Individual and population stature is correlated with health, education and economic achievement. Strong sexual selection pressures for stature have been observed in multiple diverse populations, however; there is significant global variance in gender equality and prohibitions on female mate selection. This paper explores the contribution of general standard of living and gender inequality to the variance in global female population heights. Female population heights of 96 nations were culled from previously published sources and public access databases. Factor analysis with United Nations international data on education rates, life expectancy, incomes, maternal and childhood mortality rates, ratios of gender participation in education and politics, the Human Development Index (HDI) and the Gender Inequality Index (GII) was run. Results indicate that population heights vary more closely with gender inequality than with population health, income or education.

  14. Comprehensive national database of tree effects on air quality and human health in the United States.

    PubMed

    Hirabayashi, Satoshi; Nowak, David J

    2016-08-01

    Trees remove air pollutants through dry deposition processes depending upon forest structure, meteorology, and air quality that vary across space and time. Employing nationally available forest, weather, air pollution and human population data for 2010, computer simulations were performed for deciduous and evergreen trees with varying leaf area index for rural and urban areas in every county in the conterminous United States. The results populated a national database of annual air pollutant removal, concentration changes, and reductions in adverse health incidences and costs for NO2, O3, PM2.5 and SO2. The developed database enabled a first order approximation of air quality and associated human health benefits provided by trees with any forest configurations anywhere in the conterminous United States over time. Comprehensive national database of tree effects on air quality and human health in the United States was developed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Modelling Future Cardiovascular Disease Mortality in the United States: National Trends and Racial and Ethnic Disparities

    PubMed Central

    Pearson-Stuttard, Jonathan; Guzman-Castillo, Maria; Penalvo, Jose L.; Rehm, Colin D.; Afshin, Ashkan; Danaei, Goodarz; Kypridemos, Chris; Gaziano, Tom; Mozaffarian, Dariush; Capewell, Simon; O’Flaherty, Martin

    2016-01-01

    Background Accurate forecasting of cardiovascular disease (CVD) mortality is crucial to guide policy and programming efforts. Prior forecasts have often not incorporated past trends in rates of reduction in CVD mortality. This creates uncertainties about future trends in CVD mortality and disparities. Methods and Results To forecast US CVD mortality and disparities to 2030, we developed a hierarchical Bayesian model to determine and incorporate prior age, period and cohort (APC) effects from 1979–2012, stratified by age, gender and race; which we combined with expected demographic shifts to 2030. Data sources included the National Vital Statistics System, SEER single year population estimates, and US Bureau of Statistics 2012 National Population projections. We projected coronary disease and stroke deaths to 2030, first based on constant APC effects at 2012 values, as most commonly done (conventional); and then using more rigorous projections incorporating expected trends in APC effects (trend-based). We primarily evaluated absolute mortality. The conventional model projected total coronary and stroke deaths by 2030 to increase by approximately 18% (67,000 additional coronary deaths/year) and 50% (64,000 additional stroke deaths/year). Conversely, the trend-based model projected that coronary mortality would fall by 2030 by approximately 27% (79,000 fewer deaths/year); and stroke mortality would remain unchanged (200 fewer deaths/year). Health disparities will be improved in stroke deaths, but not coronary deaths. Conclusions After accounting for prior mortality trends and expected demographic shifts, total US coronary deaths are expected to decline, while stroke mortality will remain relatively constant. Health disparities in stroke, but not coronary, deaths will be improved but not eliminated. These APC approaches offer more plausible predictions than conventional estimates. PMID:26846769

  16. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group.

    PubMed

    Alkema, Leontine; Chou, Doris; Hogan, Daniel; Zhang, Sanqian; Moller, Ann-Beth; Gemmill, Alison; Fat, Doris Ma; Boerma, Ties; Temmerman, Marleen; Mathers, Colin; Say, Lale

    2016-01-30

    Millennium Development Goal 5 calls for a 75% reduction in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed projections to show the requirements for the Sustainable Development Goal (SDG) of less than 70 maternal deaths per 100,000 livebirths globally by 2030. We updated the UN Maternal Mortality Estimation Inter-Agency Group (MMEIG) database with more than 200 additional records (vital statistics from civil registration systems, surveys, studies, or reports). We generated estimates of maternal mortality and related indicators with 80% uncertainty intervals (UIs) using a Bayesian model. The model combines the rate of change implied by a multilevel regression model with a time-series model to capture data-driven changes in country-specific MMRs, and includes a data model to adjust for systematic and random errors associated with different data sources. We had data for 171 of 183 countries. The global MMR fell from 385 deaths per 100,000 livebirths (80% UI 359-427) in 1990, to 216 (207-249) in 2015, corresponding to a relative decline of 43·9% (34·0-48·7), with 303,000 (291,000-349,000) maternal deaths worldwide in 2015. Regional progress in reducing the MMR since 1990 ranged from an annual rate of reduction of 1·8% (0·0-3·1) in the Caribbean to 5·0% (4·0-6·0) in eastern Asia. Regional MMRs for 2015 ranged from 12 deaths per 100,000 livebirths (11-14) for high-income regions to 546 (511-652) for sub-Saharan Africa. Accelerated progress will be needed to achieve the SDG goal; countries will need to reduce their MMRs at an annual rate of reduction of at least 7·5%. Despite global progress in reducing maternal mortality, immediate action is needed to meet the ambitious SDG 2030 target, and ultimately eliminate preventable maternal mortality. Although the rates of reduction that are needed to achieve country

  17. Inaccurate Ascertainment of Morbidity and Mortality due to Influenza in Administrative Databases: A Population-Based Record Linkage Study

    PubMed Central

    Muscatello, David J.; Amin, Janaki; MacIntyre, C. Raina; Newall, Anthony T.; Rawlinson, William D.; Sintchenko, Vitali; Gilmour, Robin; Thackway, Sarah

    2014-01-01

    Background Historically, counting influenza recorded in administrative health outcome databases has been considered insufficient to estimate influenza attributable morbidity and mortality in populations. We used database record linkage to evaluate whether modern databases have similar limitations. Methods Person-level records were linked across databases of laboratory notified influenza, emergency department (ED) presentations, hospital admissions and death registrations, from the population (∼6.9 million) of New South Wales (NSW), Australia, 2005 to 2008. Results There were 2568 virologically diagnosed influenza infections notified. Among those, 25% of 40 who died, 49% of 1451 with a hospital admission and 7% of 1742 with an ED presentation had influenza recorded on the respective database record. Compared with persons aged ≥65 years and residents of regional and remote areas, respectively, children and residents of major cities were more likely to have influenza coded on their admission record. Compared with older persons and admitted patients, respectively, working age persons and non-admitted persons were more likely to have influenza coded on their ED record. On both ED and admission records, persons with influenza type A infection were more likely than those with type B infection to have influenza coded. Among death registrations, hospital admissions and ED presentations with influenza recorded as a cause of illness, 15%, 28% and 1.4%, respectively, also had laboratory notified influenza. Time trends in counts of influenza recorded on the ED, admission and death databases reflected the trend in counts of virologically diagnosed influenza. Conclusions A minority of the death, hospital admission and ED records for persons with a virologically diagnosed influenza infection identified influenza as a cause of illness. Few database records with influenza recorded as a cause had laboratory confirmation. The databases have limited value for estimating incidence

  18. Danish Colorectal Cancer Group Database.

    PubMed

    Ingeholm, Peter; Gögenur, Ismail; Iversen, Lene H

    2016-01-01

    The aim of the database, which has existed for registration of all patients with colorectal cancer in Denmark since 2001, is to improve the prognosis for this patient group. All Danish patients with newly diagnosed colorectal cancer who are either diagnosed or treated in a surgical department of a public Danish hospital. The database comprises an array of surgical, radiological, oncological, and pathological variables. The surgeons record data such as diagnostics performed, including type and results of radiological examinations, lifestyle factors, comorbidity and performance, treatment including the surgical procedure, urgency of surgery, and intra- and postoperative complications within 30 days after surgery. The pathologists record data such as tumor type, number of lymph nodes and metastatic lymph nodes, surgical margin status, and other pathological risk factors. The database has had >95% completeness in including patients with colorectal adenocarcinoma with >54,000 patients registered so far with approximately one-third rectal cancers and two-third colon cancers and an overrepresentation of men among rectal cancer patients. The stage distribution has been more or less constant until 2014 with a tendency toward a lower rate of stage IV and higher rate of stage I after introduction of the national screening program in 2014. The 30-day mortality rate after elective surgery has been reduced from >7% in 2001-2003 to <2% since 2013. The database is a national population-based clinical database with high patient and data completeness for the perioperative period. The resolution of data is high for description of the patient at the time of diagnosis, including comorbidities, and for characterizing diagnosis, surgical interventions, and short-term outcomes. The database does not have high-resolution oncological data and does not register recurrences after primary surgery. The Danish Colorectal Cancer Group provides high-quality data and has been documenting an

  19. Socioeconomic and Behavioral Risk Factors for Mortality in a National 19-Year Prospective Study of U.S. Adults

    PubMed Central

    Lantz, Paula M.; Golberstein, Ezra; House, James S.; Morenoff, Jeffrey D.

    2012-01-01

    Many demographic, socioeconomic, and behavioral risk factors predict mortality in the United States. However, very few population-based longitudinal studies are able to investigate simultaneously the impact of a variety of social factors on mortality. We investigated the degree to which demographic characteristics, socioeconomic variables and major health risk factors were associated with mortality in a nationally-representative sample of 3,617 U.S. adults from 1986-2005, using data from the 4 waves of the Americans’ Changing Lives study. Cox proportional hazard models with time-varying covariates were employed to predict all-cause mortality verified through the National Death Index and death certificate review. The results revealed that low educational attainment was not associated with mortality when income and health risk behaviors were included in the model. The association of low-income with mortality remained after controlling for major behavioral risks. Compared to those in the “normal” weight category, neither overweight nor obesity was significantly associated with the risk of mortality. Among adults age 55 and older at baseline, the risk of mortality was actually reduced for those were overweight (hazard rate ratio=0.83, 95% C.I. = 0.71 – 0.98) and those who were obese (hazard rate ratio=0.68, 95% C.I. = 0.55 – 0.84), controlling for other health risk behaviors and health status. Having a low level of physical activity was a significant risk factor for mortality (hazard rate ratio=1.58, 95% C.I. = 1.20 – 2.07). The results from this national longitudinal study underscore the need for health policies and clinical interventions focusing on the social and behavioral determinants of health, with a particular focus on income security, smoking prevention/cessation, and physical activity. PMID:20226579

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

    PubMed

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

    2014-02-01

    To better characterize national genital burns (GBs) characteristics using a large burn registry. We hypothesized that mortality and morbidity will be higher in patients with GBs. The National Burn Repository, a large North American registry of hospitalized burn patients, was queried for patients with GB. Burn characteristics and mechanism, demographics, mortality, and surgical interventions were retrieved. Outcomes of interest were mortality, hospital-acquired infection (HAI), and surgical intervention on the genitalia. Adjusted odds ratios (aOR) for outcomes were determined with binomial logistic regression controlling for age, total burn surface area, race, length of stay, gender, and inhalation injury presence. GBs were present in 1245 cases of 71,895 burns (1.7%). Patients with GB had significantly greater average total burn surface area, length of stay, and mortality. In patients with GB, surgery of the genitalia was infrequent (10.4%), with the aOR of receiving surgery higher among men (aOR 2.7, P <.001) and those with third-degree burns (aOR 3.1, P <.002). Presence of a GB increased the odds of HAI (aOR 3.0, P <.0001) and urinary tract infections (aOR 3.4, P <.0001). GB was also an independent predictor of mortality (aOR 1.54) even after adjusting for the increased HAI risk. GBs are rare but associated with higher HAI rates and higher mortality after adjusting for well-established mortality risk factors. Although a cause and effect relationship cannot be established using these registry data, we believe this study suggests the need for special management considerations in GB cases to improve overall outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. A national look at carbon capture and storage-National carbon sequestration database and geographical information system (NatCarb)

    USGS Publications Warehouse

    Carr, T.R.; Iqbal, A.; Callaghan, N.; ,; Look, K.; Saving, S.; Nelson, K.

    2009-01-01

    The US Department of Energy's Regional Carbon Sequestration Partnerships (RCSPs) are responsible for generating geospatial data for the maps displayed in the Carbon Sequestration Atlas of the United States and Canada. Key geospatial data (carbon sources, potential storage sites, transportation, land use, etc.) are required for the Atlas, and for efficient implementation of carbon sequestration on a national and regional scale. The National Carbon Sequestration Database and Geographical Information System (NatCarb) is a relational database and geographic information system (GIS) that integrates carbon storage data generated and maintained by the RCSPs and various other sources. The purpose of NatCarb is to provide a national view of the carbon capture and storage potential in the U.S. and Canada. The digital spatial database allows users to estimate the amount of CO2 emitted by sources (such as power plants, refineries and other fossil-fuel-consuming industries) in relation to geologic formations that can provide safe, secure storage sites over long periods of time. The NatCarb project is working to provide all stakeholders with improved online tools for the display and analysis of CO2 carbon capture and storage data. NatCarb is organizing and enhancing the critical information about CO2 sources and developing the technology needed to access, query, model, analyze, display, and distribute natural resource data related to carbon management. Data are generated, maintained and enhanced locally at the RCSP level, or at specialized data warehouses, and assembled, accessed, and analyzed in real-time through a single geoportal. NatCarb is a functional demonstration of distributed data-management systems that cross the boundaries between institutions and geographic areas. It forms the first step toward a functioning National Carbon Cyberinfrastructure (NCCI). NatCarb provides access to first-order information to evaluate the costs, economic potential and societal issues of

  2. Morbidity and Mortality of Radical Nephrectomy for Patients With Disseminated Cancer: An Analysis of the National Surgical Quality Improvement Program Database.

    PubMed

    Wallis, Christopher J D; Bjarnason, Georg; Byrne, James; Cheung, Douglas C; Hoffman, Azik; Kulkarni, Girish S; Nathens, Avery B; Nam, Robert K; Satkunasivam, Raj

    2016-09-01

    To determine the effect of disseminated cancer on perioperative outcomes following radical nephrectomy. We conducted a retrospective cohort study of patients undergoing radical nephrectomy for kidney cancer from 2005 to 2014 using the American College of Surgeons National Surgical Quality Improvement Program, a multi-institutional prospective registry that captures perioperative surgical complications. Patients were stratified according to the presence (n = 657) or absence (n = 7143) of disseminated cancer at the time of surgery. We examined major complications (death, reoperation, cardiac event, or neurologic event) within 30 days of surgery. Secondary outcomes included pulmonary, infectious, venous thromboembolic, and bleeding complications; prolonged length of stay; and concomitant procedures (bowel, liver, spleen, pancreas, and vascular procedures). Adjusted odds ratio (aOR) and 95% confidence interval (95% CI) were calculated using multivariate logical regression models. Patients with disseminated cancer were older and more likely to be male, have greater comorbidities, and have undergone open surgery. Major complications were more common among patients with disseminated cancer (7.8%) than those without disseminated cancer (3.2%; aOR 2.01, 95% CI 1.46-2.86). Mortality was significantly higher in patients with disseminated cancer (3.2%) than those without disseminated cancer (0.5%; P < .0001). Pulmonary (aOR 1.68, 95% CI 1.09-2.59), thromboembolic (aOR 1.72, 95% CI 1.01-2.96), and bleeding complications (aOR 2.12, 95% CI 1.73-2.60) were more common among patients with disseminated cancer as was prolonged length of stay (aOR 1.27, 95% CI 1.06-1.53). Nephrectomy in patients with disseminated cancer is a morbid operation with significant perioperative mortality. These data may be used for preoperative counseling of patients undergoing cytoreductive nephrectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Down syndrome: national conference on patient registries, research databases, and biobanks.

    PubMed

    Oster-Granite, Mary Lou; Parisi, Melissa A; Abbeduto, Leonard; Berlin, Dorit S; Bodine, Cathy; Bynum, Dana; Capone, George; Collier, Elaine; Hall, Dan; Kaeser, Lisa; Kaufmann, Petra; Krischer, Jeffrey; Livingston, Michelle; McCabe, Linda L; Pace, Jill; Pfenninger, Karl; Rasmussen, Sonja A; Reeves, Roger H; Rubinstein, Yaffa; Sherman, Stephanie; Terry, Sharon F; Whitten, Michelle Sie; Williams, Stephen; McCabe, Edward R B; Maddox, Yvonne T

    2011-01-01

    A December 2010 meeting, "Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks," was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome. They charged the participants to focus on the separate issues of contact registries, research databases, and biobanks through both podium presentations and breakout session discussions. Among the breakout groups for each of the major sessions, participants were asked to generate responses to questions posed by the organizers concerning these three research resources as they related to Down syndrome and then to report back to the group at large with a summary of their discussions. This report represents a synthesis of the discussions and suggested approaches formulated by the group as a whole. Copyright © 2011. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2012-03-01

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

  5. Effects of Childhood and Middle-Adulthood Family Conditions on Later-Life Mortality: Evidence from the Utah Population Database, 1850-2002

    PubMed Central

    Mineau, Mineau P; Gilda, Garibotti; Kerber, Richard

    2014-01-01

    We examine how key early family circumstances affect mortality risks decades later. Early life conditions are measured by parental mortality, parental fertility (e.g., offspring sibship size, parental age at offspring birth), religious upbringing, and parental socioeconomic status. Prior to these early life conditions are familial and genetic factors that affect life-span. Accordingly, we consider the role of parental and familial longevity on adult mortality risks. We analyze the large Utah Population Database which contains a vast amount of genealogical and other vital/health data that contain full life histories of individuals and hundreds of their relatives. To control for unobserved heterogeneity, we analyze sib-pair data for 12,000 sib-pairs using frailty models. We found modest effects of key childhood conditions (birth order, sibship size, parental religiosity, parental SES, and parental death in childhood). Our measures of familial aggregation of longevity were large and suggest an alternative view of early life conditions. PMID:19278766

  6. Co-morbidities associated with influenza-attributed mortality, 1994-2000, Canada.

    PubMed

    Schanzer, Dena L; Langley, Joanne M; Tam, Theresa W S

    2008-08-26

    The elderly and persons with specific chronic conditions are known to face elevated morbidity and mortality risks resulting from an influenza infection, and hence are routinely recommended for annual influenza vaccination. However, risk-specific mortality rates have not been established. We estimated age-specific influenza-attributable mortality rates stratified by the presence of chronic conditions and type of residence based on deaths of persons who were admitted to hospital with a respiratory complication captured in our national database. The majority of patients had chronic heart or respiratory conditions (80%) and were admitted from the community (80%). Influenza-attributable mortality rates clearly increase with age for all risk groups. Our influenza-specific estimates identified higher risk ratios for chronic lung or heart disease than have been suggested by other methods. These estimates identify groups most in need of improved vaccines and for whom the use of additional strategies, such as immunization of household contacts or caregivers should be considered.

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

    PubMed

    Huicho, Luis; Trelles, Miguel; Gonzales, Fernando

    2006-07-04

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

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

    PubMed Central

    Huicho, Luis; Trelles, Miguel; Gonzales, Fernando

    2006-01-01

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

  9. Development and analysis of a meteorological database, Argonne National Laboratory, Illinois

    USGS Publications Warehouse

    Over, Thomas M.; Price, Thomas H.; Ishii, Audrey L.

    2010-01-01

    A database of hourly values of air temperature, dewpoint temperature, wind speed, and solar radiation from January 1, 1948, to September 30, 2003, primarily using data collected at the Argonne National Laboratory station, was developed for use in continuous-time hydrologic modeling in northeastern Illinois. Missing and apparently erroneous data values were replaced with adjusted values from nearby stations used as 'backup'. Temporal variations in the statistical properties of the data resulting from changes in measurement and data-storage methodologies were adjusted to match the statistical properties resulting from the data-collection procedures that have been in place since January 1, 1989. The adjustments were computed based on the regressions between the primary data series from Argonne National Laboratory and the backup series using data obtained during common periods; the statistical properties of the regressions were used to assign estimated standard errors to values that were adjusted or filled from other series. Each hourly value was assigned a corresponding data-source flag that indicates the source of the value and its transformations. An analysis of the data-source flags indicates that all the series in the database except dewpoint have a similar fraction of Argonne National Laboratory data, with about 89 percent for the entire period, about 86 percent from 1949 through 1988, and about 98 percent from 1989 through 2003. The dewpoint series, for which observations at Argonne National Laboratory did not begin until 1958, has only about 71 percent Argonne National Laboratory data for the entire period, about 63 percent from 1948 through 1988, and about 93 percent from 1989 through 2003, indicating a lower reliability of the dewpoint sensor. A basic statistical analysis of the filled and adjusted data series in the database, and a series of potential evapotranspiration computed from them using the computer program LXPET (Lamoreux Potential

  10. Determination of the impact of melanoma surgical timing on survival using the National Cancer Database.

    PubMed

    Conic, Ruzica Z; Cabrera, Claudia I; Khorana, Alok A; Gastman, Brian R

    2018-01-01

    The ideal timing for melanoma treatment, predominantly surgery, remains undetermined. Patient concern for receiving immediate treatment often exceeds surgeon or hospital availability, requiring establishment of a safe window for melanoma surgery. To assess the impact of time to definitive melanoma surgery on overall survival. Patients with stage I to III cutaneous melanoma and with available time to definitive surgery and overall survival were identified by using the National Cancer Database (N = 153,218). The t test and chi-square test were used to compare variables. Cox regression was used for multivariate analysis. In a multivariate analysis of patients in all stages who were treated between 90 and 119 days after biopsy (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.01-1.18) and more than 119 days (HR, 1.12; 95% CI, 1.02-1.22) had a higher risk for mortality compared with those treated within 30 days of biopsy. In a subgroup analysis of stage I, higher mortality risk was found in patients treated within 30 to 59 days (HR, 1.05; 95% CI, 1.01-1.1), 60 to 89 days (HR, 1.16; 95% CI, 1.07-1.25), 90 to 119 days (HR, 1.29; 95% CI, 1.12-1.48), and more than 119 days after biopsy (HR, 1.41; 95% CI, 1.21-1.65). Surgical timing did not affect survival in stages II and III. Melanoma-specific survival was not available. Expeditious treatment of stage I melanoma is associated with improved outcomes. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Psychological and Cognitive Determinants of Mortality: Evidence from a Nationally Representative Sample Followed over Thirty-five Years

    PubMed Central

    Karraker, Amelia; Schoeni, Robert F.; Cornman, Jennifer C.

    2015-01-01

    Growing evidence suggests that psychological factors, such as conscientiousness and anger, as well as cognitive ability are related to mortality. Less is known about 1) the relative importance of each of these factors in predicting mortality, 2) through what social, economic, and behavioral mechanisms these factors influence mortality, and 3) how these processes unfold over long periods of time in nationally-representative samples. We use 35 years (1972–2007) of data from men (ages 20–40) in the Panel Study of Income Dynamics (PSID), a nationally representative sample in the United States, and discrete time event history analysis (n=27,373 person-years) to examine the importance of measures of follow-through (a dimension of conscientiousness), anger, and cognitive ability in predicting mortality. We also assess the extent to which income, marriage, and smoking explain the relationship between psychological and cognitive factors with mortality. We find that while follow-through, anger, and cognitive ability are all associated with subsequent mortality when modeled separately, when they are modeled together and baseline demographic characteristics are controlled, only anger remains associated with mortality: being in the top quartile for anger is associated with a 1.57 fold increase in the risk of dying at follow-up compared with those in the bottom quartile. This relationship is robust to the inclusion of income, marriage, and smoking as mediators. PMID:26397865

  12. Gender as a Modifying Factor Influencing Myotonic Dystrophy Type 1 Phenotype Severity and Mortality: A Nationwide Multiple Databases Cross-Sectional Observational Study.

    PubMed

    Dogan, Celine; De Antonio, Marie; Hamroun, Dalil; Varet, Hugo; Fabbro, Marianne; Rougier, Felix; Amarof, Khadija; Arne Bes, Marie-Christine; Bedat-Millet, Anne-Laure; Behin, Anthony; Bellance, Remi; Bouhour, Françoise; Boutte, Celia; Boyer, François; Campana-Salort, Emmanuelle; Chapon, Françoise; Cintas, Pascal; Desnuelle, Claude; Deschamps, Romain; Drouin-Garraud, Valerie; Ferrer, Xavier; Gervais-Bernard, Helene; Ghorab, Karima; Laforet, Pascal; Magot, Armelle; Magy, Laurent; Menard, Dominique; Minot, Marie-Christine; Nadaj-Pakleza, Aleksandra; Pellieux, Sybille; Pereon, Yann; Preudhomme, Marguerite; Pouget, Jean; Sacconi, Sabrina; Sole, Guilhem; Stojkovich, Tanya; Tiffreau, Vincent; Urtizberea, Andoni; Vial, Christophe; Zagnoli, Fabien; Caranhac, Gilbert; Bourlier, Claude; Riviere, Gerard; Geille, Alain; Gherardi, Romain K; Eymard, Bruno; Puymirat, Jack; Katsahian, Sandrine; Bassez, Guillaume

    2016-01-01

    Myotonic Dystrophy type 1 (DM1) is one of the most heterogeneous hereditary disease in terms of age of onset, clinical manifestations, and severity, challenging both medical management and clinical trials. The CTG expansion size is the main factor determining the age of onset although no factor can finely predict phenotype and prognosis. Differences between males and females have not been specifically reported. Our aim is to study gender impact on DM1 phenotype and severity. We first performed cross-sectional analysis of main multiorgan clinical parameters in 1409 adult DM1 patients (>18 y) from the DM-Scope nationwide registry and observed different patterns in males and females. Then, we assessed gender impact on social and economic domains using the AFM-Téléthon DM1 survey (n = 970), and morbidity and mortality using the French National Health Service Database (n = 3301). Men more frequently had (1) severe muscular disability with marked myotonia, muscle weakness, cardiac, and respiratory involvement; (2) developmental abnormalities with facial dysmorphism and cognitive impairment inferred from low educational levels and work in specialized environments; and (3) lonely life. Alternatively, women more frequently had cataracts, dysphagia, digestive tract dysfunction, incontinence, thyroid disorder and obesity. Most differences were out of proportion to those observed in the general population. Compared to women, males were more affected in their social and economic life. In addition, they were more frequently hospitalized for cardiac problems, and had a higher mortality rate. Gender is a previously unrecognized factor influencing DM1 clinical profile and severity of the disease, with worse socio-economic consequences of the disease and higher morbidity and mortality in males. Gender should be considered in the design of both stratified medical management and clinical trials.

  13. National Land Cover Database 2001 (NLCD01)

    USGS Publications Warehouse

    LaMotte, Andrew E.

    2016-01-01

    This 30-meter data set represents land use and land cover for the conterminous United States for the 2001 time period. The data have been arranged into four tiles to facilitate timely display and manipulation within a Geographic Information System (see http://water.usgs.gov/GIS/browse/nlcd01-partition.jpg). The National Land Cover Data Set for 2001 was produced through a cooperative project conducted by the Multi-Resolution Land Characteristics (MRLC) Consortium. The MRLC Consortium is a partnership of Federal agencies (http://www.mrlc.gov), consisting of the U.S. Geological Survey (USGS), the National Oceanic and Atmospheric Administration (NOAA), the U.S. Environmental Protection Agency (USEPA), the U.S. Department of Agriculture (USDA), the U.S. Forest Service (USFS), the National Park Service (NPS), the U.S. Fish and Wildlife Service (USFWS), the Bureau of Land Management (BLM), and the USDA Natural Resources Conservation Service (NRCS). One of the primary goals of the project is to generate a current, consistent, seamless, and accurate National Land Cover Database (NLCD) circa 2001 for the United States at medium spatial resolution. For a detailed definition and discussion on MRLC and the NLCD 2001 products, refer to Homer and others (2004), (see: http://www.mrlc.gov/mrlc2k.asp). The NLCD 2001 was created by partitioning the United States into mapping zones. A total of 68 mapping zones (see http://water.usgs.gov/GIS/browse/nlcd01-mappingzones.jpg), were delineated within the conterminous United States based on ecoregion and geographical characteristics, edge-matching features, and the size requirement of Landsat mosaics. Mapping zones encompass the whole or parts of several states. Questions about the NLCD mapping zones can be directed to the NLCD 2001 Land Cover Mapping Team at the USGS/EROS, Sioux Falls, SD (605) 594-6151 or mrlc@usgs.gov.

  14. Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010)

    PubMed Central

    2013-01-01

    Background The National Cardiovascular Disease (NCVD) Database Registry represents one of the first prospective, multi-center registries to treat and prevent coronary artery disease (CAD) in Malaysia. Since ethnicity is an important consideration in the occurrence of acute coronary syndrome (ACS) globally, therefore, we aimed to identify the role of ethnicity in the occurrence of ACS among high-risk groups in the Malaysian population. Methods The NCVD involves more than 15 Ministry of Health (MOH) hospitals nationwide, universities and the National Heart Institute and enrolls patients presenting with ACS [ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA)]. We analyzed ethnic differences across socio-demographic characteristics, hospital medications and invasive therapeutic procedures, treatment of STEMI and in-hospital clinical outcomes. Results We enrolled 13,591 patients. The distribution of the NCVD population was as follows: 49.0% Malays, 22.5% Chinese, 23.1% Indians and 5.3% Others (representing other indigenous groups and non-Malaysian nationals). The mean age (SD) of ACS patients at presentation was 59.1 (12.0) years. More than 70% were males. A higher proportion of patients within each ethnic group had more than two coronary risk factors. Malays had higher body mass index (BMI). Chinese had highest rate of hypertension and hyperlipidemia. Indians had higher rate of diabetes mellitus (DM) and family history of premature CAD. Overall, more patients had STEMI than NSTEMI or UA among all ethnic groups. The use of aspirin was more than 94% among all ethnic groups. Utilization rates for elective and emergency percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were low among all ethnic groups. In STEMI, fibrinolysis (streptokinase) appeared to be the dominant treatment options (>70%) for all ethnic groups. In-hospital mortality rates for STEMI across ethnicity ranges

  15. Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010).

    PubMed

    Lu, Hou Tee; Nordin, Rusli Bin

    2013-11-06

    The National Cardiovascular Disease (NCVD) Database Registry represents one of the first prospective, multi-center registries to treat and prevent coronary artery disease (CAD) in Malaysia. Since ethnicity is an important consideration in the occurrence of acute coronary syndrome (ACS) globally, therefore, we aimed to identify the role of ethnicity in the occurrence of ACS among high-risk groups in the Malaysian population. The NCVD involves more than 15 Ministry of Health (MOH) hospitals nationwide, universities and the National Heart Institute and enrolls patients presenting with ACS [ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA)]. We analyzed ethnic differences across socio-demographic characteristics, hospital medications and invasive therapeutic procedures, treatment of STEMI and in-hospital clinical outcomes. We enrolled 13,591 patients. The distribution of the NCVD population was as follows: 49.0% Malays, 22.5% Chinese, 23.1% Indians and 5.3% Others (representing other indigenous groups and non-Malaysian nationals). The mean age (SD) of ACS patients at presentation was 59.1 (12.0) years. More than 70% were males. A higher proportion of patients within each ethnic group had more than two coronary risk factors. Malays had higher body mass index (BMI). Chinese had highest rate of hypertension and hyperlipidemia. Indians had higher rate of diabetes mellitus (DM) and family history of premature CAD. Overall, more patients had STEMI than NSTEMI or UA among all ethnic groups. The use of aspirin was more than 94% among all ethnic groups. Utilization rates for elective and emergency percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were low among all ethnic groups. In STEMI, fibrinolysis (streptokinase) appeared to be the dominant treatment options (>70%) for all ethnic groups. In-hospital mortality rates for STEMI across ethnicity ranges from 8.1% to 10.1% (p = 0

  16. Health Care Disparity and Pregnancy-Related Mortality in the United States, 2005-2014.

    PubMed

    Moaddab, Amirhossein; Dildy, Gary A; Brown, Haywood L; Bateni, Zhoobin H; Belfort, Michael A; Sangi-Haghpeykar, Haleh; Clark, Steven L

    2018-04-01

    To quantitate the contribution of various demographic factors to the U.S. maternal mortality ratio. This was a retrospective observational study. We analyzed data from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics database and the Detailed Mortality Underlying Cause of Death database (CDC WONDER) from 2005 to 2014 that contains mortality and population counts for all U.S. counties. Bivariate correlations between the maternal mortality ratio and all maternal demographic, lifestyle, health, and medical service utilization characteristics were calculated. We performed a maximum likelihood factor analysis with varimax rotation retaining variables that were significant (P<.05) in the univariate analysis to deal with multicollinearity among the existing variables. The United States has experienced an increase in maternal mortality ratio since 2005 with rates increasing from 15 per 100,00 live births in 2005 to 21-22 per 100,000 live births in 2013 and 2014. (P<.001) This increase in mortality was most pronounced in non-Hispanic black women, with ratios rising from 39 to 49 per 100,000 live births. A significant correlation between state mortality ranking and the percentage of non-Hispanic black women in the delivery population was demonstrated. Cesarean deliveries, unintended births, unmarried status, percentage of deliveries to non-Hispanic black women, and four or fewer prenatal visits were significantly (P<.05) associated with the increased maternal mortality ratio. The current U.S. maternal mortality ratio is heavily influenced by a higher rate of death among non-Hispanic black or unmarried patients with unplanned pregnancies. Racial disparities in health care availability and access or utilization by underserved populations are important issues faced by states seeking to decrease maternal mortality.

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

    PubMed

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

    2014-10-01

    HIV/AIDS is a worldwide threat to human health with mortality, prevalence, and incidence rates varying widely. We evaluated the association between the global HIV/AIDS epidemic and national socioeconomic development. We obtained global age-standardized HIV/AIDS mortality, prevalence, and incidence rates from World Health Statistics Report of the World Health Organization. The human development indexes (HDIs) of 141 countries were obtained from a Human Development Report. Countries were divided into 4 groups according to the HDI distribution. We explored the association between HIV/AIDS epidemic and HDI information using Spearman correlation analysis, regression analysis, and the Kruskal-Wallis test. HIV/AIDS mortality, prevalence, and incidence rates were inversely correlated with national HDI (r = -0.675, -0.519, and -0.398, respectively; P < .001), as well as the 4 indicators of HDI (ie, life expectancy at birth, mean years of schooling, expected years of schooling, and gross national income per capita). Low HDI countries had higher HIV/AIDS mortality, prevalence, and incidence rates than that of medium, high, and very high HDI countries. Quantile regression results indicated that HDI had a greater negative effect on the HIV/AIDS epidemic in countries with more severe HIV/AIDS epidemic. Less-developed countries are likely to have more severe HIV/AIDS epidemic. There is a need to pay more attention to HIV/AIDS control in less-developed countries, where lower socioeconomic status might have accelerated the HIV/AIDS epidemic more rapidly. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2010-01-01

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

  19. 30-days mortality in patients with perforated peptic ulcer: A national audit

    PubMed Central

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

    2008-01-01

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

  20. Acute myocardial infarction mortality in Cuba, 1999-2008.

    PubMed

    Armas, Nurys B; Ortega, Yanela Y; de la Noval, Reinaldo; Suárez, Ramón; Llerena, Lorenzo; Dueñas, Alfredo F

    2012-10-01

    Acute myocardial infarction is one of the leading causes of death in the world. This is also true in Cuba, where no national-level epidemiologic studies of related mortality have been published in recent years. Describe acute myocardial infarction mortality in Cuba from 1999 through 2008. A descriptive study was conducted of persons aged ≥25 years with a diagnosis of acute myocardial infarction from 1999 through 2008. Data were obtained from the Ministry of Public Health's National Statistics Division database for variables: age; sex; site (out of hospital, in hospital or in hospital emergency room) and location (jurisdiction) of death. Proportions, age- and sex-specific rates and age-standardized overall rates per 100,000 population were calculated and compared over time, using the two five-year time frames within the study period. A total of 145,808 persons who had suffered acute myocardial infarction were recorded, 75,512 of whom died, for a case-fatality rate of 51.8% (55.1% in 1999-2003 and 49.7% in 2004-2008). In the first five-year period, mortality was 98.9 per 100,000 population, falling to 81.8 per 100,000 in the second; most affected were people aged ≥75 years and men. Of Cuba's 14 provinces and special municipality, Havana, Havana City and Camagüey provinces, and the Isle of Youth Special Municipality showed the highest mortality; Holguín, Ciego de Ávila and Granma provinces the lowest. Out-of-hospital deaths accounted for the greatest proportion of deaths in both five-year periods (54.8% and 59.2% in 1999-2003 and 2004-2008, respectively). Although risk of death from acute myocardial infarction decreased through the study period, it remains a major health problem in Cuba. A national acute myocardial infarction case registry is needed. Also required is further research to help elucidate possible causes of Cuba's high acute myocardial infarction mortality: cardiovascular risk studies, studies of out-of-hospital mortality and quality of care

  1. NATIONAL URBAN DATABASE AND ACCESS PORTAL TOOL (NUDAPT): FACILITATING ADVANCEMENTS IN URBAN METEOROLOGY AND CLIMATE MODELING WITH COMMUNITY-BASED URBAN DATABASES

    EPA Science Inventory

    We discuss the initial design and application of the National Urban Database and Access Portal Tool (NUDAPT). This new project is sponsored by the USEPA and involves collaborations and contributions from many groups from federal and state agencies, and from private and academic i...

  2. Avian mortality events in the United States caused by anticholinesterase pesticides: A retrospective summary of National Wildlife Health Center records from 1980 to 2000

    USGS Publications Warehouse

    Fleischli, Margaret A.; Franson, J.C.; Thomas, N.J.; Finley, D.L.; Riley, Walter

    2004-01-01

    We reviewed the U.S. Geological Survey National Wildlife Health Center (NWHC) mortality database from 1980 to 2000 to identify cases of poisoning caused by organophosphorus and carbamate pesticides. From the 35,022 cases from which one or more avian carcasses were submitted to the NWHC for necropsy, we identified 335 mortality events attributed to anticholinesterase poisoning, 119 of which have been included in earlier reports. Poisoning events were classified as confirmed (n = 205) when supported by findings of ≥50% inhibition of cholinesterase (ChE) activity in brain tissue and the detection of a specific pesticide in the gastrointestinal contents of one or more carcasses. Suspected poisonings (n = 130) were defined as cases where brain ChE activity was ≥50% inhibited or a specific pesticide was identified in gastrointestinal contents. The 335 avian mortality events occurred in 42 states. Washington, Virginia, and Ohio had the highest frequency of events, with 24 (7.2%), 21 (6.3%), and 20 (6.0%) events, respectively. A total of 8877 carcasses of 103 avian species in 12 orders was recovered. Because carcass counts underestimate total mortality, this represents the minimum actual mortality. Of 24 different pesticides identified, the most frequent were famphur (n = 59; 18%), carbofuran (n = 52; 15%), diazinon (n = 40; 12%), and fenthion (n = 17; 5.1%). Falconiformes were reported killed most frequently (49% of all die-offs) but Anseriformes were found dead in the greatest numbers (64% of 8877 found dead). The majority of birds reported killed by famphur were Passeriformes and Falconiformes, with the latter found dead in 90% of famphur-related poisoning events. Carbofuran and famphur were involved in mortality of the greatest variety of species (45 and 33, respectively). Most of the mortality events caused by diazinon involved waterfowl.

  3. National Databases with Information on College Students with Disabilities. NCCSD Research Brief. Volume 1, Issue 1

    ERIC Educational Resources Information Center

    Avellone, Lauren; Scott, Sally

    2017-01-01

    The purpose of this research brief was to identify and provide an overview of national databases containing information about college students with disabilities. Eleven instruments from federal and university-based sources were described. Databases reflect a variety of survey methods, respondents, definitions of disability, and research questions.…

  4. Cancer registries in Japan: National Clinical Database and site-specific cancer registries.

    PubMed

    Anazawa, Takayuki; Miyata, Hiroaki; Gotoh, Mitsukazu

    2015-02-01

    The cancer registry is an essential part of any rational program of evidence-based cancer control. The cancer control program is required to strategize in a systematic and impartial manner and efficiently utilize limited resources. In Japan, the National Clinical Database (NCD) was launched in 2010. It is a nationwide prospective registry linked to various types of board certification systems regarding surgery. The NCD is a nationally validated database using web-based data collection software; it is risk adjusted and outcome based to improve the quality of surgical care. The NCD generalizes site-specific cancer registries by taking advantage of their excellent organizing ability. Some site-specific cancer registries, including pancreatic, breast, and liver cancer registries have already been combined with the NCD. Cooperation between the NCD and site-specific cancer registries can establish a valuable platform to develop a cancer care plan in Japan. Furthermore, the prognosis information of cancer patients arranged using population-based and hospital-based cancer registries can help in efficient data accumulation on the NCD. International collaboration between Japan and the USA has recently started and is expected to provide global benchmarking and to allow a valuable comparison of cancer treatment practices between countries using nationwide cancer registries in the future. Clinical research and evidence-based policy recommendation based on accurate data from the nationwide database may positively impact the public.

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

    PubMed

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

    2017-03-15

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

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

    PubMed

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

    2014-12-01

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

  7. Current status of cardiovascular surgery in Japan 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database. 2: Congenital heart surgery.

    PubMed

    Hirata, Yasutaka; Hirahara, Norimichi; Murakami, Arata; Motomura, Noboru; Miyata, Hiroaki; Takamoto, Shinichi

    2018-01-01

    We analyzed the mortality and morbidity of congenital heart surgery in Japan using the Japan Cardiovascular Surgery Database (JCVSD). Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. The mortality rates of atrial septal defect repair and ventricular septal defect repair were less than 1%, and the mortality rates of tetralogy of Fallot repair, complete atrioventricular septal defect repair, bidirectional Glenn, and total cavopulmonary connection were less than 2%. The mortality rates of the Norwood procedure and total anomalous pulmonary venous connection repair were more than 10%. The rates of unplanned reoperation, pacemaker implantation, chylothorax, deep sternal infection, phrenic nerve injury, and neurological deficit were shown for each procedure. Using JCVSD, the national data for congenital heart surgery, including postoperative complications, were analyzed. Further improvements of the database and feedback for clinical practice are required.

  8. Impact of missing data on standardised mortality ratios for acute myocardial infarction: evidence from the Myocardial Ischaemia National Audit Project (MINAP) 2004-7.

    PubMed

    Gale, C P; Cattle, B A; Moore, J; Dawe, H; Greenwood, D C; West, R M

    2011-12-01

    Standardised mortality ratios (SMR) are often used to depict cardiovascular care. Data missingness, data quality, temporal variation and case-mix can, however, complicate the assessment of clinical performance. To study Primary Care Trust (PCT) 30-day SMRs for STEMI and NSTEMI whilst considering the impact of missing data for age, sex and IMD score. Observational study using data from the Myocardial Ischaemia National Audit Project (MINAP) database to generate PCT SMR maps and funnel plots for England, 2004-2007. 217,157 40.4% STEMI and 59.6% NSTEMI. 95% CI 30-day unadjusted mortality: STEMI 5.8% to 6.2%; NSTEMI 6.6% to 6.9%; relative risk, 95% CI 1.14, 1.10 to 1.19. Median (IQR) data missingess by PCT for composite of age, sex and IMD score was 1.4% (0.7% to 2.2%). For STEMI and NSTEMI statistically significant predictors of mortality were mean age (STEMI: P<0.001; NSTEMI: P<0.001), proportion of females (STEMI: P<0.001; NSTEMI: P<0.001) and proportion of missing ages (STEMI: P=0.02; NSTEMI: P<0.001). Proportion of missing sex also predicted 30-day mortality for NSTEMI (P=0.01). Maps of SMRs demonstrated substantial mortality variation, but no evidence of North / South divide. There were significant correlations between STEMI and NSTEMI observed (R² 0.72) and standardised mortality (R² 0.49) rates. PCT data aggregation gave an acceptable model fit in terms of deviance explained. For STEMI there were 33 (21.7%) regions below the 99.8% lower limit of the associated performance funnel plot, and 28 (18.4%) for NSTEMI; the inclusion of missing data did not affect the distribution of SMRs. The proportion of missing data was associated with 30-day mortality for STEMI and NSTEMI, however it did not influence the distribution of PCTs within the funnel plots. There was considerable variation in mortality not attributable to key patient-specific factors, supporting the notion of regional-dependent variation in STEMI and NSTEMI care.

  9. Differences in the Reporting of Racial and Socioeconomic Disparities among Three Large National Databases for Breast Reconstruction.

    PubMed

    Kamali, Parisa; Zettervall, Sara L; Wu, Winona; Ibrahim, Ahmed M S; Medin, Caroline; Rakhorst, Hinne A; Schermerhorn, Marc L; Lee, Bernard T; Lin, Samuel J

    2017-04-01

    Research derived from large-volume databases plays an increasing role in the development of clinical guidelines and health policy. In breast cancer research, the Surveillance, Epidemiology and End Results, National Surgical Quality Improvement Program, and Nationwide Inpatient Sample databases are widely used. This study aims to compare the trends in immediate breast reconstruction and identify the drawbacks and benefits of each database. Patients with invasive breast cancer and ductal carcinoma in situ were identified from each database (2005-2012). Trends of immediate breast reconstruction over time were evaluated. Patient demographics and comorbidities were compared. Subgroup analysis of immediate breast reconstruction use per race was conducted. Within the three databases, 1.2 million patients were studied. Immediate breast reconstruction in invasive breast cancer patients increased significantly over time in all databases. A similar significant upward trend was seen in ductal carcinoma in situ patients. Significant differences in immediate breast reconstruction rates were seen among races; and the disparity differed among the three databases. Rates of comorbidities were similar among the three databases. There has been a significant increase in immediate breast reconstruction; however, the extent of the reporting of overall immediate breast reconstruction rates and of racial disparities differs significantly among databases. The Nationwide Inpatient Sample and the National Surgical Quality Improvement Program report similar findings, with the Surveillance, Epidemiology and End Results database reporting results significantly lower in several categories. These findings suggest that use of the Surveillance, Epidemiology and End Results database may not be universally generalizable to the entire U.S.

  10. Psychological and cognitive determinants of mortality: Evidence from a nationally representative sample followed over thirty-five years.

    PubMed

    Karraker, Amelia; Schoeni, Robert F; Cornman, Jennifer C

    2015-11-01

    Growing evidence suggests that psychological factors, such as conscientiousness and anger, as well as cognitive ability are related to mortality. Less is known about 1) the relative importance of each of these factors in predicting mortality, 2) through what social, economic, and behavioral mechanisms these factors influence mortality, and 3) how these processes unfold over long periods of time in nationally-representative samples. We use 35 years (1972-2007) of data from men (ages 20-40) in the Panel Study of Income Dynamics (PSID), a nationally representative sample in the United States, and discrete time event history analysis (n = 27,373 person-years) to examine the importance of measures of follow-through (a dimension of conscientiousness), anger, and cognitive ability in predicting mortality. We also assess the extent to which income, marriage, and smoking explain the relationship between psychological and cognitive factors with mortality. We find that while follow-through, anger, and cognitive ability are all associated with subsequent mortality when modeled separately, when they are modeled together and baseline demographic characteristics are controlled, only anger remains associated with mortality: being in the top quartile for anger is associated with a 1.57 fold increase in the risk of dying at follow-up compared with those in the bottom quartile. This relationship is robust to the inclusion of income, marriage, and smoking as mediators. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

    Loprinzi, Paul D

    2016-05-01

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

  12. Identifying types and causes of errors in mortality data in a clinical registry using multiple information systems.

    PubMed

    Koetsier, Antonie; Peek, Niels; de Keizer, Nicolette

    2012-01-01

    Errors may occur in the registration of in-hospital mortality, making it less reliable as a quality indicator. We assessed the types of errors made in in-hospital mortality registration in the clinical quality registry National Intensive Care Evaluation (NICE) by comparing its mortality data to data from a national insurance claims database. Subsequently, we performed site visits at eleven Intensive Care Units (ICUs) to investigate the number, types and causes of errors made in in-hospital mortality registration. A total of 255 errors were found in the NICE registry. Two different types of software malfunction accounted for almost 80% of the errors. The remaining 20% were five types of manual transcription errors and human failures to record outcome data. Clinical registries should be aware of the possible existence of errors in recorded outcome data and understand their causes. In order to prevent errors, we recommend to thoroughly verify the software that is used in the registration process.

  13. The National Deep-Sea Coral and Sponge Database: A Comprehensive Resource for United States Deep-Sea Coral and Sponge Records

    NASA Astrophysics Data System (ADS)

    Dornback, M.; Hourigan, T.; Etnoyer, P.; McGuinn, R.; Cross, S. L.

    2014-12-01

    Research on deep-sea corals has expanded rapidly over the last two decades, as scientists began to realize their value as long-lived structural components of high biodiversity habitats and archives of environmental information. The NOAA Deep Sea Coral Research and Technology Program's National Database for Deep-Sea Corals and Sponges is a comprehensive resource for georeferenced data on these organisms in U.S. waters. The National Database currently includes more than 220,000 deep-sea coral records representing approximately 880 unique species. Database records from museum archives, commercial and scientific bycatch, and from journal publications provide baseline information with relatively coarse spatial resolution dating back as far as 1842. These data are complemented by modern, in-situ submersible observations with high spatial resolution, from surveys conducted by NOAA and NOAA partners. Management of high volumes of modern high-resolution observational data can be challenging. NOAA is working with our data partners to incorporate this occurrence data into the National Database, along with images and associated information related to geoposition, time, biology, taxonomy, environment, provenance, and accuracy. NOAA is also working to link associated datasets collected by our program's research, to properly archive them to the NOAA National Data Centers, to build a robust metadata record, and to establish a standard protocol to simplify the process. Access to the National Database is provided through an online mapping portal. The map displays point based records from the database. Records can be refined by taxon, region, time, and depth. The queries and extent used to view the map can also be used to download subsets of the database. The database, map, and website is already in use by NOAA, regional fishery management councils, and regional ocean planning bodies, but we envision it as a model that can expand to accommodate data on a global scale.

  14. Trends and perioperative outcomes for laparoscopic and robotic nephrectomy using the National Surgical Quality Improvement Program (NSQIP) database.

    PubMed

    Liu, Jen-Jane; Leppert, John T; Maxwell, Bryan G; Panousis, Periklis; Chung, Benjamin I

    2014-05-01

    We sought to examine the trends in perioperative outcomes of kidney cancer surgery stratified by type (radical nephrectomy [RN] vs. partial nephrectomy [PN]) and approach (open vs. minimally invasive). We queried the National Surgical Quality Improvement Program database to identify kidney cancer operations performed from 2005 to 2011. We examined 30-day perioperative outcomes including operative time, transfusion rate, length of stay, major morbidity (cardiovascular, pulmonary, renal, and infectious), and mortality. A total of 2,902 PN and 5,459 RN cases were identified. The use of PN increased over time, accounting for 39% of all nephrectomies in 2011. Minimally invasive approaches also increased over time for both RN and PN. Open surgery was associated with increased length of stay, receipt of transfusion, major complications, and perioperative mortality. Resident involvement and open approach were independent predictors of major complications for both PN and RN. Additionally, the presence of a medical comorbidity was also a risk factor for complications after RN. The overall complication rates decreased for all approaches over the study period. Minimally invasive approaches to kidney cancer renal surgery have increased with favorable outcomes. The safety of open and minimally invasive PN improved significantly over the study period. Although pathologic features cannot be determined from this data set, these data show that complications from renal surgical procedures are decreasing in an era of increasing use. © 2013 Published by Elsevier Inc.

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

    PubMed

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

    2015-02-01

    Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57,471 during 492 nonmeeting days; heart failure, 19,282 during meeting days and 11,4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low- and high-risk patients. Differences in treatment utilization were assessed. Hospitalization during cardiology meeting dates. Thirty-day mortality, procedure rates, charges, length of stay. Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%-21.2%] vs 24.8% [95% CI, 22.9%-26.6%]; P < .001; cardiac arrest, 59.1% [95% CI, 51.4%-66.8%] vs 69.4% [95% CI, 66.2%-72.6%]; P = .01). Adjusted mortality for high-risk AMI in teaching hospitals was similar between meeting and nonmeeting dates (39.2% [95% CI, 31.8%-46.6%] vs 38.5% [95% CI, 35.0%-42.0%]; P = .86), although adjusted percutaneous coronary intervention (PCI) rates were lower during meetings (20.8% vs 28.2%; P = .02). No

  16. Global trends in testicular cancer incidence and mortality.

    PubMed

    Rosen, Alexandre; Jayram, Gautam; Drazer, Michael; Eggener, Scott E

    2011-08-01

    Epidemiologic studies on testicular cancer have focused primarily on European countries. Global incidence and mortality have been less thoroughly evaluated. Our goal was to gain a better understanding of the most recent global age-standardized incidence and mortality rates for testicular cancer and to use these values to estimate a region's health care quality. Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for testicular cancer were obtained for men of all ages in 172 countries by using the GLOBOCAN 2008 database, reflecting the annual rate of cancer incidence and mortality per 100,000 men. These data were evaluated on a regional level to compare incidence and mortality rates. Global plots of these values were constructed to better visualize geographic distributions. Finally, the ratio of ASIR to ASMR was calculated as a method to assess each region's proficiency in diagnosing and effectively treating testicular cancer. ASIR and ASMR were analyzed by region, and each region's ratio of ASIR to ASMR was calculated. Testicular cancer ASIR is highest in Western Europe (7.8%), Northern Europe (6.7%), and Australia (6.5%). Asia and Africa had the lowest incidence (<1.0%). ASMR was highest in Central America (0.7%), western Asia (0.6%), and Central and Eastern Europe (0.6%). Mortality was lowest in North America, Northern Europe, and Australia (0.1-0.2%). The ASIR-ASMR ratio was highest in Australia (65.0%) and lowest in western Africa (1.0%). National reporting systems varied by country, and data quality may have fluctuated between regions. Testicular cancer incidence remains highest in developed nations with primarily Caucasian populations. Variable ASIR-ASMR ratios suggest markedly different geographic-specific reporting mechanisms, access to care, and treatment capabilities. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  17. Comparing surgical infections in National Surgical Quality Improvement Project and an Institutional Database.

    PubMed

    Selby, Luke V; Sjoberg, Daniel D; Cassella, Danielle; Sovel, Mindy; Weiser, Martin R; Sepkowitz, Kent; Jones, David R; Strong, Vivian E

    2015-06-15

    Surgical quality improvement requires accurate tracking and benchmarking of postoperative adverse events. We track surgical site infections (SSIs) with two systems; our in-house surgical secondary events (SSE) database and the National Surgical Quality Improvement Project (NSQIP). The SSE database, a modification of the Clavien-Dindo classification, categorizes SSIs by their anatomic site, whereas NSQIP categorizes by their level. Our aim was to directly compare these different definitions. NSQIP and the SSE database entries for all surgeries performed in 2011 and 2012 were compared. To match NSQIP definitions, and while blinded to NSQIP results, entries in the SSE database were categorized as either incisional (superficial or deep) or organ space infections. These categorizations were compared with NSQIP records; agreement was assessed with Cohen kappa. The 5028 patients in our cohort had a 6.5% SSI in the SSE database and a 4% rate in NSQIP, with an overall agreement of 95% (kappa = 0.48, P < 0.0001). The rates of categorized infections were similarly well matched; incisional rates of 4.1% and 2.7% for the SSE database and NSQIP and organ space rates of 2.6% and 1.5%. Overall agreements were 96% (kappa = 0.36, P < 0.0001) and 98% (kappa = 0.55, P < 0.0001), respectively. Over 80% of cases recorded by the SSE database but not NSQIP did not meet NSQIP criteria. The SSE database is an accurate, real-time record of postoperative SSIs. Institutional databases that capture all surgical cases can be used in conjunction with NSQIP with excellent concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Multinational Corporations, Democracy and Child Mortality: A Quantitative, Cross-National Analysis of Developing Countries

    ERIC Educational Resources Information Center

    Shandra, John M.; Nobles, Jenna E.; London, Bruce; Williamson, John B.

    2005-01-01

    This study presents quantitative, sociological models designed to account for cross-national variation in child mortality. We consider variables linked to five different theoretical perspectives that include the economic modernization, social modernization, political modernization, ecological-evolutionary, and dependency perspectives. The study is…

  19. High mortality in cirrhotic patients following hemorrhagic stroke.

    PubMed

    Hung, Tsung-Hsing; Hsieh, Yu-Hsi; Tseng, Kuo-Chih; Tseng, Chih-Wei; Lee, Hsing-Feng; Tsai, Chih-Chun; Tsai, Chen-Chi

    2015-06-01

    The impact of hemorrhagic stroke (HS) on the mortality of cirrhotic patients is unknown. To evaluate the morality risk of HS in cirrhotic patients, we used the Taiwan National Health Insurance Database to evaluate cirrhotic patients with HS who were discharged between 1 January and 31 December 2007. In total, there were 321 cirrhotic patients with HS. We randomly selected 3210 cirrhotic patients without HS as a comparison group. The 30 and 90 day mortality rates were 29.6% and 43.0% in the HS group, and 9.1% and 17.7% in the comparison group, respectively (p<0.001). After Cox proportional hazard regression model adjustment of patients' sex, age, and other comorbid disorders, the hazard ratio (HR) for 90 day mortality in the HS group was 3.89 (95% confidence interval [CI] 3.20-4.71, p<0.001), compared to the comparison group. In the subgroup analysis, the HR for 90 day mortality in the subarachnoid hemorrhage and other HS groups were 7.93 (95% CI 5.23-12.0, p<0.001) and 3.51 (95% CI 2.85-4.32, p<0.001), respectively, compared to the comparison group. In conclusion, HS is associated with a very high 90 day mortality risk in cirrhotic patients, in whom subarachnoid hemorrhage can also increase the risk of mortality eight-fold. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Database for chemical contents of streams on the White Mountain National Forest.

    Treesearch

    James W. Hornbeck; Michelle M. Alexander; Christopher Eagar; Joan Y. Carlson; Robert B. Smith

    2001-01-01

    Producing and protecting high-quality streamwater requires background or baseline data from which one can evaluate the impacts of natural and human disturbances. A database was created for chemical analyses of streamwater samples collected during the past several decades from 446 locations on the White Mountain National Forest (304,000 ha in New Hampshire and Maine)....

  1. Home versus hospital mortality from cancer in Mexico (1999-2009).

    PubMed

    Castillo-Guzmán, Sandra; Palacios-Ríos, Dionicio; Nava-Obregón, Teresa Adriana; Torres-Pérez, Juan Francisco; González-Santiago, Omar

    2013-05-01

    To analyze the place of death from cancer in México from 1999 to 2009 and find the associated factors. We collected data on mortality by cancer from the national database including age, gender, area of residence, level of education, place of death, and type of cancer. The proportion of deaths at home and hospital was 55.67% and 39%, respectively. Factors associated with home deaths were old age, female gender, rural area of residence, and lack of formal education. There was a short but significant decrease in home deaths for cervical cancer and leukemia. In México, mortality in home is greater than in hospital for patients with cancer. Our results have important implications for palliative care professionals and health services of México.

  2. A Service evaluation of a hospital child death review process to elucidate understanding of contributory factors to child mortality and inform practice in the English National Health Service.

    PubMed

    Magnus, Daniel S; Schindler, Margrid B; Marlow, Robin D; Fraser, James I

    2018-03-16

    To describe a novel approach to hospital mortality meetings to elucidate understanding of contributory factors to child death and inform practice in the National Health Service. All child deaths were separately reviewed at a meeting attended by professionals across the healthcare pathway, and an assessment was made of contributory factors to death across domains intrinsic to the child, family and environment, parenting capacity and service delivery. Data were analysed from a centrally held database of records. All child deaths in a tertiary children's hospital between 1 April 2010 and 1 April 2013. Descriptive data summarising contributory factors to child deaths. 95 deaths were reviewed. In 85% cases, factors intrinsic to the child provided complete explanation for death. In 11% cases, factors in the family and environment and, in 5% cases, factors in parenting capacity, contributed to patient vulnerability. In 33% cases, factors in service provision contributed to patient vulnerability and in two patients provided complete explanation for death. 26% deaths were classified as potentially preventable and in those cases factors in service provision were more commonly identified than factors across other domains (OR: 4.89; 95% CI 1.26 to 18.9). Hospital child death review meetings attended by professionals involved in patient management across the healthcare pathway inform understanding of events leading to a child's death. Using a bioecological approach to scrutinise contributory factors the multidisciplinary team concluded most deaths occurred as a consequence of underlying illness. Although factors relating to service provision were commonly identified, they rarely provided a complete explanation for death. Efforts to reduce child mortality should be driven by an understanding of modifiable risk factors. Systematic data collection arising from a standardised approach to hospital reviews should be the basis for national mortality review processes and database

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

    PubMed

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

    2017-04-01

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

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

    PubMed

    Chang, Alex R; Grams, Morgan E

    2014-10-01

    Serum phosphorus levels have been associated with mortality in some but not all studies. Because dietary intake prior to measurement can affect serum phosphorus levels, we hypothesized that the association between serum phosphorus level and mortality is strongest in those who have fasted longer. Prospective cohort study. Nationally representative sample of 12,984 participants 20 years or older in the Third National Health and Nutrition Examination Survey (1988-1994). Serum phosphorus level, fasting duration (dichotomized as ≥ 12 or < 12 hours). All-cause and cardiovascular mortality determined by death certificate data from the National Death Index. Serum phosphorus measured in a central laboratory and fasting duration recorded as time since food or drink other than water was consumed. Individuals fasting 12 or more hours had lower serum phosphorus levels than those fasting less than 12 hours (3.34 vs 3.55 mg/dL; P < 0.001) and higher correlation with repeat measurement (0.66 vs 0.53; P = 0.002). In multivariable-adjusted Cox regression models, the highest quartile of serum phosphorus was associated with increased mortality in participants fasting 12 or more hours (adjusted HR, 1.74; 95% CI, 1.38-2.20; reference, lowest quartile) but not in participants fasting less than 12 hours (adjusted HR, 1.08; 95% CI, 0.89-1.32; P for interaction = 0.002). Relationships were consistent using 8 hours as the fasting cutoff point or cardiovascular mortality as the outcome. Observational study, lack of fibroblast growth factor 23 or intact parathyroid hormone measurements. Fasting but not nonfasting serum phosphorus levels were associated with increased mortality. Risk prognostication based on serum phosphorus may be improved using fasting levels. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. Individual education, area income, and mortality and recurrence of myocardial infarction in a Medicare cohort: the National Longitudinal Mortality Study.

    PubMed

    Coady, Sean A; Johnson, Norman J; Hakes, Jahn K; Sorlie, Paul D

    2014-07-09

    The Medicare program provides universal access to hospital care for the elderly; however, mortality disparities may still persist in this population. The association of individual education and area income with survival and recurrence post Myocardial Infarction (MI) was assessed in a national sample. Individual level education from the National Longitudinal Mortality Study was linked to Medicare and National Death Index records over the period of 1991-2001 to test the association of individual education and zip code tabulation area median income with survival and recurrence post-MI. Survival was partitioned into 3 periods: in-hospital, discharge to 1 year, and 1 year to 5 years and recurrence was partitioned into two periods: 28 day to 1 year, and 1 year to 5 years. First MIs were found in 8,043 women and 7,929 men. In women and men 66-79 years of age, less than a high school education compared with a college degree or more was associated with 1-5 year mortality in both women (HRR 1.61, 95% confidence interval 1.03-2.50) and men (HRR 1.37, 1.06-1.76). Education was also associated with 1-5 year recurrence in men (HRR 1.68, 1.18-2.41, < High School compared with college degree or more), but not women. Across the spectrum of survival and recurrence periods median zip code level income was inconsistently associated with outcomes. Associations were limited to discharge-1 year survival (RR lowest versus highest quintile 1.31, 95% confidence interval 1.03-1.67) and 28 day-1 year recurrence (RR lowest versus highest quintile 1.72, 95% confidence interval 1.14-2.57) in older men. Despite the Medicare entitlement program, disparities related to individual socioeconomic status remain. Additional research is needed to elucidate the barriers and mechanisms to eliminating health disparities among the elderly.

  6. Mortality Rates in the General Irish Population Compared to Those with an Intellectual Disability from 2003 to 2012

    ERIC Educational Resources Information Center

    McCarron, Mary; Carroll, Rachael; Kelly, Caraiosa; McCallion, Philip

    2015-01-01

    Background:Historically, there has been higher and earlier mortality among people with intellectual disability as compared to the general population, but there have also been methodological problems and differences in the available studies. Method: Data were drawn from the 2012 National Intellectual Disability Database and the Census in Ireland. A…

  7. Dependency, democracy, and infant mortality: a quantitative, cross-national analysis of less developed countries.

    PubMed

    Shandra, John M; Nobles, Jenna; London, Bruce; Williamson, John B

    2004-07-01

    This study presents quantitative, sociological models designed to account for cross-national variation in infant mortality rates. We consider variables linked to four different theoretical perspectives: the economic modernization, social modernization, political modernization, and dependency perspectives. The study is based on a panel regression analysis of a sample of 59 developing countries. Our preliminary analysis based on additive models replicates prior studies to the extent that we find that indicators linked to economic and social modernization have beneficial effects on infant mortality. We also find support for hypotheses derived from the dependency perspective suggesting that multinational corporate penetration fosters higher levels of infant mortality. Subsequent analysis incorporating interaction effects suggest that the level of political democracy conditions the effects of dependency relationships based upon exports, investments from multinational corporations, and international lending institutions. Transnational economic linkages associated with exports, multinational corporations, and international lending institutions adversely affect infant mortality more strongly at lower levels of democracy than at higher levels of democracy: intranational, political factors interact with the international, economic forces to affect infant mortality. We conclude with some brief policy recommendations and suggestions for the direction of future research.

  8. Admission factors associated with hospital mortality in patients with haematological malignancy admitted to UK adult, general critical care units: a secondary analysis of the ICNARC Case Mix Programme Database

    PubMed Central

    2009-01-01

    Introduction Patients with haematological malignancy admitted to intensive care have a high mortality. Adverse prognostic factors include the number of organ failures, invasive mechanical ventilation and previous bone marrow transplantation. Severity-of-illness scores may underestimate the mortality of critically ill patients with haematological malignancy. This study investigates the relationship between admission characteristics and outcome in patients with haematological malignancies admitted to intensive care units (ICUs) in England, Wales and Northern Ireland, and assesses the performance of three severity-of-illness scores in this population. Methods A secondary analysis of the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme Database was conducted on admissions to 178 adult, general ICUs in England, Wales and Northern Ireland between 1995 and 2007. Multivariate logistic regression analysis was used to identify factors associated with hospital mortality. The Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II and ICNARC score were evaluated for discrimination (the ability to distinguish survivors from nonsurvivors); and the APACHE II, SAPS II and ICNARC mortality probabilities were evaluated for calibration (the accuracy of the estimated probability of survival). Results There were 7,689 eligible admissions. ICU mortality was 43.1% (3,312 deaths) and acute hospital mortality was 59.2% (4,239 deaths). ICU and hospital mortality increased with the number of organ failures on admission. Admission factors associated with an increased risk of death were bone marrow transplant, Hodgkin's lymphoma, severe sepsis, age, length of hospital stay prior to intensive care admission, tachycardia, low systolic blood pressure, tachypnoea, low Glasgow Coma Score, sedation, PaO2:FiO2, acidaemia, alkalaemia, oliguria, hyponatraemia, hypernatraemia, low haematocrit, and uraemia. The ICNARC

  9. Admission factors associated with hospital mortality in patients with haematological malignancy admitted to UK adult, general critical care units: a secondary analysis of the ICNARC Case Mix Programme Database.

    PubMed

    Hampshire, Peter A; Welch, Catherine A; McCrossan, Lawrence A; Francis, Katharine; Harrison, David A

    2009-01-01

    Patients with haematological malignancy admitted to intensive care have a high mortality. Adverse prognostic factors include the number of organ failures, invasive mechanical ventilation and previous bone marrow transplantation. Severity-of-illness scores may underestimate the mortality of critically ill patients with haematological malignancy. This study investigates the relationship between admission characteristics and outcome in patients with haematological malignancies admitted to intensive care units (ICUs) in England, Wales and Northern Ireland, and assesses the performance of three severity-of-illness scores in this population. A secondary analysis of the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme Database was conducted on admissions to 178 adult, general ICUs in England, Wales and Northern Ireland between 1995 and 2007. Multivariate logistic regression analysis was used to identify factors associated with hospital mortality. The Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II and ICNARC score were evaluated for discrimination (the ability to distinguish survivors from nonsurvivors); and the APACHE II, SAPS II and ICNARC mortality probabilities were evaluated for calibration (the accuracy of the estimated probability of survival). There were 7,689 eligible admissions. ICU mortality was 43.1% (3,312 deaths) and acute hospital mortality was 59.2% (4,239 deaths). ICU and hospital mortality increased with the number of organ failures on admission. Admission factors associated with an increased risk of death were bone marrow transplant, Hodgkin's lymphoma, severe sepsis, age, length of hospital stay prior to intensive care admission, tachycardia, low systolic blood pressure, tachypnoea, low Glasgow Coma Score, sedation, PaO2:FiO2, acidaemia, alkalaemia, oliguria, hyponatraemia, hypernatraemia, low haematocrit, and uraemia. The ICNARC model had the best discrimination

  10. A Data Preparation Methodology in Data Mining Applied to Mortality Population Databases.

    PubMed

    Pérez, Joaquín; Iturbide, Emmanuel; Olivares, Víctor; Hidalgo, Miguel; Martínez, Alicia; Almanza, Nelva

    2015-11-01

    It is known that the data preparation phase is the most time consuming in the data mining process, using up to 50% or up to 70% of the total project time. Currently, data mining methodologies are of general purpose and one of their limitations is that they do not provide a guide about what particular task to develop in a specific domain. This paper shows a new data preparation methodology oriented to the epidemiological domain in which we have identified two sets of tasks: General Data Preparation and Specific Data Preparation. For both sets, the Cross-Industry Standard Process for Data Mining (CRISP-DM) is adopted as a guideline. The main contribution of our methodology is fourteen specialized tasks concerning such domain. To validate the proposed methodology, we developed a data mining system and the entire process was applied to real mortality databases. The results were encouraging because it was observed that the use of the methodology reduced some of the time consuming tasks and the data mining system showed findings of unknown and potentially useful patterns for the public health services in Mexico.

  11. Mortality on match days of the German national soccer team: a time series analysis from 1995 to 2009.

    PubMed

    Medenwald, D; Kuss, O

    2014-09-01

    There is inconsistent evidence on population mortality, especially cardiovascular disease mortality, on match days of national soccer teams during particular international tournaments. This study examines the number of deaths in Germany on match days of the national soccer team during a long-term period including several tournaments. We analysed all registered daily deaths in Germany from 1995 to 2009 (11 225 966 cases) using time series analysis methods. Following the Box/Jenkins approach, we applied a seasonal autoregressive integrated moving average model. To assess the effect of match days, we performed an intervention analysis by including a transfer function model representing match days of the national team in the statistical analyses. We conducted separate analyses for all matches and for matches during international tournaments (European and World Championships) only. Time series and results were stratified in terms of sex, age (<50 years, 50-70 years, >70 years) and cause of death (cardiovascular deaths, injuries, others). We performed a further independent analysis focusing only on the effect of match results (victory, loss, draw) and kind of tournament (international championships, qualifications, friendly matches). Most of the results did not indicate a distinct effect of matches of the national team on general mortality. Moreover, all null value deviations were small when compared with the average number of daily deaths (n=2270). There is no relevant increase or decrease in mortality on match days of the German national soccer team. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Prediction of cancer incidence and mortality in Korea, 2014.

    PubMed

    Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Oh, Chang-Mo; Lee, Duk Hyoung; Lee, Jin Soo

    2014-04-01

    We studied and reported on cancer incidence and mortality rates as projected for the year 2014 in order to estimate Korea's current cancer burden. Cancer incidence data from 1999 to 2011 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2012 were acquired from Statistics Korea. Cancer incidence in 2014 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was employed, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly. A total of 265,813 new cancer cases and 74,981 cancer deaths are expected to occur in Korea in 2014. Further, the crude incidence rate per 100,000 of all sites combined will likely reach 524.7 and the age-standardized incidence rate, 338.5. Meanwhile, the crude mortality rate of all sites combined and age-standardized rate are projected to be 148.0 and 84.6, respectively. Given the rapid rise in prostate cancer cases, it is anticipated to be the fourth most frequently occurring cancer site in men for the first time. Cancer has become the most prominent public health concern in Korea, and as the population ages, the nation's cancer burden will continue to increase.

  13. Neuromuscular scoliosis complication rates from 2004 to 2015: a report from the Scoliosis Research Society Morbidity and Mortality database.

    PubMed

    Cognetti, Daniel; Keeny, Heather M; Samdani, Amer F; Pahys, Joshua M; Hanson, Darrell S; Blanke, Kathy; Hwang, Steven W

    2017-10-01

    OBJECTIVE Postoperative complications are one of the most significant concerns in surgeries of the spine, especially in higher-risk cases such as neuromuscular scoliosis. Neuromuscular scoliosis is a classification of multiple diseases affecting the neuromotor system or musculature of patients leading to severe degrees of spinal deformation, disability, and comorbidity, all likely contributing to higher rates of postoperative complications. The objective of this study was to evaluate deformity correction of patients with neuromuscular scoliosis over a 12-year period (2004-2015) by looking at changes in postsurgical complications and management. METHODS The authors queried the Scoliosis Research Society (SRS) Morbidity and Mortality (M&M) database for neuromuscular scoliosis cases from 2004 to 2015. The SRS M&M database is an international database with thousands of self-reported cases by fellowship-trained surgeons. The database has previously been validated, but reorganization in 2008 created less-robust data sets from 2008 to 2011. Consequently, the majority of analysis in this report was performed using cohorts that bookend the 12-year period (2004-2007 and 2012-2015). Of the 312 individual fields recorded per patient, demographic analysis was completed for age, sex, diagnosis, and preoperative curvature. Analysis of complications included infection, bleeding, mortality, respiratory, neurological deficit, and management practices. RESULTS From 2004 to 2015, a total of 29,019 cases of neuromuscular scoliosis were reported with 1385 complications, equating to a 6.3% complication rate when excluding the less-robust data from 2008 to 2011. This study shows a 3.5-fold decrease in overall complication rates from 2004 to 2015. A closer look at complications shows a significant decrease in wound infections (superficial and deep), respiratory complications, and implant-associated complications. The overall complication rate decreased by approximately 10% from 2004

  14. Interacting with the National Database for Autism Research (NDAR) via the LONI Pipeline workflow environment.

    PubMed

    Torgerson, Carinna M; Quinn, Catherine; Dinov, Ivo; Liu, Zhizhong; Petrosyan, Petros; Pelphrey, Kevin; Haselgrove, Christian; Kennedy, David N; Toga, Arthur W; Van Horn, John Darrell

    2015-03-01

    Under the umbrella of the National Database for Clinical Trials (NDCT) related to mental illnesses, the National Database for Autism Research (NDAR) seeks to gather, curate, and make openly available neuroimaging data from NIH-funded studies of autism spectrum disorder (ASD). NDAR has recently made its database accessible through the LONI Pipeline workflow design and execution environment to enable large-scale analyses of cortical architecture and function via local, cluster, or "cloud"-based computing resources. This presents a unique opportunity to overcome many of the customary limitations to fostering biomedical neuroimaging as a science of discovery. Providing open access to primary neuroimaging data, workflow methods, and high-performance computing will increase uniformity in data collection protocols, encourage greater reliability of published data, results replication, and broaden the range of researchers now able to perform larger studies than ever before. To illustrate the use of NDAR and LONI Pipeline for performing several commonly performed neuroimaging processing steps and analyses, this paper presents example workflows useful for ASD neuroimaging researchers seeking to begin using this valuable combination of online data and computational resources. We discuss the utility of such database and workflow processing interactivity as a motivation for the sharing of additional primary data in ASD research and elsewhere.

  15. Conversion of National Health Insurance Service-National Sample Cohort (NHIS-NSC) Database into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM).

    PubMed

    You, Seng Chan; Lee, Seongwon; Cho, Soo-Yeon; Park, Hojun; Jung, Sungjae; Cho, Jaehyeong; Yoon, Dukyong; Park, Rae Woong

    2017-01-01

    It is increasingly necessary to generate medical evidence applicable to Asian people compared to those in Western countries. Observational Health Data Sciences a Informatics (OHDSI) is an international collaborative which aims to facilitate generating high-quality evidence via creating and applying open-source data analytic solutions to a large network of health databases across countries. We aimed to incorporate Korean nationwide cohort data into the OHDSI network by converting the national sample cohort into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM). The data of 1.13 million subjects was converted to OMOP-CDM, resulting in average 99.1% conversion rate. The ACHILLES, open-source OMOP-CDM-based data profiling tool, was conducted on the converted database to visualize data-driven characterization and access the quality of data. The OMOP-CDM version of National Health Insurance Service-National Sample Cohort (NHIS-NSC) can be a valuable tool for multiple aspects of medical research by incorporation into the OHDSI research network.

  16. A guidebook for using automatic passenger counter data for National Transit Database (NTD) reporting

    DOT National Transportation Integrated Search

    2010-12-01

    This document provides guidance for transit agencies to use data from their automatic passenger counters (APCs) for reporting to the National Transit Database (NTD). It first reviews both the traditional data requirements on the data items to be repo...

  17. National Nutrient Database for Standard Reference - Find Nutrient Value of Common Foods by Nutrient

    MedlinePlus

    ... grams Household * required field ​ USDA Food Composition Databases Software developed by the National Agricultural Library v.3.9.4.1 2018-06-11 NAL Home | USDA.gov | Agricultural Research Service | Plain Language | FOIA | Accessibility Statement | Information Quality | Privacy ...

  18. Contribution of different causes of death to socioeconomic mortality inequality in Korean children aged 1-9: findings from a national mortality follow-up study.

    PubMed

    Jung-Choi, K; Khang, Y H

    2011-02-01

    To determine the contribution of different causes of death to absolute socioeconomic inequalities in mortality for the whole population of children of South Korea aged 1-4 years and 5-9 years. A cohort study based on the national birth and death registers of Korea was performed for 3,724,347 children born in 1995-2000 and 657,209 children born in 1995 to analyse mortality among children aged 1-4 and 5-9 years old, respectively. Adjusted mortality, risk difference (RD), slope index of inequality (SII), RR and relative index of inequality were calculated. The contributions of different causes of death to absolute mortality inequalities were calculated as percentages based on RD and SII. Injuries other than from transport accidents contributed the most to total SIIs for male deaths at ages 1-4 (30.0% for father's education). The second largest contribution was from transport accident injuries (19.6% for father's education). For male deaths at ages 5-9, transport accident injuries and other injuries also accounted for most of the educational and occupational differentials in absolute mortality (63.5-90.5%). Patterns in cause-specific contribution to total inequalities in mortality among girls were generally similar to those among boys. The major contributing causes to absolute socioeconomic inequality in all-cause mortality for children aged 1-9 were external. To reduce the absolute magnitude of socioeconomic inequalities in childhood mortality, policy efforts should be directed towards injury prevention and treatment in South Korea.

  19. Flavonoid intake and all-cause mortality.

    PubMed

    Ivey, Kerry L; Hodgson, Jonathan M; Croft, Kevin D; Lewis, Joshua R; Prince, Richard L

    2015-05-01

    Flavonoids are bioactive compounds found in foods such as tea, chocolate, red wine, fruit, and vegetables. Higher intakes of specific flavonoids and flavonoid-rich foods have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoids in preventing all-cause mortality remains uncertain. The objective was to explore the association between flavonoid intake and risk of 5-y mortality from all causes by using 2 comprehensive food composition databases to assess flavonoid intake. The study population included 1063 randomly selected women aged >75 y. All-cause, cancer, and cardiovascular mortalities were assessed over 5 y of follow-up through the Western Australia Data Linkage System. Two estimates of flavonoid intake (total flavonoidUSDA and total flavonoidPE) were determined by using food composition data from the USDA and the Phenol-Explorer (PE) databases, respectively. During the 5-y follow-up period, 129 (12%) deaths were documented. Participants with high total flavonoid intake were at lower risk [multivariate-adjusted HR (95% CI)] of 5-y all-cause mortality than those with low total flavonoid consumption [total flavonoidUSDA: 0.37 (0.22, 0.58); total flavonoidPE: 0.36 (0.22, 0.60)]. Similar beneficial relations were observed for both cardiovascular disease mortality [total flavonoidUSDA: 0.34 (0.17, 0.69); flavonoidPE: 0.32 (0.16, 0.61)] and cancer mortality [total flavonoidUSDA: 0.25 (0.10, 0.62); flavonoidPE: 0.26 (0.11, 0.62)]. Using the most comprehensive flavonoid databases, we provide evidence that high consumption of flavonoids is associated with reduced risk of mortality in older women. The benefits of flavonoids may extend to the etiology of cancer and cardiovascular disease. © 2015 American Society for Nutrition.

  20. Can information on functional and cognitive status improve short-term mortality risk prediction among community-dwelling older people? A cohort study using a UK primary care database

    PubMed Central

    Sultana, Janet; Fontana, Andrea; Giorgianni, Francesco; Basile, Giorgio; Patorno, Elisabetta; Pilotto, Alberto; Molokhia, Mariam; Stewart, Robert; Sturkenboom, Miriam; Trifirò, Gianluca

    2018-01-01

    Background Functional and cognitive domains have rarely been evaluated for their prognostic value in general practice databases. The aim of this study was to identify functional and cognitive domains in The Health Improvement Network (THIN) and to evaluate their additional value for the prediction of 1-month and 1-year mortality in elderly people. Materials and methods A cohort study was conducted using a UK nationwide general practitioner database. A total of 1,193,268 patients aged 65 years or older, of whom 15,300 had dementia, were identified from 2000 to 2012. Information on mobility, dressing and accommodation was recorded frequently enough to be analyzed further in THIN. Cognition data could not be used due to very poor recording of data in THIN. One-year and 1-month mortality was predicted using logistic models containing variables such as age, sex, disease score and functionality status. Results A significant but moderate improvement in 1-year and 1-month mortality prediction in elderly people was observed by adding accommodation to the variables age, sex and disease score, as the c-statistic (95% confidence interval [CI]) increased from 0.71 (0.70–0.72) to 0.76 (0.75–0.77) and 0.73 (0.71–0.75) to 0.79 (0.77–0.80), respectively. A less notable improvement in the prediction of 1-year and 1-month mortality was observed in people with dementia. Conclusion Functional domains moderately improved the accuracy of a model including age, sex and comorbidities in predicting 1-year and 1-month mortality risk among community-dwelling older people, but they were much less able to predict mortality in people with dementia. Cognition could not be explored as a predictor of mortality due to insufficient data being recorded. PMID:29296099

  1. Morbidity, Self-Perceived Health and Mortality Among non-Western Immigrants and Their Descendants in Denmark in a Life Phase Perspective.

    PubMed

    Jervelund, Signe Smith; Malik, Sanam; Ahlmark, Nanna; Villadsen, Sarah Fredsted; Nielsen, Annemette; Vitus, Kathrine

    2017-04-01

    To enable preventive policies to address health inequity across ethnic groups, this review overviews the current knowledge on morbidity, self-perceived health and mortality among non-Western immigrants and their descendants in Denmark. A systematic search in PUBMED, SCOPUS, Embase and Cochrane as well as in national databases was undertaken. The final number of publications included was 45. Adult immigrants had higher morbidity, but lower mortality compared to ethnic Danes. Immigrant children had higher mortality and morbidity compared to ethnic Danes. Immigrants' health is critical to reach the political goals of integration. Despite non-Western immigrants' higher morbidity than ethnic Danes, no national strategy targeting immigrants' health has been implemented. Future research should include elderly immigrants and children, preferably employing a life-course perspective to enhance understanding of parallel processes of societal adaptation and health.

  2. Customized sampling plans : a guide to alternative sampling techniques for National Transit Database reporting

    DOT National Transportation Integrated Search

    2004-05-01

    For estimating the system total unlinked passenger trips and passenger miles of a fixed-route bus system for the National Transit Database (NTD), the FTA approved sampling plans may either over-sample or do not yield FTAs required confidence and p...

  3. Understanding the productive author who published papers in medicine using National Health Insurance Database: A systematic review and meta-analysis.

    PubMed

    Chien, Tsair-Wei; Chang, Yu; Wang, Hsien-Yi

    2018-02-01

    Many researchers used National Health Insurance database to publish medical papers which are often retrospective, population-based, and cohort studies. However, the author's research domain and academic characteristics are still unclear.By searching the PubMed database (Pubmed.com), we used the keyword of [Taiwan] and [National Health Insurance Research Database], then downloaded 2913 articles published from 1995 to 2017. Social network analysis (SNA), Gini coefficient, and Google Maps were applied to gather these data for visualizing: the most productive author; the pattern of coauthor collaboration teams; and the author's research domain denoted by abstract keywords and Pubmed MESH (medical subject heading) terms.Utilizing the 2913 papers from Taiwan's National Health Insurance database, we chose the top 10 research teams shown on Google Maps and analyzed one author (Dr. Kao) who published 149 papers in the database in 2015. In the past 15 years, we found Dr. Kao had 2987 connections with other coauthors from 13 research teams. The cooccurrence abstract keywords with the highest frequency are cohort study and National Health Insurance Research Database. The most coexistent MESH terms are tomography, X-ray computed, and positron-emission tomography. The strength of the author research distinct domain is very low (Gini < 0.40).SNA incorporated with Google Maps and Gini coefficient provides insight into the relationships between entities. The results obtained in this study can be applied for a comprehensive understanding of other productive authors in the field of academics.

  4. Development of 2010 national land cover database for the Nepal.

    PubMed

    Uddin, Kabir; Shrestha, Him Lal; Murthy, M S R; Bajracharya, Birendra; Shrestha, Basanta; Gilani, Hammad; Pradhan, Sudip; Dangol, Bikash

    2015-01-15

    Land cover and its change analysis across the Hindu Kush Himalayan (HKH) region is realized as an urgent need to support diverse issues of environmental conservation. This study presents the first and most complete national land cover database of Nepal prepared using public domain Landsat TM data of 2010 and replicable methodology. The study estimated that 39.1% of Nepal is covered by forests and 29.83% by agriculture. Patch and edge forests constituting 23.4% of national forest cover revealed proximate biotic interferences over the forests. Core forests constituted 79.3% of forests of Protected areas where as 63% of area was under core forests in the outside protected area. Physiographic regions wise forest fragmentation analysis revealed specific conservation requirements for productive hill and mid mountain regions. Comparative analysis with Landsat TM based global land cover product showed difference of the order of 30-60% among different land cover classes stressing the need for significant improvements for national level adoption. The online web based land cover validation tool is developed for continual improvement of land cover product. The potential use of the data set for national and regional level sustainable land use planning strategies and meeting several global commitments also highlighted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. The Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model: Part 1—Statistical Methodology

    PubMed Central

    O’Brien, Sean M.; Jacobs, Jeffrey P.; Pasquali, Sara K.; Gaynor, J. William; Karamlou, Tara; Welke, Karl F.; Filardo, Giovanni; Han, Jane M.; Kim, Sunghee; Shahian, David M.; Jacobs, Marshall L.

    2016-01-01

    Background This study’s objective was to develop a risk model incorporating procedure type and patient factors to be used for case-mix adjustment in the analysis of hospital-specific operative mortality rates after congenital cardiac operations. Methods Included were patients of all ages undergoing cardiac operations, with or without cardiopulmonary bypass, at centers participating in The Society of Thoracic Surgeons Congenital Heart Surgery Database during January 1, 2010, to December 31, 2013. Excluded were isolated patent ductus arteriosus closures in patients weighing less than or equal to 2.5 kg, centers with more than 10% missing data, and patients with missing data for key variables. Data from the first 3.5 years were used for model development, and data from the last 0.5 year were used for assessing model discrimination and calibration. Potential risk factors were proposed based on expert consensus and selected after empirically comparing a variety of modeling options. Results The study cohort included 52,224 patients from 86 centers with 1,931 deaths (3.7%). Covariates included in the model were primary procedure, age, weight, and 11 additional patient factors reflecting acuity status and comorbidities. The C statistic in the validation sample was 0.858. Plots of observed-vs-expected mortality rates revealed good calibration overall and within subgroups, except for a slight overestimation of risk in the highest decile of predicted risk. Removing patient preoperative factors from the model reduced the C statistic to 0.831 and affected the performance classification for 12 of 86 hospitals. Conclusions The risk model is well suited to adjust for case mix in the analysis and reporting of hospital-specific mortality for congenital heart operations. Inclusion of patient factors added useful discriminatory power and reduced bias in the calculation of hospital-specific mortality metrics. PMID:26245502

  6. Development of a biomarkers database for the National Children's Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lobdell, Danelle T.; Mendola, Pauline

    The National Children's Study (NCS) is a federally-sponsored, longitudinal study of environmental influences on the health and development of children across the United States (www.nationalchildrensstudy.gov). Current plans are to study approximately 100,000 children and their families beginning before birth up to age 21 years. To explore potential biomarkers that could be important measurements in the NCS, we compiled the relevant scientific literature to identify both routine or standardized biological markers as well as new and emerging biological markers. Although the search criteria encouraged examination of factors that influence the breadth of child health and development, attention was primarily focused onmore » exposure, susceptibility, and outcome biomarkers associated with four important child health outcomes: autism and neurobehavioral disorders, injury, cancer, and asthma. The Biomarkers Database was designed to allow users to: (1) search the biomarker records compiled by type of marker (susceptibility, exposure or effect), sampling media (e.g., blood, urine, etc.), and specific marker name; (2) search the citations file; and (3) read the abstract evaluations relative to our search criteria. A searchable, user-friendly database of over 2000 articles was created and is publicly available at: http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=85844. PubMed was the primary source of references with some additional searches of Toxline, NTIS, and other reference databases. Our initial focus was on review articles, beginning as early as 1996, supplemented with searches of the recent primary research literature from 2001 to 2003. We anticipate this database will have applicability for the NCS as well as other studies of children's environmental health.« less

  7. Mortality from and Incidence of Pesticide Poisoning in South Korea: Findings from National Death and Health Utilization Data between 2006 and 2010

    PubMed Central

    Cha, Eun Shil; Khang, Young-Ho; Lee, Won Jin

    2014-01-01

    Pesticide poisoning has been recognized as an important public health issue around the world. The objectives of this study were to report nationally representative figures on mortality from and the incidence of pesticide poisoning in South Korea and to describe their epidemiologic characteristics. We calculated the age-standardized rates of mortality from and the incidence of pesticide poisoning in South Korea by gender and region from 2006 through 2010 using registered death data obtained from Statistics Korea and national healthcare utilization data obtained from the National Health Insurance Review and Assessment Service of South Korea. During the study period of 2006 through 2010, a total of 16,161 deaths and 45,291 patients related to pesticide poisoning were identified, marking respective mortality and incidence rates of 5.35 and 15.37 per 100,000 population. Intentional self-poisoning was identified as the major cause of death due to pesticides (85.9%) and accounted for 20.8% of all recorded suicides. The rates of mortality due to and incidence of pesticide poisoning were higher in rural than in urban areas, and this rural-urban discrepancy was more pronounced for mortality than for incidence. Both the rate of mortality due to pesticide poisoning and its incidence rate increased with age and were higher among men than women. This study provides the magnitude and epidemiologic characteristics for mortality from and the incidence of pesticide poisoning at the national level, and strongly suggests the need for further efforts to prevent pesticide self-poisonings, especially in rural areas in South Korea. PMID:24743877

  8. Mortality from and incidence of pesticide poisoning in South Korea: findings from National Death and Health Utilization Data between 2006 and 2010.

    PubMed

    Cha, Eun Shil; Khang, Young-Ho; Lee, Won Jin

    2014-01-01

    Pesticide poisoning has been recognized as an important public health issue around the world. The objectives of this study were to report nationally representative figures on mortality from and the incidence of pesticide poisoning in South Korea and to describe their epidemiologic characteristics. We calculated the age-standardized rates of mortality from and the incidence of pesticide poisoning in South Korea by gender and region from 2006 through 2010 using registered death data obtained from Statistics Korea and national healthcare utilization data obtained from the National Health Insurance Review and Assessment Service of South Korea. During the study period of 2006 through 2010, a total of 16,161 deaths and 45,291 patients related to pesticide poisoning were identified, marking respective mortality and incidence rates of 5.35 and 15.37 per 100,000 population. Intentional self-poisoning was identified as the major cause of death due to pesticides (85.9%) and accounted for 20.8% of all recorded suicides. The rates of mortality due to and incidence of pesticide poisoning were higher in rural than in urban areas, and this rural-urban discrepancy was more pronounced for mortality than for incidence. Both the rate of mortality due to pesticide poisoning and its incidence rate increased with age and were higher among men than women. This study provides the magnitude and epidemiologic characteristics for mortality from and the incidence of pesticide poisoning at the national level, and strongly suggests the need for further efforts to prevent pesticide self-poisonings, especially in rural areas in South Korea.

  9. Pathogen Research Databases

    Science.gov Websites

    Hepatitis C Virus (HCV) database project is funded by the Division of Microbiology and Infectious Diseases of the National Institute of Allergies and Infectious Diseases (NIAID). The HCV database project started as a spin-off from the HIV database project. There are two databases for HCV, a sequence database

  10. Aviation Safety Issues Database

    NASA Technical Reports Server (NTRS)

    Morello, Samuel A.; Ricks, Wendell R.

    2009-01-01

    The aviation safety issues database was instrumental in the refinement and substantiation of the National Aviation Safety Strategic Plan (NASSP). The issues database is a comprehensive set of issues from an extremely broad base of aviation functions, personnel, and vehicle categories, both nationally and internationally. Several aviation safety stakeholders such as the Commercial Aviation Safety Team (CAST) have already used the database. This broader interest was the genesis to making the database publically accessible and writing this report.

  11. Beyond volume: hospital-based healthcare technology as a predictor of mortality for cardiovascular patients in Korea.

    PubMed

    Kim, Jae-Hyun; Lee, Yunhwan; Park, Eun-Cheol

    2016-06-01

    To examine whether hospital-based healthcare technology is related to 30-day postoperative mortality rates after adjusting for hospital volume of cardiovascular surgical procedures.This study used the National Health Insurance Service-Cohort Sample Database from 2002 to 2013, which was released by the Korean National Health Insurance Service. A total of 11,109 cardiovascular surgical procedure patients were analyzed. The primary analysis was based on logistic regression models to examine our hypothesis.After adjusting for hospital volume of cardiovascular surgical procedures as well as for all other confounders, the odds ratio (OR) of 30-day mortality in low healthcare technology hospitals was 1.567-times higher (95% confidence interval [CI] = 1.069-2.297) than in those with high healthcare technology. We also found that, overall, cardiovascular surgical patients treated in low healthcare technology hospitals, regardless of the extent of cardiovascular surgical procedures, had the highest 30-day mortality rate.Although the results of our study provide scientific evidence for a hospital volume-mortality relationship in cardiovascular surgical patients, the independent effect of hospital-based healthcare technology is strong, resulting in a lower mortality rate. As hospital characteristics such as clinical pathways and protocols are likely to also play an important role in mortality, further research is required to explore their respective contributions.

  12. NATIVE HEALTH DATABASES: NATIVE HEALTH RESEARCH DATABASE (NHRD)

    EPA Science Inventory

    The Native Health Databases contain bibliographic information and abstracts of health-related articles, reports, surveys, and other resource documents pertaining to the health and health care of American Indians, Alaska Natives, and Canadian First Nations. The databases provide i...

  13. Cervical cancer trends in Mexico: incidence, mortality and research output.

    PubMed

    Anaya-Ruiz, Maricruz; Vincent, Ana Karen; Perez-Santos, Martin

    2014-01-01

    To evaluate the recent incidence and mortality of and scientific research trends in cervical cancer in Mexican females. Data between 2000 and 2010 from the Department of Epidemiology of the Ministry of Health, and International Agency for Research on Cancer (IARC) of World Health Organization were analyzed, and age-standardized rates (ASRs) were calculated. In addition, scientific research data were retrieved from the Web of Science database from 2003 to 2012, using different terms related to cervical cancer. The incidence rate decreased during last five years, while mortality rates showed an annual decrease of 4.93%. A total of 780 articles were retrieved, and the institutions with the majority of publications were National Autonomous University of Mexico (34.87%), Social Security Mexican Institute (16.02%), and National Institute of Cancerology (15%). The main types of research were treatment, diagnosis, and prevention. The above results show that incidence of cervical cancer decreased over time in Mexico during last five years; similarly, the downturn observed in mortality mainly reflects improved survival as a result of earlier diagnosis and cancer treatment. Also, this article demonstrates the usefulness of bibliometrics to address key evaluation questions and to establish priorities, define future areas of research, and develop cervical cancer control strategies in Mexico.

  14. Prisoners' expectations of the national forensic DNA database: surveillance and reconfiguration of individual rights.

    PubMed

    Machado, Helena; Santos, Filipe; Silva, Susana

    2011-07-15

    In this paper we aim to discuss how Portuguese prisoners know and what they feel about surveillance mechanisms related to the inclusion and deletion of the DNA profiles of convicted criminals in the national forensic database. Through a set of interviews with individuals currently imprisoned we focus on the ways this group perceives forensic DNA technologies. While the institutional and political discourses maintain that the restricted use and application of DNA profiles within the national forensic database protects individuals' rights, the prisoners claim that police misuse of such technologies potentially makes it difficult to escape from surveillance and acts as a mean of reinforcing the stigma of delinquency. The prisoners also argue that additional intensive and extensive use of surveillance devices might be more protective of their own individual rights and might possibly increase potential for exoneration. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

    Petti, Stefano; Scully, Crispian

    2005-09-01

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

  16. Impact of renal dysfunction on outcomes of coronary artery bypass surgery: results from the Society of Thoracic Surgeons National Adult Cardiac Database.

    PubMed

    Cooper, William A; O'Brien, Sean M; Thourani, Vinod H; Guyton, Robert A; Bridges, Charles R; Szczech, Lynda A; Petersen, Rebecca; Peterson, Eric D

    2006-02-28

    Although patients with end-stage renal disease are known to be at high risk for mortality after coronary artery bypass graft (CABG) surgery, the impact of lesser degrees of renal impairment has not been well studied. The purpose of this study was to compare outcomes in patients undergoing CABG with a range from normal renal function to dependence on dialysis. We reviewed 483,914 patients receiving isolated CABG from July 2000 to December 2003, using the Society of Thoracic Surgeons National Adult Cardiac Database. Glomerular filtration rate (GFR) was estimated for patients with the use of the Modification of Diet in Renal Disease study formula. Multivariable logistic regression was used to determine the association of GFR with operative mortality and morbidities (stroke, reoperation, deep sternal infection, ventilation >48 hours, postoperative stay >2 weeks) after adjustment for 27 other known clinical risk factors. Preoperative renal dysfunction (RD) was common among CABG patients, with 51% having mild RD (GFR 60 to 90 mL/min per 1.73 m2, excludes dialysis), 24% moderate RD (GFR 30 to 59 mL/min per 1.73 m2, excludes dialysis), 2% severe RD (GFR <30 mL/min per 1.73 m2, excludes dialysis), and 1.5% requiring dialysis. Operative mortality rose inversely with declining renal function, from 1.3% for those with normal renal function to 9.3% for patients with severe RD not on dialysis and 9.0% for those who were dialysis dependent. After adjustment for other covariates, preoperative GFR was one of the most powerful predictors of operative mortality and morbidities. Preoperative RD is common in the CABG population and carries important prognostic importance. Assessment of preoperative renal function should be incorporated into clinical risk assessment and prediction models.

  17. Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national irish smoking ban: interrupted time-series analysis.

    PubMed

    Stallings-Smith, Sericea; Zeka, Ariana; Goodman, Pat; Kabir, Zubair; Clancy, Luke

    2013-01-01

    Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76-0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63-0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54-0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46-0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35-64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32-0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305-4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in

  18. Family Structure and Child Mortality in Sub-Saharan Africa: Cross-National Effects of Polygyny

    ERIC Educational Resources Information Center

    Omariba, D. Walter Rasugu; Boyle, Michael H.

    2007-01-01

    This study applies multilevel logistic regression to Demographic and Health Survey data from 22 sub-Saharan African countries to examine whether the relationship between child mortality and family structure, with a specific emphasis on polygyny, varies cross-nationally and over time. Hypotheses were developed on the basis of competing theories on…

  19. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations.

    PubMed

    Finegold, Judith A; Asaria, Perviz; Francis, Darrel P

    2013-09-30

    Ischaemic heart disease (IHD) is the leading cause of death worldwide. The World Health Organisation (WHO) collects mortality data coded using the International Statistical Classification of Diseases (ICD) code. We analysed IHD deaths world-wide between 1995 and 2009 and used the UN population database to calculate age-specific and directly and indirectly age-standardised IHD mortality rates by country and region. IHD is the single largest cause of death worldwide, causing 7,249,000 deaths in 2008, 12.7% of total global mortality. There is more than 20-fold variation in IHD mortality rates between countries. Highest IHD mortality rates are in Eastern Europe and Central Asian countries; lowest rates in high income countries. For the working-age population, IHD mortality rates are markedly higher in low-and-middle income countries than in high income countries. Over the last 25 years, age-standardised IHD mortality has fallen by more than half in high income countries, but the trend is flat or increasing in some low-and-middle income countries. Low-and-middle income countries now account for more than 80% of global IHD deaths. The global burden of IHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. In high income countries, population ageing maintains IHD as the leading cause of death. Nevertheless, the progressive decline in age-standardised IHD mortality in high income countries shows that increasing IHD mortality is not inevitable. The 20-fold mortality difference between countries, and the temporal trends, may hold vital clues for handling IHD epidemic which is migratory, and still burgeoning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Fast Updating National Geo-Spatial Databases with High Resolution Imagery: China's Methodology and Experience

    NASA Astrophysics Data System (ADS)

    Chen, J.; Wang, D.; Zhao, R. L.; Zhang, H.; Liao, A.; Jiu, J.

    2014-04-01

    Geospatial databases are irreplaceable national treasure of immense importance. Their up-to-dateness referring to its consistency with respect to the real world plays a critical role in its value and applications. The continuous updating of map databases at 1:50,000 scales is a massive and difficult task for larger countries of the size of more than several million's kilometer squares. This paper presents the research and technological development to support the national map updating at 1:50,000 scales in China, including the development of updating models and methods, production tools and systems for large-scale and rapid updating, as well as the design and implementation of the continuous updating workflow. The use of many data sources and the integration of these data to form a high accuracy, quality checked product were required. It had in turn required up to date techniques of image matching, semantic integration, generalization, data base management and conflict resolution. Design and develop specific software tools and packages to support the large-scale updating production with high resolution imagery and large-scale data generalization, such as map generalization, GIS-supported change interpretation from imagery, DEM interpolation, image matching-based orthophoto generation, data control at different levels. A national 1:50,000 databases updating strategy and its production workflow were designed, including a full coverage updating pattern characterized by all element topographic data modeling, change detection in all related areas, and whole process data quality controlling, a series of technical production specifications, and a network of updating production units in different geographic places in the country.

  1. National information network and database system of hazardous waste management in China

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ma Hongchang

    1996-12-31

    Industries in China generate large volumes of hazardous waste, which makes it essential for the nation to pay more attention to hazardous waste management. National laws and regulations, waste surveys, and manifest tracking and permission systems have been initiated. Some centralized hazardous waste disposal facilities are under construction. China`s National Environmental Protection Agency (NEPA) has also obtained valuable information on hazardous waste management from developed countries. To effectively share this information with local environmental protection bureaus, NEPA developed a national information network and database system for hazardous waste management. This information network will have such functions as information collection, inquiry,more » and connection. The long-term objective is to establish and develop a national and local hazardous waste management information network. This network will significantly help decision makers and researchers because it will be easy to obtain information (e.g., experiences of developed countries in hazardous waste management) to enhance hazardous waste management in China. The information network consists of five parts: technology consulting, import-export management, regulation inquiry, waste survey, and literature inquiry.« less

  2. Public health vulnerability to wintertime weather: time-series regression and episode analyses of national mortality and morbidity databases to inform the Cold Weather Plan for England.

    PubMed

    Hajat, S; Chalabi, Z; Wilkinson, P; Erens, B; Jones, L; Mays, N

    2016-08-01

    To inform development of Public Health England's Cold Weather Plan (CWP) by characterizing pre-existing relationships between wintertime weather and mortality and morbidity outcomes, and identification of groups most at risk. Time-series regression analysis and episode analysis of daily mortality, emergency hospital admissions, and accident and emergency visits for each region of England. Seasonally-adjusted Poisson regression models estimating the percent change in daily health events per 1 °C fall in temperature or during individual episodes of extreme weather. Adverse cold effects were observed in all regions, with the North East, North West and London having the greatest risk of cold-related mortality. Nationally, there was a 3.44% (95% CI: 3.01, 3.87) increase in all-cause deaths and 0.78% (95% CI: 0.53, 1.04) increase in all-cause emergency admissions for every 1 °C drop in temperature below identified thresholds. The very elderly and people with COPD were most at risk from low temperatures. A&E visits for fractures were elevated during heavy snowfall periods, with adults (16-64 years) being the most sensitive age-group. Since even moderately cold days are associated with adverse health effects, by far the greatest health burdens of cold weather fell outside of the alert periods currently used in the CWP. Our findings indicate that levels 0 ('year round planning') and 1 ('winter preparedness and action') are crucial components of the CWP in comparison to the alerts. Those most vulnerable during winter may vary depending on the type of weather conditions being experienced. Recommendations are made for the CWP. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Completion of the 2006 National Land Cover Database Update for the Conterminous United States

    EPA Science Inventory

    Under the organization of the Multi-Resolution Land Characteristics (MRLC) Consortium, the National Land Cover Database (NLCD) has been updated to characterize both land cover and land cover change from 2001 to 2006. An updated version of NLCD 2001 (Version 2.0) is also provided....

  4. PrimateLit Database

    Science.gov Websites

    Primate Info Net Related Databases NCRR PrimateLit: A bibliographic database for primatology Top of any problems with this service. We welcome your feedback. The PrimateLit database is no longer being Resources, National Institutes of Health. The database is a collaborative project of the Wisconsin Primate

  5. High early cardiovascular mortality following liver transplantation

    PubMed Central

    VanWagner, Lisa B.; Lapin, Brittany; Levitsky, Josh; Wilkins, John T.; Abecassis, Michael M.; Skaro, Anton I.; Lloyd-Jones, Donald M.

    2014-01-01

    Cardiovascular disease (CVD) contributes to excess long-term mortality after liver transplantation (LT), however little is known about early post-operative CVD mortality in the current era. In addition, there is no model to predict early post-operative CVD mortality across centers. We analyzed adult recipients of primary LT in the Organ Procurement and Transplantation Network (OPTN) database between February 2002 and December 2012 to assess prevalence and predictors of early (30-day) CVD mortality, defined as death from arrhythmia, heart failure, myocardial infarction, cardiac arrest, thromboembolism, and/or stroke. We performed logistic regression with stepwise selection to develop a predictive model of early CVD mortality. Sex and center volume were forced into the final model, which was validated using bootstrapping techniques. Among 54,697 LT recipients, there were 1576 (2.9%) deaths within 30 days. CVD death was the leading cause of 30-day mortality (42.1%), followed by infection (27.9%) and graft failure (12.2%). In multivariate analysis, 9 (6 recipient, 2 donor, 1 operative) significant covariates were identified: age, pre-operative hospitalization, ICU and ventilator status, calculated MELD score, portal vein thrombosis, national organ sharing, donor BMI and cold ischemia time. The model showed moderate discrimination (c-statistic 0.66, 95% CI: 0.63–0.68). We provide the first multicenter prognostic model for the prediction of early post-LT CVD death, the most common cause of early post-LT mortality in the current transplant era. However, evaluation of additional CVD-related variables not collected by the OPTN are needed in order to improve model accuracy and potential clinical utility. PMID:25044256

  6. Mortality Associations with Long-Term Exposure to Outdoor Air Pollution in a National English Cohort

    PubMed Central

    Carey, Iain M.; Kent, Andrew J.; van Staa, Tjeerd; Cook, Derek G.; Anderson, H. Ross

    2013-01-01

    Rationale: Cohort evidence linking long-term exposure to outdoor particulate air pollution and mortality has come largely from the United States. There is relatively little evidence from nationally representative cohorts in other countries. Objectives: To investigate the relationship between long-term exposure to a range of pollutants and causes of death in a national English cohort. Methods: A total of 835,607 patients aged 40–89 years registered with 205 general practices were followed from 2003–2007. Annual average concentrations in 2002 for particulate matter with a median aerodynamic diameter less than 10 (PM10) and less than 2.5 μm (PM2.5), nitrogen dioxide (NO2), ozone, and sulfur dioxide (SO2) at 1 km2 resolution, estimated from emission-based models, were linked to residential postcode. Deaths (n = 83,103) were ascertained from linkage to death certificates, and hazard ratios (HRs) for all- and cause-specific mortality for pollutants were estimated for interquartile pollutant changes from Cox models adjusting for age, sex, smoking, body mass index, and area-level socioeconomic status markers. Measurements and Main Results: Residential concentrations of all pollutants except ozone were positively associated with all-cause mortality (HR, 1.02, 1.03, and 1.04 for PM2.5, NO2, and SO2, respectively). Associations for PM2.5, NO2, and SO2 were larger for respiratory deaths (HR, 1.09 each) and lung cancer (HR, 1.02, 1.06, and 1.05) but nearer unity for cardiovascular deaths (1.00, 1.00, and 1.04). Conclusions: These results strengthen the evidence linking long-term ambient air pollution exposure to increased all-cause mortality. However, the stronger associations with respiratory mortality are not consistent with most US studies in which associations with cardiovascular causes of death tend to predominate. PMID:23590261

  7. Strategy for a transparent, accessible, and sustainable national claims database.

    PubMed

    Gelburd, Robin

    2015-03-01

    The article outlines the strategy employed by FAIR Health, Inc, an independent nonprofit, to maintain a national database of over 18 billion private health insurance claims to support consumer education, payer and provider operations, policy makers, and researchers with standard and customized data sets on an economically self-sufficient basis. It explains how FAIR Health conducts all operations in-house, including data collection, security, validation, information organization, product creation, and transmission, with a commitment to objectivity and reliability in data and data products. It also describes the data elements available to researchers and the diverse studies that FAIR Health data facilitate.

  8. Epidemiology and outcomes of older patients admitted to Scottish intensive care units: a national database linkage study.

    PubMed

    Docherty, Annemarie; Lone, Nazir; Anderson, Niall; Walsh, Timothy

    2015-02-26

    As the general population ages and life expectancy increases, health-care use by elderly people increases, including intensive care. Rationing and variation of access are ethically and politically challenging. We aimed to characterise the population-based incidence of intensive care unit (ICU) admissions of elderly people in Scotland; compare ICU admission and mortality between elderly and younger populations; and compare treatment intensity between these groups. We extracted complete, national 6-year cohort Scottish ICU admissions (Jan 1, 2005, to Dec 31, 2010) from the Scottish Intensive Care Society Audit Group database, which we linked to hospital Scottish Morbidity Record (SMR01) and death records. Annual incidence of ICU admissions of people aged 80 years or older was standardised for sex and socioeconomic status to the standard Scottish population (≥80 years) 2005-10. We compared mortality of elderly and younger people (<65 years) using the log-rank test. During 2005-10, 47 779 people were admitted to ICU (4561 patients ≥80 years [9·5%, 35·0/10 000 population], 26 784 patients <65 years [56·1%, 13·2/10 000]). Incidence of ICU admissions of elderly people fell from 36·6/10 000 population (95%CI 34·0-39·2) in 2005 to 30·3/10 000 (28·0-32·5) in 2010. ICU mortality was higher in elderly than in younger people (26·4% vs 16·1%, p<0·0001) as was 6-year mortality (68·0% vs 34·5%, p<0·0001). 2110 (80%) of 2627 elderly survivors were discharged home (younger 92%, 19 221/20 902), with a further 373 (14·2%) given rehabilitation (younger 1063, 5·1%) (χ(2)=525, p<0·0001). Age was an independent predictor of mortality (odds ratio 1·46, 95% CI 1·23-1·73, p<0·0001) after adjustment for confounders. In the pneumonia subgroup (elderly 294, younger 2167), mean acute physiology scores were similar (17·0 [SD 6·4] vs 17·6 [6·6]), organ support was higher in the elderly patients (77·0% vs 68·1%, p<0·0001), and median ICU length of

  9. Nationwide In-hospital Mortality Following Pancreatic Surgery in Germany is Higher than Anticipated.

    PubMed

    Nimptsch, Ulrike; Krautz, Christian; Weber, Georg F; Mansky, Thomas; Grützmann, Robert

    2016-12-01

    We aimed to determine the unbiased mortality rates for pancreatic surgery procedures at the national level through a comprehensive analysis of every inpatient case in Germany. Several studies have proclaimed a general improvement of perioperative outcomes following pancreatic surgery. These results are challenged by recent analyses of large US databases that found strong volume-outcome relationships, with high mortality in low-volume facilities. All inpatient cases with a pancreatic surgery procedure code in Germany from 2009 to 2013 were identified from nationwide administrative hospital data. We determined the absolute number of patients and the in-hospital death rate for crucial subcategories such as medical indications and types of surgical procedure. A total of 58,003 inpatient episodes of pancreatic surgery were identified between 2009 and 2013. Annual case numbers increased significantly, which was primarily attributed to patients aged 70 years and older. The overall in-hospital mortality rate (10.1%) did not significantly change during the study period. Major pancreatic resections were associated with mortality ranging from 7.3% (distal pancreatectomy) to 22.9% (total pancreatectomy). Postoperative interventions indicative of severe complications were documented frequently (eg, more than 6 blood transfusions in 20% of all patients and relaparotomy in 16%). Their occurrence was associated with a dramatic increase in mortality. At the national level in Germany, perioperative mortality is higher than anticipated from previous studies. The absence of a significant reduction in overall mortality challenges current health policies that aim to improve the outcomes of high-risk surgical procedures in Germany.

  10. Mortality outcomes for Chinese and Japanese immigrants in the USA and countries of origin (Hong Kong, Japan): a comparative analysis using national mortality records from 2003 to 2011.

    PubMed

    Hastings, Katherine G; Eggleston, Karen; Boothroyd, Derek; Kapphahn, Kristopher I; Cullen, Mark R; Barry, Michele; Palaniappan, Latha P

    2016-10-28

    With immigration and minority populations rapidly growing in the USA, it is critical to assess how these populations fare after immigration, and in subsequent generations. Our aim is to compare death rates and cause of death across foreign-born, US-born and country of origin Chinese and Japanese populations. We analysed all-cause and cause-specific age-standardised mortality rates and trends using 2003-2011 US death record data for Chinese and Japanese decedents aged 25 or older by nativity status and sex, and used the WHO Mortality Database for Hong Kong and Japan decedents in the same years. Characteristics such as age at death, absolute number of deaths by cause and educational attainment were also reported. We examined a total of 10 458 849 deaths. All-cause mortality was highest in Hong Kong and Japan, intermediate for foreign-born, and lowest for US-born decedents. Improved mortality outcomes and higher educational attainment among foreign-born were observed compared with developed Asia counterparts. Lower rates in US-born decedents were due to decreased cancer and communicable disease mortality rates in the US heart disease mortality was either similar or slightly higher among Chinese-Americans and Japanese-Americans compared with those in developed Asia counterparts. Mortality advantages in the USA were largely due to improvements in cancer and communicable disease mortality outcomes. Mortality advantages and higher educational attainments for foreign-born populations compared with developed Asia counterparts may suggest selective migration. Findings add to our limited understanding of the racial and environmental contributions to immigrant health disparities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Risk model of valve surgery in Japan using the Japan Adult Cardiovascular Surgery Database.

    PubMed

    Motomura, Noboru; Miyata, Hiroaki; Tsukihara, Hiroyuki; Takamoto, Shinichi

    2010-11-01

    Risk models of cardiac valve surgery using a large database are useful for improving surgical quality. In order to obtain accurate, high-quality assessments of surgical outcome, each geographic area should maintain its own database. The study aim was to collect Japanese data and to prepare a risk stratification of cardiac valve procedures, using the Japan Adult Cardiovascular Surgery Database (JACVSD). A total of 6562 valve procedure records from 97 participating sites throughout Japan was analyzed, using a data entry form with 255 variables that was sent to the JACVSD office from a web-based data collection system. The statistical model was constructed using multiple logistic regression. Model discrimination was tested using the area under the receiver operating characteristic curve (C-index). The model calibration was tested using the Hosmer-Lemeshow (H-L) test. Among 6562 operated cases, 15% had diabetes mellitus, 5% were urgent, and 12% involved preoperative renal failure. The observed 30-day and operative mortality rates were 2.9% and 4.0%, respectively. Significant variables with high odds ratios included emergent or salvage status (3.83), reoperation (3.43), and left ventricular dysfunction (3.01). The H-L test and C-index values for 30-day mortality were satisfactory (0.44 and 0.80, respectively). The results obtained in Japan were at least as good as those reported elsewhere. The performance of this risk model also matched that of the STS National Adult Cardiac Database and the European Society Database.

  12. Incidence and Short-term Mortality From Perforated Peptic Ulcer in Korea: A Population-Based Study

    PubMed Central

    Bae, SeungJin; Shim, Ki-Nam; Kim, Nayoung; Kang, Jung Mook; Kim, Dong-Sook; Kim, Kyoung-Min; Cho, Yu Kyung; Jung, Sung Woo

    2012-01-01

    Background Perforated peptic ulcer (PPU) is associated with serious health and economic outcomes. However, few studies have estimated the incidence and health outcomes of PPU using a nationally representative sample in Asia. We estimated age- and sex-specific incidence and short-term mortality from PPU among Koreans and investigated the risk factors for mortality associated with PPU development. Methods A retrospective population-based study was conducted from 2006 through 2007 using the Korean National Health Insurance claims database. A diagnostic algorithm was derived and validated to identify PPU patients, and PPU incidence rates and 30-day mortality rates were determined. Results From 2006 through 2007, the PPU incidence rate per 100 000 population was 4.4; incidence among men (7.53) was approximately 6 times that among women (1.24). Incidence significantly increased with advanced age, especially among women older than 50 years. Among 4258 PPU patients, 135 (3.15%) died within 30 days of the PPU event. The 30-day mortality rate increased with advanced age and reached almost 20% for patients older than 80 years. The 30-day mortality rate was 10% for women and 2% for men. Older age, being female, and higher comorbidity were independently associated with 30-day mortality rate among PPU patients in Korea. Conclusions Special attention should be paid to elderly women with high comorbidity who develop PPU. PMID:22955110

  13. Mortality among elder abuse victims in rural Malaysia: A two-year population-based descriptive study.

    PubMed

    Yunus, Raudah Mohd; Hairi, Noran Naqiah; Choo, Wan Yuen; Hairi, Farizah Mohd; Sooryanarayana, Rajini; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Peramalah, Devi; Abdul Aziz, Suriyati; Mohammad, Zaiton Lal; Mohamad, Rosmala; Mohd Ali, Zainudin; Bulgiba, Awang

    2017-01-01

    Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.

  14. Surgical Mortality Audit-lessons Learned in a Developing Nation.

    PubMed

    Bindroo, Sandiya; Saraf, Rakesh

    2015-06-01

    Surgical audit is a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards. It is used to improve surgical practice with the ultimate goal of improving patient care. As the pattern of surgical care is different in the developing world, we analyzed mortalities in a referral medical institute of India to suggest interventions for improvement. An analysis of total admissions, different surgeries, and mortalities over 1 year in an urban referral medical institute of northern India was performed, followed by "peer review" of the mortalities. Mortality rates as outcomes and classification was done to provide comparative results. Of 10,005 surgical patients, 337 (male = 221, female = 116) deaths were reported over 1 year. The overall mortality rate was 3.36%, while mortality in operative cases was 1.76%. Total deaths were classified into (1) Viable: 153 (45%), (2) Nonviable: 174 (52%), and (3) Indeterminate: 10 (3%). Exclusion of the nonviable group reduced the mortality rate from 3.36% to 1.62%. Trauma was the major cause of mortality (n = 235; 70%) as compared to other surgical patients (n = 102; 30%). Increased mortality was also associated with emergency procedures (3.66%) as compared to elective surgeries (0.34%). In conclusion, audit of mortality and morbidity helps in initiating and implementing preventive strategies to improve surgical practice and patient care, and to reduce mortality rates. The mortality and morbidity forum is an important educational activity. It should be considered a mandatory activity in all postgraduate training programs.

  15. Mortality Following Catheter Drainage Versus Thoracentesis in Cirrhotic Patients with Pleural Effusion.

    PubMed

    Hung, Tsung-Hsing; Tseng, Chih-Wei; Tsai, Chen-Chi; Hsieh, Yu-Hsi; Tseng, Kuo-Chih; Tsai, Chih-Chun

    2017-04-01

    Pleural effusion is an abnormal collection of body fluids that may cause related morbidity or mortality in cirrhotic patients. There are insufficient data to determine the optimal method of drainage, for symptomatic relief in cirrhotic patients with pleural effusion. In this study, we compare the mortality outcomes of catheter drainage versus thoracentesis in cirrhotic patients. The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify cirrhotic patients with pleural effusion requiring drainage between January 1, 2007, and December 31, 2010. In all, 2556 cirrhotic patients with pleural effusion were selected for the study and divided into the two groups (n = 1278/group) after propensity score matching. The mean age was 61.0 ± 14.3 years, and 68.9% (1761/2556) were men. The overall 30-day mortality was 21.0% (538/2556) and was higher in patients treated with catheter drainage than those treated with thoracentesis (23.5 vs. 18.6%, respectively, P < 0.001 by log-rank test). After Cox proportional hazard regression analysis adjusted by patient sex, age, and comorbid disorders, the risk of 30-day mortality was significantly higher in cirrhotic patients who accepted catheter drainage compared to thoracentesis (hazard ratio 1.30, 95% confidence interval 1.10-1.54, P = 0.003). Old age, hepatic encephalopathy, bleeding esophageal varices, hepatocellular carcinoma, ascites, and pneumonia were associated with higher risks for 30-day mortality. In cirrhotic patients with pleural effusion requiring drainage, catheter drainage is associated with higher mortality compared to thoracentesis.

  16. Hospital Spending and Inpatient Mortality: Evidence from California

    PubMed Central

    Romley, John A.; Jena, Anupam B.; Goldman, Dana P.

    2013-01-01

    Background Evidence shows that high Medicare spending is not associated with better health outcomes at a regional level, and that high spending in hospitals is not associated with better process quality. But the relationship between hospital spending and inpatient mortality is less well understood. Objective To determine the association between hospital spending and risk-adjusted inpatient mortality. Design Retrospective cohort study. Setting Database of discharge records from 1999–2008 for 208 California hospitals included in the Dartmouth Atlas of Health Care Patients 2,545,352 patients hospitalized during 1999–2008 with one of six major medical conditions. Measurements Inpatient mortality rates among patients admitted to hospitals with varying levels of end-of-life hospital spending. Results For each of six admitting diagnoses – acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia – patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. During 1999–2003, for example, patients admitted with acute myocardial infarction to California hospitals in the highest quintile of hospital spending had lower inpatient mortality than those admitted to hospitals in the lowest quintile (odds ratio of mortality 0.862, 95% confidence interval 0.742–0.983). Predicted inpatient deaths would increase by 1,831 if all patients admitted with acute myocardial infarction were cared for in hospitals in the lowest quintile of spending rather than the highest. The association between hospital spending and inpatient mortality did not vary by geographic region or hospital size. Limitations Unobserved predictors of mortality create uncertainty about whether greater inpatient hospital spending leads to lower inpatient mortality. Conclusion Hospitals that spend more at the end of life have lower inpatient mortality for a variety of major admitting medical

  17. Leptin, adiposity, and mortality: results from the National Health and Nutrition Examination Survey III, 1988 to 1994.

    PubMed

    Batsis, John A; Sahakyan, Karine R; Singh, Prachi; Bartels, Stephen J; Somers, Virend K; Lopez-Jimenez, Francisco

    2015-04-01

    To determine whether leptin is related to all-cause and cardiovascular (CV) mortality in older adults. Participants 60 years and older with plasma leptin level measurements from the National Health and Nutrition Examination Survey III (1988-1994) and mortality data linked to the National Death Index were included. We created sex-specific tertiles of leptin (men: 4.2-7.7 μg/L; women: 11.5-21.4 μg/L) to identify the effect of leptin on all-cause and CV mortality. We also determined whether leptin predicted mortality in patients with obesity. We classified obesity using 4 possible definitions: body mass index 30 kg/m(2) or greater; body fat 25% or more in men and 35% or more in women; waist circumference 102 cm or greater in men and 88 cm or greater in women; and waist-hip ratio 0.85 or higher in women and 0.95 or higher in men. Sex-specific proportional hazard models were used to assess the effect of leptin on all-cause and CV mortality. Of 1794 participants, 51.6% were women; the mean age was 70.3±0.4 years, and the follow-up period was 12.5 years with 994 deaths (469 were CV deaths). All-cause mortality in the highest leptin tertile was significant neither in men (hazard ratio [HR], 1.23; 95% CI, 0.93-1.63) nor in women (HR, 0.97; 95% CI, 0.68-1.40). CV mortality was the highest in the highest leptin tertile in men (HR, 1.69; 95% CI, 1.06-2.70) but not in women (HR, 1.21; 95% CI, 0.73-1.98). Evaluating the effect of leptin in subgroups of different obesity definitions, we found that high leptin levels as predict CV mortality in men as measured by waist circumference or body fat. Elevated leptin level is predictive of CV mortality only in men. Leptin may provide additional mortality discrimination in obese men. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  18. Causes of mortality in sea ducks (Mergini) necropsied at the USGS-National Wildlife Health Center

    USGS Publications Warehouse

    Skerratt, L.F.; Franson, J.C.; Meteyer, C.U.; Hollmén, Tuula E.

    2005-01-01

    A number of factors were identified as causes of mortality in 254 (59%) of 431 sea ducks submitted for necropsy at the USGS-National Wildlife Health Center, Madison, Wisconsin from 1975 until 2003. Bacteria causing large outbreaks of mortality were Pasteurella multocida and Clostridium botulinum Type E. Starvation was responsible for large mortality events as well as sporadic deaths of individuals. Lead toxicity, gunshot and exposure to petroleum were important anthropogenic factors. Other factors that caused mortality were avian pox virus, bacteria (Clostridium botulinum Type C, Riemerella anatipestifer and Clostridium perfringens), fungi (Aspergillus fumigatus and an unidentified fungus), protozoans (unidentified coccidia), nematodes (Eustrongylides spp.), trematodes (Sphaeridiotrema globulus and Schistosoma spp.), acanthocephalans (Polymorphus spp.), predation, cyanide and trauma (probably due to collisions). There were also a number of novel infectious organisms in free-living sea ducks in North America, which were incidental to the death, including avipoxvirus and reovirus, bacteria Mycobacterium avium, protozoans Sarcocystis sp. and nematodes Streptocara sp. Apart from anthropogenic factors, the other important mortality factors listed here have not been studied as possible causes for the decline of sea ducks in North America.

  19. Impact of Accurate 30-Day Status on Operative Mortality: Wanted Dead or Alive, Not Unknown.

    PubMed

    Ring, W Steves; Edgerton, James R; Herbert, Morley; Prince, Syma; Knoff, Cathy; Jenkins, Kristin M; Jessen, Michael E; Hamman, Baron L

    2017-12-01

    Risk-adjusted operative mortality is the most important quality metric in cardiac surgery for determining The Society of Thoracic Surgeons (STS) Composite Score for star ratings. Accurate 30-day status is required to determine STS operative mortality. The goal of this study was to determine the effect of unknown or missing 30-day status on risk-adjusted operative mortality in a regional STS Adult Cardiac Surgery Database cooperative and demonstrate the ability to correct these deficiencies by matching with an administrative database. STS Adult Cardiac Surgery Database data were submitted by 27 hospitals from five hospital systems to the Texas Quality Initiative (TQI), a regional quality collaborative. TQI data were matched with a regional hospital claims database to resolve unknown 30-day status. The risk-adjusted operative mortality observed-to-expected (O/E) ratio was determined before and after matching to determine the effect of unknown status on the operative mortality O/E. TQI found an excessive (22%) unknown 30-day status for STS isolated coronary artery bypass grafting cases. Matching the TQI data to the administrative claims database reduced the unknowns to 7%. The STS process of imputing unknown 30-day status as alive underestimates the true operative mortality O/E (1.27 before vs 1.30 after match), while excluding unknowns overestimates the operative mortality O/E (1.57 before vs 1.37 after match) for isolated coronary artery bypass grafting. The current STS algorithm of imputing unknown 30-day status as alive and a strategy of excluding cases with unknown 30-day status both result in erroneous calculation of operative mortality and operative mortality O/E. However, external validation by matching with an administrative database can improve the accuracy of clinical databases such as the STS Adult Cardiac Surgery Database. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Global quantitative indices reflecting provider process-of-care: data-base derivation.

    PubMed

    Moran, John L; Solomon, Patricia J

    2010-04-19

    demonstrating a low correlation with mortality probability. Global indices reflecting process of care may be formally established at the level of national patient data-bases. These indices appear orthogonal to mortality outcome.

  1. Associations between air pollution and mortality in Phoenix, 1995-1997.

    PubMed Central

    Mar, T F; Norris, G A; Koenig, J Q; Larson, T V

    2000-01-01

    We evaluated the association between mortality outcomes in elderly individuals and particulate matter (PM) of varying aerodynamic diameters (in micrometers) [PM(10), PM(2.5), and PM(CF )(PM(10) minus PM(2.5))], and selected particulate and gaseous phase pollutants in Phoenix, Arizona, using 3 years of daily data (1995-1997). Although source apportionment and epidemiologic methods have been previously combined to investigate the effects of air pollution on mortality, this is the first study to use detailed PM composition data in a time-series analysis of mortality. Phoenix is in the arid Southwest and has approximately 1 million residents (9. 7% of the residents are > 65 years of age). PM data were obtained from the U.S. Environmental Protection Agency (EPA) National Exposure Research Laboratory Platform in central Phoenix. We obtained gaseous pollutant data, specifically carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide data, from the EPA Aerometric Information Retrieval System Database. We used Poisson regression analysis to evaluate the associations between air pollution and nonaccidental mortality and cardiovascular mortality. Total mortality was significantly associated with CO and NO(2) (p < 0.05) and weakly associated with SO(2), PM(10), and PM(CF) (p < 0. 10). Cardiovascular mortality was significantly associated with CO, NO(2), SO(2), PM(2.5), PM(10), PM(CF) (p < 0.05), and elemental carbon. Factor analysis revealed that both combustion-related pollutants and secondary aerosols (sulfates) were associated with cardiovascular mortality. PMID:10753094

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

    PubMed

    Sabanayagam, Charumathi; Shankar, Anoop

    2012-03-01

    Low socioeconomic status (SES) is associated with mortality in several populations. SES measures, such as education and income, may operate through different pathways. However, the independent effect of each measure mutually adjusting for the effect of other SES measures is not clear. The association between poverty-income ratio (PIR) and education and all-cause mortality among 15,646 adults, aged >20 years, who participated in the Third National Health and Nutrition Examination Survey in the USA, was examined. The lower PIR quartiles and less than high school education were positively associated with all-cause mortality in initial models adjusting for the demographic, lifestyle and clinical risk factors. After additional adjustment for education, the lower PIR quartiles were still significantly associated with all-cause mortality. The multivariable odds ratio (OR) [95% confidence interval (CI)] of all-cause mortality comparing the lowest to the highest quartile of PIR was 2.11 (1.52-2.95, p trend < or = 0.0001). In contrast, after additional adjustment for income, education was no longer associated with all-cause mortality [multivariable OR (95% CI) of all-cause mortality comparing less than high school to more than high school education was 1.05 (0.85-1.31, p trend=0.57)]. The results suggest that income may be a stronger predictor of mortality than education, and narrowing the income differentials may reduce the health disparities.

  3. Palliative interventions for hepatocellular carcinoma patients: analysis of the National Cancer Database.

    PubMed

    Hammad, Abdulrahman Y; Robbins, Jared R; Turaga, Kiran K; Christians, Kathleen K; Gamblin, T Clark; Johnston, Fabian M

    2017-01-01

    Palliative therapies are provided to a subset of hepatocellular carcinoma (HCC) patients with the aim of providing symptomatic relief, better quality of life and improved survival. The present study sought to assess and compare the efficacy of different palliative therapies for HCC. The National Cancer Database (NCDB), a retrospective national database that captures approximately 70% of all patients treated for cancer in the US, was queried for patients with HCC who were deemed unresectable from 1998-2011. Patients were stratified by receipt of palliative therapy. Survival analysis was examined by log-rank test and Kaplan Meier curves, and a multivariate proportional hazards model was utilized to identify the predictors of survival. A total of 3,267 patients were identified; 287 (8.7%) received surgical palliation, 827 (25.3%) received radiotherapy (RT), 877 (26.8%) received chemotherapy, 1,067 (32.6%) received pain management therapy, while 209 (6.4%) received a combination of the previous three modalities. On multivariate analysis palliative RT was identified as a positive predictor of survival [hazards ratio (HR) 0.65; 95% CI, 0.50-0.83]. Stratifying by disease stage, palliative RT provided a significant survival benefit for patients with stage IV disease. Palliative RT appears to extend survival and should be considered for patients presenting with late stage HCC.

  4. USDA National Nutrient Database for Standard Reference Dataset for What We Eat in America, NHANES (Survey-SR) 2013-2014

    USDA-ARS?s Scientific Manuscript database

    USDA National Nutrient Database for Standard Reference Dataset for What We Eat In America, NHANES (Survey-SR) provides the nutrient data for assessing dietary intakes from the national survey What We Eat In America, National Health and Nutrition Examination Survey (WWEIA, NHANES). The current versi...

  5. Mortality of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Standley, W.G.; Berry, W.H.; O'Farrell, T.P.

    1992-09-01

    Sources and rates of mortality of a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. National Guard-authorized activities, including military training, caused the death of three of the 94 (3%) kit foxes radiocollared, and do not appear to jeopardize the continued existence of the population. Predation by larger carnivores, primarily coyotes (Canis latrans), caused the death of 75% of the 32 radiocollared kit foxes recovered dead for which a cause of death could be determined; vehicle impacts, disease (rabies), poisoning, and shooting weremore » each responsible for the deaths of 6.3%. Adult annual mortality rate was 0.47 and the juvenile mortality rate was 0.80, and both rates are similar to rates reported for kit foxes in other locations. There was no significant difference between male and female mortality rates in either age class. The proportions of dead kit foxes recovered in different habitat types were similar to the availability of the habitat types within the distribution of kit fox on the installation.« less

  6. Administrative Databases in Orthopaedic Research: Pearls and Pitfalls of Big Data.

    PubMed

    Patel, Alpesh A; Singh, Kern; Nunley, Ryan M; Minhas, Shobhit V

    2016-03-01

    The drive for evidence-based decision-making has highlighted the shortcomings of traditional orthopaedic literature. Although high-quality, prospective, randomized studies in surgery are the benchmark in orthopaedic literature, they are often limited by size, scope, cost, time, and ethical concerns and may not be generalizable to larger populations. Given these restrictions, there is a growing trend toward the use of large administrative databases to investigate orthopaedic outcomes. These datasets afford the opportunity to identify a large numbers of patients across a broad spectrum of comorbidities, providing information regarding disparities in care and outcomes, preoperative risk stratification parameters for perioperative morbidity and mortality, and national epidemiologic rates and trends. Although there is power in these databases in terms of their impact, potential problems include administrative data that are at risk of clerical inaccuracies, recording bias secondary to financial incentives, temporal changes in billing codes, a lack of numerous clinically relevant variables and orthopaedic-specific outcomes, and the absolute requirement of an experienced epidemiologist and/or statistician when evaluating results and controlling for confounders. Despite these drawbacks, administrative database studies are fundamental and powerful tools in assessing outcomes on a national scale and will likely be of substantial assistance in the future of orthopaedic research.

  7. Some estimates of growth and mortality from the Malheur National Forest in eastern Oregon.

    Treesearch

    Donald R. Gedney; Floyd A. Johnson; Vernon E. Hicks

    1959-01-01

    During 1955-56 an inventory was made of forested land in the Middle Fork Working Circle of the Malheur National Forest to provide information necessary for calculation of the allowable cut and for other management purposes. The growth and mortality estimates in the following report were obtained from this inventory. Although the estimates apply directly to the Middle...

  8. Trends in Coronary Revascularization and Ischemic Heart Disease-Related Mortality in Israel.

    PubMed

    Blumenfeld, Orit; Na'amnih, Wasef; Shapira-Daniels, Ayelet; Lotan, Chaim; Shohat, Tamy; Shapira, Oz M

    2017-02-17

    We investigated national trends in volume and outcomes of percutaneous coronary angioplasty (PCI), coronary artery bypass grafting (CABG), and ischemic heart disease-related mortality in Israel. Using International Classification of Diseases 9th and 10th revision codes, we linked 5 Israeli national databases, including the Israel Center for Disease Control National PCI and CABG Registries, the Ministry of Health Hospitalization Report, the Center of Bureau of Statistics, and the Ministry of Interior Mortality Report, to assess the annual PCI and CABG volume, procedural mortality, comorbidities, and ischemic heart disease-related mortality between 2002 and 2014. Trends over time were analyzed using linear regression, assuming a Poisson distribution. A total of 298 390 revascularization procedures (PCI: 255 724, CABG: 42 666) were performed during the study period. PCI volume increased by 9% from 2002 to 2008 (387.4/100 000 to 423.2/100 000), steadily decreasing by 10.5% to 378.5/100 000 in 2014 ( P =0.70 for the trend). CABG volume decreased by 59% (109.0/100 000 to 45.2/100 000) from 2002 to 2013, leveling at 46.4/100 000 ( P <0.0001). PCI/CABG ratio increased from 3.6 in 2002 to 8.5 in 2013, slightly decreasing to 8.2 by 2014 ( P <0.0001). In-hospital procedural mortality remained stable (PCI: 1.2-1.6%, P =0.34, CABG: 3.7-4.4%, P =0.29) despite a significant change in patient clinical profile. During the course of the study, ischemic heart disease-related mortality decreased by 46% (84.6-46/100 000, P <0.001). We observed a dramatic change in coronary revascularization procedures type and volume, and a marked decrease in ischemic heart disease-related mortality in Israel. The reasons for the observed changes remain unclear and need to be further investigated. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Leveraging a Critical Care Database

    PubMed Central

    Ghassemi, Marzyeh; Marshall, John; Singh, Nakul; Stone, David J.

    2014-01-01

    Background: Observational studies have found an increased risk of adverse effects such as hemorrhage, stroke, and increased mortality in patients taking selective serotonin reuptake inhibitors (SSRIs). The impact of prior use of these medications on outcomes in critically ill patients has not been previously examined. We performed a retrospective study to determine if preadmission use of SSRIs or serotonin norepinephrine reuptake inhibitors (SNRIs) is associated with mortality differences in patients admitted to the ICU. Methods: The retrospective study used a modifiable data mining technique applied to the publicly available Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) 2.6 database. A total of 14,709 patient records, consisting of 2,471 in the SSRI/SNRI group and 12,238 control subjects, were analyzed. The study outcome was in-hospital mortality. Results: After adjustment for age, Simplified Acute Physiology Score, vasopressor use, ventilator use, and combined Elixhauser score, SSRI/SNRI use was associated with significantly increased in-hospital mortality (OR, 1.19; 95% CI, 1.02-1.40; P = .026). Among patient subgroups, risk was highest in patients with acute coronary syndrome (OR, 1.95; 95% CI, 1.21-3.13; P = .006) and patients admitted to the cardiac surgery recovery unit (OR, 1.51; 95% CI, 1.11-2.04; P = .008). Mortality appeared to vary by specific SSRI, with higher mortalities associated with higher levels of serotonin inhibition. Conclusions: We found significant increases in hospital stay mortality among those patients in the ICU taking SSRI/SNRIs prior to admission as compared with control subjects. Mortality was higher in patients receiving SSRI/SNRI agents that produce greater degrees of serotonin reuptake inhibition. The study serves to demonstrate the potential for the future application of advanced data examination techniques upon detailed (and growing) clinical databases being made available by the digitization of medicine. PMID

  10. Mortality of captive black-footed ferrets (Mustela nigripes) at Smithsonian's National Zoological Park, 1989-2004.

    PubMed

    Bronson, Ellen; Bush, Mitchell; Viner, Tabitha; Murray, Suzan; Wisely, Samantha M; Deem, Sharon L

    2007-06-01

    Black-footed ferret (Mustela nigripes) mortality was investigated retrospectively based on the pathology records of 107 captive animals held at Smithsonian's National Zoological Park from 1989 to 2004. The majority of deaths in neonates were due to cannibalism (n = 42; 64.6%) and maternal trauma (n = 11; 16.9%); both of these causes of mortality decreased during the study period. Prior to 2001, juvenile mortality was most often caused by gastrointestinal disease (n = 11; 52.4%), including coccidiosis, salmonellosis, and clostridium infection. In 2001, improvements in husbandry, hygiene, and medical treatment led to decreases in juvenile mortality associated with gastrointestinal disease. The most common causes of death in adult ferrets were renal or neoplastic disease. The etiology of the high prevalence of renal disease in the last 4 yr of the study is unknown; it was not associated with increasing age or inbreeding. Improved hygiene and vigilant monitoring for signs of gastrointestinal and renal disease will continue to improve the success of the captive propagation of this species.

  11. Is there a trade-off between fertility and longevity? A comparative study of women from three large historical databases accounting for mortality selection.

    PubMed

    Gagnon, Alain; Smith, Ken R; Tremblay, Marc; Vézina, Hélène; Paré, Paul-Philippe; Desjardins, Bertrand

    2009-01-01

    Frontier populations provide exceptional opportunities to test the hypothesis of a trade-off between fertility and longevity. In such populations, mechanisms favoring reproduction usually find fertile ground, and if these mechanisms reduce longevity, demographers should observe higher postreproductive mortality among highly fertile women. We test this hypothesis using complete female reproductive histories from three large demographic databases: the Registre de la population du Québec ancien (Université de Montréal), which covers the first centuries of settlement in Quebec; the BALSAC database (Université du Québec à Chicoutimi), including comprehensive records for the Saguenay-Lac-St-Jean (SLSJ) in Quebec in the nineteenth and twentieth centuries; and the Utah Population Database (University of Utah), including all individuals who experienced a vital event on the Mormon Trail and their descendants. Together, the three samples allow for comparisons over time and space, and represent one of the largest set of natural fertility cohorts used to simultaneously assess reproduction and longevity. Using survival analyses, we found a negative influence of parity and a positive influence of age at last child on postreproductive survival in the three populations, as well as a significant interaction between these two variables. The effect sizes of all these parameters were remarkably similar in the three samples. However, we found little evidence that early fertility affects postreproductive survival. The use of Heckman's procedure assessing the impact of mortality selection during reproductive ages did not appreciably alter these results. We conclude our empirical investigation by discussing the advantages of comparative approaches. 2009 Wiley-Liss, Inc.

  12. Conference Proceedings: “Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks”

    PubMed Central

    Oster-Granite, Mary Lou; Parisi, Melissa A.; Abbeduto, Leonard; Berlin, Dorit S.; Bodine, Cathy; Bynum, Dana; Capone, George; Collier, Elaine; Hall, Dan; Kaeser, Lisa; Kaufmann, Petra; Krischer, Jeffrey; Livingston, Michelle; McCabe, Linda L.; Pace, Jill; Pfenninger, Karl; Rasmussen, Sonja A.; Reeves, Roger H.; Rubinstein, Yaffa; Sherman, Stephanie; Terry, Sharon F.; Whitten, Michelle Sie; Williams, Stephen; McCabe, Edward R.B.; Maddox, Yvonne T.

    2011-01-01

    A December 2010 meeting, “Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks,” was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome. They charged the participants to focus on the separate issues of contact registries, research databases, and biobanks through both podium presentations and breakout session discussions. Among the breakout groups for each of the major sessions, participants were asked to generate responses to questions posed by the organizers concerning these three research resources as they related to Down syndrome and then to report back to the group at large with a summary of their discussions. This report represents a synthesis of the discussions and suggested approaches formulated by the group as a whole. PMID:21835664

  13. Reductions in Cardiovascular, Cerebrovascular, and Respiratory Mortality following the National Irish Smoking Ban: Interrupted Time-Series Analysis

    PubMed Central

    Stallings-Smith, Sericea; Zeka, Ariana; Goodman, Pat; Kabir, Zubair; Clancy, Luke

    2013-01-01

    Background Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. Methods A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76–0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63–0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54–0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46–0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35–64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32–0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305–4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. Conclusions The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular

  14. Pneumonia Mortality in Children Aged <5 Years in 56 Countries: A Retrospective Analysis of Trends from 1960 to 2012.

    PubMed

    Wu, Jie; Yang, Shigui; Cao, Qing; Ding, Cheng; Cui, Yuanxia; Zhou, Yuqing; Li, Yiping; Deng, Min; Wang, Chencheng; Xu, Kaijin; Ruan, Bing; Li, Lanjuan

    2017-10-30

    Pneumonia is now the second leading cause of death for children aged <5 years worldwide. However, analyses of the long-term evolution of under-5 mortality from pneumonia are still scarce in the literature. We aimed to explore long-term trends of under-5 mortality from pneumonia in 56 countries from 1960 to 2012. Data on under-5 mortality from pneumonia were extracted from the World Health Organization mortality database. Long-term trends were assessed for 56 countries and for 4 national income transition groups. We also used joinpoint regression analysis to detect distinct period segments of long-term trends and estimate the annual percent of changes of each period segment. The average mortality rate from pneumonia for children aged 0-4 years in 56 countries declined from 163.0 per 100000 children (95% confidence interval [CI], 119.4 to 212.8) in 1960 to 9.9 per 100000 children (95% CI, 6.4 to 13.4) in 2012, with an average annual percent of change of -5.6% (95% CI, -7.2% to -3.9%). The temporal trends of childhood mortality were different between national income transition groups. Our findings suggest a striking overall downward trend in under-5 mortality from pneumonia between 1960 and 2012. However, the rate and absolute terms of decline differ by national income transition group. These variable patterns between national income transition groups may inform further intervention setting and priority setting. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  15. Morbidity and Mortality Associated with Geriatric Ankle Fractures: A Medicare Part A Claims Database Analysis.

    PubMed

    Hsu, Raymond Y; Lee, Yoojin; Hayda, Roman; DiGiovanni, Christopher W; Mor, Vincent; Bariteau, Jason T

    2015-11-04

    The purpose of this study was to examine the incidence of adverse events in elderly patients who required inpatient admission after sustaining an ankle fracture and to consider these data in relation to geriatric hip fracture and other geriatric patient admissions. A retrospective cohort study of patients admitted with an ankle fracture, a hip fracture, or any other diagnosis was performed with the Medicare Part A database for 2008. The primary outcome measure was the one-year mortality rate, examined with multivariate analysis factoring for both patient age and preexisting comorbidity. Secondary outcome measures analyzed additional morbidity as reflected by length of stay, discharge disposition, readmissions, and medical complications. There were 19,648 patients with ankle fractures, 193,980 patients with hip fractures, and 5,801,831 patients with other admitting diagnoses. Significant differences (p < 0.001) were noted in both age and comorbidity status between the group with ankle fractures and the group with hip fractures. The one-year mortality after admission was 11.9% for patients with ankle fracture, 28.2% for patients with hip fracture, and 21.5% for patients with any other admission. Upon using multivariate analysis to account for both age and comorbidity, the hazard ratio for one-year mortality associated with fracture was 1.088 for patients with hip fracture and 0.557 for patients with ankle fracture. Even after selecting for admitted patients and accounting for both age and comorbidity, geriatric patients with ankle fractures were found to have a lower one-year morbidity compared with geriatric patients who had sustained a hip fracture or alternative admitting diagnoses. Geriatric patients with ankle fractures are likely healthier and more active in ways that are not captured by simply accounting for age and comorbidity. These findings may support more aggressive definitive management of such injuries in this population. Prognostic Level III. See

  16. Maize databases

    USDA-ARS?s Scientific Manuscript database

    This chapter is a succinct overview of maize data held in the species-specific database MaizeGDB (the Maize Genomics and Genetics Database), and selected multi-species data repositories, such as Gramene/Ensembl Plants, Phytozome, UniProt and the National Center for Biotechnology Information (NCBI), ...

  17. Mortality from systemic erythematosus lupus in Brazil: evaluation of causes according to the government health database.

    PubMed

    Costi, Luisa Ribeiro; Iwamoto, Hatsumi Miyashiro; Neves, Dilma Costa de Oliveira; Caldas, Cezar Augusto Muniz

    To characterize the causes of mortality in patients with systemic lupus erythematosus (SLE) in Brazil between 2002 and 2011. An exploratory ecological study of a time series using data from the Mortality Information System of DATASUS, the Department of the Unified Health System (Brazil's National Health System). Brazil's SLE mortality rate was 4.76 deaths/10 5 inhabitants. The mortality rate was higher in the Midwest, North and Southeast regions than in the country as a whole. There were 6.3% fewer and 4.2% more deaths than expected in the Northeast and Southeast regions, respectively. The mean age at death was 40.7±18 years, and 45.61% of deaths occurred between the ages of 20 and 39. Incidence was highest in women (90.7%) and whites (49.2%). Disorders of the musculoskeletal system and connective tissue were mentioned as an underlying cause of death in 77.5% of cases, and diseases of the circulatory system and infectious and parasitic diseases were also noted in fewer cases. SLE was mentioned as an underlying cause of death in 77% of cases, with no difference between the Brazilian regions (p=0.2058). The main SLE-related causes of death were, sequentially, diseases of the respiratory and circulatory systems and infectious and parasitic diseases. This study identified a need for greater control of risk factors for cardiovascular diseases and a better understanding of the pathogenesis of atherosclerosis in SLE. Infectious causes are still frequent, and management should be improved, especially in the early stages of the disease. Copyright © 2017 Elsevier Editora Ltda. All rights reserved.

  18. Overcoming barriers to a research-ready national commercial claims database.

    PubMed

    Newman, David; Herrera, Carolina-Nicole; Parente, Stephen T

    2014-11-01

    Billions of dollars have been spent on the goal of making healthcare data available to clinicians and researchers in the hopes of improving healthcare and lowering costs. However, the problems of data governance, distribution, and accessibility remain challenges for the healthcare system to overcome. In this study, we discuss some of the issues around holding, reporting, and distributing data, including the newest "big data" challenge: making the data accessible to researchers and policy makers. This article presents a case study in "big healthcare data" involving the Health Care Cost Institute (HCCI). HCCI is a nonprofit, nonpartisan, independent research institute that serves as a voluntary repository of national commercial healthcare claims data. Governance of large healthcare databases is complicated by the data-holding model and further complicated by issues related to distribution to research teams. For multi-payer healthcare claims databases, the 2 most common models of data holding (mandatory and voluntary) have different data security requirements. Furthermore, data transport and accessibility may require technological investment. HCCI's efforts offer insights from which other data managers and healthcare leaders may benefit when contemplating a data collaborative.

  19. Spatially detailed water footprint assessment using the U.S. National Water-Economy Database

    NASA Astrophysics Data System (ADS)

    Ruddell, B. L.

    2015-12-01

    The new U.S. National Water-Economy Database (NWED) provides a complete picture of water use and trade in water-derived goods and services in the U.S. economy, by economic sector, at the county and metropolitan area scale. This data product provides for the first time a basis for spatially detailed calculations of water footprints and virtual water trade in the entire U.S.. This talk reviews the general patterns of U.S. water footprint and virtual water trade, at the county scale., and provides an opportunity for the community to discuss applications of this database for water resource policy and economics. The water footprints of irrigated agriculture and energy are specifically addressed, as well as overall patterns of water use in the economy.

  20. Prediction of Cancer Incidence and Mortality in Korea, 2018.

    PubMed

    Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Lee, Eun Sook

    2018-04-01

    This study aimed to report on cancer incidence and mortality for the year 2018 to estimate Korea's current cancer burden. Cancer incidence data from 1999 to 2015 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2016 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly, we only used the data of the latest trend. A total of 204,909 new cancer cases and 82,155 cancer deaths are expected to occur in Korea in 2018. The most common cancer sites were lung, followed by stomach, colorectal, breast and liver. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites were lung cancer, followed by liver, colorectal, stomach and pancreas. The incidence rate of all cancer in Korea are estimated to decrease gradually, mainly due to decrease of thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs.

  1. Impact of pneumococcal conjugate vaccine in children morbidity and mortality in Peru: Time series analyses.

    PubMed

    Suarez, Victor; Michel, Fabiana; Toscano, Cristiana M; Bierrenbach, Ana Luiza; Gonzales, Marco; Alencar, Airlane Pereira; Ruiz Matus, Cuauhtemoc; Andrus, Jon K; de Oliveira, Lucia H

    2016-09-07

    Streptococcus pneumoniae is the leading cause of bacterial pneumonia, meningitis and sepsis in children worldwide. Despite available evidence on pneumococcal conjugate vaccine (PCV) impact on pneumonia hospitalizations in children, studies demonstrating PCV impact in morbidity and mortality in middle-income countries are still scarce. Given the disease burden, PCV7 was introduced in Peru in 2009, and then switched to PCV10 in late 2011. National public healthcare system provides care for 60% of the population, and national hospitalization, outpatient and mortality data are available. We thus aimed to assess the effects of routine PCV vaccination on pneumonia hospitalization and mortality, and acute otitis media (AOM) and all cause pneumonia outpatient visits in children under one year of age in Peru. We conducted a segmented time-series analysis using outcome-specific regression models. Study period was from January 2006 to December 2012. Data sources included the National information systems for hospitalization, mortality, outpatient visits, and RENACE, the national database of aggregated weekly notifications of pneumonia and other acute respiratory diseases (both hospitalized and non-hospitalized). Study outcomes included community acquired pneumonia outpatient visits, hospitalizations and deaths (ICD10 codes J12-J18); and AOM outpatient visits (H65-H67). Monthly age- and sex-specific admission, outpatient visit, and mortality rates per 100,000 children aged <1year, as well as weekly rates for pneumonia and AOM recorded in RENACE were estimated. After PCV introduction, we observed significant vaccine impact in morbidity and mortality in children aged <1year. Vaccine effectiveness was 26.2% (95% CI 16.9-34.4) for AOM visits, 35% (95% CI 8.6-53.8) for mortality due to pneumonia, and 20.6% (95% CI 10.6-29.5) for weekly cases of pneumonia hospitalization and outpatient visits notified to RENACE. We used secondary data sources which are usually developed for other non

  2. Bladder Cancer Mortality in the United States: A Geographic and Temporal Analysis of Socioeconomic and Environmental Factors.

    PubMed

    Smith, Norm D; Prasad, Sandip M; Patel, Amit R; Weiner, Adam B; Pariser, Joseph J; Razmaria, Aria; Maene, Chieko; Schuble, Todd; Pierce, Brandon; Steinberg, Gary D

    2016-02-01

    We assessed the association of temporal, socioeconomic and environmental factors with bladder cancer mortality in the United States. Our hypothesis was that bladder cancer mortality is associated with distinct environmental and socioeconomic factors with effects varying by region, race and gender. NCI (National Cancer Institute) age adjusted, county level bladder cancer mortality data from 1950 to 2007 were analyzed to identify clusters of increased bladder cancer death using the Getis-Ord Gi* statistic. Socioeconomic, clinical and environmental data were assessed using geographically weighted spatial regression analysis adjusting for spatial autocorrelation. County level socioeconomic, clinical and environmental data were obtained from national databases, including the United States Census, CDC (Centers for Disease Control and Prevention), NCHS (National Center for Health Statistics) and County Health Rankings. Bladder cancer mortality hot spots and risk factors for bladder cancer death differed significantly by gender, race and geographic region. From 1996 to 2007 smoking, unemployment, physically unhealthy days, air pollution ozone days, percent of houses with well water, employment in the mining industry and urban residences were associated with increased rates of bladder cancer mortality (p <0.05). Model fit was significantly improved in hot spots compared to all American counties (R(2) = 0.20 vs 0.05). Environmental and socioeconomic factors affect bladder cancer mortality and effects appear to vary by gender and race. Additionally there were temporal trends of bladder cancer hot spots which, when persistent, should be the focus of individual level studies of occupational and environmental factors. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Multicenter neonatal databases: Trends in research uses.

    PubMed

    Creel, Liza M; Gregory, Sean; McNeal, Catherine J; Beeram, Madhava R; Krauss, David R

    2017-01-13

    In the US, approximately 12.7% of all live births are preterm, 8.2% of live births were low birth weight (LBW), and 1.5% are very low birth weight (VLBW). Although technological advances have improved mortality rates among preterm and LBW infants, improving overall rates of prematurity and LBW remains a national priority. Monitoring short- and long-term outcomes is critical for advancing medical treatment and minimizing morbidities associated with prematurity or LBW; however, studying these infants can be challenging. Several large, multi-center neonatal databases have been developed to improve research and quality improvement of treatments for and outcomes of premature and LBW infants. The purpose of this systematic review was to describe three multi-center neonatal databases. We conducted a literature search using PubMed and Google Scholar over the period 1990 to August 2014. Studies were included in our review if one of the databases was used as a primary source of data or comparison. Included studies were categorized by year of publication; study design employed, and research focus. A total of 343 studies published between 1991 and 2014 were included. Studies of premature and LBW infants using these databases have increased over time, and provide evidence for both neonatology and community-based pediatric practice. Research into treatment and outcomes of premature and LBW infants is expanding, partially due to the availability of large, multicenter databases. The consistency of clinical conditions and neonatal outcomes studied since 1990 demonstrates that there are dedicated research agendas and resources that allow for long-term, and potentially replicable, studies within this population.

  4. Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives.

    PubMed

    Saltzman, Bryan M; Cvetanovich, Gregory L; Bohl, Daniel D; Cole, Brian J; Bach, Bernard R; Romeo, Anthony A

    2016-09-01

    There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies. Cross-sectional study; Level of evidence, 3. This study utilized patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), meniscectomy (MX), rotator cuff repair (RCR), and shoulder stabilization (SS) from the NSQIP database (2005-2013). Two prospective studies (either randomized controlled trials or, in 1 case, a major cohort study) were identified for each of the 4 procedures for comparison. Demographic variables available for comparison in both the identified prospective studies and the NSQIP included age, sex, and body mass index (BMI). From the NSQIP database, 5576 ACLR patients, 18,882 MX patients, 7282 RCR patients, and 993 SS patients were identified. The comparison clinical studies included cohort sizes as follows: ACLR, n = 121 and 2683; MX, n = 146 and 330; RCR, n = 90 and 103; SS, n = 88 and 196. Age differed significantly between the NSQIP and the patients in 6 of the 8 prospective clinical studies. Sex differed significantly between the NSQIP and the patients in 7 of the 8 prospective clinical studies. BMI differed significantly between the NSQIP and the patients of all 4 of the prospective clinical studies that reported this demographic variable. Significant differences exist for patient age, sex, and BMI between patients included in major sports medicine

  5. Characteristics, availability and uses of vital registration and other mortality data sources in post-democracy South Africa

    PubMed Central

    Joubert, Jané; Rao, Chalapati; Bradshaw, Debbie; Dorrington, Rob E.; Vos, Theo; Lopez, Alan D.

    2012-01-01

    The value of good-quality mortality data for public health is widely acknowledged. While effective civil registration systems remains the ‘gold standard’ source for continuous mortality measurement, less than 25% of deaths are registered in most African countries. Alternative data collection systems can provide mortality data to complement those from civil registration, given an understanding of data source characteristics and data quality. We aim to document mortality data sources in post-democracy South Africa; to report on availability, limitations, strengths, and possible complementary uses of the data; and to make recommendations for improved data for mortality measurement. Civil registration and alternative mortality data collection systems, data availability, and complementary uses were assessed by reviewing blank questionnaires, death notification forms, death data capture sheets, and patient cards; legislation; electronic data archives and databases; and related information in scientific journals, research reports, statistical releases, government reports and books. Recent transformation has enhanced civil registration and official mortality data availability. Additionally, a range of mortality data items are available in three population censuses, three demographic surveillance systems, and a number of national surveys, mortality audits, and disease notification programmes. Child and adult mortality items were found in all national data sources, and maternal mortality items in most. Detailed cause-of-death data are available from civil registration and demographic surveillance. In a continent often reported as lacking the basic data to infer levels, patterns and trends of mortality, there is evidence of substantial improvement in South Africa in the availability of data for mortality assessment. Mortality data sources are many and varied, providing opportunity for comparing results and improved public health planning. However, more can and must be

  6. Characteristics, availability and uses of vital registration and other mortality data sources in post-democracy South Africa.

    PubMed

    Joubert, Jané; Rao, Chalapati; Bradshaw, Debbie; Dorrington, Rob E; Vos, Theo; Lopez, Alan D

    2012-12-27

    The value of good-quality mortality data for public health is widely acknowledged. While effective civil registration systems remains the 'gold standard' source for continuous mortality measurement, less than 25% of deaths are registered in most African countries. Alternative data collection systems can provide mortality data to complement those from civil registration, given an understanding of data source characteristics and data quality. We aim to document mortality data sources in post-democracy South Africa; to report on availability, limitations, strengths, and possible complementary uses of the data; and to make recommendations for improved data for mortality measurement. Civil registration and alternative mortality data collection systems, data availability, and complementary uses were assessed by reviewing blank questionnaires, death notification forms, death data capture sheets, and patient cards; legislation; electronic data archives and databases; and related information in scientific journals, research reports, statistical releases, government reports and books. Recent transformation has enhanced civil registration and official mortality data availability. Additionally, a range of mortality data items are available in three population censuses, three demographic surveillance systems, and a number of national surveys, mortality audits, and disease notification programmes. Child and adult mortality items were found in all national data sources, and maternal mortality items in most. Detailed cause-of-death data are available from civil registration and demographic surveillance. In a continent often reported as lacking the basic data to infer levels, patterns and trends of mortality, there is evidence of substantial improvement in South Africa in the availability of data for mortality assessment. Mortality data sources are many and varied, providing opportunity for comparing results and improved public health planning. However, more can and must be done to

  7. The Chilean infant mortality decline: improvement for whom? Socioeconomic and geographic inequalities in infant mortality, 1990-2005.

    PubMed

    Hertel-Fernandez, Alexander Warren; Giusti, Alejandro Esteban; Sotelo, Juan Manuel

    2007-10-01

    To measure socioeconomic inequalities and differential risk in infant mortality on national and regional levels in Chile from 1990 to 2005, and propose new policy targets. The study analysed Chilean vital events registries from 1990 to 2005 for infant mortality by maternal education, head of household occupational status, cause, age and location of death. Annual infant mortality rates and relative risk were calculated by maternal education and head of household occupational status for each cause and age of death. Socioeconomic inequalities were then mapped to 29 regional health services. Reductions in the national infant mortality rate were driven by reductions among highly educated mothers, while recent stagnation in the national rate is caused by high levels of infant mortality among uneducated mothers. These vulnerable households are particularly prone to infant mortality risk due to infectious disease and trauma. We also identify clustering of high socioeconomic inequalities in infant mortality throughout the poorer north, indigenous south and densely populated metropolitan centre of Santiago. Finally, we report large inequities in vital statistics coverage, with infant deaths among vulnerable households much more likely to be inadequately defined than in the remaining population. These results indicate that the socioeconomically disadvantaged in Chile are at a significantly higher risk for infant mortality by infectious diseases and trauma during the first month of life. Efforts to reduce national infant mortality in Chile and other countries must involve policies that target child survival for at-risk populations for specific diseases, ages and locations.

  8. Race Matters: Analyzing the Relationship between Colorectal Cancer Mortality Rates and Various Factors within Respective Racial Groups.

    PubMed

    Veach, Emma; Xique, Ismael; Johnson, Jada; Lyle, Jessica; Almodovar, Israel; Sellers, Kimberly F; Moore, Calandra T; Jackson, Monica C

    2014-01-01

    Colorectal cancer (CRC) is the third leading cause of mortality due to cancer (with over 50,000 deaths annually), representing 9% of all cancer deaths in the United States (1). In particular, the African-American CRC mortality rate is among the highest reported for any race/ethnic group. Meanwhile, the CRC mortality rate for Hispanics is 15-19% lower than that for non-Hispanic Caucasians (2). While factors such as obesity, age, and socio-economic status are known to associate with CRC mortality, do these and other potential factors correlate with CRC death in the same way across races? This research linked CRC mortality data obtained from the National Cancer Institute with data from the United States Census Bureau, the Centers for Disease Control and Prevention, and the National Solar Radiation Database to examine geographic and racial/ethnic differences, and develop a spatial regression model that adjusted for several factors that may attribute to health disparities among ethnic/racial groups. This analysis showed that sunlight, obesity, and socio-economic status were significant predictors of CRC mortality. The study is significant because it not only verifies known factors associated with the risk of CRC death but, more importantly, demonstrates how these factors vary within different racial groups. Accordingly, education on reducing risk factors for CRC should be directed at specific racial groups above and beyond creating a generalized education plan.

  9. Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit & Research Centre Case Mix Programme Database

    PubMed Central

    2005-01-01

    Introduction The present paper describes the methods of data collection and validation employed in the Intensive Care National Audit & Research Centre Case Mix Programme (CMP), a national comparative audit of outcome for adult, critical care admissions. The paper also describes the case mix, outcome and activity of the admissions in the Case Mix Programme Database (CMPD). Methods The CMP collects data on consecutive admissions to adult, general critical care units in England, Wales and Northern Ireland. Explicit steps are taken to ensure the accuracy of the data, including use of a dataset specification, of initial and refresher training courses, and of local and central validation of submitted data for incomplete, illogical and inconsistent values. Criteria for evaluating clinical databases developed by the Directory of Clinical Databases were applied to the CMPD. The case mix, outcome and activity for all admissions were briefly summarised. Results The mean quality level achieved by the CMPD for the 10 Directory of Clinical Databases criteria was 3.4 (on a scale of 1 = worst to 4 = best). The CMPD contained validated data on 129,647 admissions to 128 units. The median age was 63 years, and 59% were male. The mean Acute Physiology and Chronic Health Evaluation II score was 16.5. Mortality was 20.3% in the CMP unit and was 30.8% at ultimate discharge from hospital. Nonsurvivors stayed longer in intensive care than did survivors (median 2.0 days versus 1.7 days in the CMP unit) but had a shorter total hospital length of stay (9 days versus 16 days). Results for the CMPD were comparable with results from other published reports of UK critical care admissions. Conclusions The CMP uses rigorous methods to ensure data are complete, valid and reliable. The CMP scores well against published criteria for high-quality clinical databases.

  10. Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit & Research Centre Case Mix Programme Database

    PubMed Central

    Harrison, David A; Brady, Anthony R; Rowan, Kathy

    2004-01-01

    Introduction The present paper describes the methods of data collection and validation employed in the Intensive Care National Audit & Research Centre Case Mix Programme (CMP), a national comparative audit of outcome for adult, critical care admissions. The paper also describes the case mix, outcome and activity of the admissions in the Case Mix Programme Database (CMPD). Methods The CMP collects data on consecutive admissions to adult, general critical care units in England, Wales and Northern Ireland. Explicit steps are taken to ensure the accuracy of the data, including use of a dataset specification, of initial and refresher training courses, and of local and central validation of submitted data for incomplete, illogical and inconsistent values. Criteria for evaluating clinical databases developed by the Directory of Clinical Databases were applied to the CMPD. The case mix, outcome and activity for all admissions were briefly summarised. Results The mean quality level achieved by the CMPD for the 10 Directory of Clinical Databases criteria was 3.4 (on a scale of 1 = worst to 4 = best). The CMPD contained validated data on 129,647 admissions to 128 units. The median age was 63 years, and 59% were male. The mean Acute Physiology and Chronic Health Evaluation II score was 16.5. Mortality was 20.3% in the CMP unit and was 30.8% at ultimate discharge from hospital. Nonsurvivors stayed longer in intensive care than did survivors (median 2.0 days versus 1.7 days in the CMP unit) but had a shorter total hospital length of stay (9 days versus 16 days). Results for the CMPD were comparable with results from other published reports of UK critical care admissions. Conclusions The CMP uses rigorous methods to ensure data are complete, valid and reliable. The CMP scores well against published criteria for high-quality clinical databases. PMID:15025784

  11. Home Literacy Experiences and Early Childhood Disability: A Descriptive Study Using the National Household Education Surveys (NHES) Program Database

    ERIC Educational Resources Information Center

    Breit-Smith, Allison; Cabell, Sonia Q.; Justice, Laura M.

    2010-01-01

    Purpose: The present article illustrates how the National Household Education Surveys (NHES; U.S. Department of Education, 2009) database might be used to address questions of relevance to researchers who are concerned with literacy development among young children. Following a general description of the NHES database, a study is provided that…

  12. Data resource profile: United Nations Children's Fund (UNICEF).

    PubMed

    Murray, Colleen; Newby, Holly

    2012-12-01

    The United Nations Children's Fund (UNICEF) plays a leading role in the collection, compilation, analysis and dissemination of data to inform sound policies, legislation and programmes for promoting children's rights and well-being, and for global monitoring of progress towards the Millennium Development Goals. UNICEF maintains a set of global databases representing nearly 200 countries and covering the areas of child mortality, child health, maternal health, nutrition, immunization, water and sanitation, HIV/AIDS, education and child protection. These databases consist of internationally comparable and statistically sound data, and are updated annually through a process that draws on a wealth of data provided by UNICEF's wide network of >150 field offices. The databases are composed primarily of estimates from household surveys, with data from censuses, administrative records, vital registration systems and statistical models contributing to some key indicators as well. The data are assessed for quality based on a set of objective criteria to ensure that only the most reliable nationally representative information is included. For most indicators, data are available at the global, regional and national levels, plus sub-national disaggregation by sex, urban/rural residence and household wealth. The global databases are featured in UNICEF's flagship publications, inter-agency reports, including the Secretary General's Millennium Development Goals Report and Countdown to 2015, sector-specific reports and statistical country profiles. They are also publicly available on www.childinfo.org, together with trend data and equity analyses.

  13. Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development

    PubMed Central

    Singh, Gopal K.; Azuine, Romuladus E.; Siahpush, Mohammad

    2012-01-01

    Objectives This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI), socioeconomic factors, Gender Inequality Index (GII), and healthcare expenditure. Methods Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates. Results Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks. Conclusions and Public Health Implications Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by reducing

  14. Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development.

    PubMed

    Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad

    2012-01-01

    This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI), socioeconomic factors, Gender Inequality Index (GII), and healthcare expenditure. Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates. Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks. Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by reducing inequalities in socioeconomic conditions, availability of preventive health

  15. NPL-PAD (National Priorities List Publication Assistance Database) for Region 7

    EPA Pesticide Factsheets

    THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the National Priorities List (NPL) Publication Assistance Databsae (PAD), a Lotus Notes application that holds Region 7's universe of NPL site information such as site description, threats and contaminants, cleanup approach, environmental process, community involvement, site repository, and regional contacts. This database used to be updated annually, at different times for different NPLs, but it is currently no longer being used. This work fell under objectives for EPA's 2003-2008 Strategic Plan (Goal 3) for Land Preservation & Restoration, which are to clean up and reuse contaminated land.

  16. What Is the Best Way to Measure Surgical Quality? Comparing the American College of Surgeons National Surgical Quality Improvement Program versus Traditional Morbidity and Mortality Conferences.

    PubMed

    Zhang, Jacques X; Song, Diana; Bedford, Julie; Bucevska, Marija; Courtemanche, Douglas J; Arneja, Jugpal S

    2016-04-01

    Morbidity and mortality conferences have played a traditional role in tracking complications. Recently, the American College of Surgeons National Surgical Quality Improvement Program Pediatrics (ACS NSQIP-P) has gained popularity as a risk-adjusted means of addressing quality assurance. The purpose of this article is to report an analysis of the two methodologies used within pediatric plastic surgery to determine the best way to manage quality. ACS NSQIP-P and morbidity and mortality data were extracted for 2012 and 2013 at a quaternary care institution. Overall complication rates were compared statistically, segregated by type and severity, followed by a subset comparison of ACS NSQIP-P-eligible cases only. Concordance and discordance rates between the two methodologies were determined. One thousand two hundred sixty-one operations were performed in the study period. Only 51.4 percent of cases were ACS NSQIP-P eligible. The overall complication rates of ACS NSQIP-P (6.62 percent) and morbidity and mortality conferences (6.11 percent) were similar (p = 0.662). Comparing for only ACS NSQIP-P-eligible cases also yielded a similar rate (6.62 percent versus 5.71 percent; p = 0.503). Although different complications are tracked, the concordance rate for morbidity and mortality and ACS NSQIP-P was 35.1 percent and 32.5 percent, respectively. The ACS NSQIP-P database is able to accurately track complication rates similarly to morbidity and mortality conferences, although it samples only half of all procedures. Although both systems offer value, limitations exist, such as differences in definitions and purpose. Because of the rigor of the ACS NSQIP-P, we recommend that it be expanded to include currently excluded cases and an extension of the study interval.

  17. Hospital days, hospitalization costs, and inpatient mortality among patients with mucormycosis: a retrospective analysis of US hospital discharge data

    PubMed Central

    2014-01-01

    Background Mucormycosis is a rare and potentially fatal fungal infection occurring primarily in severely immunosuppressed patients. Because it is so rare, reports in the literature are mainly limited to case reports or small case series. The aim of this study was to evaluate inpatient mortality, length of stay (LOS), and costs among a matched sample of high-risk patients with and without mucormycosis in a large nationally representative database. Methods We conducted a retrospective analysis using the 2003–2010 Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS). The NIS is a nationally representative 20% sample of hospitalizations from acute care United States (US) hospitals, with survey weights available to compute national estimates. We classified hospitalizations into four mutually exclusive risk categories for mucormycosis: A- severely immunocompromised, B- critically ill, C- mildly/moderately immunocompromised, D- major surgery or pneumonia. Mucormycosis hospitalizations (“cases”) were identified by ICD-9-CM code 117.7. Non-mucormycosis hospitalizations (“non-cases”) were propensity-score matched to cases 3:1. We examined demographics, clinical characteristics, and hospital outcomes (mortality, LOS, costs). Weighted results were reported. Results From 319,366,817 total hospitalizations, 5,346 cases were matched to 15,999 non-cases. Cases and non-cases did not differ significantly in age (49.6 vs. 49.7 years), female sex (40.5% vs. 41.0%), White race (53.3% vs. 55.9%) or high-risk group (A-49.1% vs. 49.0%, B-20.0% vs. 21.8%, C-25.5% vs. 23.8%, D-5.5% vs. 5.4%). Cases experienced significantly higher mortality (22.1% vs. 4.4%, P < 0.001), with mean LOS and total costs more than 3-fold higher (24.5 vs. 8.0 days and $90,272 vs. $25,746; both P < 0.001). Conclusions In a national hospital database, hospitalizations with mucormycosis had significantly higher inpatient mortality, LOS, and hospital costs than matched

  18. "Would you accept having your DNA profile inserted in the National Forensic DNA database? Why?" Results of a questionnaire applied in Portugal.

    PubMed

    Machado, Helena; Silva, Susana

    2014-01-01

    The creation and expansion of forensic DNA databases might involve potential threats to the protection of a range of human rights. At the same time, such databases have social benefits. Based on data collected through an online questionnaire applied to 628 individuals in Portugal, this paper aims to analyze the citizens' willingness to donate voluntarily a sample for profiling and inclusion in the National Forensic DNA Database and the views underpinning such a decision. Nearly one-quarter of the respondents would indicate 'no', and this negative response increased significantly with age and education. The overriding willingness to accept the inclusion of the individual genetic profile indicates an acknowledgement of the investigative potential of forensic DNA technologies and a relegation of civil liberties and human rights to the background, owing to the perceived benefits of protecting both society and the individual from crime. This rationale is mostly expressed by the idea that all citizens should contribute to the expansion of the National Forensic DNA Database for reasons that range from the more abstract assumption that donating a sample for profiling would be helpful in fighting crime to the more concrete suggestion that everyone (criminals and non-criminals) should be in the database. The concerns with the risks of accepting the donation of a sample for genetic profiling and inclusion in the National Forensic DNA Database are mostly related to lack of control and insufficient or unclear regulations concerning safeguarding individuals' data and supervising the access and uses of genetic data. By providing an empirically-grounded understanding of the attitudes regarding willingness to donate voluntary a sample for profiling and inclusion in a National Forensic DNA Database, this study also considers the citizens' perceived benefits and risks of operating forensic DNA databases. These collective views might be useful for the formation of international common

  19. Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey.

    PubMed

    Walker, Elizabeth Reisinger; Pratt, Laura A; Schoenborn, Charlotte A; Druss, Benjamin G

    2017-02-01

    The purpose of this study was to determine the mortality risks, over 20 years of follow-up in a nationally representative sample, associated with illegal drug use and to describe risk factors for mortality. We analyzed data from the 1991 National Health Interview Survey, which is a nationally representative household survey in the United States, linked to the National Death Index through 2011. This study included 20,498 adults, aged 18-44 years in 1991, with 1047 subsequent deaths. A composite variable of self-reported lifetime illegal drug use was created (hierarchical categories of heroin, cocaine, hallucinogens/inhalants, and marijuana use). Mortality risk was significantly elevated among individuals who reported lifetime use of heroin (HR=2.40, 95% CI: 1.65-3.48) and cocaine (HR=1.27, 95% CI: 1.04-1.55), but not for those who used hallucinogens/inhalants or marijuana, when adjusting for demographic characteristics. Baseline health risk factors (smoking, alcohol use, physical activity, and BMI) explained the greatest amount of this mortality risk. After adjusting for all baseline covariates, the association between heroin or cocaine use and mortality approached significance. In models adjusted for demographics, people who reported lifetime use of heroin or cocaine had an elevated mortality risk due to external causes (poisoning, suicide, homicide, and unintentional injury). People who had used heroin, cocaine, or hallucinogens/inhalants had an elevated mortality risk due to infectious diseases. Heroin and cocaine are associated with considerable excess mortality, particularly due to external causes and infectious diseases. This association can be explained mainly by health risk behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. National health care providers' database (NHCPD) of Slovenia--information technology solution for health care planning and management.

    PubMed

    Albreht, T; Paulin, M

    1999-01-01

    The article describes the possibilities of planning of the health care providers' network enabled by the use of information technology. The cornerstone of such planning is the development and establishment of a quality database on health care providers, health care professionals and their employment statuses. Based on the analysis of information needs, a new database was developed for various users in health care delivery as well as for those in health insurance. The method of information engineering was used in the standard four steps of the information system construction, while the whole project was run in accordance with the principles of two internationally approved project management methods. Special attention was dedicated to a careful analysis of the users' requirements and we believe the latter to be fulfilled to a very large degree. The new NHCPD is a relational database which is set up in two important state institutions, the National Institute of Public Health and the Health Insurance Institute of Slovenia. The former is responsible for updating the database, while the latter is responsible for the technological side as well as for the implementation of data security and protection. NHCPD will be inter linked with several other existing applications in the area of health care, public health and health insurance. Several important state institutions and professional chambers are users of the database in question, thus integrating various aspects of the health care system in Slovenia. The setting up of a completely revised health care providers' database in Slovenia is an important step in the development of a uniform and integrated information system that would support top decision-making processes at the national level.

  1. The impact of blood transfusion on perioperative outcomes following gastric cancer resection: an analysis of the American College of Surgeons National Surgical Quality Improvement Program database.

    PubMed

    Elmi, Maryam; Mahar, Alyson; Kagedan, Daniel; Law, Calvin H L; Karanicolas, Paul J; Lin, Yulia; Callum, Jeannie; Coburn, Natalie G; Hallet, Julie

    2016-09-01

    Red blood cell transfusions (RBCT) carry risk of transfusion-related immunodulation that may impact postoperative recovery. This study examined the association between perioperative RBCT and short-term postoperative outcomes following gastrectomy for gastric cancer. Using the American College of Surgeons National Surgical Quality Improvement Program database, we compared outcomes of patients (transfused v. nontransfused) undergoing elective gastrectomy for gastric cancer (2007-2012). Outcomes were 30-day major morbidity, mortality and length of stay. The association between perioperative RBCT and outcomes was estimated using modified Poisson, logistic, or negative binomial regression. Of the 3243 patients in the entire cohort, we included 2884 patients with nonmissing data, of whom 535 (18.6%) received RBCT. Overall 30-day major morbidity and mortality were 20% and 3.5%, respectively. After adjustment for baseline and clinical characteristics, RBCT was independently associated with increased 30-day mortality (relative risk [RR] 3.1, 95% confidence interval [CI] 1.9-5.0), major morbidity (RR 1.4, 95% CI 1.2-1.8), length of stay (RR 1.2, 95% CI 1.1-1.2), infections (RR 1.4, 95% CI 1.1-1.6), cardiac complications (RR 1.8, 95% CI 1.0-3.2) and respiratory failure (RR 2.3, 95% CI 1.6-3.3). Red blood cell transfusions are associated with worse postoperative short-term outcomes in patients with gastric cancer. Blood management strategies are needed to reduce the use of RBCT after gastrectomy for gastric cancer.

  2. Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries.

    PubMed

    Raj, Anita; Boehmer, Ulrike

    2013-04-01

    This study was designed to assess associations between national rates of girl child marriage and national rates of HIV and maternal and child health (MCH) concerns, using national indicator data from 2009 United Nations reports. Current analyses were limited to the N = 97 nations (of 188 nations) for which girl child marriage data were available. Regression analyses adjusted for development and world region demonstrate that nations with higher rates of girl child marriage are significantly more likely to contend with higher rates of maternal and infant mortality and nonutilization of maternal health services, but not HIV.

  3. The Danish Inguinal Hernia database.

    PubMed

    Friis-Andersen, Hans; Bisgaard, Thue

    2016-01-01

    To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Patients ≥18 years operated for groin hernia. Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair.

  4. Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research.

    PubMed

    Saokaew, Surasak; Sugimoto, Takashi; Kamae, Isao; Pratoomsoot, Chayanin; Chaiyakunapruk, Nathorn

    2015-01-01

    Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases' characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Forty databases- 20 from Thailand and 20 from Japan-were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed.

  5. Perioperative medicine and Taiwan National Health Insurance Research Database.

    PubMed

    Chang, C C; Liao, C C; Chen, T L

    2016-09-01

    "Big data", characterized by 'volume', 'velocity', 'variety', and 'veracity', being routinely collected in huge amounts of clinical and administrative healthcare-related data are becoming common and generating promising viewpoints for a better understanding of the complexity for medical situations. Taiwan National Health Insurance Research Database (NHIRD), one of large and comprehensive nationwide population reimbursement databases in the world, provides the strength of sample size avoiding selection and participation bias. Abundant with the demographics, clinical diagnoses, and capable of linking diverse laboratory and imaging information allowing for integrated analysis, NHIRD studies could inform us of the incidence, prevalence, managements, correlations and associations of clinical outcomes and diseases, under the universal coverage of healthcare used. Perioperative medicine has emerged as an important clinical research field over the past decade, moving the categorization of the specialty of "Anesthesiology and Perioperative Medicine". Many studies concerning perioperative medicine based on retrospective cohort analyses have been published in the top-ranked journal, but studies utilizing Taiwan NHIRD were still not fully visualized. As the prominent growth curve of NHIRD studies, we have contributed the studies covering surgical adverse outcomes, trauma, stroke, diabetes, and healthcare inequality, etc., to this ever growing field for the past five years. It will definitely become a trend of research using Taiwan NHIRD and contributing to the progress of perioperative medicine with the recruitment of devotion from more research groups and become a famous doctrine. Copyright © 2016. Published by Elsevier B.V.

  6. Ninety day mortality following pancreatoduodenectomy in England: has the optimum centre volume been identified?

    PubMed

    Liu, Z; Peneva, I S; Evison, F; Sahdra, S; Mirza, D F; Charnley, R M; Savage, R; Moss, P A; Roberts, K J

    2018-06-09

    Mortality following pancreatoduodenectomy is related to centre volume although the optimal volume is not defined. Patients undergoing PD between 2001 and 2016 were identified from UK national databases. The effects of patient variables, centre volume and time period upon 90 day mortality were studied. 90 day mortality (970/14,935, 6.5%) was related to advanced age, comorbidity, diagnosis, ethnicity, deprivation, centre volume and time period. Mortality rates fell markedly from 10.0% in 2001-4 to 4.1% in 2013-16. There was no difference in 90 day mortality between high (36 -60 PD per year) and very high volume (>60) centres. However, patients operated upon at very high volume centres were more elderly (66, 58 -73 vs 65, 56 -72; median, IQR; p = 0.006), deprived (38.7 vs 34.6%; p < 0.001) and co morbid (48.9 vs 46.1%; p = 0.027). Although a plateau in the centre volume and mortality relationship appears to have been demonstrated those patients treated at the highest volume centres were at higher risk of mortality. This data suggests therefore that to further understand outcomes from specialist centres characteristics of the patient population should be defined, not just centre volume. Copyright © 2018. Published by Elsevier Ltd.

  7. Quantifying Intrinsic and Extrinsic Contributions to Human Longevity: Application of a Two-Process Vitality Model to the Human Mortality Database.

    PubMed

    Sharrow, David J; Anderson, James J

    2016-12-01

    The rise in human life expectancy has involved declines in intrinsic and extrinsic mortality processes associated, respectively, with senescence and environmental challenges. To better understand the factors driving this rise, we apply a two-process vitality model to data from the Human Mortality Database. Model parameters yield intrinsic and extrinsic cumulative survival curves from which we derive intrinsic and extrinsic expected life spans (ELS). Intrinsic ELS, a measure of longevity acted on by intrinsic, physiological factors, changed slowly over two centuries and then entered a second phase of increasing longevity ostensibly brought on by improvements in old-age death reduction technologies and cumulative health behaviors throughout life. The model partitions the majority of the increase in life expectancy before 1950 to increasing extrinsic ELS driven by reductions in environmental, event-based health challenges in both childhood and adulthood. In the post-1950 era, the extrinsic ELS of females appears to be converging to the intrinsic ELS, whereas the extrinsic ELS of males is approximately 20 years lower than the intrinsic ELS.

  8. Quantifying Intrinsic and Extrinsic Contributions to Human Longevity: Application of a Two-Process Vitality Model to the Human Mortality Database

    PubMed Central

    Anderson, James J.

    2016-01-01

    The rise in human life expectancy has involved declines in intrinsic and extrinsic mortality processes associated, respectively, with senescence and environmental challenges. To better understand the factors driving this rise, we apply a two-process vitality model to data from the Human Mortality Database. Model parameters yield intrinsic and extrinsic cumulative survival curves from which we derive intrinsic and extrinsic expected life spans (ELS). Intrinsic ELS, a measure of longevity acted on by intrinsic, physiological factors, changed slowly over two centuries and then entered a second phase of increasing longevity ostensibly brought on by improvements in old-age death reduction technologies and cumulative health behaviors throughout life. The model partitions the majority of the increase in life expectancy before 1950 to increasing extrinsic ELS driven by reductions in environmental, event-based health challenges in both childhood and adulthood. In the post-1950 era, the extrinsic ELS of females appears to be converging to the intrinsic ELS, whereas the extrinsic ELS of males is approximately 20 years lower than the intrinsic ELS. PMID:27837429

  9. Recent lung cancer mortality trends in Europe: effect of national smoke-free legislation strengthening.

    PubMed

    López-Campos, Jose L; Ruiz-Ramos, Miguel; Fernandez, Esteve; Soriano, Joan B

    2018-07-01

    The impact of smoke-free legislation within European Union (EU) countries on lung cancer mortality has not been evaluated to date. We aimed to determine lung cancer mortality trends in the EU-27 by sex, age, and calendar year for the period of 1994 and 2012, and relate them with changes in tobacco legislation at the national level. Deaths by Eurostat in each European country were analyzed, focusing on ICD-10 codes C33 and C34 from the years 1994 to 2012. Age-standardized mortality rates (ASR) were estimated separately for women and men in the EU-27 total and within country for each one of the years studied, and the significance of changing trends was estimated by joinpoint regression analysis, exploring lag times after initiation of smoke-free legislation in every country, if any. From 1994 to 2012, there were 4 681 877 deaths from lung cancer in Europe (3 491 607 in men and 1 190 180 in women) and a nearly linear decrease in mortality rates because of lung cancer in men from was observed1994 to 2012, mirrored in women by an upward trend, narrowing the sex gap during the study period from 5.1 in 1994 to 2.8 in 2012. Joinpoint regression analysis identified a number of trend changes over time, but it appears that they were unrelated to the implementation of smoke-free legislations. A few years after the introduction of smoke-free legislations across Europe, trends of lung cancer mortality trends have not changed.

  10. Forest service contributions to the national land cover database (NLCD): Tree Canopy Cover Production

    Treesearch

    Bonnie Ruefenacht; Robert Benton; Vicky Johnson; Tanushree Biswas; Craig Baker; Mark Finco; Kevin Megown; John Coulston; Ken Winterberger; Mark Riley

    2015-01-01

    A tree canopy cover (TCC) layer is one of three elements in the National Land Cover Database (NLCD) 2011 suite of nationwide geospatial data layers. In 2010, the USDA Forest Service (USFS) committed to creating the TCC layer as a member of the Multi-Resolution Land Cover (MRLC) consortium. A general methodology for creating the TCC layer was reported at the 2012 FIA...

  11. Analyzing legacy U.S. Geological Survey geochemical databases using GIS: applications for a national mineral resource assessment

    USGS Publications Warehouse

    Yager, Douglas B.; Hofstra, Albert H.; Granitto, Matthew

    2012-01-01

    This report emphasizes geographic information system analysis and the display of data stored in the legacy U.S. Geological Survey National Geochemical Database for use in mineral resource investigations. Geochemical analyses of soils, stream sediments, and rocks that are archived in the National Geochemical Database provide an extensive data source for investigating geochemical anomalies. A study area in the Egan Range of east-central Nevada was used to develop a geographic information system analysis methodology for two different geochemical datasets involving detailed (Bureau of Land Management Wilderness) and reconnaissance-scale (National Uranium Resource Evaluation) investigations. ArcGIS was used to analyze and thematically map geochemical information at point locations. Watershed-boundary datasets served as a geographic reference to relate potentially anomalous sample sites with hydrologic unit codes at varying scales. The National Hydrography Dataset was analyzed with Hydrography Event Management and ArcGIS Utility Network Analyst tools to delineate potential sediment-sample provenance along a stream network. These tools can be used to track potential upstream-sediment-contributing areas to a sample site. This methodology identifies geochemically anomalous sample sites, watersheds, and streams that could help focus mineral resource investigations in the field.

  12. Mortality and cancer incidence among male volunteer Australian firefighters.

    PubMed

    Glass, Deborah C; Del Monaco, Anthony; Pircher, Sabine; Vander Hoorn, Stephen; Sim, Malcolm R

    2017-09-01

    This study aims to investigate mortality and cancer incidence of Australian male volunteer firefighters and of subgroups of firefighters by duration of service, era of first service and the number and type of incidents attended. Participating fire agencies supplied records of individual volunteer firefighters, including incidents attended. The cohort was linked to the Australian National Death Index and Australian Cancer Database. standardised mortality ratios (SMRs) and standardised incidence ratios (SIRs) for cancer were calculated. Firefighters were grouped into tertiles by duration of service and by number of incidents attended and relative mortality ratios and relative incidence ratios calculated. Compared with the general population, there were significant decreases in overall cancer incidence and in most major cancer categories. Prostate cancer incidence was increased compared with the general population, but this was not related to the number of incidents attended. Kidney cancer was associated with increased attendance at fires, particularly structural fires.The overall risk of mortality was significantly decreased, and all major causes of death were significantly reduced for volunteer firefighters. There was evidence of an increased mortality from ischaemic heart disease, with increased attendance at fires. Volunteer firefighters have a reduced risk of mortality and cancer incidence compared with the general population, which is likely to be a result of a 'healthy-volunteer' effect and, perhaps, lower smoking rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    PubMed

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

    2017-12-01

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

  14. Effect of plasma exchange on in-hospital mortality in patients with pulmonary hemorrhage secondary to antineutrophil cytoplasmic antibody-associated vasculitis: A propensity-matched analysis using a nationwide administrative database.

    PubMed

    Uechi, Eishi; Okada, Masato; Fushimi, Kiyohide

    2018-01-01

    Secondary pulmonary hemorrhage increases the risk of mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV); plasma exchange therapy may improve outcomes in these patients. We conducted a retrospective cohort study to investigate the effect of plasma exchange therapy on short-term prognoses in patients with pulmonary hemorrhage secondary to AAV. This study utilized the Diagnosis Procedure Combination database, which is a nationwide inpatient database in Japan. We checked the abstract data and medical actions and identified the patients with pulmonary hemorrhage secondary to AAV who required proactive treatment between 2009 and 2014. To compare the in-hospital mortality, we performed propensity score matching between the plasma exchange and non-plasma exchange groups at a ratio of 1:1. Of the 52,932 patients with AAV, 940 developed pulmonary hemorrhage as a complication. A total of 249 patients from 194 hospitals were eligible for the study. Propensity score matching at a ratio of 1:1 was performed, and 59 pairs were formed (plasma exchange group, n = 59; non-plasma exchange group, n = 59). A statistically significant difference was found in the all-cause in-hospital mortality between the plasma exchange and non-plasma exchange groups (35.6% vs. 54.2%; p = 0041; risk difference, -18.6; 95% confidence interval (CI), -35.4% to -0.67%). Thus, plasma exchange therapy was associated with improved in-hospital mortality in patients with pulmonary hemorrhage secondary to AAV.

  15. Trends in Outcomes and Hospitalization Charges of Infant Botulism in the United States: A Comparative Analysis Between Kids' Inpatient Database and National Inpatient Sample.

    PubMed

    Opila, Tamara; George, Asha; El-Ghanem, Mohammad; Souayah, Nizar

    2017-02-01

    New therapeutic strategies, including immune globulin intravenous, have emerged in the past two decades for the management of botulism. However, impact on outcomes and hospitalization charges among infants (aged ≤1 year) with botulism in the United States is unknown. We analyzed the Kids' Inpatient Database (KID) and National Inpatient Sample (NIS) for in-hospital outcomes and charges for infant botulism cases from 1997 to 2009. Demographics, discharge status, mortality, length of stay, and hospitalization charges were reported from the two databases and compared. Between 1997 and 2009, 504 infant hospitalizations were captured in KID', and 340 hospitalizations from NIS, for comparable years. A significant decrease was observed in mean length of stay for 'KID (P < 0.01); a similar decrease was observed for the NIS. The majority of patients were discharged to home. Despite an initial decrease after 1997, an increasing trend was observed for 'KID/NIS mean hospital charges from 2000 to 2009 (from $57,659/$56,309 to $143,171/$106,378; P < 0.001/P < 0.001). A linear increasing trend was evident when examining mean daily hospitalization charges for both databases. In conducting a subgroup analysis of the 'KID database, the youngest patients with infantile botulism (≤1.9 months) displayed the highest average number of procedures during their hospitalization (P < .001) and the highest rate of mechanical ventilation (P < .001), compared with their older counterparts. Infant botulism cases have demonstrated a significant increase in hospitalization charges over the years despite reduced length of stay. Additionally, there were significantly higher daily adjusted hospital charges and an increased rate of routine discharges for immune globulin intravenous-treated patients. More controlled studies are needed to define the criteria for cost-effective use of intravenous immune globulin in the population with infant botulism. Copyright © 2016 Elsevier Inc. All

  16. Development of a national, dynamic reservoir-sedimentation database

    USGS Publications Warehouse

    Gray, J.R.; Bernard, J.M.; Stewart, D.W.; McFaul, E.J.; Laurent, K.W.; Schwarz, G.E.; Stinson, J.T.; Jonas, M.M.; Randle, T.J.; Webb, J.W.

    2010-01-01

    The importance of dependable, long-term water supplies, coupled with the need to quantify rates of capacity loss of the Nation’s re servoirs due to sediment deposition, were the most compelling reasons for developing the REServoir- SEDimentation survey information (RESSED) database and website. Created under the auspices of the Advisory Committee on Water Information’s Subcommittee on Sedimenta ion by the U.S. Geological Survey and the Natural Resources Conservation Service, the RESSED database is the most comprehensive compilation of data from reservoir bathymetric and dry-basin surveys in the United States. As of March 2010, the database, which contains data compiled on the 1950s vintage Soil Conservation Service’s Form SCS-34 data sheets, contained results from 6,616 surveys on 1,823 reservoirs in the United States and two surveys on one reservoir in Puerto Rico. The data span the period 1755–1997, with 95 percent of the surveys performed from 1930–1990. The reservoir surface areas range from sub-hectare-scale farm ponds to 658 km2 Lake Powell. The data in the RESSED database can be useful for a number of purposes, including calculating changes in reservoir-storage characteristics, quantifying sediment budgets, and estimating erosion rates in a reservoir’s watershed. The March 2010 version of the RESSED database has a number of deficiencies, including a cryptic and out-of-date database architecture; some geospatial inaccuracies (although most have been corrected); other data errors; an inability to store all data in a readily retrievable manner; and an inability to store all data types that currently exist. Perhaps most importantly, the March 2010 version of RESSED database provides no publically available means to submit new data and corrections to existing data. To address these and other deficiencies, the Subcommittee on Sedimentation, through the U.S. Geological Survey and the U.S. Army Corps of Engineers, began a collaborative project in

  17. Indications and results of systemic to pulmonary shunts: results from a national database.

    PubMed

    Dorobantu, Dan Mihai; Pandey, Ragini; Sharabiani, Mansour Taghavi; Mahani, Alireza Shahidzadeh; Angelini, Gianni Davide; Martin, Robin Peter; Stoica, Serban Constantin

    2016-06-01

    The systemic-to-pulmonary shunt (SPS) remains an important palliative therapy in many congenital heart defects. Unlike other surgical treatments, the mortality after shunt operations has risen. We used an audit dataset to investigate potential reasons for this change and to report national results. A total of 1993 patients classified in 13 diagnoses underwent an SPS procedure between 2000 and 2013. Indication trends by era and also results before repair or next stage are reported. A dynamic hazard model with competing risks and modulated renewal was used to determine predictors of outcomes. The usage of SPS in Tetralogy of Fallot (ToF) has significantly decreased in the last decade, with cases of single ventricle (SV) and pulmonary atresia (PA) with septal communication increasing (P < 0.001 for trends). This is correlated with an increase of early mortality from 5.1% in the first half of the decade to 9.8% in the latter (P = 0.007 for trend). At 1.5 years, 13.9% of patients have died, 17.8% had a shunt reintervention and 68.3% of patients are alive and reintervention-free. Low weight, PA-intact septum, SV and central shunt type are among the factors associated with increased mortality, whereas PA-ventricular septal defect, corrected transposition, isomerism, central shunt and low weight are among those associated with increased reintervention, also having a dynamic effect on the relative risk when compared with ToF patients. Shunt reinterventions are not associated with worse outcomes when adjusted by other covariates, but they do have higher 30-day mortality if occurring earlier than 30 days from the index (P < 0.001). Patients operated in later years were found to have significantly lower survival at a distance from index. The observed historical rise in mortality for shunt operations relates to complex factors including changing practice for repair of ToF and for univentricular palliation. PA and SV patients are the groups of patients at the highest risk of

  18. Foliar injury, tree growth and mortality, and lichen studies in Mammoth Cave National Park. Final report, 1985-1986

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McCune, B.; Cloonan, C.L.; Armentano, T.V.

    1987-03-01

    Foliar condition, tree growth, tree mortality, and lichen communities were studied in Mammoth Cave National Park, Kentucky, to document the present forest condition and to provide a basis for detecting future changes. Foliar injury by ozone was common on many plant species in 1985. Species showing the most injury were white ash, green ash, redbud, sycamore, tulip poplar, milkweed, and wild grape. Injury apparently depended on canopy position and vigor. Tree growth was equivocally related to visible symptoms in 1986, probably because of the low ozone levels in that year. Tree mortality rates from 1966-1985 in two natural stands weremore » somewhat lower than mortality rates known for other midwestern woods.« less

  19. Premature mortality in a national cohort of people recently discharged from their first psychiatric inpatient treatment episode

    PubMed Central

    Walter, Florian; Carr, Matthew J.; Mok, Pearl L.H.; Astrup, Aske; Antonsen, Sussie; Pedersen, Carsten B.; Shaw, Jenny; Webb, Roger T.

    2017-01-01

    Importance Patients recently discharged from psychiatric inpatient services are at elevated risk of dying prematurely. National cohorts provide sufficient statistical power for examining cause-specific mortality in this population. Objective To comprehensively investigate premature mortality in a national cohort of recently discharged psychiatric patients at 15-44 years of age. Design, setting, and participants Cohort study of all persons born in Denmark during 1967-1996 (N=1,683,385). Participants were followed up from their 15th birthday until their date of death, emigration or December 31st 2011, whichever came first. Exposures First discharge from inpatient psychiatric care. Main outcome measures Incidence rates and incidence rate ratios (IRRs) for all-cause mortality and for an array of unnatural and natural causes among discharged patients versus persons not admitted for psychiatric care. Our primary analysis considered risk within a year of first discharge. Results Compared to persons not admitted, discharged patients had an elevated risk for all-cause mortality within a year (IRR 16.2, 95% CI 14.5-18.0). Relative risk for unnatural death (IRR 25.0, 95% CI 22.0- 28.4) was much higher than for natural death (IRR 8.6, 95% CI 7.0-10.7). The highest IRR found was for suicide: IRR 66.9, 95% CI 56.4-79.4; the IRR for alcohol-related deaths was the second highest observed: IRR 42.0, 95% CI 26.6-66.1. Among the psychiatric diagnostic categories assessed, psychoactive substance abuse conferred the highest risk for all-cause mortality (IRR 24.8, 95% CI 21.0-29.4). Across the array of cause-specific outcomes examined, risk of premature death during the first year post-discharge was markedly elevated compared to longer term follow up. Conclusions and relevance Enhanced liaison between primary and secondary health services post-discharge, as well as early intervention programs for drug and alcohol misuse could substantially decrease the greatly elevated mortality risk

  20. The National Hip Fracture Database (NHFD) - Using a national clinical audit to raise standards of nursing care.

    PubMed

    Johansen, Antony; Boulton, Christopher; Hertz, Karen; Ellis, Michael; Burgon, Vivienne; Rai, Sunil; Wakeman, Rob

    2017-08-01

    The National Hip Fracture Database (NHFD) is a key clinical governance programme for staff working in trauma wards across England, Wales and Northern Ireland. It uses prospectively collected information about the 65,000 people who present with hip fracture each year, and links these with information about the quality of care and outcome for each individual. The NHFD can, therefore, provide a picture of the care offered to frail older people with this injury - people who, between them, occupy nearly half of inpatient trauma beds. The NHFD uses its website (www.nhfd.co.uk) to feed back live information to each of the countries' 180 trauma units - allowing them to bench mark their performance against national standards, and against that in other hospitals. This helps to develop a consensus over the best care for frail older people in areas where national guidance is not yet available. This article shows how the NHFD is contributing to four key aspects of patient safety and nursing care: the prevention of pressure ulcers and post-operative delirium, the monitoring of falls incidence across hospitals and nutritional assessment of patients with hip fracture. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. One-Year Mortality after Traumatic Brain Injury in Liver Cirrhosis Patients—A Ten-Year Population-Based Study

    PubMed Central

    Cheng, Chieh-Yang; Ho, Chung-Han; Wang, Che-Chuan; Liang, Fu-Wen; Wang, Jhi-Joung; Chio, Chung-Ching; Chang, Chin-Hung; Kuo, Jinn-Rung

    2015-01-01

    Abstract This study investigated the 1-year mortality of patients who underwent brain surgery following traumatic brain injury (TBI) who also had alcoholic and/or nonalcoholic liver cirrhosis (LC) using a nationwide database in Taiwan. A longitudinal cohort study matched by propensity score with age, gender, length of ICU stay, HTN, DM, MI, stroke, HF, renal diseases, and year of TBI diagnosis in TBI patients with alcoholic and/or nonalcoholic LC and TBI patients without LC was conducted using the National Health Insurance Research Database in Taiwan between January 1997 and December 2007. The main outcome studied was 1-year mortality. In total, 7296 subjects (2432 TBI patients with LC and 4864 TBI patients without LC) were enrolled in this study. The main findings were (1) TBI patients with LC had a higher 1-year mortality (52.18% vs 30.61%) and a 1.75-fold increased risk of mortality (95% CI 1.61–1.90) compared with non-LC TBI patients, (2) renal diseases and HF are risk factors, but hypertension could be a protective factor in cirrhotic TBI patients, and (3) TBI patients with non-alcoholic LC and the coexistence of alcoholic and nonalcoholic LC had higher 1-year mortality compared with TBI patients with alcoholic cirrhosis. This study showed that patients with LC who have undergone brain surgery might have higher risk of 1-year mortality than those without LC. In addition, nonalcoholic and the coexistence of alcoholic and nonalcoholic LC show higher 1-year mortality risk than alcoholic in TBI patients with LC, especially in those with comorbidities of hypertension, diabetes mellitus, and stroke. PMID:26448001

  2. Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America.

    PubMed

    Biggs, Brian; King, Lawrence; Basu, Sanjay; Stuckler, David

    2010-07-01

    Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how

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

    PubMed

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

    2017-12-01

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

  4. Data Resource Profile: United Nations Children’s Fund (UNICEF)

    PubMed Central

    Murray, Colleen; Newby, Holly

    2012-01-01

    The United Nations Children’s Fund (UNICEF) plays a leading role in the collection, compilation, analysis and dissemination of data to inform sound policies, legislation and programmes for promoting children’s rights and well-being, and for global monitoring of progress towards the Millennium Development Goals. UNICEF maintains a set of global databases representing nearly 200 countries and covering the areas of child mortality, child health, maternal health, nutrition, immunization, water and sanitation, HIV/AIDS, education and child protection. These databases consist of internationally comparable and statistically sound data, and are updated annually through a process that draws on a wealth of data provided by UNICEF’s wide network of >150 field offices. The databases are composed primarily of estimates from household surveys, with data from censuses, administrative records, vital registration systems and statistical models contributing to some key indicators as well. The data are assessed for quality based on a set of objective criteria to ensure that only the most reliable nationally representative information is included. For most indicators, data are available at the global, regional and national levels, plus sub-national disaggregation by sex, urban/rural residence and household wealth. The global databases are featured in UNICEF’s flagship publications, inter-agency reports, including the Secretary General’s Millennium Development Goals Report and Countdown to 2015, sector-specific reports and statistical country profiles. They are also publicly available on www.childinfo.org, together with trend data and equity analyses. PMID:23211414

  5. Predictors of short- and long-term mortality in first-ever ischaemic older stroke patients.

    PubMed

    Hsu, Chia-Yu; Hu, Gwo-Chi; Chen, Yi-Min; Chen, Chiu-Hsiang; Hu, Yu-Ning

    2013-12-01

    Predictors of short- and long-term all-cause mortality of older stroke patients were explored. Cox regression models were used to estimate the relative risk and 95% confidence intervals (CI) in the database entries of 636 older stroke patients aged 70 years and over. National Institutes of Health Stroke Scale (NIHSS) score on admission, age and coronary heart disease were significantly associated with 28-day death. The hazard ratios for the predictors of long-term mortality were as follows: NIHSS score, 1.1 (95% CI: 1.07-1.1); serum glucose level, 1.08 (95% CI: 1.01-1.2); serum triglyceride level, 0.6 (95% CI: 0.4-0.8); age, 1.04 (95% CI: 1.01-1.08); and coronary heart disease, 2.7 (95% CI: 1.4-5.4). NIHSS score on admission, age and coronary heart disease are independent predictors of short- and long-term mortality. Higher glucose and lower triglyceride level are significantly associated with the long-term mortality. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

  6. Prediction of Cancer Incidence and Mortality in Korea, 2018

    PubMed Central

    Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Lee, Eun Sook

    2018-01-01

    Purpose This study aimed to report on cancer incidence and mortality for the year 2018 to estimate Korea’s current cancer burden. Materials and Methods Cancer incidence data from 1999 to 2015 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2016 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly, we only used the data of the latest trend. Results A total of 204,909 new cancer cases and 82,155 cancer deaths are expected to occur in Korea in 2018. The most common cancer sites were lung, followed by stomach, colorectal, breast and liver. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites were lung cancer, followed by liver, colorectal, stomach and pancreas. Conclusion The incidence rate of all cancer in Korea are estimated to decrease gradually, mainly due to decrease of thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs. PMID:29566480

  7. Social, economic, and political factors in progress towards improving child survival in developing nations.

    PubMed

    Lykens, Kristine; Singh, Karan P; Ndukwe, Elewichi; Bae, Sejong

    2009-01-01

    Child mortality is a persistent health problem faced by developing nations. In 2000 the United Nations (UN) established a set of high priority goals to address global problems of poverty and health, the Millennium Development Goals, which address extreme poverty, hunger, primary education, child mortality, maternal health, infectious diseases, environmental sustainability, and partnerships for development. Goal 4 aims to reduce by two thirds, between 2000 and 2015, the under-five mortality rate in developing countries. In sub-Saharan Africa from 2000 to 2006 these rates have only been reduced from 167 per 1,000 live births to 157, and 27 nations in this region have made no progress towards the goal. A country-specific database was developed from the UN Millennium Development Goal tracking project and other international sources which include age distribution, under-nutrition, per capita income, government expenditures on health, external resources for health, civil liberties, and political rights. A multiple regression analysis examined the extent to which these factors explain the variance in child mortality rates in developing countries. Nutrition, external resources, and per capita income were shown to be significant factors in child survivability. Policy options include developed countries' renewed commitment of resources, and developing nations' commitments towards governance, development, equity, and transparency.

  8. Enriching Great Britain's National Landslide Database by searching newspaper archives

    NASA Astrophysics Data System (ADS)

    Taylor, Faith E.; Malamud, Bruce D.; Freeborough, Katy; Demeritt, David

    2015-11-01

    Our understanding of where landslide hazard and impact will be greatest is largely based on our knowledge of past events. Here, we present a method to supplement existing records of landslides in Great Britain by searching an electronic archive of regional newspapers. In Great Britain, the British Geological Survey (BGS) is responsible for updating and maintaining records of landslide events and their impacts in the National Landslide Database (NLD). The NLD contains records of more than 16,500 landslide events in Great Britain. Data sources for the NLD include field surveys, academic articles, grey literature, news, public reports and, since 2012, social media. We aim to supplement the richness of the NLD by (i) identifying additional landslide events, (ii) acting as an additional source of confirmation of events existing in the NLD and (iii) adding more detail to existing database entries. This is done by systematically searching the Nexis UK digital archive of 568 regional newspapers published in the UK. In this paper, we construct a robust Boolean search criterion by experimenting with landslide terminology for four training periods. We then apply this search to all articles published in 2006 and 2012. This resulted in the addition of 111 records of landslide events to the NLD over the 2 years investigated (2006 and 2012). We also find that we were able to obtain information about landslide impact for 60-90% of landslide events identified from newspaper articles. Spatial and temporal patterns of additional landslides identified from newspaper articles are broadly in line with those existing in the NLD, confirming that the NLD is a representative sample of landsliding in Great Britain. This method could now be applied to more time periods and/or other hazards to add richness to databases and thus improve our ability to forecast future events based on records of past events.

  9. The Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil.

    PubMed

    Zampieri, Fernando Godinho; Soares, Márcio; Borges, Lunna Perdigão; Salluh, Jorge Ibrain Figueira; Ranzani, Otávio Tavares

    2017-01-01

    To describe the Epimed Monitor Database®, a Brazilian intensive care unit quality improvement database. We described the Epimed Monitor® Database, including its structure and core data. We presented aggregated informative data from intensive care unit admissions from 2010 to 2016 using descriptive statistics. We also described the expansion and growth of the database along with the geographical distribution of participating units in Brazil. The core data from the database includes demographic, administrative and physiological parameters, as well as specific report forms used to gather detailed data regarding the use of intensive care unit resources, infectious episodes, adverse events and checklists for adherence to best clinical practices. As of the end of 2016, 598 adult intensive care units in 318 hospitals totaling 8,160 intensive care unit beds were participating in the database. Most units were located at private hospitals in the southeastern region of the country. The number of yearly admissions rose during this period and included a predominance of medical admissions. The proportion of admissions due to cardiovascular disease declined, while admissions due to sepsis or infections became more common. Illness severity (Simplified Acute Physiology Score - SAPS 3 - 62 points), patient age (mean = 62 years) and hospital mortality (approximately 17%) remained reasonably stable during this time period. A large private database of critically ill patients is feasible and may provide relevant nationwide epidemiological data for quality improvement and benchmarking purposes among the participating intensive care units. This database is useful not only for administrative reasons but also for the improvement of daily care by facilitating the adoption of best practices and use for clinical research.

  10. Risk Factors for Thirty-Day Morbidity and Mortality in Extradural Lumbar Spine Tumor Resection.

    PubMed

    Sarkiss, Christopher A; Hersh, Eliza H; Ladner, Travis R; Lee, Nathan; Kothari, Parth; Lakomkin, Nikita; Caridi, John M

    2018-06-01

    Epidural tumors in the lumbar spine represent a unique cohort of lesions with individual risks and challenges to resection. Knowledge of modifiable risk factors are important in minimizing postoperative complications. To determine the risk factors for 30-day morbidity and mortality in patients undergoing extradural lumbar tumor resection. A retrospective study of prospectively collected data using the American College of Surgeons National Quality Improvement Program database was performed. Adults who underwent laminectomy for excision of lumbar spine tumors between 2011 and 2014 were included in the study. Demographics and medical comorbidities were collected, along with morbidities and mortalities within 30 postoperative days. A multivariate binary logistic analysis of these clinical variables was performed to determine covariates of morbidity and mortality. The database search yielded 300 patients, of whom 118 (39.3%) were female. Overall, complications within 30 days of surgery occurred in 102 (34%) patients. Significant risk factors for morbidity included preoperative anemia (P < 0.0001), the need for preoperative blood transfusion (P = 0.034), preoperative hypoalbuminemia (P = 0.002), American Society of Anesthesiologists score 3 or 4 (P = 0.0002), and operative time >4 hours (P < 0.0001). Thirty-day mortality occurred in 15 (5%) patients and was independently associated with preoperative anemia (odds ratio 3.4, 95% confidence interval 1.8-6.5) and operative time >4 hours (odds ratio 2.6, 95% confidence interval 1.1-6.0). Excision of epidural lumbar spinal tumors carries a relatively high complication rate. This series reveals distinct risk factors that contribute to 30-day morbidity and mortality, which may be optimized preoperatively to improve surgical safety. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Association of BMI with risk of CVD mortality and all-cause mortality.

    PubMed

    Kee, Chee Cheong; Sumarni, Mohd Ghazali; Lim, Kuang Hock; Selvarajah, Sharmini; Haniff, Jamaiyah; Tee, Guat Hiong Helen; Gurpreet, Kaur; Faudzi, Yusoff Ahmad; Amal, Nasir Mustafa

    2017-05-01

    To determine the relationship between BMI and risk of CVD mortality and all-cause mortality among Malaysian adults. Population-based, retrospective cohort study. Participants were followed up for 5 years from 2006 to 2010. Mortality data were obtained via record linkages with the Malaysian National Registration Department. Multiple Cox regression was applied to compare risk of CVD and all-cause mortality between BMI categories adjusting for age, gender and ethnicity. Models were generated for all participants, all participants the first 2 years of follow-up, healthy participants, healthy never smokers, never smokers, current smokers and former smokers. All fourteen states in Malaysia. Malaysian adults (n 32 839) aged 18 years or above from the third National Health and Morbidity Survey. Total follow-up time was 153 814 person-years with 1035 deaths from all causes and 225 deaths from CVD. Underweight (BMI<18·5 kg/m2) was associated with a significantly increased risk of all-cause mortality, while obesity (BMI ≥30·0 kg/m2) was associated with a heightened risk of CVD mortality. Overweight (BMI=25·0-29·9 kg/m2) was inversely associated with risk of all-cause mortality. Underweight was significantly associated with all-cause mortality in all models except for current smokers. Overweight was inversely associated with all-cause mortality in all participants. Although a positive trend was observed between BMI and CVD mortality in all participants, a significant association was observed only for severe obesity (BMI≥35·0 kg/m2). Underweight was associated with increased risk of all-cause mortality and obesity with increased risk of CVD mortality. Therefore, maintaining a normal BMI through leading an active lifestyle and healthy dietary habits should continue to be promoted.

  12. Marijuana use and mortality.

    PubMed Central

    Sidney, S; Beck, J E; Tekawa, I S; Quesenberry, C P; Friedman, G D

    1997-01-01

    OBJECTIVES: The purpose of this study was to examine the relationship of marijuana use to mortality. METHODS: The study population comprised 65171 Kaiser Permanente Medical Care Program enrollees, aged 15 through 49 years, who completed questionnaires about smoking habits, including marijuana use, between 1979 and 1985. Mortality follow-up was conducted through 1991. RESULTS: Compared with nonuse or experimentation (lifetime use six or fewer times), current marijuana use was not associated with a significantly increased risk of non-acquired immunodeficiency syndrome (AIDS) mortality in men (relative risk [RR] = 1.12, 95% confidence interval [CI] = 0.89, 1.39) or of total mortality in women (RR = 1.09, 95% CI = 0.80, 1.48). Current marijuana use was associated with increased risk of AIDS mortality in men (RR = 1.90, 95% CI = 1.33, 2.73), an association that probably was not causal but most likely represented uncontrolled confounding by male homosexual behavior. This interpretation was supported by the lack of association of marijuana use with AIDS mortality in men from a Kaiser Permanente AIDS database. Relative risks for ever use of marijuana were similar. CONCLUSIONS: Marijuana use in a prepaid health care-based study cohort had little effect on non-AIDS mortality in men and on total mortality in women. PMID:9146436

  13. National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment.

    PubMed

    Chao, Fengqing; You, Danzhen; Pedersen, Jon; Hug, Lucia; Alkema, Leontine

    2018-05-01

    The progress to achieve the fourth Millennium Development Goal in reducing mortality rate in children younger than 5 years since 1990 has been remarkable. However, work remains to be done in the Sustainable Development Goal era. Estimates of under-5 mortality rates at the national level can hide disparities within countries. We assessed disparities in under-5 mortality rates by household economic status in low-income and middle-income countries (LMICs). We estimated country-year-specific under-5 mortality rates by wealth quintile on the basis of household wealth indices for 137 LMICs from 1990 to 2016, using a Bayesian statistical model. We estimated the association between quintile-specific and national-level under-5 mortality rates. We assessed the levels and trends of absolute and relative disparity in under-5 mortality rate between the poorest and richest quintiles, and among all quintiles. In 2016, for all LMICs (excluding China), the aggregated under-5 mortality rate was 64·6 (90% uncertainty interval [UI] 61·1-70·1) deaths per 1000 livebirths in the poorest households (first quintile), 31·3 (29·5-34·2) deaths per 1000 livebirths in the richest households (fifth quintile), and in between those outcomes for the middle quintiles. Between 1990 and 2016, the largest absolute decline in under-5 mortality rate occurred in the two poorest quintiles: 77·6 (90% UI 71·2-82·6) deaths per 1000 livebirths in the poorest quintile and 77·9 (72·0-82·2) deaths per 1000 livebirths in the second poorest quintile. The difference in under-5 mortality rate between the poorest and richest quintiles decreased significantly by 38·8 (90% UI 32·9-43·8) deaths per 1000 livebirths between 1990 and 2016. The poorest to richest under-5 mortality rate ratio, however, remained similar (2·03 [90% UI 1·94-2·11] in 1990, 1·99 [1·91-2·08] in 2000, and 2·06 [1·92-2·20] in 2016). During 1990-2016, around half of the total under-5 deaths occurred in the poorest two quintiles

  14. Evaluation of the National Land Database for Hydrologic Applications in Urban And Suburban Baltimore, Maryland

    Treesearch

    Monica Lipscomb Smith; Weiqi Zhou; Mary Cadenasso; J. Morgan Grove; Lawrence Band

    2010-01-01

    We compared the National Land Cover Database (NLCD) 2001 land cover, impervious, and canopy data products to land cover data derived from 0.6-m resolution three-band digital imagery and ancillary data. We conducted this comparison at the 1 km2, 9 km2, and gauged watershed scales within the Baltimore Ecosystem Study to...

  15. Integration of Remotely Sensed Data Into Geospatial Reference Information Databases. Un-Ggim National Approach

    NASA Astrophysics Data System (ADS)

    Arozarena, A.; Villa, G.; Valcárcel, N.; Pérez, B.

    2016-06-01

    Remote sensing satellites, together with aerial and terrestrial platforms (mobile and fixed), produce nowadays huge amounts of data coming from a wide variety of sensors. These datasets serve as main data sources for the extraction of Geospatial Reference Information (GRI), constituting the "skeleton" of any Spatial Data Infrastructure (SDI). Since very different situations can be found around the world in terms of geographic information production and management, the generation of global GRI datasets seems extremely challenging. Remotely sensed data, due to its wide availability nowadays, is able to provide fundamental sources for any production or management system present in different countries. After several automatic and semiautomatic processes including ancillary data, the extracted geospatial information is ready to become part of the GRI databases. In order to optimize these data flows for the production of high quality geospatial information and to promote its use to address global challenges several initiatives at national, continental and global levels have been put in place, such as European INSPIRE initiative and Copernicus Programme, and global initiatives such as the Group on Earth Observation/Global Earth Observation System of Systems (GEO/GEOSS) and United Nations Global Geospatial Information Management (UN-GGIM). These workflows are established mainly by public organizations, with the adequate institutional arrangements at national, regional or global levels. Other initiatives, such as Volunteered Geographic Information (VGI), on the other hand may contribute to maintain the GRI databases updated. Remotely sensed data hence becomes one of the main pillars underpinning the establishment of a global SDI, as those datasets will be used by public agencies or institutions as well as by volunteers to extract the required spatial information that in turn will feed the GRI databases. This paper intends to provide an example of how institutional

  16. All-cause mortality and use of antithrombotics within 90 days of discharge in acutely ill medical patients.

    PubMed

    Mahan, Charles E; Fields, Larry E; Mills, Roger M; Stephenson, Judith J; Fu, An-Chen; Fisher, Maxine D; Spyropoulos, Alex C

    2015-10-01

    Conflicting evidence exists regarding predictors of and antithrombotic benefit on mortality in hospitalised acutely-ill medical patients. We compared mortality risk within 90 days post-discharge among medically ill patients who did and did not receive antithrombotics. This retrospective claims analysis included patients ≥ 40 years with nonsurgical hospitalisation ≥ 2 days between 2005 and 2009 using the HealthCore Integrated Research Database. Antithrombotic use (i.e. anticoagulants and antiplatelets) post-discharge was captured from pharmacy claims. All-cause mortality was determined from Social Security Death Index; cause of death was identified from National Death Index database. Kaplan-Meier survival curves were generated and hazard ratios (HR) for mortality risk were estimated using Cox proportional hazards models. Patients prescribed anticoagulants or antiplatelets post-discharge had lower risk of short-term mortality. For the anticoagulant model, the most significant predictors of mortality were malignant/benign neoplasms (hazard ratio [HR] 1.6, 95% confidence interval [CI] 1.5-1.7), liver disease (HR 1.6, 95% CI 1.5-1.7), anticoagulant omission (HR 1.6, 95% CI 1.4-1.8), gastrointestinal or respiratory tract intubations (HR 1.5, 95% CI 1.3-1.7), and blood dyscrasias (HR 1.4, 95% CI 1.4-1.5). For the antiplatelet model, the most significant predictors of mortality were antiplatelet omission (HR 3.7, 95% CI 3.3-4.1), liver disease (HR 1.6, 95% CI 1.4-1.7), malignant/benign neoplasms (HR 1.6, 95% CI 1.5-1.6), gastrointestinal or respiratory tract intubations (HR 1.5, 95% CI 1.3-1.7), and blood dyscrasias (HR 1.4, 95% CI 1.4-1.5). These mortality risk factors may guide future studies assessing potential benefits of antithrombotics in specific subsets of patients.

  17. REPORT FROM THE STS NATIONAL DATABASE WORK FORCE

    PubMed Central

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

    2013-01-01

    Several distinct definitions of postoperative death have been used in various quality reporting programs. Some have defined a postoperative mortality as a patient who expires while still in the hospital, while others have considered all deaths occurring within a predetermined, standardized time interval after surgery. While if continues to collect mortality data using both these individual definitions, the Society of Thoracic Surgeons (STS) believes that either alone may be inadequate. Accordingly, the STS prefers a more encompassing metric, Operative Mortality, which is defined as (1) all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days; and (2) all deaths occurring after discharge from the hospital, but before the end of the thirtieth postoperative day. This manuscript provides clarification for some uncommon but important scenarios where the correct application of this definition may be problematic. PMID:23799748

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

    PubMed

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

    2015-03-09

    Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain. We employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables. Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001). Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001). We have documented statistically significant positive associations between GII and child mortality rates. Our results suggest that the initiatives to curtail child mortality rates should extend beyond medical interventions and should prioritize women's rights and autonomy. We discuss major pathways connecting gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of

  19. Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States

    PubMed Central

    Espey, David K.; Swan, Judith; Wiggins, Charles L.; Eheman, Christie; Kaur, Judith S.

    2014-01-01

    Objectives. We used improved data on American Indian and Alaska Native (AI/AN) ancestry to provide an updated and comprehensive description of cancer mortality and incidence among AI/AN populations from 1990 to 2009. Methods. We linked the National Death Index and central cancer registry records independently to the Indian Health Service (IHS) patient registration database to improve identification of AI/AN persons in cancer mortality and incidence data, respectively. Analyses were restricted to non-Hispanic persons residing in Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted mortality and incidence rates for AI/AN populations with White populations using rate ratios and mortality-to-incidence ratios. Trends were described using joinpoint analysis. Results. Cancer mortality and incidence rates for AI/AN persons compared with Whites varied by region and type of cancer. Trends in death rates showed that greater progress in cancer control was achieved for White populations compared with AI/AN populations over the last 2 decades. Conclusions. Spatial variations in mortality and incidence by type of cancer demonstrated both persistent and emerging challenges for cancer control in AI/AN populations. PMID:24754660

  20. The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

    PubMed

    Linnen, Daniel T; Kornak, John; Stephens, Caroline

    2018-03-28

    Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p < 0.001). For hospitals in small metro counties, the odds of having such a rating were 3.7 times greater (95% confidence interval = 0.7-23.4, p = 0.12), although not statistically significant. Few ratings were provided for rural counties, and analysis of rural counties was underpowered. Hospitals in medium-sized metro counties are associated with unfavorable Medicare mortality ratings, but current methods to assign mortality ratings may hinder fair comparisons. Patient transfers from rural locations to regional medical centers may contribute to these results, a potential factor that future research should examine.

  1. Development and Dissemination of a Nationwide Helium Database for a National Assessment of Helium Resources.

    NASA Astrophysics Data System (ADS)

    Brennan, S. T.; East, J. A., II; Garrity, C. P.

    2015-12-01

    In 2013, Congress passed the Helium Stewardship Act requiring the U.S. Geological Survey (USGS) to undertake a national helium gas resource assessment to determine the nation's helium resources. An important initial component necessary to complete this assessment was the development of a comprehensive database of Helium (He) concentrations from petroleum exploration wells. Because Helium is often used as the carrier gas for compositional analyses for commercial and exploratory oil and gas wells, this limits the available helium concentration data. A literature search in peer-reviewed publications, state geologic survey databases, USGS energy geochemical databases, and the Bureau of Land Management databases provided approximately 16,000 data points from wells that had measurable He concentrations in the gas composition analyses. The data from these wells includes, date of sample collection, American Petroleum Institute well number, formation name, field name, depth of sample collection, and location. The gas compositional analyses, some performed as far back as 1934, do not all have the same level of precision and accuracy, therefore the date of the analysis is critical to the assessment as it indicates the relative amount of uncertainty in the analytical results. Non-proprietary data was used to create a GIS based interactive web interface that allows users to visualize, inspect, interact, and download our most current He data. The user can click on individual locations to see the available data at that location, as well as zoom in and out on a data density map. Concentrations on the map range from .04 mol% (lowest concentration of economic value) to 12% (highest naturally occurring values). This visual interface will allow users to develop a rapid appreciation of the areas with the highest potential for high helium concentrations within oil and gas fields.

  2. Is income inequality a determinant of population health? Part 2. U.S. National and regional trends in income inequality and age- and cause-specific mortality.

    PubMed

    Lynch, John; Smith, George Davey; Harper, Sam; Hillemeier, Marianne

    2004-01-01

    This article describes U.S. income inequality and 100-year national and 30-year regional trends in age- and cause-specific mortality. There is little congruence between national trends in income inequality and age- or cause-specific mortality except perhaps for suicide and homicide. The variable trends in some causes of mortality may be associated regionally with income inequality. However, between 1978 and 2000 those regions experiencing the largest increases in income inequality had the largest declines in mortality (r= 0.81, p < 0.001). Understanding the social determinants of population health requires appreciating how broad indicators of social and economic conditions are related, at different times and places, to the levels and social distribution of major risk factors for particular health outcomes.

  3. Mixed conifer forest mortality and establishment before and after prescribed fire in Sequoia National Park, California

    USGS Publications Warehouse

    Mutch, L.S.; Parsons, D.J.

    1998-01-01

    Pre-and post-burn tree mortality rates, size structure, basal area, and ingrowth were determined for four 1.0 ha mixed conifer forest stands in the Log Creek and Tharp's Creek watersheds of Sequoia National Park. Mean annual mortality between 1986 and 1990 was 0.8% for both watersheds. In the fall of 1990, the Tharp's Creek watershed was treated with a prescribed burn. Between 1991 and 1995, mean annual mortality was 1.4% in the unburned Log Creek watershed and 17.2% in the burned Tharp's Creek watershed. A drought from 1987 to 1992 likely contributed to the mortality increase in the Log Creek watershed. The high mortality in the Tharp's Creek watershed was primarily related to crown scorch from the 1990 fire and was modeled with logistic regression for white fir (Abies concolor [Gord. and Glend.]) and sugar pine (Pinus lambertiana [Dougl.]). From 1989 to 1994, basal area declined an average of 5% per year in the burned Tharp's Creek watershed, compared to average annual increases of less than 1% per year in the unburned Log Creek watershed and in the Tharp's watershed prior to burning. Post-burn size structure was dramatically changed in the Tharp's Creek stands: 75% of trees ???50 cm and 25% of trees >50 cm were killed by the fire.

  4. Global Prostate Cancer Incidence and Mortality Rates According to the Human Development Index.

    PubMed

    Khazaei, Salman; Rezaeian, Shahab; Ayubi, Erfan; Gholamaliee, Behzad; Pishkuhi, Mahin Ahmadi; Khazaei, Somayeh; Mansori, Kamyar; Nematollahi, Shahrzad; Sani, Mohadeseh; Hanis, Shiva Mansouri

    2016-01-01

    Prostate cancer (PC) is one of the leading causes of death, especially in developed countries. The human development index (HDI) and its dimensions seem correlated with incidence and mortality rates of PC. This study aimed to assess the association of the specific components of HDI (life expectancy at birth, education, gross national income per 1000 capita, health, and living standards) with burden indicators of PC worldwide. Information of the incidence and mortality rates of PC was obtained from the GLOBOCAN cancer project in year 2012 and data about the HDI 2013 were obtained from the World Bank database. The correlation between incidence, mortality rates, and the HDI parameters were assessed using STATA software. A significant inequality of PC incidence rates was observed according to concentration indexes=0.25 with 95% CI (0.22, 0.34) and a negative mortality concentration index of -0.04 with 95% CI (-0.09, 0.01) was observed. A positive significant correlation was detected between the incidence rates of PC and the HDI and its dimensions including life expectancy at birth, education, income, urbanization level and obesity. However, there was a negative significant correlation between the standardized mortality rates and the life expectancy, income and HDI.

  5. Marijuana use and mortality following orthopedic surgical procedures.

    PubMed

    Moon, Andrew S; Smith, Walter; Mullen, Sawyer; Ponce, Brent A; McGwin, Gerald; Shah, Ashish; Naranje, Sameer M

    2018-03-20

    The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries. The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing five common orthopedic procedures: hip (THA), knee (TKA), and shoulder arthroplasty (TSA), spinal fusion, and traumatic femur fracture fixation. Of 9,561,963 patients who underwent one of the five selected procedures in the four-year period, 26,416 (0.28%) were identified with a diagnosis of marijuana use disorder. In hip and knee arthroplasty patients, marijuana use was associated with decreased odds of mortality compared to no marijuana use (p<0.0001), and increased odds of HF (p = 0.018), stroke (p = 0.0068), and CD (p = 0.0123). Traumatic femur fixation patients had the highest prevalence of marijuana use (0.70%), which was associated with decreased odds of mortality (p = 0.0483), HF (p = 0.0076), and CD (p = 0.0003). For spinal fusions, marijuana use was associated with increased odds of stroke (p<0.0001) and CD (p<0.0001). Marijuana use in patients undergoing shoulder arthroplasty was associated with decreased odds of mortality (p<0.001) and stroke (p<0.001). In this study, marijuana use was associated with decreased mortality in patients undergoing THA, TKA, TSA and traumatic femur fixation, although the significance of these findings remains unclear. More research is needed to provide insight into these associations in a growing surgical population.

  6. Effect of Rehabilitation Intensity on Mortality Risk After Stroke.

    PubMed

    Hsieh, Cheng-Yang; Huang, Hsiu-Chen; Wu, Darren Philbert; Li, Chung-Yi; Chiu, Meng-Jun; Sung, Sheng-Feng

    2018-06-01

    To determine the relation between rehabilitation intensity and poststroke mortality. Retrospective cohort study. Nationwide claims data. From Taiwan's National Health Insurance claims databases, patients (N=6737; mean age, 66.9y; 40.3% women) hospitalized between 2001 and 2013 for a first-ever stroke who had mild to moderate stroke and survived the first 90 days of stroke were enrolled. The intensity of rehabilitation therapy within 90 days after stroke was categorized into low, medium, or high based on the tertile distribution of the number of rehabilitation sessions. Long-term all-cause mortality. The Cox proportional hazard models with Bonferroni correction were used to assess the association between rehabilitation intensity and mortality, adjusting for age, comorbidities, stroke severity, and other covariates. Patients in the high-intensity group were younger but had a higher burden of comorbidities and greater stroke severity. During follow-up, the high-intensity group was associated with a significantly lower adjusted risk (hazard ratio [HR], .73; 95% confidence interval [CI], .63-.84) of mortality than the low-intensity group, whereas the medium-intensity group carried a similar risk of mortality (HR, 0.94; 95% CI, 0.84-1.06) compared with the low-intensity group. This association was not modified by stroke severity. Among patients with mild to moderate stroke severity, high-intensity rehabilitation therapy within the first 90 days was associated with a lower mortality risk than low-intensity therapy. Efforts to promote high-intensity rehabilitation therapy for this group of patients with stroke should be encouraged. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Acute kidney injury impact on inpatient mortality in Clostridium difficile infection: A national propensity-matched study.

    PubMed

    Charilaou, Paris; Devani, Kalpit; John, Febin; Kanna, Sowjanya; Ahlawat, Sushil; Young, Mark; Khanna, Sahil; Reddy, Chakradhar

    2018-06-01

    Acute kidney injury (AKI) is used as a marker of severity in Clostridium difficile infection (CDI) patients. We estimated the true effect of AKI in inpatient mortality of CDI patients, as there are no large-scale, population-based, propensity-matched studies evaluating AKI's effect in this patient cohort. A retrospective observational study utilizing the National Inpatient Sample from years 2003 to 2012, including all adults with CDI, excluding cases missing data on age, inpatient mortality or gender. Trends and CDI-related complications as mortality predictors were assessed using survey-weighted multivariable regression. We estimated AKI's independent effect by propensity-matching, post-stratifying by chronic kidney disease status, allowing for multiple comorbidity adjustment. A total of 2 859 599 patients with CDI were included, of which 896 122 (31.3%) had principal diagnosis of CDI. AKI prevalence was 22%. Mortality rate was 8.4%, while among AKI patients was higher (18.2%). In multivariable regression, AKI was associated with higher mortality (odds ratio [OR] = 3.16, 95% confidence interval [CI]: 3.02-3.30; P < 0.001), while after propensity matching, AKI increased mortality by 86% (OR = 1.86, 95% CI: 1.79-1.94; P < 0.001). CDI incidence increased by 1.8, together with the rate of AKI (12.6% in 2003 to 28.8% in 2012, P-trend < 0.001). Despite increasing hospitalizations, mortality over the study period decreased to 7.2% (2012) from 9.0% (2003); P-trend < 0.001. Hospital admissions of patients with CDI and concomitant AKI are increasing, but their inpatient mortality has improved over the study period. AKI is a significant contributor to mortality, independently of other comorbidities, complications, and hospital characteristics, emphasizing the need for early diagnosis and aggressive management in such patients. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  8. A prospective study of water intake and subsequent risk of all-cause mortality in a national cohort.

    PubMed

    Kant, Ashima K; Graubard, Barry I

    2017-01-01

    Water, an essential nutrient, is believed to be related to a variety of health outcomes. Published studies have examined the association of fluid or beverage intake with risk of mortality from coronary diseases, diabetes, or cancer, but few studies have examined the association of total water intake with all-cause mortality. We examined prospective risk of mortality from all causes in relation to intakes of total water and each of the 3 water sources. We used public-domain, mortality-linked water intake data from the NHANES conducted in 1988-1994 and 1999-2004 for this prospective cohort study (n = 12,660 women and 12,050 men; aged ≥25 y). Mortality follow-up was completed through 31 December 2011. We used sex-specific Cox proportional hazards regression methods that were appropriate for complex surveys to examine the independent associations of plain water, beverage water, water in foods, and total water with multiple covariate-adjusted risk of mortality from all causes. Over a median of 11.4 y of follow-up, 3504 men and 3032 women died of any cause in this cohort. In men, neither total water intake nor each of the individual water source variables (plain water, water in beverages, and water in foods) was independently related with risk of all-cause mortality. In women, risk of mortality increased slightly in the highest quartile of total or plain water intake but did not approach the Bonferroni-corrected level of significance of P < 0.002. There was no survival advantage in association with higher total or plain water intake in men or women in this national cohort. The slight increase in risk of mortality noted in women with higher total and plain water intakes may be spurious and requires further investigation. © 2017 American Society for Nutrition.

  9. Geothopica and the interactive analysis and visualization of the updated Italian National Geothermal Database

    NASA Astrophysics Data System (ADS)

    Trumpy, Eugenio; Manzella, Adele

    2017-02-01

    The Italian National Geothermal Database (BDNG), is the largest collection of Italian Geothermal data and was set up in the 1980s. It has since been updated both in terms of content and management tools: information on deep wells and thermal springs (with temperature > 30 °C) are currently organized and stored in a PostgreSQL relational database management system, which guarantees high performance, data security and easy access through different client applications. The BDNG is the core of the Geothopica web site, whose webGIS tool allows different types of user to access geothermal data, to visualize multiple types of datasets, and to perform integrated analyses. The webGIS tool has been recently improved by two specially designed, programmed and implemented visualization tools to display data on well lithology and underground temperatures. This paper describes the contents of the database and its software and data update, as well as the webGIS tool including the new tools for data lithology and temperature visualization. The geoinformation organized in the database and accessible through Geothopica is of use not only for geothermal purposes, but also for any kind of georesource and CO2 storage project requiring the organization of, and access to, deep underground data. Geothopica also supports project developers, researchers, and decision makers in the assessment, management and sustainable deployment of georesources.

  10. Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research

    PubMed Central

    Saokaew, Surasak; Sugimoto, Takashi; Kamae, Isao; Pratoomsoot, Chayanin; Chaiyakunapruk, Nathorn

    2015-01-01

    Background Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Method Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases’ characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Results Forty databases– 20 from Thailand and 20 from Japan—were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Conclusion Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed. PMID:26560127

  11. Comprehensive target populations for current active safety systems using national crash databases.

    PubMed

    Kusano, Kristofer D; Gabler, Hampton C

    2014-01-01

    The objective of active safety systems is to prevent or mitigate collisions. A critical component in the design of active safety systems is the identification of the target population for a proposed system. The target population for an active safety system is that set of crashes that a proposed system could prevent or mitigate. Target crashes have scenarios in which the sensors and algorithms would likely activate. For example, the rear-end crash scenario, where the front of one vehicle contacts another vehicle traveling in the same direction and in the same lane as the striking vehicle, is one scenario for which forward collision warning (FCW) would be most effective in mitigating or preventing. This article presents a novel set of precrash scenarios based on coded variables from NHTSA's nationally representative crash databases in the United States. Using 4 databases (National Automotive Sampling System-General Estimates System [NASS-GES], NASS Crashworthiness Data System [NASS-CDS], Fatality Analysis Reporting System [FARS], and National Motor Vehicle Crash Causation Survey [NMVCCS]) the scenarios developed in this study can be used to quantify the number of police-reported crashes, seriously injured occupants, and fatalities that are applicable to proposed active safety systems. In this article, we use the precrash scenarios to identify the target populations for FCW, pedestrian crash avoidance systems (PCAS), lane departure warning (LDW), and vehicle-to-vehicle (V2V) or vehicle-to-infrastructure (V2I) systems. Crash scenarios were derived using precrash variables (critical event, accident type, precrash movement) present in all 4 data sources. This study found that these active safety systems could potentially mitigate approximately 1 in 5 of all severity and serious injury crashes in the United States and 26 percent of fatal crashes. Annually, this corresponds to 1.2 million all severity, 14,353 serious injury (MAIS 3+), and 7412 fatal crashes. In addition

  12. Ninety-Day Postoperative Mortality after Robot-assisted Laparoscopic Prostatectomy and Retropubic Radical Prostatectomy. Nation-wide population-based study

    PubMed Central

    Björklund, Johan; Folkvaljon, Yasin; Cole, Alexander; Carlsson, Stefan; Robinson, David; Loeb, Stacy; Stattin, Pär; Akre, Olof

    2016-01-01

    Objective To assess 90-day postoperative mortality after Robot assisted laparoscopic Radical prostatectomy (RARP) and retropubic radical prostatectomy (RRP) by use of nationwide population-based registry data. Patients and methods Cohort study in the National Prostate Cancer Register (NPCR) of Sweden of 22 344 men with prostate cancer in clinical local stage T1-T3, PSA <50 μg/ml who had undergone primary RP in 1998 - 2012. Vital status was ascertained through the Total Population Register. 90-day postoperative mortality was analysed by use of logistic regression analysis and comparison of 90-day mortality with the background population were made using standardised mortality ratios (SMR). Results 29 out of 14820 men (0.20%) died after RRP and 10 out of 7524 men (0.13%) died after RARP. Mortality during the 90-day postoperative period in the cohort was lower than in an age-matched background population, SMR 0.57 (CI 95% 0.39-0.75). There was no statistically significant difference in 90-day mortality according to surgical method, RARP vs. RRP (odds ratio, OR 1.14; 95% CI, 0.46-2.81). Postoperative 90-day mortality decreased over time, 2008-2012 vs. 1998-2007 (OR 0.44; 95% CI, 0.21-0.95), mainly due to decreased mortality after RARP. Limitations of our study include the non-randomised design and that more RARP were performed in recent years compared to RRP. Conclusion 90-day postoperative mortality was low after RARP and RRP and there was nostatistically significant difference between the methods. Given the long life expectancy among men with low and intermediate risk prostate cancer, very low postoperative mortality is a prerequisite for RP which was fulfilled by both RRP and RARP. The selection of healthy men for RP is highlighted by the lower 90-day mortality after RP compared to the background population. PMID:26762928

  13. Adolescent conduct problems and premature mortality: follow-up to age 65 years in a national birth cohort.

    PubMed

    Maughan, B; Stafford, M; Shah, I; Kuh, D

    2014-04-01

    Severe youth antisocial behaviour has been associated with increased risk of premature mortality in high-risk samples for many years, and some evidence now points to similar effects in representative samples. We set out to assess the prospective association between adolescent conduct problems and premature mortality in a population-based sample of men and women followed to the age of 65 years. A total of 4158 members of the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort) were assessed for conduct problems at the ages of 13 and 15 years. Follow-up to the age of 65 years via the UK National Health Service Central Register provided data on date and cause of death. Dimensional measures of teacher-rated adolescent conduct problems were associated with increased hazards of death from cardiovascular disease by the age of 65 years in men [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.04-1.32], and of all-cause and cancer mortality by the age of 65 years in women (all-cause HR 1.16, 95% CI 1.07-1.25). Adjustment for childhood cognition and family social class did little to attenuate these risks. Adolescent conduct problems were not associated with increased risks of unnatural/substance-related deaths in men or women in this representative sample. Whereas previous studies of high-risk delinquent or offender samples have highlighted increased risks of unnatural and alcohol- or substance abuse-related deaths in early adulthood, we found marked differences in mortality risk from other causes emerging later in the life course among women as well as men.

  14. Infant mortality gap in the Baltic region - Latvia, Estonia, and Lithuania - in relation to macroeconomic factors in 1996-2010.

    PubMed

    Ebela, Inguna; Zile, Irisa; Ebela, Danute Razuka; Rozenfelde, Ingrida Rumba

    2013-01-01

    BACKGROUND AND OBJECTIVE. A constant gap has appeared in infant mortality among the 3 Baltic States - Latvia, Estonia, and Lithuania - since the restoration of independence in 1991. The aim of the study was to compare infant mortality rates in all the 3 Baltic countries and examine some of the macro- and socioeconomic factors associated with infant mortality. MATERIAL AND METHODS. The data were obtained from international databases, such as World Health Organization and EUROSTAT, and the national statistical databases of the Baltic States. The time series data sets (1996-2010) were used in the regression and correlation analysis. RESULTS. In all the 3 Baltic States, a strong and significant correlation was found: Latvia (r=-0.81, P<0.01), Lithuania (r=-0.93, P<0.01), and Estonia (r=-0.91, P<0.01). There was also a correlation between infant mortality and healthcare expenditure in local currency per capita: Latvia (r=-0.81, P<0.01); Lithuania (r=-0.90, P<0.01) and Estonia (r=-0.88, P<0.01). In Latvia (r=0.87, P<0.01) and Estonia (r=0.70; P<0.01), a significant correlation between infant mortality and unemployment levels was observed from 1996 to 2008, whereas the statistical significance disappeared in the period from 1996 to 2010. In Lithuania, the relationship was not significant. CONCLUSIONS. Higher infant mortality rates and a less stable decreasing tendency in Latvia are apparently explained by less successful adaptation to a new political and economic situation and limited skills in adjusting the healthcare system to the reality of life.

  15. Immigrant Health Inequalities in the United States: Use of Eight Major National Data Systems

    PubMed Central

    Kogan, Michael D.

    2013-01-01

    Eight major federal data systems, including the National Vital Statistics System (NVSS), National Health Interview Survey (NHIS), National Survey of Children's Health, National Longitudinal Mortality Study, and American Community Survey, were used to examine health differentials between immigrants and the US-born across the life course. Survival and logistic regression, prevalence, and age-adjusted death rates were used to examine differentials. Although these data systems vary considerably in their coverage of health and behavioral characteristics, ethnic-immigrant groups, and time periods, they all serve as important research databases for understanding the health of US immigrants. The NVSS and NHIS, the two most important data systems, include a wide range of health variables and many racial/ethnic and immigrant groups. Immigrants live 3.4 years longer than the US-born, with a life expectancy ranging from 83.0 years for Asian/Pacific Islander immigrants to 69.2 years for US-born blacks. Overall, immigrants have better infant, child, and adult health and lower disability and mortality rates than the US-born, with immigrant health patterns varying across racial/ethnic groups. Immigrant children and adults, however, fare substantially worse than the US-born in health insurance coverage and access to preventive health services. Suggestions and new directions are offered for improvements in health monitoring and for strengthening and developing databases for immigrant health assessment in the USA. PMID:24288488

  16. Patient demographics, insurance status, race, and ethnicity as predictors of morbidity and mortality after spine trauma: a study using the National Trauma Data Bank.

    PubMed

    Schoenfeld, Andrew J; Belmont, Philip J; See, Aaron A; Bader, Julia O; Bono, Christopher M

    2013-12-01

    Predictors of complications and mortality after spine trauma are underexplored. At present, no study exists capable of predicting the impact of demographic factors, injury-specific predictors, race, ethnicity, and insurance status on morbidity and mortality after spine trauma. This study endeavored to describe the impact of patient demographics, comorbidities, injury-specific factors, race/ethnicity, and insurance status on outcomes after spinal trauma using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB). The weighted sample of 75,351 incidents of spine trauma in the NTDB was used to develop a predictive model for important factors associated with mortality, postinjury complications, length of hospital stay, intensive care unit (ICU) days, and time on a ventilator. A weighted sample of 75,351 incidents of spine trauma as contained in the NTDB. Mortality, postinjury complications, length of hospital stay, ICU days, and time on a ventilator as reported in the NTDB. The 2008 NSP of the NTDB was queried to identify patients sustaining spine trauma. Patient demographics, race/ethnicity, insurance status, comorbidities, injury-specific factors, and outcomes were recorded, and a national estimate model was derived. Unadjusted differences in baseline characteristics between racial/ethnic groups and insurance status were evaluated using the t test for continuous variables and Wald chi-square analysis for categorical variables with Bonferroni correction for multiple comparisons. Weighted logistic regression was performed for categorical variables (mortality and risk of one or more complications), and weighted multiple linear regression analysis was used for continuous variables (length of hospital stay, ICU days, and ventilator time). Initial determinations were checked against a sensitivity analysis using imputed data. The weighted sample contained 75,351 incidents of spine trauma. The average age was 45.8 years. Sixty-four percent of the

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

    PubMed

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

    2018-02-27

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

  18. Cervical cancer, a disease of poverty: mortality differences between urban and rural areas in Mexico.

    PubMed

    Palacio-Mejía, Lina Sofía; Rangel-Gómez, Gudelia; Hernández-Avila, Mauricio; Lazcano-Ponce, Eduardo

    2003-01-01

    To examine cervical cancer mortality rates in Mexican urban and rural communities, and their association with poverty-related factors, during 1990-2000. We analyzed data from national databases to obtain mortality trends and regional variations using a Poisson regression model based on location (urban-rural). During 1990-2000 a total of 48,761 cervical cancer (CC) deaths were reported in Mexico (1990 = 4,280 deaths/year; 2000 = 4,620 deaths/year). On average, 12 women died every 24 hours, with 0.76% yearly annual growth in CC deaths. Women living in rural areas had 3.07 higher CC mortality risks compared to women with urban residence. Comparison of state CC mortality rates (reference = Mexico City) found higher risk in states with lower socio-economic development (Chiapas, relative risk [RR] = 10.99; Nayarit, RR = 10.5). Predominantly rural states had higher CC mortality rates compared to Mexico City (lowest rural population). CC mortality is associated with poverty-related factors, including lack of formal education, unemployment, low socio-economic level, rural residence and insufficient access to healthcare. This indicates the need for eradication of regional differences in cancer detection. This paper is available too at: http://www.insp.mx/salud/index.html.

  19. [Mortality rate of acute heart attack in Zalaegerszeg micro-region. Results of the first Hungarian 24-hour acute ST-elevation myocardial infarction intervention care unit].

    PubMed

    Lupkovics, Géza; Motyovszki, Akos; Németh, Zoltán; Takács, István; Kenéz, András; Burkali, Bernadett; Menyhárt, Ildikó

    2010-04-04

    Morbidity and mortality rates of acute heart attack emphasize the significance of this patient group worldwide. The prompt and exact diagnosis and the timing of adequate therapy is crucial for this patients. Modern supply of acute heart attack includes invasive cardiology intervention, primer percutaneous coronary intervention. In year 1999, American and European recommendations suggested primer percutaneous coronary intervention only as an alternative possibility instead of thrombolysis, or in case of cardiogenic shock. 24 hour intervention unit for patients with acute heart attack was first organized in Hungary in Zala County Hospital's Cardiology Department, in year 1998. Our present study confirms, that since the intervention treatment has been introduced, average mortality rate has been reduced considerably in our area comparing to the national average. Mortality rates in West Transdanubian region and in Zalaegerszeg's micro-region were studied and compared for the period between 1997-2004, according to the data of National Public Health and Medical Officer Service. These data were then compared with the national average mortality data of Hungarian Central Statistical Office. With the help of our own computerized database we examined this period and compared the number of the completed invasive interventions to the mortality statistics. In the first full year, in 1998, we completed 82 primer and 283 elective PCIs; these number increased to 318 and 1265 by year 2005. At the same time, significant decrease of acute infarction related mortality was detectable among men of the Zalaegerszeg micro-region, comparing to the national average (p<0.001). The first Hungarian 24 hour acute heart attack intervention care improved the area's mortality statistics significantly, comparing to the national average. The skilled work of the experienced team means an important advantage to the patients in Zalaegerszeg micro-region.

  20. Trainee participation is associated with adverse outcomes in emergency general surgery: an analysis of the National Surgical Quality Improvement Program database.

    PubMed

    Kasotakis, George; Lakha, Aliya; Sarkar, Beda; Kunitake, Hiroko; Kissane-Lee, Nicole; Dechert, Tracey; McAneny, David; Burke, Peter; Doherty, Gerard

    2014-09-01

    To identify whether resident involvement affects clinically relevant outcomes in emergency general surgery. Previous research has demonstrated a significant impact of trainee participation on outcomes in a broad surgical patient population. We identified 141,010 patients who underwent emergency general surgery procedures in the 2005-2010 Surgeons National Surgical Quality Improvement Program database. Because of the nonrandom assignment of complex cases to resident participation, patients were matched (1:1) on known risk factors [age, sex, inpatient status, preexisting comorbidities (obesity, diabetes, smoking, alcohol, steroid use, coronary artery disease, chronic renal failure, pulmonary disease)] and preoperatively calculated probability for morbidity and mortality. Clinically relevant outcomes were compared with a t or χ test. The impact of resident participation on outcomes was assessed with multivariable regression modeling, adjusting for risk factors and operative time. The most common procedures in the matched cohort (n = 83,790) were appendectomy (39.9%), exploratory laparotomy (8.8%), and adhesiolysis (6.6%). Trainee participation is independently associated with intra- and postoperative events, wound, pulmonary, and venous thromboembolic complications, and urinary tract infections. Trainee participation is associated with adverse outcomes in emergency general surgery procedures.

  1. Relationship Between Preoperative Anemia and In-Hospital Mortality in Children Undergoing Noncardiac Surgery.

    PubMed

    Faraoni, David; DiNardo, James A; Goobie, Susan M

    2016-12-01

    The relationship between preoperative anemia and in-hospital mortality has not been investigated in the pediatric surgical population. We hypothesized that children with preoperative anemia undergoing noncardiac surgery may have an increased risk of in-hospital mortality. We identified all children between 1 and 18 years of age with a recorded preoperative hematocrit (HCT) in the 2012, 2013, and 2014 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) pediatric databases. The endpoint was defined as the incidence of in-hospital mortality. Children with preoperative anemia were identified based on their preoperative HCT. Demographic and surgical characteristics, as well as comorbidities, were considered potential confounding variables in a multivariable logistic regression analysis. A sensitivity analysis was performed using propensity-matched analysis. Among the 183,833 children included in the 2012, 2013, and 2014 ACS NSQIP database, 74,508 had a preoperative HCT recorded (41%). After exclusion of all children <1 year of age (n = 12,063), those with congenital heart disease (n = 8943), and those who received a preoperative red blood cell (RBC) transfusion (n = 1880), 12,551 (24%) children were anemic, and 39,071 (76%) were nonanemic. The median preoperative HCT was 33% (interquartile range, 31-35) in anemic children, and 39% (interquartile range, 37-42) in nonanemic children (P < .001). Using multivariable logistic regression analysis, and after adjustment for RBC transfusion (OR, 2.13; 95% CI, 1.39-3.26; P < .001), we observed that preoperative anemia was associated with higher odds for in-hospital mortality (OR, 2.17; 95% CI, 1.48-3.19; P < .001). After propensity matching, the presence of anemia was also associated with higher odds of in-hospital mortality (OR, 1.75; 95% CI, 1.15-2.65; P = .004). Our study demonstrates that children with preoperative anemia are at increased risk for in-hospital mortality. Further studies are

  2. Distinct Age and Self-Rated Health Crossover Mortality Effects for African Americans: Evidence from a National Cohort Study

    PubMed Central

    Roth, David L.; Skarupski, Kimberly A.; Crews, Deidra C.; Howard, Virginia J.; Locher, Julie L.

    2016-01-01

    The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may “crossover” at about 75 to 80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality

  3. Distinct age and self-rated health crossover mortality effects for African Americans: Evidence from a national cohort study.

    PubMed

    Roth, David L; Skarupski, Kimberly A; Crews, Deidra C; Howard, Virginia J; Locher, Julie L

    2016-05-01

    The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may "crossover" at about 75-80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality

  4. Long-term chemical carcinogenesis experiments for identifying potential human cancer hazards: collective database of the National Cancer Institute and National Toxicology Program (1976-1991).

    PubMed Central

    Huff, J; Haseman, J

    1991-01-01

    The carcinogenicity database used for this paper originated in the late 1960s by the National Cancer Institute (NCI) and since 1978 has been continued and made more comprehensive by the National Toxicology Program (NTP). The extensive files contain, among other sets of information, detailed pathology data on more than 400 long-term (most often 24-month) chemical carcinogenesis studies, comprising nearly 1600 individual experiments having at least 10 million tissue sections that have been evaluated for toxicity and carcinogenicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1820269

  5. Infant Mortality: 1989 Research Accomplishments.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    Collected in this document are reports of the National Institutes of Health's 1989 accomplishments in research on the problem of infant mortality. Reports are provided by the: (1) National Institute of Child Health and Human Development; (2) National Cancer Institute; (3) National Heart, Lung, and Blood Institute; (4) National Institute of…

  6. [Technical improvement of cohort constitution in administrative health databases: Providing a tool for integration and standardization of data applicable in the French National Health Insurance Database (SNIIRAM)].

    PubMed

    Ferdynus, C; Huiart, L

    2016-09-01

    Administrative health databases such as the French National Heath Insurance Database - SNIIRAM - are a major tool to answer numerous public health research questions. However the use of such data requires complex and time-consuming data management. Our objective was to develop and make available a tool to optimize cohort constitution within administrative health databases. We developed a process to extract, transform and load (ETL) data from various heterogeneous sources in a standardized data warehouse. This data warehouse is architected as a star schema corresponding to an i2b2 star schema model. We then evaluated the performance of this ETL using data from a pharmacoepidemiology research project conducted in the SNIIRAM database. The ETL we developed comprises a set of functionalities for creating SAS scripts. Data can be integrated into a standardized data warehouse. As part of the performance assessment of this ETL, we achieved integration of a dataset from the SNIIRAM comprising more than 900 million lines in less than three hours using a desktop computer. This enables patient selection from the standardized data warehouse within seconds of the request. The ETL described in this paper provides a tool which is effective and compatible with all administrative health databases, without requiring complex database servers. This tool should simplify cohort constitution in health databases; the standardization of warehouse data facilitates collaborative work between research teams. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Semantic mediation in the national geologic map database (US)

    USGS Publications Warehouse

    Percy, D.; Richard, S.; Soller, D.

    2008-01-01

    Controlled language is the primary challenge in merging heterogeneous databases of geologic information. Each agency or organization produces databases with different schema, and different terminology for describing the objects within. In order to make some progress toward merging these databases using current technology, we have developed software and a workflow that allows for the "manual semantic mediation" of these geologic map databases. Enthusiastic support from many state agencies (stakeholders and data stewards) has shown that the community supports this approach. Future implementations will move toward a more Artificial Intelligence-based approach, using expert-systems or knowledge-bases to process data based on the training sets we have developed manually.

  8. ETHNOS: A versatile electronic tool for the development and curation of national genetic databases

    PubMed Central

    2010-01-01

    National and ethnic mutation databases (NEMDBs) are emerging online repositories, recording extensive information about the described genetic heterogeneity of an ethnic group or population. These resources facilitate the provision of genetic services and provide a comprehensive list of genomic variations among different populations. As such, they enhance awareness of the various genetic disorders. Here, we describe the features of the ETHNOS software, a simple but versatile tool based on a flat-file database that is specifically designed for the development and curation of NEMDBs. ETHNOS is a freely available software which runs more than half of the NEMDBs currently available. Given the emerging need for NEMDB in genetic testing services and the fact that ETHNOS is the only off-the-shelf software available for NEMDB development and curation, its adoption in subsequent NEMDB development would contribute towards data content uniformity, unlike the diverse contents and quality of the available gene (locus)-specific databases. Finally, we allude to the potential applications of NEMDBs, not only as worldwide central allele frequency repositories, but also, and most importantly, as data warehouses of individual-level genomic data, hence allowing for a comprehensive ethnicity-specific documentation of genomic variation. PMID:20650823

  9. ETHNOS : A versatile electronic tool for the development and curation of national genetic databases.

    PubMed

    van Baal, Sjozef; Zlotogora, Joël; Lagoumintzis, George; Gkantouna, Vassiliki; Tzimas, Ioannis; Poulas, Konstantinos; Tsakalidis, Athanassios; Romeo, Giovanni; Patrinos, George P

    2010-06-01

    National and ethnic mutation databases (NEMDBs) are emerging online repositories, recording extensive information about the described genetic heterogeneity of an ethnic group or population. These resources facilitate the provision of genetic services and provide a comprehensive list of genomic variations among different populations. As such, they enhance awareness of the various genetic disorders. Here, we describe the features of the ETHNOS software, a simple but versatile tool based on a flat-file database that is specifically designed for the development and curation of NEMDBs. ETHNOS is a freely available software which runs more than half of the NEMDBs currently available. Given the emerging need for NEMDB in genetic testing services and the fact that ETHNOS is the only off-the-shelf software available for NEMDB development and curation, its adoption in subsequent NEMDB development would contribute towards data content uniformity, unlike the diverse contents and quality of the available gene (locus)-specific databases. Finally, we allude to the potential applications of NEMDBs, not only as worldwide central allele frequency repositories, but also, and most importantly, as data warehouses of individual-level genomic data, hence allowing for a comprehensive ethnicity-specific documentation of genomic variation.

  10. Systemic inaccuracies in the National Surgical Quality Improvement Program database: Implications for accuracy and validity for neurosurgery outcomes research.

    PubMed

    Rolston, John D; Han, Seunggu J; Chang, Edward F

    2017-03-01

    The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides a rich database of North American surgical procedures and their complications. Yet no external source has validated the accuracy of the information within this database. Using records from the 2006 to 2013 NSQIP database, we used two methods to identify errors: (1) mismatches between the Current Procedural Terminology (CPT) code that was used to identify the surgical procedure, and the International Classification of Diseases (ICD-9) post-operative diagnosis: i.e., a diagnosis that is incompatible with a certain procedure. (2) Primary anesthetic and CPT code mismatching: i.e., anesthesia not indicated for a particular procedure. Analyzing data for movement disorders, epilepsy, and tumor resection, we found evidence of CPT code and postoperative diagnosis mismatches in 0.4-100% of cases, depending on the CPT code examined. When analyzing anesthetic data from brain tumor, epilepsy, trauma, and spine surgery, we found evidence of miscoded anesthesia in 0.1-0.8% of cases. National databases like NSQIP are an important tool for quality improvement. Yet all databases are subject to errors, and measures of internal consistency show that errors affect up to 100% of case records for certain procedures in NSQIP. Steps should be taken to improve data collection on the frontend of NSQIP, and also to ensure that future studies with NSQIP take steps to exclude erroneous cases from analysis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Establishing of National Birth Defects Registry in Thailand.

    PubMed

    Pangkanon, Suthipong; Sawasdivorn, Siraporn; Kuptanon, Chulaluck; Chotigeat, Uraiwan; Vandepitte, Warunee

    2014-06-01

    Deaths attributed to birth defects are a major cause of infant and under-five mortality as well as lifetime disabilities among those who survive. In Thailand, birth defects contribute to 21% of neonatal deaths. There is currently no systematic registry for congenital anomalies in Thailand. Queen Sirikit National Institute of Child Health has initiated a Thailand Birth Defects Registry to capture birth defects among newborn infants. To establish the national birth defects registry in order to determine the burden of birth defects in Thailand. The birth defects data come from four main sources: National Birth Registry Database; National Health Security Office's reimbursement database; Online Birth Defect Registry Database designed to capture new cases that were detected later; and birth defects data from 20 participated hospitals. All data are linked by unique 13-digit national identification number and International Classification of Diseases (ICD)-10 codes. This registry includes 19 common structural birth defects conditions and pilots in 20 hospitals. The registry is hospital-based, hybrid reporting system, including only live births whose information was collected up to 1 year of age. 3,696 infants out of 67,813 live births (8.28% of total live births in Thailand) were diagnosed with congenital anomalies. The prevalence rate of major anomalies was 26.12 per 1,000 live births. The five most common birth defects were congenital heart defects, limb anomalies, cleft lip/cleft palate, Down syndrome, and congenital hydrocephalus respectively. The present study established the Birth Defects Registry by collecting data from four databases in Thailand. Information obtained from this registry and surveillance is essential in the planning for effective intervention programs for birth defects. The authors suggest that this program should be integrated in the existing public health system to ensure sustainability.

  12. Alignment of systematic reviews published in the Cochrane Database of Systematic Reviews and the Database of Abstracts and Reviews of Effectiveness with global burden-of-disease data: a bibliographic analysis.

    PubMed

    Yoong, Sze Lin; Hall, Alix; Williams, Christopher M; Skelton, Eliza; Oldmeadow, Christopher; Wiggers, John; Karimkhani, Chante; Boyers, Lindsay N; Dellavalle, Robert P; Hilton, John; Wolfenden, Luke

    2015-07-01

    Systematic reviews of high-quality evidence are used to inform policy and practice. To improve community health, the production of such reviews should align with burden of disease. This study aims to assess if the volume of research output from systematic reviews proportionally aligns with burden of disease assessed using percentages of mortality and disability-adjusted life years (DALYs). A cross-sectional audit of reviews published between January 2012 and August 2013 in the Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE) was undertaken. Percentages of mortality and DALYs were obtained from the 2010 Global Burden of Disease study. Standardised residual differences (SRD) based on percentages of mortality and DALYs were calculated, where conditions with SRD of more than or less than three were considered overstudied or understudied, respectively. 1029 reviews from CDSR and 1928 reviews from DARE were examined. There was a significant correlation between percentage DALYs and systematic reviews published in CDSR and DARE databases (CDSR: r=0.68, p=0.001; DARE: r=0.60, p<0.001). There was no significant correlation between percentage mortality and number of systematic reviews published in either database (CDSR: r=0.34, p=0.14; DARE: r=0.22, p=0.34). Relative to percentage of mortality, mental and behavioural disorders, musculoskeletal conditions and other non-communicable diseases were overstudied. Maternal disorders were overstudied relative to percentages of mortality and DALYs in CDSR. The focus of systematic reviews is moderately correlated with DALYs. A number of conditions may be overstudied relative to percentage of mortality particularly in the context of health and medical reviews. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Association of Hypothyroidism with All-cause Mortality: A Cohort Study in an Older Adult Population.

    PubMed

    Huang, Huei-Kai; Wang, Jen-Hung; Kao, Sheng-Lun

    2018-06-26

    Although hypothyroidism is associated with many comorbidities, the evidence for its association with all-cause mortality in older adults is limited. To evaluate the association between hypothyroidism and all-cause mortality in older adults. Population-based retrospective cohort study. National Health Insurance Research Database in Taiwan. After 1:10 age/sex/index year matching, 2029 patients aged ≥65 years who received a new diagnosis of hypothyroidism between 2001 and 2011, and 20290 patients without hypothyroidism or other thyroid diseases, were included in the hypothyroidism and non-hypothyroidism cohorts respectively. All-cause mortality was defined as the primary outcome. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of mortality. To further evaluate the effect of thyroxine replacement therapy (TRT) on mortality, we divided patients with hypothyroidism into two groups: patients who received TRT and those who did not. Hypothyroidism was associated with an increased risk of all-cause mortality (adjusted HR [aHR] = 1.82, 95% confidence interval [CI] = 1.68-1.98, p < 0.001). Patients with hypothyroidism who received TRT had a lower risk of mortality than patients who did not receive TRT (aHR = 0.57, 95% CI = 0.49-0.66, p < 0.001). Similar results were obtained after further propensity score matching, in age-, sex-, and comorbidity-stratified analyses. Hypothyroidism was independently associated with increased all-cause mortality in older adults. In patients with hypothyroidism, TRT was associated with a lower risk of all-cause mortality.

  14. An assessment study of maternal mortality ratio databank in five districts of North Western Frontier Province Pakistan.

    PubMed

    Farooq, Nasir; Jadoon, Huma; Masood, Tayyeb Imran; Wazir, M Saleem; Farooq, Umer; Lodhi, Mohammad Saqib

    2006-01-01

    Maternal mortality ratio is an indicator to measure the summary of information about mother and child health. It is estimated that about 500 maternal deaths occur per 100,000 live births each year in Pakistan. It is a well known fact that all health statistics coming out of the developing countries are calculated "guesstimates" some are perhaps more close to the real figures than the others. There is a dire need to help generate information that can be used by health professionals, health care planners and managers to save women's lives by improving the quality of care provided to turn away maternal mortality. The maternal mortality ratio for Pakistan as well as for NWFP is projected as 533/100,000 live births for the year 1990-91 produced by National Institute of Population Studies, Pakistan. This was a retrospective cross-sectional quantitative study for the period (2001-2002) conducted in five districts of (NWFP) North Western Frontier Province, Pakistan. National HMIS data opened the maternal mortality ratio for; Haripur as 0.168 and 0.173, Mansehra 00 and 00, Battagram 00 and 00, Swat 0.051. and 0.524 and Swabi 00 and 0.968 per/1000 live births, respectively. The small part exercise outcome (the study) endorsed more shadowy side of the actual maternal mortality ratio for the same period in the same districts. In our country there is a urgent need to institute an efficient mode of operation to get accurate maternal mortality database. Verbal Autopsy method is cost effective and feasible approach for implementation in a country like Pakistan.

  15. The extent of intestinal failure-associated liver disease in patients referred for intestinal rehabilitation is associated with increased mortality: an analysis of the pediatric intestinal failure consortium database.

    PubMed

    Javid, Patrick J; Oron, Assaf P; Duggan, Christopher; Squires, Robert H; Horslen, Simon P

    2017-09-05

    The advent of regional multidisciplinary intestinal rehabilitation programs has been associated with improved survival in pediatric intestinal failure. Yet, the optimal timing of referral for intestinal rehabilitation remains unknown. We hypothesized that the degree of intestinal failure-associated liver disease (IFALD) at initiation of intestinal rehabilitation would be associated with overall outcome. The multicenter, retrospective Pediatric Intestinal Failure Consortium (PIFCon) database was used to identify all subjects with baseline bilirubin data. Conjugated bilirubin (CBili) was used as a marker for IFALD, and we stratified baseline bilirubin values as CBili<2 mg/dL, CBili 2-4 mg/dL, and CBili>4 mg/dL. The association between baseline CBili and mortality was examined using Cox proportional hazards regression. Of 272 subjects in the database, 191 (70%) children had baseline bilirubin data collected. 38% and 28% of patients had CBili >4 mg/dL and CBili <2 mg/dL, respectively, at baseline. All-cause mortality was 23%. On univariate analysis, mortality was associated with CBili 2-4 mg/dL, CBili >4 mg/dL, prematurity, race, and small bowel atresia. On regression analysis controlling for age, prematurity, and diagnosis, the risk of mortality was increased by 3-fold for baseline CBili 2-4 mg/dL (HR 3.25 [1.07-9.92], p=0.04) and 4-fold for baseline CBili >4 mg/dL (HR 4.24 [1.51-11.92], p=0.006). On secondary analysis, CBili >4 mg/dL at baseline was associated with a lower chance of attaining enteral autonomy. In children with intestinal failure treated at intestinal rehabilitation programs, more advanced IFALD at referral is associated with increased mortality and decreased prospect of attaining enteral autonomy. Early referral of children with intestinal failure to intestinal rehabilitation programs should be strongly encouraged. Treatment Study, Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Completion of the 2011 National Land Cover Database for the Conterminous United States – Representing a Decade of Land Cover Change Information

    EPA Science Inventory

    The National Land Cover Database (NLCD) provides nationwide data on land cover and land cover change at the native 30-m spatial resolution of the Landsat Thematic Mapper (TM). The database is designed to provide five-year cyclical updating of United States land cover and associat...

  17. USDA's National Food and Nutrient Analysis Program (NFNAP) Produces High-Quality Data for USDA Food Composition Databases: Two Decades of Collaboration

    USDA-ARS?s Scientific Manuscript database

    For nearly 20 years, the National Food and Nutrient Analysis Program (NFNAP) has expanded and improved the quantity and quality of data in US Department of Agriculture’s (USDA) food composition databases through the collection and analysis of nationally representative food samples. This manuscript d...

  18. The Abdominal Aortic Aneurysm Statistically Corrected Operative Risk Evaluation (AAA SCORE) for predicting mortality after open and endovascular interventions.

    PubMed

    Ambler, Graeme K; Gohel, Manjit S; Mitchell, David C; Loftus, Ian M; Boyle, Jonathan R

    2015-01-01

    Accurate adjustment of surgical outcome data for risk is vital in an era of surgeon-level reporting. Current risk prediction models for abdominal aortic aneurysm (AAA) repair are suboptimal. We aimed to develop a reliable risk model for in-hospital mortality after intervention for AAA, using rigorous contemporary statistical techniques to handle missing data. Using data collected during a 15-month period in the United Kingdom National Vascular Database, we applied multiple imputation methodology together with stepwise model selection to generate preoperative and perioperative models of in-hospital mortality after AAA repair, using two thirds of the available data. Model performance was then assessed on the remaining third of the data by receiver operating characteristic curve analysis and compared with existing risk prediction models. Model calibration was assessed by Hosmer-Lemeshow analysis. A total of 8088 AAA repair operations were recorded in the National Vascular Database during the study period, of which 5870 (72.6%) were elective procedures. Both preoperative and perioperative models showed excellent discrimination, with areas under the receiver operating characteristic curve of .89 and .92, respectively. This was significantly better than any of the existing models (area under the receiver operating characteristic curve for best comparator model, .84 and .88; P < .001 and P = .001, respectively). Discrimination remained excellent when only elective procedures were considered. There was no evidence of miscalibration by Hosmer-Lemeshow analysis. We have developed accurate models to assess risk of in-hospital mortality after AAA repair. These models were carefully developed with rigorous statistical methodology and significantly outperform existing methods for both elective cases and overall AAA mortality. These models will be invaluable for both preoperative patient counseling and accurate risk adjustment of published outcome data. Copyright © 2015 Society

  19. Hospital Utilization, Costs, and Mortality for Adults With Multiple Chronic Conditions, Nationwide Inpatient Sample, 2009

    PubMed Central

    Friedman, Bernard

    2013-01-01

    Objective Our objective was to provide a national estimate across all payers of the distribution and cost of selected chronic conditions for hospitalized adults in 2009, stratified by demographic characteristics. Analysis We analyzed the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient database in the United States. Use, cost, and mortality estimates across payer, age, sex, and race/ethnicity are produced for grouped or multiple chronic conditions (MCC). The 5 most common dyads and triads were determined. Results In 2009, there were approximately 28 million adult discharges from US hospitals other than those related to pregnancy and maternity; 39% had 2 to 3 MCC, and 33% had 4 or more. A higher number of MCC was associated with higher mortality, use of services, and average cost. The percentages of Medicaid, privately insured patients, and ethnic/racial groups with 4 or more MCC were highly sensitive to age. Summary This descriptive analysis of multipayer inpatient data provides a robust national view of the substantial use and costs among adults hospitalized with MCC. PMID:23618542

  20. Establishing the ACORN National Practitioner Database: Strategies to Recruit Practitioners to a National Practice-Based Research Network.

    PubMed

    Adams, Jon; Steel, Amie; Moore, Craig; Amorin-Woods, Lyndon; Sibbritt, David

    2016-10-01

    The purpose of this paper is to report on the recruitment and promotion strategies employed by the Australian Chiropractic Research Network (ACORN) project aimed at helping recruit a substantial national sample of participants and to describe the features of our practice-based research network (PBRN) design that may provide key insights to others looking to establish a similar network or draw on the ACORN project to conduct sub-studies. The ACORN project followed a multifaceted recruitment and promotion strategy drawing on distinct branding, a practitioner-focused promotion campaign, and a strategically designed questionnaire and distribution/recruitment approach to attract sufficient participation from the ranks of registered chiropractors across Australia. From the 4684 chiropractors registered at the time of recruitment, the project achieved a database response rate of 36% (n = 1680), resulting in a large, nationally representative sample across age, gender, and location. This sample constitutes the largest proportional coverage of participants from any voluntary national PBRN across any single health care profession. It does appear that a number of key promotional and recruitment features of the ACORN project may have helped establish the high response rate for the PBRN, which constitutes an important sustainable resource for future national and international efforts to grow the chiropractic evidence base and research capacity. Further rigorous enquiry is needed to help evaluate the direct contribution of specific promotional and recruitment strategies in attaining high response rates from practitioner populations who may be invited to participate in future PBRNs. Copyright © 2016. Published by Elsevier Inc.