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Sample records for age standardized mortality

  1. Standardization of age-adjusted mortality rates

    SciTech Connect

    Selvin, S.; Sacks, S.T.; Merrill, D.W.

    1980-02-01

    Because age is a significant variable in the occurrence and frequency of human disease, any comparison of disease or mortality rates, to be useful, must be age-specific or age-adjusted. Age-specific comparisons are not always appropriate or possible, however. A common method of eliminating the influence of age in comparing mortality rates from one community to another is to employ statistical methods of age-adjustment. While a variety of methods will accomplish this task, most are weighted averages of the age-specific rates. Two widely used adjustment procedures are direct and indirect age-adjustment.

  2. Comparisons of infant mortality using a percentile-based method of standardization for birthweight or gestational age.

    PubMed

    Hertz-Picciotto, I; Din-Dzietham, R

    1998-01-01

    Comparisons of infant, perinatal, or neonatal mortality across populations with different birthweight or gestational age distributions are problematic. Summary measures with adjustment for birthweight or gestational age frequently are invalid or lack interpretability. We propose a percentile-based method of standardization for comparing infant, perinatal, or neonatal mortality across populations that have different distributions of birthweight and/or gestational age. The underlying concept is a simple one: comparable health for two population groups will be expressed as equal rates of disease or mortality at equal quantiles in the two distributions of birthweight or gestational age. We describe this method mathematically and present an example comparing mortality rates for African-American vs European-American infants in North Carolina. When gestational age is transformed to its rank, the well-known crossover in mortality rates, in which preterm African-American infants die at lower rates but term infants at higher rates, disappears: African-Americans show higher mortality rates at any percentile of gestational age. With homogeneous mortality rate ratios, a summary statistic becomes meaningful. We also demonstrate adjustment for percentile-transformed gestational age or birthweight in multiple logistic regression models. Percentile standardization is easily implemented, has advantages over other methods of internal standardization such as that of Wilcox and Russell, and communicates an intuitive public health-based concept of equality of mortality across populations.

  3. Differences in age-standardized mortality rates for avoidable deaths based on urbanization levels in Taiwan, 1971-2008.

    PubMed

    Chen, Brian K; Yang, Chun-Yuh

    2014-02-05

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result.

  4. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008

    PubMed Central

    Chen, Brian K.; Yang, Chun-Yuh

    2014-01-01

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result. PMID:24503974

  5. Autoantibodies, mortality and ageing.

    PubMed

    Richaud-Patin, Y; Villa, A R

    1995-01-01

    Immunological failure may be the cause of predisposition to certain infections, neoplasms, and vascular diseases in adulthood. Mortality risks through life may reflect an undetermined number of causes. This study describes the prevalence of positivity of autoantibodies through life, along with general and specific mortality causes in three countries with different socioeconomic development (Guatemala, Mexico and the United States). Prevalence of autoantibodies by age was obtained from previous reports. In spite of having involved different ethnic groups, the observed trends in prevalence of autoantibodies, as well as mortality through life, showed a similar behavior. Thus, both the increase in autoantibody production and death risk as age rises, may share physiopathological phenomena related to the ageing process.

  6. Weight-for-age standard score - distribution and effect on in-hospital mortality: A retrospective analysis in pediatric cardiac surgery

    PubMed Central

    George, Antony; Jagannath, Pushpa; Joshi, Shreedhar S.; Jagadeesh, A. M.

    2015-01-01

    Objective: To study the distribution of weight for age standard score (Z score) in pediatric cardiac surgery and its effect on in-hospital mortality. Introduction: WHO recommends Standard Score (Z score) to quantify and describe anthropometric data. The distribution of weight for age Z score and its effect on mortality in congenital heart surgery has not been studied. Methods: All patients of younger than 5 years who underwent cardiac surgery from July 2007 to June 2013, under single surgical unit at our institute were enrolled. Z score for weight for age was calculated. Patients were classified according to Z score and mortality across the classes was compared. Discrimination and calibration of the for Z score model was assessed. Improvement in predictability of mortality after addition of Z score to Aristotle Comprehensive Complexity (ACC) score was analyzed. Results: The median Z score was -3.2 (Interquartile range -4.24 to -1.91] with weight (mean±SD) of 8.4 ± 3.38 kg. Overall mortality was 11.5%. 71% and 52.59% of patients had Z score < -2 and < -3 respectively. Lower Z score classes were associated with progressively increasing mortality. Z score as continuous variable was associated with O.R. of 0.622 (95% CI- 0.527 to 0.733, P < 0.0001) for in-hospital mortality and remained significant predictor even after adjusting for age, gender, bypass duration and ACC score. Addition of Z score to ACC score improved its predictability for in-hosptial mortality (δC - 0.0661 [95% CI - 0.017 to 0.0595, P = 0.0169], IDI- 3.83% [95% CI - 0.017 to 0.0595, P = 0.00042]). Conclusion: Z scores were lower in our cohort and were associated with in-hospital mortality. Addition of Z score to ACC score significantly improves predictive ability for in-hospital mortality. PMID:26139742

  7. Onset of mortality increase with age and age trajectories of mortality from all diseases in the four Nordic countries

    PubMed Central

    Dolejs, Josef; Marešová, Petra

    2017-01-01

    Background The answer to the question “At what age does aging begin?” is tightly related to the question “Where is the onset of mortality increase with age?” Age affects mortality rates from all diseases differently than it affects mortality rates from nonbiological causes. Mortality increase with age in adult populations has been modeled by many authors, and little attention has been given to mortality decrease with age after birth. Materials and methods Nonbiological causes are excluded, and the category “all diseases” is studied. It is analyzed in Denmark, Finland, Norway, and Sweden during the period 1994–2011, and all possible models are screened. Age trajectories of mortality are analyzed separately: before the age category where mortality reaches its minimal value and after the age category. Results Resulting age trajectories from all diseases showed a strong minimum, which was hidden in total mortality. The inverse proportion between mortality and age fitted in 54 of 58 cases before mortality minimum. The Gompertz model with two parameters fitted as mortality increased with age in 17 of 58 cases after mortality minimum, and the Gompertz model with a small positive quadratic term fitted data in the remaining 41 cases. The mean age where mortality reached minimal value was 8 (95% confidence interval 7.05–8.95) years. The figures depict an age where the human population has a minimal risk of death from biological causes. Conclusion Inverse proportion and the Gompertz model fitted data on both sides of the mortality minimum, and three parameters determined the shape of the age–mortality trajectory. Life expectancy should be determined by the two standard Gompertz parameters and also by the single parameter in the model c/x. All-disease mortality represents an alternative tool to study the impact of age. All results are based on published data. PMID:28176929

  8. Standardized Thyroid Cancer Mortality in Korea between 1985 and 2010

    PubMed Central

    Choi, Yun Mi; Jang, Eun Kyung; Kwon, Hyemi; Jeon, Min Ji; Kim, Won Gu; Shong, Young Kee; Kim, Won Bae

    2014-01-01

    Background The prevalence of thyroid cancer has increased very rapidly in Korea. However, there is no published report focusing on thyroid cancer mortality in Korea. In this study, we aimed to evaluate standardized thyroid cancer mortality using data from Statistics Korea (the Statistical Office of Korea). Methods Population and mortality data from 1985 to 2010 were obtained from Statistics Korea. Age-standardized rates of thyroid cancer mortality were calculated according to the standard population of Korea, as well as World Health Organization (WHO) standard population and International Cancer Survival Standard (ICSS) population weights. Results The crude thyroid cancer mortality rate increased from 0.1 to 0.7 per 100,000 between 1985 and 2010. The pattern was the same for both sexes. The age-standardized mortality rate (ASMR) for thyroid cancer for Korean resident registration population increased from 0.19 to 0.67 between 1985 and 2000. However, it decreased slightly, from 0.67 to 0.55, between 2000 and 2010. When mortality was adjusted using the WHO standard population and ICSS population weights, the ASMR similarly increased until 2000, and then decreased between 2000 and 2010. Conclusion Thyroid cancer mortality increased until 2000 in Korea. It started to decrease from 2000. PMID:25559576

  9. Biodemography of old-age mortality in humans and rodents.

    PubMed

    Gavrilova, Natalia S; Gavrilov, Leonid A

    2015-01-01

    The growing number of persons living beyond age 80 underscores the need for accurate measurement of mortality at advanced ages and understanding the old-age mortality trajectories. It is believed that exponential growth of mortality with age (Gompertz law) is followed by a period of deceleration, with slower rates of mortality increase at older ages. This pattern of mortality deceleration is traditionally described by the logistic (Kannisto) model, which is considered as an alternative to the Gompertz model. Mortality deceleration was observed for many invertebrate species, but the evidence for mammals is controversial. We compared the performance (goodness-of-fit) of two competing models-the Gompertz model and the logistic (Kannisto) model using data for three mammalian species: 22 birth cohorts of U.S. men and women, eight cohorts of laboratory mice, and 10 cohorts of laboratory rats. For all three mammalian species, the Gompertz model fits mortality data significantly better than the "mortality deceleration" Kannisto model (according to the Akaike's information criterion as the goodness-of-fit measure). These results suggest that mortality deceleration at advanced ages is not a universal phenomenon, and survival of mammalian species follows the Gompertz law up to very old ages.

  10. Biodemography of Old-Age Mortality in Humans and Rodents

    PubMed Central

    Gavrilov, Leonid A.

    2015-01-01

    The growing number of persons living beyond age 80 underscores the need for accurate measurement of mortality at advanced ages and understanding the old-age mortality trajectories. It is believed that exponential growth of mortality with age (Gompertz law) is followed by a period of deceleration, with slower rates of mortality increase at older ages. This pattern of mortality deceleration is traditionally described by the logistic (Kannisto) model, which is considered as an alternative to the Gompertz model. Mortality deceleration was observed for many invertebrate species, but the evidence for mammals is controversial. We compared the performance (goodness-of-fit) of two competing models—the Gompertz model and the logistic (Kannisto) model using data for three mammalian species: 22 birth cohorts of U.S. men and women, eight cohorts of laboratory mice, and 10 cohorts of laboratory rats. For all three mammalian species, the Gompertz model fits mortality data significantly better than the “mortality deceleration” Kannisto model (according to the Akaike’s information criterion as the goodness-of-fit measure). These results suggest that mortality deceleration at advanced ages is not a universal phenomenon, and survival of mammalian species follows the Gompertz law up to very old ages. PMID:24534516

  11. Outcomes of surgery among the Medicare aged: mortality after surgery.

    PubMed

    Lubitz, J; Riley, G; Newton, M

    1985-01-01

    This study examines post-surgical mortality, up to 1 year after surgery, for eight common operations among aged Medicare enrollees. The operations with the highest mortality in the 1.5 months after surgery were femur fracture reduction, hip arthroplasty (other, i.e., not total replacement), and coronary artery bypass. Mortality was still above average for femur fracture reduction, hip arthroplasty (other), and transurethral prostatectomy 1 year after surgery. The highest mortality rates following surgery were for people 85 years of age or over. This raises the following question: Should certain elective surgery be performed at younger ages if it appears that surgery may eventually be needed?

  12. Age, colors and ISO standards

    NASA Astrophysics Data System (ADS)

    van Nes, Floris L.

    2010-01-01

    Age influences all bodily functions, also vision. Therefore, the effects of age on vision should be mirrored in ergonomic requirements laid down in display standards such as ISO 9241-300/307, 'Electronic visual display requirements'. However, this is only true to a limited extent - just as is the case with other standards dealing with ergonomic requirements, because developers of such standards do not possess the necessary specific knowledge. It therefore was an important step by ISO and IEC to publish in 2001 ISO/IEC Guide 71: 'Guidelines for standard developers to address the needs of older persons and persons with disabilities'. This guide was followed by a more specific and detailed Technical Report from ISO, ISO/TR 22411, as well as by 'Guidelines on Accessibility' from CIE. These three guidelines are reviewed. The paper concludes with developments around ISO 9241-300/307 in general, especially future additions on autostereoscopic displays and electronic paper. As to the former, the visual fatigue often accompanying viewing 3D displays needs methods for characterizing and validating such displays, to reduce visual fatigue as much as possible. Standardizing certain properties of electronic paper is an example of the present pro-active way of working of ISO/TC159/SC4/WG2, 'Visual Display Requirements', that developed ISO 9241-300/307.

  13. Age-adjusted mortality and its association to variations in urban conditions in Shanghai.

    PubMed

    Takano, Takehito; Fu, Jia; Nakamura, Keiko; Uji, Kazuyuki; Fukuda, Yoshiharu; Watanabe, Masafumi; Nakajima, Hiroshi

    2002-09-01

    The objective of this study was to explore the association between health and urbanization in a megacity, Shanghai, by calculating the age-adjusted mortality ratio by ward-unit of Shanghai and by examining relationships between mortalities and urban indicators. Crude mortality rates and age-adjusted mortality ratios by ward-unit were calculated. Demographic, residential environment, healthcare, and socioeconomic indicators were formulated for each of the ward-units between 1995 and 1998. Correlation and Poisson regression analyses were performed to examine the association between urban indicators and mortalities. The crude mortality rate by ward-unit in 1997 varied from 6.3 to 9.4 deaths per 1000 population. The age-adjusted mortality ratio in 1997 by ward-units as reference to the average mortality of urban China varied from 57.8 to 113.3 within Shanghai. Age-adjusted mortalities were inversely related with indicators of a larger floor space of dwellings per population, a larger proportion of parks, gardens, and green areas to total land area; a greater number of health professionals per population; and a greater number of employees in retail business per population. Spacious living showed independent association to a higher standard of community health in Shanghai (P < 0.05). Consequences of health policy and the developments of urban infrastructural resources from the viewpoint of the Healthy Cities concept were discussed.

  14. Negative Control Outcomes and the Analysis of Standardized Mortality Ratios

    PubMed Central

    Richardson, DB; Keil, A; Tchetgen, Tchetgen E; Cooper, GS

    2016-01-01

    In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to non-comparability of the occupational cohort and reference population. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for bias due to unmeasured differences between the occupational cohort and the reference population. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR=1.90; 1.27, 2.72) but not among monthly-paid males (SMR=0.96; 0.67, 1.33). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR=2.22; 1.52, 3.24; and, aSMR=1.99; 1.43, 2.76, respectively). The proposed adjusted SMR offers a complement to typical standardized mortality ratio analyses. PMID:26172862

  15. Trends in age-adjusted coronary heart disease mortality rates in Slovakia between 1993 and 2009.

    PubMed

    Psota, Marek; Pekarciková, Jarmila; O'Mullane, Monica; Rusnák, Martin

    2013-06-01

    Cardiovascular diseases (CVD) and especially coronary heart disease (CHD) are the main causes of death in the Slovak Republic (SR). The aim of this study is to explore trends in age-adjusted coronary heart disease mortality rates in the whole Slovak population and in the population of working age between the years 1993 and 2009. A related indicator - potential years of life lost (PYLL) due to CHD--was calculated in the same period for males and females. Crude CHD mortality rates were age-adjusted using European standard population. The joinpoint Poisson regression was performed in order to find out the annual percentage change in trends. The age-adjusted CHD mortality rates decreased in the Slovak population and also in the population of working age. The change was significant only within the working-age sub-group. We found that partial diagnoses (myocardial infarction and chronic ischaemic heart disease) developed in the mirror-like manner. PYLL per 100,000 decreased during the observed period and the decline was more prominent in males. For further research we recommend to focus on several other issues, namely, to examine the validity of cause of death codes, to examine the development of mortality rates in selected age groups, to find out the cause of differential development of mortality rates in the Slovak Republic in comparison with the Czech Republic and Poland, and to explain the causes of decrease of the age-adjusted CHD mortality rates in younger age groups in Slovakia.

  16. Blood Epigenetic Age may Predict Cancer Incidence and Mortality.

    PubMed

    Zheng, Yinan; Joyce, Brian T; Colicino, Elena; Liu, Lei; Zhang, Wei; Dai, Qi; Shrubsole, Martha J; Kibbe, Warren A; Gao, Tao; Zhang, Zhou; Jafari, Nadereh; Vokonas, Pantel; Schwartz, Joel; Baccarelli, Andrea A; Hou, Lifang

    2016-03-01

    Biological measures of aging are important for understanding the health of an aging population, with epigenetics particularly promising. Previous studies found that tumor tissue is epigenetically older than its donors are chronologically. We examined whether blood Δage (the discrepancy between epigenetic and chronological ages) can predict cancer incidence or mortality, thus assessing its potential as a cancer biomarker. In a prospective cohort, Δage and its rate of change over time were calculated in 834 blood leukocyte samples collected from 442 participants free of cancer at blood draw. About 3-5 years before cancer onset or death, Δage was associated with cancer risks in a dose-responsive manner (P = 0.02) and a one-year increase in Δage was associated with cancer incidence (HR: 1.06, 95% CI: 1.02-1.10) and mortality (HR: 1.17, 95% CI: 1.07-1.28). Participants with smaller Δage and decelerated epigenetic aging over time had the lowest risks of cancer incidence (P = 0.003) and mortality (P = 0.02). Δage was associated with cancer incidence in a 'J-shaped' manner for subjects examined pre-2003, and with cancer mortality in a time-varying manner. We conclude that blood epigenetic age may mirror epigenetic abnormalities related to cancer development, potentially serving as a minimally invasive biomarker for cancer early detection.

  17. Past and recent attempts to model mortality at all ages.

    PubMed

    Hartmann, M

    1987-01-01

    "Most laws of mortality are partial in the sense that they apply only to a broad age group and not to all ages. This paper focuses on three laws of mortality that apply to all ages. Two of them were developed by the actuaries Thiele and Wittstein in the late 19th century. The third, developed by Heligman and Pollard, is of recent origin. The three laws are discussed with references to Scandinavian mortality data. The results suggest that the most recently proposed law can be used for generation of model life tables, for making population projections, simulations, and other statistical work where there is a need for a realistic model of human mortality."

  18. Mortality Measurement at Advanced Ages: A Study of the Social Security Administration Death Master File.

    PubMed

    Gavrilov, Leonid A; Gavrilova, Natalia S

    2011-01-01

    Accurate estimates of mortality at advanced ages are essential to improving forecasts of mortality and the population size of the oldest old age group. However, estimation of hazard rates at extremely old ages poses serious challenges to researchers: (1) The observed mortality deceleration may be at least partially an artifact of mixing different birth cohorts with different mortality (heterogeneity effect); (2) standard assumptions of hazard rate estimates may be invalid when risk of death is extremely high at old ages and (3) ages of very old people may be exaggerated. One way of obtaining estimates of mortality at extreme ages is to pool together international records of persons surviving to extreme ages with subsequent efforts of strict age validation. This approach helps researchers to resolve the third of the above-mentioned problems but does not resolve the first two problems because of inevitable data heterogeneity when data for people belonging to different birth cohorts and countries are pooled together. In this paper we propose an alternative approach, which gives an opportunity to resolve the first two problems by compiling data for more homogeneous single-year birth cohorts with hazard rates measured at narrow (monthly) age intervals. Possible ways of resolving the third problem of hazard rate estimation are elaborated. This approach is based on data from the Social Security Administration Death Master File (DMF). Some birth cohorts covered by DMF could be studied by the method of extinct generations. Availability of month of birth and month of death information provides a unique opportunity to obtain hazard rate estimates for every month of age. Study of several single-year extinct birth cohorts shows that mortality trajectory at advanced ages follows the Gompertz law up to the ages 102-105 years without a noticeable deceleration. Earlier reports of mortality deceleration (deviation of mortality from the Gompertz law) at ages below 100 appear to be

  19. Mortality Measurement at Advanced Ages: A Study of the Social Security Administration Death Master File

    PubMed Central

    Gavrilov, Leonid A.; Gavrilova, Natalia S.

    2011-01-01

    Accurate estimates of mortality at advanced ages are essential to improving forecasts of mortality and the population size of the oldest old age group. However, estimation of hazard rates at extremely old ages poses serious challenges to researchers: (1) The observed mortality deceleration may be at least partially an artifact of mixing different birth cohorts with different mortality (heterogeneity effect); (2) standard assumptions of hazard rate estimates may be invalid when risk of death is extremely high at old ages and (3) ages of very old people may be exaggerated. One way of obtaining estimates of mortality at extreme ages is to pool together international records of persons surviving to extreme ages with subsequent efforts of strict age validation. This approach helps researchers to resolve the third of the above-mentioned problems but does not resolve the first two problems because of inevitable data heterogeneity when data for people belonging to different birth cohorts and countries are pooled together. In this paper we propose an alternative approach, which gives an opportunity to resolve the first two problems by compiling data for more homogeneous single-year birth cohorts with hazard rates measured at narrow (monthly) age intervals. Possible ways of resolving the third problem of hazard rate estimation are elaborated. This approach is based on data from the Social Security Administration Death Master File (DMF). Some birth cohorts covered by DMF could be studied by the method of extinct generations. Availability of month of birth and month of death information provides a unique opportunity to obtain hazard rate estimates for every month of age. Study of several single-year extinct birth cohorts shows that mortality trajectory at advanced ages follows the Gompertz law up to the ages 102–105 years without a noticeable deceleration. Earlier reports of mortality deceleration (deviation of mortality from the Gompertz law) at ages below 100 appear to be

  20. Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011.

    PubMed

    Pou, Sonia Alejandra; Tumas, Natalia; Coquet, Julia Becaria; Niclis, Camila; Román, María Dolores; Díaz, María Del Pilar

    2017-03-09

    The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.

  1. Aging differently: diet- and sex-dependent late-life mortality patterns in Drosophila melanogaster.

    PubMed

    Zajitschek, Felix; Jin, Tuo; Colchero, Fernando; Maklakov, Alexei A

    2014-06-01

    Diet effects on age-dependent mortality patterns are well documented in a large number of animal species, but studies that look at the effects of nutrient availability on late-life mortality plateaus are lacking. Here, we focus on the effect of dietary protein content (low, intermediate, and high) on mortality trajectories in late life in the fruit fly Drosophila melanogaster. According to the two theories that are mainly implicated in explaining the deceleration of mortality rate in late life (the heterogeneity/frailty theory and the Hamiltonian theory), we predict, in general, the occurrence of late-life mortality deceleration under most circumstances, independent of sex and dietary regime. However, the heterogeneity theory of late life is more flexible in allowing no mortality deceleration to occur under certain circumstances compared with the Hamiltonian theory. We applied a novel statistical approach based on Bayesian inference of age-specific mortality rates and found a deceleration of late-life mortality rates on all diets in males but only on the intermediate (standard) diet in females. The difference in mortality rate deceleration between males and females on extreme diets suggests that the existence of mortality plateaus in late life is sex and diet dependent and, therefore, not a universal characteristic of large enough cohorts.

  2. Negative Control Outcomes and the Analysis of Standardized Mortality Ratios.

    PubMed

    Richardson, David B; Keil, Alexander P; Tchetgen Tchetgen, Eric; Cooper, Glinda

    2015-09-01

    In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to noncomparability of the occupational cohort and reference population with respect to unmeasured risk factors for the outcome of interest. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for such bias. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR = 1.9; 95% confidence interval [CI] = 1.3, 2.7) but not among monthly-paid males (SMR = 1.0; 95% CI = 0.67, 1.3). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR = 2.2; 95% CI = 1.5, 3.2; and, aSMR = 2.0; 95% CI = 1.4, 2.8, respectively). The proposed adjusted SMR offers a complement to typical SMR analyses.

  3. Recent trends of cancer mortality in Romanian adults: mortality is still increasing, although young adults do better than the middle-aged and elderly population.

    PubMed

    Tereanu, Carmen; Baili, Paolo; Berrino, Franco; Micheli, Andrea; Furtunescu, Florentina L; Minca, Dana G; Sant, Milena

    2013-05-01

    We analysed the mortality trends (1986-2009) for all cancers combined and selected cancers in adult Romanians by three age groups (15-49, 50-69 and older than 70 years of age) in comparison with 11 other European countries. We extracted mortality data from the WHO database and grouped the countries into four regions: central and eastern Europe (Romania, Bulgaria, the Czech Republic, Hungary), Baltic countries (Estonia, Latvia and Lithuania), western and northern Europe (Austria, the Netherlands and Finland), and southern Europe (Croatia and Slovenia). Mortality rates were age-standardized against the standard European population. Significant changes in mortality trends were identified by Joinpoint regression and annual percentage changes (APCs) were calculated for periods with uniform trends. Cancer mortality in Romania was among the lowest in Europe in 1986, but was higher than most countries by 2009. Despite the declining mortality (APC) in younger Romanians for all cancers combined (men-1.5% from 1997, women-1.2% 1997-2004 and -3.8% 2004-2009), male lung cancer (-2.8% from 1997), female breast (-3.5% from 1999) and cervical (-5.4% from 2004) cancers, mortality has increased in middle-aged and elderly patients for most cancers analysed. The exception was declining stomach cancer mortality in most Romanians, except elderly men. For most cancers analysed, mortality declined in the Baltic countries in young and middle-aged patients, and in western and northern countries for all ages. Lung cancer mortality in women increased in all countries except Latvia. We urge immediate steps to reverse the alarming increase in cancer mortality among middle-aged and elderly Romanians.

  4. Estimating child mortality and modelling its age pattern for India.

    PubMed

    Roy, S G

    1989-06-01

    "Using data [for India] on proportions of children dead...estimates of infant and child mortality are...obtained by Sullivan and Trussell modifications of [the] Brass basic method. The estimate of child survivorship function derived after logit smoothing appears to be more reliable than that obtained by the Census Actuary. The age pattern of childhood mortality is suitably modelled by [a] Weibull function defining the probability of surviving from birth to a specified age and involving two parameters of level and shape. A recently developed linearization procedure based on [a] graphical approach is adopted for estimating the parameters of the function."

  5. Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males.

    PubMed

    Wada, Koji; Gilmour, Stuart

    2016-03-03

    The mortality rate for Japanese males aged 30-59 years in managerial and professional spiked in 2000 and remains worse than that of other occupations possibly associated with the economic downturn of the 1990s and the global economic stagnation after 2008. The present study aimed to assess temporal occupation-specific mortality trends from 1980 to 2010 for Japanese males aged 30-59 years for major causes of death. We obtained data from the Occupation-specific Vital Statistics. We calculated age-standardized mortality rates for the four leading causes of death (all cancers, suicide, ischaemic heart disease, and cerebrovascular disease). We used a generalized estimating equation model to determine specific effects of the economic downturn after 2000. The age-standardized mortality rate for the total working-age population steadily declined up to 2010 in all major causes of death except suicide. Managers had a higher risk of mortality in all leading causes of death compared with before 1995. Mortality rates among unemployed people steadily decreased for all cancers and ischaemic heart disease. Economic downturn may have caused the prolonged increase in suicide mortality. Unemployed people did not experience any change in mortality due to suicide and cerebrovascular disease and saw a decline in cancer and ischemic heart disease mortality, perhaps because the basic properties of Japan's social welfare system were maintained even during economic recession.

  6. Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males

    PubMed Central

    Wada, Koji; Gilmour, Stuart

    2016-01-01

    The mortality rate for Japanese males aged 30–59 years in managerial and professional spiked in 2000 and remains worse than that of other occupations possibly associated with the economic downturn of the 1990s and the global economic stagnation after 2008. The present study aimed to assess temporal occupation-specific mortality trends from 1980 to 2010 for Japanese males aged 30–59 years for major causes of death. We obtained data from the Occupation-specific Vital Statistics. We calculated age-standardized mortality rates for the four leading causes of death (all cancers, suicide, ischaemic heart disease, and cerebrovascular disease). We used a generalized estimating equation model to determine specific effects of the economic downturn after 2000. The age-standardized mortality rate for the total working-age population steadily declined up to 2010 in all major causes of death except suicide. Managers had a higher risk of mortality in all leading causes of death compared with before 1995. Mortality rates among unemployed people steadily decreased for all cancers and ischaemic heart disease. Economic downturn may have caused the prolonged increase in suicide mortality. Unemployed people did not experience any change in mortality due to suicide and cerebrovascular disease and saw a decline in cancer and ischemic heart disease mortality, perhaps because the basic properties of Japan’s social welfare system were maintained even during economic recession. PMID:26936097

  7. Gene expression profiles associated with aging and mortality in humans

    PubMed Central

    Kerber, Richard A; O’Brien, Elizabeth; Cawthon, Richard M

    2009-01-01

    We investigated the hypothesis that gene expression profiles in cultured cell lines from adults, aged 57–97 years, contain information about the biological age and potential longevity of the donors. We studied 104 unrelated grandparents from 31 Utah CEU (Centre d’Etude du Polymorphisme Humain – Utah) families, for whom lymphoblastoid cell lines were established in the 1980s. Combining publicly available gene expression data from these cell lines, and survival data from the Utah Population Database, we tested the relationship between expression of 2151 always-expressed genes, age, and survival of the donors. Approximately 16% of 2151 expression levels were associated with donor age: 10% decreased in expression with age, and 6% increased with age. Cell division cycle 42 (CDC42) and CORO1A exhibited strong associations both with age at draw and survival after draw (multiple comparisons-adjusted Monte Carlo P-value < 0.05). In general, gene expressions that increased with age were associated with increased mortality. Gene expressions that decreased with age were generally associated with reduced mortality. A multivariate estimate of biological age modeled from expression data was dominated by CDC42 expression, and was a significant predictor of survival after blood draw. A multivariate model of survival as a function of gene expression was dominated by CORO1A expression. This model accounted for approximately 23% of the variation in survival among the CEU grandparents. Some expression levels were negligibly associated with age in this cross-sectional dataset, but strongly associated with inter-individual differences in survival. These observations may lead to new insights regarding the genetic contribution to exceptional longevity. PMID:19245677

  8. Gene expression profiles associated with aging and mortality in humans.

    PubMed

    Kerber, Richard A; O'Brien, Elizabeth; Cawthon, Richard M

    2009-06-01

    We investigated the hypothesis that gene expression profiles in cultured cell lines from adults, aged 57-97 years, contain information about the biological age and potential longevity of the donors. We studied 104 unrelated grandparents from 31 Utah CEU (Centre d'Etude du Polymorphisme Humain - Utah) families, for whom lymphoblastoid cell lines were established in the 1980s. Combining publicly available gene expression data from these cell lines, and survival data from the Utah Population Database, we tested the relationship between expression of 2151 always-expressed genes, age, and survival of the donors. Approximately 16% of 2151 expression levels were associated with donor age: 10% decreased in expression with age, and 6% increased with age. Cell division cycle 42 (CDC42) and CORO1A exhibited strong associations both with age at draw and survival after draw (multiple comparisons-adjusted Monte Carlo P-value < 0.05). In general, gene expressions that increased with age were associated with increased mortality. Gene expressions that decreased with age were generally associated with reduced mortality. A multivariate estimate of biological age modeled from expression data was dominated by CDC42 expression, and was a significant predictor of survival after blood draw. A multivariate model of survival as a function of gene expression was dominated by CORO1A expression. This model accounted for approximately 23% of the variation in survival among the CEU grandparents. Some expression levels were negligibly associated with age in this cross-sectional dataset, but strongly associated with inter-individual differences in survival. These observations may lead to new insights regarding the genetic contribution to exceptional longevity.

  9. Shorter Stay, Longer life: Age at Migration and Mortality among the Older Mexican-Origin Population

    PubMed Central

    Angel, Ronald J.; Angel, Jacqueline L.; Venegas, Carlos Díaz; Bonazzo, Claude

    2011-01-01

    Objectives In this paper we investigate the association between age at migration and mortality during a 13-year period in a sample of Mexican American immigrants 65 and older at baseline Methods We employ the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) to control for mortality-related health and social factors. Results Our analyses show that the immigrant generation does not represent a homogeneous mortality risk category. Individuals who migrated to the United States in mature adulthood have a considerably lower risk of death than individuals who migrated in childhood or mid-life. Chronic conditions or functional capacity do not account for these differences. Conclusion Our findings suggest that standard risk pools may differ significantly on the basis of genetic and unmeasured life-course factors. A better understanding of the late-life immigrant mortality advantage has important implications for more effective and targeted social and medical interventions. PMID:20682948

  10. Low heel ultrasound parameters predict mortality in men: results from the European Male Ageing Study (EMAS)

    PubMed Central

    Pye, Stephen R.; Vanderschueren, Dirk; Boonen, Steven; Gielen, Evelien; Adams, Judith E.; Ward, Kate A.; Lee, David M.; Bartfai, György; Casanueva, Felipe F.; Finn, Joseph D.; Forti, Gianni; Giwercman, Aleksander; Han, Thang S.; Huhtaniemi, Ilpo T.; Kula, Krzysztof; Lean, Michael E.; Pendleton, Neil; Punab, Margus; Wu, Frederick C.; O'Neill, Terence W.

    2015-01-01

    Background: low bone mineral density measured by dual-energy x-ray absorptiometry is associated with increased mortality. The relationship between other skeletal phenotypes and mortality is unclear. The aim of this study was to determine the relationship between quantitative heel ultrasound parameters and mortality in a cohort of European men. Methods: men aged 40–79 years were recruited for participation in a prospective study of male ageing: the European Male Ageing Study (EMAS). At baseline, subjects attended for quantitative ultrasound (QUS) of the heel (Hologic—SAHARA) and completed questionnaires on lifestyle factors and co-morbidities. Height and weight were measured. After a median of 4.3 years, subjects were invited to attend a follow-up assessment, and reasons for non-participation, including death, were recorded. The relationship between QUS parameters (broadband ultrasound attenuation [BUA] and speed of sound [SOS]) and mortality was assessed using Cox proportional hazards model. Results: from a total of 3,244 men (mean age 59.8, standard deviation [SD] 10.8 years), 185 (5.7%) died during the follow-up period. After adjusting for age, centre, body mass index, physical activity, current smoking, number of co-morbidities and general health, each SD decrease in BUA was associated with a 20% higher risk of mortality (hazard ratio [HR] per SD = 1.2; 95% confidence interval [CI] = 1.0–1.4). Compared with those in higher quintiles (2nd–5th), those in the lowest quintile of BUA and SOS had a greater mortality risk (BUA: HR = 1.6; 95% CI = 1.1–2.3 and SOS: HR = 1.6; 95% CI = 1.2–2.2). Conclusion: lower heel ultrasound parameters are associated with increased mortality in European men. PMID:26162912

  11. Single parameter of inverse proportion between mortality and age could determine all mortality indicators in the first year of life.

    PubMed

    Dolejs, Josef

    2016-05-21

    Mortality increase with age in adult population has been studied and modeled by many authors, but relatively little attention has been given to mortality decrease with age after birth. Data split in more detailed age categories can newly test mortality decrease with age. Age trajectories of mortality are studied in 20 age categories in the specific age interval 1-365 days. Four basic models mentioned in literature are tested here. The linear model and the linear model with the specific slope -1 in the log-log scale represent the most successful formalism. Mortality indicators describing the first year could be determined by a single parameter of the model with slope -1 in the log-log scale. All conclusions are based on published data which are presented as a supplement.

  12. Impact of the age of stored blood on trauma patient mortality: a systematic review

    PubMed Central

    Sowers, Nicholas; Froese, Patrick C.; Erdogan, Mete; Green, Robert S.

    2015-01-01

    Background The impact of the age of stored red blood cells on mortality in patients sustaining traumatic injuries requiring transfusion of blood products is unknown. The objective of this systematic review was to identify and describe the available literature on the use of older versus newer blood in trauma patient populations. Methods We searched PubMed, Embase, Lilac and the Cochrane Database for published studies comparing the transfusion of newer versus older red blood cells in adult patients sustaining traumatic injuries. Studies included for review reported on trauma patients receiving transfusions of packed red blood cells, identified the age of stored blood that was transfused and reported patient mortality as an end point. We extracted data using a standardized form and assessed study quality using the Newcastle–Ottawa Scale. Results Seven studies were identified (6780 patients) from 3936 initial search results. Four studies reported that transfusion of older blood was independently associated with increased mortality in trauma patients, while 3 studies did not observe any increase in patient mortality with the use of older versus newer blood. Three studies associated the transfusion of older blood with adverse patient outcomes, including longer stay in the intensive care unit, complicated sepsis, pneumonia and renal dysfunction. Studies varied considerably in design, volumes of blood transfused and definitions applied for old and new blood. Conclusion The impact of the age of stored packed red blood cells on mortality in trauma patients is inconclusive. Future investigations are warranted. PMID:26384149

  13. Tendency for age-specific mortality with hypertension in the European Union from 1980 to 2011.

    PubMed

    Tao, Lichan; Pu, Cunying; Shen, Shutong; Fang, Hongyi; Wang, Xiuzhi; Xuan, Qinkao; Xiao, Junjie; Li, Xinli

    2015-01-01

    Tendency for mortality in hypertension has not been well-characterized in European Union (EU). Mortality data from 1980 to 2011 in EU were used to calculate age-standardized mortality rate (ASMR, per 100,000), annual percentage change (APC) and average annual percentage change (AAPC). The Joinpoint Regression Program was used to compare the changes in tendency. Mortality rates in the most recent year studied vary between different countries, with the highest rates observed in Slovakia men and Estonia women. A downward trend in ASMR was demonstrated over all age groups. Robust decreases in ASMR were observed for both men (1991-1994, APC = -13.54) and women (1996-1999, APC = -14.80) aged 55-65 years. The tendency of systolic blood pressure (SBP) from 1980 to 2009 was consistent with ASMR, and the largest decrease was observed among Belgium men and France women. In conclusion, SBP associated ASMR decreased significantly on an annual basis from 1980 to 2009 while a slight increase was observed after 2009. Discrepancies in ASMR from one country to another in EU are significant during last three decades. With a better understanding of the tendency of the prevalence of hypertension and its mortality, efforts will be made to improve awareness and help strict control of hypertension.

  14. Tendency for age-specific mortality with hypertension in the European Union from 1980 to 2011

    PubMed Central

    Tao, Lichan; Pu, Cunying; Shen, Shutong; Fang, Hongyi; Wang, Xiuzhi; Xuan, Qinkao; Xiao, Junjie; Li, Xinli

    2015-01-01

    Tendency for mortality in hypertension has not been well-characterized in European Union (EU). Mortality data from 1980 to 2011 in EU were used to calculate age-standardized mortality rate (ASMR, per 100,000), annual percentage change (APC) and average annual percentage change (AAPC). The Joinpoint Regression Program was used to compare the changes in tendency. Mortality rates in the most recent year studied vary between different countries, with the highest rates observed in Slovakia men and Estonia women. A downward trend in ASMR was demonstrated over all age groups. Robust decreases in ASMR were observed for both men (1991-1994, APC = -13.54) and women (1996-1999, APC = -14.80) aged 55-65 years. The tendency of systolic blood pressure (SBP) from 1980 to 2009 was consistent with ASMR, and the largest decrease was observed among Belgium men and France women. In conclusion, SBP associated ASMR decreased significantly on an annual basis from 1980 to 2009 while a slight increase was observed after 2009. Discrepancies in ASMR from one country to another in EU are significant during last three decades. With a better understanding of the tendency of the prevalence of hypertension and its mortality, efforts will be made to improve awareness and help strict control of hypertension. PMID:25932090

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

    USGS Publications Warehouse

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

    2004-01-01

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

  16. The epigenetic clock and telomere length are independently associated with chronological age and mortality

    PubMed Central

    Marioni, Riccardo E; Harris, Sarah E; Shah, Sonia; McRae, Allan F; von Zglinicki, Thomas; Martin-Ruiz, Carmen; Wray, Naomi R; Visscher, Peter M; Deary, Ian J

    2016-01-01

    Background: Telomere length and DNA methylation have been proposed as biological clock measures that track chronological age. Whether they change in tandem, or contribute independently to the prediction of chronological age, is not known. Methods: We address these points using data from two Scottish cohorts: the Lothian Birth Cohorts of 1921 (LBC1921) and 1936 (LBC1936). Telomere length and epigenetic clock estimates from DNA methylation were measured in 920 LBC1936 participants (ages 70, 73 and 76 years) and in 414 LBC1921 participants (ages 79, 87 and 90 years). Results: The epigenetic clock changed over time at roughly the same rate as chronological age in both cohorts. Telomere length decreased at 48–67 base pairs per year on average. Weak, non-significant correlations were found between epigenetic clock estimates and telomere length. Telomere length explained 6.6% of the variance in age in LBC1921, the epigenetic clock explained 10.0%, and combined they explained 17.3% (all P < 1 × 10−7). Corresponding figures for the LBC1936 cohort were 14.3%, 11.7% and 19.5% (all P < 1 × 10−12). In a combined cohorts analysis, the respective estimates were 2.8%, 28.5% and 29.5%. Also in a combined cohorts analysis, a one standard deviation increase in baseline epigenetic age was linked to a 22% increased mortality risk (P = 2.6 × 10−4) whereas, in the same model, a one standard deviation increase in baseline telomere length was independently linked to an 11% decreased mortality risk (P = 0.06). Conclusions: These results suggest that telomere length and epigenetic clock estimates are independent predictors of chronological age and mortality risk. PMID:27075770

  17. Trends of Esophageal Cancer Mortality in Rural China from 1989 to 2013: An Age-Period-Cohort Analysis.

    PubMed

    Gao, Xudong; Wang, Zhenkun; Kong, Chan; Yang, Fen; Wang, Ying; Tan, Xiaodong

    2017-02-23

    Background: Esophageal cancer is one of the most common cancers in rural China. The aim of this study was to describe the time trends of esophageal cancer mortality in rural China and to better elucidate the causes of these trends. Methods: The mortality data were obtained from the World Health Organization Mortality Database and the China Health Statistical Yearbook Database. The mortality data were analyzed with age-period-cohort (APC) analysis. Results: Our study indicates that the Age-Standardized Mortality Rates (ASMRs) in rural China generally decreased from 1989 to 2003, and thereafter increased until the year 2008 in both sexes. After 2008, the ASMRs decreased again. The results of APC analysis suggest that the general decrease in esophageal cancer mortality in rural China from 1989 to 2003 might be caused by the downtrend of the cohort effects and period effects, while the general increase in mortality from 2004 to 2008 might be caused by the uptrend of the period effects. The decrease in mortality after 2008 may be relevant to the Four Trillion RMB Investment Plan launched by the Chinese Government. Conclusions: The declining cohort effects were probably related to the improvement of socioeconomic status in childhood and the decreasing consumptions of alcohol drinking and smoking, while the trends of the period effects were relevant to the changes in the dietary pattern. Our findings may help predict future changes in esophageal cancer mortality.

  18. Trends of Esophageal Cancer Mortality in Rural China from 1989 to 2013: An Age-Period-Cohort Analysis

    PubMed Central

    Gao, Xudong; Wang, Zhenkun; Kong, Chan; Yang, Fen; Wang, Ying; Tan, Xiaodong

    2017-01-01

    Background: Esophageal cancer is one of the most common cancers in rural China. The aim of this study was to describe the time trends of esophageal cancer mortality in rural China and to better elucidate the causes of these trends. Methods: The mortality data were obtained from the World Health Organization Mortality Database and the China Health Statistical Yearbook Database. The mortality data were analyzed with age-period-cohort (APC) analysis. Results: Our study indicates that the Age-Standardized Mortality Rates (ASMRs) in rural China generally decreased from 1989 to 2003, and thereafter increased until the year 2008 in both sexes. After 2008, the ASMRs decreased again. The results of APC analysis suggest that the general decrease in esophageal cancer mortality in rural China from 1989 to 2003 might be caused by the downtrend of the cohort effects and period effects, while the general increase in mortality from 2004 to 2008 might be caused by the uptrend of the period effects. The decrease in mortality after 2008 may be relevant to the Four Trillion RMB Investment Plan launched by the Chinese Government. Conclusions: The declining cohort effects were probably related to the improvement of socioeconomic status in childhood and the decreasing consumptions of alcohol drinking and smoking, while the trends of the period effects were relevant to the changes in the dietary pattern. Our findings may help predict future changes in esophageal cancer mortality. PMID:28241504

  19. Marriage behavior response to prime-age adult mortality: evidence from Malawi.

    PubMed

    Ueyama, Mika; Yamauchi, Futoshi

    2009-02-01

    This article examines the effect of AIDS-related mortality of the prime-age adult population on marriage behavior among women in Malawi. A rise in prime-age adult mortality increases risks associated with the search for a marriage partner in the marriage market. A possible behavioral change in the marriage market in response to an increase in prime-age adult mortality is to marry earlier to avoid exposure to HIV/AIDS risks. We test this hypothesis by using micro data from Malawi, where prime-age adult mortality has drastically increased. In the analysis, we estimate the probability of prime-age adult mortality that sample women have observed during their adolescent period by utilizing retrospective information on deaths of their siblings. Empirical analysis shows that excess prime-age adult mortality in the local marriage market lowers the marriage age for females and shortens the interval between the first sex and first marriage.

  20. Age-specific mortality among advanced-age Chinese citizens and its difference between the two genders.

    PubMed

    Gan, J; Zheng, Z; Li, G

    1998-01-01

    This study describes the patterns of age-specific mortality among the elderly in China. Data were obtained from the 1990 census. The age groups ending in zero were validated with the Weber Index and found to be of good quality among those aged under 97 years. Differences were found between censuses and genders. The data for the aged were adjusted with 2-year moving averages in order to smooth the data. The end age of interval mortality is used. Tables provide single years of age between 60 years and 104 years by sex for the actual number and the adjusted number of each census year: 1953, 1964, 1982, and 1990. The pattern of change in age specific mortality rates (ASMRs) was similar in all census years. Mortality rates were highest among infants aged under 1 year, declined with increased age, and were lowest among 10 year olds. Mortality rose gradually after 10 years and sharply after 40-50 years. ASMRs were "U" shaped. Age-specific interval mortality rates among the elderly show that mortality increased drastically as it approached 90 years of age and then grew more slowly or declined. The Gompers rule about exponential increases among the extremely old (over 90 years) does not apply. Male mortality was higher than female mortality until the very old ages, which showed lower male mortality. The ratio declined with rising age until the two genders were equal. Mortality rose to a point and then declined to a lesser extent. The peak was 93 years in 1953, with a sex ratio (SR) of 32.48; 90 years in 1964, with an SR of 35.22; 93 years in 1982, with an SR of 35.96; and 95 years in 1990, with an SR of 32.94.

  1. Comparison of Secular Trends in Cervical Cancer Mortality in China and the United States: An Age-Period-Cohort Analysis.

    PubMed

    Wang, Jinyao; Bai, Zhiqiang; Wang, Zhenkun; Yu, Chuanhua

    2016-11-17

    Background: As one of the most common cancers in the female population, cervical cancer has ranked as the second most incident gynecological cancer in recent years, trailing only breast cancer. We aimed to assess and compare the secular trends in cervical cancer mortality in China and the United States and analyze the independent effects of chronological age, time period and birth cohort using age-period-cohort (APC) analysis. Methods: We performed an age-period-cohort analysis using the intrinsic estimator method to estimate the independent effects of age, time period, and birth cohort on cervical cancer mortality. We collected mortality data for China and the United States from the WHO Mortality Database and China Health Statistical Yearbook database. Results: We examined the general trends in cervical mortality rates in China and the United States during the periods 1988-2012 and 1953-2012, respectively. The age-standardized mortality rates (ASMRs) for cervical cancer in urban China, rural China and the U.S. showed a general decreasing trend during the observation period, except for urban China, which experienced a significant increase beginning in 2002. The mortality rates for cervical cancer in the three areas showed a general increasing trend with age, regardless of the period effect. Period effects declined steadily in both rural China (from 0.19 to -0.26) and the U.S. (from -0.20 to -0.43); however, a slight increasing trend was identified (from -0.25 to 0.33) in urban China, which indicated that the risk of mortality increased with time. Cohort effects peaked in the cohort born in 1911-1915 in both rural China and urban China, declined consistently in the cohort born before 1950, and then decreased again in the cohort born after 1976-1980. The cohort effect in the U.S. peaked in the birth cohort born in 1876-1880, then leveled off and slightly decreased in younger generations. Conclusions: Our study showed that in general, cervical cancer mortality rates

  2. Comparison of Secular Trends in Cervical Cancer Mortality in China and the United States: An Age-Period-Cohort Analysis

    PubMed Central

    Wang, Jinyao; Bai, Zhiqiang; Wang, Zhenkun; Yu, Chuanhua

    2016-01-01

    Background: As one of the most common cancers in the female population, cervical cancer has ranked as the second most incident gynecological cancer in recent years, trailing only breast cancer. We aimed to assess and compare the secular trends in cervical cancer mortality in China and the United States and analyze the independent effects of chronological age, time period and birth cohort using age-period-cohort (APC) analysis. Methods: We performed an age-period-cohort analysis using the intrinsic estimator method to estimate the independent effects of age, time period, and birth cohort on cervical cancer mortality. We collected mortality data for China and the United States from the WHO Mortality Database and China Health Statistical Yearbook database. Results: We examined the general trends in cervical mortality rates in China and the United States during the periods 1988–2012 and 1953–2012, respectively. The age-standardized mortality rates (ASMRs) for cervical cancer in urban China, rural China and the U.S. showed a general decreasing trend during the observation period, except for urban China, which experienced a significant increase beginning in 2002. The mortality rates for cervical cancer in the three areas showed a general increasing trend with age, regardless of the period effect. Period effects declined steadily in both rural China (from 0.19 to −0.26) and the U.S. (from −0.20 to −0.43); however, a slight increasing trend was identified (from −0.25 to 0.33) in urban China, which indicated that the risk of mortality increased with time. Cohort effects peaked in the cohort born in 1911–1915 in both rural China and urban China, declined consistently in the cohort born before 1950, and then decreased again in the cohort born after 1976–1980. The cohort effect in the U.S. peaked in the birth cohort born in 1876–1880, then leveled off and slightly decreased in younger generations. Conclusions: Our study showed that in general, cervical cancer

  3. Mortality Trajectories at Extreme Old Ages: A Comparative Study of Different Data Sources on U.S. Old-Age Mortality.

    PubMed

    Gavrilova, Natalia S; Gavrilov, Leonid A

    The growing number of individuals living beyond age 80 underscores the need for accurate measurement of mortality at advanced ages. Our earlier published study challenged the common view that the exponential growth of mortality with age (Gompertz law) is followed by a period of deceleration, with slower rates of mortality increase (Gavrilov and Gavrilova 2011). This refutation of mortality deceleration was made using records from the U.S. Social Security Administration's Death Master File (DMF). Taking into account the significance of this finding for actuarial theory and practice, we tested these earlier observations using additional independent datasets and alternative statistical approaches. In particular, the following data sources for U.S. mortality at advanced ages were analyzed: (1) data from the Human Mortality Database (HMD) on age-specific death rates for 1890-99 U.S. birth cohorts, (2) recent extinct birth cohorts of U.S. men and women based on DMF data, and (3) mortality data for railroad retirees. In the case of HMD data, the analyses were conducted for 1890-99 birth cohorts in the age range 80-106. Mortality was fitted by the Gompertz and logistic (Kannisto) models using weighted nonlinear regression and Akaike information criterion as the goodness-of-fit measure. All analyses were conducted separately for men and women. It was found that for all studied HMD birth cohorts, the Gompertz model demonstrated better fit of mortality data than the Kannisto model in the studied age interval. Similar results were obtained for U.S. men and women born in 1890-99 and railroad retirees born in 1895-99 using the full DMF file (obtained from the National Technical Information Service, or NTIS). It was also found that mortality estimates obtained from the DMF records are close to estimates obtained using the HMD cohort data. An alternative approach for studying mortality patterns at advanced ages is based on calculating the age-specific rate of mortality change

  4. Mortality Trajectories at Extreme Old Ages: A Comparative Study of Different Data Sources on U.S. Old-Age Mortality

    PubMed Central

    Gavrilova, Natalia S.; Gavrilov, Leonid A.

    2014-01-01

    The growing number of individuals living beyond age 80 underscores the need for accurate measurement of mortality at advanced ages. Our earlier published study challenged the common view that the exponential growth of mortality with age (Gompertz law) is followed by a period of deceleration, with slower rates of mortality increase (Gavrilov and Gavrilova 2011). This refutation of mortality deceleration was made using records from the U.S. Social Security Administration’s Death Master File (DMF). Taking into account the significance of this finding for actuarial theory and practice, we tested these earlier observations using additional independent datasets and alternative statistical approaches. In particular, the following data sources for U.S. mortality at advanced ages were analyzed: (1) data from the Human Mortality Database (HMD) on age-specific death rates for 1890–99 U.S. birth cohorts, (2) recent extinct birth cohorts of U.S. men and women based on DMF data, and (3) mortality data for railroad retirees. In the case of HMD data, the analyses were conducted for 1890–99 birth cohorts in the age range 80–106. Mortality was fitted by the Gompertz and logistic (Kannisto) models using weighted nonlinear regression and Akaike information criterion as the goodness-of-fit measure. All analyses were conducted separately for men and women. It was found that for all studied HMD birth cohorts, the Gompertz model demonstrated better fit of mortality data than the Kannisto model in the studied age interval. Similar results were obtained for U.S. men and women born in 1890–99 and railroad retirees born in 1895–99 using the full DMF file (obtained from the National Technical Information Service, or NTIS). It was also found that mortality estimates obtained from the DMF records are close to estimates obtained using the HMD cohort data. An alternative approach for studying mortality patterns at advanced ages is based on calculating the age-specific rate of mortality

  5. Frailty, Inflammation, and Mortality Among Persons Aging With HIV Infection and Injection Drug Use

    PubMed Central

    Varadhan, Ravi; Mehta, Shruti H.; Brown, Todd T.; Li, Huifen; Walston, Jeremy D.; Leng, Sean X.; Kirk, Gregory D.

    2015-01-01

    Background. Serum markers of inflammation increase with age and have been strongly associated with adverse clinical outcomes among both HIV-infected and uninfected adults. Yet, limited data exist on the predictive and clinical utility of aggregate measures of inflammation. This study sought to evaluate the relationship of a recently validated aggregate inflammatory index with frailty and mortality among aging HIV-infected and uninfected injection drug users. Methods. Frailty was assessed among HIV-infected and uninfected participants in the AIDS Linked to the IntraVenous Experience (ALIVE) cohort study using the five Fried phenotypic criteria: weight loss, exhaustion, low physical activity, decreased grip strength, and slow gait. The aggregate inflammatory index was constructed from serum measures of interleukin-6 and soluble tumor necrosis factor-α receptor-1. Multinomial logistic regression was used to assess the relationship of frailty with inflammation. Cox proportional hazards models were used to estimate risk for all-cause mortality. Results. Among 1,326 subjects, the median age was 48 years and 29% were HIV-infected. Adjusting for sociodemographics, comorbidity, and HIV status, frailty was significantly associated with each standard deviation increase in log interleukin-6 (odds ratio 1.33; 95% CI, 1.09–1.61), log tumor necrosis factor-α receptor-1 (odds ratio 1.25; 95% CI, 1.04–1.51) and inflammatory index score (odds ratio 1.39; 95% CI, 1.14–1.68). Adjusting for sociodemographics, comorbidity, HIV status, and frailty, the inflammatory index score was independently associated with increased mortality (HR 1.65; 95% CI, 1.44–1.89). Conclusion. A recently validated, simple, biologically informed inflammatory index is independently associated with frailty and mortality risk among aging HIV-infected and uninfected injection drug users. PMID:26386010

  6. How individual age-associated changes may influence human morbidity and mortality patterns.

    PubMed

    Ukraintseva, S V; Yashin, A I

    2001-09-15

    Patterns of human mortality share common traits in different populations. They include higher mortality in early childhood, lower mortality during the reproductive period, an accelerated increase of mortality near the end of the reproductive period, and deceleration in the mortality increase at oldest old ages. The deceleration of mortality rate is one of the most intriguing recent findings in longevity research. The role of differential selection in this phenomenon has been well studied. Possible contribution of individual aging in the shape of mortality curve is also recognized. However, this contribution has not been studied in details. In this paper, we specify most common patterns of age-associated changes in an individual organism and discuss their possible influence on morbidity and mortality in population. We subdivide individual age-associated changes into three components, having different influence on morbidity and mortality: (1) basal, (2) ontogenetic, and (3) time-dependent. Basal changes are connected with the universal decrease in the rate of living during an individual life. As a result, some phenotypic effects of aging may accumulate in an organism at a slower rate with age. Basal changes are likely to contribute to a plateau of morbidity often observed at old ages, and may partially be responsible for mortality deceleration at oldest old ages. Ontogenetic component is connected with change of the stages of ontogenesis (e.g., the growth, the reproductive period and the climacteric) during an individual life. The ontogenesis-related changes contribute to wave-like patterns of morbidity in population and may partially be responsible for mortality increase at middle ages and its deceleration at old ages. Time-dependent changes are connected with long-time exposure of an organism to different harmful factors. They are most likely to contribute to morbidity and mortality acceleration. We discuss how all three components of individual age

  7. Assessing the relationship between global warming and mortality: lag effects of temperature fluctuations by age and mortality categories.

    PubMed

    Yu, Weiwei; Mengersen, Kerrie; Hu, Wenbiao; Guo, Yuming; Pan, Xiaochuan; Tong, Shilu

    2011-07-01

    Although interests in assessing the relationship between temperature and mortality have arisen due to climate change, relatively few data are available on lag structure of temperature-mortality relationship, particularly in the Southern Hemisphere. This study identified the lag effects of mean temperature on mortality among age groups and death categories using polynomial distributed lag models in Brisbane, Australia, a subtropical city, 1996-2004. For a 1 °C increase above the threshold, the highest percent increase in mortality on the current day occurred among people over 85 years (7.2% (95% CI: 4.3%, 10.2%)). The effect estimates among cardiovascular deaths were higher than those among all-cause mortality. For a 1 °C decrease below the threshold, the percent increases in mortality at 21 lag days were 3.9% (95% CI: 1.9%, 6.0%) and 3.4% (95% CI: 0.9%, 6.0%) for people aged over 85 years and with cardiovascular diseases, respectively. These findings may have implications for developing intervention strategies to reduce and prevent temperature-related mortality.

  8. Stunting Mediates the Association between Small-for-Gestational-Age and Postneonatal Mortality123

    PubMed Central

    Oddo, Vanessa M; Christian, Parul; Katz, Joanne; Liu, Li; Kozuki, Naoko; Black, Robert E; Ntozini, Robert; Humphrey, Jean

    2016-01-01

    Background: In sub-Saharan Africa, one-third of all births are small for gestational age (SGA), and 4.4 million children are stunted; both conditions increase the risk of child mortality. SGA has also been shown to increase the risk of stunting. Objective: We tested whether the association between SGA and postneonatal mortality is mediated by stunting. Methods: We used longitudinal data from children aged 6 wk to 24 mo (n = 12,155) enrolled in the ZVITAMBO (Zimbabwe Vitamin A for Mothers and Babies) trial. HIV exposure was defined based on maternal HIV status at baseline. SGA was defined as birthweight <10th percentile of the INTERGROWTH-21st (International Fetal and Newborn Growth Consortium for the 21st Century) standards. We used a standard mediation approach by comparing the attenuation of the risk when the mediator was added to the model. We used Cox proportional hazards models first to regress SGA on postneonatal mortality, controlling for age. Stunting (length-for-age z score <−2) was then included in the model to test mediation. Results: Approximately 20% of children were term SGA, and 23% were stunted before their last follow-up visit. In this cohort, 31% of children were exposed to HIV; the HIV-exposed group represented a pooled group of HIV-infected and HIV-exposed but uninfected children. Postneonatal mortality was significantly higher among children born SGA (HR: 1.5; 95% CI: 1.3, 1.7). This association was attenuated and not statistically significant when stunting was included in the model, suggesting a mediation effect (HR: 1.1; 95% CI: 0.91, 1.3). When stratified by HIV exposure status, we observed a significant attenuation of the risk, suggesting mediation, only among HIV-exposed children (model 1, HR: 1.3; 95% CI: 1.1, 1.6; model 2, HR: 1.1; 95% CI: 0.88, 1.3). Conclusions: This analysis aids in investigating pathways that underlie an observed SGA-mortality relation and may inform survival interventions in undernourished settings. PMID:27733526

  9. Frailty Index Predicts All-Cause Mortality for Middle-Aged and Older Taiwanese: Implications for Active-Aging Programs

    PubMed Central

    Lin, Shu-Yu; Lee, Wei-Ju; Chou, Ming-Yueh; Peng, Li-Ning; Chiou, Shu-Ti; Chen, Liang-Kung

    2016-01-01

    Background Frailty Index, defined as an individual’s accumulated proportion of listed health-related deficits, is a well-established metric used to assess the health status of old adults; however, it has not yet been developed in Taiwan, and its local related structure factors remain unclear. The objectives were to construct a Taiwan Frailty Index to predict mortality risk, and to explore the structure of its factors. Methods Analytic data on 1,284 participants aged 53 and older were excerpted from the Social Environment and Biomarkers of Aging Study (2006), in Taiwan. A consensus workgroup of geriatricians selected 159 items according to the standard procedure for creating a Frailty Index. Cox proportional hazard modeling was used to explore the association between the Taiwan Frailty Index and mortality. Exploratory factor analysis was used to identify structure factors and produce a shorter version–the Taiwan Frailty Index Short-Form. Results During an average follow-up of 4.3 ± 0.8 years, 140 (11%) subjects died. Compared to those in the lowest Taiwan Frailty Index tertile (< 0.18), those in the uppermost tertile (> 0.23) had significantly higher risk of death (Hazard ratio: 3.2; 95% CI 1.9–5.4). Thirty-five items of five structure factors identified by exploratory factor analysis, included: physical activities, life satisfaction and financial status, health status, cognitive function, and stresses. Area under the receiver operating characteristic curves (C-statistics) of the Taiwan Frailty Index and its Short-Form were 0.80 and 0.78, respectively, with no statistically significant difference between them. Conclusion Although both the Taiwan Frailty Index and Short-Form were associated with mortality, the Short-Form, which had similar accuracy in predicting mortality as the full Taiwan Frailty Index, would be more expedient in clinical practice and community settings to target frailty screening and intervention. PMID:27537684

  10. The Effects of Age, Period, and Cohort on Mortality from Ischemic Heart Disease in China

    PubMed Central

    Chang, Jie; Li, Boyang; Li, Jingjing; Sun, Yang

    2017-01-01

    In contrast with most developed countries, mortality due to ischemic heart disease (IHD) continues to rise in China. We examined the effects of age, period, and cohort on IHD mortality in urban and rural populations from 1987 to 2013 to identify the drivers of this trend. Region-specific data on annual IHD mortality among adults aged 20 to 84 years and corresponding population statistics were collected. We then tested for age, period, and cohort effects using the Intrinsic Estimator approach. Our results indicated that IHD mortality in China increased significantly over the three decades studied. There was a log-linear increase in the age effect on IHD mortality as those aged 80–84 showed 277 and 161 times greater IHD mortality risk than those aged 20–24 in urban and rural populations, respectively. While there was an upward trend in the period effect in both populations, the influence of the cohort effect on mortality decreased over time for those born from 1904 to 1993. The age, period, and cohort effects on mortality in China were generally comparable between urban and rural populations. The results suggest that population aging is a major driver behind the rapid rise in IHD mortality. Increased exposure to air pollution may also have played a role in driving the period effect PMID:28067846

  11. Age- and Gender-Normalized Coronary Incidence and Mortality Risks in Primary and Secondary Prevention

    PubMed Central

    Puddu, Paolo Emilio; Iannetta, Loredana; Schiariti, Michele

    2012-01-01

    Epidemiologic differences in ischemic heart disease incidence between women and men remain largely unexplained. The reasons of women’s “protection” against coronary artery disease (CAD) are not still clear. However, there are subsets more likely to die of a first myocardial infarction. The purpose of this review is to underline different treatment strategies between genders and describe the role of classical and novel factors defined to evaluate CAD risk and mortality, aimed at assessing applicability and relevance for primary and secondary prevention. Women and men present different age-related risk patterns: it should be important to understand whether standard factors may index CAD risk, including mortality, in different ways and/or whether specific factors might be targeted gender-wise. Take home messages include: HDL-cholesterol levels, higher in pre-menopausal women than in men, are more strictly related to CAD. The same is true for high triglycerides and Lp(a). HDL-cholesterol levels are inversely related to incidence and mortality. In primary prevention the role of statins is not completely ascertained in women although in secondary prevention these agents are equally effective in both genders. Weight and glycemic control are effective to reduce cardiovascular disease (CVD) mortality in women from middle to older age. Blood pressure is strongly and directly related to CVD mortality, from middle to older age, particularly in diabetic and over weighted women. Kidney dysfunction, defined using UAE and eGFR predicts primary CVD incidence and risk in both genders. In secondary prediction, kidney dysfunction predicts sudden death in women in conjunction with left ventricular ejection fraction evaluation. Serum uric acid does not differentiate gender-related CVD incidences, although it increases with age. Age-related differences between genders have been related to loss of ovarian function traditionally and to lower iron stores more recently. QT interval

  12. Low migrant mortality in Germany for men aged 65 and older: fact or artifact?

    PubMed

    Kibele, Eva; Scholz, Rembrandt; Shkolnikov, Vladimir M

    2008-01-01

    Migrant mortality in Europe was found to be lower than mortality of host populations. In Germany, residents with migrant background constitute nearly one tenth of the population aged 65+ with about 40% of them being foreigners. The German Pension Scheme follows vital status of pensioners very accurately. Mortality re-estimation reveals two-fold underestimation of mortality of foreigners due to biased death numerator and population denominator.

  13. Analysis of mortality trends by specific ethnic groups and age groups in Malaysia

    NASA Astrophysics Data System (ADS)

    Ibrahim, Rose Irnawaty; Siri, Zailan

    2014-07-01

    The number of people surviving until old age has been increasing worldwide. Reduction in fertility and mortality have resulted in increasing survival of populations to later life. This study examines the mortality trends among the three main ethnic groups in Malaysia, namely; the Malays, Chinese and Indians for four important age groups (adolescents, adults, middle age and elderly) for both gender. Since the data on mortality rates in Malaysia is only available in age groups such as 1-5, 5-9, 10-14, 15-19 and so on, hence some distribution or interpolation method was essential to expand it to the individual ages. In the study, the Heligman and Pollard model will be used to expand the mortality rates from the age groups to the individual ages. It was found that decreasing trend in all age groups and ethnic groups. Female mortality is significantly lower than male mortality, and the difference may be increasing. Also the mortality rates for females are different than that for males in all ethnic groups, and the difference is generally increasing until it reaches its peak at the oldest age category. Due to the decreasing trend of mortality rates, the government needs to plan for health program to support more elderly people in the coming years.

  14. Mortality and Incidence of Hospital Admissions for Stroke among Brazilians Aged 15 to 49 Years between 2008 and 2012

    PubMed Central

    Adami, Fernando; Figueiredo, Francisco Winter dos Santos; Paiva, Laércio da Silva; de Sá, Thiago Hérick; Santos, Edige Felipe de Sousa; Martins, Bruno Luis; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos

    2016-01-01

    Introduction The objective was to analyze rates of stroke-related mortality and incidence of hospital admissions in Brazilians aged 15 to 49 years according to region and age group between 2008 and 2012. Methods Secondary analysis was performed in 2014 using data from the Hospital and Mortality Information Systems and the Brazilian Institute of Geography and Statistics. Stroke was defined by ICD, 10th revision (I60–I64). Crude and standardized mortality (WHO reference) and incidence of hospital admissions per 100,000 inhabitants, stratified by region and age group, were estimated. Absolute and relative frequencies; and linear regression were also used. The software used was Stata 11.0. Results There were 35,005 deaths and 131,344 hospital admissions for stroke in Brazilians aged 15–49 years old between 2008 and 2012. Mortality decreased from 7.54 (95% CI 7.53; 7.54) in 2008 to 6.32 (95% CI 6.31; 6.32) in 2012 (β = -0.27, p = 0.013, r2 = 0.90). During the same time, incidence of hospital admissions stabilized: 24.67 (95% CI 24.66; 24.67) in 2008 and 25.11 (95% CI 25.10; 25.11) in 2012 (β = 0.09, p = 0.692, r2 = 0.05). There was a reduction in mortality in all Brazilian regions and in the age group between 30 and 49 years. Incidence of hospitalizations decreased in the South, but no significant decrease was observed in any age group. Conclusion We observed a decrease in stroke-related mortality, particularly in individuals over 30 years old, and stability of the incidence of hospitalizations; and also regional variation in stroke-related hospital admission incidence and mortality among Brazilian young adults. PMID:27332892

  15. 5 CFR 551.601 - Minimum age standards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all...

  16. 5 CFR 551.601 - Minimum age standards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all...

  17. 5 CFR 551.601 - Minimum age standards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all...

  18. 5 CFR 551.601 - Minimum age standards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Minimum age standards. 551.601 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year minimum age. The Act, in section 3(l), sets a general 16-year minimum age, which applies to all...

  19. Age-specific mortality during the 1918 influenza pandemic: unravelling the mystery of high young adult mortality.

    PubMed

    Gagnon, Alain; Miller, Matthew S; Hallman, Stacey A; Bourbeau, Robert; Herring, D Ann; Earn, David J D; Madrenas, Joaquín

    2013-01-01

    The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889-90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics.

  20. Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality

    PubMed Central

    Gagnon, Alain; Miller, Matthew S.; Hallman, Stacey A.; Bourbeau, Robert; Herring, D. Ann; Earn, David JD.; Madrenas, Joaquín

    2013-01-01

    The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889–90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics. PMID:23940526

  1. Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories

    PubMed Central

    Flegal, Katherine M.; Kit, Brian K.; Orpana, Heather; Graubard, Barry I.

    2016-01-01

    Importance Estimates of the relative mortality risks associated with normal weight, overweight, and obesity may help to inform decision making in the clinical setting. Objective To perform a systematic review of reported hazard ratios (HRs) of all-cause mortality for overweight and obesity relative to normal weight in the general population. Data Sources PubMed and EMBASE electronic databases were searched through September 30, 2012, without language restrictions. Study Selection Articles that reported HRs for all-cause mortality using standard body mass index (BMI) categories from prospective studies of general populations of adults were selected by consensus among multiple reviewers. Studies were excluded that used nonstandard categories or that were limited to adolescents or to those with specific medical conditions or to those undergoing specific procedures. PubMed searches yielded 7034 articles, of which 141 (2.0%) were eligible. An EMBASE search yielded 2 additional articles. After eliminating overlap, 97 studies were retained for analysis, providing a combined sample size of more than 2.88 million individuals and more than 270 000 deaths. Data Extraction Data were extracted by 1 reviewer and then reviewed by 3 independent reviewers. We selected the most complex model available for the full sample and used a variety of sensitivity analyses to address issues of possible overadjustment (adjusted for factors in causal pathway) or underadjustment (not adjusted for at least age, sex, and smoking). Results Random-effects summary all-cause mortality HRs for overweight (BMI of 25–<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30–<35), and grades 2 and 3 obesity (BMI of ≥35) were calculated relative to normal weight (BMI of 18.5–<25). The summary HRs were 0.94 (95% CI, 0.91–0.96) for overweight, 1.18 (95% CI, 1.12–1.25) for obesity (all grades combined), 0.95 (95% CI, 0.88–1.01) for grade 1 obesity, and 1.29 (95% CI, 1.18–1.41) for grades 2 and

  2. Age, growth and size interact with stress to determine life span and mortality

    PubMed Central

    Roach, Deborah Ann

    2012-01-01

    Individuals in a large experimental field population, of the short-lived perennial species Plantago lanceolata, were followed to determine the sources of variation that influence mortality and life span. The design included multiple age groups with initially similar genetic structure, which made it possible to separate age effects from period effects and to identify the genetic component to variation in life span. During a period of stress, individuals of all ages showed parallel increases in mortality but different cohorts experienced this period of high mortality at different ages. This then influenced the distribution of life spans across cohorts. Age and size-age interactions influenced mortality during the period of stress. Smaller individuals died but only if they were old. Additionally, growth and age interacted with stress such that older individuals had negative growth and high mortality whereas younger individuals had positive growth and relatively lower mortality during stress. The results of this study show that it is not simply the environment that can have a major impact on demography in natural populations, rather, age, size and growth can interact with the environment to influence mortality and life span when the environment is stressful. PMID:22664575

  3. Decelerating Mortality Rates in Older Ages and its Prospects through Lee-Carter Approach

    PubMed Central

    Yadav, Awdhesh; Yadav, Suryakant; Kesarwani, Ranjana

    2012-01-01

    The present study attempts to study the age pattern mortality and prospects through Lee-Carter approach. The objectives of the study are to examine the trend of mortality decline and life expectancy. Contemporaneously, we have projected life expectancy up to 2025, projecting ASDR using Lee-Carter method. Life table aging rate (LAR) used to estimate the rate of mortality deceleration. Overtime, LAR increased and during recent decade it remained more or less unchanged. By age, LAR significant increased in the oldest of old. The slope is steepest in the oldest of old in the recent decade. The rates of mortality increased in oldest of old as the age group is more vulnerable to chronic disease and vulnerable to identifiable risk factors for virtually every disease, marked by senility. The analysis revealed that the level of mortality is not declining but rate of acceleration is declining and is further expected to decline. By the year 2025, the age specific death rates for the age group 5–9 and 10–14 will go below one per thousand.Life expectancy will attained as high as 73 and 79 years for male and female and is further expected to increase linearly. 71 percent of total female birth and 57 percent of total male birth will survive up to age 70+. Also the findings revealed that mortality rate is declining with constant rate up to age 70 and thereafter, the mortality rate accelerates and this holds true for both sexes. PMID:23236414

  4. Divergence in age patterns of mortality change drives international divergence in lifespan inequality.

    PubMed

    Gillespie, Duncan O S; Trotter, Meredith V; Tuljapurkar, Shripad D

    2014-06-01

    In the past six decades, lifespan inequality has varied greatly within and among countries even while life expectancy has continued to increase. How and why does mortality change generate this diversity? We derive a precise link between changes in age-specific mortality and lifespan inequality, measured as the variance of age at death. Key to this relationship is a young-old threshold age, below and above which mortality decline respectively decreases and increases lifespan inequality. First, we show for Sweden that shifts in the threshold's location have modified the correlation between changes in life expectancy and lifespan inequality over the last two centuries. Second, we analyze the post-World War II (WWII) trajectories of lifespan inequality in a set of developed countries-Japan, Canada, and the United States-where thresholds centered on retirement age. Our method reveals how divergence in the age pattern of mortality change drives international divergence in lifespan inequality. Most strikingly, early in the 1980s, mortality increases in young U.S. males led to a continuation of high lifespan inequality in the United States; in Canada, however, the decline of inequality continued. In general, our wider international comparisons show that mortality change varied most at young working ages after WWII, particularly for males. We conclude that if mortality continues to stagnate at young ages yet declines steadily at old ages, increases in lifespan inequality will become a common feature of future demographic change.

  5. Time trend and age-period-cohort effect on kidney cancer mortality in Europe, 1981–2000

    PubMed Central

    Pérez-Farinós, Napoleón; López-Abente, Gonzalo; Pastor-Barriuso, Roberto

    2006-01-01

    Background The incorporation of diagnostic and therapeutic improvements, as well as the different smoking patterns, may have had an influence on the observed variability in renal cancer mortality across Europe. This study examined time trends in kidney cancer mortality in fourteen European countries during the last two decades of the 20th century. Methods Kidney cancer deaths and population estimates for each country during the period 1981–2000 were drawn from the World Health Organization Mortality Database. Age- and period-adjusted mortality rates, as well as annual percentage changes in age-adjusted mortality rates, were calculated for each country and geographical region. Log-linear Poisson models were also fitted to study the effect of age, death period, and birth cohort on kidney cancer mortality rates within each country. Results For men, the overall standardized kidney cancer mortality rates in the eastern, western, and northern European countries were 20, 25, and 53% higher than those for the southern European countries, respectively. However, age-adjusted mortality rates showed a significant annual decrease of -0.7% in the north of Europe, a moderate rise of 0.7% in the west, and substantial increases of 1.4% in the south and 2.0% in the east. This trend was similar among women, but with lower mortality rates. Age-period-cohort models showed three different birth-cohort patterns for both men and women: a decrease in mortality trend for those generations born after 1920 in the Nordic countries, a similar but lagged decline for cohorts born after 1930 in western and southern European countries, and a continuous increase throughout all birth cohorts in eastern Europe. Similar but more heterogeneous regional patterns were observed for period effects. Conclusion Kidney cancer mortality trends in Europe showed a clear north-south pattern, with high rates on a downward trend in the north, intermediate rates on a more marked rising trend in the east than in the

  6. Low income, unemployment, and suicide mortality rates for middle-age persons in Japan.

    PubMed

    Yamasaki, Akiko; Sakai, Ryoji; Shirakawa, Taro

    2005-04-01

    The relationships between age-specific suicide mortality rates and social life factors for all 47 Japanese prefectures in 1980, 1985, and 1990 were assessed by multiple regression analysis after factor analysis on 20 social life indicators. During this period, Japan experienced a secondary oil crisis in 1980-1983 and a bubble economy in 1986-1990. It was concluded that (1) low income was the major determinant which positively affected suicide mortality rate in middle-aged men during a previous 20-yr. period (1970-1990), (2) urbanization was negatively associated with male suicide mortality rates in most of the age classes in the 1980s, (3) unemployment was one of the major determinants of increased suicide mortality rate in middle-age men in the 1980s, and (4) unemployment was the major factor which was inversely associated with suicide mortality rate for elderly women from 1980 to 1990 in Japan.

  7. Slowing of Mortality Rates at Older Ages in Large Medfly Cohorts

    NASA Astrophysics Data System (ADS)

    Carey, James R.; Liedo, Pablo; Orozco, Dina; Vaupel, James W.

    1992-10-01

    It is generally assumed for most species that mortality rates increase monotonically at advanced ages. Mortality rates were found to level off and decrease at older ages in a population of 1.2 million medflies maintained in cages of 7,200 and in a group of approximately 48,000 adults maintained in solitary confinement. Thus, life expectancy in older individuals increased rather than decreased with age. These results cast doubt on several central concepts in gerontology and the biology of aging: (i) that senescence can be characterized by an increase in age-specific mortality, (ii) that the basic pattern of mortality in nearly all species follows the same unitary pattern at older ages, and (iii) that species have absolute life-span limits.

  8. Slowing of mortality rates at older ages in large medfly cohorts.

    PubMed

    Carey, J R; Liedo, P; Orozco, D; Vaupel, J W

    1992-10-16

    It is generally assumed for most species that mortality rates increase monotonically at advanced ages. Mortality rates were found to level off and decrease at older ages in a population of 1.2 million medflies maintained in cages of 7,200 and in a group of approximately 48,000 adults maintained in solitary confinement. Thus, life expectancy in older individuals increased rather than decreased with age. These results cast doubt on several central concepts in gerontology and the biology of aging: (i) that senescence can be characterized by an increase in age-specific mortality, (ii) that the basic pattern of mortality in nearly all species follows the same unitary pattern at older ages, and (iii) that species have absolute life-span limits.

  9. Growth and mortality of age-0 northern squawfish, Ptychocheilus oregonensis, rearing in shoreline habitats of the Columbia River Reservoir

    USGS Publications Warehouse

    Barfoot, C.A.; Gadomski, D.M.; Wertheimer, R.H.

    1999-01-01

    We investigated growth and mortality of age-0 northern squawfish during early rearing in shallow shoreline habitats. Larvae and juveniles (n=22914) were collected by weekly seining at three sample sites in the upper John Day Reservoir, Columbia River, during June through early September 1994–1996. Using a length-based ageing method, it was estimated that the exponential growth rate (G) for a common growth stanza (10–28 mm standard length SL) was significantly higher in 1994 (G=0.047) than in 1996 (G=0.037). Growth rate in 1995 could not be estimated, but was probably intermediate between 1994 and 1996 based on mean standard lengths of fish collected at the end of each sampling season (46.3, 40.0, and 32.0 mm SL in 1994, 1995, and 1996, respectively). For many fish species, variations in early growth can influence survival through size-selective mortality processes. Consistent with this possibility, our estimates of instantaneous mortality rates (Z) demonstrated that larvae and juveniles had significantly higher mortality in 1996 than in 1994 (Z=0.103 in 1994, versus Z=0.138 in 1996). Enhanced growth and lower mortality in 1994 were associated with a number of interrelated environmental conditions – comparatively low flows and turbidities, abundant instream vegetative cover, and high near-shore water temperatures.

  10. Dynamical network model for age-related health deficits and mortality

    NASA Astrophysics Data System (ADS)

    Taneja, Swadhin; Mitnitski, Arnold B.; Rockwood, Kenneth; Rutenberg, Andrew D.

    2016-02-01

    How long people live depends on their health, and how it changes with age. Individual health can be tracked by the accumulation of age-related health deficits. The fraction of age-related deficits is a simple quantitative measure of human aging. This quantitative frailty index (F ) is as good as chronological age in predicting mortality. In this paper, we use a dynamical network model of deficits to explore the effects of interactions between deficits, deficit damage and repair processes, and the connection between the F and mortality. With our model, we qualitatively reproduce Gompertz's law of increasing human mortality with age, the broadening of the F distribution with age, the characteristic nonlinear increase of the F with age, and the increased mortality of high-frailty individuals. No explicit time-dependence in damage or repair rates is needed in our model. Instead, implicit time-dependence arises through deficit interactions—so that the average deficit damage rates increase, and deficit repair rates decrease, with age. We use a simple mortality criterion, where mortality occurs when the most connected node is damaged.

  11. Radiation and mortality of workers at Oak Ridge National Laboratory: positive associations for doses received at older ages.

    PubMed Central

    Richardson, D B; Wing, S

    1999-01-01

    We examined associations between low-level exposure to ionizing radiation and mortality among 14,095 workers hired at the Oak Ridge National Laboratory between 1943 and 1972. Workers at the facility were individually monitored for external exposure to ionizing radiation and have been followed through 1990 to ascertain cause of death information. Positive associations were observed between low-level exposure to external ionizing radiation and mortality. These associations were larger for doses received after 45 years of age, larger under longer lag assumptions, and primarily due to cancer causes of death. All cancer mortality was estimated to increase 4.98% [standard error (SE) = 1.5] per 10-mSv cumulative dose received after age 45 under a 10-year lag, and 7.31% (SE = 2.2) per 10-mSv cumulative dose received after age 45 under a 20-year lag. Associations between radiation dose and lung cancer were of similar magnitude to associations between radiation dose and all cancers except lung cancer. Nonmalignant respiratory disease exhibited a positive association with cumulative radiation dose received after age 45, whereas ischemic heart disease exhibited no association with radiation dose. These findings suggest increases in cancer mortality associated with low-level external exposure to ionizing radiation and potentially greater sensitivity to the carcinogenic effects of ionizing radiation with older ages at exposure. Images Figure 1 PMID:10417363

  12. Radiation and mortality of workers at Oak Ridge National Laboratory: positive associations for doses received at older ages.

    PubMed

    Richardson, D B; Wing, S

    1999-08-01

    We examined associations between low-level exposure to ionizing radiation and mortality among 14,095 workers hired at the Oak Ridge National Laboratory between 1943 and 1972. Workers at the facility were individually monitored for external exposure to ionizing radiation and have been followed through 1990 to ascertain cause of death information. Positive associations were observed between low-level exposure to external ionizing radiation and mortality. These associations were larger for doses received after 45 years of age, larger under longer lag assumptions, and primarily due to cancer causes of death. All cancer mortality was estimated to increase 4.98% [standard error (SE) = 1.5] per 10-mSv cumulative dose received after age 45 under a 10-year lag, and 7.31% (SE = 2.2) per 10-mSv cumulative dose received after age 45 under a 20-year lag. Associations between radiation dose and lung cancer were of similar magnitude to associations between radiation dose and all cancers except lung cancer. Nonmalignant respiratory disease exhibited a positive association with cumulative radiation dose received after age 45, whereas ischemic heart disease exhibited no association with radiation dose. These findings suggest increases in cancer mortality associated with low-level external exposure to ionizing radiation and potentially greater sensitivity to the carcinogenic effects of ionizing radiation with older ages at exposure.

  13. Age-specific measles mortality during the late 19th-early 20th centuries.

    PubMed

    Shanks, G D; Waller, M; Briem, H; Gottfredsson, M

    2015-12-01

    Measles mortality fell prior to the introduction of vaccines or antibiotics. By examining historical mortality reports we sought to determine how much measles mortality was due to epidemiological factors such as isolation from major population centres or increased age at time of infection. Age-specific records were available from Aberdeen; Scotland; New Zealand and the states of Australia at the end of the 19th and beginning of the 20th centuries. Despite the relative isolation of Australia, measles mortality was concentrated in very young children similar to Aberdeen. In the more isolated states of Tasmania, Western Australia and Queensland adults made up 14-15% of measles deaths as opposed to 8-9% in Victoria, South Australia and New South Wales. Mortality in Iceland and Faroe Islands during the 1846 measles epidemic was used as an example of islands isolated from respiratory pathogens. The transition from crisis mortality across all ages to deaths concentrated in young children occurred prior to the earliest age-specific mortality data collected. Factors in addition to adult age of infection and epidemiological isolation such as nutritional status and viral virulence may have contributed to measles mortality outcomes a century ago.

  14. [Maternal mortality in Spain, 1980-1992. Relationship with birth distributions according to the mother's age].

    PubMed

    Valero Juan, L F; Sáenz González, M C

    1997-11-01

    The maternal mortality evolution in Spain during the 1980-1992 period is reported. The influence of birth distribution according to maternal age is analyzed. The information was gathered from vital statistics published by Instituto Nacional de Estadística. The mortality rates have stabilized since 1985 (4.8 per 10(5) for 1992) associated with the increase in the proportion of births in women aged > or = 30 years (40.6% for 1992). Birth distributions according to maternal age account for 13.1% of the deaths observed. The predictions point to an increase in maternal mortality for the year 2000.

  15. Mortality after Distal Radius Fracture in Men and Women Aged 50 Years and Older in Southern Norway

    PubMed Central

    Øyen, Jannike; Diamantopoulos, Andreas P.; Haugeberg, Glenn

    2014-01-01

    Increased mortality rates in patients sustaining hip and vertebral fractures are well documented; however in distal radius fracture patients the results are conflicting. The aim of this study was to examine short- and long-term mortality in distal radius fracture patient in comparison with the background population. Patients aged ≥50 years with distal radius fracture living in Southern Norway who suffered a fracture in the two year period 2004 and 2005 were included in the study. The mortality risk of the standard Norwegian population was used to calculate the standardized mortality ratio (SMR). The number of distal radius fractures was 883 (166 men and 717 women). Mean age was 69 years (men 65 years and women 70 years). After one year the overall mortality rate was 3.4% (men 5.4% and women 2.9%) and after five years 4.6% (men 4.0% and women 4.8%). The SMR for men and women compared to the Norwegian population for the first year was 1.6 (95% confidence interval (CI): 0.6, 2.7) and 0.9 (95% CI: 0.4, 1.2), respectively, and after five years 1.7 (95% CI: 0.3, 3.0) and 2.0 (95% CI: 1.2, 2.7). Stratified on age groups (50–70 and >70 years) an increased SMR was only seen in female patients aged >70 years five years after the fracture (SMR: 1.9, 95% CI: 1.1, 2.6). In conclusion, increased SMR was found in female patients aged >70 years five years after the distal radius fracture, but not in men or in women younger than 70 years. PMID:25380128

  16. Sustained enjoyment of life and mortality at older ages: analysis of the English Longitudinal Study of Ageing

    PubMed Central

    Zaninotto, Paola; Wardle, Jane

    2016-01-01

    Objective To test whether the number of reports of enjoyment of life over a four year period is quantitatively associated with all cause mortality, and with death from cardiovascular disease and from other causes. Design and setting Longitudinal observational population study using the English Longitudinal Study of Ageing (ELSA), a nationally representative sample of older men and women living in England. Participants 9365 men and women aged 50 years or older (mean 63, standard deviation 9.3) at recruitment. Main outcome measures Time to death, based on mortality between the third phase of data collection (wave 3 in 2006) and March 2013 (up to seven years). Results Subjective wellbeing with measures of enjoyment of life were assessed in 2002 (wave 1), 2004 (wave 2), and 2006 (wave 3). 2264 (24%) respondents reported no enjoyment of life on any assessment, with 1833 (20%) reporting high enjoyment on one report of high enjoyment of life, 2063 (22%) on two reports, and 3205 (34%) on all three occasions. 1310 deaths were recorded during follow-up. Mortality was inversely associated with the number of occasions on which participants reported high enjoyment of life. Compared with the no high enjoyment group, the hazard ratio for all cause mortality was 0.83 (95% confidence interval 0.70 to 0.99) for two reports of enjoyment of life, and 0.76 (0.64 to 0.89) for three reports, after adjustment for demographic factors, baseline health, mobility impairment, and depressive symptoms. The same association was observed after deaths occurring within two years of the third enjoyment measure were excluded (0.90 (0.85 to 0.95) for every additional report of enjoyment), and in the complete case analysis (0.90 (0.83 to 0.96)). Conclusions This is an observational study, so causal conclusions cannot be drawn. Nonetheless, the results add a new dimension to understanding the significance of subjective wellbeing for health outcomes by documenting the importance of sustained

  17. Creating Better School-Age Care Jobs: Model Work Standards.

    ERIC Educational Resources Information Center

    Haack, Peggy

    Built on the premise that good school-age care jobs are the cornerstone of high-quality services for school-age youth and their families, this guide presents model work standards for school-age care providers. The guide begins with a description of the strengths and challenges of the school-age care profession. The model work standards are…

  18. Age at Menarche and Cardiovascular Disease Mortality in Singaporean Chinese Women: The Singapore Chinese Health Study

    PubMed Central

    Mueller, NT; Odegaard, AO; Gross, MD; Koh, WP; Yuan, JM; Pereira, MA

    2012-01-01

    Purpose To examine whether menarcheal age was inversely associated with CVD mortality in Singaporean Chinese women. Methods 34,022 Chinese women aged 45–74 at enrollment (1993–1998), with complete data on study variables, were followed prospectively through 2009 for primary cause of death due to CVD, including coronary heart disease (CHD) and cerebrovascular disease (CERE). Hazard ratios (HRs) for CVD mortality were computed across menarcheal age categories and adjusted for potential confounders and BMI. Results Over 460,374 person-years of follow-up, 1,852 women died from CVD; 998 of them from CHD and 557 from CERE. There was a significant interaction between menarcheal age and smoking (p<0.05). In nonsmokers, menarcheal age was inversely associated with risk for CVD and CHD mortality. HRs (and 95% CI) for CVD mortality across menarcheal age categories (≤12, 13–14, 15–16, ≥17) were: 1.06 (0.87–1.29), 1 (referent), 0.89 (0.79–1.00), and 0.80 (0.69–0.93), respectively (ptrend<0.001); HRs for CHD mortality were: 1.06 (0.80–1.34), 1 (referent), 0.76 (0.65–0.90), and 0.72 (0.58–0.88), respectively (ptrend<0.001). In nonsmokers there was no association between menarcheal age and CERE mortality. Among smokers, menarcheal age was not associated with CVD, CHD or CERE mortality. Conclusion Menarcheal age was inversely associated with risk of CVD mortality in nonsmoking Chinese women. PMID:22939833

  19. Evidence of accelerated aging among African Americans and its implications for mortality.

    PubMed

    Levine, M E; Crimmins, E M

    2014-10-01

    Blacks experience morbidity and mortality earlier in the life course compared to whites. Such premature declines in health may be indicative of an acceleration of the aging process. The current study uses data on 7644 black and white participants, ages 30 and above, from the third National Health and Nutrition Examination Survey, to compare the biological ages of blacks and whites as indicated from a combination of ten biomarkers and to determine if such differences in biological age relative to chronological age account for racial disparities in mortality. At a specified chronological age, blacks are approximately 3 years older biologically than whites. Differences in biological age between blacks and whites appear to increase up until ages 60-65 and then decline, presumably due to mortality selection. Finally, differences in biological age were found to completely account for higher levels of all-cause, cardiovascular and cancer mortality among blacks. Overall, these results suggest that being black is associated with significantly higher biological age at a given chronological age and that this is a pathway to early death both overall and from the major age-related diseases.

  20. Age-Specific Morbidity and Mortality Rates Among U.S. Navy Enlisted Divers and Controls

    DTIC Science & Technology

    1984-07-01

    The purpose of this study was to compare age-specific hospitalization, disability, and mortality rates for diving-related and stress- induced...actions for stress-related disorders were observed among controls than divers. For both groups, medical board, physical evaluation board, and mortality ... rates increased with age as did hospitalization for musculoskeletal disorders, stress-related disorders, and circulatory diseases. Subsequent research

  1. Emotional Reactivity and Mortality: Longitudinal Findings From the VA Normative Aging Study

    PubMed Central

    Stawski, Robert S.; Turiano, Nicholas A.; Chan, Wai; Almeida, David M.; Neupert, Shevaun D.; Spiro, Avron

    2015-01-01

    Objectives. Evidence suggests a predictive association between emotion and mortality risk. However, no study has examined dynamic aspects of emotion in relation to mortality. This study used an index of emotional reactivity, defined as changes in positive or negative affect in response to daily stressors, to predict 10-year survival. Methods. An 8-day daily diary study was conducted in 2002 on 181 men aged 58–88. Multilevel models were employed to estimate emotional reactivity coefficients, which were subsequently entered into a Cox proportional hazards model to predict mortality. Results. Results indicated that positive emotional reactivity, that is, greater decreases in positive affect in response to daily stressors, increased mortality risk. Negative emotional reactivity did not predict mortality. Discussion. Findings highlight the potential importance of dynamic aspects of positive affect in prediction of physical health outcomes such as mortality. PMID:24170714

  2. Disentangling trait-based mortality in species with decoupled size and age.

    PubMed

    O'Farrell, Shay; Salguero-Gómez, Roberto; van Rooij, Jules M; Mumby, Peter J

    2015-09-01

    1. Size and age are fundamental organismal traits, and typically, both are good predictors of mortality. For many species, however, size and age predict mortality in ontogenetically opposing directions. Specifically, mortality due to predation is often more intense on smaller individuals whereas mortality due to senescence impacts, by definition, on older individuals. 2. When size-based and age-based mortality are independent in this manner, modelling mortality in both traits is often necessary. Classical approaches, such as Leslie or Lefkovitch matrices, usually require the model to infer the state of one trait from the state of the other, for example by assuming that explicitly modelled age (or stage) class structure provides implicit information on underlying size-class structure, as is the case in many species. 3. However, the assumption that one trait informs on the other is challenged when size and age are decoupled, as often occurs in invertebrates, amphibians, fish, reptiles and plants. In these cases, age-structured models may perform poorly at capturing size-based mortality, and vice versa. 4. We offer a solution to this dilemma, relaxing the assumption that class structure in one trait is inferable from class structure in another trait. Using empirical data from a reef fish, Sparisoma viride (Scaridae), we demonstrate how an individual-based model (IBM) can be implemented to model mortality as explicit, independent and simultaneous functions of individual size and age - an approach that mimics the effects of mortality in many wild populations. By validating this 'multitrait IBM' against three independent lines of empirical data, we determine that the approach produces more convincing predictions of size-class structure, longevity and post-settlement mortality for S. viride than do the trait-independent or single-trait mortality models tested. 5. Multitrait IBMs also allow trait-based mortality to be modelled either additively or multiplicatively, and

  3. Early Standard Electroencephalogram Abnormalities Predict Mortality in Septic Intensive Care Unit Patients

    PubMed Central

    Azabou, Eric; Magalhaes, Eric; Braconnier, Antoine; Yahiaoui, Lyria; Moneger, Guy; Heming, Nicholas; Annane, Djillali; Mantz, Jean; Chrétien, Fabrice; Durand, Marie-Christine; Lofaso, Frédéric; Porcher, Raphael; Sharshar, Tarek

    2015-01-01

    Introduction Sepsis is associated with increased mortality, delirium and long-term cognitive impairment in intensive care unit (ICU) patients. Electroencephalogram (EEG) abnormalities occurring at the acute stage of sepsis may correlate with severity of brain dysfunction. Predictive value of early standard EEG abnormalities for mortality in ICU septic patients remains to be assessed. Methods In this prospective, single center, observational study, standard EEG was performed, analyzed and classified according to both Synek and Young EEG scales, in consecutive patients acutely admitted in ICU for sepsis. Delirium, coma and the level of sedation were assessed at the time of EEG recording; and duration of sedation, occurrence of in-ICU delirium or death were assessed during follow-up. Adjusted analyses were carried out using multiple logistic regression. Results One hundred ten patients were included, mean age 63.8 (±18.1) years, median SAPS-II score 38 (29–55). At the time of EEG recording, 46 patients (42%) were sedated and 22 (20%) suffered from delirium. Overall, 54 patients (49%) developed delirium, of which 32 (29%) in the days after EEG recording. 23 (21%) patients died in the ICU. Absence of EEG reactivity was observed in 27 patients (25%), periodic discharges (PDs) in 21 (19%) and electrographic seizures (ESZ) in 17 (15%). ICU mortality was independently associated with a delta-predominant background (OR: 3.36; 95% CI [1.08 to 10.4]), absence of EEG reactivity (OR: 4.44; 95% CI [1.37–14.3], PDs (OR: 3.24; 95% CI [1.03 to 10.2]), Synek grade ≥ 3 (OR: 5.35; 95% CI [1.66–17.2]) and Young grade > 1 (OR: 3.44; 95% CI [1.09–10.8]) after adjustment to Simplified Acute Physiology Score (SAPS-II) at admission and level of sedation. Delirium at the time of EEG was associated with ESZ in non-sedated patients (32% vs 10%, p = 0.037); with Synek grade ≥ 3 (36% vs 7%, p< 0.05) and Young grade > 1 (36% vs 17%, p< 0.001). Occurrence of delirium in the days after

  4. Statin, testosterone and phosphodiesterase 5-inhibitor treatments and age related mortality in diabetes

    PubMed Central

    Hackett, Geoffrey; Jones, Peter W; Strange, Richard C; Ramachandran, Sudarshan

    2017-01-01

    AIM To determine how statins, testosterone (T) replacement therapy (TRT) and phosphodiesterase 5-inhibitors (PDE5I) influence age related mortality in diabetic men. METHODS We studied 857 diabetic men screened for the BLAST study, stratifying them (mean follow-up = 3.8 years) into: (1) Normal T levels/untreated (total T > 12 nmol/L and free T > 0.25 nmol/L), Low T/untreated and Low T/treated; (2) PDE5I/untreated and PDE5I/treated; and (3) statin/untreated and statin/treated groups. The relationship between age and mortality, alone and with T/TRT, statin and PDE5I treatment was studied using logistic regression. Mortality probability and 95%CI were calculated from the above models for each individual. RESULTS Age was associated with mortality (logistic regression, OR = 1.10, 95%CI: 1.08-1.13, P < 0.001). With all factors included, age (OR = 1.08, 95%CI: 1.06-1.11, P < 0.001), Low T/treated (OR = 0.38, 95%CI: 0.15-0.92, P = 0.033), PDE5I/treated (OR = 0.17, 95%CI: 0.053-0.56, P = 0.004) and statin/treated (OR = 0.59, 95%CI: 0.36-0.97, P = 0.038) were associated with lower mortality. Age related mortality was as described by Gompertz, r2 = 0.881 when Ln (mortality) was plotted against age. The probability of mortality and 95%CI (from logistic regression) of individuals, treated/untreated with the drugs, alone and in combination was plotted against age. Overlap of 95%CI lines was evident with statins and TRT. No overlap was evident with PDE5I alone and with statins and TRT, this suggesting a change in the relationship between age and mortality. CONCLUSION We show that statins, PDE5I and TRT reduce mortality in diabetes. PDE5I, alone and with the other treatments significantly alter age related mortality in diabetic men. PMID:28344753

  5. Aging in the natural world: comparative data reveal similar mortality patterns across primates.

    PubMed

    Bronikowski, Anne M; Altmann, Jeanne; Brockman, Diane K; Cords, Marina; Fedigan, Linda M; Pusey, Anne; Stoinski, Tara; Morris, William F; Strier, Karen B; Alberts, Susan C

    2011-03-11

    Human senescence patterns-late onset of mortality increase, slow mortality acceleration, and exceptional longevity-are often described as unique in the animal world. Using an individual-based data set from longitudinal studies of wild populations of seven primate species, we show that contrary to assumptions of human uniqueness, human senescence falls within the primate continuum of aging; the tendency for males to have shorter life spans and higher age-specific mortality than females throughout much of adulthood is a common feature in many, but not all, primates; and the aging profiles of primate species do not reflect phylogenetic position. These findings suggest that mortality patterns in primates are shaped by local selective forces rather than phylogenetic history.

  6. Aging in the Natural World: Comparative Data Reveal Similar Mortality Patterns Across Primates

    PubMed Central

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

    2012-01-01

    Human senescence patterns—late onset of mortality increase, slow mortality acceleration, and exceptional longevity—are often described as unique in the animal world. Using an individual-based data set from longitudinal studies of wild populations of seven primate species, we show that contrary to assumptions of human uniqueness, human senescence falls within the primate continuum of aging; the tendency for males to have shorter life spans and higher age-specific mortality than females throughout much of adulthood is a common feature in many, but not all, primates; and the aging profiles of primate species do not reflect phylogenetic position. These findings suggest that mortality patterns in primates are shaped by local selective forces rather than phylogenetic history. PMID:21393544

  7. The happy survivor? Effects of differential mortality on life satisfaction in older age.

    PubMed

    Segerstrom, Suzanne C; Combs, Hannah L; Winning, Ashley; Boehm, Julia K; Kubzansky, Laura D

    2016-06-01

    Older adults report higher psychological well-being than younger adults. Those highest in well-being also have the lowest risk of mortality. If those with lower well-being die earlier, it could affect the appearance of developmental change in well-being. In adults aged 50 and older (N = 4,458), we estimated effects of differential mortality on life satisfaction by imputing life satisfaction, adjusting for attrition due to death, or estimating life satisfaction using pattern-mixture modeling. There was an increase in life satisfaction with age; however, differential mortality affected the elevation of the curve. Observed life satisfaction, particularly above age 70, is affected by differential mortality. (PsycINFO Database Record

  8. Age-Specific Variation in Adult Mortality Rates in Developed Countries

    PubMed Central

    Zheng, Hui; Yang, Y. Claire; Land, Kenneth C.

    2016-01-01

    This paper investigates historical changes in both single-year-of-age adult mortality rates and variation of the single-year mortality rates around expected values within age intervals over the past two centuries in 15 developed countries. We apply an integrated Hierarchical Age-Period-Cohort—Variance Function Regression Model to data from the Human Mortality Database. We find increasing variation of the single-year rates within broader age intervals over the life course for all countries, but the increasing variation slows down at age 90 and then increases again after age 100 for some countries; the variation significantly declined across cohorts born after the early 20th century; and the variation continuously declined over much of the last two centuries but has substantially increased since 1980. Our further analysis finds the recent increases in mortality variation are not due to increasing proportions of older adults in the population, trends in mortality rates, or disproportionate delays in deaths from degenerative and man-made diseases, but rather due to increasing variations in young and middle-age adults. PMID:28133402

  9. 29 CFR 570.2 - Minimum age standards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Minimum age standards. 570.2 Section 570.2 Labor... REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General § 570.2 Minimum age standards. (a) All occupations except in agriculture. (1) The Act, in section 3(1), sets a general 16-year minimum age...

  10. 29 CFR 570.2 - Minimum age standards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Minimum age standards. 570.2 Section 570.2 Labor... REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General § 570.2 Minimum age standards. (a) All occupations except in agriculture. (1) The Act, in section 3(1), sets a general 16-year minimum age...

  11. 29 CFR 570.2 - Minimum age standards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Minimum age standards. 570.2 Section 570.2 Labor... REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General § 570.2 Minimum age standards. (a) All occupations except in agriculture. (1) The Act, in section 3(1), sets a general 16-year minimum age...

  12. 29 CFR 570.2 - Minimum age standards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Minimum age standards. 570.2 Section 570.2 Labor... REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General § 570.2 Minimum age standards. (a) All occupations except in agriculture. (1) The Act, in section 3(1), sets a general 16-year minimum age...

  13. 29 CFR 570.2 - Minimum age standards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Minimum age standards. 570.2 Section 570.2 Labor... REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General § 570.2 Minimum age standards. (a) All occupations except in agriculture. (1) The Act, in section 3(1), sets a general 16-year minimum age...

  14. Aging and the germ line: where mortality and immortality meet.

    PubMed

    Jones, D Leanne

    2007-01-01

    Germ cells are highly specialized cells that form gametes, and they are the only cells within an organism that contribute genes to offspring. Germline stem cells (GSCs) sustain gamete production, both oogenesis (egg production) and spermatogenesis (sperm production), in many organisms. Since the genetic information contained within germ cells is passed from generation to generation, the germ line is often referred to as immortal. Therefore, it is possible that germ cells possess unique strategies to protect and transmit the genetic information contained within them indefinitely. However, aging often leads to a dramatic decrease in gamete production and fecundity. In addition, single gene mutations affecting longevity often have a converse effect on reproduction. Recent studies examining age-related changes in GSC number and activity, as well as changes to the stem cell microenvironment, provide insights into the mechanisms underlying the observed reduction in gametogenesis over the lifetime of an organism.

  15. Spatial gender-age-period-cohort analysis of pancreatic cancer mortality in Spain (1990–2013)

    PubMed Central

    Etxeberria, Jaione; Goicoa, Tomás; López-Abente, Gonzalo; Riebler, Andrea

    2017-01-01

    Recently, the interest in studying pancreatic cancer mortality has increased due to its high lethality. In this work a detailed analysis of pancreatic cancer mortality in Spanish provinces was performed using recent data. A set of multivariate spatial gender-age-period-cohort models was considered to look for potential candidates to analyze pancreatic cancer mortality rates. The selected model combines features of APC (age-period-cohort) models with disease mapping approaches. To ensure model identifiability sum-to-zero constraints were applied. A fully Bayesian approach based on integrated nested Laplace approximations (INLA) was considered for model fitting and inference. Sensitivity analyses were also conducted. In general, estimated average rates by age, cohort, and period are higher in males than in females. The higher differences according to age between males and females correspond to the age groups [65, 70), [70, 75), and [75, 80). Regarding the cohort, the greatest difference between men and women is observed for those born between the forties and the sixties. From there on, the younger the birth cohort is, the smaller the difference becomes. Some cohort differences are also identified by regions and age-groups. The spatial pattern indicates a North-South gradient of pancreatic cancer mortality in Spain, the provinces in the North being the ones with the highest effects on mortality during the studied period. Finally, the space-time evolution shows that the space pattern has changed little over time. PMID:28199327

  16. Age-specific patterns of genetic variance in Drosophila melanogaster. I. Mortality

    SciTech Connect

    Promislow, D.E.L.; Tatar, M.; Curtsinger, J.W.

    1996-06-01

    Peter Medawar proposed that senescence arises from an age-related decline in the force of selection, which allows late-acting deleterious mutations to accumulate. Subsequent workers have suggested that mutation accumulation could produce an age-related increase in additive genetic variance (V{sub A}) for fitness traits, as recently found in Drosophila melanogaster. Here we report results from a genetic analysis of mortality in 65,134 D. melanogaster. Additive genetic variance for female mortality rates increases from 0.007 in the first week of life to 0.325 by the third week, and then declines to 0.002 by the seventh week. Males show a similar pattern, though total variance is lower than in females. In contrast to a predicted divergence in mortality curves, mortality curves of different genotypes are roughly parallel. Using a three-parameter model, we find significant V{sub A} for the slope and constant term of the curve describing age-specific mortality rates, and also for the rate at which mortality decelerates late in life. These results fail to support a prediction derived from Medawar`s {open_quotes}mutation accumulation{close_quotes} theory for the evolution of senescence. However, our results could be consistent with alternative interpretations of evolutionary models of aging. 65 refs., 2 figs., 2 tabs.

  17. Paradise Lost: Age-Dependent Mortality of American Communes, 1609-1965

    ERIC Educational Resources Information Center

    Kitts, James A.

    2009-01-01

    Theorists agree that the risk of folding changes as organizations age, but there is little consensus as to the general form or generative processes of age-dependent mortality. This article investigates four such processes (maturation, senescence, legitimation and obsolescence), which have been taken as competing accounts. Using two analytical…

  18. Age Differences in the Effects of Mortality Salience on the Correspondence Bias.

    PubMed

    Maxfield, Molly; Pyszczynski, Tom; Greenberg, Jeff; Bultmann, Michael N

    2017-04-01

    According to terror management theory, awareness of death affects diverse aspects of human thought and behavior. Studies have shown that older and younger adults differ in how they respond to reminders of their mortality. The present study investigated one hypothesized explanation for these findings: Age-related differences in the tendency to make correspondent inferences. The correspondence bias was assessed in younger and older samples after death-related, negative, or neutral primes. Younger adults displayed increased correspondent inferences following mortality primes, whereas older adults' inferences were not affected by the reminder of death. As in prior research, age differences were evident in control conditions; however, age differences were eliminated in the death condition. Results support the existence of age-related differences in responses to mortality, with only younger adults displaying increased reliance on simplistic information structuring after a death reminder.

  19. Smoothing two-dimensional Malaysian mortality data using P-splines indexed by age and year

    NASA Astrophysics Data System (ADS)

    Kamaruddin, Halim Shukri; Ismail, Noriszura

    2014-06-01

    Nonparametric regression implements data to derive the best coefficient of a model from a large class of flexible functions. Eilers and Marx (1996) introduced P-splines as a method of smoothing in generalized linear models, GLMs, in which the ordinary B-splines with a difference roughness penalty on coefficients is being used in a single dimensional mortality data. Modeling and forecasting mortality rate is a problem of fundamental importance in insurance company calculation in which accuracy of models and forecasts are the main concern of the industry. The original idea of P-splines is extended to two dimensional mortality data. The data indexed by age of death and year of death, in which the large set of data will be supplied by Department of Statistics Malaysia. The extension of this idea constructs the best fitted surface and provides sensible prediction of the underlying mortality rate in Malaysia mortality case.

  20. Height loss starting in middle age predicts increased mortality in the elderly.

    PubMed

    Masunari, Naomi; Fujiwara, Saeko; Kasagi, Fumiyoshi; Takahashi, Ikuno; Yamada, Michiko; Nakamura, Toshitaka

    2012-01-01

    The purpose of this study was to determine the mortality risk among Japanese men and women with height loss starting in middle age, taking into account lifestyle and physical factors. A total of 2498 subjects (755 men and 1743 women) aged 47 to 91 years old underwent physical examinations during the period 1994 to 1995. Those individuals were followed for mortality status through 2003. Mortality risk was estimated using an age-stratified Cox proportional hazards model. In addition to sex, adjustment factors such as radiation dose, lifestyle, and physical factors measured at the baseline--including smoking status, alcohol intake, total cholesterol, blood pressure, and diagnosed diseases--were used for analysis of total mortality and mortality from each cause of death. There were a total of 302 all-cause deaths, 46 coronary heart disease and stroke deaths, 58 respiratory deaths including 45 pneumonia deaths, and 132 cancer deaths during the follow-up period. Participants were followed for 20,787 person-years after baseline. Prior history of vertebral deformity and hip fracture were not associated with mortality risk. However, more than 2 cm of height loss starting in middle age showed a significant association with all-cause mortality among the study participants (HR = 1.76, 95% CI 1.31 to 2.38, p = 0.0002), after adjustment was made for sex, attained age, atomic-bomb radiation exposure, and lifestyle and physical factors. Such height loss also was significantly associated with death due to coronary heart disease or stroke (HR = 3.35, 95% CI 1.63 to 6.86, p = 0.0010), as well as respiratory-disease death (HR = 2.52, 95% CI 1.25 to 5.22, p = 0.0130), but not cancer death. Continuous HL also was associated with all-cause mortality and CHD- or stroke-caused mortality. Association between height loss and mortality was still significant, even after excluding persons with vertebral deformity. Height loss of more than 2 cm starting in middle age

  1. Total cholesterol concentration and mortality at a relatively young age: do men and women differ?

    PubMed Central

    Monique Verschuren, W. M.; Kromhout, D.

    1995-01-01

    OBJECTIVE--To investigate the relation between total cholesterol concentration and mortality from coronary heart disease, cardiovascular diseases, non-cardiovascular causes, and all causes. DESIGN--Population based cohort study. SUBJECTS--23,000 men and 26,000 women aged 30-54 years examined between 1974 and 1980. MAIN OUTCOME MEASURES--Mortality for the above mentioned end points for fifths of cholesterol distribution, and relative risks estimated by using Cox's proportional hazard (survival) analysis. Adjustment was made for age, smoking, systolic blood pressure, and body mass index. RESULTS--Mortality from coronary heart disease in men was five times higher than that in women. A strong positive association between total cholesterol concentration and mortality from coronary heart disease and cardiovascular diseases was observed in both men and women. The relative risk for the highest compared with the lowest fifth of the cholesterol distribution was for mortality from coronary heart disease (3.0 (95% confidence interval 1.8 to 5.1) in men and 3.8 (1.1 to 13.1) in women) and for mortality from cardiovascular disease (2.8 (1.8 to 4.2) in men and 2.9 (1.4 to 6.0) in women). No increase of non-cardiovascular mortality at low cholesterol concentration was observed. All cause mortality was significantly higher in the highest compared with the lowest fifth of the cholesterol distribution: relative risk 1.6 (1.3 to 2.0) in men and 1.5 (1.1 to 1.9) in women. CONCLUSION--Total cholesterol concentration is a strong predictor of mortality from coronary heart disease, cardiovascular diseases, and all causes in women as well as in men. Low cholesterol concentrations are not associated with increased mortality from non-cardiovascular causes. PMID:7580439

  2. Age-Related Mortality Trends in Italy from 1901 to 2008

    PubMed Central

    Vercelli, Marina; Lillini, Roberto; Quaglia, Alberto; Micale, Rosanna T.; La Maestra, Sebastiano; De Flora, Silvio

    2014-01-01

    We stratified the Italian population according to age and gender in order to evaluate mortality trends over more than one century. Data covering the 1901–2008 period were used to study the yearly variations in mortality. Fluctuations in age-adjusted mortality curves were analyzed by Join Point Regression Models, identifying Join Points and Annual Percent Changes. A consistent decline in all-cause mortality occurred across the whole period, the most striking variations being observed in the 0–49 years population. In 1901, other and undefined diseases were the main causes of death, followed by infectious, digestive, and respiratory diseases in the 0–49 years population and by respiratory, cardiovascular, and cerebrovascular diseases in the ≥50 years population groups. In 2008 the main causes of death were accidents (males) and tumors (females) in the 0–49 age class, tumors in the 50–69 age class (both genders), and tumors (males) and cardiovascular diseases (females) in the elderly. The results highlight the interplay between age and gender in affecting mortality trends and reflect the dramatic progress in nutritional, lifestyle, socioeconomic, medical, and hygienic conditions. PMID:25486606

  3. Relationships between in-hospital and 30-day standardized hospital mortality: implications for profiling hospitals.

    PubMed Central

    Rosenthal, G. E.; Baker, D. W.; Norris, D. G.; Way, L. E.; Harper, D. L.; Snow, R. J.

    2000-01-01

    OBJECTIVE: To examine the relationship of in-hospital and 30-day mortality rates and the association between in-hospital mortality and hospital discharge practices. DATA SOURCES/STUDY SETTING: A secondary analysis of data for 13,834 patients with congestive heart failure who were admitted to 30 hospitals in northeast Ohio in 1992-1994. DESIGN: A retrospective cohort study was conducted. DATA COLLECTION: Demographic and clinical data were collected from patients' medical records and were used to develop multivariable models that estimated the risk of in-hospital and 30-day (post-admission) mortality. Standardized mortality ratios (SMRs) for in-hospital and 30-day mortality were determined by dividing observed death rates by predicted death rates. PRINCIPAL FINDINGS: In-hospital SMRs ranged from 0.54 to 1.42, and six hospitals were classified as statistical outliers (p <.05); 30-day SMRs ranged from 0.63 to 1.73, and seven hospitals were outliers. Although the correlation between in-hospital SMRs and 30-day SMRs was substantial (R = 0.78, p < .001), outlier status changed for seven of the 30 hospitals. Nonetheless, changes in outlier status reflected relatively small differences between in-hospital and 30-day SMRs. Rates of discharge to nursing homes or other inpatient facilities varied from 5.4 percent to 34.2 percent across hospitals. However, relationships between discharge rates to such facilities and in-hospital SMRs (R = 0.08; p = .65) and early post-discharge mortality rates (R = 0.23; p = .21) were not significant. CONCLUSIONS: SMRs based on in-hospital and 30-day mortality were relatively similar, although classification of hospitals as statistical outliers often differed. However, there was no evidence that in-hospital SMRs were biased by differences in post-discharge mortality or discharge practices. PMID:10737447

  4. Socioeconomic inequalities in mortality rates in old age in the World Health Organization Europe region.

    PubMed

    Huisman, Martijn; Read, Sanna; Towriss, Catriona A; Deeg, Dorly J H; Grundy, Emily

    2013-01-01

    Socioeconomic adversity is among the foremost fundamental causes of human suffering, and this is no less true in old age. Recent reports on socioeconomic inequalities in mortality rate in old age suggest that a low socioeconomic position continues to increase the risk of death even among the oldest old. We aimed to examine the evidence for socioeconomic mortality rate inequalities in old age, including information about associations with various indicators of socioeconomic position and for various geographic locations within the World Health Organization Region for Europe. The articles included in this review leave no doubt that inequalities in mortality rate by socioeconomic position persist into the oldest ages for both men and women in all countries for which information is available, although the relative risk measures observed were rarely higher than 2.00. Still, the available evidence base is heavily biased geographically, inasmuch as it is based largely on national studies from Nordic and Western European countries and local studies from urban areas in Southern Europe. This bias will hamper the design of European-wide policies to reduce inequalities in mortality rate. We call for a continuous update of the empiric evidence on socioeconomic inequalities in mortality rate.

  5. Mortality among the working age population receiving incapacity benefits in New Zealand, 1981-2004.

    PubMed

    Shaw, Caroline; Blakely, Tony; Tobias, Martin

    2011-08-01

    Like many OECD countries New Zealand has experienced a large increase in the number of working-age people receiving incapacity benefits in the last 3 decades, despite apparent improvements in population health. This paper examines trends in mortality rates of people receiving sickness benefit or invalid's benefit (SBIB) between 1981 and 2004 using repeated cohort studies (linking the 1981, 1986, 1991, 1996, and 2001 censuses to mortality data). Mortality rates, standardised for age and ethnicity, were calculated for each census cohort for 25-64 year olds by benefit receipt status. Standardised rate differences and rate ratios and 95% confidence intervals were calculated to measure disparities on both absolute and relative scales. Between 1981 and 2004 overall SBIB receipt increased from 2% to 5% of the working age population. Mortality rates were at least three times higher in the SBIB than the non-SBIB group at all points in time for men and women. Mortality rates declined in all groups, for example in men receiving SBIB, mortality decreased from 2354/100,000 in the 1981-84 cohort to 1371/100,000 in the 2001-04 cohort. Absolute inequalities between SBIB and non-SBIB declined in both men and women (for example in women standardised rate differences decreased from 954/100,000 to 688/100,000) but relative inequalities remained largely stable (for example in men the risk ratio increased from 4.27 to 4.54). Mortality rates declined more in sickness benefit than invalid's benefit recipients. The substantial expansion of SBIB receipt in New Zealand has not been accompanied by any reduction in the excess mortality risk experienced by SBIB recipients. These findings are likely to reflect the changing nature of the economy, labour force and disability experience in New Zealand.

  6. 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

  7. Age-specific mortality trends in France and Italy since 1900: period and cohort effects.

    PubMed

    Caselli, G; Vallin, J; Vaupel, J W; Yashin, A

    1987-11-01

    The age/sex-specific mortality trends of France and Italy were studied over the 1899-1979 period in as much detail as possible in an effort to distinguish between cohort effects and those related to period changes. Complete series of mortality data by individual years of age and calendar years were available from 1869 to 1979 for Italy and from 1899 to 1982 for France. For both countries, these data include the military and civil deaths not registered in vital statistics during the war periods. They cover each national territory as defined by its present boundaries. The graphical representation method of mortality surfaces, elaborated by Vaupel, Gambill, and Yashin (1985), was adopted. The age/sex-specific mortality patterns of France and Italy have not followed the same trends, and the differences observed today are not those of 100 years ago. The mean death probabilities for the 1975-79 period were used to illustrate the age-specific patterns of mortality. Although infant mortality was higher in Italy than in France, the death probabilities at ages 1-15 for both sexes were roughly the same for both countries. At ages 15-23, they were much higher in France than in Italy, and they remained considerably higher in France up to age 55. From then on, the sexes differ: for males, the 2 countries showed similar patterns, whereas for females the probabilities were noticeably higher for France. The situation was very different for both countries at the beginning of the century. For both sexes, higher mortality was observed in Italy not only during infancy but throughout childhood and the adolescent years up to age 15. The 2 countries showed similar patterns from 15-25. Above age 25, the 2 countries had similar patterns for females, whereas male mortality was higher in France right up to the old age groups. Such differences in the age-specific mortality trends depend in part on a different development of health and social conditions but also may be due to factors concerning

  8. Cardiac Mortality Among 200 000 Five-Year Survivors of Cancer Diagnosed at 15 to 39 Years of Age

    PubMed Central

    Henson, Katherine E.; Reulen, Raoul C.; Winter, David L.; Bright, Chloe J.; Fidler, Miranda M.; Frobisher, Clare; Guha, Joyeeta; Wong, Kwok F.; Kelly, Julie; Edgar, Angela B.; McCabe, Martin G.; Whelan, Jeremy; Cutter, David J.; Darby, Sarah C.

    2016-01-01

    Background: Survivors of teenage and young adult cancer are acknowledged as understudied. Little is known about their long-term adverse health risks, particularly of cardiac disease that is increased in other cancer populations where cardiotoxic treatments have been used. Methods: The Teenage and Young Adult Cancer Survivor Study cohort comprises 200 945 5-year survivors of cancer diagnosed at 15 to 39 years of age in England and Wales from 1971 to 2006, and followed to 2014. Standardized mortality ratios, absolute excess risks, and cumulative risks were calculated. Results: Two thousand sixteen survivors died of cardiac disease. For all cancers combined, the standardized mortality ratios for all cardiac diseases combined was greatest for individuals diagnosed at 15 to 19 years of age (4.2; 95% confidence interval, 3.4–5.2) decreasing to 1.2 (95% confidence interval, 1.1–1.3) for individuals aged 35 to 39 years (2P for trend <0.0001). Similar patterns were observed for both standardized mortality ratios and absolute excess risks for ischemic heart disease, valvular heart disease, and cardiomyopathy. Survivors of Hodgkin lymphoma, acute myeloid leukaemia, genitourinary cancers other than bladder cancer, non-Hodgkin lymphoma, lung cancer, leukaemia other than acute myeloid, central nervous system tumour, cervical cancer, and breast cancer experienced 3.8, 2.7, 2.0, 1.7, 1.7, 1.6, 1.4, 1.3 and 1.2 times the number of cardiac deaths expected from the general population, respectively. Among survivors of Hodgkin lymphoma aged over 60 years, almost 30% of the total excess number of deaths observed were due to heart disease. Conclusions: This study of over 200 000 cancer survivors shows that age at cancer diagnosis was critical in determining subsequent cardiac mortality risk. For the first time, risk estimates of cardiac death after each cancer diagnosed between the ages of 15 and 39 years have been derived from a large population-based cohort with prolonged

  9. Unintentional drowning mortality, by age and body of water: an analysis of 60 countries

    PubMed Central

    Lin, Ching-Yih; Wang, Yi-Fong; Lu, Tsung-Hsueh; Kawach, Ichiro

    2015-01-01

    Background To examine unintentional drowning mortality by age and body of water across 60 countries, to provide a starting point for further in-depth investigations within individual countries. Methods The latest available three years of mortality data for each country were extracted from WHO Health Statistics and Information Services (updated at 13 November 2013). We calculated mortality rate of unintentional drowning by age group for each country. For countries using International Classification of Disease 10 (ICD-10) detailed 3 or 4 Character List, we further examined the body of water involved. Results A huge variation in age-standardised mortality rate (deaths per 100 000 population) was noted, from 0.12 in Turkey to 9.19 in Guyana. Of the ten countries with the highest age-standardised mortality rate, six (Belarus, Lithuania, Latvia, Russia, Ukraine and Moldova) were in Eastern Europe and two (Kazakhstan and Kyrgyzstan) were in Central Asia. Some countries (Japan, Finland and Greece) had a relatively low rank in mortality rate among children aged 0–4 years, but had a high rank in mortality rate among older adults. On the contrary, South Africa and Colombia had a relatively high rank among children aged 0–4 years, but had a relatively low rank in mortality rate among older adults. With regard to body of water involved, the proportion involving a bathtub was extremely high in Japan (65%) followed by Canada (11%) and the USA (11%). Of the 13 634 drowning deaths involving bathtubs in Japan between 2009 and 2011, 12 038 (88%) were older adults aged 65 years or above. The percentage involving a swimming pool was high in the USA (18%), Australia (13%), and New Zealand (7%). The proportion involving natural water was high in Finland (93%), Panama (87%), and Lithuania (85%). Conclusions After considering the completeness of reporting and quality of classifying drowning deaths across countries, we conclude that drowning is a high-priority public health

  10. The implications of increased survivorship for mortality variation in aging populations.

    PubMed

    Engelman, Michal; Canudas-Romo, Vladimir; Agree, Emily M

    2010-01-01

    The remarkable growth in life expectancy during the twentieth century inspired predictions of a future in which all people, not just a fortunate few, will live long lives ending at or near the maximum human life span. We show that increased longevity has been accompanied by less variation in ages at death, but survivors to the oldest ages have grown increasingly heterogeneous in their mortality risks. These trends are consistent across countries, and apply even to populations with record-low variability in the length of life. We argue that as a result of continuing improvements in survival, delayed mortality selection has shifted health disparities from early to later life, where they manifest in the growing inequalities in late-life mortality.

  11. [The Russian and international standards of age-related allocation of population for medical statistics, medical demographic analysis and risk assessment].

    PubMed

    Demin, V F; Paltsev, M A

    2013-01-01

    The actual European standard of age-related allocation of population in action is largely implemented in medical demographic studies of international (WHO etc.) and national organizations. The Rosstat also implements this standard in its demographic yearbooks and other publications. The standard is applied in computing the standardized indicator of population mortality in different countries and territories and also in assessing risk factors. The standard is based on the idea of evaluating mortality with an integrated standard in order to compare between different countries mortality of population, genders and calendar years. The analysis of results of testing calculations of values of standardized indicator of mortality of population of Russia and EU countries applying European standard in action revealed serious shortcomings. For example. unfounded overstating of values of standardized indicator, of mortality for males and its understating for females artificially increases already wide difference in mortality of males and females in the Russian Federation. The calculation on this background of standardized indicator of mortality for particular causes of death results in erroneous values due to neglected concurrence of risks. Because of necessity of improvement of standard a new concept of development of national and international standards is proposed. This concept is based on application of notion of balanced age-related allocation of population and its number values.

  12. Comorbidity, age and mortality among adults treated intensively for acute myeloid leukemia (AML)

    PubMed Central

    Tawfik, Bernard; Pardee, Timothy; Isom, Scott; Sliesoraitis, Sarunas; Winter, Allison; Lawrence, Julia; Powell, Bayard L.; Klepin, Heidi D.

    2015-01-01

    Introduction Our goal was to characterize comorbidities among adults receiving intensive therapy for AML, and investigate their association with outcomes. Methods We retrospectively analyzed 277 consecutive patients with newly diagnosed AML treated intensively at the Comprehensive Cancer Center of Wake Forest University from 2002–2009. Pretreatment comorbidities were identified by ICD-9 codes and chart review. Comorbidity burden (modified Charlson Comorbidity Index [CCI]) and specific conditions were analyzed individually. Outcomes were overall survival (OS), remission, and 30-day mortality. Covariates included age, gender, cytogenetic characteristics, hemoglobin, white cell count, lactate dehydrogenase, body mass index, and insurance type. Cox proportional hazards models were used to evaluate OS; logistic regression was used for remission and 30-day mortality. Results In this series, 144 patients were ≥60 years old (median age 70 years, median survival 8.7 months) and 133 were <60 years (median age 47 years, median survival 23.1 months). Older patients had a higher comorbidity burden (CCI≥1 58% versus 26%, p<0.001). Prevalent comorbid conditions differed by age (diabetes 19.2% versus 7.5%; cardiovascular disease 12.5% versus 4.5%, for older versus younger patients, respectively). The CCI was not independently associated with OS or 30-day mortality in either age group. Among older patients, diabetes was associated with higher 30-day mortality (33.3% vs. 12.0% in diabetic vs. non diabetic patients, p =0.006). Controlling for age, cytogenetic characteristics and other comorbidities, the presence of diabetes increased the odds of 30-day mortality by 4.9 (CI 1.6–15.2) times. Discussion Diabetes is adversely associated with 30-day survival in older AML patients receiving intensive therapy. PMID:26527394

  13. Age of red blood cells and mortality in the critically ill

    PubMed Central

    2011-01-01

    Introduction In critically ill patients, it is uncertain whether exposure to older red blood cells (RBCs) may contribute to mortality. We therefore aimed to evaluate the association between the age of RBCs and outcome in a large unselected cohort of critically ill patients in Australia and New Zealand. We hypothesized that exposure to even a single unit of older RBCs may be associated with an increased risk of death. Methods We conducted a prospective, multicenter observational study in 47 ICUs during a 5-week period between August 2008 and September 2008. We included 757 critically ill adult patients receiving at least one unit of RBCs. To test our hypothesis we compared hospital mortality according to quartiles of exposure to maximum age of RBCs without and with adjustment for possible confounding factors. Results Compared with other quartiles (mean maximum red cell age 22.7 days; mortality 121/568 (21.3%)), patients treated with exposure to the lowest quartile of oldest RBCs (mean maximum red cell age 7.7 days; hospital mortality 25/189 (13.2%)) had an unadjusted absolute risk reduction in hospital mortality of 8.1% (95% confidence interval = 2.2 to 14.0%). After adjustment for Acute Physiology and Chronic Health Evaluation III score, other blood component transfusions, number of RBC transfusions, pretransfusion hemoglobin concentration, and cardiac surgery, the odds ratio for hospital mortality for patients exposed to the older three quartiles compared with the lowest quartile was 2.01 (95% confidence interval = 1.07 to 3.77). Conclusions In critically ill patients, in Australia and New Zealand, exposure to older RBCs is independently associated with an increased risk of death. PMID:21496231

  14. Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study

    PubMed Central

    Razvi, Salman; Yadegarfar, Mohammad E.; Martin-Ruiz, Carmen; Kingston, Andrew; Collerton, Joanna; Visser, Theo J.; Kirkwood, Tom B.; Jagger, Carol

    2016-01-01

    Context: Perturbations in thyroid function are common in older individuals but their significance in the very old is not fully understood. Objective: This study sought to determine whether thyroid hormone status and variation of thyroid hormones within the reference range correlated with mortality and disability in a cohort of 85-year-olds. Design: A cohort of 85-year-old individuals were assessed in their own homes (community or institutional care) for health status and thyroid function, and followed for mortality and disability for up to 9 years. Setting and Participants: Six hundred and forty-three 85-year-olds registered with participating general practices in Newcastle and North Tyneside, United Kingdom. Main Outcomes: All-cause mortality, cardiovascular mortality, and disability according to thyroid disease status and baseline thyroid hormone parameters (serum TSH, FT4, FT3, and rT3). Models were adjusted for age, sex, education, body mass index, smoking, and disease count. Results: After adjustment for age and sex, all-cause mortality was associated with baseline serum rT3 and FT3 (both P < .001), but not FT4 or TSH. After additional adjustment for potential confounders, only rT3 remained significantly associated with mortality (P = .001). Baseline serum TSH and rT3 predicted future disability trajectories in men and women, respectively. Conclusions: Our study is reassuring that individuals age 85 y with both subclinical hypothyroidism and subclinical hyperthyroidism do not have a significantly worse survival over 9 years than their euthyroid peers. However, thyroid function tests did predict disability, with higher serum TSH levels predicting better outcomes. These data strengthen the argument for routine use of age-specific thyroid function reference ranges. PMID:27552542

  15. Marital Status and Mortality among Middle Age and Elderly Men and Women in Urban Shanghai

    PubMed Central

    Va, Puthiery; Yang, Wan-Shui; Nechuta, Sarah; Chow, Wong-Ho; Cai, Hui; Yang, Gong; Gao, Shan; Gao, Yu-Tang; Zheng, Wei; Shu, Xiao-Ou; Xiang, Yong-Bing

    2011-01-01

    Background Previous studies have suggested that marital status is associated with mortality, but few studies have been conducted in China where increasing aging population and divorce rates may have major impact on health and total mortality. Methods We examined the association of marital status with mortality using data from the Shanghai Women's Health Study (1996–2009) and Shanghai Men's Health Study (2002–2009), two population-based cohort studies of 74,942 women aged 40–70 years and 61,500 men aged 40–74 years at the study enrollment. Deaths were identified by biennial home visits and record linkage with the vital statistics registry. Marital status was categorized as married, never married, divorced, widowed, and all unmarried categories combined. Cox regression models were used to derive hazard ratios (HR) and 95% confidence interval (CI). Results Unmarried and widowed women had an increased all-cause HR = 1.11, 95% CI: 1.03, 1.21 and HR = 1.10, 95% CI: 1.02, 1.20 respectively) and cancer (HR = 1.17, 95% CI: 1.04, 1.32 and HR = 1.18, 95% CI: 1.04, 1.34 respectively) mortality. Never married women had excess all-cause mortality (HR = 1.46, 95% CI: 1.03, 2.09). Divorce was associated with elevated cardiovascular disease (CVD) mortality in women (HR = 1.47, 95% CI: 1.01, 2.13) and elevated all-cause mortality (HR = 2.45, 95% CI: 1.55, 3.86) in men. Amongst men, not being married was associated with excess all-cause (HR = 1.45, 95% CI: 1.12, 1.88) and CVD (HR = 1.65, 95% CI: 1.07, 2.54) mortality. Conclusions Marriage is associated with decreased all cause mortality and CVD mortality, in particular, among both Chinese men and women. PMID:22073174

  16. Activity and mortality among aged persons over an eight-year period.

    PubMed

    Lee, D J; Markides, K S

    1990-01-01

    The influence of level of activity examined with data from an eight-year (1976 to 1984) longitudinal study of 508 older Mexican Americans and Anglos. Over the study interval, 119 subjects were confirmed to have died. Activity was a significant predictor of mortality at the univariate level. However, when age, gender, education, marital status, ethnicity, and self-rated health were controlled for in the analysis, activity was not a significant predictor of mortality. The popular notion that an active life among elderly persons might lead to extended longevity was not supported by these data.

  17. Smoking mediates the effect of conscientiousness on mortality: The Veterans Affairs Normative Aging Study.

    PubMed

    Turiano, Nicholas A; Hill, Patrick L; Roberts, Brent W; Spiro, Avron; Mroczek, Daniel K

    2012-12-01

    This study examined the relationship between conscientiousness and mortality over 18 years and whether smoking behavior mediated this relationship. We utilized data from the Veterans Affairs Normative Aging Study on 1349 men who completed the Goldberg (1992) adjectival markers of the Big Five. Over the 18-year follow-up, 547 (41%) participants died. Through proportional hazards modeling in a structural equation modeling framework, we found that higher levels of conscientiousness significantly predicted longer life, and that this effect was mediated by current smoking status at baseline. Methodologically, we also demonstrate the effectiveness of using a structural equation modeling framework to evaluate mediation when using a censored outcome such as mortality.

  18. Age- and sex-specific mortality and population structure in sea otters

    USGS Publications Warehouse

    Bodkin, J.L.; Burdin, A.M.; Ryazanov, D.A.

    2000-01-01

    We used 742 beach-cast carcasses to characterize age- and sex-specific sea otter mortality during the winter of 1990-1991 at Bering Island, Russia. We also examined 363 carcasses recovered after the 1989 grounding of the T/V Exxon Valdez, to characterize age and sex composition in the living western Prince William Sound (WPWS) sea otter population. At Bering Island, mortality was male-biased (81%), and 75% were adults. The WPWS population was female-biased (59%) and most animals were subadult (79% of the males and 45% of the females). In the decade prior to 1990-1991 we found increasing sea otter densities (particularly among males), declining prey resources, and declining weights in adult male sea otters at Bering Island. Our findings suggest the increased mortality at Bering Island in 1990-1991 was a density-dependent population response. We propose male-maintained breeding territories and exclusion of juvenile females by adult females, providing a mechanism for potentially moderating the effects of prey reductions on the female population. Increased adult male mortality at Bearing Island in 1990-1991 likely modified the sex and age class structure there toward that observed in Prince William Sound.

  19. Longitudinal selectivity in aging populations: separating mortality-associated versus experimental components in the Berlin Aging Study (BASE).

    PubMed

    Lindenberger, Ulman; Singer, Tania; Baltes, Paul B

    2002-11-01

    The authors examined 3.7-year selectivity in the Berlin Aging Study by comparing the T1 parent sample (N = 516) with the T3 sample (N = 206). Selectivity was partitioned into a mortality-associated component, reflecting the degree to which individuals still alive at T3 (T3 survivors, N = 313) differ from the T1 parent sample (N = 516) from which they originated, and an experimental component, reflecting the degree to which the T3 sample (N = 206) differed from T3 survivors (N = 313). Across 48 variables representing medical, sensorimotor, cognitive, personality-related, and socioeconomic domains, the mortality-associated component accounted for 64% of total selectivity, and the experimental component for 36% (0.18 vs 0.10 SD units; t = 7.20, p <.01). Except for age and intelligence, experimental selectivity effects regarding means and prevalence rates were generally small. Partitioning selectivity into mortality-associated and experimental components is a useful tool in the longitudinal study of aging populations.

  20. Nativity Differentials in Older Age Mortality in Taiwan: Do They Exist and Why?

    PubMed Central

    Hermalin, Albert I.; Ofstedal, Mary Beth; Sun, Cathy; Liu, I-Wen

    2011-01-01

    Comparisons of migrants versus native populations have become increasingly important as a means of gaining insight into the factors affecting health and mortality levels and the relationship between them. Taiwan underwent a unique migration in 1949–50, as more than a million people, mostly young men, arrived from Mainland China following the Communist civil war victory. The Mainlanders were distinct from the original settlers in several ways: they represented different provinces in China, were better educated, and had distinct occupational profiles. Since 1950, Taiwan has experienced a rapid demographic transition and notable economic development, resulting in mortality decline. In this paper, we generate age- and cause-specific death rates circa 1990 by education and nativity to evaluate the relative importance of each factor. We also use longitudinal survey data to help interpret the differentials in terms of selection, risk factors, and other dynamics of health and mortality. PMID:21887404

  1. LIFE HISTORY. Age-related mortality explains life history strategies of tropical and temperate songbirds.

    PubMed

    Martin, Thomas E

    2015-08-28

    Life history theory attempts to explain why species differ in offspring number and quality, growth rate, and parental effort. I show that unappreciated interactions of these traits in response to age-related mortality risk challenge traditional perspectives and explain life history evolution in songbirds. Counter to a long-standing paradigm, tropical songbirds grow at similar overall rates to temperate species but grow wings relatively faster. These growth tactics are favored by predation risk, both in and after leaving the nest, and are facilitated by greater provisioning of individual offspring by parents. Increased provisioning of individual offspring depends on partitioning effort among fewer young because of constraints on effort from adult and nest mortality. These growth and provisioning responses to mortality risk finally explain the conundrum of small clutch sizes of tropical birds.

  2. Method for projecting age-specific mortality rates for certain causes of death

    SciTech Connect

    Leggett, R.W.; Crawford, D.J.

    1981-01-01

    A method is presented for projecting mortality rates for certain causes on the basis of observed rates during past years. This method arose from a study of trends in age-specific mortality rates for respiratory cancers, and for heuristic purposes it is shown how the method can be developed from certain theories of cancer induction. However, the method is applicable in the more common situation in which the underlying physical processes cannot be modeled with any confidence but the mortality rates are approximable over short time intervals by functions of the form a exp(bt), where b may vary in a continuous, predictable fashion as the time interval is varied. It appears from applications to historical data that this projection method is in some cases a substantial improvement over conventional curve-fitting methods and often uncovers trends which are not apparent from observed data.

  3. A method for projecting age-specific mortality rates for certain causes of death

    SciTech Connect

    Leggett, R.W.; Crawford, D.J.

    1981-09-01

    A method is presented for projecting mortality rates for certain causes on the basis of observed rates during past years. This method arose from a study of trends in age-specific mortality rates for respiratory cancers, and for heuristic purposes it is shown how the method can be developed from certain theories of cancer induction. However, the method is applicable in the more common situation in which the underlying physical processes cannot be modeled with any confidence but the mortality rates are approximable over short time intervals by functions of the form a exp(bt), where b may vary in a continuous, predictable fashion as the time interval is varied. It appears from applications to historical data that this projection method is in some cases a substantial improvement over conventional curve-fitting methods and often uncovers trends which are not from observed data.

  4. MARK-AGE standard operating procedures (SOPs): A successful effort.

    PubMed

    Moreno-Villanueva, María; Capri, Miriam; Breusing, Nicolle; Siepelmeyer, Anne; Sevini, Federica; Ghezzo, Alessandro; de Craen, Anton J M; Hervonen, Antti; Hurme, Mikko; Schön, Christiane; Grune, Tilman; Franceschi, Claudio; Bürkle, Alexander

    2015-11-01

    Within the MARK-AGE project, a population study (3337 subjects) was conducted to identify a set of biomarkers of ageing which, as a combination of parameters with appropriate weighting, would measure biological age better than any single marker. The MARK-AGE project involves 14 European countries and a total of 26 research centres. In such a study, standard operating procedures (SOPs) are an essential task, which are binding for all MARK-AGE Beneficiaries. The SOPs cover all aspects of subject's recruitment, collection, shipment and distribution of biological samples (blood and its components, buccal mucosa cells or BMC and urine) as well as the anthropometric measurements and questionnaires.

  5. Age and the Association of Kidney Measures with Mortality and End-Stage Renal Disease

    PubMed Central

    Hallan, Stein I.; Matsushita, Kunihiro; Sang, Yingying; Mahmoodi, Bakhtawar K.; Black, Corri; Ishani, Areef; Kleefstra, Nanne; Naimark, David; Roderick, Paul; Tonelli, Marcello; Wetzels, Jack F.M.; Astor, Brad C.; Gansevoort, Ron T.; Levin, Adeera; Wen, Chi-Pang; Coresh, Josef

    2014-01-01

    Context Chronic kidney disease (CKD) is prevalent in older individuals, but the risk implications of low estimated glomerular filtration rate (eGFR) and high albuminuria across the full age range are controversial. Objective To evaluate possible effect modification (interaction) of age on the association of estimated GFR and albuminuria with clinical risk examining both relative and absolute risk. Design, Setting, Participants We investigated 2,051,244 participants from 33 general population or high-risk (of vascular disease) cohorts and 13 CKD cohorts from Asia, Australesia, Europe, and North/South America conducted during 1972–2011 with mean follow-up time of 5.8 years (range 0–31 years). Main Outcome Measures Hazard ratios (HRs) of mortality and end-stage renal disease (ESRD) according to eGFR and albuminuria were meta-analyzed across age categories after adjusting for sex, race, cardiovascular disease, diabetes, systolic blood pressure, cholestserol, body mass index, and smoking. Absolute risks were estimated using HRs and average incidence rates. Results Mortality (112,325 deaths) and ESRD (8,411 events) risk were higher at lower eGFR and higher albuminuria in every age category. In general/high-risk cohorts, relative mortality risk for reduced eGFR decreased with increasing age: e.g., adjusted HRs (95% CI) at eGFR 45 vs. 80 ml/min/1.73m2 were 3.50 (2.55–4.81), 2.21 (2.02–2.41), 1.59 (1.42–1.77), and 1.35 (1.23–1.48) in age categories 18–54, 55–64, 65–74 and 75+ years, respectively (P-values for age interaction <0.05). Absolute risk differences for the same comparisons were higher at older age (9.0 [95% CI, 6.0–12.8], 12.2 [10.3–14.3], 13.3 [9.0–18.6], and 27.2 [13.5–45.5] excess deaths per 1,000 person-years, respectively). For increased albuminuria, reduction of relative risk with increasing age were less evident, while differences in absolute risk were higher in the older age categories (7.5 [95% CI, 4.3–11.9], 12.2 [7.9–17

  6. Obesity-induced oxidative stress, accelerated functional decline with age and increased mortality in mice

    PubMed Central

    Zhang, Yiqiang; Fischer, Kathleen E.; Soto, Vanessa; Liu, Yuhong; Sosnowska, Danuta; Richardson, Arlan; Salmon, Adam B.

    2015-01-01

    Obesity is a serious chronic disease that increases the risk of numerous co-morbidities including metabolic syndrome, cardiovascular disease and cancer as well as increases risk of mortality leading some to suggest this represents accelerated aging. Obesity is associated with significant increases in oxidative stress in vivo and, despite the well-explored relationship between oxidative stress and aging, the role this plays in the increased mortality of obese subjects remains an unanswered question. Here, we addressed this by undertaking a comprehensive, longitudinal study of a group of high fat-fed obese mice and assessed both their changes in oxidative stress and in their performance in physiological assays known to decline with aging. In female C57BL/6J mice fed a high-fat diet starting in adulthood, mortality was significantly increased in high fat-fed mice as was oxidative damage in vivo. High fat-feeding significantly accelerated the decline in performance in several assays, including activity, gait, and rotarod. However, we also found that obesity had little effect on other markers and actually improved performance in grip strength, a marker of muscular function. Together, this first comprehensive assessment of longitudinal functional changes in high fat-fed mice suggests that obesity may induce segmental acceleration of some of the aging process. PMID:25558793

  7. Mortality of breast cancer in Taiwan, 1971-2010: temporal changes and an age-period-cohort analysis.

    PubMed

    Ho, M-L; Hsiao, Y-H; Su, S-Y; Chou, M-C; Liaw, Y-P

    2015-01-01

    The current paper describes the age, period and cohort effects on breast cancer mortality in Taiwan. Female breast cancer mortality data were collected from the Taiwan death registries for 1971-2010. The annual percentage changes, age- standardised mortality rates (ASMR) and age-period-cohort model were calculated. The mortality rates increased with advancing age groups when fixing the period. The percentage change in the breast cancer mortality rate increased from 54.79% at aged 20-44 years, to 149.78% in those aged 45-64 years (between 1971-75 and 2006-10). The mortality rates in the 45-64 age group increased steadily from 1971 to 1975 and 2006-10. The 1951 birth cohorts (actual birth cohort; 1947-55) showed peak mortalities in both the 50-54 and 45-49 age groups. We found that the 1951 birth cohorts had the greatest mortality risk from breast cancer. This might be attributed to the DDT that was used in large amounts to prevent deaths from malaria in Taiwan. However, future researches require DDT data to evaluate the association between breast cancer and DDT use.

  8. Looking into the demography of an iron age population in the western Mediterranean. I. Mortality.

    PubMed

    Alesan, A; Malgosa, A; Simó, C

    1999-11-01

    In this paper, we attempt to reconstruct the mortality pattern of the population buried in S'Illot des Porros (Majorca), an Iron Age necropolis in the western Mediterranean, by means of paleodemographic analysis. The skeletal sample consists of 285 individuals, 93 subadults (under 20 years old) and 192 adults. The aim of this study is twofold: first, to identify and to evaluate the structural anomalies of the skeletal sample, and second, to obtain a possible and realistic description of the biological dynamics of this population, with special reference to its mortality pattern. The study uses current demographic methodology and several demographic models (for comparison). An abridged life table was built to estimate the mortality parameters. To evaluate the likelihood of the estimated data, an indirect analysis, which consisted of a comparison of our results with different population models (Weiss [1973] American Antiquity 38; Coale and Demeny [1996] Regional Model Life Tables and Stable Populations. Princeton: Princeton University Press; Ledermann [1969] Nouvelles tables-types de mortalité. Paris: Presses Universitaires de France), was carried out. An important bias was identified in the case of children, mostly affecting infants but also children between the ages of 1 and 5. This was interpreted as a census error due to taphonomic reasons and to an excluding differential funeral rite. A life expectancy at birth of approximately 28 years was estimated from the observed data. When this bias was removed, the estimated life expectancy at birth dropped to 23 years. The use of the Brass logit system allowed us to sketch a possible mortality profile for this population: low life expectancy, high infant mortality and hard life conditions, which were the cause of the low levels of survivorship in old ages. Am J Phys Anthropol 110:285-301, 1999.

  9. Age, growth, mortality, and abundance of lake sturgeon in the Grasse River, New York, USA

    USGS Publications Warehouse

    Trested, D.G.; Isely, J.J.

    2011-01-01

    An increased understanding of lake sturgeon (Acipenser fulvescens) population dynamics is a key requirement for successful management efforts. Little is known regarding the Grasse River population of lake sturgeon except that it is one of a few populations in New York State where spawning has been documented. Thus our purpose was to assess the current status of lake sturgeon in the Grasse River system, including age, growth, mortality, and abundance. Age was determined for 196 of 211 lake sturgeon by examination of sectioned pectoral fin rays. Ages ranged from 0 to 32 years and the annual mortality rate for fish between ages 7 and 14 was 16.8%. The weight (W, g) to total length (TL, mm) relationship was W = 1.281 x 10-6TL3.202. The von Bertalanffy growth equation was TL = 1913(1-e-0.0294(t+9.5691)). While the range of observed ages was similar to that of nearby St. Lawrence River populations, mean weight at age for an individual at 1000 mm TL was lower than that observed for lake sturgeon within Lake St. Francis of the St. Lawrence River. Predicted growth based on von Bertalanffy parameters was similar to that observed for the nearby Lake St. Francis. An open population estimator using the POPAN sub-module in the Program MARK produced an abundance estimate of 793 lake sturgeon (95% CI = 337-1249).

  10. Extremes of maternal age and child mortality: analysis between 2000 and 2009☆

    PubMed Central

    Ribeiro, Fanciele Dinis; Ferrari, Rosângela Aparecida Pimenta; Sant'Anna, Flávia Lopes; Dalmas, José Carlos; Girotto, Edmarlon

    2014-01-01

    OBJECTIVE: To analyze the characteristics of infant mortality at the extremes of maternal age. METHOD: Retrospective, cross-sectional quantitative study using data from Live Birth Certificates, Death Certificates and from Child Death Investigation records in Londrina, Paraná, in the years of 2000-2009. RESULTS: During the 10-year study period , there were 176 infant deaths among mothers up to 19 years of age, and 113 deaths among mothers aged 35 years or more. The infant mortality rate among young mothers was 14.4 deaths per thousand births, compared to 12.9 deaths in the other age group. For adolescent mothers, the following conditions prevailed: lack of a stable partner (p<0.001), lack of a paid job (p<0.001), late start of prenatal care in the second trimester of pregnancy (p<0.001), fewer prenatal visits (p<0.001) and urinary tract infections (p<0.001). On the other hand, women aged 35 or more had a higher occurrence of hypertension during pregnancy (p<0.001), and of surgical delivery (p<0.001). Regarding the underlying cause of infant death, congenital anomalies prevailed in the group of older mothers (p=0.002), and external causes were predominant in the group of young mothers (p=0.019). CONCLUSION: Both age groups deserve the attention of social services for maternal and child health, especially adolescent mothers, who presented a higher combination of factors deemed hazardous to the child's health. PMID:25511003

  11. Influence of sex, age, body mass index, and smoking on alcohol intake and mortality.

    PubMed Central

    Grønbaek, M.; Deis, A.; Sørensen, T. I.; Becker, U.; Borch-Johnsen, K.; Müller, C.; Schnohr, P.; Jensen, G.

    1994-01-01

    OBJECTIVE--To examine the association between self reported alcohol intake and subsequent mortality from all causes and if the effect of alcohol intake on the risk of death is modified by sex, age, body mass index, and smoking. DESIGN--Prospective population study with baseline assessment of alcohol and tobacco consumption and body mass index, and 10-12 years' follow up of mortality. SETTING--Copenhagen city heart study, Denmark. SUBJECTS--7234 women and 6051 men aged 30-79 years. MAIN OUTCOME MEASURE--Number and time of deaths from 1976 to 1988. RESULTS--A total of 2229 people died, 1398 being men. A U shaped curve described the relation between alcohol intake and mortality. The lowest risk was observed at one to six alcoholic beverages a week (relative risk set at 1). Abstainers had a relative risk of 1.37 (95% confidence interval 1.20 to 1.56) whereas those drinking more than 70 beverages a week had a relative risk of 2.29 (1.75 to 3.00). Among the drinkers, the risk was significantly increased only among those drinking more than 42 beverages a week. Sex, age, body mass index, and smoking did not significantly modify the risk function. The risk among heavy drinkers was slightly reduced when smoking was controlled for. The risk function was similar in the first and second period of six years of observation. CONCLUSION--Alcohol intake showed a U shaped relation to mortality with the nadir at one to six beverages a week. The risk function was not modified by sex, age, body mass index, or smoking and remained stable over 12 years. PMID:8124118

  12. Your morality, my mortality: conscientious objection and the standard of care.

    PubMed

    Rich, Ben A

    2015-04-01

    Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result. With the exponential increase in the penetration of Catholic-affiliated healthcare across the country, physicians and nurses who are not practicing Catholics are nevertheless required to execute documents pledging to conform their patient care to the Ethical and Religious Directives for Health Care Services as a condition of employment or medical staff privileges. In some instances, doing so may result in patient morbidity or mortality or violate professional standards for respecting advance directives or surrogate decisionmaking. This article challenges the ethical propriety of such institutional mandates and argues that legal protections for conscientious refusal must provide redress for patients who are harmed by care that falls below the prevailing clinical standards.

  13. Morbidity, mortality and quality of life in the ageing haemodialysis population: results from the ELDERLY study

    PubMed Central

    Dschietzig, Wilfried; Leimenstoll, Gerd; Rob, Peter M.; Kuhlmann, Martin K.; Pommer, Wolfgang; Fraass, Uwe; Ritz, Eberhard; Schwenger, Vedat

    2016-01-01

    Background The physical–functional and social–emotional health as well as survival of the elderly (≥75 years of age) haemodialysis patient is commonly thought to be poor. In a prospective, multicentre, non-interventional, observational study, the morbidity, mortality and quality of life (QoL) in this patient group were examined and compared with a younger cohort. Methods In 92 German dialysis centres, 2507 prevalent patients 19–98 years of age on haemodialysis for a median of 19.2 months were included in a drug monitoring study of darbepoetin alfa. To examine outcome and QoL parameters, 24 months of follow-up data in the age cohorts <75 and ≥75 years were analysed. Treatment parameters, adverse and intercurrent events, hospitalizations, morbidity and mortality were assessed. QoL was evaluated by means of the 47-item Functional Assessment of Chronic Illness Therapy–Anaemia score (FACT-An, version 4). Results The 2-year mortality rate was 34.7% for the older cohort and 15.8% for the younger cohort. The mortality rate for the haemodialysed elderly patients was 6.2% higher in absolute value compared with the age-matched background population. A powerful predictor of survival was the baseline FACT-An score and a close correlation with the 20-item anaemia subscale (AnS) was demonstrated. While the social QoL in the elderly patients was more stable than in the younger cohort (leading to equivalent values at the end of the study period), a pronounced deterioration of physical and functional status was observed. The median number of all-cause hospital days per patient-year was 12.3 for the elderly cohort and 8.9 for the younger patient population. The overall 24-month hospitalization rate was only marginally higher in the elderly cohort (34.0 versus 33.3%). Conclusions In this observational study, the mortality rate of elderly haemodialysis patients was not exceedingly high compared with the age-matched background population. Furthermore, the hospitalization

  14. Ar/Ar Dating Independent of Monitor Standard Ages

    NASA Astrophysics Data System (ADS)

    Boswell, S.; Hemming, S. R.

    2015-12-01

    Because the reported age of an analyzed sample is dependent on the age of the co-irradiated monitor standard(s), Ar/Ar dating is a relative dating technique. There is disagreement at the 1% scale in the age of commonly used monitor standards, and there is a great need to improve the inter-laboratory calibrations. Additionally, new approaches and insights are needed to meet the challenge of bringing the Ar/Ar chronometer to the highest possible precision and accuracy. In this spirit, we present a conceptual framework for Ar/Ar dating that does not depend on the age of monitor standards, but only on the K content of a solid standard. The concept is demonstrated by introducing a re-expressed irradiation parameter (JK) that depends on the ratio of 39ArK to 40Ar* rather than the 40Ar*/39ArK ratio. JK is equivalent to the traditional irradiation parameter J and is defined as JK = (39Ar/40K) • (λ/λe). The ultimate precision and accuracy of the method will depend on how precisely and accurately the 39Ar and 40K can be estimated, and will require isotope dilution measurements of both from the same aliquot. We are testing the workability of our technique at the 1% level by measuring weighed and irradiated hornblende and biotite monitor standards using GLO-1 glauconite to define a calibration curve for argon signals versus abundance.

  15. Multiple Metazoan Life-span Interventions Exhibit a Sex-specific Strehler-Mildvan Inverse Relationship Between Initial Mortality Rate and Age-dependent Mortality Rate Acceleration.

    PubMed

    Shen, Jie; Landis, Gary N; Tower, John

    2017-01-01

    The Gompertz equation describes survival in terms of initial mortality rate (parameter a), indicative of health, and age-dependent acceleration in mortality rate (parameter b), indicative of aging. Gompertz parameters were analyzed for several published studies. In Drosophila females, mating increases egg production and decreases median life span, consistent with a trade-off between reproduction and longevity. Mating increased parameter a, causing decreased median life span, whereas time parameter b was decreased. The inverse correlation between parameters indicates the Strehler-Mildvan (S-M) relationship, where loss of low-vitality individuals yields a cohort with slower age-dependent mortality acceleration. The steroid hormone antagonist mifepristone/RU486 reversed these effects. Mating and mifepristone showed robust S-M relationships across genotypes, and dietary restriction showed robust S-M relationship across diets. Because nutrient optima differed between females and males, the same manipulation caused opposite effects on mortality rates in females versus males across a range of nutrient concentrations. Similarly, p53 mutation in Drosophila and mTOR mutation in mice caused increased median life span associated with opposite direction changes in mortality rate parameters in females versus males. The data demonstrate that dietary and genetic interventions have sex-specific and sometimes sexually opposite effects on mortality rates consistent with sexual antagonistic pleiotropy.

  16. Standardized mortality ratio analysis on a sample of severely injured patients from a large Canadian city without regionalized trauma care.

    PubMed

    Sampalis, J S; Lavoie, A; Williams, J I; Mulder, D S; Kalina, M

    1992-08-01

    Flora's Z statistic and standardized mortality ratios (SMRs) as indicators of excess mortality were calculated for a sample of 355 patients with major trauma. A statistically significant overall excess mortality was observed in this sample (Z = 6.77, SMR = 1.81, p less than 0.05). Advanced life support provided by physicians at the scene (MD-ALS) was not associated with reduced excess mortality. A significant trend toward lower excess mortality was associated with a higher level of trauma care at the receiving hospital (p less than 0.05). Total prehospital time over 60 minutes was associated with a significant increase in excess mortality (p less than 0.001). These results support regionalization of trauma care and failed to show any benefit associated with MD-ALS.

  17. Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium

    PubMed Central

    Gaksch, Martin; Jorde, Rolf; Grimnes, Guri; Joakimsen, Ragnar; Schirmer, Henrik; Wilsgaard, Tom; Mathiesen, Ellisiv B.; Njølstad, Inger; Løchen, Maja-Lisa; März, Winfried; Kleber, Marcus E.; Tomaschitz, Andreas; Grübler, Martin; Eiriksdottir, Gudny; Gudmundsson, Elias F.; Harris, Tamara B.; Cotch, Mary F.; Aspelund, Thor; Gudnason, Vilmundur; Rutters, Femke; Beulens, Joline W. J.; van ‘t Riet, Esther; Nijpels, Giel; Dekker, Jacqueline M.; Grove-Laugesen, Diana; Rejnmark, Lars; Busch, Markus A.; Mensink, Gert B. M.; Scheidt-Nave, Christa; Thamm, Michael; Swart, Karin M. A.; Brouwer, Ingeborg A.; Lips, Paul; van Schoor, Natasja M.; Sempos, Christopher T.; Durazo-Arvizu, Ramón A.; Škrabáková, Zuzana; Dowling, Kirsten G.; Cashman, Kevin D.; Kiely, Mairead; Pilz, Stefan

    2017-01-01

    Background Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality. Methods In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488. Findings We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00–1.29), 1.33 (1.16–1.51), and 1.67 (1.44–1.89), respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OH)D and cancer mortality. There was also no significantly increased mortality risk at high 25(OH)D levels up to 125 nmol/L. Interpretation In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths. PMID:28207791

  18. Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China.

    PubMed Central

    Yuan, J. M.; Ross, R. K.; Gao, Y. T.; Henderson, B. E.; Yu, M. C.

    1997-01-01

    OBJECTIVE: To assess the risk of death associated with various patterns of alcohol intake. DESIGN: Prospective study of mortality in relation to alcohol consumption at recruitment, with active annual follow up. SETTING: Four small, geographically defined communities in Shanghai, China. SUBJECTS: 18,244 men aged 45-64 years enrolled in a prospective study of diet and cancer during January 1986 to September 1989. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: By 28 February 1995, 1198 deaths (including 498 from cancer, 269 from stroke, and 104 from ischaemic heart disease) had been identified. Compared with lifelong non-drinkers, those who consumed 1-14 drinks a week had a 19% reduction in overall mortality (relative risk 0.81; 95% confidence interval 0.70 to 0.94) after age, level of education, and cigarette smoking were adjusted for. This protective effect was not restricted to any specific type of alcoholic drink. Although light to moderate drinking (28 or fewer drinks per week) was associated with a 36% reduction in death from ischaemic heart disease (0.64; 0.41 to 0.998), it had no effect on death from stroke, which is the leading cause of death in this population. As expected, heavy drinking (29 or more drinks per week) was significantly associated with increased risks of death from cancer of the upper aerodigestive tract, hepatic cirrhosis, and stroke. CONCLUSIONS: Regular consumption of small amounts of alcohol is associated with lower overall mortality including death from ischaemic heart disease in middle aged Chinese men. The type of alcoholic drink does not affect this association. PMID:9001474

  19. Cognitive Reserve, Incident Dementia, and Associated Mortality in the Ibadan Study of Ageing

    PubMed Central

    Ojagbemi, Akin; Bello, Toyin; Gureje, Oye

    2016-01-01

    Objectives To describe factors associated with incident dementia and dementia mortality over 5 years in a large community sample of elderly persons. Design Longitudinal investigation of a household multistage probability sample. Setting Eight contiguous states of the Yoruba-speaking region of Nigeria. Participants Individuals aged 65 and older (N=2,149). Measurements Dementia was diagnosed using tools previously validated in the population. Incident cases of dementia over three follow-up waves were determined after censoring cases in the preceding wave. Information on mortality was collected from key informants in subjects’ households. Results A dementia incident rate was found of 20.9 per 1,000 person-years (95% confidence interval (CI)=17.7–24.9). The adjusted mortality hazard for those with dementia was 1.5 (95% CI=1.1–2.1). Along with previously identified social and demographic factors, poor predementia cognitive function (hazard ratio (HR)=1.8, 95% CI=1.1–2.8) and low occupational complexity (HR=3.2, 95% CI=1.3–8.0) were associated with incident dementia. Conclusion The findings confirm the low incidence of dementia in this population, as previously reported. The condition is nevertheless associated with higher risk of mortality. Along with some features of social disadvantage, proxies of lower cognitive reserve were risk factors for incident dementia. PMID:26926137

  20. Racial Disparities in Mortality Among Middle-Aged and Older Men: Does Marriage Matter?

    PubMed

    Su, Dejun; Stimpson, Jim P; Wilson, Fernando A

    2015-07-01

    Based on longitudinal data from the Health and Retirement Study, this study assesses the importance of marital status in explaining racial disparities in all-cause mortality during an 18-year follow-up among White and African American men aged 51 to 61 years in 1992. Being married was associated with significant advantages in household income, health behaviors, and self-rated health. These advantages associated with marriage at baseline also got translated into better survival chance for married men during the 1992-2010 follow-up. Both marital selection and marital protection were relevant in explaining the mortality advantages associated with marriage. After adjusting for the effect of selected variables on premarital socioeconomic status and health, about 28% of the mortality gap between White and African American men in the Health and Retirement Study can be explained by the relatively low rates of marriage among African American men. Addressing the historically low rates of marriage among African Americans and their contributing factors becomes important for reducing racial disparities in men's mortality.

  1. The anorexia of ageing: physiopathology, prevalence, associated comorbidity and mortality. A systematic review.

    PubMed

    Malafarina, Vincenzo; Uriz-Otano, Francisco; Gil-Guerrero, Lucía; Iniesta, Raquel

    2013-04-01

    The physiological processes of ageing and factors prevalent in the elderly such as comorbidities and polypharmacy often cause loss of appetite in the elderly, which we call anorexia of ageing. Social factors, together with changes in the sensory organs, can be important causes of a reduction in both appetite and ingestion. This review assesses the regulation of appetite in the elderly and the development of anorexia of ageing. It also examines the prevalence of this type of anorexia, its associated comorbidities and mortality rates. We have reviewed 27 studies, with a total of 6208 patients. These reported changes in the secretion and response of both central and peripheral hormones that regulate appetite. Anorexia, very prevalent among hospitalized and institutionalized elderly people, is associated with comorbidity and represents a predictive factor for mortality. No treatment for it has been proved to be effective. The mechanism regulating ingestion in elderly people is complex and difficult to resolve. Comorbidity as a cause or a consequence of anorexia of ageing has become a research field of great interest in geriatrics. A correct nutritional evaluation is a fundamental part of an integrated geriatric assessment.

  2. Age-dependent association between sex and renal cell carcinoma mortality: a population-based analysis.

    PubMed

    Qu, Yuanyuan; Chen, Haitao; Gu, Weijie; Gu, Chengyuan; Zhang, Hailiang; Xu, Jianfeng; Zhu, Yao; Ye, Dingwei

    2015-03-17

    Research on sex differences in renal cancer-specific mortality (RCSM), which considered the sex effect to be constant throughout life, has yielded conflicting results. This study hypothesized the sex effect may be modified by age, which is a proxy for hormonal status. Data from the Surveillance, Epidemiology and End Results database (1988-2010) were used to identify 114,539 patients with renal cell carcinoma (RCC). The study cohort was divided into three age groups using cutoffs of 42 and 58 years, which represent the premenopausal and postmenopausal periods. The cumulative incidence function and competing risks analyses were used to examine the effect of covariates on RCSM and other-cause mortality (OCM). In premenopausal period, male sex was a significant predictor of poor RCSM for both localized (adjusted subdistribution hazard ratio [aSHR] = 1.63, P = 0.002) and advanced (aSHR = 1.20, P = 0.041) disease. In postmenopausal period, the sex disparity diminished (aSHR = 1.05, P = 0.16) and reversed (aSHR = 0.95, P = 0.017) in localized and advanced disease, respectively. On the contrary, similar trend was not found for OCM across all age groups. Our results demonstrated the sex effect on RCSM was strongly modified by age. These findings may aid in clinical practice and need further evaluation of underlying biological mechanisms.

  3. Toward "Our Ways of Knowing" in the Age of Standardization

    ERIC Educational Resources Information Center

    Soto, Lourdes Diaz; De Moed, Simone Tuinhof

    2011-01-01

    Current neoliberal educational policies are impacting young children and their teachers in the United States in many ways. Young children and teachers find themselves in vulnerable positions within a framework of an imperialist education in the age of standardization. Part of the struggle is to open spaces of decolonization that include home…

  4. Evolution of aging: individual life history trade-offs and population heterogeneity account for mortality patterns across species.

    PubMed

    Le Cunff, Y; Baudisch, A; Pakdaman, K

    2014-08-01

    A broad range of mortality patterns has been documented across species, some even including decreasing mortality over age. Whether there exist a common denominator to explain both similarities and differences in these mortality patterns remains an open question. The disposable soma theory, an evolutionary theory of aging, proposes that universal intracellular trade-offs between maintenance/lifespan and reproduction would drive aging across species. The disposable soma theory has provided numerous insights concerning aging processes in single individuals. Yet, which specific population mortality patterns it can lead to is still largely unexplored. In this article, we propose a model exploring the mortality patterns which emerge from an evolutionary process including only the disposable soma theory core principles. We adapt a well-known model of genomic evolution to show that mortality curves producing a kink or mid-life plateaus derive from a common minimal evolutionary framework. These mortality shapes qualitatively correspond to those of Drosophila melanogaster, Caenorhabditis elegans, medflies, yeasts and humans. Species evolved in silico especially differ in their population diversity of maintenance strategies, which itself emerges as an adaptation to the environment over generations. Based on this integrative framework, we also derive predictions and interpretations concerning the effects of diet changes and heat-shock treatments on mortality patterns.

  5. Associations of serum haptoglobin in newborn dairy calves with health, growth, and mortality up to 4 months of age.

    PubMed

    Murray, C F; Windeyer, M C; Duffield, T F; Haley, D B; Pearl, D L; Waalderbos, K M; Leslie, K E

    2014-12-01

    The objective of this research was to investigate factors associated with serum haptoglobin (Hp) levels in newborn calves. In addition, the associations between serum Hp levels in newborn calves with growth, morbidity, and mortality in calves <4 mo of age were investigated. A total of 1,365 Holstein heifer calves from 15 dairy farms were enrolled in this study from January to December, 2008. Following calving, a birth record was completed, including information on the calving event, colostrum administration, and other details. During weekly farm visits, each calf was assessed at 1 to 8 d, 15 to 21 d, 36 to 42 d, and 90 to 120 d of age. At these sampling times, each calf was assessed using a standardized clinical score for general health, and height and weight were measured. At 1 to 8 d of age, a blood sample was collected to measure serum total protein and Hp concentrations. Treatment events and death loss were recorded throughout the study by the farm staff. Serum Hp concentration in the first week of life was not significantly associated with the degree of calving difficulty. However, serum Hp was higher in calves with a higher rectal temperature and depressed attitude at the first sampling time. Furthermore, the association between serum Hp and the severity of nasal discharge varied by age at first sampling time. Calves with higher Hp in their first week of life had significantly higher total health scores throughout the entire sampling period. Haptoglobin was not significantly associated with average daily gain or treatment for bovine respiratory disease. Yet, for every 1 g/L increase in serum Hp in the first week of life, the odds of being treated for any other disease during the study period increased by 7.6 times. Treatment for bovine respiratory disease, diarrhea, or any other disease resulted in increased odds of calf mortality. In addition, Hp concentration in the first week of life was associated with mortality in calves <4 mo of age. The optimal cut

  6. Recent Demographic Developments in France: Relatively Low Mortality at Advanced Ages

    PubMed Central

    Prioux, France; Barbieri, Magali

    2013-01-01

    France had 65.3 million inhabitants as of 1 January 2012, including 1.9 million in the overseas départements. The population is slightly younger than that of the European Union as a whole. Population growth continues at the same rate, mainly through natural increase. There are now more African than European immigrants living in France. Fertility was practically stable in 2011 (2.01 children per woman), but the lifetime fertility of the 1971–1972 cohorts reached a historic low in metropolitan France (1.99 children per woman), nevertheless remaining among the highest in Europe. Abortion levels remained stable and rates among young people are no longer increasing. The marriage rate is falling and the divorce rate has stabilized (46.2 divorces per 100 marriages in 2011). The risk of divorce decreases with age, but has greatly increased among the under-70s over the last decade. Life expectancy at birth (78.4 years for men, 85.0 for women) has continued to increase at the same rate, mainly thanks to progress at advanced ages. Among European countries, France has the lowest mortality in the over-65 age group, but it ranks less well for premature mortality. PMID:24285939

  7. Being overweight in early adulthood is associated with increased mortality in middle age

    PubMed Central

    Carslake, David; Jeffreys, Mona; Davey Smith, George

    2016-01-01

    Observational analyses of the association between body mass index (BMI) and all-cause mortality often suggest that overweight is neutral or beneficial, but such analyses are potentially confounded by smoking or by reverse causation. The use of BMI measured in early adulthood offers one means of reducing the latter problem. We used a cohort who were first measured while 16–24 year old students at Glasgow University in 1948–1968 and subsequently re-measured in 2000–2003, offering a rare opportunity to compare BMI measured at different ages as a predictor of mortality. Analysis of the later BMI measurements suggested that overweight was beneficial to survival, while analysis of BMI measured in early adulthood suggested that overweight was harmful and that the optimum BMI lay towards the lower end of the recommended range of 18.5–25 kg m−2. We interpret the association with later BMI as being probably distorted by reverse causality, although it remains possible instead that the optimum BMI increases with age. Differences when analyses were restricted to healthy non-smokers also suggested some residual confounding by smoking. These results suggest that analyses of BMI recorded in middle or old age probably over-estimate the optimum BMI for survival and should be treated with caution. PMID:27782178

  8. Age and growth of round gobies in Lake Michigan, with preliminary mortality estimation

    USGS Publications Warehouse

    Huo, Bin; Madenjian, Charles P.; Xie, Cong X.; Zhao, Yingming; O'Brien, Timothy P.; Czesny, Sergiusz J.

    2015-01-01

    The round goby (Neogobius melanostomus) is a prevalent invasive species throughout Lake Michigan, as well as other Laurentian Great Lakes, yet little information is available on spatial variation in round goby growth within one body of water. Age and growth of round goby at three areas of Lake Michigan were studied by otolith analysis from a sample of 659 specimens collected from 2008 to 2012. Total length (TL) ranged from 48 to 131 mm for Sturgeon Bay, from 50 to 125 mm for Waukegan, and from 54 to 129 mm for Sleeping Bear Dunes. Ages ranged from 2 to 7 years for Sturgeon Bay, from 2 to 5 years for Waukegan, and from 2 to 6 years for Sleeping Bear Dunes. Area-specific and sex-specific body–otolith relationships were used to back-calculate estimates of total length at age, which were fitted to von Bertalanffy models to estimate growth rates. For both sexes, round gobies at Sleeping Bear Dunes and Waukegan grew significantly faster than those at Sturgeon Bay. However, round goby growth did not significantly differ between Sleeping Bear Dunes and Waukegan for either sex. At all three areas of Lake Michigan, males grew significantly faster than females. Based on catch curve analysis, estimates of annual mortality rates ranged from 0.79 to 0.84. These relatively high mortality rates suggested that round gobies may be under predatory control in Lake Michigan.

  9. Avian growth and development rates and age-specific mortality: the roles of nest predation and adult mortality.

    PubMed

    Remes, V

    2007-01-01

    Previous studies have shown that avian growth and development covary with juvenile mortality. Juveniles of birds under strong nest predation pressure grow rapidly, have short incubation and nestling periods, and leave the nest at low body mass. Life-history theory predicts that parental investment increases with adult mortality rate. Thus, developmental traits that depend on the parental effort exerted (pre- and postnatal growth rate) should scale positively with adult mortality, in contrast to those that do not have a direct relationship with parental investment (timing of developmental events, e.g. nest leaving). I tested this prediction on a sample of 84 North American songbirds. Nestling growth rate scaled positively and incubation period duration negatively with annual adult mortality rates even when controlled for nest predation and other covariates, including phylogeny. On the contrary, neither the duration of the nestling period nor body mass at fledging showed any relationship. Proximate mechanisms generating the relationship of pre- and postnatal growth rates to adult mortality may include increased feeding, nest attentiveness during incubation and/or allocation of hormones, and deserve further attention.

  10. Age, growth and natural mortality of coney (Cephalopholis fulva) from the southeastern United States

    PubMed Central

    Potts, Jennifer C.; Carr, Daniel R.

    2015-01-01

    Coney (Cephalopholis fulva) sampled from recreational and commercial vessels along the southeastern coast of the United States in 1998–2013 (n = 353) were aged by counting opaque bands on sectioned sagittal otoliths. Analysis of otolith edge type (opaque or translucent) revealed that annuli formed in January–June with a peak in April. Coney were aged up to 19 years, and the largest fish measured 430 mm in total length (TL). The weight-length relationship was ln(W) = 3.03 × ln(TL) − 18.05 (n = 487; coefficient of determination [r2] = 0.91), where W = whole weight in kilograms and and TL = total length in millimeters. Mean observed sizes at ages 1, 3, 5, 10, and 19 years were 225, 273, 307, 338, and 400 mm TL, respectively. The von Bertalanffy growth equation for coney was Lt = 377 (1 − e(−0.20(t+3.53))). Natural mortality (M) estimated by Hewitt and Hoenig’s longevity-based method which integrates all ages was 0.22. Age-specific M values, estimated with the method of Charnov and others, were 0.40, 0.30, 0.26, 0.22, and 0.20 for ages 1, 3, 5, 10, and 19, respectively. PMID:25802801

  11. Mortality from Unspecified Unintentional Injury among Individuals Aged 65 Years and Older by U.S. State, 1999–2013

    PubMed Central

    Cheng, Xunjie; Wu, Yue; Yao, Jie; Schwebel, David C.; Hu, Guoqing

    2016-01-01

    Introduction: Recent changes in unspecified unintentional injury mortality for the elderly by U.S. state remain unreported. This study aims to examine U.S. state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013; Methods: Using mortality rates from the U.S. CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™), we examined unspecified unintentional injury mortality for older adults aged 65+ from 1999 to 2013 by state. Specifically, the proportion of unintentional injury deaths with unspecified external cause in the data was considered. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013; Results: Of the 36 U.S. states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. Twenty-nine of the 36 states showed reductions in the proportion of unspecified unintentional injury cause, with Oklahoma (−89%), Massachusetts (−86%) and Oregon (−81%) displaying the largest changes. As unspecified unintentional injury mortality decreased, mortality from falls in 28 states and poisoning in 3 states increased significantly. Mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states also decreased; Conclusions: The proportion of unintentional injuries among older adults with unspecified cause decreased significantly for many states in the United States from 1999 to 2013. The reduced proportion of unspecified injury has implications for research and practice. It should be considered in state-level trend analysis during 1999–2013. It also suggests comparisons between states for specific injury mortality should be conducted with caution, as large differences in unspecified injury mortality across states and over time could create bias

  12. Age- and gender-specific population attributable risks of metabolic disorders on all-cause and cardiovascular mortality in Taiwan

    PubMed Central

    2012-01-01

    Background The extent of attributable risks of metabolic syndrome (MetS) and its components on mortality remains unclear, especially with respect to age and gender. We aimed to assess the age- and gender-specific population attributable risks (PARs) for cardiovascular disease (CVD)-related mortality and all-cause mortality for public health planning. Methods A total of 2,092 men and 2,197 women 30 years of age and older, who were included in the 2002 Taiwan Survey of Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH), were linked to national death certificates acquired through December 31, 2009. Cox proportional hazard models were used to calculate adjusted hazard ratios and PARs for mortality, with a median follow-up of 7.7 years. Results The respective PAR percentages of MetS for all-cause and CVD-related mortality were 11.6 and 39.2 in men, respectively, and 18.6 and 44.4 in women, respectively. Central obesity had the highest PAR for CVD mortality in women (57.5%), whereas arterial hypertension had the highest PAR in men (57.5%). For all-cause mortality, younger men and post-menopausal women had higher PARs related to Mets and its components; for CVD mortality, post-menopausal women had higher overall PARs than their pre-menopausal counterparts. Conclusions MetS has a limited application to the PAR for all-cause mortality, especially in men; its PAR for CVD mortality is more evident. For CVD mortality, MetS components have higher PARs than MetS itself, especially hypertension in men and waist circumference in post-menopausal women. In addition, PARs for diabetes mellitus and low HDL-cholesterol may exceed 20%. We suggest differential control of risk factors in different subpopulation as a strategy to prevent CVD-related mortality. PMID:22321049

  13. [The age and sex indicators of mortality of population and years of life lost as a result of premature mortality in the Russian Federation in 2012].

    PubMed

    Boiytsov, S A; Samorodskaya, I V

    2014-01-01

    The age-specific mortality coefficients and years of life lost as a result of premature mortality are among important medical demographic characteristics of population health. The study analyzed age and sex indicators of mortality of population in the Russian Federation. The number of years of life lost as a result of premature mortality is calculated. The comparison of values of years of life lost in various subjects of the Russian Federation was carried out. The data of Rosstat concerning population size and number of the deceased in year age groups in the Russian Federation and subjects of the Russian Federation in 2012 was used. The indicator was calculated on the basis of technique included into "The global burden of diseases report" (2010). The minimal indicators of mortality of males are noted at the age of 11 years (25.4 per 100 000 of population) and females at the age of 10 years (18.2 per 100 000 of population). The maximal differences in indicators of mortality of males and females are marked in the age group 20-29 years (314.5 of males and 92.3 of females per 100 000 of population). The percentage of deceased prior 70 years consists 63.2% among males and 29.9% among females. The total number of years of life lost in the Russian Federation consisted 36 864 309 and out of them 24 321 992 (65.9%) as a result of death of males and 12 542 317 (34.1%) as a result of death of females. The maximum percentage of years of life lost among males is marked in the age group of 51-60 years (24.61%) and among females in the age group of 71-80 years (22.38%). The indicator of years of life lost per 100 000 of population consisted 25769 for total population, 36 753 for male population and 16 314 for female population. The highest rate of indicator of years of life lost is marked in the Chukchi Autonomous Okrug and the lowest rate in the Republics of the Northern Caucasus and Moscow. However, in all subjects of the Russian Federation indicator of years of life lost is

  14. Age-specific patterns of genetic variance in Drosophila melanogaster. II. Fecundity and its genetic covariance with age-specific mortality

    SciTech Connect

    Tatar, M.; Promislow, D.E.L.; Khazaeli, A.A.; Curtsinger, J.W.

    1996-06-01

    Under the mutation accumulation model of senescence, it was predicted that the additive genetic variance (V{sub A}) for fitness traits will increase with age. We measured age-specific mortality and fecundity from 65,134 Drosophila melanogaster and estimated genetic variance components, based on reciprocal crosses of extracted second chromosome lines. Elsewhere we report the results for mortality. Here, for fecundity, we report a biomodal pattern for V{sub A} with peaks at 3 days and at 17-31 days. Under the antagonistic pleiotropy model of senescence, it was predicted that negative correlations will exist between early and late life history traits. For fecundity itself we find positive genetic correlations among age classes >3 days but negative nonsignificant correlations between fecundity at 3 days and at older age classes. For fecundity vs. age-specific mortality, we find positive fitness correlations (negative genetic correlations) among the traits at all ages >3 days but a negative fitness correlation between fecundity at 3 days and mortality at the oldest ages (positive genetic correlations). For age-specific mortality itself we find overwhelmingly positive genetic correlations among all age classes. The data suggest that mutation accumulation may be a major source of standing genetic variance for senescence. 75 refs., 4 figs., 1 tab.

  15. Trends of stomach cancer mortality in Eastern Asia in 1950-2004: comparative study of Japan, Hong Kong and Singapore using age, period and cohort analysis.

    PubMed

    Tanaka, Masahiro; Ma, Enbo; Tanaka, Hideo; Ioka, Akiko; Nakahara, Toshitaka; Takahashi, Hideto

    2012-02-15

    To characterize the temporal trends of stomach cancer mortality in Eastern Asia and to better interpret the causes of the trends, we performed age, period and cohort analysis (APC analysis) on the mortality rates in Japan, Hong Kong and Singapore during 1950-2004, as well as the rates in the US as a control population. For the APC analysis, Holford's approach was used to avoid the identification problem. Age-standardized mortality rates (ASMR) decreased consistently in all four areas during the observation period in both males and females. Japan had the highest ASMR in both sexes, followed by Singapore, Hong Kong and the US, but the differences in ASMR among the four areas diminished with time. The results of APC analysis suggested that the decreasing mortality rates in Eastern Asia were caused by the combination of decreasing cohort effect since the end of the 1800s and decreasing period effect from the 1950s. The US showed similar results, but its decreases in the period and cohort effect preceded those of Eastern Asia. Possible causes for the decrease in the cohort effect include improvement in the socioeconomic conditions during childhood and a decrease in the prevalence of H. pylori infection, while possible causes for the decrease in the period effect include a decrease in dietary salt intake and improvements in cancer detection and treatment. These findings may help us to predict future changes in the mortality rates of stomach cancer.

  16. Recommendations for the treatment of aging in standard technical specifications

    SciTech Connect

    Orton, R.D.; Allen, R.P.

    1995-09-01

    As part of the US Nuclear Regulatory Commission`s Nuclear Plant Aging Research Program, Pacific Northwest Laboratory (PNL) evaluated the standard technical specifications for nuclear power plants to determine whether the current surveillance requirements (SRs) were effective in detecting age-related degradation. Nuclear Plant Aging Research findings for selected systems and components were reviewed to identify the stressors and operative aging mechanisms and to evaluate the methods available to detect, differentiate, and trend the resulting aging degradation. Current surveillance and testing requirements for these systems and components were reviewed for their effectiveness in detecting degraded conditions and for potential contributions to premature degradation. When the current surveillance and testing requirements appeared ineffective in detecting aging degradation or potentially could contribute to premature degradation, a possible deficiency in the SRs was identified that could result in undetected degradation. Based on this evaluation, PNL developed recommendations for inspection, surveillance, trending, and condition monitoring methods to be incorporated in the SRs to better detect age- related degradation of these selected systems and components.

  17. Mortality Benefits of Antibiotic Computerised Decision Support System: Modifying Effects of Age

    NASA Astrophysics Data System (ADS)

    Chow, Angela L. P.; Lye, David C.; Arah, Onyebuchi A.

    2015-11-01

    Antibiotic computerised decision support systems (CDSSs) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. We conducted a prospective cohort study in a 1500-bed tertiary-care hospital in Singapore, to evaluate the effectiveness of the hospital’s antibiotic CDSS on patients’ clinical outcomes, and the modification of these effects by patient factors. To account for clustering, we used multilevel logistic regression models. One-quarter of 1886 eligible inpatients received CDSS-recommended antibiotics. Receipt of antibiotics according to CDSS’s recommendations seemed to halve mortality risk of patients (OR 0.54, 95% CI 0.26-1.10, P = 0.09). Patients aged ≤65 years had greater mortality benefit (OR 0.45, 95% CI 0.20-1.00, P = 0.05) than patients that were older than 65 (OR 1.28, 95% CI 0.91-1.82, P = 0.16). No effect was observed on incidence of Clostridium difficile (OR 1.02, 95% CI 0.34-3.01), and multidrug-resistant organism (OR 1.06, 95% CI 0.42-2.71) infections. No increase in infection-related readmission (OR 1.16, 95% CI 0.48-2.79) was found in survivors. Receipt of CDSS-recommended antibiotics reduced mortality risk in patients aged 65 years or younger and did not increase the risk in older patients. Physicians should be informed of the benefits to increase their acceptance of CDSS recommendations.

  18. On the derivation of a full life table from mortality data recorded in five-year age groups.

    PubMed

    Pollard, J H

    1989-01-01

    Mortality data are often gathered using 5-year age groups rather than individual years of life. Furthermore, it is common practice to use a large open-ended interval (such as 85 and over) for mortality data at the older ages. These limitations of the data pose problems for the actuary or demographer who wishes to compile a full and accurate life table using individual years of life. The author devises formulae which handle these problems. He also devises methods for handling mortality during the 1st year of life and for dealing with other technical problems which arise in the compilation of the full life table from grouped data.

  19. Age Related Patterns of Disease and Mortality in Hospitalised Adults in Malawi

    PubMed Central

    Allain, Theresa J.; Aston, Stephen; Mapurisa, Gugulethu; Ganiza, Thokozani N.; Banda, Ndaziona P.; Sakala, Servace; Gonani, Andrew; Heyderman, Robert S.; Peterson, Ingrid

    2017-01-01

    Background The epidemic of non-communicable diseases (NCDs) in low and middle income countries (LMICs) is widely recognised as the next major challenge to global health. However, in many LMICs, infectious diseases are still prevalent resulting in a “double burden” of disease. With increased life expectancy and longevity with HIV, older adults may particularly be at risk of this double burden. Here we describe the relative contributions of infections and NCDs to hospital admissions and mortality, according to age, in Malawi’s largest hospital. Methods Primary diagnosis on discharge/death, mortality rates, and HIV status were recorded prospectively on consecutive adult medical in-patients over 2 years using an electronic medical records system. Diagnoses were classified as infections or NCDs and analysed according to age and gender. Findings 10,191 records were analysed. Overall, infectious diseases, particularly those associated with HIV, were the leading cause of admission. However, in adults ≥55 years, NCDs were the commonest diagnoses. In adults <55 years 71% of deaths were due to infections whereas in adults ≥55 years 56% of deaths were due to NCDs. Interpretation Infectious diseases are still the leading cause of adult admission to a central hospital in Malawi but in adults aged ≥55 years NCDs are the most frequent diagnoses. HIV was an underlying factor in the majority of adults with infections and was also present in 53% of those with NCDs. These findings highlight the need for further health sector shifts to address the double burden of infectious and NCDs, particularly in the ageing population. PMID:28099438

  20. Associations between AUDIT-C and mortality vary by age and sex.

    PubMed

    Harris, Alex H S; Bradley, Katharine A; Bowe, Thomas; Henderson, Patricia; Moos, Rudolf

    2010-10-01

    We sought to determine the sex- and age-specific risk of mortality associated with scores on the 3-item Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire using data from a national sample of Veterans Health Administration (VHA) patients. Men (N = 215,924) and women (N = 9168) who completed the AUDIT-C in a patient survey were followed for 24 months. AUDIT-C categories (0, 1-4, 5-8, 9-12) were evaluated as predictors of mortality in logistic regression models, adjusted for age, race, education, marital status, smoking, depression, and comorbidities. For women, AUDIT-C scores of 9-12 were associated with a significantly increased risk of death compared to the AUDIT-C 1-4 group (odds ratio [OR] 7.09; 95% confidence interval [CI] = 2.67, 18.82). For men overall, AUDIT-C scores of 5-8 and 9-12 were associated with increased risk of death compared to the AUDIT-C 1-4 group (OR 1.13, 95% CI = 1.05, 1.21, and OR 1.63, 95% CI = 1.45, 1.84, respectively) but these associations varied by age. These results provide sex- and age-tailored risk information that clinicians can use in evidence-based conversations with patients about the health-related risks of their alcohol consumption. This study adds to the growing literature establishing the AUDIT-C as a scaled marker of alcohol-related risk or "vital sign" that might facilitate the detection and management of alcohol-related risks and problems.

  1. Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age-period-cohort analysis.

    PubMed

    Pesce, Giancarlo

    2016-01-01

    Chronic lower respiratory diseases (CLRDs) are a major cause of morbidity and mortality worldwide. The objectives of this study were to estimate the trends in CLRD mortality in Italy, and the specific contributions of age, time period and birth cohort in driving these trends. Population and cause-of-death data in Italy between 1979 and 2010 were collected from the World Health Organization website. Age-specific mortality rates for CLRDs, and effects for age, time period and birth cohort on mortality trends were estimated using age-period-cohort models. Chronic obstructive pulmonary disease (COPD) and chronic bronchitis represent nearly 98% of the deaths from CLRDs. Despite the overall number of deaths have been stable (in men) or increasing (in women), the age-standardised rates have been steadily decreasing from 1979 to 2010, passing from 104.3 to 55.4 per 100 000 person-years in men and from 32.2 to 19.6 per 100 000 person-years in women. The average relative annual decrease was -3.6% in men and -2.7% in women. Since the end of the 1990s, the decreasing trend of CLRD mortality has started to level off, in particular in women. The decrease in CLRD mortality rates has been more accentuated in more recent cohorts and in younger age groups. Both birth cohort and time period significantly affected the CLRD mortality rates, suggesting that changes in the spread of risk factors (smoking habits, early-life and occupational exposures) across different birth cohorts, as well as in advanced in healthcare and medical practice, may have played a major role in secular changes in COPD mortality rates in Italy.

  2. Age, growth, and natural mortality of schoolmaster (Lutjanus apodus) from the southeastern United States

    PubMed Central

    Burton, Michael L.; Myers, Amanda R.

    2016-01-01

    Ages of schoolmaster (n = 136) from the southeastern Florida coast from 1981–2015 were determined using sectioned sagittal otoliths. Opaque zones were annular, forming March–July (peaking in May–June). Schoolmaster ranged in age from 1–42 years; the largest fish measured 505 mm total length (TL) and was 19 years old. The oldest fish measured 440 mm TL. Estimated body size relationships for schoolmaster were: W = 9.26 × 10−6 TL3.11 (n = 256, r2 = 0.95); W = 2.13 × 10−5 FL2.99 (n = 161, r2 = 0.95); TL = 1.03 FL + 10.36 (n = 143, r2 = 0.99); and FL = 0.96 TL − 8.41 (n = 143, r2 = 0.99), where W = whole weight in g, FL = fork length in mm, and TL in mm. The fitted von Bertalanffy growth equation was: Lt = 482 (1 − e−0.12(t+2.79)) (n = 136). Based on published life history relationships, a point estimate of natural mortality for schoolmaster was M = 0.10, while age-specific estimates of M ranged from 1.57–0.18 for ages 1–42. PMID:27761332

  3. A Web Tool for Age-Period-Cohort Analysis of Cancer Incidence and Mortality Rates

    PubMed Central

    Rosenberg, Philip S.; Check, David P.; Anderson, William F.

    2014-01-01

    BACKGROUND Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. METHODS We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly web tool. RESULTS Input data for the web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates; period and cohort rate ratios that incorporate the overall annual percentage change (net drift); and estimators of the age-specific annual percentage change (local drifts). The web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value (csv) file. Model outputs can be saved in a variety of formats including R and Excel. CONCLUSIONS APC methodology can now be carried out through a freely-available user-friendly web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. IMPACT The web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns. PMID:25146089

  4. Temporal Trends of Suicide Mortality in Mainland China: Results from the Age-Period-Cohort Framework

    PubMed Central

    Wang, Zhenkun; Wang, Jinyao; Bao, Junzhe; Gao, Xudong; Yu, Chuanhua; Xiang, Huiyun

    2016-01-01

    The aim of this study is to explore the long-term trends of suicide mortality in China. We implemented the age-period-cohort (APC) framework, using data from the Global Burden of Disease Study 2013. Our results showed that the net drift of suicide mortality was −4.727% (95% CI: −4.821% to −4.634%) per year for men and −6.633% (95% CI: −6.751% to −6.515%) per year for women, and the local drift values were below 0 in all age groups (p < 0.01 for all) for both sexes during the period of 1994–2013. Longitudinal age curves indicated that, in the same birth cohort, suicide death risk increased rapidly to peak at the life stage of 20–24 years old and 15–24 years old for men and women, respectively, and then showed a decelerated decline, followed by a rise thereafter after 54 years old for men and a slight one after 69 years old for women. The estimated period and cohort RRs were found to show similar monotonic downward patterns (significantly with p < 0.01 for all) for both sexes, with more quickly decreasing for women than for men during the whole period. The decreasing trend of suicide was likely to be related to the economic rapid growth, improvements in health care, enhancement on the level of education, and increasing awareness of suicide among the public in China. In addition, fast urbanization and the effective control of pesticides and rodenticides might be the special reasons behind these trends we observed in this study. PMID:27527195

  5. Future Declines of Coronary Heart Disease Mortality in England and Wales Could Counter the Burden of Population Ageing

    PubMed Central

    Guzman Castillo, Maria; Gillespie, Duncan O. S.; Allen, Kirk; Bandosz, Piotr; Schmid, Volker; Capewell, Simon; O’Flaherty, Martin

    2014-01-01

    Background Coronary Heart Disease (CHD) remains a major cause of mortality in the United Kingdom. Yet predictions of future CHD mortality are potentially problematic due to population ageing and increase in obesity and diabetes. Here we explore future projections of CHD mortality in England & Wales under two contrasting future trend assumptions. Methods In scenario A, we used the conventional counterfactual scenario that the last-observed CHD mortality rates from 2011 would persist unchanged to 2030. The future number of deaths was calculated by applying those rates to the 2012–2030 population estimates. In scenario B, we assumed that the recent falling trend in CHD mortality rates would continue. Using Lee-Carter and Bayesian Age Period Cohort (BAPC) models, we projected the linear trends up to 2030. We validate our methods using past data to predict mortality from 2002–2011. Then, we computed the error between observed and projected values. Results In scenario A, assuming that 2011 mortality rates stayed constant by 2030, the number of CHD deaths would increase 62% or approximately 39,600 additional deaths. In scenario B, assuming recent declines continued, the BAPC model (the model with lowest error) suggests the number of deaths will decrease by 56%, representing approximately 36,200 fewer deaths by 2030. Conclusions The decline in CHD mortality has been reasonably continuous since 1979, and there is little reason to believe it will soon halt. The commonly used assumption that mortality will remain constant from 2011 therefore appears slightly dubious. By contrast, using the BAPC model and assuming continuing mortality falls offers a more plausible prediction of future trends. Thus, despite population ageing, the number of CHD deaths might halve again between 2011 and 2030. This has implications for how the potential benefits of future cardiovascular strategies might best be calculated and presented. PMID:24918442

  6. Age- and sex-specific spatio-temporal patterns of colorectal cancer mortality in Spain (1975-2008)

    PubMed Central

    2014-01-01

    In this paper, space-time patterns of colorectal cancer (CRC) mortality risks are studied by sex and age group (50-69, ≥70) in Spanish provinces during the period 1975-2008. Space-time conditional autoregressive models are used to perform the statistical analyses. A pronounced increase in mortality risk has been observed in males for both age-groups. For males between 50 and 69 years of age, trends seem to stabilize from 2001 onward. In females, trends reflect a more stable pattern during the period in both age groups. However, for the 50-69 years group, risks take an upward trend in the period 2006-2008 after the slight decline observed in the second half of the period. This study offers interesting information regarding CRC mortality distribution among different Spanish provinces that could be used to improve prevention policies and resource allocation in different regions. PMID:25136264

  7. Interactions between hatch dates, growth rates, and mortality of Age-0 native Rainbow Smelt and nonnative Alewife in Lake Champlain

    USGS Publications Warehouse

    Parrish, Donna; Simonin, Paul W.; Rudstam, Lars G.; Pientka, Bernard; Sullivan, Patrick J.

    2016-01-01

    Timing of hatch in fish populations can be critical for first-year survival and, therefore, year-class strength and subsequent species interactions. We compared hatch timing, growth rates, and subsequent mortality of age-0 Rainbow Smelt Osmerus mordax and Alewife Alosa pseudoharengus, two common open-water fish species of northern North America. In our study site, Lake Champlain, Rainbow Smelt hatched (beginning May 26) almost a month earlier than Alewives (June 20). Abundance in the sampling area was highest in July for age-0 Rainbow Smelt and August for age-0 Alewives. Late-hatching individuals of both species grew faster than those hatching earlier (0.6 mm/d versus 0.4 for Rainbow Smelt; 0.7 mm/d versus 0.6 for Alewives). Mean mortality rate during the first 45 d of life was 3.4%/d for age-0 Rainbow Smelt and was 5.5%/d for age-0 Alewives. Alewife mortality rates did not differ with hatch timing but daily mortality rates of Rainbow Smelt were highest for early-hatching fish. Cannibalism is probably the primary mortality source for age-0 Rainbow Smelt in this lake. Therefore, hatching earlier may not be advantageous because the overlap of adult and age-0 Rainbow Smelt is highest earlier in the season. However, Alewives, first documented in Lake Champlain in 2003, may increase the mortality of age-0 Rainbow Smelt in the summer, which should favor selection for earlier hatching.

  8. Austerity and old-age mortality in England: a longitudinal cross-local area analysis, 2007–2013

    PubMed Central

    McKee, Martin; Katikireddi, Srinivasa Vittal; Taylor-Robinson, David; Barr, Ben; Stuckler, David

    2016-01-01

    Objective There has been significant concern that austerity measures have negatively impacted health in the UK. We examined whether budgetary reductions in Pension Credit and social care have been associated with recent rises in mortality rates among pensioners aged 85 years and over. Design Cross-local authority longitudinal study. Setting Three hundred and twenty-four lower tier local authorities in England. Main outcome measure Annual percentage changes in mortality rates among pensioners aged 85 years or over. Results Between 2007 and 2013, each 1% decline in Pension Credit spending (support for low income pensioners) per beneficiary was associated with an increase in 0.68% in old-age mortality (95% CI: 0.41 to 0.95). Each reduction in the number of beneficiaries per 1000 pensioners was associated with an increase in 0.20% (95% CI: 0.15 to 0.24). Each 1% decline in social care spending was associated with a significant rise in old-age mortality (0.08%, 95% CI: 0.0006–0.12) but not after adjusting for Pension Credit spending. Similar patterns were seen in both men and women. Weaker associations observed for those aged 75 to 84 years, and none among those 65 to 74 years. Categories of service expenditure not expected to affect old-age mortality, such as transportation, showed no association. Conclusions Rising mortality rates among pensioners aged 85 years and over were linked to reductions in spending on income support for poor pensioners and social care. Findings suggest austerity measures in England have affected vulnerable old-age adults. PMID:26980412

  9. Health Disparities in Ischaemic Heart Disease Mortality in Hungary From 1970 to 2010: An Age-Period-Cohort Analysis

    PubMed Central

    Gero, Krisztina; Eshak, Ehab S.; Ma, Enbo; Takahashi, Hideto; Noda, Hiroyuki; Iso, Hiroyasu

    2015-01-01

    Background The objective of this study was to examine long-term trends in rates of ischaemic heart disease (IHD) mortality, a leading cause of mortality in Hungary. The study examined the effects of age, period, and cohort on IHD mortality rates and compared mortality rates between the capital (Budapest) and non-capital counties. Methods Data on IHD deaths and population censuses were obtained from the Hungarian Central Statistical Office. Age-period-cohort analysis utilized nine age-group classes for ages 40 to 84 years, eight time periods from 1970 to 2009, and 16 birth cohorts from 1886 to 1969. Results Age-adjusted IHD mortality rates for men and for women generally increased from 1970 to 1993 and from 1980 to 1999, respectively, decreasing thereafter for both sexes. IHD mortality rates for men and for women from Budapest were lower from 1991 and from 1970, respectively, than corresponding rates in non-capital counties, with the difference increasing after 1999. Age had a more significant influence on mortality rates for women than for men. The period effect increased from 1972 to 1982 and decreased thereafter for men, while the period effect decreased consistently for women from 1972 to 2007. The decline in period effect for both sexes was larger for individuals from the capital than for those from non-capital counties. The cohort effect for both sexes declined from birth years 1890 to 1965, with a steeper decline for individuals from the capital than for those from non-capital counties. Conclusions The findings indicate a need for programs in Hungary for IHD prevention, especially for non-capital counties. PMID:25986153

  10. Secular trends in infant mortality by age-group and avoidable components in the State of São Paulo, 1996–2012

    PubMed Central

    Areco, Kelsy Catherina Nema; Konstantyner, Tulio; Taddei, José Augusto de Aguiar Carrazedo

    2016-01-01

    Abstract Objective: To describe trends and composition of infant mortality rate in the State of São Paulo, from 1996 to 2012. Methods: An ecological study was conducted, based on official secondary data of births and infant deaths of residents in São Paulo, from 1996 to 2012. The infant mortality rate was calculated by the direct method and was analyzed by graphs and polynomial regression models for age groups (early neonatal, late neonatal and post-neonatal) and for groups of avoidable causes of death. Results: The mortality rate in the State of São Paulo tended to fall, ranging from 22.5 to 11.5 per thousand live births. Half of the infant deaths occurred in the early neonatal group. The proportion of avoidable infant deaths varied from 76.0 to 68.7%. The deaths which were avoidable by adequate attention to women during pregnancy and childbirth and newborn care accounted for 54% of infant deaths throughout the period. Conclusions: The mortality rate levels are still far from those in developed countries, which highlight the need to prioritize access and quality of healthcare services during pregnancy, childbirth and newborn care, especially in the first week of life, aiming at achieving standards of infant mortality similar to those of developed societies. PMID:27105575

  11. Estimation of the cumulated exposure to polychlorinated dibenzo-p-dioxins/furans and standardized mortality ratio analysis of cancer mortality by dose in an occupationally exposed cohort.

    PubMed Central

    Flesch-Janys, D; Steindorf, K; Gurn, P; Becher, H

    1998-01-01

    For a cohort of 1189 male German former herbicide and insecticide workers with exposure to polychlorinated dibenzo-p-dioxins and -furans (PCDD/F), we report an extended standardized mortality ratio (SMR) analysis based on a new quantitative exposure index. This index characterizes the cumulative lifetime exposure by integrating the estimated concentration of PCDD/F at every point in time (area under the curve). Production department-specific dose rates were derived from blood levels and working histories of 275 workers by applying a first-order kinetic model. These dose rates were used to estimate exposure levels for all cohort members. Total mortality was elevated in the cohort; 413 deaths yielded an SMR of 1.15 (95% confidence interval [Cl] 1.05, 1.27) compared to the mortality of the population of Germany. Overall cancer mortality (n = 124) was significantly increased (SMR = 1.41, 95% Cl 1.17, 1.68). Various cancer sites showed significantly increased SMRs. The exposure index was used for an SMR analysis of total cancer mortality by dose. For 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) a significant trend (p = 0.01) for the SMRs with increasing cumulative PCDD/F exposure was observed. The SMR in the first exposure quartile (0-125.2 ng/kg x years) was 1.24 (95% Cl 0.82, 1.79), increasing to 1.73 (95% Cl 1.21, 2.40) in the last quartile (> or = 2503.0 ng/kg x years). For all congeners combined as toxic equivalencies (TEQ) using international toxic equivalency factors, a significant increase in cancer mortality was observed in the second quartile (360.9-1614.4 ng/kg x years, SMR 1.64; 95% Cl 1.13, 2.29) and the fourth quartile (> or = 5217.7 ng/kg x years TEQ, SMR 1.64, 95% Cl 1.13, 2.29). The trend test was not significant. The results justify the use of this cohort for a quantitative risk assessment for TCDD and to a lesser extent for TEQ. Images Figure 1 PMID:9599713

  12. Suicide mortality of young, middle-aged and elderly males and females in Japan for the years 1953-96: time series analysis for the effects of unemployment, female labour force, young and aged population, primary industry and population density.

    PubMed

    Yamasaki, Akiko; Araki, Shunichi; Sakai, Ryoji; Yokoyama, Kazuhito; Voorhees, A Scott

    2008-12-01

    Effects of nine social life indicators on age-adjusted and age-specific annual suicide mortality of male and female Japanese population in the years 1953-96 were investigated by multiple regression analysis on time series data. Unemployment rate was significantly related to the age-adjusted mortality in both males and females. Also, female labour force participation was positively related to the male mortality; persons and 65 and above was inversely related to the male mortality. Results on the age-specific mortality indicated that: during the 44 yr, (1) unemployment significantly related with the mortality of young, middle-aged and elderly males and young females; (2) female labour force participation significantly related with the mortality of young and elderly males and young females; aged population significantly related with the mortality of middle-aged and elderly males; (4) young population significantly related with the mortality of young and middle-aged males and females; (5) divorce significantly related with the mortality of middle-aged and elderly males and young males and females; (6) persons employed in primary industries significantly related with the mortality in middle-aged males and young males and females; and (7) population density significantly related with the mortality of middle-aged males and young females.

  13. Hospital Strategies for Reducing Risk-Standardized Mortality Rates in Acute Myocardial Infarction

    PubMed Central

    Bradley, Elizabeth H.; Curry, Leslie A.; Spatz, Erica S.; Herrin, Jeph; Cherlin, Emily J.; Curtis, Jeptha P.; Thompson, Jennifer W.; Ting, Henry H.; Wang, Yongfei; Krumholz, Harlan M.

    2012-01-01

    Background Despite recent improvements in survival after acute myocardial infarction (AMI), U.S. hospitals vary 2-fold in their 30-day risk-standardized mortality rates (RSMRs). Nevertheless, information is limited on hospital-level factors that may be associated with RSMRs. Objective To identify hospital strategies that were associated with lower RSMRs. Design Cross-sectional survey of 537 hospitals (91% response rate) and weighted multivariate regression by using data from the Centers for Medicare & Medicaid Services to determine the associations between hospital strategies and hospital RSMRs. Setting Acute care hospitals with an annualized AMI volume of at least 25 patients. Participants Patients hospitalized with AMI between 1 January 2008 and 31 December 2009. Measurements Hospital performance improvement strategies, characteristics, and 30-day RSMRs. Results In multivariate analysis, several hospital strategies were significantly associated with lower RSMRs and in aggregate were associated with clinically important differences in RSMRs. These strategies included holding monthly meetings to review AMI cases between hospital clinicians and staff who transported patients to the hospital (RSMR lower by 0.70 percentage points), having cardiologists always on site (lower by 0.54 percentage points), fostering an organizational environment in which clinicians are encouraged to solve problems creatively (lower by 0.84 percentage points), not cross-training nurses from intensive care units for the cardiac catheterization laboratory (lower by 0.44 percentage points), and having physician and nurse champions rather than nurse champions alone (lower by 0.88 percentage points). Fewer than 10% of hospitals reported using at least 4 of these 5 strategies. Limitation The cross-sectional design demonstrates statistical associations but cannot establish causal relationships. Conclusion Several strategies, which are currently implemented by relatively few hospitals, are

  14. Multiple testing on standardized mortality ratios: a Bayesian hierarchical model for FDR estimation.

    PubMed

    Ventrucci, Massimo; Scott, E Marian; Cocchi, Daniela

    2011-01-01

    The analysis of large data sets of standardized mortality ratios (SMRs), obtained by collecting observed and expected disease counts in a map of contiguous regions, is a first step in descriptive epidemiology to detect potential environmental risk factors. A common situation arises when counts are collected in small areas, that is, where the expected count is very low, and disease risks underlying the map are spatially correlated. Traditional p-value-based methods, which control the false discovery rate (FDR) by means of Poisson p-values, might achieve small sensitivity in identifying risk in small areas. This problem is the focus of the present work, where a Bayesian approach which performs a test to evaluate the null hypothesis of no risk over each SMR and controls the posterior FDR is proposed. A Bayesian hierarchical model including spatial random effects to allow for extra-Poisson variability is implemented providing estimates of the posterior probabilities that the null hypothesis of absence of risk is true. By means of such posterior probabilities, an estimate of the posterior FDR conditional on the data can be computed. A conservative estimation is needed to achieve the control which is checked by simulation. The availability of this estimate allows the practitioner to determine nonarbitrary FDR-based selection rules to identify high-risk areas according to a preset FDR level. Sensitivity and specificity of FDR-based rules are studied via simulation and a comparison with p-value-based rules is also shown. A real data set is analyzed using rules based on several FDR levels.

  15. Assessment of the spatial occurrence of childhood leukaemia mortality using standardized rate ratios with a simple linear Poisson model.

    PubMed

    Aickin, M; Chapin, C A; Flood, T J; Englender, S J; Caldwell, G G

    1992-08-01

    Reports of a suspected cluster of childhood leukaemia cases in West Central Phoenix have led to a number of epidemiological studies in the geographical area. We report here on a death certificate-based mortality study, which indicated an elevated rate ratio of 1.95 during 1966-1986, using the remainder of the Phoenix standard metropolitan statistical area (SMSA) as a comparison region. In the process of analysing the data from this study, a methodology for dealing with denominator variability in a standardized mortality ratio was developed using a simple linear Poisson model. This new approach is seen as being of general use in the analysis of standardized rate ratios (SRR), as well as being particularly appropriate for cluster investigations.

  16. Self-perceptions of aging predict mortality and change with approaching death: 16-year longitudinal results from the Berlin Aging Study.

    PubMed

    Kotter-Grühn, Dana; Kleinspehn-Ammerlahn, Anna; Gerstorf, Denis; Smith, Jacqui

    2009-09-01

    Satisfaction with one's own aging and feeling young are indicators of positive well-being in late life. Using 16-year longitudinal data from participants of the Berlin Aging Study (P. B. Baltes & K. U. Mayer, 1999; N = 439; 70- to 100-year-olds), the authors examined whether and how these self-perceptions of aging change with age and how such changes relate to distance from death. Extending previous studies, they found that it is not only higher aging satisfaction and younger subjective age but also more favorable change patterns (e.g., less decline in aging satisfaction) that are uniquely associated with lower mortality hazards. These effects are robust after controls for objective measures such as age, gender, socioeconomic status, diagnosis of dementia, or number of illnesses. As individuals approach death, they become less satisfied with their aging and report feeling older. For aging satisfaction, mortality-related decline is much steeper than age-related decline, whereas change in subjective age is best characterized as an age-related process. The authors discuss how self-perceptions of aging are embedded in mechanisms underlying pathways of dying late in life.

  17. Mortality Among Teenagers Aged 12-19 Years: United States, 1999-2006

    MedlinePlus

    ... Mortality Series 21. Data on Natality, Marriage, and Divorce Series 22. Data from the National Natality and ... Compilations of Data on Natality, Mortality, Marriage, and Divorce Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard ...

  18. Social Determinants of Active Aging: Differences in Mortality and the Loss of Healthy Life between Different Income Levels among Older Japanese in the AGES Cohort Study.

    PubMed

    Hirai, Hiroshi; Kondo, Katsunori; Kawachi, Ichiro

    2012-01-01

    We examined the relationship between income, mortality, and loss of years of healthy life in a sample of older persons in Japan. We analyzed 22,829 persons aged 65 or older who were functionally independent at baseline as a part of the Aichi Gerontological Evaluation Study (AGES). Two outcome measures were adopted, mortality and loss of healthy life. Independent variables were income level and age. The occurrence of mortality and need for care during these 1,461 days were tracked. Cox regressions were used to calculate the hazard ratio for mortality and loss of healthy life by income level. We found that people with lower incomes were more likely than those with higher incomes to report worse health. For the overall sample, using the governmental administrative data, the hazard ratios of mortality and loss of healthy life-years comparing the lowest to the highest income level were 3.50 for men and 2.48 for women for mortality and 3.71 for men and 2.27 for women for loss of healthy life. When only those who responded to questions about income on the mail survey were included in the analysis, the relationships became weaker and lost statistical significance.

  19. Age-at-exposure effects on risk estimates for non-cancer mortality in the Japanese atomic bomb survivors.

    PubMed

    Zhang, Wei; Muirhead, Colin R; Hunter, Nezahat

    2005-12-01

    Statistically significant increases in non-cancer disease mortality with radiation dose have been observed among survivors of the atomic bombings of Hiroshima and Nagasaki. The increasing trends arise particularly for diseases of the circulatory, digestive, and respiratory systems. Rates for survivors exposed to a dose of 1 Sv are elevated by about 10%, a smaller relative increase than that for cancer. The aetiology of this increased risk is not yet understood. Neither animal nor human studies have found clear evidence for excess non-cancer mortality at the lower range of doses received by A-bomb survivors. In this paper, we examine the age and time patterns of excess risks in the A-bomb survivors. The results suggest that the excess relative risk of non-cancer disease mortality might be highest for exposure at ages 30-49 years, and that those exposed at ages 0-29 years might have a very low excess relative risk compared with those exposed at older ages. The differences in excess relative risk for different age-at-exposure groups imply that the dose response relationships for non-cancer disease mortality need to be modelled with adjustment for age-at-exposure.

  20. Mortality in mild cognitive impairment varies by subtype, sex and lifestyle factors. The Mayo Clinic Study of Aging

    PubMed Central

    Vassilaki, Maria; Cha, Ruth H.; Aakre, Jeremiah A.; Therneau, Terry M.; Geda, Yonas E.; Mielke, Michelle M.; Knopman, David S.; Petersen, Ronald C.; Roberts, Rosebud O.

    2015-01-01

    Background Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods Participants aged 70–89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases vs. cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results Over a median follow-up of 5.8 years, 331 of 862 (38.4%) MCI cases and 224 of 1292 (17.3%) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 2.03; 95% CI: 1.61 to 2.55), and was higher for non-amnestic MCI (naMCI; HR = 2.47; 95% CI: 1.80 to 3.39) than for amnestic MCI (aMCI; HR = 1.89; 95% CI: 1.48 to 2.41) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education vs. CN without these factors, and for naMCI cases vs. aMCI cases without these factors. Conclusions These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality. Delayed MCI diagnosis in persons with higher education impacts mortality, and higher mortality in men may explain similar dementia incidence by sex in our cohort. PMID:25697699

  1. Adjusted Age-Adjusted Charlson Comorbidity Index Score as a Risk Measure of Perioperative Mortality before Cancer Surgery

    PubMed Central

    Chang, Chun-Ming; Yin, Wen-Yao; Wei, Chang-Kao; Wu, Chin-Chia; Su, Yu-Chieh; Yu, Chia-Hui; Lee, Ching-Chih

    2016-01-01

    Background Identification of patients at risk of death from cancer surgery should aid in preoperative preparation. The purpose of this study is to assess and adjust the age-adjusted Charlson comorbidity index (ACCI) to identify cancer patients with increased risk of perioperative mortality. Methods We identified 156,151 patients undergoing surgery for one of the ten common cancers between 2007 and 2011 in the Taiwan National Health Insurance Research Database. Half of the patients were randomly selected, and a multivariate logistic regression analysis was used to develop an adjusted-ACCI score for estimating the risk of 90-day mortality by variables from the original ACCI. The score was validated. The association between the score and perioperative mortality was analyzed. Results The adjusted-ACCI score yield a better discrimination on mortality after cancer surgery than the original ACCI score, with c-statics of 0.75 versus 0.71. Over 80 years of age, 70–80 years, and renal disease had the strongest impact on mortality, hazard ratios 8.40, 3.63, and 3.09 (P < 0.001), respectively. The overall 90-day mortality rates in the entire cohort varied from 0.9%, 2.9%, 7.0%, and 13.2% in four risk groups stratifying by the adjusted-ACCI score; the adjusted hazard ratio for score 4–7, 8–11, and ≥ 12 was 2.84, 6.07, and 11.17 (P < 0.001), respectively, in 90-day mortality compared to score 0–3. Conclusions The adjusted-ACCI score helps to identify patients with a higher risk of 90-day mortality after cancer surgery. It might be particularly helpful for preoperative evaluation of patients over 80 years of age. PMID:26848761

  2. REGIONAL TRENDS IN THE WORKING-AGE POPULATION MORTALITY RATE IN THE REPUBLIC OF SAKHA (YAKUTIA) IN 1990-2012.

    PubMed

    Ivanova, A A; Kakorina, E P; Timofeev, L F; Potapov, A F; Aprosimov, L A

    2015-01-01

    Regions of the Russian Federation differ in climatic-geographic, medical-demographic and social-economic situations. One of the regions with distinct peculiarities is the Republic of Sakha (Yakutia). Ranking first by the territory (3,103.2 thousand sq x km), Yakutia is on the 81th place by the population density among regions of the Russian Federation (0.3 people per 1 km2).Yakutia is one of the most isolated and inaccessible regions of the world: 90% of the territory lacks all-the-year-round transportation. Regions of the republic, as well, differ significantly in the climatic conditions and the levels of social-economic development, which influences the population health indicators, including mortality. This survey aimed to study the trends of mortality in the working-age population in different groups of regions. To do this, basing on the statistical data, we compared the levels, trends and structure of mortality in 1990-2012. It was established that the different groups of regions show a significant variation in the working-age population mortality, depending on the social-economic conditions. Since 2000, the Arctic group of regions has demonstrated higher mortality in working-age men and women, especially of cardiovascular and digestive system diseases, and external causes. Lying beyond the Arctic Circle, these regions have severe conditions and a relatively low level of social-economic development. As for the rural regions, despite the relatively favourabe situation, they also show a high level of mortality of external causes. The industrial regions are characterized by higher social-economic development, better transport infrastructure, a satisfactory material base of medical institutions. They also have sufficient resources of health institutions, including the staff and modern equipment for treatment and diagnostics, as well as, which is critical, the full range of medical specialists. Thus, these regions demonstrate lower population mortality; however

  3. Age and Diet Affect Genetically Separable Secondary Injuries that Cause Acute Mortality Following Traumatic Brain Injury in Drosophila

    PubMed Central

    Katzenberger, Rebeccah J.; Ganetzky, Barry; Wassarman, David A.

    2016-01-01

    Outcomes of traumatic brain injury (TBI) vary because of differences in primary and secondary injuries. Primary injuries occur at the time of a traumatic event, whereas secondary injuries occur later as a result of cellular and molecular events activated in the brain and other tissues by primary injuries. We used a Drosophila melanogaster TBI model to investigate secondary injuries that cause acute mortality. By analyzing mortality percentage within 24 hr of primary injuries, we previously found that age at the time of primary injuries and diet afterward affect the severity of secondary injuries. Here, we show that secondary injuries peaked in activity 1–8 hr after primary injuries. Additionally, we demonstrate that age and diet activated distinct secondary injuries in a genotype-specific manner, and that concurrent activation of age- and diet-regulated secondary injuries synergistically increased mortality. To identify genes involved in secondary injuries that cause mortality, we compared genome-wide mRNA expression profiles of uninjured and injured flies under age and diet conditions that had different mortalities. During the peak period of secondary injuries, innate immune response genes were the predominant class of genes that changed expression. Furthermore, age and diet affected the magnitude of the change in expression of some innate immune response genes, suggesting roles for these genes in inhibiting secondary injuries that cause mortality. Our results indicate that the complexity of TBI outcomes is due in part to distinct, genetically controlled, age- and diet-regulated mechanisms that promote secondary injuries and that involve a subset of innate immune response genes. PMID:27754853

  4. Disability Stage Is an Independent Risk Factor for Mortality in Medicare Beneficiaries 65 Years of Age and Older

    PubMed Central

    Hennessy, Sean; Kurichi, Jibby E.; Pan, Qiang; Streim, Joel E.; Bogner, Hillary; Xie, Dawei; Stineman, Margaret G.

    2015-01-01

    Background Stages of activity limitation based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) have been found to predict mortality in those age 70 years and above but have not been examined in Medicare beneficiaries age 65 years and older using routinely collected data. Objective To examine the association between functional stages based on activities of ADLs and IADLs with three-year mortality in Medicare beneficiaries age 65 years and older, accounting for baseline sociodemographics, heath status, smoking, subjective health, and psychological well-being. Design Cohort study using the Medicare Current Beneficiary Survey (MCBS) and associated health care utilization data. Setting Community administered survey. Participants We included 9698 Medicare beneficiaries 65 years of age and older who entered the MCBS in 2005–07. Main outcome measures Death within three years of cohort entry. Results The overall mortality rate was 3.6 per 100 person years, and three-year cumulative mortality was 10.3%. Unadjusted three-year mortality was monotonically associated with both ADL stage and IADL stag. Adjusted three-year mortality was associated with ADL and IADL stages, except that in some models the hazard ratio for stage III (which includes persons with atypical activity limitation patterns) was numerically lower than that for stage II. Conclusion We found nearly monotonic relationships between ADL and IADL stage and adjusted three-year mortality. These findings could aid in the development of population health approaches and metrics for evaluating the success of alternative economic, social, or health policies on the longevity of older adults with activity limitations. PMID:26003869

  5. Direct estimation of cause-specific mortality fractions from verbal autopsies: multisite validation study using clinical diagnostic gold standards

    PubMed Central

    2011-01-01

    Background Verbal autopsy (VA) is used to estimate the causes of death in areas with incomplete vital registration systems. The King and Lu method (KL) for direct estimation of cause-specific mortality fractions (CSMFs) from VA studies is an analysis technique that estimates CSMFs in a population without predicting individual-level cause of death as an intermediate step. In previous studies, KL has shown promise as an alternative to physician-certified verbal autopsy (PCVA). However, it has previously been impossible to validate KL with a large dataset of VAs for which the underlying cause of death is known to meet rigorous clinical diagnostic criteria. Methods We applied the KL method to adult, child, and neonatal VA datasets from the Population Health Metrics Research Consortium gold standard verbal autopsy validation study, a multisite sample of 12,542 VAs where gold standard cause of death was established using strict clinical diagnostic criteria. To emulate real-world populations with varying CSMFs, we evaluated the KL estimations for 500 different test datasets of varying cause distribution. We assessed the quality of these estimates in terms of CSMF accuracy as well as linear regression and compared this with the results of PCVA. Results KL performance is similar to PCVA in terms of CSMF accuracy, attaining values of 0.669, 0.698, and 0.795 for adult, child, and neonatal age groups, respectively, when health care experience (HCE) items were included. We found that the length of the cause list has a dramatic effect on KL estimation quality, with CSMF accuracy decreasing substantially as the length of the cause list increases. We found that KL is not reliant on HCE the way PCVA is, and without HCE, KL outperforms PCVA for all age groups. Conclusions Like all computer methods for VA analysis, KL is faster and cheaper than PCVA. Since it is a direct estimation technique, though, it does not produce individual-level predictions. KL estimates are of similar

  6. Influence of Social Engagement on Mortality in Korea: Analysis of the Korean Longitudinal Study of Aging (2006–2012)

    PubMed Central

    2016-01-01

    The objective of this study was to investigate the impact of social engagement and patterns of change in social engagement over time on mortality in a large population, aged 45 years or older. Data from the Korean Longitudinal Study of Aging from 2006 and 2012 were assessed using longitudinal data analysis. We included 8,234 research subjects at baseline (2006). The primary analysis was based on Cox proportional hazards models to examine our hypothesis. The hazard ratio of all-cause mortality for the lowest level of social engagement was 1.841-times higher (P < 0.001) compared with the highest level of social engagement. Subgroup analysis results by gender showed a similar trend. A six-class linear solution fit the data best, and class 1 (the lowest level of social engagement class, 7.6% of the sample) was significantly related to the highest mortality (HR: 4.780, P < 0.001). Our results provide scientific insight on the effects of the specificity of the level of social engagement and changes in social engagement on all-cause mortality in current practice, which are important for all-cause mortality risk. Therefore, protection from all-cause mortality may depend on avoidance of constant low-levels of social engagement. PMID:27365997

  7. Influence of Social Engagement on Mortality in Korea: Analysis of the Korean Longitudinal Study of Aging (2006-2012).

    PubMed

    Kim, Jae-Hyun; Lee, Sang Gyu; Kim, Tae-Hyun; Choi, Young; Lee, Yunhwan; Park, Eun-Cheol

    2016-07-01

    The objective of this study was to investigate the impact of social engagement and patterns of change in social engagement over time on mortality in a large population, aged 45 years or older. Data from the Korean Longitudinal Study of Aging from 2006 and 2012 were assessed using longitudinal data analysis. We included 8,234 research subjects at baseline (2006). The primary analysis was based on Cox proportional hazards models to examine our hypothesis. The hazard ratio of all-cause mortality for the lowest level of social engagement was 1.841-times higher (P < 0.001) compared with the highest level of social engagement. Subgroup analysis results by gender showed a similar trend. A six-class linear solution fit the data best, and class 1 (the lowest level of social engagement class, 7.6% of the sample) was significantly related to the highest mortality (HR: 4.780, P < 0.001). Our results provide scientific insight on the effects of the specificity of the level of social engagement and changes in social engagement on all-cause mortality in current practice, which are important for all-cause mortality risk. Therefore, protection from all-cause mortality may depend on avoidance of constant low-levels of social engagement.

  8. Relation between Age-Related Macular Degeneration and Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis

    PubMed Central

    Wang, Jie; Xue, Yangjing; Thapa, Saroj; Wang, Luping; Tang, Jifei

    2016-01-01

    Data on the association between age-related macular degeneration (AMD) and cardiovascular disease and mortality are conflicting. The purpose of this report is to conduct a systematic review to better understand the role of AMD as a risk factor for CVD events and mortality. We searched Medline (Ovid) and Embase (Ovid) for trials published from 1980 to 2015. We included 20 cohort studies that reported relative risks with 95% confidence intervals for the association of AMD and cardiovascular events and mortality, involving 29,964,334 participants. In a random-effects model, the adjusted RR (95% confidence interval [CI]) associated with AMD was 1.08 (1.00–1.117) for all-cause mortality (8 studies) and 1.18 (0.98–1.43) for cardiovascular disease mortality (5 studies). The pooled RR (95% CI) was 1.17 (0.94–1.45) for coronary heart disease (CHD; 3 studies) and 1.13 (0.93–1.36) for stroke (8 studies). Findings from this systematic review support that AMD is associated with increased risk of all-cause mortality. The evidence that AMD predicts incident CVD events or CVD mortality remains inclusive and warrants further study in the future. PMID:28070519

  9. Empirical evidence for various evolutionary hypotheses on species demonstrating increasing mortality with increasing chronological age in the wild.

    PubMed

    Libertini, Giacinto

    2008-02-19

    Many species show a significant increase in mortality with increasing chronological age in the wild. For this phenomenon, three possible general hypotheses are proposed, namely that: (1) it has no adaptive meaning; (2) it has an adaptive meaning; (3) the ancestry is the pivotal determinant. These hypotheses are evaluated according to their consistency with the empirical evidence. In particular, (1) the existence of many species with a constant, or almost constant, mortality rate, especially the so-called "animals with negligible senescence"; (2) the inverse correlation, observed in mammals and birds in the wild, between extrinsic mortality and the proportion of deaths due to intrinsic mortality; (3) the existence of highly sophisticated, genetically determined, and regulated mechanisms that limit and modulate cell duplication capacities and overall cell functionality. On the whole, the hypothesis of an adaptive meaning appears to be consistent with the empirical evidence, while the other two hypotheses hardly appear compatible.

  10. Early life socioeconomic conditions in rural areas and old-age mortality in twentieth-century Quebec.

    PubMed

    Gagnon, Alain; Bohnert, Nora

    2012-10-01

    This study examines the effects of early life socioeconomic and residential conditions on adult mortality. The family and residential details of children living in rural areas of Quebec, Canada, in 1901 were linked to their subsequent ages at death using a database compiling information from the 1901 Canadian Census and Quebec vital statistics registers. Survival analysis results suggest that males raised on a farm and in a household owned by their father had lower mortality after the age of fifty than other males from rural areas. Chances for survival at older ages were not equal, however, among males whose father was a farmer. Most notably, males raised on a larger farmstead, an indicator of a higher socioeconomic status, experienced lower risk of mortality than those raised by farmers owning fewer acres. Results were widely different for females, who did not gain an advantage from being raised on a farm, wealthy or not, regardless of homeownership, but instead from having a literate father. Accounting for selection bias and shared frailty among brothers served to enhance the significance and effect size of acreage wealth and of other early life factors in the prediction of male adult mortality risk. This study provides evidence that early life effects on later life health and mortality could often be underestimated, due to a failure to account for selection and unobserved heterogeneity.

  11. Smoking Status, Physical Health–Related Quality of Life, and Mortality in Middle-Aged and Older Women

    PubMed Central

    2013-01-01

    Introduction: Women who smoke, particularly older women, have been relatively neglected in smoking research. There is a lack of knowledge concerning the relation of level of smoking to quality of life and mortality among middle-aged and older women smokers. Methods: This study examined the relation of smoking status to physical health–related quality of life (PHRQL) and total mortality in women in the Women’s Health Initiative (WHI) Observational Study. Participants were 90,849 postmenopausal women, who were an average age of 63.6 years at baseline. Analyses used multiple linear and Cox proportional hazards regression and controlled for age, educational level, and ethnicity. Never-smokers were the reference group. Results: We found that smoking status was significantly related to PHRQL cross-sectionally at baseline and prospectively at a 3-year follow-up, with those who smoked having lower PHRQL. Heavier smokers showed large, clinically meaningful associations with PHRQL and light smokers showed small associations. In addition, we found that the smoking status at baseline was significantly related to 10-year total mortality. Both light and heavier smoking at baseline significantly correlated with higher mortality risk; however, the relationship of smoking to mortality was dose dependent. Among former smokers, those who had smoked longer showed significantly lower PHRQL and significantly increased mortality risk. Conclusions: Findings suggest that the risks of smoking may not be evident to light smokers and that educational interventions targeted to middle-aged and older women stressing the consequences of light smoking may be particularly beneficial. PMID:22965789

  12. Abortion index and mortality of offspring among women of different age, caste and population groups of north Indian Muslims.

    PubMed

    Ara, Gulshan; Siddique, Yasir Hasan; Beg, Tanveer; Afzal, Mohammad

    2008-05-01

    The Muslims of Aligarh city are predominantly Sunnis, although there are also a considerable number of Shias. Among the Sunnis, approximately a quarter belong to Syed, Sheikh, Moghal and Pathan groups, and three-quarters belong to various lower biradaris. In the present study, 304 women attending the Primary Health Centre of the J. N. Medical College and Hospital, Aligarh Muslim University, Uttar Pradesh, were surveyed and the following recorded among Muslim women of high-rank (Ashraf) and low-rank (Ajlaf) castes: incidence of marriage, age of the mother at the time of marriage, present age of the mother, abortions, still births, pre-reproductive mortality and overall mortality. The Ashraf are comprised of the Sheikh, Syed and Pathan, whereas the Ajlafs have Qureshi, Saifi and Ansari biradaris. Maternal age was scored as above and below 45 years in each biradari. Significant effects of maternal age were seen on mortality of offspring, whereas populations did not show consistent differences, except when Ashrafs and Ajlafs were considered separately. The results show higher mortality and abortions for various groups. This may be due to various biological and socio-cultural factors, including hidden inbreeding in the remote past.

  13. Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan

    PubMed Central

    Eguchi, Hisashi; Wada, Koji; Prieto-Merino, David; Smith, Derek R.

    2017-01-01

    We examined occupational and industrial differences in lung, gastric, and colorectal cancer risk among Japanese men of working age (25–64 years) using the 2010 Japanese national survey data for occupation and industry-specific death rates. Poisson regression models were used to estimate the age-adjusted incident rate ratios by lung, gastric, and colorectal cancers, with manufacturing used as the referent occupation or industry. Unemployed Japanese men and those in manufacturing had an 8–11-fold increased risk of lung, gastric and colorectal cancer. The highest mortality rates for lung and colorectal cancer by occupation were “administrative and managerial” (by occupation) and “mining” (by industry). For gastric cancer, the highest mortality rate was “agriculture” (by occupation) and “mining” (by industry). By occupation; Japanese men in service occupations, those in administrative and managerial positions, those in agriculture, forestry and fisheries, and those in professional and engineering categories had higher relative mortality risks for lung, gastric, and colorectal cancers. By industry; mining, electricity and gas, fisheries, and agriculture and forestry had the higher mortality risks for those cancers. Unemployed men had higher mortality rates than men in any occupation and industry for all three cancers. Overall, this study suggests that for Japanese men, occupations and industries may be a key social determinant of health. PMID:28230191

  14. Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan.

    PubMed

    Eguchi, Hisashi; Wada, Koji; Prieto-Merino, David; Smith, Derek R

    2017-02-23

    We examined occupational and industrial differences in lung, gastric, and colorectal cancer risk among Japanese men of working age (25-64 years) using the 2010 Japanese national survey data for occupation and industry-specific death rates. Poisson regression models were used to estimate the age-adjusted incident rate ratios by lung, gastric, and colorectal cancers, with manufacturing used as the referent occupation or industry. Unemployed Japanese men and those in manufacturing had an 8-11-fold increased risk of lung, gastric and colorectal cancer. The highest mortality rates for lung and colorectal cancer by occupation were "administrative and managerial" (by occupation) and "mining" (by industry). For gastric cancer, the highest mortality rate was "agriculture" (by occupation) and "mining" (by industry). By occupation; Japanese men in service occupations, those in administrative and managerial positions, those in agriculture, forestry and fisheries, and those in professional and engineering categories had higher relative mortality risks for lung, gastric, and colorectal cancers. By industry; mining, electricity and gas, fisheries, and agriculture and forestry had the higher mortality risks for those cancers. Unemployed men had higher mortality rates than men in any occupation and industry for all three cancers. Overall, this study suggests that for Japanese men, occupations and industries may be a key social determinant of health.

  15. Disability and all-cause mortality in the older population: evidence from the English Longitudinal Study of Ageing.

    PubMed

    Pongiglione, Benedetta; De Stavola, Bianca L; Kuper, Hannah; Ploubidis, George B

    2016-08-01

    Despite the vast body of literature studying disability and mortality, evidence to support their association is scarce. This work investigates the role of disability in explaining all-cause mortality among individuals aged 50+ who participated in the English Longitudinal Study of Aging. The aim is to explain the gender paradox in health and mortality by analysing whether the association of disability with mortality differs between women and men. Disability was conceived following the International Classification of Functioning, Disability and Health (ICF), proposed by the WHO, that conceptualizes disability as a combination of three components: impairment, activity limitation and participation restriction. Latent variable models were used to identify domain-specific factors and general disability. The association of the latter with mortality up to 10 years after enrolment was estimated using discrete-time survival analysis. Our work confirms the validity of the ICF framework and finds that disability is strongly associated with mortality, with a time-varying effect among men, and a smaller constant effect for women. Adjusting for demographic, socioeconomic and behavioural factors attenuated the association for both sexes, but overall the effects remained high and significant. These findings confirm the existence of gender paradox by showing that, when affected by disability, women survive longer than men, although if men survive the first years they appear to become more resilient to disability. Sensitivity analyses suggested that the gender paradox cannot be solely explained by gender-specific health conditions: there must be other mechanisms acting within the pathway between disability and mortality that need to be explored.

  16. Age- and sex-specific mortality patterns in an emerging wildlife epidemic: the phocine distemper in European harbour seals.

    PubMed

    Härkönen, Tero; Harding, Karin; Rasmussen, Thomas Dau; Teilmann, Jonas; Dietz, Rune

    2007-09-12

    Analyses of the dynamics of diseases in wild populations typically assume all individuals to be identical. However, profound effects on the long-term impact on the host population can be expected if the disease has age and sex dependent dynamics. The Phocine Distemper Virus (PDV) caused two mass mortalities in European harbour seals in 1988 and in 2002. We show the mortality patterns were highly age specific on both occasions, where young of the year and adult (>4 yrs) animals suffered extremely high mortality, and sub-adult seals (1-3 yrs) of both sexes experienced low mortality. Consequently, genetic differences cannot have played a main role explaining why some seals survived and some did not in the study region, since parents had higher mortality levels than their progeny. Furthermore, there was a conspicuous absence of animals older than 14 years among the victims in 2002, which strongly indicates that the survivors from the previous disease outbreak in 1988 had acquired and maintained immunity to PDV. These specific mortality patterns imply that contact rates and susceptibility to the disease are strongly age and sex dependent variables, underlining the need for structured epidemic models for wildlife diseases. Detailed data can thus provide crucial information about a number of vital parameters such as functional herd immunity. One of many future challenges in understanding the epidemiology of the PDV and other wildlife diseases is to reveal how immune system responses differ among animals in different stages during their life cycle. The influence of such underlying mechanisms may also explain the limited evidence for abrupt disease thresholds in wild populations.

  17. Looking for age-related growth decline in natural forests: unexpected biomass patterns from tree rings and simulated mortality

    USGS Publications Warehouse

    Foster, Jane R.; D'Amato, Anthony W.; Bradford, John B.

    2014-01-01

    Forest biomass growth is almost universally assumed to peak early in stand development, near canopy closure, after which it will plateau or decline. The chronosequence and plot remeasurement approaches used to establish the decline pattern suffer from limitations and coarse temporal detail. We combined annual tree ring measurements and mortality models to address two questions: first, how do assumptions about tree growth and mortality influence reconstructions of biomass growth? Second, under what circumstances does biomass production follow the model that peaks early, then declines? We integrated three stochastic mortality models with a census tree-ring data set from eight temperate forest types to reconstruct stand-level biomass increments (in Minnesota, USA). We compared growth patterns among mortality models, forest types and stands. Timing of peak biomass growth varied significantly among mortality models, peaking 20–30 years earlier when mortality was random with respect to tree growth and size, than when mortality favored slow-growing individuals. Random or u-shaped mortality (highest in small or large trees) produced peak growth 25–30 % higher than the surviving tree sample alone. Growth trends for even-aged, monospecific Pinus banksiana or Acer saccharum forests were similar to the early peak and decline expectation. However, we observed continually increasing biomass growth in older, low-productivity forests of Quercus rubra, Fraxinus nigra, and Thuja occidentalis. Tree-ring reconstructions estimated annual changes in live biomass growth and identified more diverse development patterns than previous methods. These detailed, long-term patterns of biomass development are crucial for detecting recent growth responses to global change and modeling future forest dynamics.

  18. Looking for age-related growth decline in natural forests: unexpected biomass patterns from tree rings and simulated mortality.

    PubMed

    Foster, Jane R; D'Amato, Anthony W; Bradford, John B

    2014-05-01

    Forest biomass growth is almost universally assumed to peak early in stand development, near canopy closure, after which it will plateau or decline. The chronosequence and plot remeasurement approaches used to establish the decline pattern suffer from limitations and coarse temporal detail. We combined annual tree ring measurements and mortality models to address two questions: first, how do assumptions about tree growth and mortality influence reconstructions of biomass growth? Second, under what circumstances does biomass production follow the model that peaks early, then declines? We integrated three stochastic mortality models with a census tree-ring data set from eight temperate forest types to reconstruct stand-level biomass increments (in Minnesota, USA). We compared growth patterns among mortality models, forest types and stands. Timing of peak biomass growth varied significantly among mortality models, peaking 20-30 years earlier when mortality was random with respect to tree growth and size, than when mortality favored slow-growing individuals. Random or u-shaped mortality (highest in small or large trees) produced peak growth 25-30% higher than the surviving tree sample alone. Growth trends for even-aged, monospecific Pinus banksiana or Acer saccharum forests were similar to the early peak and decline expectation. However, we observed continually increasing biomass growth in older, low-productivity forests of Quercus rubra, Fraxinus nigra, and Thuja occidentalis. Tree-ring reconstructions estimated annual changes in live biomass growth and identified more diverse development patterns than previous methods. These detailed, long-term patterns of biomass development are crucial for detecting recent growth responses to global change and modeling future forest dynamics.

  19. Vitamin D, PTH and the risk of overall and disease-specific mortality: Results of the Longitudinal Aging Study Amsterdam.

    PubMed

    El Hilali, Jamila; de Koning, Elisa J; van Ballegooijen, Adriana J; Lips, Paul; Sohl, Evelien; van Marwijk, Harm W J; Visser, Marjolein; van Schoor, Natasja M

    2016-11-01

    Observational studies suggest that low concentrations of serum 25-hydroxyvitamin D (25(OH)D) and high concentrations of parathyroid hormone (PTH) are associated with a higher risk of mortality. The aim of this study was to examine whether 25(OH)D and PTH concentrations are independently associated with overall and disease-specific (cardiovascular and cancer-related) mortality in a large, prospective population-based cohort of older adults. Data from 1317 men and women (65-85 years) of the Longitudinal Aging Study Amsterdam were used. Cox proportional hazard analyses were used to examine whether 25(OH)D and PTH at baseline were associated with overall mortality (with a follow-up of 18 years) and disease-specific mortality (with a follow-up of 13 years). Compared to persons in the reference category of ≥75nmol/L, persons with serum 25(OH)D <25nmol/L (HR 1.46; 95% CI: 1.12-1.91) and 25-49.9nmol/L (HR 1.24; 95% CI: 1.01-1.53) had a significantly higher risk of overall mortality, as well as men with baseline PTH concentrations ≥7pmol/L (HR 2.54 (95% CI: 1.58-4.08)), compared to the reference category of <2.33pmol/L. The relationship of 25(OH)D with overall mortality was partly mediated by PTH. Furthermore, men with PTH concentrations of ≥7pmol/L (HR 3.22; 95% CI: 1.40-7.42) had a higher risk of cardiovascular mortality, compared to the reference category. No significant associations of 25(OH)D or PTH with cancer-related mortality were observed. Both 25(OH)D and PTH should be considered as important health markers.

  20. [Mortality of old-aged (60 years and older) population in Yakutia subject to data of prospective cohort seven-year study].

    PubMed

    Tatarinova, O V; Nikitin, Iu P; Shcherbakova, L V

    2014-01-01

    Level of total mortality and mortality from cardiovascular diseases was defined subsequent to the results of carried out novel prospective study of cohort of old-age population of the Republic. Subject to seven-year cohort study high indexes of mortality from all reasons (42,7%) and from cardiovascular diseases (28,4%) were registered for the population of Yakutia aged 60 years and older. Circulatory diseases comprise 68% of all died; ischemic heart diseases (59%) and cerebrovascular diseases (22%) are the main reasons among the cardiovascular pathology. In the studied cohort there were found no ethnic and gender differences in mortality levels. Total mortality and mortality from cardiovascular pathology, relative risk of fatal issue development increase statistically significant with the age. The growth rate of total and cardiovascular mortality are practically identical in both ethnic groups.

  1. Incident Subjective Cognitive Decline Does Not Predict Mortality in the Elderly – Results from the Longitudinal German Study on Ageing, Cognition, and Dementia (AgeCoDe)

    PubMed Central

    Roehr, Susanne; Luck, Tobias; Heser, Kathrin; Fuchs, Angela; Ernst, Annette; Wiese, Birgitt; Werle, Jochen; Bickel, Horst; Brettschneider, Christian; Koppara, Alexander; Pentzek, Michael; Lange, Carolin; Prokein, Jana; Weyerer, Siegfried; Mösch, Edelgard; König, Hans-Helmut; Maier, Wolfgang; Scherer, Martin

    2016-01-01

    Objective Subjective cognitive decline (SCD) might represent the first symptomatic representation of Alzheimer’s disease (AD), which is associated with increased mortality. Only few studies, however, have analyzed the association of SCD and mortality, and if so, based on prevalent cases. Thus, we investigated incident SCD in memory and mortality. Methods Data were derived from the German AgeCoDe study, a prospective longitudinal study on the epidemiology of mild cognitive impairment (MCI) and dementia in primary care patients over 75 years covering an observation period of 7.5 years. We used univariate and multivariate Cox regression analyses to examine the relationship of SCD and mortality. Further, we estimated survival times by the Kaplan Meier method and case-fatality rates with regard to SCD. Results Among 971 individuals without objective cognitive impairment, 233 (24.0%) incidentally expressed SCD at follow-up I. Incident SCD was not significantly associated with increased mortality in the univariate (HR = 1.0, 95% confidence interval = 0.8–1.3, p = .90) as well as in the multivariate analysis (HR = 0.9, 95% confidence interval = 0.7–1.2, p = .40). The same applied for SCD in relation to concerns. Mean survival time with SCD was 8.0 years (SD = 0.1) after onset. Conclusion Incident SCD in memory in individuals with unimpaired cognitive performance does not predict mortality. The main reason might be that SCD does not ultimately lead into future cognitive decline in any case. However, as prevalence studies suggest, subjectively perceived decline in non-memory cognitive domains might be associated with increased mortality. Future studies may address mortality in such other cognitive domains of SCD in incident cases. PMID:26766555

  2. Age, growth, and mortality of introduced flathead catfish in Atlantic rivers and a review of other populations

    USGS Publications Warehouse

    Kwak, T.J.; Pine, William E.; Waters, D.S.

    2006-01-01

    Knowledge of individual growth and mortality rates of an introduced fish population is required to determine the success and degree of establishment as well as to predict the fish's impact on native fauna. The age and growth of flathead catfish Pylodictis olivaris have been studied extensively in the species' native and introduced ranges, and estimates have varied widely. We quantified individual growth rates and age structure of three introduced flathead catfish populations in North Carolina's Atlantic slope rivers using sagittal otoliths, determined trends in growth rates over time, compared these estimates among rivers in native and introduced ranges, and determined total mortality rates for each population. Growth was significantly faster in the Northeast Cape Fear River (NECFR) than in the Lumber and Neuse rivers. Fish in the NECFR grew to a total length of 700 mm by age 7, whereas fish in the Neuse and Lumber river populations reached this length by 8 and 10 years, respectively. The growth rates of fish in all three rivers were consistently higher than those of native riverine populations, similar to those of native reservoir populations, and slower than those of other introduced riverine populations. In general, recent cohorts (1998-2001 year-classes) in these three rivers exhibited slower growth among all ages than did cohorts previous to the 1998 year-class. The annual total mortality rate was similar among the three rivers, ranging from 0.16 to 0.20. These mortality estimates are considerably lower than those from the Missouri and Mississippi rivers, suggesting relatively low fishing mortality for these introduced populations. Overall, flathead catfish populations in reservoirs grow faster than those in rivers, the growth rates of introduced populations exceed those of native populations, and eastern United States populations grow faster than those in western states. Such trends constitute critical information for understanding and managing local

  3. Rheumatic Heart Disease-Attributable Mortality at Ages 5–69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study

    PubMed Central

    Parks, Tom; Kado, Joseph; Miller, Anne E.; Ward, Brenton; Heenan, Rachel; Colquhoun, Samantha M.; Bärnighausen, Till W.; Mirabel, Mariana; Bloom, David E.; Bailey, Robin L.; Tukana, Isimeli N.; Steer, Andrew C.

    2015-01-01

    Background Rheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008–2012 in people aged 5–69 years. Methods and Findings Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8–10.0) and 331 years of life-lost (YLL, 95% CI 330.4–331.5) due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0–69 years. Valuing life using Fiji’s per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011–2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses. Conclusions Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases. PMID:26371755

  4. Avoidable mortality measured by years of potential life lost (YPLL) aged 5 before 65 years in Kyrgyzstan, 1989-2003.

    PubMed

    Bozgunchievz, Maratbek; Ito, Katsuki

    2007-01-01

    There is considerable willingness in the entire medical society of Kyrgyzstan, which was directly involved in the reform process, to obtain reliable information about changes in population health that have occurred in the last decade, as well as about changes in mortality, which is the basic component of population health. The objective of this paper is to introduce the Year of Potential Life Lost (YPLL) in Kyrgyzstan caused by avoidable mortality in the population between 5 and 65 years of age during 1989-2003, and to provide a basis for setting the priorities for the reducing YPLL in the coming years. YPLL was calculated using data from the annual mortality tables according to causes of deaths and age for 1989, 1996, 1999 and 2003. YPLL is defined as the summation of the difference between 65 years of age and the age at death from the age of 5 and before 65. In 2003, the total number of YPLL due to avoidable mortality among those who died was 216,860, which represents a decline of 5.0% in comparison with 228,266 in 1989. During the study years, the largest proportion of YPLL in the population between 5 and 65 years of age resulted from injury and poisoning. In 2003, this proportion represented 41.5% of the total amount of YPLL due to all the causes studied here, followed by infections and parasitic diseases (12.0%), circulatory disturbance of the brain (11.5%), chronic liver diseases and cirrhosis (11.4%), diseases of the respiratory system (9.2%), and malignant neoplasm of the upper airways and digestive tract (4.6%). The decline in avoidable mortality caused by injury and poisoning, infections disease, malignant neoplasm of the female breast and uterus has to be priority-driven direction for developing Health Policy in the coming years in Kyrgyzstan. Attention also has to be given to reducing of avoidable mortality caused by malignant neoplasm of the female breast by implementing screening programs.

  5. Land use mix and five-year mortality in later life: Results from the Cognitive Function and Ageing Study

    PubMed Central

    Wu, Yu-Tzu; Prina, A. Matthew; Jones, Andy; Barnes, Linda E.; Matthews, Fiona E.; Brayne, Carol; MRC CFAS

    2016-01-01

    This study explores the potential modifying effect of age and mediation effect of co-morbidity on the association between land use mix, a measure of neighbourhood walkability, and five-year mortality among the 2424 individuals participating in the year-10 follow-up of the Cognitive Function and Ageing Study in England. Postcodes of participants were mapped onto Lower-layer Super Output Areas, a small area level geographical unit in the UK, and linked to Generalised Land Use data. Cox regression models were fitted to investigate the association. For the younger older age group (75–79 years), the effect of high land use mix on an elevated risk of mortality was mediated by co-morbidity. For older old age groups (80–84, 85+ years), a higher land use mix was directly associated with a 10% lower risk of five-year mortality. The findings suggest differential impacts of land use mix on the health of the younger and older old. PMID:26798962

  6. Examining mortality risk and rate of ageing among Polish Olympic athletes: a survival follow-up from 1924 to 2012

    PubMed Central

    Lin, Yuhui; Gajewski, Antoni; Poznańska, Anna

    2016-01-01

    Objectives Population-based studies have shown that an active lifestyle reduces mortality risk. Therefore, it has been a longstanding belief that individuals who engage in frequent exercise will experience a slower rate of ageing. It is uncertain whether this widely-accepted assumption holds for intense wear-and-tear. Here, using the 88 years survival follow-up data of Polish Olympic athletes, we report for the first time on whether frequent exercise alters the rate of ageing. Design Longitudinal survival data of male elite Polish athletes who participated in the Olympic Games from year 1924 to 2010 were used. Deaths occurring before the end of World War II were excluded for reliable estimates. Setting and participants Recruited male elite athletes N=1273 were preassigned to two categorical birth cohorts—Cohort I 1890–1919; Cohort II 1920–1959—and a parametric frailty survival analysis was conducted. An event-history analysis was also conducted to adjust for medical improvements from year 1920 onwards: Cohort II. Results Our findings suggest (1) in Cohort I, for every threefold reduction in mortality risk, the rate of ageing decelerates by 1%; (2) socioeconomic transitions and interventions contribute to a reduction in mortality risk of 29% for the general population and 50% for Olympic athletes; (3) an optimum benefit gained for reducing the rate of ageing from competitive sports (Cohort I 0.086 (95% CI 0.047 to 0.157) and Cohort II 0.085 (95% CI 0.050 to 0.144)). Conclusions This study further suggests that intensive physical training during youth should be considered as a factor to improve ageing and mortality risk parameters. PMID:27091824

  7. Mediational pathways connecting secondary education and age at marriage to maternal mortality: A comparison between developing and developed countries.

    PubMed

    Hagues, Rachel Joy; Bae, DaYoung; Wickrama, Kandauda K A S

    2017-02-01

    While studies have shown that maternal mortality rates have been improving worldwide, rates are still high across developing nations. In general, poor health of women is associated with higher maternal mortality rates in developing countries. Understanding country-level risk factors can inform intervention and prevention efforts that could bring high maternal mortality rates down. Specifically, the authors were interested in investigating whether: (1) secondary education participation (SEP) or age at marriage (AM) of women were related to maternal mortality rates, and (2) adolescent birth rate and contraceptive use (CU) acted as mediators of this association. The authors add to the literature with this current article by showing the relation of SEP and AM to maternal mortality rates globally (both directly and indirectly through mediators) and then by comparing differences between developed and developing/least developed countries. Path analysis was used to test the hypothesized model using country level longitudinal data from 2000 to 2010 obtained from United Nations publications, World Health Organization materials, and World Bank development reports. Findings include a significant correlation between SEP and AM for developing countries; for developed countries the relation was not significant. As well, SEP in developing countries was associated with increased CU. Women in developing countries who finish school before marriage may have important social capital gains.

  8. Changes in self-perceived economic satisfaction and mortality at old ages: evidence from a survey of middle-aged and elderly adults in Taiwan.

    PubMed

    Lee, Miaw-Chwen; Huang, Nicole

    2015-04-01

    Experiencing a low socioeconomic status (SES) throughout the life course has been reported to be correlated with poor health outcomes. Several studies have suggested that income, wealth, and perceptions of economic status are associated with increased risk of death among elderly people. Few studies have investigated the association between lifetime SES and mortality among elderly adults. The analysis in this study was based on 2310 elderly adults for whom SES data from the four phases of the longitudinal survey of Health and Living Status of the Elderly in Taiwan (1989, 1993, 1996, and 1999) were available, and who were alive in 1999. The SES measures included in the analysis were annual income, the household wealth, and the self-perceived economic satisfaction. A group-based trajectory modelling approach was employed to create SES trajectories. Cox proportional hazard models were employed to examine the association between SES trajectories and 8-year all-cause mortality (1999-2007). Irrespective of whether income, wealth, or self-perceived economic satisfaction was used, the elderly adults with consistently low SES trajectory throughout early old age were independently and significantly associated with higher hazards of mortality than were those in a consistently high SES trajectory. Downward or upward mobility of income and wealth were associated with increased hazard of mortality. However, decreased self-perceived economic satisfaction was not significantly associated with increased hazard of mortality. According to the results, the strong distinction between trajectory patterns of income, wealth, and self-perceived economic satisfaction among elderly adults indicate that neither should be overlooked when investigating the role of SES mobility in mortality. Retirement policies or strategies for maintaining and promoting favorable SES in early old age may benefit the health of elderly adults later in life.

  9. Age and sex-specific mortality of wild and captive populations of a monogamous pair-bonded primate (Aotus azarae).

    PubMed

    Larson, Sam M; Colchero, Fernando; Jones, Owen R; Williams, Lawrence; Fernandez-Duque, Eduardo

    2016-03-01

    In polygynous primates, a greater reproductive variance in males have been linked to their reduced life expectancy relative to females. The mortality patterns of monogamous pair-bonded primates, however, are less clear. We analyzed the sex differences in mortality within wild (NMales  = 70, NFemales  = 73) and captive (NMales  = 25, NFemales  = 29) populations of Azara's owl monkeys (Aotus azarae), a socially and genetically monogamous primate exhibiting biparental care. We used Bayesian Survival Trajectory Analysis (BaSTA) to test age-dependent models of mortality. The wild and captive populations were best fit by the logistic and Gompertz models, respectively, implying greater heterogeneity in the wild environment likely due to harsher conditions. We found that age patterns of mortality were similar between the sexes in both populations. We calculated life expectancy and disparity, the latter a measure of the steepness of senescence, for both sexes in each population. Males and females had similar life expectancies in both populations; the wild population overall having a shorter life expectancy than the captive one. Furthermore, captive females had a reduced life disparity relative to captive males and to both sexes in the wild. We interpret this pattern in light of the hazards associated with reproduction. In captivity, where reproduction is intensely managed, the risks associated with gestation and birth are tempered so that there is a reduction in the likelihood of captive females dying prematurely, decreasing their overall life disparity.

  10. Influence of social support on cognitive change and mortality in old age: results from the prospective multicentre cohort study AgeCoDe

    PubMed Central

    2012-01-01

    Background Social support has been suggested to positively influence cognition and mortality in old age. However, this suggestion has been questioned due to inconsistent operationalisations of social support among studies and the small number of longitudinal studies available. This study aims to investigate the influence of perceived social support, understood as the emotional component of social support, on cognition and mortality in old age as part of a prospective longitudinal multicentre study in Germany. Methods A national subsample of 2,367 primary care patients was assessed twice over an observation period of 18 months regarding the influence of social support on cognitive function and mortality. Perceived social support was assessed using the 14-item version of the FSozU, which is a standardised and validated questionnaire of social support. Cognition was tested by the neuropsychological test battery of the Structured Interview for the Diagnosis of Dementia (SIDAM). The influence of perceived support on cognitive change was analysed by multivariate ANCOVA; mortality was analysed by multivariate logistic and cox regression. Results Sample cognitive change (N = 1,869): Mean age was 82.4 years (SD 3.3) at the beginning of the observation period, 65.9% were female, mean cognition was 49 (SD 4.4) in the SIDAM. Over the observation period cognitive function declined in 47.2% by a mean of 3.4 points. Sample mortality (N = 2,367): Mean age was 82.5 years (SD 3.4), 65.7% were female and 185 patients died during the observation period. Perceived social support showed no longitudinal association with cognitive change (F = 2.235; p = 0.135) and mortality (p = 0.332; CI 0.829-1.743). Conclusions Perceived social support did not influence cognition and mortality over an 18 months observation period. However, previous studies using different operationalisations of social support and longer observation periods indicate that such an influence may exist. This influence is

  11. Mortality at older ages and moves in residential and sheltered housing: evidence from the UK

    PubMed Central

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

    2014-01-01

    Background The study examines the relationship between transitions to residential and sheltered housing and mortality. Past research has focused on housing moves over extended time periods and subsequent mortality. In this paper, annual housing transitions allow the identification of the patterning of housing moves, the duration of stay in each sector and the assessment of the relationship of preceding moves to a heightened risk of dying. Methods The study uses longitudinal data constructed from pooled observations from the British Household Panel Survey (waves 1993–2008). Records were pooled for all cases where the survey member is 65 years or over and living in private housing at baseline and observed at three consecutive time points, including baseline (N=23 727). Binary logistic regression (death as outcome three waves after baseline) explored the relative strength of different housing transitions, controlling for sociodemographic predictors. Results (1) Transition to residential housing within the previous 12 months was associated with the highest mortality risk. (2) Results support existing findings showing an interaction between marital status and mortality, whereby unmarried persons were more likely to die. (3) Higher male mortality was observed across all housing transitions. Conclusions An older person's move to residential housing is associated with a higher risk of mortality within 12 months of the move. Survivors living in residential housing for more than a year, show a similar probability of dying to those living in sheltered housing. Results highlight that it is the type of accommodation that affects an older person's mortality risk, and the length of time they spend there. PMID:24638058

  12. Ending tobacco-caused mortality and morbidity: the case for performance standards for tobacco products.

    PubMed

    Hatsukami, Dorothy K

    2013-05-01

    The US Family Smoking Prevention and Tobacco Control Act and WHO Framework Convention on Tobacco Control provide us with powerful tools to reduce the death and disease caused by the use of tobacco products. One tool that can contribute substantially toward this goal is the authority to establish performance standards for tobacco products. Conjointly with reducing levels of nicotine in cigarettes, performance and quality control standards need to be established for non-combusted tobacco products. Performance standards and incentives should be provided so that tobacco companies are compelled to manufacture and market products with very low or almost non-existent toxicity (eg, nicotine-only products).

  13. Second derivative of the finger photoplethysmogram and cardiovascular mortality in middle-aged and elderly Japanese women.

    PubMed

    Inoue, Noriko; Kawakami, Hideshi; Yamamoto, Hideya; Ito, Chikako; Fujiwara, Saeko; Sasaki, Hideo; Kihara, Yasuki

    2017-02-01

    The second derivative of the digital photoplethysmogram (SDPTG) is an indicator of arterial stiffness. The ratio of the height of the d wave to the a wave of the SDPTG (d/a) is associated with functional peripheral vascular tension and represents aortic-blood pressure (BP) augmented by reflection waves from the periphery. This longitudinal study aimed to investigate the relationship between SDPTG and cardiovascular mortality in middle-aged and elderly Japanese women. From 1998 to 2008, we recruited 4373 women (50-79 years old at baseline) who underwent medical check-ups and SDPTG measurement. The SDPTG index (d/a) was calculated from the wave component height, and was divided into quartiles (Q) according to the d/a value. The median follow-up period was 9.0 years. The d/a value was negatively associated with age and BP, and positively associated with heart rate and body height. Using the Cox proportional hazards model, the hazard ratios for cardiovascular mortality for Q2, Q3 and Q4 were significantly higher than that of Q1. In multivariate analysis, the hazard ratio was 2.30 for Q3 (95% confidence interval (CI): 1.06-4.99, P<0.05) and 2.60 for Q4 (95% CI: 1.21-5.60, P<0.05), after adjustment for age, height, body mass index, BP levels, heart rate and other atherosclerosis-related factors. The hazard ratios of cardiovascular mortality for Q3 and Q4 were significantly higher compared with the reference (Q1). Thus, the SDPTG d/a is an independent predictor of cardiovascular mortality in middle-aged and elderly Japanese women.

  14. Isolated systolic hypertension in Dutch middle aged and all-cause mortality: a 25-year prospective study.

    PubMed

    van den Ban, G C; Kampman, E; Schouten, E G; Kok, F J; van der Heide, R M; van der Heide-Wessel, C

    1989-03-01

    In the early 1950s, the blood pressure of 3901 Dutch civil servants and their spouses aged 40-65 years was measured in a general health survey. Isolated systolic hypertension (systolic pressure greater than 160 mmHg, diastolic pressure less than 90 mmHg) was observed in 6.3% of the women and 3.0% of the men. The prevalence increased with age and it was more common in women in all age groups. Using logistic regression, with adjustment for potential confounders (age, smoking, serum cholesterol, Quetelet index, alcohol consumption, haemoglobin level, pulse rate and diastolic blood pressure) the association of 15- and 25-year total mortality with isolated systolic hypertension was determined. Compared to normotensive people (systolic pressure less than or equal to 135 mmHg, diastolic pressure less than 90 mmHg), the risk of death from all causes was significantly higher for men with isolated systolic hypertension after 15 and 25 years of follow-up (odds ratio OR = 2.4, 95% confidence interval (CI) 1.2-4.8 and OR = 3.2, 95% CI 1.3-8.0). For women 15-years mortality risk was strongly associated with isolated systolic hypertension (OR = 3.7, 95% CI 1.4-9.7). The increased risk was less pronounced after 25 years of follow-up (OR = 1.7, 95% CI 0.96-3.0). Our results support those of other studies and indicate that isolated systolic hypertension is an important independent risk factor for all-cause mortality. Since isolated systolic hypertension may be an indicator for the early onset of ageing, it is important to study its determinants and to pay more attention to its diagnosis and treatment in middle-aged populations.

  15. The Mortality Penalty of Incarceration: Evidence from a Population-based Case-control Study of Working-age Males.

    PubMed

    Pridemore, William Alex

    2014-06-01

    There is a growing body of research on the effects of incarceration on health, though there are few studies in the sociological literature of the association between incarceration and premature mortality. This study examined the risk of male premature mortality associated with incarceration. Data came from the Izhevsk (Russia) Family Study, a large-scale population-based case-control design. Cases (n = 1,750) were male deaths aged 25 to 54 in Izhevsk between October 2003 and October 2005. Controls (n = 1,750) were selected at random from a city population register. The key independent variable was lifetime prevalence of incarceration. I used logistic regression to estimate mortality odds ratios, controlling for age, hazardous drinking, smoking status, marital status, and education. Seventeen percent of cases and 5 percent of controls had been incarcerated. Men who had been incarcerated were more than twice as likely as those who had not to experience premature mortality (odds ratio = 2.2, 95 percent confidence interval: 1.6-3.0). Relative to cases with no prior incarceration, cases who had been incarcerated were more likely to die from infectious diseases, respiratory diseases, non-alcohol-related accidental poisonings, and homicide. Taken together with other recent research, these results from a rigorous case-control design reveal not only that incarceration has durable effects on illness, but that its consequences extend to a greater risk of early death. I draw on the sociology of health literature on exposure, stress, and social integration to speculate about the reasons for this mortality penalty of incarceration.

  16. Improving the Prediction of Mortality and the Need for Life-Saving Interventions in Trauma Patients Using Standard Vital Signs With Heart-Rate Variability and Complexity

    DTIC Science & Technology

    2015-06-01

    IMPROVING THE PREDICTION OF MORTALITY AND THE NEED FOR LIFE-SAVING INTERVENTIONS IN TRAUMA PATIENTS USING STANDARD VITAL SIGNS WITH HEART -RATE...effectiveness of using traditional and new vital signs ( heart rate variability and complexity [HRV, HRC]) for predicting mortality and the need for life...from the point of injury via helicopter. Heart rate variability and HRC were calculated using criterion standard R-R interval sequences manually

  17. The biological standard of living and mortality in Central Italy at the beginning of the 19th century.

    PubMed

    Coppola, Michela

    2013-12-01

    The biological standard of living in Central Italy at the beginning of the 19th century is analyzed using newly collected data on the height of recruits in the army of the Papal States. The results reveal a decline in height for the cohorts born under French rule (1796-1815). Although this trend was common to many parts of Europe, the estimated magnitude of the decline suggests a worsening of the biological standard of living of the working classes in the Papal States even relative to that of other countries. Despite the differences in the economic systems within the Papal States, no significant geographical variation in height has been found: even the most dynamic and advanced regions experienced a dramatic height decline. Mortality also increased during the period under consideration.

  18. Age, differential growth and mortality rates in unexploited populations of Florida gar, an apex predator in the Florida Everglades

    USGS Publications Warehouse

    Murie, D.J.; Parkyn, D.C.; Nico, L.G.; Herod, J.J.; Loftus, W.F.

    2009-01-01

    Florida gar, Lepisosteus platyrhincus DeKay, were sampled in two canal systems in south Florida during 2000-2001 to estimate age, growth and mortality as part of the Everglades ecosystem-restoration effort. Tamiami (C-4) and L-31W canal systems had direct connections to natural wetlands of the Everglades and harboured large Florida gar populations. Of 476 fish aged, maximum ages were 19 and 10years for females and males, respectively. Maximum sizes were also larger for females compared with males (817 vs 602 mm total length). Overall, female Florida gar from both Tamiami and L-31W were larger at age than males from L-31W that, in turn, were larger at any given age than males from Tamiami. Females also had lower rates of annual mortality (Z = 0.21) than males from L-31W (Z = 0.31) or males from Tamiami (Z = 0.54). As a large and long-lived apex predator in the Everglades, Florida gar may structure lower trophic levels. Regional- and sex-specific population parameters for Florida gar will contribute to the simulation models designed to evaluate Everglades restoration alternatives. ?? 2009 Blackwell Publishing Ltd.

  19. Factors associated with morbidity, mortality, and growth of dairy heifer calves up to 3 months of age.

    PubMed

    Windeyer, M C; Leslie, K E; Godden, S M; Hodgins, D C; Lissemore, K D; LeBlanc, S J

    2014-02-01

    Calfhood disease is an important problem on many dairy operations that can have substantial effects on heifer survival and productivity, and has economic and welfare impacts. Neonatal calf diarrhea (NCD) and bovine respiratory disease (BRD) are the most common causes of morbidity and mortality in young dairy cattle. The objective of this observational study was to investigate factors associated with the risks of morbidity and mortality, and with growth, in commercial dairy heifers calves. A total of 2874 heifer calves from 19 commercial dairy farms in Minnesota and Ontario were enrolled at 1-7 days of age and followed for approximately 3 months. Using cut-points of serum total protein of 5.2 and 5.7 g/dl, the incidences of failure of transfer of passive immunity (FTPI) were 11 and 32%, respectively. A cut-point of 5.7 g/dl was the most predictive of BRD before 5 weeks of age (sensitivity=40%, specificity=69%). The positive predictive value was poor (PPV=18%), but the negative predictive value was good (NPV=87%). A cut-point of 5.2g/dl was most predictive of death before 5 weeks of age (sensitivity=27%, specificity=89%, PPV=5%, NPV=98%). Serum total protein during the first week of life was a poor predictor of NCD. Over 23% of calves were treated for diarrhea. Risk factors were weight at enrollment, other diseases before 2 weeks of age, and an interaction between season of birth and herd-level incidence of NCD. Almost 22% of calves were treated at least once for BRD. Factors associated with an increased risk of BRD included herd-level incidence of BRD, season of birth, navel dipping, other diseases before 2 weeks of age, failure of transfer of passive immunity, and manual control of temperature in pre-weaning housing. Administration of supplemental antibody products at birth was associated with a reduced incidence of BRD. Overall mortality was 3.5%. Risk of mortality was increased by treatment for BRD and other diseases. The mean average weight gain was 0.95 kg

  20. Development and Validation of an Age-Risk Score for Mortality Predication after Thermal Injury

    DTIC Science & Technology

    2005-05-01

    Organisms resistant to Sulfamylon appeared; gram-negative sepsis became more common, with a concomitant increase in mortality. 1973–1977 Silver ... sulfadiazine was introduced, and improved control of sepsis was gradually achieved. 1978–1983 Excision of burns was gradually introduced. 1984–1999 In 1983

  1. Early Childbearing, Marital Status, and Women's Health and Mortality after Age 50

    ERIC Educational Resources Information Center

    Henretta, John C.

    2007-01-01

    This article examines the relationship between a woman's childbearing history and her later health and mortality, with primary focus on whether the association between them is due to early and later socioeconomic status. Data are drawn from the Health and Retirement Study birth cohort of 1931-1941. Results indicate that, conditional on reaching…

  2. Multiple, but not traditional risk factors predict mortality in older people: the Concord Health and Ageing in Men Project.

    PubMed

    Hirani, Vasant; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Gnjidic, Danijela; Stanaway, Fiona F; Seibel, Markus J; Waite, Louise M; Handelsman, David J; Cumming, Robert G

    2014-01-01

    This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005-2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors delete time until of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of delete time to time to mortality included in the final model (p < 0.05) were older age, body mass index < 20 kg m(2), high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong non-drinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a

  3. Modeling turbidity type and intensity effects on the growth and starvation mortality of age-0 yellow perch

    USGS Publications Warehouse

    Manning, Nathan M; Bossenbroek, Jonathan M.; Mayer, Christine M.; Bunnell, David B.; Tyson, Jeff T.; Rudstam, Lars G.; Jackson, James R.

    2014-01-01

    We sought to quantify the possible population-level influence of sediment plumes and algal blooms on yellow perch (Perca flavescens), a visual predator found in systems with dynamic water clarity. We used an individual-based model (IBM), which allowed us to include variance in water clarity and the distribution of individual sizes. Our IBM was built with laboratory data showing that larval yellow perch feeding rates increased slightly as sediment turbidity level increased, but that both larval and juvenile yellow perch feeding rates decreased as phytoplankton level increased. Our IBM explained a majority of the variance in yellow perch length in data from the western and central basins of Lake Erie and Oneida Lake, with R2 values ranging from 0.611 to 0.742. Starvation mortality was size dependent, as the greatest daily mortality rates in each simulation occurred within days of each other. Our model showed that turbidity-dependent consumption rates and temperature are key components in determining growth and starvation mortality of age-0 yellow perch, linking fish production to land-based processes that influence water clarity. These results suggest the timing and persistence of sediment plumes and algal blooms can drastically alter the growth potential and starvation mortality of a yellow perch cohort.

  4. Do Hassles Mediate between Life Events and Mortality in Older Men? Longitudinal Findings from the VA Normative Aging Study

    PubMed Central

    Aldwin, Carolyn M.; Jeong, Yu-Jin; Igarashi, Heidi; Choun, Soyoung; Spiro, Avron

    2014-01-01

    We investigated whether hassles mediated the effect of life events on mortality in a sample of 1,293 men (Mage = 65.58, SD = 7.01), participants in the VA Normative Aging Study. We utilized measures of stressful life event (SLE) and hassles from 1989 to 2004, and men were followed for mortality until 2010. For life events and hassles, previous research identified three and four patterns of change over time, respectively, generally indicating low, moderate, and high trajectories, with one moderate, non-linear pattern for hassles (shallow U curve). Controlling for demographics and health behaviors, we found that those with moderate SLE trajectories (38%) more likely to die than those with low SLE trajectories, HR = 1.42, 95% CI [1.16, 3.45]. Including the hassles classes showed that those with the moderate non-linear hassles trajectory were 63% more likely to die than those with low hassles trajectory, HR = 1.63, 95% CI [1.19, 2.23],, while those with consistently high hassles trajectory were over 3 times more likely to die, HR = 3.30, 95% CI [1.58, 6.89]. However, the HR for moderate SLE trajectory decreased only slightly to 1.38, 95% CI [1.13, 1.68], suggesting that the two types of stress have largely independent effects on mortality. Research is needed to determine the physiological and behavioral pathways through which SLE and hassles differentially affect mortality. PMID:24995936

  5. Comparison of Long-Term Mortality of Patients Aged ≤40 Versus >40 Years With Acute Myocardial Infarction.

    PubMed

    Jing, Mingxue; Gao, Fei; Chen, Qifeng; de Carvalho, Leonardo P; Sim, Ling-Ling; Koh, Tian-Hai; Foo, David; Ong, Hean-Yee; Tong, Khim-Leng; Tan, Huay-Cheem; Yeo, Tiong-Cheng; Roe, Matthew T; Chua, Terrance; Chan, Mark Y

    2016-08-01

    Young patients with acute myocardial infarction (MI) have a more favorable prognosis than older patients with MI. However, there are limited data comparing the prognosis of young patients with MI with young population controls. Comparison with an age-matched background population could unmask residual mortality risk in young patients with MI that would otherwise not be apparent when merely comparing the mortality risk of young and older patients with MI. We studied 15,151 patients with AMI from 2000 to 2005, of which 601 patients were ≤40 years (young MI). The relative survival ratio (RSR) was calculated as the ratio of the observed survival of patients with MI divided by the expected survival, estimated from the background population (n = 3,771,700) matched for age, gender, and follow-up year. An RSR of <1.0 or >1.0 indicates poorer or better survival, respectively, than the background population. The 12-year all-cause and cardiovascular mortality of young versus older patients was 12.8% versus 50.7% (p <0.001) and 9.2% versus 34.5% (p <0.001), respectively. The adjusted hazard ratio (95% confidence interval) for all-cause and cardiovascular mortality comparing young with older patients was 0.20 (0.16 to 0.27) and 0.27 (0.20 to 0.36), respectively. The RSR (95% confidence interval) of young and older patients was, respectively, 0.969 (0.950 to 0.980) and 0.804 (0.797 to 0.811) at 1 year, 0.942 (0.918 to 0.960) and 0.716 (0.707 to 0.726) at 5 years, and 0.908 (0.878 to 0.938) and 0.638 (0.620 to 0.654) at 9 years. In conclusion, despite a fivefold lower long-term mortality than older patients with MI, young patients with MI remain at significantly greater risk of long-term mortality than an age-matched background population.

  6. The Effect of Obesity on Incidence of Disability and Mortality in Mexicans Aged 50 Years and Older

    PubMed Central

    Kumar, Amit; Karmarkar, Amol M.; Tan, Alai; Graham, James E.; Arcari, Christine M.; Ottenbacher, Kenneth J.; Snih, Soham Al

    2015-01-01

    Objective To examine the effect of obesity on incidence of disability and mortality among non-disabled older Mexicans at baseline. Material and Methods The sample included 8,415 Mexicans aged ≥50 years from the Mexican Health and Aging Study (2001-2012), who reported no limitations in activities of daily living (ADLs) at baseline and have complete data on all covariates. Socio-demographics, smoking status, comorbidities, ADL activities, and body mass index (BMI) were collected. Results The lowest hazard ratio (HR) for disability was at BMI of 25 to <30 (HR=0.97; 95% confidence interval [CI], 0.85-1.12). The lowest HR for mortality were seen among participants with BMIs 25 to <30 (HR=0.85; 95% CI, 075-0.97), 30 to <35 (HR=0.86; 95 % CI, 0.72-1.02), and ≥35 (HR=0.92; 95 % CI, 0.70-1.22). Conclusion Mexican older adults with a BMI of 25 to <30 were at less risk for both disability and mortality. PMID:26172232

  7. Impact of extreme temperatures on daily mortality in Madrid (Spain) among the 45-64 age-group

    NASA Astrophysics Data System (ADS)

    Díaz, Julio; Linares, Cristina; Tobías, Aurelio

    2006-07-01

    This paper analyses the relationship between extreme temperatures and mortality among persons aged 45-64 years. Daily mortality in Madrid was analysed by sex and cause, from January 1986 to December 1997. Quantitative analyses were performed using generalised additive models, with other covariables, such as influenza, air pollution and seasonality, included as controls. Our results showed that impact on mortality was limited for temperatures ranging from the 5th to the 95th percentiles, and increased sharply thereafter. During the summer period, the effect of heat was detected solely among males in the target age group, with an attributable risk (AR) of 13.3% for circulatory causes. Similarly, NO2 concentrations registered the main statistically significant associations in females, with an AR of 15% when circulatory causes were considered. During winter, the impact of cold was exclusively observed among females having an AR of 7.7%. The magnitude of the AR indicates that the impact of extreme temperature is by no means negligible.

  8. Typical and Optimal Aging in Women and Men: Is There a Double Standard?

    ERIC Educational Resources Information Center

    Canetto, Silvia Sara; And Others

    1995-01-01

    Examined gender stereotypes of typical and optimal mentally healthy aging. Respondents--young adults (n=232) and their older adult relatives/acquaintances (n=233)--reported more gender stereotypes than age stereotypes. Perceptions of typical aging varied with certain factors. Findings suggest a double standard of aging for typical but not for…

  9. Age-standardized Incidence Rates for Leukemia Associated with Consanguineous Marriages in 68 Countries, an Ecological Study

    PubMed Central

    Saadat, Mostafa

    2015-01-01

    Consanguineous marriage that defines as a union between biologically related persons has a variety of known deleterious correlations with factors that affect public health within human populations. To investigate the association between the mean of inbreeding coefficient (α) and incidence of leukemia, the present ecological study on 68 countries was carried out. Statistical analysis showed that the age-standardized incidence rate of leukemia positively correlated with log10GNI per capita (r=0.699, df=66, P<0.001) and negatively correlated with log10α (r=−0.609, df=66, P<0.001). Controlling log10GNI per capita, a significant negative correlation between log10α and the age-standardized incidence rate of leukemia was observed (r=−0.392, df=65, P=0.001). The countries were stratified according to their annual GNI per capita, low and high-income countries with GNI per capita less than and more than 10,000$, respectively. Statistical analysis showed that in high-income countries, after controlling for log10GNI per capita, the correlation between the age-standardized incidence rate of leukemia and log10α was still significant (r=−0.600, df=36, P<0.001). It should be noted that there was no significant association between the age-standardized mortality rate due to leukemia and log10α (P>0.05). The present finding indicates that the rate of leukemia, age-standardized for incidence, is lower in countries with a high prevalence of consanguineous marriages. PMID:25960855

  10. Effects of bait age and prior protein feeding on cumulative time-dependent mortality of Anastrepha ludens (Diptera: Tephritidae) exposed to GF-120 spinosad baits.

    PubMed

    Mangan, Robert L

    2009-06-01

    A fruit fly bait to attract and kill adult fruit flies, GF-120, was tested in cages to determine effects of pretreatment diet and bait aging before use on cumulative mortality rates of Mexican fruit fly, Anastrepha ludens (Loew) (Diptera: Tephritidae). Protein-starved and protein-fed, 9-d-old flies both experienced varying overall cumulative mortality at 4, 8, 24, and 48 h. Pretreatment diet had no significant effect on mortality. Overall mortality rates were below 10% for 4 h, 39-43% at 8 h, but mortality in all treatments increased to 89-93% by 24 h, and 99% by 48 h. In a second experiment, GF-120 baits were either freshly prepared or aged for 24 h. Subtreatments consisted of protein-fed and protein-starved flies. The 24-h-aged bait killed significantly more flies at 4 and 8 h than the freshly prepared bait. Protein-starved flies had significantly higher mortality at 4 h and marginally higher mortality at 8 h than protein-fed flies. At 24 and 48 h, there were no significant differences among treatments, and overall morality rose to 99-100% by 48 h. These results may explain differences noted in previous publications in which fruit fly mortality to GF-120 was reported as unusually low as well as reports of bait ineffectiveness for protein-fed flies. The overall impact of any initial repellency of GF-120 seems negligible as judged by overall cumulative mortality at later evaluation times.

  11. Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis

    PubMed Central

    Mayo-Wilson, Evan; Imdad, Aamer; Herzer, Kurt; Yakoob, Mohammad Yawar

    2011-01-01

    Objective To determine if vitamin A supplementation is associated with reductions in mortality and morbidity in children aged 6 months to 5 years. Design Systematic review and meta-analysis. Two reviewers independently assessed studies for inclusion. Data were double extracted; discrepancies were resolved by discussion. Meta-analyses were performed for mortality, illness, vision, and side effects. Data sources Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline, Embase, Global Health, Latin American and Caribbean Health Sciences, metaRegister of Controlled Trials, and African Index Medicus. Databases were searched to April 2010 without restriction by language or publication status. Eligibility criteria for selecting studies Randomised trials of synthetic oral vitamin A supplements in children aged 6 months to 5 years. Studies of children with current illness (such as diarrhoea, measles, and HIV), studies of children in hospital, and studies of food fortification or β carotene were excluded. Results 43 trials with about 215 633 children were included. Seventeen trials including 194 483 participants reported a 24% reduction in all cause mortality (rate ratio=0.76, 95% confidence interval 0.69 to 0.83). Seven trials reported a 28% reduction in mortality associated with diarrhoea (0.72, 0.57 to 0.91). Vitamin A supplementation was associated with a reduced incidence of diarrhoea (0.85, 0.82 to 0.87) and measles (0.50, 0.37 to 0.67) and a reduced prevalence of vision problems, including night blindness (0.32, 0.21 to 0.50) and xerophthalmia (0.31, 0.22 to 0.45). Three trials reported an increased risk of vomiting within the first 48 hours of supplementation (2.75, 1.81 to 4.19). Conclusions Vitamin A supplementation is associated with large reductions in mortality, morbidity, and vision problems in a range of settings, and these results cannot be explained by bias. Further placebo controlled trials of vitamin A supplementation

  12. Improved Blood Pressure Control to Reduce Cardiovascular Disease Morbidity and Mortality: The Standardized Hypertension Treatment and Prevention Project.

    PubMed

    Patel, Pragna; Ordunez, Pedro; DiPette, Donald; Escobar, Maria Cristina; Hassell, Trevor; Wyss, Fernando; Hennis, Anselm; Asma, Samira; Angell, Sonia

    2016-12-01

    Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. While hypertension can be successfully diagnosed and treated, only one in seven persons with hypertension have controlled blood pressure. To meet the challenge of improving the control of hypertension, particularly in low- and middle-income countries, the authors developed the Standardized Hypertension Treatment and Prevention Project, which involves a health systems-strengthening approach that advocates for standardized hypertension management using evidence-based interventions. These interventions include the use of standardized treatment protocols, a core set of medications along with improved procurement mechanisms to increase the availability and affordability of these medications, registries for cohort monitoring and evaluation, patient empowerment, team-based care (task shifting), and community engagement. With political will and strong partnerships, this approach provides the groundwork to reduce high blood pressure and cardiovascular disease-related morbidity and mortality.

  13. Is It Possible to Prove the Existence of an Aging Program by Quantitative Analysis of Mortality Dynamics?

    PubMed

    Shilovsky, G A; Putyatina, T S; Lysenkov, S N; Ashapkin, V V; Luchkina, O S; Markov, A V; Skulachev, V P

    2016-12-01

    Accumulation of various types of lesions in the course of aging increases an organism's vulnerability and results in a monotonous elevation of mortality rate, irrespective of the position of a species on the evolutionary tree. Stroustrup et al. (Nature, 530, 103-107) [1] showed in 2016 that in the nematode Caenorhabditis elegans, longevity-altering factors (e.g. oxidative stress, temperature, or diet) do not change the shape of the survival curve, but either stretch or shrink it along the time axis, which the authors attributed to the existence of an "aging program". Modification of the accelerated failure time model by Stroustrup et al. uses temporal scaling as a basic approach for distinguishing between quantitative and qualitative changes in aging dynamics. Thus we analyzed data on the effects of various longevity-increasing genetic manipulations in flies, worms, and mice and used several models to choose a theory that would best fit the experimental results. The possibility to identify the moment of switch from a mortality-governing pathway to some other pathways might be useful for testing geroprotective drugs. In this work, we discuss this and other aspects of temporal scaling.

  14. The reverse J shaped association between serum total 25- hydroxyvitamin D and all-cause mortality: The impact of assay standardization

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The impact of standardizing the originally measured serum total 25-hydroxyvitamin D [25(OH)D] values from Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) on the association between 25(OH)D and rate of all-cause mortality was evaluated. Values were standardized to gold ...

  15. Survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to stabilization centers in Gedeo Zone: a retrospective cohort study.

    PubMed

    Girum, Tadele; Kote, Mesfin; Tariku, Befikadu; Bekele, Henok

    2017-01-01

    Despite the existence of standard protocol, many stabilization centers (SCs) continue to experience high mortality of children receiving treatment for severe acute malnutrition. Assessing treatment outcomes and identifying predictors may help to overcome this problem. Therefore, a 30-month retrospective cohort study was conducted among 545 randomly selected medical records of children <5 years of age admitted to SCs in Gedeo Zone. Data was entered by Epi Info version 7 and analyzed by STATA version 11. Cox proportional hazards model was built by forward stepwise procedure and compared by the likelihood ratio test and Harrell's concordance, and fitness was checked by Cox-Snell residual plot. During follow-up, 51 (9.3%) children had died, and 414 (76%) and 26 (4.8%) children had recovered and defaulted (missed follow-up for 2 consecutive days), respectively. The survival rates at the end of the first, second and third weeks were 95.3%, 90% and 85%, respectively, and the overall mean survival time was 79.6 days. Age <24 months (adjusted hazard ratio [AHR] =2.841, 95% confidence interval [CI] =1.101-7.329), altered pulse rate (AHR =3.926, 95% CI =1.579-9.763), altered temperature (AHR =7.173, 95% CI =3.05-16.867), shock (AHR =3.805, 95% CI =1.829-7.919), anemia (AHR =2.618, 95% CI =1.148-5.97), nasogastric tube feeding (AHR =3.181, 95% CI =1.18-8.575), hypoglycemia (AHR =2.74, 95% CI =1.279-5.87) and treatment at hospital stabilization center (AHR =4.772, 95% CI =1.638-13.9) were independent predictors of mortality. The treatment outcomes and incidence of death were in the acceptable ranges of national and international standards. Intervention to further reduce deaths has to focus on young children with comorbidities and altered general conditions.

  16. Isolated Systolic Hypertension in Young and Middle-Aged Adults and 31-Year Risk for Cardiovascular Mortality

    PubMed Central

    Yano, Yuichiro; Stamler, Jeremiah; Garside, Daniel B.; Daviglus, Martha L.; Franklin, Stanley S.; Carnethon, Mercedes R.; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald M.

    2016-01-01

    BACKGROUND Isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) ≥140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg, in younger and middle-aged adults is increasing in prevalence. OBJECTIVE The aim of this study was to assess the risk for cardiovascular disease (CVD) with ISH in younger and middle-aged adults. METHODS CVD risks were explored in 15,868 men and 11,213 women 18 to 49 years of age (mean age 34 years) at baseline, 85% non-Hispanic white, free of coronary heart disease (CHD) and antihypertensive therapy, from the Chicago Heart Association Detection Project in Industry study. Participant classifications were as follows: 1) optimal-normal blood pressure (BP) (SBP <130 mm Hg and DBP <85 mm Hg); 2) high-normal BP (130 to 139/85 to 89 mm Hg); 3) ISH; 4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg); and 5) systolic diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg). RESULTS During a 31-year average follow-up period (842,600 person-years), there were 1,728 deaths from CVD, 1,168 from CHD, and 223 from stroke. Cox proportional hazards models were adjusted for age, race, education, body mass index, current smoking, total cholesterol, and diabetes. In men, with optimal-normal BP as the reference stratum, hazard ratios for CVD and CHD mortality risk for those with ISH were 1.23 (95% confidence interval [CI]: 1.03 to 1.46) and 1.28 (95% CI: 1.04 to 1.58), respectively. ISH risks were similar to those with high-normal BP and less than those associated with isolated diastolic hypertension and systolic diastolic hypertension. In women with ISH, hazard ratios for CVD and CHD mortality risk were 1.55 (95% CI: 1.18 to 2.05) and 2.12 (95% CI: 1.49 to 3.01), respectively. ISH risks were higher than in those with high-normal BP or isolated diastolic hypertension and less than those associated with systolic diastolic hypertension. CONCLUSIONS Over long-term follow-up, younger and middle-aged adults with ISH

  17. Mortality in active adults age 70-79 years in relation to performance in a long-distance corridor walk.

    PubMed

    Singer, Richard B

    2009-01-01

    The authors conducted the source study to determine if a brisk corridor walk of 400 meters could be used to classify the performance of active older adults and relate this performance to mortality and other outcomes over a 6-year follow-up. The cohort consisted of 3075 adults resident in designated ZIP codes in Pittsburgh, Pa, and Memphis, Tenn, participating in the Health Aging and Body Composition Study. Out of this cohort, 395 subjects were excluded after evaluation revealed abnormal vital signs or ECG findings, recent cardiac symptoms, recent surgery, recent chest pain, shortness of breath or fainting. Another 356 subjects were unable to complete the 400-meter walk. The 2324 subjects who completed the walk were divided into quartiles according to the time in seconds required for completion (the overall time required ranged widely from 201 to 942 seconds). These 3 groups were designated as "excluded," "stopped," and "completed." Outcomes reported for the 3075 subjects in the total cohort included mortality, new cardiovascular disease events, mobility limitation, and mobility disability. Cardiovascular events were reported for the 2234 subjects (73% of the total) who were free of cardiovascular disease at entry. Results in the article were given in tables and figures and included numbers of entrants, exposures, and events, annual event rates and hazard ratios with SDs. Out of the 3075 entrant subjects, 430 died in the 6 years of follow-up (FU). Excess mortality measured as excess death rate (EDR) was much higher in the excluded and stopped groups (about 22 per 1000 per year) compared with an EDR of 6.4 per 1000 in the completed group. The corresponding mortality ratios (MR), designated as a hazard ratio in the article were about 220% and 135%. Results for comparative morbidity are also given in this abstract.

  18. Historical perspective on induced abortion through the ages and its links with maternal mortality.

    PubMed

    Drife, James Owen

    2010-08-01

    Abortion is mentioned in ancient medical texts but the effectiveness of the methods described is doubtful. Attitudes varied from apparent disapproval by Hippocrates to open approval in Ancient Rome. In mediaeval times abortion was practised by women in secret and this continued during the 19th and early 20th centuries. Despite being illegal in England induced abortion became more common in Victorian times as the population grew. At the same time the link between criminal abortion and maternal mortality became increasingly clear, and if a woman died after a procedure the abortionist (sometimes a midwife) could be sentenced to death. The law was more tolerant of abortions performed by registered doctors. In the 20th century pressure grew for its legalisation. At the time of the 1967 Abortion Act, abortion was the leading cause of maternal death in the UK but within fifteen years death from illegal abortion had been abolished.

  19. [Age, marital status, fecundity and mortality of the population of Colombia: demographic results of the National Household Survey, June 1978].

    PubMed

    1980-06-01

    This paper presents the results of the National Household Survey conducted in Colombia in June 1978, which covered about 0.2% of the total population, and which interviewed 60,000 people in rural and in urban areas. Main findings were: 1) a decrease in the percentage of the population aged 0-4, and 5-9, as compared to the population aged 10-14; 2) a decrease in the number of live births, especially in young women; and, 3) average parity per woman was 3.7, a decrease of 12% since 1976. Crude birth rate was measured to be 27.4/1000, while it was 31.1/1000 in 1976. Life expectancy was estimated to be 65.1 for women, and 55.1 for men, much too low to be acceptable, and possibly caused by wrong information given to interviewers. Total mortality was 6.7/1000, too low to be acceptable, while infant mortality was 69/1000.

  20. Association between gross domestic product throughout the life course and old-age mortality across birth cohorts: parallel analyses of seven European countries, 1950-1999.

    PubMed

    Janssen, Fanny; Kunst, Anton E; Mackenbach, Johan P

    2006-07-01

    Mortality levels of national populations have often been studied in relation to levels of gross domestic product (GDP) at time of death. Following the life course perspective, we assessed whether old-age mortality levels for subsequent cohorts are differentially associated with GDP levels prevailing at different ages of the cohorts. We used all-cause and cause-specific mortality data by sex, age at death (65-99), year at death (1950-1999), and year of birth (1865-1924) for Denmark, England and Wales, Finland, France, the Netherlands, Norway, and Sweden. Trends in national GDP per capita between 1865 and 1999 were reconstructed from historical national accounts data. Through Poisson regression analyses, we determined for each country both univariate and multivariate associations across five-year birth cohorts between mortality and GDP levels prevailing at time of death, and at earlier ages of the cohorts (i.e. 0-5, 6-19, 20-49, and 50-64). For the subsequent cohorts, levels of GDP at time of death were strongly inversely associated with all-cause mortality, especially among women, and among men in England and Wales, Finland, and France. In most countries, stronger associations were observed with GDP levels prevailing at earlier ages of the cohorts. After control for GDP at time of death, these associations remained. An independent association of GDP at earlier ages of the cohort was also observed for cause-specific mortality. The associations were negative for ischaemic heart diseases, cerebrovascular diseases, and stomach cancer. They were positive for prostate cancer, breast cancer, COPD (women), and lung cancer (women). GDP prevailing at ages 20-49 (men) and ages 50-64 (women) had the largest associations with old-age mortality. These findings suggest an independent, mostly negative effect of GDP prevailing at earlier ages of subsequent cohorts on old-age mortality. Socio-economic circumstances during adulthood and middle age seem more important in determining

  1. Maternal age, gravidity, and pregnancy spacing effects on spontaneous fetal mortality.

    PubMed

    Casterline, J B

    1989-01-01

    Differentials in the probability of pregnancy loss are examined using pregnancy history data from eight WFS surveys in developing countries. Multiple logistic regression equations are estimated. The probability of loss varies substantially over the reproductive career. Both higher-order pregnancies and those conceived at older ages are more likely to terminate in loss. maternal age differentials are more pronounced for lower-order pregnancies. First and second pregnancies conceived over age thirty suffer especially high levels of loss. Pregnancies conceived relatively soon after the termination of the previous pregnancy are more likely to be lost, as are pregnancies conceived after long intervals. Risk of loss is higher for women previously experiencing loss, and the effect persists beyond the pregnancy following the loss.

  2. Sex and age mortality responses in zinc acetate-treated mice

    SciTech Connect

    Hogan, G.R.; Cole, B.S.; Lovelace, J.M.

    1987-07-01

    In regard to trace metal treatment or exposure, a number of variables are known to affect the expression of toxicity concerning its time course and degree. For example, known variables are route of administration, anionic component of the test substance, and sex and age of the recipient animal. Concerning the latter, little, if any, data have been reported dealing with sex- and age-related responses to excess zinc in mammalian systems. The primary purpose of the short communication presented here focuses on the determination of median lethal dose in sexually immature, i.e., juvenile, and adult female and male mice following a single zinc acetate insult. In addition, variation of lethality responses was examined with the age and sex groups to a divided treatment of a lethal dosage of zinc acetate, the injections of which were separated by various intervals.

  3. How the effects of aging and stresses of life are integrated in mortality rates: insights for genetic studies of human health and longevity.

    PubMed

    Yashin, Anatoliy I; Arbeev, Konstantin G; Arbeeva, Liubov S; Wu, Deqing; Akushevich, Igor; Kovtun, Mikhail; Yashkin, Arseniy; Kulminski, Alexander; Culminskaya, Irina; Stallard, Eric; Li, Miaozhu; Ukraintseva, Svetlana V

    2016-02-01

    Increasing proportions of elderly individuals in developed countries combined with substantial increases in related medical expenditures make the improvement of the health of the elderly a high priority today. If the process of aging by individuals is a major cause of age related health declines then postponing aging could be an efficient strategy for improving the health of the elderly. Implementing this strategy requires a better understanding of genetic and non-genetic connections among aging, health, and longevity. We review progress and problems in research areas whose development may contribute to analyses of such connections. These include genetic studies of human aging and longevity, the heterogeneity of populations with respect to their susceptibility to disease and death, forces that shape age patterns of human mortality, secular trends in mortality decline, and integrative mortality modeling using longitudinal data. The dynamic involvement of genetic factors in (i) morbidity/mortality risks, (ii) responses to stresses of life, (iii) multi-morbidities of many elderly individuals, (iv) trade-offs for diseases, (v) genetic heterogeneity, and (vi) other relevant aging-related health declines, underscores the need for a comprehensive, integrated approach to analyze the genetic connections for all of the above aspects of aging-related changes. The dynamic relationships among aging, health, and longevity traits would be better understood if one linked several research fields within one conceptual framework that allowed for efficient analyses of available longitudinal data using the wealth of available knowledge about aging, health, and longevity already accumulated in the research field.

  4. Comparing Changes in Late-Life Depressive Symptoms across Aging, Disablement, and Mortality Processes

    ERIC Educational Resources Information Center

    Fauth, Elizabeth B.; Gerstorf, Denis; Ram, Nilam; Malmberg, Bo

    2014-01-01

    Developmental processes are inherently time-related, with various time metrics and transition points being used to proxy how change is organized with respect to the theoretically underlying mechanisms. Using data from 4 Swedish studies of individuals aged 70-100+ (N = 453) who were measured every 2 years for up to 5 waves, we tested whether…

  5. Relationship between socioeconomic status and mortality after femur fracture in a Korean population aged 65 years and older

    PubMed Central

    Shin, Jaeyong; Choi, Young; Lee, Sang Gyu; Kim, Woorim; Park, Eun-Cheol; Kim, Tae Hyun

    2016-01-01

    Abstract Femur fracture is an emerging public health concern in aging societies, owing to the substantially high morbidity and mortality. Because the recent increase in femur fracture incidence in Asian populations is comparable to that in the West, it is necessary to investigate the association between socioeconomic status (SES) and mortality after femur fracture in developed Asian societies. Data were obtained from the National Health Insurance Claims Database. During 2002 to 2013, femur fractures were newly diagnosed in 5441 patients among 1025,340 enrollees. Multiple logistic regression and the Cox proportional model were used to investigate the associations between individual SES and probability of surgery and mortality after femur fracture. Of 5441 patients, 1928 (35.4%) received surgery. Patients with low (odds ratio [OR] = 0.87, 95% confidence interval [CI]: 0.75–0.99) and middle (OR = 0.85, 95% CI: 0.74–0.98) income were less likely to undergo surgery than high-income patients. Patients with low (hazard ratio [HR] = 1.12, 95% CI: 1.01–1.24) and middle (HR = 1.20, 95% CI: 1.08–1.33) income had a higher HR for mortality. This difference was more prominent in patients who underwent surgery (low income: HR = 1.07, 95% CI: 0.94–1.21; middle income: HR = 1.18, 95% CI: 1.04–1.33) than in patients with conservative treatment (low income: HR = 1.24, 95% CI: 1.04–1.49; middle income: HR = 1.30, 95% CI: 1.08–1.56). Femur-fracture patients with low SES are less likely to receive surgery for and more likely to die after femur fracture. The difference in mortality risk remained even when only the patients who received surgery were considered, suggesting that we need to consider support measures for these deprived patients. PMID:27930508

  6. Association of regular physical activity with total and cause-specific mortality among middle-aged and older Chinese: a prospective cohort study.

    PubMed

    Zhou, Yun; Zhang, Runbo; Liu, Yuewei; Guo, Yanjun; Wang, Dongming; He, Meian; Yuan, Jing; Liang, Yuan; Zhang, Xiaomin; Wang, Youjie; Guo, Huan; Wei, Sheng; Miao, Xiaoping; Yao, Ping; Wu, Tangchun; Chen, Weihong

    2017-01-04

    Association between physical activity and mortality has rarely been investigated among the Chinese population. Furthermore, the most appropriate amount of physical activity for longevity benefits remains unclear. We used data from the Dongfeng-Tongji cohort, including 24,606 middle-aged and older retired adults in 2008 and followed to 2013, to quantify linear and non-linear dose-response relationships between regular physical activity and mortality risks by Cox proportional hazards model. Compared with participants who did not engage in regular physical activity, those performing regular physical activity had significantly 46%, 56%, and 49% decreased risks of mortality from all causes, circulatory, and respiratory diseases, respectively. Each one-SD increase in regular physical activity was associated with 32% decrease of respiratory disease mortality. There were significant nonlinear dose-response associations between regular physical activity and mortality from all causes and circulatory diseases. Mortality risks decreased monotonically with increased regular physical activity amount, and appeared to reach a threshold at around 100 MET-hours/week. More mortality benefits were found among non-smokers than that among current and former smokers. Our results suggest that middle-aged and older Chinese adults can achieve mortality benefits from regular physical activity at the WHO recommended minimum, and the benefit threshold appears at approximately 100 MET hours/week.

  7. Association of regular physical activity with total and cause-specific mortality among middle-aged and older Chinese: a prospective cohort study

    PubMed Central

    Zhou, Yun; Zhang, Runbo; Liu, Yuewei; Guo, Yanjun; Wang, Dongming; He, Meian; Yuan, Jing; Liang, Yuan; Zhang, Xiaomin; Wang, Youjie; Guo, Huan; Wei, Sheng; Miao, Xiaoping; Yao, Ping; Wu, Tangchun; Chen, Weihong

    2017-01-01

    Association between physical activity and mortality has rarely been investigated among the Chinese population. Furthermore, the most appropriate amount of physical activity for longevity benefits remains unclear. We used data from the Dongfeng-Tongji cohort, including 24,606 middle-aged and older retired adults in 2008 and followed to 2013, to quantify linear and non-linear dose-response relationships between regular physical activity and mortality risks by Cox proportional hazards model. Compared with participants who did not engage in regular physical activity, those performing regular physical activity had significantly 46%, 56%, and 49% decreased risks of mortality from all causes, circulatory, and respiratory diseases, respectively. Each one-SD increase in regular physical activity was associated with 32% decrease of respiratory disease mortality. There were significant nonlinear dose-response associations between regular physical activity and mortality from all causes and circulatory diseases. Mortality risks decreased monotonically with increased regular physical activity amount, and appeared to reach a threshold at around 100 MET-hours/week. More mortality benefits were found among non-smokers than that among current and former smokers. Our results suggest that middle-aged and older Chinese adults can achieve mortality benefits from regular physical activity at the WHO recommended minimum, and the benefit threshold appears at approximately 100 MET hours/week. PMID:28051177

  8. Relationships between Chronological Age, Developmental Age, and Standardized Achievement Tests in Kindergarten.

    ERIC Educational Resources Information Center

    Freberg, Laura

    1991-01-01

    Evaluated chronological age and results of Gesell School Readiness Test as predictors of kindergarten performance as measured by Stanford Achievement Test. Results from 284 kindergarten children indicated that both chronological and developmental age provided good predictors of Stanford Achievement Test performance in kindergarten. Findings have…

  9. Varying Teacher Expectations and Standards: Curriculum Differentiation in the Age of Standards-Based Reform

    ERIC Educational Resources Information Center

    Harris, Donna M.

    2012-01-01

    Ability grouping and tracking have been a major focus in educational research because of its role in promoting curriculum differentiation. However, there has been limited attention to how this differentiation occurs in contemporary schools involved with reform efforts including those focused on subject specific academic standards designed to…

  10. AGED PLASMA TRANSFUSION INCREASES MORTALITY IN A RAT MODEL OF UNCONTROLLED HEMORRHAGE

    PubMed Central

    Letourneau, Phillip A.; McManus, Madonna; Sowards, Kendell; Wang, Weiwei; Wang, Yao-wei; Matijevic, Nena; Pati, Shibani; Wade, Charles E.; Holcomb, John B.

    2011-01-01

    Introduction Recent data has associated improved survival after hemorrhagic shock with the early use of plasma based resuscitation. Our lab has shown that FFP5 has decreased hemostatic potential compared to freshly thawed plasma (FFP0). We hypothesized that FFP5 would increase bleeding and mortality compared to FFP0 in a rodent bioassay model of uncontrolled liver hemorrhage. Methods Hemostatic potential of plasma was assessed with the Calibrated Automated Thrombogram (CAT) assay. Rats underwent isovolemic hemodilution by 15% of blood volume with the two human plasma groups (FFP0 and FFP5) and two controls (sham and lactated Ringers). A liver injury was created by excising a portion of liver resulting in uncontrolled hemorrhage. Rats that lived for 30 minutes after liver injury were resuscitated to their baseline blood pressure and followed for 6 hours. Hemostasis was assessed by thromboelastography. Results Hemostatic potential of FFP5 decreased significantly in all areas measured in the CAT assay as compared to FFP0 (p<0.01). In the FFP5 group overall survival was 54%, compared to 100% in the FFP0 and sham group (p=0.03). For animals that survived 30 minutes and were resuscitated, there was no difference in bleeding and/or coagulopathy between groups. Irrespective of treatment, animals that died following resuscitation demonstrated increased intraperitoneal fluid volume (14.85 ± 1.9 mL vs. 7.02 ± 0.3 mL, p<0.001). Conclusion In this model of mild pre-injury hemodilution with plasma, rats that received FFP5 had decreased survival after uncontrolled hemorrhage from hepatic injury. There were no differences in coagulation function or intraperitoneal fluid volume between the two plasma groups. PMID:22071917

  11. Impact of Malaria Control on Mortality and Anemia among Tanzanian Children Less than Five Years of Age, 1999–2010

    PubMed Central

    Smithson, Paul; Florey, Lia; Salgado, S. Rene; Hershey, Christine L.; Masanja, Honorati; Bhattarai, Achuyt; Mwita, Alex; McElroy, Peter D.

    2015-01-01

    Background Mainland Tanzania scaled up multiple malaria control interventions between 1999 and 2010. We evaluated whether, and to what extent, reductions in all-cause under-five child mortality (U5CM) tracked with malaria control intensification during this period. Methods Four nationally representative household surveys permitted trend analysis for malaria intervention coverage, severe anemia (hemoglobin <8 g/dL) prevalence (SAP) among children 6–59 months, and U5CM rates stratified by background characteristics, age, and malaria endemicity. Prevalence of contextual factors (e.g., vaccination, nutrition) likely to influence U5CM were also assessed. Population attributable risk percentage (PAR%) estimates for malaria interventions and contextual factors that changed over time were used to estimate magnitude of impact on U5CM. Results Household ownership of insecticide-treated nets (ITNs) rose from near zero in 1999 to 64% (95% CI, 61.7–65.2) in 2010. Intermittent preventive treatment of malaria in pregnancy reached 26% (95% CI, 23.6–28.0) by 2010. Sulfadoxine-pyrimethamine replaced chloroquine in 2002 and artemisinin-based combination therapy was introduced in 2007. SAP among children 6–59 months declined 50% between 2005 (11.1%; 95% CI, 10.0–12.3%) and 2010 (5.5%; 95% CI, 4.7–6.4%) and U5CM declined by 45% between baseline (1995–9) and endpoint (2005–9), from 148 to 81 deaths/1000 live births, respectively. Mortality declined 55% among children 1–23 months of age in higher malaria endemicity areas. A large reduction in U5CM was attributable to ITNs (PAR% = 11) with other malaria interventions adding further gains. Multiple contextual factors also contributed to survival gains. Conclusion Marked declines in U5CM occurred in Tanzania between 1999 and 2010 with high impact from ITNs and ACTs. High-risk children (1–24 months of age in high malaria endemicity) experienced the greatest declines in mortality and SAP. Malaria control should remain a

  12. Burden and trend analysis of injury mortality in China among children aged 0–14 years from 2004 to 2011

    PubMed Central

    Yin, Zhaoxue; Wu, Jing; Luo, Jiesi; Pak, Anita WP; Choi, Bernard CK; Liang, Xiaofeng

    2015-01-01

    Objective To track changes of the burden and trends of childhood injury mortality among children aged 0–14 years in China from 2004 to 2011. Design National representative data from the Chinese Disease Surveillance Points system and Chinese Maternal and Child Mortality Surveillance system from 2004 to 2011 were used. Rates and 95% CIs of aged-standardised mortality, as well as the proportions of injury death, were estimated. Setting Urban and rural China. Participants Children aged 0–14 years from 2004 to 2011. Results The proportion of injury among all deaths in children increased from 18.69% in 2004 to 21.26% in 2011. A ‘V’ shape change was found in the age-standardised injury mortality rate during the study period among the children aged 0–14 years, with the age-standardised injury mortality rate decreasing from 29.71 per 100 000 per year in 2004 to 24.12 in 2007, and then increasing to 28.12 in 2011. A similar change was observed in the rural area. But the age-standardised mortality rate decreased consistently in the urban area. The rate was higher among boys than among girls. Drowning, road traffic accidents and falls were consistently the top three causes of death among children. Conclusions Childhood injury is an increasingly serious public health problem in China. The increasing trend of childhood injury mortality is driven by the rural areas rather than urban areas. More effective strategies and measures for injury prevention and control are needed for rural areas, boys, drowning, road traffic accidents and falls. PMID:26137882

  13. Age- and Sex-Specific Trends in Lung Cancer Mortality over 62 Years in a Nation with a Low Effort in Cancer Prevention

    PubMed Central

    John, Ulrich; Hanke, Monika

    2016-01-01

    Background: A decrease in lung cancer mortality among females below 50 years of age has been reported for countries with significant tobacco control efforts. The aim of this study was to describe the lung cancer deaths, including the mortality rates and proportions among total deaths, for females and males by age at death in a country with a high smoking prevalence (Germany) over a time period of 62 years. Methods: The vital statistics data were analyzed using a joinpoint regression analysis stratified by age and sex. An age-period-cohort analysis was used to estimate the potential effects of sex and school education on mortality. Results: After an increase, lung cancer mortality among women aged 35–44 years remained stable from 1989 to 2009 and decreased by 10.8% per year from 2009 to 2013. Conclusions: Lung cancer mortality among females aged 35–44 years has decreased. The potential reasons include an increase in the number of never smokers, following significant increases in school education since 1950, particularly among females. PMID:27023582

  14. Hannelore Wass: Insights Into Creative Teaching and Other Ways of Knowing When Facing Aging and Mortality.

    PubMed

    Bertman, Sandra

    2015-01-01

    Art is about freeze framing life and making it available for contemplation. This article describes creative strategies for teaching meaning-making and critical thinking through the use of imagery and the visual arts and how they have been influenced by the wisdom and guidance of Dr. Hannelore Wass. Dr. Wass's passion for encouraging death educators to explore "other ways of knowing" is reflected in the connections between visual imagery and topics such as caregiving, aging, self-care, and professional boundaries. The group known as Women in Thanatology as a mechanism for professional mentoring and support is described, including Dr. Wass's role in its history and evolution.

  15. Age, growth and mortality of Clarias gariepinus (Siluriformes: Clariidae) in the Mid-Cross River-Floodplain ecosystem, Nigeria.

    PubMed

    Okogwu, Okechukwu Idumah

    2011-12-01

    Clarias gariepinus is a threatened highly prized species used for some elite ceremonies by the local communities. Artisanal fishers take advantage of this species annual breeding migration from the lower Cross River to the floodplain lakes in Mid-Cross River during the rainy season, and some migrant stocks are not able to spawn. Since there is a lack of information on this species population dynamics in the Mid-Cross area, this study aimed to evaluate the age, growth and mortality to support the development of effective management plans. For this, monthly overnight gill net catches (from 6 to 72mm mesh sizes) were developed between March 2005 and February 2007. Growth parameters were determined using the FiSAT II length-frequency distribution. A total of 1 421 fish were collected during the survey. The asymptotic growth (L(infinity)) was 80.24cm, growth rate (K) was 0.49/year while the longevity was 6.12 years. The annual instantaneous rate of total mortality (Z) was 2.54/year and the natural mortality (M) was 0.88. Fishing mortality (1.66/year) was higher than the biological reference points (F(opt) = 0.83 and F(limit) = 1.11) and the exploitation rate (0.66) was higher than the predicted value (E(max) = 0.64) indicating that C. gariepinus was over exploited in the Mid-Cross River-Floodplain ecosystem. Some recommended immediate management actions are to strengthen the ban of ichthyocide fishing, closure of the floodplain lakes for most of the year, restricted access to the migratory path of the fish during the flood period and vocational training to the fishers. In order to recover and maintain a sustainable harvest, I suggest that a multi-sector stakeholder group should be formed with governmental agents, community leaders, fishers, fisheries scientists and non-governmental organizations. These short and long term measures, if carefully applied, will facilitate recovery of the fishery.

  16. 230Th-234U Model-Ages of Some Uranium Standard Reference Materials

    SciTech Connect

    Williams, R W; Gaffney, A M; Kristo, M J; Hutcheon, I D

    2009-05-28

    The 'age' of a sample of uranium is an important aspect of a nuclear forensic investigation and of the attribution of the material to its source. To the extent that the sample obeys the standard rules of radiochronometry, then the production ages of even very recent material can be determined using the {sup 230}Th-{sup 234}U chronometer. These standard rules may be summarized as (a) the daughter/parent ratio at time=zero must be known, and (b) there has been no daughter/parent fractionation since production. For most samples of uranium, the 'ages' determined using this chronometer are semantically 'model-ages' because (a) some assumption of the initial {sup 230}Th content in the sample is required and (b) closed-system behavior is assumed. The uranium standard reference materials originally prepared and distributed by the former US National Bureau of Standards and now distributed by New Brunswick Laboratory as certified reference materials (NBS SRM = NBL CRM) are good candidates for samples where both rules are met. The U isotopic standards have known purification and production dates, and closed-system behavior in the solid form (U{sub 3}O{sub 8}) may be assumed with confidence. We present here {sup 230}Th-{sup 234}U model-ages for several of these standards, determined by isotope dilution mass spectrometry using a multicollector ICP-MS, and compare these ages with their known production history.

  17. Birthweight by gestational age and its effect on perinatal mortality in white and in Punjabi births: experience at a district general hospital in West London 1967-1975.

    PubMed

    Dawson, I; Golder, R Y; Jonas, E G

    1982-11-01

    At Hillingdon Hospital in West London two main ethnic groups: 'UK' (i.e. white European) and 'Indian' (i.e. Punjabi) account for the bulk of obstetric work load. Birthweight by gestational age graphs were calculated for some 6000 Indian and 18000 UK infants born between 1967 and 1975 inclusive. A mean weight difference at term favoured UK male babies by 240 g and UK female babies by 230 g. Though the crude perinatal results in the two populations were not significantly different, the perinatal mortality of infants less than 2500 g in birthweight was lower in the Indian than the UK population, particularly in the 1500-2400 g group. This is attributed to a levelling off in intrauterine growth from 36 to 37 weeks gestation onwards in Indian compared with UK pregnancies, so that they were more mature than UK births of the same weight. However light-for-dates births, defined as birthweights below the 10th centile of weight-for-gestational age on their own ethnic and sex specific standards pose problems, irrespective of ethnic background.

  18. Results of interlaboratory comparison of fission-track age standards: Fission-track workshop-1984

    USGS Publications Warehouse

    Miller, D.S.; Duddy, I.R.; Green, P.F.; Hurford, A.J.; Naeser, C.W.

    1985-01-01

    Five samples were made available as standards for the 1984 Fission Track Workshop held in the summer of 1984 (Rensselaer Polytechnic Institute, Troy, New York). Two zircons, two apatites and a sphene were distributed prior to the meeting to 40 different laboratories. To date, 24 different analysts have reported results. The isotopic ages of the standards ranged from 16.8 to 98.7 Myr. Only the statement that the age of each sample was less than 200 Myr was provided with the set of standards distributed. Consequently, each laboratory was required to use their laboratory's accepted treatment (irradiation level, etching conditions, counting conditions, etc.) for these samples. The results show that some workers have serious problems in achieving accurate age determinations. This emphasizes the need to calibrate experimental techniques and counting procedures against age standards before unknown ages are determined. Any fission-track age determination published or submitted for publication can only be considered reliable if it is supported by evidence of consistent determinations on age standards. Only this can provide the scientific community with the background to build up confidence concerning the validity of the fission-track method. ?? 1985.

  19. Temporal Scaling of Age-Dependent Mortality: Dynamics of Aging in Caenorhabditis elegans Is Easy to Speed Up or Slow Down, but Its Overall Trajectory Is Stable.

    PubMed

    Markov, A V; Naimark, E B; Yakovleva, E U

    2016-08-01

    The dynamics of aging is often described by survival curves that show the proportion of individuals surviving to a given age. The shape of the survival curve reflects the dependence of mortality on age, and it varies greatly for different organisms. In a recently published paper, Stroustrup and coauthors ((2016) Nature, 530, 103-107) showed that many factors affecting the lifespan of Caenorhabditis elegans do not change the shape of the survival curve, but only stretch or compress it in time. Apparently, this means that aging is a programmed process whose trajectory is difficult to change, although it is possible to speed it up or slow it down. More research is needed to clarify whether the "rule of temporal scaling" is applicable to other organisms. A good indicator of temporal scaling is the coefficient of lifespan variation: similar values of this coefficient for two samples indicate similar shape of the survival curves. Preliminary results of experiments on adaptation of Drosophila melanogaster to unfavorable food show that temporal scalability of survival curves is sometimes present in more complex organisms, although this is not a universal rule. Both evolutionary and environmental changes sometimes affect only the average lifespan without changing the coefficient of variation (in this case, temporal scaling is present), but often both parameters (i.e. both scale and shape of the survival curve) change simultaneously. In addition to the relative stability of the coefficient of variation, another possible argument in favor of genetic determination of the aging process is relatively low variability of the time of death, which is sometimes of the same order of magnitude as the variability of timing of other ontogenetic events, such as the onset of sexual maturation.

  20. Developmental Screening Using the Ages and Stages Questionnaire: Standardized versus Real-World Conditions

    ERIC Educational Resources Information Center

    San Antonio, Marianne C.; Fenick, Ada M.; Shabanova, Veronika; Leventhal, John M.; Weitzman, Carol C.

    2014-01-01

    Developmental screens are often used in nonstandardized conditions, such as pediatric waiting rooms, despite validation under standardized conditions. We examined the reproducibility of the Ages and Stages Questionnaire (ASQ), a developmental screening instrument commonly used in pediatric practices, under standardized versus nonstandardized…

  1. Age, growth, mortality, and reproduction of Roughtongue bass, Pronotogrammus martinicensis 9Serranidae), in the northeastern Gulf of Mexico

    USGS Publications Warehouse

    McBride, Richard S.; Sulak, Kenneth J.; Thurman, Paul E.; Richardson, Adam K.

    2009-01-01

    The inaccessibility of outer continental shelf reefs has made it difficult to investigate the biology of Pronotogrammus martinicensis, a small sea bass known to be numerous and widely distributed in such habitat. This study takes advantage of a series of cruises in the northeastern Gulf of Mexico that collected 1,485 individuals. Fish were collected over or in the vicinity of reef habitats with hook and line, otter trawl, and rotenone. We present a preliminary validation of an otolith ageing method and report that P. martinicensis reached a maximum size of 143 mm standard length (SL), grew to about 50% of this size within their first year, and lived to a maximum age of 15 yr. Size at age data (n = 490) fitted to the von Bertalanffy growth model yielded the predictive equation: SLt = 106.3(1 2 e [20.641{t20.646}]), where t = age in years. Gonad histology (n = 333) was examined to confirm that P. martinicensis is a protogynous, monandric hermaphrodite. We found no evidence of simultaneous hermaphroditism, which had been tentatively proposed in a previous study. Most P. martinicensis matured as females in their second year (age 1), primary oocytes developed asynchronously into secondary oocytes, and females were batch spawners. Males were postmaturational. Seminiferous tissue formed as early as age 1, but, although the rate of sex change is unknown, most fish did not function as a male until age 3 or age 4. These data provide age-based benchmarks of a common reef fish species living on the outer continental shelf of the tropical western North Atlantic Ocean.

  2. How to measure the burden of mortality?

    PubMed Central

    Bonneux, L

    2002-01-01

    Objectives: To explore various methods to quantify the burden of mortality, with a special interest for the more recent method at the core of calculations of disability adjusted life years (DALY). Design: Various methods calculating the age schedule at death are applied to two historical life table populations. One method calculates the "years of life lost", by multiplying the numbers of deaths at age x by the residual life expectancy. This residual life expectancy may be discounted and age weighted. The other method calculates the "potential years of life lost" by multiplying the numbers of deaths at age x by the years missing to reach a defined threshold (65 years or 75 years). Methods: The period life tables describing the mortality of Dutch male populations from 1900–10 (high mortality) and from 1990–1994 (low mortality). Results: A standard life table with idealised long life expectancy increases the burden of death more if mortality is lower. People at old age, more prevalent if mortality is low, lose more life years in an idealised life table. The discounted life table decreases the burden of death strongly if mortality is high: the life lost by a person dying at a young age is discounted. Age weighting the discounted life table balances the effect of discounting. Conclusions: For the purpose of description of the burden of mortality, the aggregate life table of the studied populations gives the better description of the age schedule at death. Discounting and the use of idealised lifetables as a standard increase the burden of mortality of degenerative disease at the end of life. The age weighted discounted life table violates the principle of parsimony. PMID:11812812

  3. Occupational Class Inequalities in All-Cause and Cause-Specific Mortality among Middle-Aged Men in 14 European Populations during the Early 2000s

    PubMed Central

    Toch-Marquardt, Marlen; Menvielle, Gwenn; Eikemo, Terje A.; Kulhánová, Ivana; Kulik, Margarete C.; Bopp, Matthias; Esnaola, Santiago; Jasilionis, Domantas; Mäki, Netta; Martikainen, Pekka; Regidor, Enrique; Lundberg, Olle; Mackenbach, Johan P.

    2014-01-01

    This study analyses occupational class inequalities in all-cause mortality and four specific causes of death among men, in Europe in the early 2000s, and is the most extensive comparative analysis of occupational class inequalities in mortality in Europe so far. Longitudinal data, obtained from population censuses and mortality registries in 14 European populations, from around the period 2000–2005, were used. Analyses concerned men aged 30–59 years and included all-cause mortality and mortality from all cancers, all cardiovascular diseases (CVD), all external, and all other causes. Occupational class was analysed according to five categories: upper and lower non-manual workers, skilled and unskilled manual workers, and farmers and self-employed combined. Inequalities were quantified with mortality rate ratios, rate differences, and population attributable fractions (PAF). Relative and absolute inequalities in all-cause mortality were more pronounced in Finland, Denmark, France, and Lithuania than in other populations, and the same countries (except France) also had the highest PAF values for all-cause mortality. The main contributing causes to these larger inequalities differed strongly between countries (e.g., cancer in France, all other causes in Denmark). Relative and absolute inequalities in CVD mortality were markedly lower in Southern European populations. We conclude that relative and absolute occupational class differences in all-cause and cause specific mortality have persisted into the early 2000's, although the magnitude differs strongly between populations. Comparisons with previous studies suggest that the relative gap in mortality between occupational classes has further widened in some Northern and Western European populations. PMID:25268702

  4. Age-standardized incidence rates of primordial cyst (keratocyst) on the Witwatersrand.

    PubMed

    Rachanis, C C; Shear, M

    1978-11-01

    Cases of primordial cysts derived from the records of all the hospital pathology departments and private pathology practices on the Witwatersrand, were recorded for the 10-year period 1965-74. The population at risk (1970 census) was 974,390 Whites and 1,567,280 Blacks. Age-specific morbidity rates for each sex and race were calculated, as well as age-standardized incidence rates standardized against African, World and European standard populations. The age-standardized incidence rates for primordial cysts, standardized against a World standard population, per million per year are 0.61, 0, 4.86 and 3.50 for Black males and females and White males and females, respectively. In the population at risk, primordial cysts are much more common in Whites than in Blacks, the incidence being eight times higher in White males than in Black males. The present study confirms that there is a bimodal age distribution but with a higher incidence of the cyst in the age group 50-64 years than previously suspected. This may be either because a substantial number of cases remain undiagnosed for many years or because there are two groups of primordial cyst: one which is triggered in young patients and the other in older patients.

  5. Aging Will Amplify the Heat-Related Mortality Risk Under a Changing Climate: Projection for the Elderly in Beijing, China

    NASA Technical Reports Server (NTRS)

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-01-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heatrelated mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  6. Aging Will Amplify the Heat-related Mortality Risk under a Changing Climate: Projection for the Elderly in Beijing, China

    NASA Astrophysics Data System (ADS)

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-06-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heat-related mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  7. Aging Will Amplify the Heat-related Mortality Risk under a Changing Climate: Projection for the Elderly in Beijing, China

    PubMed Central

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-01-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heat-related mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events. PMID:27320724

  8. Survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to stabilization centers in Gedeo Zone: a retrospective cohort study

    PubMed Central

    Girum, Tadele; Kote, Mesfin; Tariku, Befikadu; Bekele, Henok

    2017-01-01

    Despite the existence of standard protocol, many stabilization centers (SCs) continue to experience high mortality of children receiving treatment for severe acute malnutrition. Assessing treatment outcomes and identifying predictors may help to overcome this problem. Therefore, a 30-month retrospective cohort study was conducted among 545 randomly selected medical records of children <5 years of age admitted to SCs in Gedeo Zone. Data was entered by Epi Info version 7 and analyzed by STATA version 11. Cox proportional hazards model was built by forward stepwise procedure and compared by the likelihood ratio test and Harrell’s concordance, and fitness was checked by Cox–Snell residual plot. During follow-up, 51 (9.3%) children had died, and 414 (76%) and 26 (4.8%) children had recovered and defaulted (missed follow-up for 2 consecutive days), respectively. The survival rates at the end of the first, second and third weeks were 95.3%, 90% and 85%, respectively, and the overall mean survival time was 79.6 days. Age <24 months (adjusted hazard ratio [AHR] =2.841, 95% confidence interval [CI] =1.101–7.329), altered pulse rate (AHR =3.926, 95% CI =1.579–9.763), altered temperature (AHR =7.173, 95% CI =3.05–16.867), shock (AHR =3.805, 95% CI =1.829–7.919), anemia (AHR =2.618, 95% CI =1.148–5.97), nasogastric tube feeding (AHR =3.181, 95% CI =1.18–8.575), hypoglycemia (AHR =2.74, 95% CI =1.279–5.87) and treatment at hospital stabilization center (AHR =4.772, 95% CI =1.638–13.9) were independent predictors of mortality. The treatment outcomes and incidence of death were in the acceptable ranges of national and international standards. Intervention to further reduce deaths has to focus on young children with comorbidities and altered general conditions. PMID:28176953

  9. Mortality Associated with Severe Sepsis Among Age-Similar Women with and without Pregnancy-Associated Hospitalization in Texas: A Population-Based Study

    PubMed Central

    Oud, Lavi

    2016-01-01

    Background The reported mortality among women with pregnancy-associated severe sepsis (PASS) has been considerably lower than among severely septic patients in the general population, with the difference being attributed to the younger age and lack of chronic illness among the women with PASS. However, no comparative studies were reported to date between patients with PASS and age-similar women with severe sepsis not associated with pregnancy (NPSS). Material/Methods We used the Texas Inpatient Public Use Data File to compare the crude and adjusted hospital mortality between women with severe sepsis, aged 20–34 years, with and without pregnancy-associated hospitalizations during 2001–2010, following exclusion of those with reported chronic comorbidities, as well as alcohol and drug abuse. Results Crude hospital mortality among PASS vs. NPSS hospitalizations was lower for the whole cohort (6.7% vs. 14.1% [p<0.0001]) and those with ≥3 organ failures (17.6% vs. 33.2% [p=0.0100]). Adjusted PASS mortality (odds ratio [95% CI]) was 0.57 (0.38–0.86) [p=0.0070]. Conclusions Hospital mortality was unexpectedly markedly and consistently lower among women with severe sepsis associated with pregnancy, as compared with contemporaneous, age-similar women with severe sepsis not associated with pregnancy, without reported chronic comorbidities. Further studies are warranted to examine the sources of the observed differences and to corroborate our findings. PMID:27286326

  10. Long-term all-sites cancer mortality time trends in Ohio, USA, 1970–2001: differences by race, gender and age

    PubMed Central

    Tyczynski, Jerzy E; Berkel, Hans J

    2005-01-01

    Background There were significant changes in cancer mortality in the USA over the last several decades, in the whole country and in particular states. However, no in depth analysis has been published so far, dealing with changes in mortality time trends in the state of Ohio. Since the state of Ohio belongs to the states of relatively high level of all-sites mortality in both males and females, it is of interest to analyze recent changes in mortality rates, as well as to compare them with the situation in the rest of the USA. The main aim of this study was to analyze, describe and interpret all-sites cancer mortality time trends in the population of the State of Ohio. Methods Cancer mortality data by age, sex, race and year for the period 1970–2001 were obtained from the Surveillance Research Program of the National Cancer Institute SEER*Stat software. A joinpoint regression methodology was used to provide estimated annual percentage changes (EAPCs) and to detect points in time where significant changes in the trends occurred. Results In both, males and females mortality rates were higher in blacks compared with whites. The difference was bigger in males (39.9%) than in women (23.3%). Mortality rates in Ohio are generally higher than average USA rates – an overall difference was 7.5% in men in 1997–2001, and 6.1% in women. All-sites mortality trends in Ohio and in the whole USA are similar. However, in general, mortality rates in Ohio remained elevated compared with the USA rates throughout the entire analyzed period. The exceptions are the rates in young and middle-aged African Americans. Conclusion Although direction of time trends in Ohio are similar in Ohio and the whole US, Ohio still have cancer mortality rates higher than the US average. In addition, there is a significant discrepancy between white and black population of Ohio in all-sites mortality level, with disadvantage for Blacks. To diminish disparities in cancer mortality between African

  11. Efficient mapping and geographic disparities in breast cancer mortality at the county-level by race and age in the U.S.

    PubMed

    Chien, Lung-Chang; Yu, Hwa-Lung; Schootman, Mario

    2013-06-01

    This study identified geographic disparities in breast cancer mortality across the U.S. using kriging to overcome unavailability of data because of confidentiality and reliability concerns. A structured additive regression model was used to detect where breast cancer mortality rates were elevated across nine divisions with 3109 U.S. counties during 1982-2004. Our analysis identified at least 25.8% of counties where breast cancer mortality rates were elevated. High-risk counties compared to lower-risk counties had higher relative risks for African American women than for White women. Greater geographic disparities more likely present in African American women and younger women. To sum up, our statistical approach reduced the impact of unavailable data, and identified the number and location of counties with high breast cancer mortality risk by race and age across the U.S.

  12. Association between Sleep Duration and Mortality Is Mediated by Markers of Inflammation and Health in Older Adults: The Health, Aging and Body Composition Study

    PubMed Central

    Hall, Martica H.; Smagula, Stephen F.; Boudreau, Robert M.; Ayonayon, Hilsa N.; Goldman, Suzanne E.; Harris, Tamara B.; Naydeck, Barbara L.; Rubin, Susan M.; Samuelsson, Laura; Satterfield, Suzanne; Stone, Katie L.; Visser, Marjolein; Newman, Anne B.

    2015-01-01

    Study Objective: Inflammation may represent a common physiological pathway linking both short and long sleep duration to mortality. We evaluated inflammatory markers as mediators of the relationship between sleep duration and mortality in community-dwelling older adults. Design: Prospective cohort with longitudinal follow-up for mortality outcomes. Setting: Pittsburgh, Pennsylvania, and Memphis, Tennessee. Participants: Participants in the Health, Aging and Body Composition (Health ABC) Study (mean age 73.6 ± 2.9 years at baseline) were sampled and recruited from Medicare listings. Measurements and Results: Baseline measures of subjective sleep duration, markers of inflammation (serum interleukin-6, tumor necrosis factor-α, and C-reactive protein) and health status were evaluated as predictors of all-cause mortality (average follow-up = 8.2 ± 2.3 years). Sleep duration was related to mortality, and age-, sex-, and race-adjusted hazard ratios (HR) were highest for those with the shortest (< 6 h HR: 1.30, CI: 1.05–1.61) and longest (> 8 h HR: 1.49, CI: 1.15–1.93) sleep durations. Adjustment for inflammatory markers and health status attenuated the HR for short (< 6 h) sleepers (HR = 1.06, 95% CI = 0.83–1.34). Age-, sex-, and race-adjusted HRs for the > 8-h sleeper group were less strongly attenuated by adjustment for inflammatory markers than by other health factors associated with poor sleep with adjusted HR = 1.23, 95% CI = 0.93–1.63. Inflammatory markers remained significantly associated with mortality. Conclusions: Inflammatory markers, lifestyle, and health status explained mortality risk associated with short sleep, while the mortality risk associated with long sleep was explained predominantly by lifestyle and health status. Citation: Hall MH, Smagula SF, Boudreau RM, Ayonayon HN, Goldman SE, Harris TB, Naydeck BL, Rubin SM, Samuelsson L, Satterfield S, Stone KL, Visser M, Newman AB. Association between sleep duration and mortality is mediated by

  13. A practical method of estimating standard error of age in the fission track dating method

    USGS Publications Warehouse

    Johnson, N.M.; McGee, V.E.; Naeser, C.W.

    1979-01-01

    A first-order approximation formula for the propagation of error in the fission track age equation is given by PA = C[P2s+P2i+P2??-2rPsPi] 1 2, where PA, Ps, Pi and P?? are the percentage error of age, of spontaneous track density, of induced track density, and of neutron dose, respectively, and C is a constant. The correlation, r, between spontaneous are induced track densities is a crucial element in the error analysis, acting generally to improve the standard error of age. In addition, the correlation parameter r is instrumental is specifying the level of neutron dose, a controlled variable, which will minimize the standard error of age. The results from the approximation equation agree closely with the results from an independent statistical model for the propagation of errors in the fission-track dating method. ?? 1979.

  14. Do conditions in early life affect old-age mortality directly and indirectly? Evidence from 19th-century rural Sweden.

    PubMed

    Bengtsson, Tommy; Broström, Göran

    2009-05-01

    Previous research has shown that the disease load experienced during the birth year, measured as the infant mortality rate, had a significant influence on old-age mortality in nineteenth-century rural Sweden. We know that children born in years with very high rates of infant mortality, due to outbreaks of smallpox or whooping cough, and who still survived to adulthood and married, faced a life length several years shorter than others. We do not know, however, whether this is a direct effect, caused by permanent physical damage leading to fatal outcomes later in life, or an indirect effect, via its influence on accumulation of wealth and obtained socio-economic status. The Scanian Demographic Database, with information on five rural parishes in southern Sweden between 1813 and 1894, contains the data needed to distinguish between the two mechanisms. First, the effects of conditions in childhood on obtained socio-economic status as an adult are analyzed, then the effects of both early-life conditions and socio-economic status at various stages of life on old-age mortality. By including random effects, we take into account possible dependencies in the data due to kinship and marriage. We find that a high disease load during the first year of life had a strong negative impact on a person's ability to acquire wealth, never before shown for a historical setting. This means that it is indeed possible that the effects of disease load in the first year of life indirectly affect mortality in old age through obtained socio-economic status. We find, however, no effects of obtained socio-economic status on old-age mortality. While the result is interesting per se, constituting a debatable issue, it means that the argument that early-life conditions indirectly affect old-age mortality is not supported. Instead, we find support for the conclusion that the effect of the disease load in early-life is direct or, in other words, that physiological damage from severe infections at the

  15. A population study of apoE genotype at the age of 85: relation to dementia, cerebrovascular disease, and mortality

    PubMed Central

    Skoog, I.; Hesse, C.; Aevarsson, O.; Landahl, S.; Wahlstrom, J.; Fredman, P.; Blennow, K.

    1998-01-01

    OBJECTIVES—To study the association of apoE genotypes with dementia and cerebrovascular disorders in a population based sample of 85year old people.
METHODS—A representative sample of 85 year old people (303 non-demented, 109 demented) were given a neuropsychiatric and a medical examination and head CT. The apoE isoforms were determined. Dementia was diagnosed according to DSM-III-R.
RESULTS—At the age of 85, carriers of the apoE ε4 allele had an increased odds ratio (OR) for dementia (1.9; p<0.01) and its subtypes Alzheimer's disease (1.9; p<0.05) and vascular dementia (2.0; p<0.05). Among those categorised as having vascular dementia, the apoE ε4 allele was associated with mixed Alzheimer's disease-multi-infarct dementia (OR 6.5; p<0.05), but not with pure multi-infarct dementia (OR 1.5; NS). Only carriers of the apoE ε4 allele who also had ischaemic white matter lesions on CT of the head had an increased OR for dementia (OR 6.1; p=0.00003), and its main subtypes Alzheimer's disease (OR 6.8; p=0.002) and vascular dementia (OR 5.6; p=0.0007), whereas carriers of the apoE ε4 allele without white matter lesions had an OR for dementia of 1.0 (OR for Alzheimer's disease 1.8; NS and for vascular dementia 0.6; NS) and non-carriers of the apoE ε4 allele with white matter lesions had an OR for dementia of 2.2; NS (OR for Alzheimer's disease 2.7; NS and for vascular dementia 1.6; NS). The apoE allele variants were not related to mortality or incidence of dementia between the ages of 85 and 88. The ε2 allele was related to a higher prevalence of stroke or transient ischaemic attack at the age of 85 (OR 2.1; p<0.05) and a higher incidence of multi-infarct dementia during the follow up (OR 2.9; p<0.05).
CONCLUSIONS—Neither the apoE ε4 allele nor white matter lesions are sufficient risk factors by themselves for dementia at very old ages, whereas possession of both these entities increases the risk for Alzheimer's disease and vascular dementia

  16. Rising inequality in mortality among working-age men and women in Sweden: a national registry-based repeated cohort study, 1990–2007

    PubMed Central

    Kondo, Naoki; Rostila, Mikael; Yngwe, Monica Åberg

    2014-01-01

    Background In the past two decades, health inequality has persisted or increased in states with comprehensive welfare. Methods We conducted a national registry-based repeated cohort study with a 3-year follow-up between 1990 and 2007 in Sweden. Information on all-cause mortality in all working-age Swedish men and women aged between 30 and 64 years was collected. Data were subjected to temporal trend analysis using joinpoint regression to statistically confirm the trajectories observed. Results Among men, age-standardised mortality rate decreased by 38.3% from 234.9 to 145 (per 100 000 population) over the whole period in the highest income quintile, whereas the reduction was only 18.3% (from 774.5 to 632.5) in the lowest quintile. Among women, mortality decreased by 40% (from 187.4 to 112.5) in the highest income group, but increased by 12.1% (from 280.2 to 314.2) in the poorest income group. Joinpoint regression identified that the differences in age-standardised mortality between the highest and the lowest income quintiles decreased among men by 18.85 annually between 1990 and 1994 (p trend=0.02), whereas it increased later, with a 2.88 point increase per year (p trend <0.0001). Among women, it continuously increased by 9.26/year (p trend <0.0001). In relative terms, age-adjusted mortality rate ratios showed a continuous increase in both genders. Conclusions Income-based inequalities among working-age male and female Swedes have increased since the late 1990s, whereas in absolute terms the increase was less remarkable among men. Structural and behavioural factors explaining this trend, such as the economic recession in the early 1990s, should be studied further. PMID:25143429

  17. Mortality risk attributable to smoking, hypertension and diabetes among English and Brazilian older adults (The ELSA and Bambui cohort ageing studies)

    PubMed Central

    Marmot, Michael G.; Demakakos, Panayotes; Vaz de Melo Mambrini, Juliana; Peixoto, Sérgio Viana; Lima-Costa, Maria Fernanda

    2016-01-01

    Background: The main aim of this study was to quantify and compare 6-year mortality risk attributable to smoking, hypertension and diabetes among English and Brazilian older adults. This study represents a rare opportunity to approach the subject in two different social and economic contexts. Methods: Data from the data from the English Longitudinal Study of Ageing (ELSA) and the Bambuí Cohort Study of Ageing (Brazil) were used. Deaths in both cohorts were identified through mortality registers. Risk factors considered in this study were baseline smoking, hypertension and diabetes mellitus. Both age–sex adjusted hazard ratios and population attributable risks (PAR) of all-cause mortality and their 95% confidence intervals for the association between risk factors and mortality were estimated using Cox proportional hazards models. Results: Participants were 3205 English and 1382 Brazilians aged 60 years and over. First, Brazilians showed much higher absolute risk of mortality than English and this finding was consistent in all age, independently of sex. Second, as a rule, hazard ratios for mortality to smoking, hypertension and diabetes showed more similarities than differences between these two populations. Third, there was strong difference among English and Brazilians on attributable deaths to hypertension. Conclusions: The findings indicate that, despite of being in more recent transitions, the attributable deaths to one or more risk factors was twofold among Brazilians relative to the English. These findings call attention for the challenge imposed to health systems to prevent and treat non-communicable diseases, particularly in populations with low socioeconomic level. PMID:26666869

  18. A gender-based dynamic multidimensional longitudinal analysis of resilience and mortality in the old-old in Israel: the cross-sectional and longitudinal aging study (CALAS).

    PubMed

    Walter-Ginzburg, Adrian; Shmotkin, Dov; Blumstein, Tzvia; Shorek, Aviva

    2005-04-01

    The objective was to examine gender differences and similarities in health, function, familial and non-familial social networks; longitudinal resilience in those factors; and their association with risk of mortality in Israeli men and women aged 75-94. We used the Cross-Sectional and Longitudinal Aging Study (CALAS), a stratified random sample of 960 Israeli Jews aged 75-94, drawn on January 1, 1989 from National Population Registry, stratified by gender, age (75-79, 80-84, 85-89, 90-94), and place of birth (Europe/America, Middle East/North Africa, Israel), interviewed twice (Wave 1, 1989-1992; Wave 2, 1993-1995); Wave 1 values and longitudinal resilience predicted the 1999 mortality risk for those alive at both waves. Gender differences and similarities were found at Wave 1 in longitudinal resilience and in risk factors for mortality, partially supporting a gender paradox. Men were more physically active, had better cognition, gave more help to children, relied less on paid caretakers, and attended synagogue more than women, factors associated with better health and functioning. Women had poorer health and functional status and more help from children. More physical activity, synagogue attendance, and resilience in activities of daily living (ADL) were associated with lower risk of mortality for both genders. Women's risk of mortality was reduced by smoking reduction and higher cognitive vitality, and men's by emotional support and solitary leisure activity. Both men and women were resilient, yet there were differences. Gender-neutral mortality reduction programs would include physical activity, religious services, maintenance and improvement of ADL, and engaging in solitary leisure activities; for women, smoking cessation and cognitively challenging activities; and for men, maintaining or increasing emotional ties.

  19. The Association of Childhood Intelligence with Mortality Risk from Adolescence to Middle Age: Findings from the Aberdeen Children of the 1950s Cohort Study

    ERIC Educational Resources Information Center

    Leon, D. A.; Lawlor, D. A.; Clark, H.; Batty, G. D.; Macintyre, S.

    2009-01-01

    There is growing evidence that childhood IQ is inversely associated with mortality in later life. However, the specificity of this association in terms of causes of death, whether it is continuous over the whole range of IQ scores and whether it is the same according to age and sex is not clear. In a large cohort (N = 11,603) of a complete…

  20. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. In a descriptive study using a pre-post design with comparison groups, the authors calculated…

  1. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    Objective: This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. Methods: In a descriptive study using a pre-post design with comparison groups, the…

  2. Ovarian cancer mortality among women aged 40-79 years in relation to reproductive factors and body mass index: latest evidence from the Japan Collaborative Cohort study

    PubMed Central

    Khan, Aklimunnessa; Nojima, Masahiro; Suzuki, Sadao; Fujino, Yoshihisa; Tokudome, Shinkan; Tamakoshi, Koji; Mori, Mitsuru; Tamakoshi, Akiko

    2013-01-01

    Objective This study mainly aimed to investigate the association of ovarian cancer mortality with reproductive factors and body mass index among Japanese women aged 40-79 years. Methods The source of the data was the Japan Collaborative Cohort (JACC) study which covered the period of 1988 to 2009. A representative sample of 64,185 women was used. Cox model was used to estimate the relative risk (RR) and 95% confidence interval (CI). Results The total number of ovarian cancer deaths was 98, with a mortality rate of 9.30 per 100,000 person-years. Women with single marital status revealed significantly higher age-adjusted RR (RR, 4.11; 95% CI, 1.66 to 10.23; p=0.005) as compared to married women. The effect of single marital status was stronger among older women aged 50+ years (RR, 4.58; 95% CI, 1.65 to 12.72; p=0.003) than younger women. An elevated risk was found for both nulliparous and nullipregnant women. Similarly, an increased risk of ovarian cancer mortality was estimated among overweight among aged 50 years or less. Conclusion Out of many factors only single marital status indicated a higher risk for ovarian cancer mortality. All other factors provided inconclusive results, which imply further epidemiological investigations. PMID:23875075

  3. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis

    PubMed Central

    Katz, Joanne; Lee, Anne CC; Kozuki, Naoko; Lawn, Joy E; Cousens, Simon; Blencowe, Hannah; Ezzati, Majid; Bhutta, Zulfiqar A; Marchant, Tanya; Willey, Barbara A; Adair, Linda; Barros, Fernando; Baqui, Abdullah H; Christian, Parul; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kolsteren, Patrick; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Osrin, David; Roberfroid, Dominique; Sania, Ayesha; Schmiegelow, Christentze; Silveira, Mariangela F; Tielsch, James; Vaidya, Anjana; Velaphi, Sithembiso C; Victora, Cesar G; Watson-Jones, Deborah; Black, Robert E

    2013-01-01

    Summary Background Babies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with these two characteristics in low-income and middle-income countries. Methods For this pooled analysis, we searched all available studies and identified 20 cohorts (providing data for 2 015 019 livebirths) from Asia, Africa, and Latin America that recorded data for birthweight, gestational age, and vital statistics through 28 days of life. Study dates ranged from 1982 through to 2010. We calculated relative risks (RR) and risk differences (RD) for mortality associated with preterm birth (<32 weeks, 32 weeks to <34 weeks, 34 weeks to <37 weeks), small-for-gestational-age (SGA; babies with birthweight in the lowest third percentile and between the third and tenth percentile of a US reference population), and preterm and SGA combinations. Findings Pooled overall RRs for preterm were 6·82 (95% CI 3·56–13·07) for neonatal mortality and 2·50 (1·48–4·22) for post-neonatal mortality. Pooled RRs for babies who were SGA (with birthweight in the lowest tenth percentile of the reference population) were 1·83 (95% CI 1·34–2·50) for neonatal mortality and 1·90 (1·32–2·73) for post-neonatal mortality. The neonatal mortality risk of babies who were both preterm and SGA was higher than that of babies with either characteristic alone (15·42; 9·11–26·12). Interpretation Many babies in low-income and middle-income countries are SGA. Preterm birth affects a smaller number of neonates than does SGA, but is associated with a higher mortality risk. The mortality risks associated with both characteristics extend beyond the neonatal period. Differentiation of the burden and risk of babies born preterm and SGA rather than with low birthweight could guide

  4. Seasonal variations of all-cause and cause-specific mortality by age, gender, and socioeconomic condition in urban and rural areas of Bangladesh

    PubMed Central

    2011-01-01

    Background Mortality exhibits seasonal variations, which to a certain extent can be considered as mid-to long-term influences of meteorological conditions. In addition to atmospheric effects, the seasonal pattern of mortality is shaped by non-atmospheric determinants such as environmental conditions or socioeconomic status. Understanding the influence of season and other factors is essential when seeking to implement effective public health measures. The pressures of climate change make an understanding of the interdependencies between season, climate and health especially important. Methods This study investigated daily death counts collected within the Sample Vital Registration System (VSRS) established by the Bangladesh Bureau of Statistics (BBS). The sample was stratified by location (urban vs. rural), gender and socioeconomic status. Furthermore, seasonality was analyzed for all-cause mortality, and several cause-specific mortalities. Daily deviation from average mortality was calculated and seasonal fluctuations were elaborated using non parametric spline smoothing. A seasonality index for each year of life was calculated in order to assess the age-dependency of seasonal effects. Results We found distinctive seasonal variations of mortality with generally higher levels during the cold season. To some extent, a rudimentary secondary summer maximum could be observed. The degree and shape of seasonality changed with the cause of death as well as with location, gender, and SES and was strongly age-dependent. Urban areas were seen to be facing an increased summer mortality peak, particularly in terms of cardiovascular mortality. Generally, children and the elderly faced stronger seasonal effects than youths and young adults. Conclusion This study clearly demonstrated the complex and dynamic nature of seasonal impacts on mortality. The modifying effect of spatial and population characteristics were highlighted. While tropical regions have been, and still are

  5. Age at Transition from Pediatric to Adult Care Has No Relationship with Mortality for Childhood-Onset Type 1 Diabetes in Japan: Diabetes Epidemiology Research International (DERI) Mortality Study

    PubMed Central

    Onda, Yoshiko; Nishimura, Rimei; Morimoto, Aya; Sano, Hironari; Utsunomiya, Kazunori; Tajima, Naoko

    2016-01-01

    Objective To follow up Japanese patients with type 1 diabetes for a maximum of 40 years to examine when they transitioned from pediatric care to adult care and to explore whether the attending physician, i.e., pediatrician or internist, was associated with prognosis. Methods Participants consisted of 1,299 patients who had been diagnosed as having type 1 diabetes at less than 15 years old between 1965 and 1979 identified through two nationwide surveys. Patients were classified as having received either pediatric care or adult care at the age of 15 and 30, and were compared for differences in mortality associated with the attending physician. Results The attending physicians were confirmed for a total of 1,093 patients at the age of 15. Of these patients, 43.8% and 40.3% received pediatric care and adult care, respectively. Of the 569 patients receiving pediatric care, 74.2%, 56.6%, 53.4%, and 51.3% continued with pediatric care at 20, 30, 40, and 50 years old, respectively. The attending physicians (pediatrician or internist) at the age of 15 and 30 had no significant impact on their survival (P = 0. 892, 0.411, respectively). Conclusions More than half of the patients who had received pediatric care at the age of 15 continued to receive pediatric care even after the age of 30, suggesting that their transition was far from smooth, while the attending physician at the age of both 15 and 30 was not a prognostic factor for mortality. Thus, the timing for transition to adult care in these patients has no relationship with mortality in Japan. PMID:26937952

  6. Age standardization in mapping adult overweight and obesity trends in the WHO European Region.

    PubMed

    Doak, C M; Wijnhoven, T M A; Schokker, D F; Visscher, T L S; Seidell, J C

    2012-02-01

    This study aims to improve comparability of available data within the World Health Organization (WHO) European Region taking into account differences related to the aging of the population. Surveys were included if they were conducted on adults aged 25-64 years between 1985 and 2010 in the WHO European Region. Overweight/obesity prevalences were adjusted to the European standard population aged 25-64. Data were entered for each of the 5-year categories between 1981 and 2010. Measured height and weight data were available for males in 16 and females in 24 of the 53 countries. The 50-64-year-olds had higher prevalence of overweight and obesity as compared to the 25-49-year-olds. This pattern occurs in every country, by male and female, in almost all surveys. Age-standardized overweight prevalence was higher among males than females in all countries. Trend data showed increases in most countries. Age-standardized maps were based on self-reported data because of insufficient availability of measured data. Results showed more countries with available data as well as the higher category of obesity in the later surveys. Measured values are needed and age adjustment is important in documenting emerging overweight and obesity trends, independent of demographic changes, in the WHO European Region.

  7. Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non-Small-Cell Lung Cancer: A Competing Risks Analysis.

    PubMed

    Eguchi, Takashi; Bains, Sarina; Lee, Ming-Ching; Tan, Kay See; Hristov, Boris; Buitrago, Daniel H; Bains, Manjit S; Downey, Robert J; Huang, James; Isbell, James M; Park, Bernard J; Rusch, Valerie W; Jones, David R; Adusumilli, Prasad S

    2017-01-20

    Purpose To perform competing risks analysis and determine short- and long-term cancer- and noncancer-specific mortality and morbidity in patients who had undergone resection for stage I non-small-cell lung cancer (NSCLC). Patients and Methods Of 5,371 consecutive patients who had undergone curative-intent resection of primary lung cancer at our institution (2000 to 2011), 2,186 with pathologic stage I NSCLC were included in the analysis. All preoperative clinical variables known to affect outcomes were included in the analysis, specifically, Charlson comorbidity index, predicted postoperative (ppo) diffusing capacity of the lung for carbon monoxide, and ppo forced expiratory volume in 1 second. Cause-specific mortality analysis was performed with competing risks analysis. Results Of 2,186 patients, 1,532 (70.1%) were ≥ 65 years of age, including 638 (29.2%) ≥ 75 years of age. In patients < 65, 65 to 74, and ≥ 75 years of age, 5-year lung cancer-specific cumulative incidence of death (CID) was 7.5%, 10.7%, and 13.2%, respectively (overall, 10.4%); noncancer-specific CID was 1.8%, 4.9%, and 9.0%, respectively (overall, 5.3%). In patients ≥ 65 years of age, for up to 2.5 years after resection, noncancer-specific CID was higher than lung cancer-specific CID; the higher noncancer-specific, early-phase mortality was enhanced in patients ≥ 75 years of age than in those 65 to 74 years of age. Multivariable analysis showed that low ppo diffusing capacity of lung for carbon monoxide was an independent predictor of severe morbidity ( P < .001), 1-year mortality ( P < .001), and noncancer-specific mortality ( P < .001), whereas low ppo forced expiratory volume in 1 second was an independent predictor of lung cancer-specific mortality ( P = .002). Conclusion In patients who undergo curative-intent resection of stage I NSCLC, noncancer-specific mortality is a significant competing event, with an increasing impact as patient age increases.

  8. Modelling Survival and Mortality Risk to 15 Years of Age for a National Cohort of Children with Serious Congenital Heart Defects Diagnosed in Infancy

    PubMed Central

    Knowles, Rachel L.; Bull, Catherine; Wren, Christopher; Wade, Angela; Goldstein, Harvey; Dezateux, Carol

    2014-01-01

    Background Congenital heart defects (CHDs) are a significant cause of death in infancy. Although contemporary management ensures that 80% of affected children reach adulthood, post-infant mortality and factors associated with death during childhood are not well-characterised. Using data from a UK-wide multicentre birth cohort of children with serious CHDs, we observed survival and investigated independent predictors of mortality up to age 15 years. Methods Data were extracted retrospectively from hospital records and death certificates of 3,897 children (57% boys) in a prospectively identified cohort, born 1992–1995 with CHDs requiring intervention or resulting in death before age one year. A discrete-time survival model accounted for time-varying predictors; hazards ratios were estimated for mortality. Incomplete data were addressed through multilevel multiple imputation. Findings By age 15 years, 932 children had died; 144 died without any procedure. Survival to one year was 79.8% (95% confidence intervals [CI] 78.5, 81.1%) and to 15 years was 71.7% (63.9, 73.4%), with variation by cardiac diagnosis. Importantly, 20% of cohort deaths occurred after age one year. Models using imputed data (including all children from birth) demonstrated higher mortality risk as independently associated with cardiac diagnosis, female sex, preterm birth, having additional cardiac defects or non-cardiac malformations. In models excluding children who had no procedure, additional predictors of higher mortality were younger age at first procedure, lower weight or height, longer cardiopulmonary bypass or circulatory arrest duration, and peri-procedural complications; non-cardiac malformations were no longer significant. Interpretation We confirm the high mortality risk associated with CHDs in the first year of life and demonstrate an important persisting risk of death throughout childhood. Late mortality may be underestimated by procedure-based audit focusing on shorter-term surgical

  9. Perinatal mortality in relation to birthweight and gestational age: a registry-based comparison of Northern Norway and Murmansk County, Russia.

    PubMed

    Anda, Erik Eik; Nieboer, Evert; Wilsgaard, Tom; Kovalenko, Anton Alexandrovich; Odland, Jon Øyvind

    2011-05-01

    The objective was to explore how perinatal mortality relates to birthweight, gestational age and optimal perinatal survival weight for two Arctic populations employing an existing and a newly established birth registry. A medical birth registry for all births in Murmansk County of North-West Russia became operational on 1st January 2006. Its primary function is to provide useful information for health care officials pertinent to improving perinatal care. The cohort studied consisted of 17,302 births in 2006-07 (Murmansk County) and 16,006 in 2004-06 (Northern Norway). Birthweight probability density functions were analysed, and logistic regression models were employed to calculate gestational-age-specific mortality ratios. The perinatal mortality rate was 10.7/1000 in Murmansk County and 5.7/1000 in Northern Norway. Murmansk County had a higher proportion of preterm deliveries (8.7%) compared to Northern Norway (6.6%). The odds ratio (OR) of risk of mortality (Northern Norway as the reference group) was higher for all gestational ages in Murmansk County, but the largest risk difference occurred among term deliveries (OR 2.45, 95% confidence interval 1.45, 4.14) which hardly changed on adjustment for maternal age, parity and gestation. Proportionately, more babies were born near (± 500 g) the optimal perinatal survival weight in Murmansk County (67.2%) than in Northern Norway (47.6%). The observed perinatal mortality was higher in Murmansk County at all birthweight strata and at gestational ages between weeks 25 and 42, but the adjusted risk difference was most significant for term deliveries.

  10. [Impact of PCV10 pneumococcal vaccine on mortality from pneumonia in children less than one year of age in Santa Catarina State, Brazil].

    PubMed

    Kupek, Emil; Vieira, Ilse Lisiane Viertel

    2016-03-01

    The aim of this study was to evaluate the impact of PCV10 pneumococcal vaccine on mortality from pneumonia in children less than one year of age in Santa Catarina State, Brazil, comparing the four years prior and the four years subsequent to the vaccine's introduction in 2010. This ecological study used data from the Mortality Information System and vaccination coverage of children less than one year. Data were grouped by municipalities of residence and regions. Average mortality from pneumonia in children under one year decreased from 29.69 to 23.40 per 100,000, comparing 2006-2009 and 2010-2013, or a reduction of 11%. However there were differences between regions with a drop in mortality (Grande Florianópolis, Sul, Planalto Norte, and Nordeste) and others with an increase in the annual rates (Oeste, Itajaí, and Serra). In short, the state as a whole showed 11% reduction in mortality from pneumonia in children less than one year of age, four years after implementing routine PCV10 vaccination in the National Immunization Program, but with heterogeneous effects when comparing regions of the state.

  11. Mortality of tuberculosis patients in Chennai, India.

    PubMed Central

    Kolappan, C.; Subramani, R.; Karunakaran, K.; Narayanan, P. R.

    2006-01-01

    OBJECTIVE: We aimed to measure the mortality rate and excess general mortality as well as identify groups at high risk for mortality among a cohort of tuberculosis patients treated in Chennai Corporation clinics in south India. METHODS: In this retrospective cohort study we followed up 2674 patients (1800 males and 874 females) who were registered and treated under the DOTS strategy in Chennai Corporation clinics in 2000. The follow-up period from the date of start of treatment to either the date of interview, or death was 600 days. FINDINGS: The mortality rate among this cohort of tuberculosis patients was 60/1000 person-years. The excess general mortality expressed as standardized mortality ratio (SMR) was 6.1 (95% confidence interval (CI)=5.4-6.9). Younger patients, men, patients with Category II disease, patients who defaulted on, or failed courses of treatment, and male smokers who were alcoholics, all had higher mortality ratios when compared to the rest of the cohort. CONCLUSION: The excess mortality in this cohort was six times more than that in the general population. Young age, male sex, smear-positivity, treatment default, treatment failure and the combination of smoking and alcoholism were identified as risk factors for tuberculosis mortality. We suggest that mortality rate and excess mortality be routinely used as a monitoring tool for evaluating the efficiency of the national control programme. PMID:16878229

  12. The influence of neighbourhood-level socioeconomic deprivation on cardiovascular disease mortality in older age: longitudinal multilevel analyses from a cohort of older British men

    PubMed Central

    Ramsay, S E; Morris, R W; Whincup, P H; Subramanian, S V; Papacosta, A O; Lennon, Lucy T; Wannamethee, S G

    2015-01-01

    Background Evidence from longitudinal studies on the influence of neighbourhood socioeconomic factors in older age on cardiovascular disease (CVD) mortality is limited. We aimed to investigate the prospective association of neighbourhood-level deprivation in later life with CVD mortality, and assess the underlying role of established cardiovascular risk factors. Methods A socially representative cohort of 3924 men, aged 60–79 years in 1998–2000, from 24 British towns, was followed up until 2012 for CVD mortality. Quintiles of the national Index of Multiple Deprivation (IMD), a composite score of neighbourhood-level factors (including income, employment, education, housing and living environment) were used. Multilevel logistic regression with discrete-time models (stratifying follow-up time into months) were used. Results Over 12 years, 1545 deaths occurred, including 580 from CVD. The risk of CVD mortality showed a graded increase from IMD quintile 1 (least deprived) to 5 (most deprived). Compared to quintile 1, the age-adjusted odds of CVD mortality in quintile 5 were 1.71 (95% CI 1.32 to 2.21), and 1.62 (95% CI 1.23 to 2.13) on further adjustment for individual social class, which was attenuated slightly to 1.44 (95% CI 1.09 to 1.89), but remained statistically significant after adjustment for smoking, body mass index, physical activity and use of alcohol. Further adjustment for blood pressure, high-density lipoprotein cholesterol and prevalent diabetes made little difference. Conclusions Neighbourhood-level deprivation was associated with an increased risk of CVD mortality in older people independent of individual-level social class and cardiovascular risk factors. The role of other specific neighbourhood-level factors merits further research. PMID:26285580

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

    PubMed Central

    Liu, Li; Li, Mengying; Cummings, Stirling; Black, Robert E.

    2015-01-01

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

  14. Evaluation of the feasibility of international growth standards for school-aged children and adolescents.

    PubMed

    Butte, Nancy F; Garza, Cutberto; de Onis, Mercedes

    2007-01-01

    The development of an international growth standard for the screening, surveillance, and monitoring of school-aged children and adolescents has been motivated by 2 contemporaneous events, the global surge in childhood obesity and the release of a new international growth standard for infants and preschool children by the WHO. If a prescriptive approach analogous to that taken by WHO for younger children is to be adopted for school-aged children and adolescents, several issues need to be addressed regarding the universality of growth potential across populations and the definition of optimal growth in children and adolescents. A working group of experts in growth and development and representatives from international organizations concluded that subpopulations exhibit similar patterns of growth when exposed to similar external conditioners of growth. However, based on available data, we cannot rule out that observed differences in linear growth across ethnic groups reflect true differences in genetic potential rather than environmental influences. Therefore, the sampling frame for the development of an international growth standard for children and adolescents must include multiethnic sampling strategies designed to capture the variation in human growth patterns. A single international growth standard for school-aged children and adolescents could be developed with careful consideration of the population and individual selection criteria, study design, sample size, measurements, and statistical modeling of primary growth and secondary ancillary data. The working group agreed that existing growth references for school-aged children and adolescents have shortcomings, particularly for assessing obesity, and that appropriate growth standards for these age groups should be developed for clinical and public health applications.

  15. [Gains in life expectancy at birth in Brazil after the year 2000: the impact of mortality variations by age and cause of death].

    PubMed

    Corrêa, Érika Ribeiro Pereira; Miranda-Ribeiro, Adriana de

    2017-03-01

    Life expectancy at birth is a synthetic mortality indicator that reflects the general living conditions of the population. Changes in mortality by age and causes of death generate no explicit changes in the indicator. The application of a decomposition method can bring light to the analysis of the phenomenon. The aim of this study was to estimate the contribution of age groups and causes of death in the variation in life expectancy at birth, for men and women, from 2000 to 2010, by applying Pollard's decomposition method. Brazilian life tables were obtained from IBGE and death data from SIM. The results indicate that the age group that most contributed to the increase in life expectancy was of less than 1 year old. Among the defined causes, cardiovascular diseases were responsible for the largest increase in life expectancy.

  16. Motor neuron disease mortality in Great Britain continues to rise: examination of mortality rates 1975 - 2004.

    PubMed

    Day, Thomas G; Scott, Martin; Perring, Roslyn; Doyle, Pat

    2007-12-01

    Motor neuron disease (MND) mortality rates are rising in Europe and the USA. The most comprehensive UK study was conducted more than 15 years ago. This study examines trends in mortality from MND in England & Wales, and Scotland, between 1975 and 2004. Age, gender, and cause-specific mortality rates were calculated for the period 1975-2004 using national data from England & Wales, and Scotland. Rates were directly age-standardized to the European standard population. Trends in mortality rates over time were examined for men and women separately, as well as by the age groups 0-59 years, and 60 or more years. MND mortality rates rose steadily over the 30-year period 1975-2004 in both sexes in England & Wales, and Scotland. There is a clear upward trend in all four groups (p for trend <0.001). All increases were largely restricted to the age group 60 years and above, with rates showing increases of 70-80%, and no evidence of a flattening of this trajectory. Rates for the 0-59 years age group remained stable over the period. There is evidence of a narrowing of the male-female gap in mortality rates for the age group over 60 years in England and Wales.

  17. Associations of Mortality With Ocular Disorders and an Intervention of High-Dose Antioxidants and Zinc in the Age-Related Eye Disease Study

    PubMed Central

    2006-01-01

    Objective To assess the association of ocular disorders and high doses of antioxidants or zinc with mortality in the Age-Related Eye Disease Study (AREDS). Methods Baseline fundus and lens photographs were used to grade the macular and lens status of AREDS participants. Participants were randomly assigned to receive oral supplements of high-dose antioxidants, zinc, antioxidants plus zinc, or placebo. Risk of all-cause and cause-specific mortality was assessed using adjusted Cox proportional hazards models. Results During median follow-up of 6.5 years, 534 (11%) of 4753 AREDS participants died. In fully adjusted models, participants with advanced age-related macular degeneration (AMD) compared with participants with few, if any, drusen had increased mortality (relative risk [RR], 1.41; 95% confidence interval [CI], 1.08–1.86). Advanced AMD was associated with cardiovascular deaths. Compared with participants having good acuity in both eyes, those with visual acuity worse than 20/40 in 1 eye had increased mortality (RR, 1.36; 95% CI, 1.12–1.65). Nuclear opacity (RR, 1.40; 95% CI, 1.12–1.75) and cataract surgery (RR, 1.55; 95% CI, 1.18–2.05) were associated with increased all-cause mortality and with cancer deaths. Participants randomly assigned to receive zinc had lower mortality than those not taking zinc (RR, 0.73; 95% CI, 0.61–0.89). Conclusions The decreased survival of AREDS participants with AMD and cataract suggests that these conditions may reflect systemic rather than only local processes. The improved survival in individuals randomly assigned to receive zinc requires further study. PMID:15136320

  18. Decomposing Black-White Disparities in Heart Disease Mortality in the United States, 1973-2010: An Age-Period-Cohort Analysis.

    PubMed

    Kramer, Michael R; Valderrama, Amy L; Casper, Michele L

    2015-08-15

    Against the backdrop of late 20th century declines in heart disease mortality in the United States, race-specific rates diverged because of slower declines among blacks compared with whites. To characterize the temporal dynamics of emerging black-white racial disparities in heart disease mortality, we decomposed race-sex-specific trends in an age-period-cohort (APC) analysis of US mortality data for all diseases of the heart among adults aged ≥35 years from 1973 to 2010. The black-white gap was largest among adults aged 35-59 years (rate ratios ranged from 1.2 to 2.7 for men and from 2.3 to 4.0 for women) and widened with successive birth cohorts, particularly for men. APC model estimates suggested strong independent trends across generations ("cohort effects") but only modest period changes. Among men, cohort-specific black-white racial differences emerged in the 1920-1960 birth cohorts. The apparent strength of the cohort trends raises questions about life-course inequalities in the social and health environments experienced by blacks and whites which could have affected their biomedical and behavioral risk factors for heart disease. The APC results suggest that the genesis of racial disparities is neither static nor restricted to a single time scale such as age or period, and they support the importance of equity in life-course exposures for reducing racial disparities in heart disease.

  19. Allanite age-dating: Non-matrix-matched standardization in quadrupole LA-ICP-MS

    NASA Astrophysics Data System (ADS)

    Burn, M.; Lanari, P.; Pettke, T.; Engi, M.

    2014-12-01

    Allanite Th-U-Pb age-dating has recently been found to be powerful in unraveling the timing of geological processes such as the metamorphic dynamics in subduction zones and crystallization velocity of magmas. However, inconsistencies among analytical techniques have raised doubts about the accuracy of allanite age data. Spot analysis techniques such as LA-ICP-MS are claimed to be crucially dependent on matrix-matched standards, the quality of which is variable. We present a new approach in LA-ICP-MS data reduction that allows non-matrix-matched standardization via well constrained zircon reference materials as primary standards. Our data were obtained using a GeoLas Pro 193 nm ArF excimer laser ablation system coupled to an ELAN DRC-e quadrupole ICP-MS. We use 32 μm and 24 μm spot sizes; laser operating conditions of 9 Hz repetition rate and 2.5 J/cm2 fluence have proven advantageous. Matrix dependent downhole fractionation evolution is empirically determined by analyzing 208Pb/232Th and 206Pb/238U and applied prior to standardization. The new data reduction technique was tested on three magmatic allanite reference materials (SISSb, CAPb, TARA); within error these show the same downhole fractionation evolution for all allanite types and in different analytical sessions, provided measurement conditions remain the same. Although the downhole evolution of allanite and zircon differs significantly, a link between zircon and allanite matrix is established by assuming CAPb and TARA to be fixed at the corresponding reference ages. Our weighted mean 208Pb/232Th ages are 30.06 ± 0.22 (2σ) for SISSb, 275.4 ± 1.3 (2σ) for CAPb, and 409.9 ± 1.8 (2σ) for TARA. Precision of single spot age data varies between 1.5 and 8 % (2σ), dependent on spot size and common lead concentrations. Quadrupole LA-ICP-MS allanite age-dating has thus similar uncertainties as do other spot analysis techniques. The new data reduction technique is much less dependent on quality and homogeneity

  20. Historical cohort study of US man-made vitreous fiber production workers: VI. Respiratory system cancer standardized mortality ratios adjusted for the confounding effect of cigarette smoking.

    PubMed

    Marsh, G M; Buchanich, J M; Youk, A O

    2001-09-01

    To date, the US cohort study of man-made vitreous fiber workers has provided no consistent evidence of a relationship between man-made vitreous fiber exposure and mortality from malignant or non-malignant respiratory disease. Nevertheless, there have been small, overall excesses in respiratory system cancer (RSC) among workers from the fiberglass and rock/slag wool production plants included in the study that were unexplained by estimated worker exposures to respirable fiber or other agents present in the plants. The present investigation was designed to provide a quantitative estimate of the extent to which the overall excess in RSC mortality observed at the total cohort level among male fiberglass and rock/slag wool workers is a result of the positive confounding effects of cigarette smoking. Because cigarette-smoking data were neither available nor obtainable at the individual level for all members of the fiberglass and rock/slag wool cohorts, we used the "indirect" method to adjust RSC standardized mortality ratios (SMRs) at the group (cohort and plant) level. Our adjustment suggested that cigarette smoking accounts for all of the 7% and 24% excesses in RSC observed, respectively, for the male fiberglass and rock/slag wool cohorts in the latest mortality updates. The same conclusion was reached regardless of which of several alternative formulations were used to adjust local rate-based RSC SMRs. We found that our smoking adjustments were robust with respect to several alternative characterizations and (with the exception of one fiberglass plant) produced adjusted RSC SMRs that were lower than their unadjusted counterparts. Further, all statistically significantly elevated unadjusted SMRs were reduced to not statistically significant levels. These results reaffirm that RSC SMRs based on US and local rates must take into account the potential confounding effects of cigarette smoking. They also suggest that the use of local county mortality rate-based SMRs may not

  1. Association of Cognitive Function With Cause-Specific Mortality in Middle and Older Age: Follow-up of Participants in the English Longitudinal Study of Ageing

    PubMed Central

    Batty, G. David; Deary, Ian J.; Zaninotto, Paola

    2016-01-01

    We examined the little-tested associations between general cognitive function in middle and older age and later risk of death from chronic diseases. In the English Longitudinal Study of Ageing (2002–2012), 11,391 study participants who were 50–100 years of age at study induction underwent a battery of cognitive tests and provided a range of collateral data. In an analytical sample of 9,204 people (4,982 women), there were 1,488 deaths during follow-up (mean duration, 9.0 years). When we combined scores from 4 cognition tests that represented 3 acknowledged key domains of cognitive functioning (memory, executive function, and processing speed), cognition was inversely associated with deaths from cancer (per each 1-standard-deviation decrease in general cognitive function score, hazard ratio = 1.21, 95% CI: 1.10, 1.33), cardiovascular disease (hazard ratio = 1.71, 95% CI: 1.55, 1.89), other causes (hazard ratio = 2.07, 95% CI: 1.79, 2.40), and respiratory illness (hazard ratio = 2.48, 95% CI: 2.12, 2.90). Controlling for a range of covariates, such as health behaviors and socioeconomic status, and left-censoring to explore reverse causality had very little impact on the strength of these relationships. These findings indicate that cognitive test scores can provide relatively simple indicators of the risk of death from an array of chronic diseases and that these associations appear to be independent of other commonly assessed risk factors. PMID:26803665

  2. Mortality due to coronary heart disease and kidney disease among middle-aged and elderly men and women with gout in the Singapore Chinese Health Study

    PubMed Central

    Teng, Gim Gee; Ang, Li-Wei; Saag, Kenneth G; Yu, Mimi C; Yuan, Jian-Min; Koh, Woon-Puay

    2012-01-01

    Objectives Whether the link between gout and mortality is causal or confounded by lifestyle factors or comorbidities remains unclear. Studies in Asia are warranted due to the rapid modernisation of the locale and ageing of the population. Methods The association between gout and mortality was examined in a prospective cohort, the Singapore Chinese Health Study, comprising 63 257 Singapore Chinese individuals, aged 45–74 years during the enrolment period of 1993–8. All enrollees were interviewed in person on lifestyle factors, current diet and medical histories. All surviving cohort members were contacted by telephone during 1999–2004 to update selected exposure and medical histories (follow-up I interview), including the history of physician-diagnosed gout. Cause-specific mortality in the cohort was identified via record linkage with the nationwide death registry, up to 31 December 2009. Results Out of 52 322 participants in the follow-up I interview, 2117 (4.1%) self-reported a history of physician-diagnosed gout, with a mean age at diagnosis of 54.7 years. After a mean follow-up period of 8.1 years, there were 6660 deaths. Relative to non-gout subjects, subjects with gout had a higher risk of death (HR 1.18; 95% CI 1.06 to 1.32), and specifi cally from death due to coronary heart disease (CHD) (HR 1.38, 95% CI 1.10 to 1.73) and kidney disease (HR 5.81, 95% CI 3.61 to 9.37). All gout–mortality risk associations were present in both genders but the risk estimates appeared higher for women. Conclusion Gout is an independent risk factor for mortality, and specifically for death due to CHD and kidney disease. PMID:22172492

  3. Temporal and spatial relations between age specific mortality and ambient air quality in the United States: regression results for counties, 1960–97

    PubMed Central

    Lipfert, F; Morris, S

    2002-01-01

    Objective: To investigate longitudinal and spatial relations between air pollution and age specific mortality for United States counties (except Alaska) from 1960 to the end of 1997. Methods: Cross sectional regressions for five specific periods using published data on mortality, air quality, demography, climate, socioeconomic status, lifestyle, and diet. Outcome measures are statistical relations between air quality and county mortalities by age group for all causes of death, other than AIDS and trauma. Results: A specific regression model was developed for each period and age group, using variables that were significant (p<0.05), not substantially collinear (variance inflation factor <2), and had the expected algebraic sign. Models were initially developed without the air pollution variables, which varied in spatial coverage. Residuals were then regressed in turn against current and previous air quality, and dose-response plots were constructed. The validity of this two stage procedure was shown by comparing a subset of results with those obtained with single stage models that included air quality (correlation=0.88). On the basis of attributable risks computed for overall mean concentrations, the strongest associations were found in the earlier periods, with attributable risks usually less than 5%. Stronger relations were found when mortality and air quality were measured in the same period and when the locations considered were limited to those of previous cohort studies (for PM2.5 and SO42-). Thresholds were suggested at 100–130 µg/m3 for mean total suspended particulate (TSP), 7–10 µg/m3 for mean sulfate, 10–15 ppm for peak (95th percentile) CO, 20–40 ppb for mean SO2. Contrary to expectations, associations were often stronger for the younger age groups (<65 y). Responses to PM, CO, and SO2 declined over time; responses in elderly people to peak O3 increased over time as did responses to NO2 for the younger age groups. These results generally agreed

  4. Canada acute coronary syndrome score was a stronger baseline predictor than age ≥75 years of in-hospital mortality in acute coronary syndrome patients in western Romania

    PubMed Central

    Pogorevici, Antoanela; Citu, Ioana Mihaela; Bordejevic, Diana Aurora; Caruntu, Florina; Tomescu, Mirela Cleopatra

    2016-01-01

    Background Several risk scores were developed for acute coronary syndrome (ACS) patients, but their use is limited by their complexity. Purpose The purpose of this study was to identify predictors at admission for in-hospital mortality in ACS patients in western Romania, using a simple risk-assessment tool – the new Canada acute coronary syndrome (C-ACS) risk score. Patients and methods The baseline risk of patients admitted with ACS was retrospectively assessed using the C-ACS risk score. The score ranged from 0 to 4; 1 point was assigned for the presence of each of the following parameters: age ≥75 years, Killip class >1, systolic blood pressure <100 mmHg, and heart rate >100 bpm. Results A total of 960 patients with ACS were included, 409 (43%) with ST-segment elevation myocardial infarction (STEMI) and 551 (57%) with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). The C-ACS score predicted in-hospital mortality in all ACS patients with a C-statistic of 0.95 (95% CI: 0.93–0.96), in STEMI patients with a C-statistic of 0.92 (95% confidence interval [CI]: 0.89–0.94), and in NSTE-ACS patients with a C-statistic of 0.97 (95% CI: 0.95–0.98). Of the 960 patients, 218 (22.7%) were aged ≥75 years. The proportion of patients aged ≥75 years was 21.7% in the STEMI subgroup and 23.4% in the NSTE-ACS subgroup (P>0.05). Age ≥75 years was significantly associated with in-hospital mortality in ACS patients (odds ratio [OR]: 3.25, 95% CI: 1.24–8.25) and in the STEMI subgroup (OR >3.99, 95% CI: 1.28–12.44). Female sex was strongly associated with mortality in the NSTE-ACS subgroup (OR: 27.72, 95% CI: 1.83–39.99). Conclusion We conclude that C-ACS score was the strongest predictor of in-hospital mortality in all ACS patients while age ≥75 years predicted the mortality well in the STEMI subgroup. PMID:27217732

  5. Higher mortality and impaired elimination of bacteria in aged mice after intracerebral infection with E. coli are associated with an age-related decline of microglia and macrophage functions.

    PubMed

    Schütze, Sandra; Ribes, Sandra; Kaufmann, Annika; Manig, Anja; Scheffel, Jörg; Redlich, Sandra; Bunkowski, Stephanie; Hanisch, Uwe-Karsten; Brück, Wolfgang; Nau, Roland

    2014-12-30

    Incidence and mortality of bacterial meningitis are strongly increased in aged compared to younger adults demanding new strategies to improve prevention and therapy of bacterial central nervous system (CNS) infections the elderly. Here, we established a geriatric mouse model for an intracerebral E. coli infection which reflects the clinical situation in aged patients: After intracerebral challenge with E. coli K1, aged mice showed a higher mortality, a faster development of clinical symptoms, and a more pronounced weight loss. Elimination of bacteria and systemic inflammatory response were impaired in aged mice, however, the number of infiltrating leukocytes and microglial cells in the CNS of aged and young mice did not differ substantially. In vitro, primary microglial cells and peritoneal macrophages from aged mice phagocytosed less E. coli and released less NO and cyto-/chemokines compared to cells from young mice both without activation and after stimulation by agonists of TLR 2, 4, and 9. Our results suggest that the age-related decline of microglia and macrophage functions plays an essential role for the higher susceptibility of aged mice to intracerebral infections. Strategies to improve the phagocytic potential of aged microglial cells and macrophages appear promising for prevention and treatment of CNS infections in elderly patients.

  6. Societal integration and age-standardized suicide rates in 21 developed countries, 1955-1989.

    PubMed

    Fernquist, R M; Cutright, P

    1998-01-01

    Gender-specific age-standardized suicide rates for 21 developed countries over seven 5-year periods (1955-59...1985-89) form the two dependent variables. Durkheim's theory of societal integration is the framework used to generate the independent variables, although several recent theories are also examined. The results from a MGLS multiple regression analysis of both male and female rates provide overwhelming support for a multidimensional theory of societal integration and suicide, as first suggested by Durkheim.

  7. Structural pluralism and all-cause mortality.

    PubMed Central

    Young, F W; Lyson, T A

    2001-01-01

    OBJECTIVES: This study tested the hypothesis that "structural pluralism" reduces age-standardized mortality rates. Structural pluralism is defined as the potential for political competition in communities. METHODS: US counties were the units of analysis. Multiple regression techniques were used to test the hypothesis. RESULTS: Structural pluralism is a stronger determinant of lower mortality than any of the other variables examined--specifically, income, education, and medical facilities. CONCLUSIONS: These findings support the case for a new structural variable, pluralism, as a possible cause of lower mortality, and they indirectly support the significance of comparable ecologic dimensions, such as social trust. PMID:11189808

  8. Validation of the Shock Index, Modified Shock Index, and Age Shock Index for Predicting Mortality of Geriatric Trauma Patients in Emergency Departments

    PubMed Central

    2016-01-01

    The shock index (SI), modified shock index (MSI), and age multiplied by SI (Age SI) are used to assess the severity and predict the mortality of trauma patients, but their validity for geriatric patients is controversial. The purpose of this investigation was to assess predictive value of the SI, MSI, and Age SI for geriatric trauma patients. We used the Emergency Department-based Injury In-depth Surveillance (EDIIS), which has data from 20 EDs across Korea. Patients older than 65 years who had traumatic injuries from January 2008 to December 2013 were enrolled. We compared in-hospital and ED mortality of groups categorized as stable and unstable according to indexes. We also assessed their predictive power of each index by calculating the area under the each receiver operating characteristic (AUROC) curve. A total of 45,880 cases were included. The percentage of cases classified as unstable was greater among non-survivors than survivors for the SI (36.6% vs. 1.8%, P < 0.001), the MSI (38.6% vs. 2.2%, P < 0.001), and the Age SI (69.4% vs. 21.3%, P < 0.001). Non-survivors had higher median values than survivors on the SI (0.84 vs. 0.57, P < 0.001), MSI (0.79 vs. 1.14, P < 0.001), and Age SI (64.0 vs. 41.5, P < 0.001). The predictive power of the Age SI for in-hospital mortality was higher than SI (AUROC: 0.740 vs. 0.674, P < 0.001) or MSI (0.682, P < 0.001) in geriatric trauma patients. PMID:27822945

  9. Validation of the Shock Index, Modified Shock Index, and Age Shock Index for Predicting Mortality of Geriatric Trauma Patients in Emergency Departments.

    PubMed

    Kim, Soon Yong; Hong, Ki Jeong; Shin, Sang Do; Ro, Young Sun; Ahn, Ki Ok; Kim, Yu Jin; Lee, Eui Jung

    2016-12-01

    The shock index (SI), modified shock index (MSI), and age multiplied by SI (Age SI) are used to assess the severity and predict the mortality of trauma patients, but their validity for geriatric patients is controversial. The purpose of this investigation was to assess predictive value of the SI, MSI, and Age SI for geriatric trauma patients. We used the Emergency Department-based Injury In-depth Surveillance (EDIIS), which has data from 20 EDs across Korea. Patients older than 65 years who had traumatic injuries from January 2008 to December 2013 were enrolled. We compared in-hospital and ED mortality of groups categorized as stable and unstable according to indexes. We also assessed their predictive power of each index by calculating the area under the each receiver operating characteristic (AUROC) curve. A total of 45,880 cases were included. The percentage of cases classified as unstable was greater among non-survivors than survivors for the SI (36.6% vs. 1.8%, P < 0.001), the MSI (38.6% vs. 2.2%, P < 0.001), and the Age SI (69.4% vs. 21.3%, P < 0.001). Non-survivors had higher median values than survivors on the SI (0.84 vs. 0.57, P < 0.001), MSI (0.79 vs. 1.14, P < 0.001), and Age SI (64.0 vs. 41.5, P < 0.001). The predictive power of the Age SI for in-hospital mortality was higher than SI (AUROC: 0.740 vs. 0.674, P < 0.001) or MSI (0.682, P < 0.001) in geriatric trauma patients.

  10. IQ in Early Adulthood, Socioeconomic Position, and Unintentional Injury Mortality by Middle Age: A Cohort Study of More Than 1 Million Swedish Men

    PubMed Central

    Batty, G. David; Gale, Catharine R.; Tynelius, Per; Deary, Ian J.

    2009-01-01

    The authors evaluated the little-examined association between intelligence (IQ) and injury mortality and, for the first known time, explored the extent to which IQ might explain established socioeconomic inequalities in injury mortality. A nationwide cohort of 1,116,442 Swedish men who underwent IQ testing at about 18 years of age was followed for mortality experience for an average of 22.6 years. In age-adjusted analyses in which IQ scores were classified into 4 groups, relative to the highest scoring category, the hazard ratio in the lowest was elevated for all injury types: poisonings (hazard ratio (HR) = 5.82, 95% confidence interval (CI): 4.25, 7.97), fire (HR = 4.39, 95% CI: 2.51, 7.77), falls (HR = 3.17, 95% CI: 2.19, 4.59), drowning (HR = 3.16, 95% CI: 1.85, 5.39), and road injury (HR = 2.17, 95% CI: 1.91, 2.47). Dose-response effects across the full IQ range were evident (P-trend < 0.001). Control for potential covariates, including socioeconomic position, had little impact on these gradients. When socioeconomic disadvantage—indexed by parental and subject's own occupational social class—was the exposure of interest, IQ explained a sizable portion (19%–86%) of the relation with injury mortality. These findings suggest that IQ may have an important role both in the etiology of injuries and in explaining socioeconomic inequalities in injury mortality. PMID:19147741

  11. The healthy immigrant effect and mortality rates.

    PubMed

    Ng, Edward

    2011-12-01

    According to the 2006 Census, almost the Canadian population were foreign-born, a percentage that is projected to reach at least 25% by 2031. Studies based on age-standardized mortality rates (ASMR) have found a healthy immigrant effect, with lower overall rates among immigrants. A duration effect has also been observed-immigrants' mortality advantage lessened as their time in Canada increased. ASMRs based on the 1991 to 2001 census mortality follow-up study indicate a healthy immigrant effect and a duration effect at the national level for all-cause mortality for both sexes. However, at the national level, the mortality rate among women from the United States and from Sub-Saharan Africa was similar to that of Canadian-born women. For the three largest Census Metropolitan Areas (Toronto, Montreal and Vancouver), a healthy immigrant effect was not observed among women or among most men from the United States or Sub-Saharan Africa.

  12. Important Risk Factors of Mortality Among Children Aged 1-59 Months in Rural Areas of Shahroud, Iran: A Community-based Nested Case-Control Study

    PubMed Central

    Chaman, Reza; Alami, Ali; Emamian, Mohammad Hassan; Naieni, Kourosh Holakouie; Mirmohammadkhani, Majid; Ahmadnezhad, Elham; Entezarmahdi, Rasool; Shati, Mohsen; Shariati, Mohammad

    2012-01-01

    Background: The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. Methods: This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. Results: Mortality was significantly associated with breastfeeding duration (OR: 0.87, 95% CI: 0.81-0.93), total health care visits (OR: 0.90, 95% CI: 0.83-0.98) and low birth weight (LBW) (OR: 7.38, 95% CI: 1.37-39.67). Conclusion: In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators. PMID:23272287

  13. Association of frontal QRS-T angle--age risk score on admission electrocardiogram with mortality in patients admitted with an acute coronary syndrome.

    PubMed

    Lown, Mark T; Munyombwe, Theresa; Harrison, Wendy; West, Robert M; Hall, Christiana A; Morrell, Christine; Jackson, Beryl M; Sapsford, Robert J; Kilcullen, Niamh; Pepper, Christopher B; Batin, Phil D; Hall, Alistair S; Gale, Chris P

    2012-02-01

    Risk assessment is central to the management of acute coronary syndromes. Often, however, assessment is not complete until the troponin concentration is available. Using 2 multicenter prospective observational studies (Evaluation of Methods and Management of Acute Coronary Events [EMMACE] 2, test cohort, 1,843 patients; and EMMACE-1, validation cohort, 550 patients) of unselected patients with acute coronary syndromes, a point-of-admission risk stratification tool using frontal QRS-T angle derived from automated measurements and age for the prediction of 30-day and 2-year mortality was evaluated. Two-year mortality was lowest in patients with frontal QRS-T angles <38° and highest in patients with frontal QRS-T angles >104° (44.7% vs 14.8%, p <0.001). Increasing frontal QRS-T angle-age risk (FAAR) scores were associated with increasing 30-day and 2-year mortality (for 2-year mortality, score 0 = 3.7%, score 4 = 57%; p <0.001). The FAAR score was a good discriminator of mortality (C statistics 0.74 [95% confidence interval 0.71 to 0.78] at 30 days and 0.77 [95% confidence interval 0.75 to 0.79] at 2 years), maintained its performance in the EMMACE-1 cohort at 30 days (C statistics 0.76 (95% confidence interval 0.71 to 0.8] at 30 days and 0.79 (95% confidence interval 0.75 to 0.83] at 2 years), in men and women, in ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction, and compared favorably with the Global Registry of Acute Coronary Events (GRACE) score. The integrated discrimination improvement (age to FAAR score at 30 days and at 2 years in EMMACE-1 and EMMACE-2) was p <0.001. In conclusion, the FAAR score is a point-of-admission risk tool that predicts 30-day and 2-year mortality from 2 variables across a spectrum of patients with acute coronary syndromes. It does not require the results of biomarker assays or rely on the subjective interpretation of electrocardiograms.

  14. All cause mortality and the case for age specific alcohol consumption guidelines: pooled analyses of up to 10 population based cohorts

    PubMed Central

    Coombs, Ngaire; Stamatakis, Emmanuel; Biddulph, Jane P

    2015-01-01

    Objectives To examine the suitability of age specific limits for alcohol consumption and to explore the association between alcohol consumption and mortality in different age groups. Design Population based data from Health Survey for England 1998-2008, linked to national mortality registration data and pooled for analysis using proportional hazards regression. Analyses were stratified by sex and age group (50-64 and ≥65 years). Setting Up to 10 waves of the Health Survey for England, which samples the non-institutionalised general population resident in England. Participants The derivation of two analytical samples was based on the availability of comparable alcohol consumption data, covariate data, and linked mortality data among adults aged 50 years or more. Two samples were used, each utilising a different variable for alcohol usage: self reported average weekly consumption over the past year and self reported consumption on the heaviest day in the past week. In fully adjusted analyses, the former sample comprised Health Survey for England years 1998-2002, 18 368 participants, and 4102 deaths over a median follow-up of 9.7 years, whereas the latter comprised Health Survey for England years 1999-2008, 34 523 participants, and 4220 deaths over a median follow-up of 6.5 years. Main outcome measure All cause mortality, defined as any death recorded between the date of interview and the end of data linkage on 31 March 2011. Results In unadjusted models, protective effects were identified across a broad range of alcohol usage in all age-sex groups. These effects were attenuated across most use categories on adjustment for a range of personal, socioeconomic, and lifestyle factors. After the exclusion of former drinkers, these effects were further attenuated. Compared with self reported never drinkers, significant protective associations were limited to younger men (50-64 years) and older women (≥65 years). Among younger men, the range of protective effects was

  15. QT-Interval Duration and Mortality Rate

    PubMed Central

    Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo

    2012-01-01

    Background Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval–corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to <410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds) with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population. PMID:22025428

  16. Trends in colorectal cancer mortality in Europe: retrospective analysis of the WHO mortality database

    PubMed Central

    Ait Ouakrim, Driss; Pizot, Cécile; Boniol, Magali; Malvezzi, Matteo; Boniol, Mathieu; Negri, Eva; Bota, Maria; Jenkins, Mark A; Bleiberg, Harry

    2015-01-01

    Objective To examine changes in colorectal cancer mortality in 34 European countries between 1970 and 2011. Design Retrospective trend analysis. Data source World Health Organization mortality database. Population Deaths from colorectal cancer between 1970 and 2011. Profound changes in screening and treatment efficiency took place after 1988; therefore, particular attention was paid to the evolution of colorectal cancer mortality in the subsequent period. Main outcomes measures Time trends in rates of colorectal cancer mortality, using joinpoint regression analysis. Rates were age adjusted using the standard European population. Results From 1989 to 2011, colorectal cancer mortality increased by a median of 6.0% for men and decreased by a median of 14.7% for women in the 34 European countries. Reductions in colorectal cancer mortality of more than 25% in men and 30% in women occurred in Austria, Switzerland, Germany, the United Kingdom, Belgium, the Czech Republic, Luxembourg, and Ireland. By contrast, mortality rates fell by less than 17% in the Netherlands and Sweden for both sexes. Over the same period, smaller or no declines occurred in most central European countries. Substantial mortality increases occurred in Croatia, the former Yugoslav republic of Macedonia, and Romania for both sexes and in most eastern European countries for men. In countries with decreasing mortality, reductions were more important for women of all ages and men younger than 65 years. In the 27 European Union member states, colorectal cancer mortality fell by 13.0% in men and 27.0% in women, compared with corresponding reductions of 39.8% and 38.8% in the United States. Conclusion Over the past 40 years, there has been considerable disparity in the level of colorectal cancer mortality between European countries, as well as between men and women and age categories. Countries with the largest reductions in colorectal cancer mortality are characterised by better accessibility to screening

  17. The ability of three different models of frailty to predict all-cause mortality: results from the European Male Aging Study (EMAS).

    PubMed

    Ravindrarajah, Rathi; Lee, David M; Pye, Stephen R; Gielen, Evelien; Boonen, Steven; Vanderschueren, Dirk; Pendleton, Neil; Finn, Joseph D; Tajar, Abdelouahid; O'Connell, Matthew D L; Rockwood, Kenneth; Bartfai, György; Casanueva, Felipe F; Forti, Gianni; Giwercman, Aleksander; Han, Thang S; Huhtaniemi, Ilpo T; Kula, Krzysztof; Lean, Michael E J; Punab, Margus; Wu, Frederick C W; O'Neill, Terence W

    2013-01-01

    Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n=2929) at baseline and 6.6% (n=193) died over a median 4.3 years of follow-up. The FI was generated from 39 deficits, including self-reported health, morbidities, functional performance and psychological assessments. The FP and FS consisted of five phenotypic criteria and both categorized individuals as robust when they had 0 criteria, prefrail as 1-2 criteria and frail as 3+ criteria. The mean FI increased linearly with age (r(2)=0.21) and in Cox regression models adjusted for age, center, smoking and partner status the hazard ratio (HR) for death for each unit increase of the FI was 1.49. Men who were prefrail or frail by either the FP or FS definitions, had a significantly increased risk of death compared to their robust counterparts. Compared to robust men, those who were FP frail at baseline had a HR for death of 3.84, while those who were FS frail had a HR of 3.87. All three frailty models significantly predicted future mortality among community-dwelling, middle-aged and older European men after adjusting for potential confounders. Our data suggest that the choice of frailty model may not be of paramount importance when predicting future risk of death, enabling flexibility in the approach used.

  18. Infant mortality and morbidity associated with preterm and small-for-gestational-age births in Southern Mozambique: A retrospective cohort study

    PubMed Central

    García-Basteiro, Alberto L.; Quintó, Llorenç; Macete, Eusebio; Bardají, Azucena; González, Raquel; Nhacolo, Arsenio; Sigauque, Betuel; Sacoor, Charfudin; Rupérez, María; Sicuri, Elisa; Bassat, Quique; Sevene, Esperança; Menéndez, Clara

    2017-01-01

    Background Preterm and small for gestational age (SGA) births have been associated with adverse outcomes during the first stages of life. We evaluated the morbidity and mortality associated with preterm and SGA births during the first year of life in a rural area of Southern Mozambique. Methods This is a retrospective cohort study using previously collected data from children born at the Manhiça District Hospital in two different periods (2003–2005 and 2010–2012). Newborns were classified as being preterm and/or SGA or as babies not fulfilling any of the previous conditions (term non-SGA). All children were followed up for a year for morbidity and mortality outcomes. Results A total of 5574 live babies were included in the analysis. The prevalence of preterm delivery was 6.2% (345/5574); the prevalence of SGA was 14.0% (776/5542) and 2.2% (114/5542) of the children presented both conditions. During the neonatal period, preterm delivery and SGA were associated with 13 (HR: 13.0, 95% CI 4.0–42.2) and 5 times (HR: 4.5, 95% CI: 1.6–12.6) higher mortality compared to term non SGA babies. Risk of hospitalization was only increased when both conditions were present (IRR: 3.5, 95%CI: 1.5–8.1). Mortality is also increased during the entire first year, although at a lower rate. Conclusions Neonatal and infant mortality rates are remarkably high among preterm and SGA babies in southern Mozambique. These increased rates are concentrated within the neonatal period. Prompt identification of these conditions is needed to implement interventions aimed at increasing survival of these high-risk newborns. PMID:28212393

  19. Patterns and Trends in Age-Specific Black-White Differences in Breast Cancer Incidence and Mortality - United States, 1999-2014.

    PubMed

    Richardson, Lisa C; Henley, S Jane; Miller, Jacqueline W; Massetti, Greta; Thomas, Cheryll C

    2016-10-14

    Breast cancer continues to be the most commonly diagnosed cancer and the second leading cause of cancer deaths among U.S. women (1). Compared with white women, black women historically have had lower rates of breast cancer incidence and, beginning in the 1980s, higher death rates (1). This report examines age-specific black-white disparities in breast cancer incidence during 1999-2013 and mortality during 2000-2014 in the United States using data from United States Cancer Statistics (USCS) (2). Overall rates of breast cancer incidence were similar, but death rates remained higher for black women compared with white women. During 1999-2013, breast cancer incidence decreased among white women but increased slightly among black women resulting in a similar average incidence at the end of the period. Breast cancer incidence trends differed by race and age, particularly from 1999 to 2004-2005, when rates decreased only among white women aged ≥50 years. Breast cancer death rates decreased significantly during 2000-2014, regardless of age with patterns varying by race. For women aged ≥50 years, death rates declined significantly faster among white women compared with black women; among women aged <50 years, breast cancer death rates decreased at the same rate among black and white women. Although some of molecular factors that lead to more aggressive breast cancer are known, a fuller understanding of the exact mechanisms might lead to more tailored interventions that could decrease mortality disparities. When combined with population-based approaches to increase knowledge of family history of cancer, increase physical activity, promote a healthy diet to maintain a healthy bodyweight, and increase screening for breast cancer, targeted treatment interventions could reduce racial disparities in breast cancer.

  20. Malignant mesothelioma mortality in the United States, 1999-2001.

    PubMed

    Bang, Ki Moon; Pinheiro, Germania A; Wood, John M; Syamlal, Girija

    2006-01-01

    Malignant mesothelioma is strongly associated with asbestos exposure. This paper describes demographic, geographic, and occupational distributions of mesothelioma mortality in the United States, 1999-2001. The data (n = 7,524) were obtained from the National Center for Health Statistics multiple-cause-of-death records. Mortality rates (per million per year) were age-adjusted to the 2000 U.S. standard population, and proportionate mortality ratios (PMRs) were calculated by occupation and industry, and adjusted for age, sex, and race. The overall age-adjusted mortality rate was 11.52, with males (22.34) showing a sixfold higher rate than females (3.94). Geographic distribution of mesothelioma mortality is predominantly coastal. Occupations with significantly elevated PMRs included plumbers/pipefitters and mechanical engineers. Industries with significantly elevated PMRs included ship and boat building and repairing, and industrial and miscellaneous chemicals. These surveillance findings can be useful in generating hypotheses and developing strategies to prevent mesothelioma.

  1. Effects of age of cattle, turning technology and compost environment on disappearance of bone from mortality compost.

    PubMed

    Stanford, K; Hao, X; Xu, S; McAllister, T A; Larney, F; Leonard, J J

    2009-10-01

    As residual bones in mortality compost negatively impact subsequent tillage, two studies were performed. For the first study, windrows of mature cattle or calves were placed on a base of barley straw and covered with beef manure. Windrows were divided into two sections and turned at 3-month intervals. Approximately 5000 kg of finished compost per windrow was passed through a 6mm trommel screen, with bones collected and weighed. Bone weight was 0.66% of mature cattle compost and 0.38% of calf compost on a dry matter basis, but did not differ after adjustment for weights of compost ingredients. In a subsequent study, four windrows were constructed containing mortalities, straw and beef manure (STATC) or straw, manure and slaughter waste (STATW). Also, straw, beef manure and slaughter waste was added to an 850 L rolling drum composter (DRUMW). Fresh bovine long-bones from calves were collected, weighed and embedded in the compost. Bones were retrieved and weighed when windrows were turned, or with DRUMW, after 8 weeks. Temperatures achieved followed the order STATW>STATC>DRUMW (p<0.05). Rate of bone disappearance followed a pattern identical to temperature, with the weight of bones in STATW declining by 53.7% during 7 weeks of composting. For STATC, temperatures were uniform over three composting periods, but bone disappearance was improved (p<0.05) when compost dry matter was lower (46%), as compared to 58%. Using a ratio of five parts manure to one part mortalities, results of this study demonstrated that residual bone was <1% of cured cattle compost and may be reduced by maintaining a high compost temperature and moisture content.

  2. External Validation of a Case-Mix Adjustment Model for the Standardized Reporting of 30-Day Stroke Mortality Rates in China

    PubMed Central

    Yu, Ping; Pan, Yuesong; Wang, Yongjun; Wang, Xianwei; Liu, Liping; Ji, Ruijun; Meng, Xia; Jing, Jing; Tong, Xu; Guo, Li; Wang, Yilong

    2016-01-01

    Background and Purpose A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke. Methods The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson’s correlation coefficient. Results The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79–0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81–0.84). Excellent calibration was reported in the two models with Pearson’s correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). Conclusions The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke. PMID:27846282

  3. Quantifying the influence of safe road systems and legal licensing age on road mortality among young adolescents: steps towards system thinking.

    PubMed

    Twisk, Divera; Commandeur, Jacques J F; Bos, Niels; Shope, Jean T; Kok, Gerjo

    2015-01-01

    Based on existing literature, a system thinking approach was used to set up a conceptual model on the interrelationships among the components influencing adolescent road mortality, distinguishing between components at the individual level and at the system level. At the individual level the role of risk behaviour (sometimes deliberate and sometimes from inexperience or other non-deliberate causes) in adolescent road mortality is well documented. However, little is known about the extent to which the 'road system' itself may also have an impact on younger adolescents' road mortality. This, by providing a safe or unsafe road environment for all road users (System-induced exposure) and by allowing access to high-risk vehicles at a young or older age through the legal licensing age. This study seeks to explore these relationships by analysing the extent to which the road mortality of 10 to 17 year olds in various jurisdictions can be predicted from the System-induced Exposure (SiE) in a jurisdiction and from its legal licensing age to drive motor vehicles. SiE was operationalized as the number of road fatalities per 10(5) inhabitants/all ages together, but excluding the 10 to 17 year olds. Data on road fatalities during the years 2001 through 2008 were obtained from the OECD International Road Traffic Accident Database (IRTAD) and from the USA NHTSA's Fatality Analysis Reporting System (FARS) database for 29 early and 10 late licensing jurisdictions. Linear mixed models were fitted with annual 'Adolescent road mortality per capita' for 2001 through 2008 as the dependent variable, and time-dependent 'SiE' and time-independent 'Licensing system' as predictor variables. To control for different levels of motorisation, the time-dependent variable 'Annual per capita vehicle distance travelled' was used as a covariate. Licensing system of a jurisdiction was entered as a categorical predictor variable with late licensing countries as a baseline group. The study found support

  4. Physical Health Indicators Improve Prediction of Cardiovascular and All-cause Mortality among Middle-Aged and Older People: a National Population-based Study

    PubMed Central

    Lee, Wei-Ju; Peng, Li-Ning; Chiou, Shu-Ti; Chen, Liang-Kung

    2017-01-01

    The effectiveness of established methods for stratifying cardiovascular risk, for example, the Framingham risk score (FRS), may be improved by adding extra variables. This study evaluated the potential benefits of adding physical health indicators (handgrip strength, walking speed, and peak expiratory flow) to the FRS in predicting cardiovascular and all-cause mortality by using a nationwide population-based cohort study data. During median follow-up of 4.1 years, 67 of 911 study subjects had died. In Cox regression analysis, all additional physical health indicators, except walking speed, significantly predicted cardiovascular and all-cause mortality (P < 0.05). Compared with the conventional FRS, c statistics were significantly increased when dominant handgrip strength or relative handgrip strength (handgrip strength adjusted for body mass index), or combination with walking speed or peak expiratory flow were incorporated into the FRS prediction model, both in the whole cohort and also in participants who did not have prevalent cardiovascular diseases at baseline. In conclusion, dominant or relative handgrip strength are simple and inexpensive physical health indicators that substantially improve the accuracy of the FRS in predicting cardiovascular and all-cause mortality among middle-aged and older people. PMID:28079182

  5. Trends in laryngeal cancer mortality in Europe.

    PubMed

    Bosetti, Cristina; Garavello, Werner; Levi, Fabio; Lucchini, Franca; Negri, Eva; La Vecchia, Carlo

    2006-08-01

    After a steady increase since the 1950s, laryngeal cancer mortality had tended to level off since the early 1980s in men from most European countries. To update trends in laryngeal cancer mortality in Europe, age-standardized (world standard) mortality rates per 100,000 were derived from the WHO mortality database for 33 European countries over the period 1980-2001. Jointpoint analysis was used to identify significant changes in mortality rates. In the European Union (EU) as a whole, male mortality declined by 0.8% per year between 1980 and 1989, by 2.8% between 1989 and 1995, by 5.3% between 1995 and 1998, and by 1.5% thereafter (rates were 5.1/100,000 in 1980-1981 and 3.3/100,000 in 2000-2001). This mainly reflects a decrease in rates in men from western and southern European countries, which had exceedingly high rates in the past. Male laryngeal mortality rose up to the early 1990s, and leveled off thereafter in several countries from central and eastern Europe. In 2000-2001 there was still a 10-15-fold variation in male laryngeal mortality between the highest rates in Croatia (7.9/100,000) and Hungary (7.7/100,000) and the lowest ones in Sweden (0.5/100,000) and Finland (0.8/100,000). Laryngeal cancer mortality was comparatively low in women from most European countries, with stable rates around 0.3/100,000 in the EU as a whole over the last 2 decades. Laryngeal cancer trends should be interpreted in terms of patterns and changes in exposure to alcohol and tobacco. Despite recent declines, the persistence of a wide variability in male laryngeal cancer mortality indicates that there is still ample scope for prevention of laryngeal cancer in Europe.

  6. Predictions of mortality from pleural mesothelioma in Italy: a model based on asbestos consumption figures supports results from age-period-cohort models.

    PubMed

    Marinaccio, Alessandro; Montanaro, Fabio; Mastrantonio, Marina; Uccelli, Raffaella; Altavista, Pierluigi; Nesti, Massimo; Costantini, Adele Seniori; Gorini, Giuseppe

    2005-05-20

    Italy was the second main asbestos producer in Europe, after the Soviet Union, until the end of the 1980s, and raw asbestos was imported on a large scale until 1992. The Italian pattern of asbestos consumption lags on average about 10 years behind the United States, Australia, the United Kingdom and the Nordic countries. Measures to reduce exposure were introduced in the mid-1970s in some workplaces. In 1986, limitations were imposed on the use of crocidolite and in 1992 asbestos was definitively banned. We have used primary pleural cancer mortality figures (1970-1999) to predict mortality from mesothelioma among Italian men in the next 30 years by age-cohort-period models and by a model based on asbestos consumption figures. The pleural cancer/mesothelioma ratio and mesothelioma misdiagnosis in the past were taken into account in the analysis. Estimated risks of birth cohorts born after 1945 decrease less quickly in Italy than in other Western countries. The findings predict a peak with about 800 mesothelioma annual deaths in the period 2012-2024. Results estimated using age-period-cohort models were similar to those obtained from the asbestos consumption model.

  7. Peptic ulcers: mortality and hospitalization.

    PubMed

    Riley, R

    1991-01-01

    This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers.

  8. Stroke Mortality Among Alaska Native People

    PubMed Central

    Horner, Ronnie D.; Day, Gretchen M.; Lanier, Anne P.; Provost, Ellen M.; Hamel, Rebecca D.

    2009-01-01

    Objectives. We aimed to describe the epidemiology of stroke among Alaska Natives, which is essential for designing effective stroke prevention and intervention efforts for this population. Methods. We conducted an analysis of death certificate data for the state of Alaska for the period 1984 to 2003, comparing age-standardized stroke mortality rates among Alaska Natives residing in Alaska vs US Whites by age category, gender, stroke type, and time. Results. Compared with US Whites, Alaska Natives had significantly elevated stroke mortality from 1994 to 2003 but not from 1984 to 1993. Alaska Native women of all age groups and Alaska Native men younger than 45 years of age had the highest risk, although the rates for those younger than 65 years were statistically imprecise. Over the 20-year study period, the stroke mortality rate was stable for Alaska Natives but declined for US Whites. Conclusions. Stroke mortality is higher among Alaska Natives, especially women, than among US Whites. Over the past 20 years, there has not been a significant decline in stroke mortality among Alaska Natives. PMID:19762671

  9. Traditional and Emerging Lifestyle Risk Behaviors and All-Cause Mortality in Middle-Aged and Older Adults: Evidence from a Large Population-Based Australian Cohort

    PubMed Central

    Ding, Ding; Rogers, Kris; van der Ploeg, Hidde; Stamatakis, Emmanuel; Bauman, Adrian E.

    2015-01-01

    Background Lifestyle risk behaviors are responsible for a large proportion of disease burden worldwide. Behavioral risk factors, such as smoking, poor diet, and physical inactivity, tend to cluster within populations and may have synergistic effects on health. As evidence continues to accumulate on emerging lifestyle risk factors, such as prolonged sitting and unhealthy sleep patterns, incorporating these new risk factors will provide clinically relevant information on combinations of lifestyle risk factors. Methods and Findings Using data from a large Australian cohort of middle-aged and older adults, this is the first study to our knowledge to examine a lifestyle risk index incorporating sedentary behavior and sleep in relation to all-cause mortality. Baseline data (February 2006– April 2009) were linked to mortality registration data until June 15, 2014. Smoking, high alcohol intake, poor diet, physical inactivity, prolonged sitting, and unhealthy (short/long) sleep duration were measured by questionnaires and summed into an index score. Cox proportional hazards analysis was used with the index score and each unique risk combination as exposure variables, adjusted for socio-demographic characteristics. During 6 y of follow-up of 231,048 participants for 1,409,591 person-years, 15,635 deaths were registered. Of all participants, 31.2%, 36.9%, 21.4%, and 10.6% reported 0, 1, 2, and 3+ risk factors, respectively. There was a strong relationship between the lifestyle risk index score and all-cause mortality. The index score had good predictive validity (c index = 0.763), and the partial population attributable risk was 31.3%. Out of all 96 possible risk combinations, the 30 most commonly occurring combinations accounted for more than 90% of the participants. Among those, combinations involving physical inactivity, prolonged sitting, and/or long sleep duration and combinations involving smoking and high alcohol intake had the strongest associations with all

  10. Clinical COPD Questionnaire score (CCQ) and mortality

    PubMed Central

    Sundh, Josefin; Janson, Christer; Lisspers, Karin; Montgomery, Scott; Ställberg, Björn

    2012-01-01

    Introduction The Clinical COPD Questionnaire (CCQ) measures health status and can be used to assess health-related quality of life (HRQL). We investigated whether CCQ is also associated with mortality. Methods Some 1111 Swedish primary and secondary care chronic obstructive pulmonary disease (COPD) patients were randomly selected. Information from questionnaires and medical record review were obtained in 970 patients. The Swedish Board of Health and Welfare provided mortality data. Cox regression estimated survival, with adjustment for age, sex, heart disease, and lung function (for a subset with spirometry data, n = 530). Age and sex-standardized mortality ratios were calculated. Results Over 5 years, 220 patients (22.7%) died. Mortality risk was higher for mean CCQ ≥ 3 (37.8% died) compared with mean CCQ < 1 (11.4%), producing an adjusted hazard ratio (HR) (and 95% confidence interval [CI]) of 3.13 (1.98 to 4.95). After further adjustment for 1 second forced expiratory volume (expressed as percent of the European Community for Steel and Coal reference values ), the association remained (HR 2.94 [1.42 to 6.10]). The mortality risk was higher than in the general population, with standardized mortality ratio (and 95% CI) of 1.87 (1.18 to 2.80) with CCQ < 1, increasing to 6.05 (4.94 to 7.44) with CCQ ≥ 3. Conclusion CCQ is predictive of mortality in COPD patients. As HRQL and mortality are both important clinical endpoints, CCQ could be used to target interventions. PMID:23277739

  11. Mortal assets

    SciTech Connect

    Howe, Geoffrey R.; Zablotska, Lydia B.; Fix, John J.; Egel, John N.; Buchanan, Jeffrey A.

    2005-11-01

    Workers employed in 15 utilities that generate nuclear power in the United States have been followed for up to 18 years between 1979 and 1997. Their cumulative dose from whole-body ionizing radiation has been determined from the dose records maintained by the facilities themselves and the REIRS and REMS systems maintained by the Nuclear Regulatory Commission and the Department of Energy, respectively. Mortality in the cohort from a number of causes has been analyzed with respect to individual radiation doses. The cohort displays a very substantial healthy worker effect, i.e. considerably lower cancer and noncancer mortality than the general population. Based on 26 and 368 deaths, respectively, positive though statistically nonsignificant associations were seen for mortality from leukemia (excluding chronic lymphocytic leukemia) and all solid cancers combined, with excess relative risks per sievert of 5.67 (95% confidence interval (CI) -2.56, 30.4) and 0.596 (95% CI -2.01, 4.64), respectively. These estimates are very similar to those from the atomic bomb survivors study, though the wide confidence intervals are also consistent with lower or higher risk estimates. A strong positive and statistically significant association between radiation dose and deaths from arteriosclerotic heart disease including coronary heart disease was also observed in the cohort, with an ERR of 8.78 (95% CI 2.10, 20.0). Whle associations with heart disease have been reported in some other occupational studies, the magnitude of the present association is not consistent with them and therefore needs cautious interpretation and merits further attention. At present, the relatively small number of deaths and the young age of the cohort (mean age at end of follow-up is 45 years) limit the power of the study, but further follow-up is 45 years) limit the power of the study, but further follow-up and the inclusion of the present data in an ongoing IARC combined analysis of nuclear workers from 15

  12. Time trends of esophageal cancer mortality in Linzhou city during the period 1988-2010 and a Bayesian approach projection for 2020.

    PubMed

    Liu, Shu-Zheng; Zhang, Fang; Quan, Pei-Liang; Lu, Jian-Bang; Liu, Zhi-Cai; Sun, Xi-Bin

    2012-01-01

    In recent decades, decreasing trends in esophageal cancer mortality have been observed across China. We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophageal cancer in China, during 1988-2010 and make a esophageal cancer mortality projection in the period 2011-2020 using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to the World population structure in 1985. A Bayesian age-period-cohort (BAPC) analysis was carried out in order to investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during 1988-2010 and to estimate future trends for the period 2011-2020. Age-adjusted rates for men and women decreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the very elderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showed risk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden of mortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decrease of esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of social- economic environment and lifestyle. The standardized mortality rates of esophageal cancer should decrease continually. The effect of aging on the population could explain the increase in esophageal mortality projected for 2020.

  13. SNAP II and SNAPPE II as Predictors of Neonatal Mortality in a Pediatric Intensive Care Unit: Does Postnatal Age Play a Role?

    PubMed Central

    Godoy, Laura Evangelina; Alvarez Barrientos, Elizabeth

    2014-01-01

    Introduction. In developing countries, a lack of decentralization of perinatal care leads to many high-risk births occurring in facilities that do not have NICU, leading to admission to a PICU. Objective. To assess SNAP II and SNAPPE II as predictors of neonatal death in the PICU. Methodology. A prospective study of newborns divided into 3 groups according to postnatal age: Group 1 (G1), of 0 to 6 days; Group 2 (G2) of 7 to 14 days; and Group 3 (G3), of 15 to 28 days. Variables analyzed were SNAP II, SNAPPE II, perinatal data, and known risk factors for death. The Hosmer-Lemeshow test and the receiver operating characteristics (ROC) curve were used with SPSS 17.0 for statistical analysis. An Alpha error <5% was considered significant. Results. We analyzed 290 newborns, including 192 from G1, 41 from G2, and 57 from G3. Mortality was similar in all 3 groups. Median SNAP II was higher in newborns that died in all 3 groups (P < 0.05). The area under the ROC curve for SNAP II for G1 was 0.78 (CI 95% 0.70–0.86), for G2 0.66 (CI 95% 0.37–0.94), and for G3 0.74 (CI 95% 0.53–0.93). The area under the ROC curve for SNAPPE II for G1 was 0.76 (CI 95% 0.67–0.85), for G2 0.60 (CI 95% 0.30–0.90), and for G3 0.74 (CI 95% 0.52–0.95). Conclusions. SNAP II and SNAPPE II showed moderate discrimination in predicting mortality. The results are not strong enough to establish the correlation between the score and the risk of mortality. PMID:24719622

  14. An alternative method for assessing early mortality in contemporary populations.

    PubMed

    Wiley, A S; Pike, I L

    1998-11-01

    Biological anthropologists are interested in a population's early mortality rates for a variety of reasons. Early mortality (infant or juvenile) is of obvious importance to those interested in demography, but early mortality statistics are useful for life history analysis, paleodemography, and human adaptability studies, among others. In general, the form of mortality statistics is derived from demography, where chronological age is the gold standard for statistical calculation and comparison. However, there are numerous problems associated with the collection, analysis, and interpretation of early mortality statistics based on age, particularly for anthropological research, which is often conducted in small or non-calendrical-age numerate populations. The infant mortality rate (IMR), for example, is notoriously difficult to determine in populations where accurate accounting of age is not routine, and yet it is widely used in demography, public health, medicine, and social science research. Here we offer an alternative to age-based early mortality statistics that makes use of human biologists' interest in, and skill at, assessing human growth and development. Our proposal is to use developmental stages of juveniles instead of relying exclusively on age as the basis for mortality statistics. Death or survival according to a developmental stage (such as crawling or weaning) may provide more accurate data that are also more closely related to the cause of death. Developmental stages have the added advantage of putting infants and children back at the center of the discussion of early mortality by focusing on their activities in relation to their environment. A case study from the Turkana population of Kenya illustrates the use of developmental stages in describing early mortality.

  15. Plum curculio (Coleoptera: Curculionidae) adult mortality and associated fruit injury after exposure to field-aged insecticides on tart cherry branches.

    PubMed

    Hoffmann, Eric J; Vandervoort, Christine; Wise, John C

    2010-08-01

    Plum curculio, Conotrachelus nenuphar (Herbst) (Coleoptera: Curculionidae), adults were exposed to field-aged residues of thiamethoxam, acetamiprid, thiacloprid, indoxacarb, or azinphos-methyl on tart cherry, Prunus cerasus L. variety Montmorency. At 1, 3, 7, and 14 d postapplication, fruit were sampled for chemical residues, and bioassays were used to assess beetle mortality and plant tissue injury. Azinphos-methyl had lethal activity within 1 d of exposure at all postapplication intervals and significant fruit protection extended to 14 d postapplication. All of the neonicotinoids had lethal activity at 3 d posttreatment, with acetamiprid activity extending to 7 d. Antifeedant and oviposition deterrent effects were seen with thiamethoxam and thiacloprid; damage incidence was significantly reduced in the absence of significant beetle mortality or intoxication. Thiamethoxam and acetamiprid penetrated into leaf and fruit tissue and were detected in the interior tissues at 14 d postapplication, but interior thiacloprid residues were not detected after day 1. Indoxacarb provided some fruit protection out to 7 d postapplication, and 14-d-old residues intoxicated beetles, but the slow action of this compound allowed significant damage to occur before beetles were incapacitated. Indoxacarb was only detected as a surface residue after the first day postapplication. These data on the plant-insect-chemistry interactions will support use and management decisions as compounds with acute contact activity are phased out.

  16. Improvement in Infant and Perinatal Mortality in the United States, 1965-1973.

    ERIC Educational Resources Information Center

    Information Sciences Research Inst., Washington, DC.

    Changes in United States infant and perinatal mortality during the period 1965-1973 are examined by race, age at death or length of gestation, and degree of urbanization. Several improvements in mortality rates are identified and discussed in relation to changes in the United States which have occurred in economic conditions and standards of…

  17. Infant Mortality

    MedlinePlus

    ... Control and Prevention. (2013). CDC health disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly ... M. (2008). The fall and rise of U.S. inequalities in premature mortality: 1960–2002. PLOS Medicine, 5 ( ...

  18. Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18

    PubMed Central

    Uchiyama, Atsushi; Okamura, Tomoka; Ago, Mako; Suenaga, Hideyo; Sugita, Eri; Ono, Hideko; Shuri, Kyoko; Masumoto, Kenichi; Totsu, Satsuki; Nakanishi, Hidehiko; Kusuda, Satoshi

    2015-01-01

    The aim of this study was to clarify the effects of gestational age and birth weight on outcomes of the infants. Medical records of 36 infants with trisomy 18 admitted to Tokyo Women's Medical University Hospital from 1991 to 2012 were reviewed retrospectively. We compared clinical characteristics between term infants (n = 15) and preterm infants (n = 21). There were one very‐low‐birth‐weight (VLBW) term infant (5%) and 12 VLBW preterm infants (80%). Although there were no significant differences in clinical characteristics and provided management between the two groups, none of the preterm infants achieved survival to discharge. On the other hand, 6 of 21 term infants (29%) achieved survival to discharge (P < 0.05). Similar results were obtained for comparisons between the VLBW infants and non‐VLBW infants. Multiple logistic regression analysis revealed that shorter gestational age had a more negative impact than lower birth weight to survival to discharge in infants with trisomy 18. In both preterm and term groups, the infants who died before 30 days commonly died of respiratory failure or apnea. Whereas, the infants who survived more than 30 days mostly died of heart failure. © 2015 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc. PMID:26307940

  19. Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18.

    PubMed

    Imai, Ken; Uchiyama, Atsushi; Okamura, Tomoka; Ago, Mako; Suenaga, Hideyo; Sugita, Eri; Ono, Hideko; Shuri, Kyoko; Masumoto, Kenichi; Totsu, Satsuki; Nakanishi, Hidehiko; Kusuda, Satoshi

    2015-11-01

    The aim of this study was to clarify the effects of gestational age and birth weight on outcomes of the infants. Medical records of 36 infants with trisomy 18 admitted to Tokyo Women's Medical University Hospital from 1991 to 2012 were reviewed retrospectively. We compared clinical characteristics between term infants (n = 15) and preterm infants (n = 21). There were one very-low-birth-weight (VLBW) term infant (5%) and 12 VLBW preterm infants (80%). Although there were no significant differences in clinical characteristics and provided management between the two groups, none of the preterm infants achieved survival to discharge. On the other hand, 6 of 21 term infants (29%) achieved survival to discharge (P < 0.05). Similar results were obtained for comparisons between the VLBW infants and non-VLBW infants. Multiple logistic regression analysis revealed that shorter gestational age had a more negative impact than lower birth weight to survival to discharge in infants with trisomy 18. In both preterm and term groups, the infants who died before 30 days commonly died of respiratory failure or apnea. Whereas, the infants who survived more than 30 days mostly died of heart failure.

  20. Statistically tested comparisons of the accuracy of forecasting methods for age-specific and sex-specific mortality and life expectancy.

    PubMed

    Shang, Han Lin

    2015-01-01

    Although there are continuing developments in the methods for forecasting mortality, there are few comparisons of the accuracy of the forecasts. The subject of the statistical validity of these comparisons, which is essential to demographic forecasting, has all but been ignored. We introduce Friedman's test statistics to examine whether the differences in point and interval forecast accuracies are statistically significant between methods. We introduce the Nemenyi test statistic to identify which methods give results that are statistically significantly different from others. Using sex-specific and age-specific data from 20 countries, we apply these two test statistics to examine the forecast accuracy obtained from several principal component methods, which can be categorized into coherent and non-coherent forecasting methods.

  1. Age-Related Differences in Responses to Thoughts of One’s Own Death: Mortality Salience and Judgments of Moral Transgressions

    PubMed Central

    Maxfield, Molly; Kluck, Benjamin; Greenberg, Jeff; Pyszczynski, Tom; Cox, Cathy R.; Solomon, Sheldon; Weise, David

    2008-01-01

    Two experiments explored age differences in response to reminders of death. Terror management research has shown that death reminders lead to increased adherence to and defense of one’s cultural worldview. In Study 1, the effect of mortality salience (MS) on evaluations of moral transgressions made by younger and older adults was compared. Whereas younger adults showed the typical pattern of harsher judgments in response to MS, older adults did not. Study 2 compared younger and older adults’ responses to both the typical MS induction and a more subtle death reminder. Whereas younger adults responded to both MS inductions with harsher evaluations, older adults made significantly less harsh evaluations after the subtle MS induction. Explanations for this developmental shift in responses to reminders of death are discussed. PMID:17563189

  2. Determinants of all-cause mortality in different age groups in patients with severe systolic left ventricular dysfunction receiving an implantable cardioverter defibrillator (from the Italian ClinicalService Multicenter Observational Project).

    PubMed

    Fumagalli, Stefano; Gasparini, Maurizio; Landolina, Maurizio; Lunati, Maurizio; Boriani, Giuseppe; Proclemer, Alessandro; Santini, Massimo; Mangoni, Lorenza; Padeletti, Margherita; Marchionni, Niccolò; Padeletti, Luigi

    2014-05-15

    Heart failure (HF) is a common condition in elderly patients. Despite great improvements in medical therapy, HF mortality remains high. Implantable cardioverter defibrillator (ICD) significantly lengthens the survival rate of subjects with severe HF, but little evidence exists on its effect in elderly persons. Aim of this study was to compare the age-related determinants of prognosis in a large population of patients with ICD. We divided all patients who underwent an ICD implantation in 117 Italian centers of the "ClinicalService Project" into 3 age groups (<65, 65 to 74, ≥ 75 years), and collected clinical and instrumental variables at baseline and during follow-up (median length: 27 months). Between 2004 and 2011, 6,311 patients were enrolled (5,174 men; left ventricular ejection fraction 29% ± 9%); 1,510 subjects were ≥ 75 years (23.9%; mean age 78 ± 3 years). The prevalence of co-morbidities increased with age. HF was most frequently due to coronary artery disease in the elderly, who also showed the worst New York Heart Association class. At multivariate analysis, older age, coronary artery disease, chronic obstructive pulmonary disease, chronic renal failure, diabetes, complex ventricular arrhythmias, and left ventricular ejection fraction were significant predictors of all-cause mortality. After adjustment, the hazard ratio(age group) for mortality was 22.6% less than at univariate analysis. When groups were analyzed separately, age alone predicted mortality in the oldest. In conclusion, a large proportion of our population was aged ≥ 75 years. Mortality was related to age and several co-morbidities, except for the oldest patients in whom age alone resulted predictive.

  3. Long-term impacts of the Exxon Valdez oil spill on sea otters, assessed through age-dependent mortality patterns

    USGS Publications Warehouse

    Monson, D.H.; Doak, D.F.; Ballachey, B.E.; Johnson, Aaron H.; Bodkin, J.L.

    2000-01-01

    We use age distributions of sea otters (Enhydra lutris) found dead on beaches of western Prince William Sound, Alaska, between 1976 and 1998 in conjunction with time-varying demographic models to test for lingering effects from the 1989 Exxon Valdez oil spill. Our results show that sea otters in this area had decreased survival rates in the years following the spill and that the effects of the spill on annual survival increased rather than dissipated for older animals. Otters born after the 1989 spill were affected less than those alive in March 1989, but do show continuing negative effects through 1998. Population-wide effects of the spill appear to have slowly dissipated through time, due largely to the loss of cohorts alive during the spill. Our results demonstrate that the difficult-to-detect long- term impacts of environmental disasters may still be highly significant and can be rigorously analyzed by using a combination of population data, modeling techniques, and statistical analyses.

  4. Long-term impacts of the Exxon Valdez oil spill on sea otters, assessed through age-dependent mortality patterns.

    PubMed

    Monson, D H; Doak, D F; Ballachey, B E; Johnson, A; Bodkin, J L

    2000-06-06

    We use age distributions of sea otters (Enhydra lutris) found dead on beaches of western Prince William Sound, Alaska, between 1976 and 1998 in conjunction with time-varying demographic models to test for lingering effects from the 1989 Exxon Valdez oil spill. Our results show that sea otters in this area had decreased survival rates in the years following the spill and that the effects of the spill on annual survival increased rather than dissipated for older animals. Otters born after the 1989 spill were affected less than those alive in March 1989, but do show continuing negative effects through 1998. Population-wide effects of the spill appear to have slowly dissipated through time, due largely to the loss of cohorts alive during the spill. Our results demonstrate that the difficult-to-detect long-term impacts of environmental disasters may still be highly significant and can be rigorously analyzed by using a combination of population data, modeling techniques, and statistical analyses.

  5. [Maternal mortality and perinatal mortality].

    PubMed

    Boutaleb, Y; Mesbahi, M; Lahlou, D; Aderdour, M

    1982-01-01

    94 maternal deaths and 1546 fetal and neonatal deaths were registered among 28,706 births at the CHU Averroes in Casablanca between 1978-80. 45% of women who deliver at the clinic are very poor and only 10% are relatively well off. Obstetrical antecedents were noted in 27% of the fetal deaths. 70% of the maternal deaths occurred in women aged 20-34. 32 maternal deaths occurred among 16,232 women with 1-2 children, 30 among 6514 women with 3-5 children, and 32 among 5960 women with 6-14 children. 11,027 of the 28,706 were primaparas. Perinatal mortality was 4.46% among primaparas, 8.24% among grand multiparas, and 4.1% among secondiparas. In 58 of the 94 cases of maternal mortality the woman was hospitalized after attempting delivery at home or in a village clinic. Among women with 1 or 2 children, hemorrhage was the cause of death in 8 cases, infection in 7 cases, eclampsia in 3 cases, thromboembolism in 2 cases, uterine inversion in 2 cases, pulmonary tuberculosis in 1 case, embolism in 5 cases, and other causes 1 case each. Among women with 3-5 children hemorrhage was the cause of death in 10 cases, septicemia in 3 cases, uterine rupture in 3 cases, eclampsia in 3 cases, uterine inversion in 2 cases, viral hepatitis in 2 cases, emboli in 2 cases, and other reasons 1 case each. Among grand multiparas hemorrhage was the cause of death in 11 cases, uterine rupture in 12 cases, peritonitis in 2 cases, eclampsia in 2 cases, emboli in 2 cases, and other causes 1 case each. 19 of the maternal deaths were judged to have been avoidable with better management. Prematurity and birth weight of 1000-2500 g associated or not with other pathology were found in 714 of 1546 perinatal deaths. Of 390 cases of death in utero with retention and maceration, 68 were caused by reno-vascular syndromes, 76 by maternal infections, 33 by maternal syphilis, 26 by fetal malformation, 18 by maternal diabetes, 10 by Rh incompatability, and 159 by indeterminate causes. In 795 cases of

  6. Teaching Traditional and Non-Traditional Age Individuals: How Should Methods, Expectations, and Standards Differ?

    ERIC Educational Resources Information Center

    Sagaria, Sabato D.

    A study examined achievement and attitudes of traditional and nontraditional age students enrolled in an undergraduate behavioral sciences statistics course. Performance and attitude data were collected from a class of 25 traditional students (average age 22) and from a class of 15 nontraditional students (average age 35). The two groups were…

  7. Estimated effect of weight loss on risk of coronary heart disease and mortality in middle-aged or older women: sensitivity analysis for unmeasured confounding by undiagnosed disease

    PubMed Central

    Danaei, Goodarz; Robins, James M.; Young, Jessica; Hu, Frank B.; Manson, JoAnn E; Hernán, Miguel A.

    2016-01-01

    Background The evidence on the effect of weight loss on coronary heart disease (CHD) or mortality has been mixed. The effect estimates can be confounded due to undiagnosed diseases that may affect weight loss. Methods We used data from the Nurses’ Health Study to estimate the 26-year risk of CHD under several hypothetical weight loss interventions (e.g. maintain baseline weight, lose 5% of weight every 2 years if overweight/obese). We applied the parametric g-formula and implemented a novel sensitivity analysis for unmeasured confounding due to undiagnosed disease by imposing a lag time for the effect of weight loss on chronic disease. Sensitivity analyses were conducted by using only the first 16 years of follow-up, restricting the analysis to women who had reported intentional weight loss, those who were younger (<49 years old at baseline), and those who never smoked. Results The 26-year risk of CHD under no weight loss intervention was 5.0% (95% Confidence Interval 4.9, 5.3). The estimated risk did not change under hypothetical weight loss interventions using lag times from 0 to 18 years. For a 6-year lag time, the risk ratios of CHD for weight loss compared with no intervention ranged from 1.00 (0.99, 1.02) to 1.02 (0.99, 1.05) for different degrees of weight loss with and without restricting the intervention to participants with no major chronic disease. Similarly, no protective effect of weight loss was estimated for mortality risk. In contrast, we estimated a protective effect of weight loss on risk of type 2 diabetes. The estimated effect of weight loss on CHD and mortality remained null in all sensitivity analyses. Conclusion We estimated that maintaining weight or losing weight after becoming overweight or obese does not reduce the risk of CHD or death in this cohort of middle-aged US women. Unmeasured confounding, measurement error, and model misspecification are possible explanations but they did not prevent us from estimating a beneficial effect of

  8. Do heads of government age more quickly? Observational study comparing mortality between elected leaders and runners-up in national elections of 17 countries

    PubMed Central

    Olenski, Andrew R; Abola, Matthew V

    2015-01-01

    Objectives To determine whether being elected to head of government is associated with accelerated mortality by studying survival differences between people elected to office and unelected runner-up candidates who never served. Design Observational study. Setting Historical survival data on elected and runner-up candidates in parliamentary or presidential elections in Australia, Austria, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, New Zealand, Norway, Poland, Spain, Sweden, United Kingdom, and United States, from 1722 to 2015. Participants Elected and runner-up political candidates. Main outcome measure Observed number of years alive after each candidate’s last election, relative to what would be expected for an average person of the same age and sex as the candidate during the year of the election, based on historical French and British life tables. Observed post-election life years were compared between elected candidates and runners-up, adjusting for life expectancy at time of election. A Cox proportional hazards model (adjusted for candidate’s life expectancy at the time of election) considered years until death (or years until end of study period for those not yet deceased by 9 September 2015) for elected candidates versus runners-up. Results The sample included 540 candidates: 279 winners and 261 runners-up who never served. A total of 380 candidates were deceased by 9 September 2015. Candidates who served as a head of government lived 4.4 (95% confidence interval 2.1 to 6.6) fewer years after their last election than did candidates who never served (17.8 v 13.4 years after last election; adjusted difference 2.7 (0.6 to 4.8) years). In Cox proportional hazards analysis, which considered all candidates (alive or deceased), the mortality hazard for elected candidates relative to runners-up was 1.23 (1.00 to 1.52). Conclusions Election to head of government is associated with a substantial increase in mortality risk compared

  9. Accidents in Canada: mortality and hospitalization.

    PubMed

    Riley, R; Paddon, P

    1989-01-01

    For Canadians under 45, accidents are the leading cause of both death and hospitalization. For the Canadian population as a whole, accidents rank fourth as a cause of death, after cardiovascular disease (CVD), cancer and respiratory disease. This article analyzes accident mortality and hospitalization in Canada using age-specific rates, age-standardized mortality rates (ASMR), and potential years of life lost (PYLL). The six major causes of accidental death for men are motor vehicle traffic accidents (MVTA), falls, drowning, fires, suffocation and poisoning. For women, the order is slightly different: MVTA, falls, fires, suffocation, poisoning and drowning. From 1971 to 1986, age-standardized mortality rates (ASMR) for accidents decreased by 44% for men and 39% for women. The largest decrease occurred in the under 15 age group. Accidents accounted for 11.5% of total hospital days in 1985, and 8% of hospital discharges. Because young people have the highest rates of accidental death, potential years of life lost (PYLL) are almost as high for accidents as for cardiovascular disease, although CVD deaths outnumbered accidental deaths by almost five to one in 1985.

  10. Age of Exploration. Grade 5 Model Lesson for Standard 5.2. California History-Social Science Course Models.

    ERIC Educational Resources Information Center

    Zachlod, Michelle, Ed.

    California State Standard 5.2 is delineated as: Students trace the routes of early explorers and describe the early explorations of the Americas. The Age of Exploration, which began in the late 1400s, was an important era in the discovery and development of land yet unknown to Europeans. During this period, Europeans sought new sea routes to Asia…

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

    PubMed

    Garcia, Monica

    2014-01-01

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

  12. Is Greulich and Pyle standards of skeletal maturation applicable for age estimation in South Indian Andhra children?

    PubMed Central

    Mohammed, Rezwana Begum; Rao, Dola Srinivasa; Goud, Alampur Srinivas; Sailaja, S.; Thetay, Anshuj Ajay Rao; Gopalakrishnan, Meera

    2015-01-01

    Introduction: Now-a-day age determination has gained importance for various forensic and legal reasons. Skeletal age (SA) of a test population can be estimated by comparing with established standards of Greulich and Pyle (G-P). As this atlas has been prepared using data from upper-class children born between 1917 and 1942 in the USA and the applicability of these standards to contemporary populations has yet to be tested on Andhra children living in India. Hence, this study was aimed to assess the reliability of bone age calculated by G-P atlas in estimation of age in selected population. Materials and Methods: A total of 660 children (330 girls, 330 boys) between ages 9 and 20 years were randomly selected from outpatient Department of Oral Medicine in GITAM Dental College, Andhra Pradesh. Digital hand-wrist radiographs were obtained and assessed for SA using G-P atlas and the difference between estimated SA and chronological age (CA) were compared with paired t-test and Wilcoxon signed rank test. Results: G-P method underestimated the SA by 0.23 ± 1.53 years for boys and overestimated SA by 0.02 ± 2 years in girls and mild underestimation was noted in the total sample of about 0.1 ± 1.78 years. Spearman rank test showed significant correlation between SA and CA (r = 0.86; P < 0.001). Conclusion: This study concluded that G-P standards were reliable in assessing age in South Indian Andhra children of age 9–20 years with unknown CA. PMID:26229357

  13. Dose-Dependent Decrease in Mortality with No Cognitive or Muscle Function Improvements Due to Dietary EGCG Supplementation in Aged Mice.

    PubMed

    Pence, Brandt D; Bhattacharya, Tushar K; Park, Pul; Rytych, Jennifer L; Allen, Jacob M; Sun, Yi; McCusker, Robert H; Kelley, Keith W; Johnson, Rodney W; Rhodes, Justin S; Woods, Jeffrey A

    2017-01-05

    We have previously shown that a diet containing epigallocatechin gallate (EGCG) and beta-alanine is not effective in improving either cognitive or muscle function in aged (18 month) mice (Gibbons et al. Behav Brain Res 2014, Pence et al. Appl Physiol Nutr Metab 2016). However, this diet reduced oxidative stress in the brain, and previous studies using longer-term interventions and other doses have documented beneficial effects in cognitive and muscle function, especially with EGCG. Here we hypothesized that a different dose of EGCG or longer feeding period would be more efficacious in improving cognition. Aged (21-25 mo) Balb/cByJ male mice underwent 63 days of feeding with EGCG at 0, 0.09, or 3.67 mg/g AIN-93M diet and were then subjected to a battery of cognitive and muscle function tests. EGCG feeding at either of the two doses did not alter preference for novel versus familiar arm in the Y-maze test (p=0.29) and did not affect learning in the active avoidance test (p=0.76). Similarly, EGCG did not affect preference for novel versus familiar mice in a social exploration test (p=0.17). Likewise, there was no effect of EGCG on muscle function by grip strength (p=0.16), rotarod (p=0.18) or treadmill test to exhaustion (p=0.25). EGCG reduced mortality in a dose-dependent fashion (p=0.05, log rank test for trend), with 91% of high EGCG, 72% of low EGCG, and 55% of control mice surviving to the end of the study. In conclusion, EGCG improves survival in aged mice but does not affect cognitive or muscle function.

  14. Incidence of WHO Stage 3 and 4 Events, Tuberculosis, and Mortality in Untreated, HIV-Infected Children Enrolling in Care Before 1 Year of Age: An Iedea (International Epidemiologic Databases To Evaluate AIDS) East Africa Regional Analysis

    PubMed Central

    Ciaranello, Andrea; Lu, Zhigang; Ayaya, Samuel; Losina, Elena; Musick, Beverly; Vreeman, Rachel; Freedberg, Kenneth A.; Abrams, Elaine J.; Dillabaugh, Lisa; Doherty, Katie; Ssali, John; Yiannoutsos, Constantin T.; Wools-Kaloustian, Kara

    2014-01-01

    Background Few studies have reported CD4%- and age-stratified rates of WHO Stage 3 (WHO3) events, WHO Stage 4 (WHO4) events, tuberculosis (TB), and mortality in HIV-infected infants before initiation of antiretroviral therapy (ART). Methods HIV-infected children enrolled before 1 year of age in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) East Africa region (10/01/2002-11/30/2008) were included. We estimated incidence rates of earliest clinical event (WHO3, WHO4, and TB), prior to ART initiation per local guidelines, stratified by current age (< or ≥6 months) and current CD4% (<15%, 15–24%, ≥25%). CD4%-stratified mortality rates were estimated separately for children who did not experience a clinical event (“background” mortality) and for children who experienced an event, including “acute” mortality (≤30 days post-event) and “later” mortality (>30 days post-event). Results Among 847 children (median enrollment age: 4.8 months; median pre-ART follow-up: 10.8 months; 603 (71%) with ≥1 CD4% recorded), event rates were comparable for those aged <6 and ≥6 months. Current CD4% was associated with risk of WHO4 events for children <6 months old, and with all evaluated events for children ≥6 months old (p<0.05). “Background” mortality was 3.7–8.4/100py. “Acute” mortality (≤30 days post-event) was 33.8/100py (after TB) and 41.1/100py (after WHO3 or WHO4). “Later” mortality (>30 days post-event) ranged by CD4% from 4.7–29.1/100py. Conclusions In treatment-naïve, HIV-infected infants, WHO3, WHO4, and TB events were common before and after 6 months of age and led to substantial increases in mortality. Early infant HIV diagnosis and treatment are critically important, regardless of CD4%. PMID:24378935

  15. The Relationship between Using Electronic Health Records and Meeting Accreditation Standards for Client Safety in Residential Aged Care Homes.

    PubMed

    Jiang, Tao; Yu, Ping

    2015-01-01

    This study aims to identify the benefits of using electronic health records (EHR) for client safety in residential aged care (RAC) homes. The aged care accreditation reports published between 27 April 2011 and 3 December 2013 were downloaded and analysed. It could be seen from these reports that only 1,031(37.45%) RAC homes in Australia had adopted an EHR system by 2013. 13 RAC homes failed one or more accreditation standards. Only one of these was using an EHR system and this one met the accreditation standards on information systems. Our study provides empirical evidence to suggest that adopting and using EHR can be one of the effective organisational mechanisms to meeting accreditation standards in RAC homes.

  16. Social capital, income inequality, and mortality.

    PubMed Central

    Kawachi, I; Kennedy, B P; Lochner, K; Prothrow-Stith, D

    1997-01-01

    OBJECTIVES: Recent studies have demonstrated that income inequality is related to mortality rates. It was hypothesized, in this study, that income inequality is related to reduction in social cohesion and that disinvestment in social capital is in turn associated with increased mortality. METHODS: In this cross-sectional ecologic study based on data from 39 states, social capital was measured by weighted responses to two items from the General Social Survey: per capita density of membership in voluntary groups in each state and level of social trust, as gauged by the proportion of residents in each state who believed that people could be trusted. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state. RESULTS: Income inequality was strongly correlated with both per capita group membership (r = -.46) and lack of social trust (r = .76). In turn, both social trust and group membership were associated with total mortality, as well as rates of death from coronary heart disease, malignant neoplasms, and infant mortality. CONCLUSIONS: These data support the notion that income inequality leads to increased mortality via disinvestment in social capital. PMID:9314802

  17. Inequalities in Alcohol-Related Mortality in 17 European Countries: A Retrospective Analysis of Mortality Registers

    PubMed Central

    Mackenbach, Johan P.; Kulhánová, Ivana; Bopp, Matthias; Borrell, Carme; Deboosere, Patrick; Kovács, Katalin; Looman, Caspar W. N.; Leinsalu, Mall; Mäkelä, Pia; Martikainen, Pekka; Menvielle, Gwenn; Rodríguez-Sanz, Maica; Rychtaříková, Jitka; de Gelder, Rianne

    2015-01-01

    Background Socioeconomic inequalities in alcohol-related mortality have been documented in several European countries, but it is unknown whether the magnitude of these inequalities differs between countries and whether these inequalities increase or decrease over time. Methods and Findings We collected and harmonized data on mortality from four alcohol-related causes (alcoholic psychosis, dependence, and abuse; alcoholic cardiomyopathy; alcoholic liver cirrhosis; and accidental poisoning by alcohol) by age, sex, education level, and occupational class in 20 European populations from 17 different countries, both for a recent period and for previous points in time, using data from mortality registers. Mortality was age-standardized using the European Standard Population, and measures for both relative and absolute inequality between low and high socioeconomic groups (as measured by educational level and occupational class) were calculated. Rates of alcohol-related mortality are higher in lower educational and occupational groups in all countries. Both relative and absolute inequalities are largest in Eastern Europe, and Finland and Denmark also have very large absolute inequalities in alcohol-related mortality. For example, for educational inequality among Finnish men, the relative index of inequality is 3.6 (95% CI 3.3–4.0) and the slope index of inequality is 112.5 (95% CI 106.2–118.8) deaths per 100,000 person-years. Over time, the relative inequality in alcohol-related mortality has increased in many countries, but the main change is a strong rise of absolute inequality in several countries in Eastern Europe (Hungary, Lithuania, Estonia) and Northern Europe (Finland, Denmark) because of a rapid rise in alcohol-related mortality in lower socioeconomic groups. In some of these countries, alcohol-related causes now account for 10% or more of the socioeconomic inequality in total mortality. Because our study relies on routinely collected underlying causes of

  18. Older Age and Time to Medical Assistance Are Associated with Severity and Mortality of Snakebites in the Brazilian Amazon: A Case-Control Study

    PubMed Central

    Feitosa, Esaú L.; Sampaio, Vanderson S.; Salinas, Jorge L.; Queiroz, Amanda M.; da Silva, Iran Mendonça; Gomes, André A.; Sachett, Jacqueline; Siqueira, André M.; Ferreira, Luiz Carlos L.; dos Santos, Maria Cristina; Lacerda, Marcus; Monteiro, Wuelton

    2015-01-01

    The Amazon region reports the highest incidence of snakebite envenomings in Brazil. We aimed to describe the epidemiology of snakebites in the state of Amazonas and to investigate factors associated with disease severity and lethality. We used a nested case-control study, in order to identify factors associated with snakebite severity and mortality using official Brazilian reporting systems, from 2007 to 2012. Patients evolving to severity or death were considered cases and those with non-severe bites were included in the control group. During the study period, 9,191 snakebites were recorded, resulting in an incidence rate of 52.8 cases per 100,000 person/years. Snakebites mostly occurred in males (79.0%) and in rural areas (70.2%). The most affected age group was between 16 and 45 years old (54.6%). Fifty five percent of the snakebites were related to work activities. Age ≤15 years [OR=1.26 (95% CI=1.03-1.52); (p=0.018)], age ≥65 years [OR=1.53 (95% CI=1.09-2.13); (p=0.012)], work related bites [OR=1.39 (95% CI=1.17-1.63); (p<0.001)] and time to medical assistance >6 hours [OR=1.73 (95% CI=1.45-2.07); (p<0.001)] were independently associated with the risk of severity. Age ≥65 years [OR=3.19 (95% CI=1.40-7.25); (p=0.006)] and time to medical assistance >6 hours [OR=2.01 (95% CI=1.15-3.50); (p=0.013)] were independently associated with the risk of death. Snakebites represent an occupational health problem for rural populations in the Brazilian Amazon with a wide distribution. These results highlight the need for public health strategies aiming to reduce occupational injuries. Most cases of severe disease occurred in the extremes of age, in those with delays in medical attention and those caused by Micrurus bites. These features of victims of snakebite demand adequate management according to well-defined protocols, including prompt referral to tertiary centres when necessary, as well as an effective response from surveillance systems and policy makers for these

  19. Older Age and Time to Medical Assistance Are Associated with Severity and Mortality of Snakebites in the Brazilian Amazon: A Case-Control Study.

    PubMed

    Feitosa, Esaú L; Sampaio, Vanderson S; Salinas, Jorge L; Queiroz, Amanda M; da Silva, Iran Mendonça; Gomes, André A; Sachett, Jacqueline; Siqueira, André M; Ferreira, Luiz Carlos L; Dos Santos, Maria Cristina; Lacerda, Marcus; Monteiro, Wuelton

    2015-01-01

    The Amazon region reports the highest incidence of snakebite envenomings in Brazil. We aimed to describe the epidemiology of snakebites in the state of Amazonas and to investigate factors associated with disease severity and lethality. We used a nested case-control study, in order to identify factors associated with snakebite severity and mortality using official Brazilian reporting systems, from 2007 to 2012. Patients evolving to severity or death were considered cases and those with non-severe bites were included in the control group. During the study period, 9,191 snakebites were recorded, resulting in an incidence rate of 52.8 cases per 100,000 person/years. Snakebites mostly occurred in males (79.0%) and in rural areas (70.2%). The most affected age group was between 16 and 45 years old (54.6%). Fifty five percent of the snakebites were related to work activities. Age ≤15 years [OR=1.26 (95% CI=1.03-1.52); (p=0.018)], age ≥65 years [OR=1.53 (95% CI=1.09-2.13); (p=0.012)], work related bites [OR=1.39 (95% CI=1.17-1.63); (p<0.001)] and time to medical assistance >6 hours [OR=1.73 (95% CI=1.45-2.07); (p<0.001)] were independently associated with the risk of severity. Age ≥65 years [OR=3.19 (95% CI=1.40-7.25); (p=0.006)] and time to medical assistance >6 hours [OR=2.01 (95% CI=1.15-3.50); (p=0.013)] were independently associated with the risk of death. Snakebites represent an occupational health problem for rural populations in the Brazilian Amazon with a wide distribution. These results highlight the need for public health strategies aiming to reduce occupational injuries. Most cases of severe disease occurred in the extremes of age, in those with delays in medical attention and those caused by Micrurus bites. These features of victims of snakebite demand adequate management according to well-defined protocols, including prompt referral to tertiary centres when necessary, as well as an effective response from surveillance systems and policy makers for these

  20. Antioxidant state and mortality from coronary heart disease in Lithuanian and Swedish men: concomitant cross sectional study of men aged 50.

    PubMed Central

    Kristenson, M.; Ziedén, B.; Kucinskienë, Z.; Elinder, L. S.; Bergdahl, B.; Elwing, B.; Abaravicius, A.; Razinkovienë, L.; Calkauskas, H.; Olsson, A. G.

    1997-01-01

    OBJECTIVE: To investigate possible risk factors and mechanisms behind the four times higher and diverging mortality from coronary heart disease in Lithuanian compared with Swedish middle aged men. DESIGN: Concomitant cross sectional comparison of randomly selected 50 year old men without serious acute or chronic disease. Methods and equipment were identical or highly standardised between the centres. SETTING: Linköping (Sweden) and Vilnius (Lithuania). SUBJECTS: 101 and 109 men aged 50 in Linköping and Vilnius respectively. MAIN OUTCOME MEASURES: Anthropometric data, blood pressure, smoking, plasma lipid and lipoprotein concentrations, susceptibility of low density lipoprotein to oxidation, and plasma concentrations of fat soluble antioxidant vitamins. RESULTS: Systolic blood pressure was higher (141 v 133 mm Hg, P < 0.01), smoking habits were similar, and plasma total cholesterol (5.10 v 5.49 mmol/l, P < 0.01) and low density lipoprotein cholesterol (3.30 v 3.68 mmol/l, P < 0.01) lower in men from Vilnius compared with those from Linköping. Triglyceride, high density lipoprotein cholesterol, and Lp(a) lipoprotein concentrations did not differ between the two groups. The resistance of low density lipoprotein to oxidation was lower in the men from Vilnius; lag phase was 67.6 v 79.5 minutes (P < 0.001). Also lower in the men from Vilnius were mean plasma concentrations of lipid soluble antioxidant vitamins (beta carotene 377 v 510 nmol/l, P < 0.01; lycopene 327 v 615 nmol/l, P < 0.001; and lipid adjusted gamma tocopherol 0.25 v 0.46 mumol/mmol, P < 0.001. alpha Tocopherol concentration did not differ). Regression analysis showed that the lag phase was still significantly shorter by 10 minutes in men from Vilnius when the influence of other known factors was taken into account. CONCLUSIONS: The high mortality from coronary heart disease in Lithuania is not caused by traditional risk factors alone. Mechanisms related to antioxidant state may be important. PMID

  1. An age adjustment of very young children of India, 1981 and reappraisal of fertility and mortality rates--A model approach.

    PubMed

    Mukhopadhyay, B K

    1986-01-01

    Several approaches were made by actuaries and demographers to correct and smooth the Indian age distribution with special emphasis on population in age group 0-4 at different points of time. The present analysis conceives the life table stationary population (using the West Model) as 'reference standard'. 2 parameters were estimated from a regression equation using the proportion of population in age groups 5-14 and 60-plus as independent variables and that in 0-4 as the dependent variable. The corrected census proportions in age group 0-4 obtained from the regression model under certain assumptions for the 14 major states and India seem to be consistent and to have slightly lower values than those of the 1971 adjusted data. Moreover, unadjusted and adjusted proportions in 5-14 and 60 plus do not show any significant difference between the predicted values. Using the corrected population aged 0-4 years, the average annual birth and death rates during the 5 year period preceeding the 1981 census have been estimated for those 14 states and India as well. The estimated birth rates so obtained were further adjusted using an appropriate factor from the West Model and Indian life table survival ratios. The final estimates seem to be consistent, except for a few, and to have slightly higher values than those of earlier estimates. As the present analysis is based on a 5% sample and confined to only 14 states, it is proposed to study the same for all the states and India in greater detail using full count data on age distribution and actul life tables as and when available.

  2. Muscle Quality and Myosteatosis: Novel Associations With Mortality Risk

    PubMed Central

    Reinders, Ilse; Murphy, Rachel A.; Brouwer, Ingeborg A.; Visser, Marjolein; Launer, Lenore; Siggeirsdottir, Kristin; Eiriksdottir, Gudny; Gudnason, Vilmundur; Jonsson, Palmi V.; Lang, Thomas F.; Harris, Tamara B.

    2016-01-01

    Muscle composition may affect mortality risk, but prior studies have been limited to specific samples or less precise determination of muscle composition. We evaluated associations of thigh muscle composition, determined using computed tomography imaging, and knee extension strength with mortality risk among 4,824 participants aged 76.4 (standard deviation (SD), 5.5) years from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (2002–2006). Cox proportional hazards models were used to estimate hazard ratios. After 8.8 years of follow-up, there were 1,942 deaths. For men, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 11% and 22%. Each SD-increment increase in intermuscular adipose tissue and intramuscular adipose tissue was associated with higher mortality risk (hazard ratio (HR) = 1.13 (95% confidence interval (CI): 1.06, 1.22) and HR = 1.23 (95% CI: 1.15, 1.30), respectively). For women, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 12% and 19%. Greater intramuscular adipose tissue was associated with an 8% higher mortality risk (HR = 1.08, 95% CI: 1.01, 1.16). This study shows that muscle composition is associated with mortality risk. These results also show the importance of improving muscle strength and area and lowering muscle adipose tissue infiltration. PMID:26643983

  3. When flux standards go wild: white dwarfs in the age of Kepler

    NASA Astrophysics Data System (ADS)

    Hermes, JJ

    2017-01-01

    White dwarfs have been used as flux standards for decades, thanks to their staid simplicity. We have tested their photometric stability by analyzing the light curves of several hundred spectroscopically confirmed white dwarfs, through K2 Campaign 8. We find that the vast majority (>90%) are <1% stable in the Kepler bandpass on 0.04-d to 10-d timescales, confirming that these stellar remnants are generally excellent flux standards. From the cases that do exhibit significant (several percent) variability, we caution that binarity and magnetism are two extremely important attributes to rule out when establishing a white dwarf as a photometric standard.

  4. Legal abortion mortality.

    PubMed

    Kestelman, P

    1978-04-01

    Statistics on legal abortion in Britain between 1968-1974 are presented. There was a mortality rate of 10+ or -2 per 100,000 abortions: 27+ or -11 in 1968-1969, 12+ or -4 in 1970-1972, and 6+ or -3 in 1973-1974. Legal abortion mortality increased from 4+ or -3 when performed at gestation under 9 weeks to 5+ or -2 at 9-12 weeks, 13+ or -7 at 13-16 weeks, and 62+ or -33 at 17 weeks and over. The ratio was 11+ or -6 for women under 20 years of age, increasing to 5+ or -3 at age 20-29, 10+ or -6 at age 30-39, and 23+ or -19 at age 40 and over. The parity had little influence on abortion mortality, but the technique used had a great influence. Hysterotomy, hypertonic saline, and abortifacient paste were the most dangerous, in increasing order, with mortality rates of 39+ or -30, 106+ or -75, and 152+ or -89, respectively. The rates for aspiration and curretage were 4+ or -2 and 4+ or -3, respectively. There was a higher mortality risk with abortion with sterilization. The main causes of legal abortion mortality were infection, pulmonary embolism, and complications of general anesthesia. The high incidence of mortality associated with legal abortion in Britain is partially caused by: 1) high incidence of concurrent sterilization, 2) former use of dangerous techniques, 3) significant incidence of second trimester abortion, 4) routine use of general anesthesia, and 5) previous ill health of some of the women.

  5. The Compounding Impact of Age on Sex--Another Dimension of the Double Standard

    ERIC Educational Resources Information Center

    Sommers, Tish

    1974-01-01

    An examination of the multiple problems of discrimination confronting elderly women which argues that aging must be redefined in a way that is more functionally accurate for women and is not based upon male chronology. (EH)

  6. Mortality among professional drivers.

    PubMed

    Rafnsson, V; Gunnarsdóttir, H

    1991-10-01

    The mortality of truck drivers and taxi drivers was studied in Reykjavík. The national mortality rate was used for comparison, and the follow-up lasted until 1 December 1988. The 868 truck drivers (28,788.0 person-years) had an excess of lung cancer deaths [24 observed, 11.2 expected, standardized mortality ratio (SMR) 2.14], but fewer deaths than expected from respiratory diseases (15 observed versus 30.1 expected). The SMR from lung cancer did not steadily increase as the duration of employment increased, nor did it change with the length of follow-up. The SMR values did not deviate substantially from unity for the taxi drivers. Since the high mortality from lung cancer among the truck drivers did not seem to be due to their smoking habits, it might have been caused by one or more occupational factors, especially in light of this group's exposure to engine exhaust gases.

  7. Common medical terminology comes of age, Part One: Standard language improves healthcare quality.

    PubMed

    Rose, J S; Fisch, B J; Hogan, W R; Levy, B; Marshal, P; Thomas, D R; Kirkley, D

    2001-01-01

    It has become abundantly clear that standards of recording clinical terms in human-readable, computer-processable format are indispensable. Controlled medical terminology is the missing link in health information standards (in fact, medical terminology can be viewed as the mother of all standards); its absence interferes with the business of healthcare and impedes the core processes of healing and maintaining health. Medicine has lacked the controlled common medical vocabulary that would enable universal sharing of data at the point of care and ensure reliable information for determining health intervention effectiveness. Simple clinical and code content alone has proven insufficient for healthcare enterprises to successfully manage the terminology problem; the "lexical runtime engine," formerly called a vocabulary server (VOSER), which manages the vocabulary ontology and serves up the relevant vocabulary to users of applications in the clinical environment, has recently become a reality.

  8. Metrologically-Calibrated 40Ar Concentrations and Ages of Mineral Standards Used in 40Ar/39Ar Geochronology

    NASA Astrophysics Data System (ADS)

    Morgan, L. E.; Davidheiser-Kroll, B.; Kuiper, K.; Wijbrans, J. R.; Mark, D. F.

    2015-12-01

    In geochronology, isotopic ages are determined from the ratio of parent and daughter nuclide concentrations in minerals. For dating of geological material using the K-Ar system, the simultaneous determination of 40Ar and 40K concentrations on the same aliquot is not possible. Therefore, a widely used variant, the 40Ar/39Ar technique, involves the production of 39Ar from 39K by neutron bombardment and the reliance on indirect natural calibrators of the neutron flux, referred to as "mineral standards." Many mineral standards still in use rely on decades-old determinations of 40Ar concentrations; resulting uncertainties, both systematic and analytical, impede the determination of higher accuracy ages using the K-Ar decay system. We present results for the 40Ar concentrations and ages of mineral standards determined based on a modern gas delivery system (Morgan et al. 2011), which delivers metrologically-traceable amounts of 40Ar and thus allows for the sensitivity calibration of noble gas mass spectrometers.

  9. Weather-Related Mortality

    PubMed Central

    Anderson, Brooke G.; Bell, Michelle L.

    2012-01-01

    Background Many studies have linked weather to mortality; however, role of such critical factors as regional variation, susceptible populations, and acclimatization remain unresolved. Methods We applied time-series models to 107 US communities allowing a nonlinear relationship between temperature and mortality by using a 14-year dataset. Second-stage analysis was used to relate cold, heat, and heat wave effect estimates to community-specific variables. We considered exposure timeframe, susceptibility, age, cause of death, and confounding from pollutants. Heat waves were modeled with varying intensity and duration. Results Heat-related mortality was most associated with a shorter lag (average of same day and previous day), with an overall increase of 3.0% (95% posterior interval: 2.4%–3.6%) in mortality risk comparing the 99th and 90th percentile temperatures for the community. Cold-related mortality was most associated with a longer lag (average of current day up to 25 days previous), with a 4.2% (3.2%–5.3%) increase in risk comparing the first and 10th percentile temperatures for the community. Mortality risk increased with the intensity or duration of heat waves. Spatial heterogeneity in effects indicates that weather–mortality relationships from 1 community may not be applicable in another. Larger spatial heterogeneity for absolute temperature estimates (comparing risk at specific temperatures) than for relative temperature estimates (comparing risk at community-specific temperature percentiles) provides evidence for acclimatization. We identified susceptibility based on age, socioeconomic conditions, urbanicity, and central air conditioning. Conclusions Acclimatization, individual susceptibility, and community characteristics all affect heat-related effects on mortality. PMID:19194300

  10. Cancer mortality in agricultural regions of Minnesota.

    PubMed Central

    Schreinemachers, D M; Creason, J P; Garry, V F

    1999-01-01

    Because of its unique geology, Minnesota can be divided into four agricultural regions: south-central region one (corn, soybeans); west-central region two (wheat, corn, soybeans); northwest region three (wheat, sugar beets, potatoes); and northeast region four (forested and urban in character). Cancer mortality (1980-1989) in agricultural regions one, two, and three was compared to region four. Using data compiled by the National Center for Health Statistics, cancer mortality was summarized by 5-year age groups, sex, race, and county. Age-standardized mortality rate ratios were calculated for white males and females for all ages combined, and for children aged 0-14. Increased mortality rate ratios and 95% confidence intervals (CIs) were observed for the following cancer sites: region one--lip (men), standardized rate ratio (SRR) = 2.70 (CI, 1.08-6.71); nasopharynx (women), SRR = 3.35 (CI, 1.20-9.31); region two--non-Hodgkin's lymphoma (women), SRR = 1.35 (CI, 1.09-1.66); and region three--prostate (men), SRR = 1.12 (CI, 1.00-1.26); thyroid (men), SRR = 2.95 (CI, 1.35-6.44); bone (men), SRR = 2.09 (CI, 1. 00-4.34); eye (women), SRR = 5.77 (CI, 1.90-17.50). Deficits of smoking-related cancers were noted. Excess cancers reported are consistent with earlier reports of agriculturally related cancers in the midwestern United States. However, reports on thyroid and bone cancer in association with agricultural pesticides are few in number. The highest use of fungicides occurs in region three. Ethylenebisdithiocarbamates, whose metabolite is a known cause of thyroid cancer in rats, are frequently applied. This report provides a rationale for evaluation of the carcinogenic potential of this suspect agent in humans. Images Figure 1 PMID:10064550

  11. This Is Only a Test: Teaching for Mathematical Understanding in an Age of Standardized Testing

    ERIC Educational Resources Information Center

    Litton, Nancy; Wickett, Maryann

    2009-01-01

    "This Is Only a Test" helps teachers plan a year of instruction that takes testing into account while staying focused on a curriculum that encourages students to love and understand mathematics. Transform teachers' and students' feelings toward standardized tests from panic and anxiety to control and confidence. This book's proven strategies help…

  12. Teacher Collaboration in the Age of Teaching Standards: The Study of a Small, Suburban School District

    ERIC Educational Resources Information Center

    Bronstein, Adam Samuel

    2013-01-01

    In the wake of new teaching standards and evaluation systems introduced in the United States, teacher collaboration has emerged as a common theme. However, despite these recent changes, teaching is still largely a private act, in which teachers are often secluded from their colleagues. This study investigated the range and variation of the…

  13. Indonesia lowers infant mortality.

    PubMed

    Bain, S

    1991-11-01

    Indonesia's success in reaching World Health Organization (WHO) universal immunization coverage standards is described as the result of a strong national program with timely, targeted donor support. USAID/Indonesia's Expanded Program for Immunization (EPI) and other USAID bilateral cooperation helped the government of Indonesia in its goal to immunize children against diphtheria, pertussis, tetanus, polio, tuberculosis, and measles by age 1. The initial project was to identify target areas and deliver vaccines against the diseases, strengthen the national immunization organization and infrastructure, and develop the Ministry of Health's capacity to conduct studies and development activities. This EPI project spanned the period 1979-90, and set the stage for continued expansion of Indonesia's immunization program to comply with the full international schedule and range of immunizations of 3 DPT, 3 polio, 1 BCG, and 1 measles inoculation. The number of immunization sites has increased from 55 to include over 5,000 health centers in all provinces, with additional services provided by visiting vaccinators and nurses in most of the 215,000 community-supported integrated health posts. While other contributory factors were at play, program success is at least partially responsible for the 1990 infant mortality rate of 58/1,000 live births compared to 72/1,000 in 1985. Strong national leadership, dedicated health workers and volunteers, and cooperation and funding from UNICEF, the World Bank, Rotary International, and WHO also played crucially positive roles in improving immunization practice in Indonesia.

  14. Homes for the Aged: Supervision and Standards. A Report on the Legal Situation in European Countries.

    ERIC Educational Resources Information Center

    Noam, Ernst

    The International Center for Social Gerontology (ICSG) is making available this translation of a timely study by Ernst Noam which describes and compares legislation, policies, and procedures for licensing, supervision, and inspection of homes for the aged in various Western and Eastern European nations. This study is presented to help provide a…

  15. Assessing Changes in Attitudes about Aging: Personal Reflections and a Standardized Measure.

    ERIC Educational Resources Information Center

    O'Hanlon, Ann M.; Brookover, B. Cecile

    2002-01-01

    Sophomore (n=31) and senior (n=24) gerontology students completed the Aging Semantic Differential at the beginning of the semester and after conducting life-history interviews with older adults. Significant positive attitude changes resulted; the interviews were specifically cited as influencing changes. (Contains 33 references.) (SK)

  16. [Setting-up an epidemiological monitoring system of mortality by trauma in children under 15 years of age in metropolitan France].

    PubMed

    Lasbeur, L; Thélot, B

    2014-11-01

    In metropolitan France in 2009, trauma was the leading cause of death among children under 15 years of age: 459 deaths (source CépiDc), with 236 deaths by home and leisure injuries (HLI). These rough mortality data do not describe the circumstances of the trauma responsible for the death. The "Fatal home and leisure injury among children under 15 years old-MAC-15" feasibility study was set up in 2009 in France in the following regions: Île-de-France, Nord-Pas-de-Calais, and Provence-Alpes-Côte d'Azur. The main objective of the survey was to understand exactly how these accidents occurred and determine their risk factors. Its secondary objectives were to test the feasibility and analyze the possibility of extending and/or scaling up the monitoring of these deaths. Case reporting was made through death certificates, contacts with regional health agencies, and media surveillance. A detailed record was completed by the medical certifier. In 2009, 76 HLI-related deaths in under 15-year-old children were identified by the survey in the three regions. The victims were mostly boys. The most common cause of death was drowning, followed by suffocation, falls, and fires. The survey contributed to precisely determining the risk factors of HLIs in children and, most often, to identifying the cause responsible for the fatal accident. The feasibility conclusions of this survey are positive, data collection is effective and practicable, and its quality and exhaustiveness were demonstrated. Implementation of the "detailed analyses of the deaths by trauma among children under 15 years old" survey is proposed. This survey will be extended to all deaths by trauma among children in Metropolitan France.

  17. Mortality as a function of obesity and diabetes mellitus.

    PubMed

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

    1982-03-01

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

  18. Advance Report of Final Mortality Statistics, 1985.

    ERIC Educational Resources Information Center

    Monthly Vital Statistics Report, 1987

    1987-01-01

    This document presents mortality statistics for 1985 for the entire United States. Data analysis and discussion of these factors is included: death and death rates; death rates by age, sex, and race; expectation of life at birth and at specified ages; causes of death; infant mortality; and maternal mortality. Highlights reported include: (1) the…

  19. Mortality among Swedish Journalists.

    ERIC Educational Resources Information Center

    Furhoff, Anna-Karin; Furhoff, Lars

    1987-01-01

    Charts the various environmental factors that might influence the mortality rate of Swedish journalists. Concludes that, although there may be a slightly higher death rate among Swedish journalists in the 50-59 age group, the death rate for journalists is the same as for the population in general. (MM)

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

    PubMed

    Spallek, Jacob; Arnold, Melina; Razum, Oliver; Juel, Knud; Rey, Grégoire; Deboosere, Patrick; Mackenbach, Johan Pieter; Kunst, Anton Eduard

    2012-12-01

    The aim of this study on cancer mortality among Turkish immigrants, for the first time, traditional comparisons in migrant health research have been extended simultaneously in two ways. First, comparisons were made to cancer mortality from the immigrants' country of origin and second, cancer mortality among Turkish immigrants across four host countries (Belgium, Denmark, France and the Netherlands) was compared. Population-based cancer mortality data from these countries were included. Age-standardized mortality rates were computed for the local-born and Turkish population of each country. Relative differences in cancer mortality were examined by fitting country-specific Poisson regression models. Globocan data on cancer mortality in Turkey from 2008 were used in order to compare mortality rates of Turkish immigrants with those from their country of origin. Turkish immigrants had lower all-cancer mortality than the local-born populations of their host countries, and mortality levels comparable to all-cancer mortality rates in Turkey. In the Netherlands and France breast cancer mortality was consistently lower in Turkish immigrants women than among local-born women. Lung cancer mortality was slightly lower in Turkish immigrants in the Netherlands and France but varied considerably between migrants in these two host countries. Stomach cancer mortality was significantly higher in Turkish immigrants when compared to local-born French and Dutch. Our findings indicate that exposures both in the country of origin and in the host country can have an effect on the cancer mortality of immigrants. Despite limitations affecting any cross-country comparison of mortality, the innovative multi-comparison approach is a promising way to gain further insights into determinants of trends in cancer mortality of immigrants.

  1. IMF-lending programs and suicide mortality.

    PubMed

    Goulas, Eleftherios; Zervoyianni, Athina

    2016-03-01

    While the economic consequences of IMF programs have been extensively analyzed in the literature, much less is known about how key welfare indicators, including suicide-mortality rates, correlate with countries' participation in such programs. This paper examines the impact of IMF lending on suicide mortality, using data from 30 developing and transition countries that received non-concessionary IMF loans during 1991-2008. Our results support the hypothesis of a positive causal relationship between suicide mortality and participation in IMF programs but reveal no systematic suicide-increasing effect from the size of IMF loans. This holds after accounting for self-selection into programs, resulting from the endogeneity of a country's decision to resort to the IMF for funding, and after controlling for standard socio-economic influences on suicidal behaviour. In particular, we find a positive aggregate suicide-mortality differential due to IMF-program participation of between 4 and 14 percentage points. We also find that the positive association between suicides and program participation is stronger and more robust among males. Comparing age groups, individuals belonging to the age group 45-to-64 exhibit the highest increase in suicide due to program-participation, which amounts to over 18 percentage points. Overall, our results imply that when countries are exposed to IMF programs in an attempt to resolve their economic problems, social-safety nets need to be designed to protect the adversely-affected part of the population.

  2. Age-standardized incidence rates of ameloblastoma and dentigerous cyst on the Witwatersrand, South Africa.

    PubMed

    Shear, M; Singh, S

    1978-07-01

    Although a great deal is known about the incidence of cancer, including oral cancer, no such study has been done on odontogenic tumors and jaw cysts. There are therefore no standardized data which would allow for comparative incidences in different countries and between different groups. In the present study, cases of ameloblastomas and dentigerous cysts derived from the records of all the hospital pathology departments and private pathology practices on the Witwatersrand, were recorded for the 10-year period 1965--1974. The population at risk (1970 census) was 974,390 Whites and 1,567,280 Blacks. The annual incidence rates, standardized against the standard world population, for ameloblastomas per million population are 1.96, 1.20, 0.18 and 0.44 for Black males, females and White males, females, respectively. The equivalent four figures for dentigerous cysts are 1.18, 1.22, 9.92 and 7.26. These figures show that ameloblastoma is very much more common in Blacks than Whites in the population at risk. Conversely, dentigerous cysts are much more common in Whites. This makes it unlikely that dentigerous cysts predispose to ameloblastoma formation. These epidemiologic observations give rise to speculation as to whether some component of the South African Black diet or other environmental substance might possibly be an etiologic factor in ameloblastoma.

  3. Educational inequalities in tuberculosis mortality in sixteen European populations

    PubMed Central

    Álvarez, J. L.; Kunst, A. E.; Leinsalu, M.; Bopp, M.; Strand, B. H.; Menvielle, Gwenn; Lundberg, O.; Martikainen, P.; Deboosere, P.; Kalediene, R.; Artnik, B.; Mackenbach, J. P.; Richardus, J. H.

    2011-01-01

    Objective We aim to describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban, and rural populations in several European countries. Design Data were obtained from the Eurothine project covering 16 populations between 1990 and 2003. Age- and sex-standardized mortality rates, the Relative Index of Inequality, and the slope index of inequality were used to assess educational inequalities. Results The number of TB deaths reported was 8530, with a death rate of 3 per 100 000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were larger than in total mortality. Relative and absolute inequalities were large in Eastern Europe, and Baltic countries but relatively small in Southern countries and in Norway, Finland, and Sweden. Mortality inequalities were observed among both men and women, and in both rural and urban populations. Conclusions Socioeconomic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve vulnerable groups’ access to treatment and thereby reduce TB mortality. PMID:22008757

  4. Response to a standard behavioral weight loss intervention by age of onset of obesity

    PubMed Central

    Taverno Ross, S. E.; Lang, W.; Jakicic, J. M.

    2016-01-01

    Summary Background The purpose of this study was to examine weight loss, physical activity, fitness and diet changes in response to a standard behavioral weight loss intervention in adults with self‐reported juvenile onset (n = 61) or adult onset (n = 116) obesity. Methods Participants (n = 177; 43.0 ± 8.6 years; body mass index [BMI] = 33.0 ± 3.4 kg m−2) engaged in an 18‐month standard behavioral weight loss intervention. Participants were randomized into three different intervention groups as part of the larger parent trial. BMI, physical activity, fitness and diet were assessed at baseline, 6, 12 and 18 months. Separate adjusted mixed models were constructed using SAS version 9.4 (SAS Institute, Cary, NC). Results There was significant weight loss, increased physical activity, improved fitness and reduced caloric intake over time (p < 0.001). There were no significant differences in these outcome variables by obesity onset group. However, there was a significant group by time interaction for fitness (p = 0.001), with the adult onset making significantly greater gains in fitness from baseline to 6 months (p < 0.001); however, this difference was no longer present at 12 or 18 months. Conclusions With the exception of fitness at 6 months, weight loss, physical activity and diet did not differ between juvenile onset and adult onset participants, suggesting that those with juvenile onset obesity are equally responsive to a standard behavioral weight loss intervention in adulthood. PMID:27708841

  5. Mortality associated with hepatitis C and hepatitis B virus infection: A nationwide study on multiple causes of death data

    PubMed Central

    Fedeli, Ugo; Grande, Enrico; Grippo, Francesco; Frova, Luisa

    2017-01-01

    AIM To analyze mortality associated with hepatitis C virus (HCV) and hepatitis B virus (HBV) infection in Italy. METHODS Death certificates mentioning either HBV or HCV infection were retrieved from the Italian National Cause of Death Register for the years 2011-2013. Mortality rates and proportional mortality (percentage of deaths with mention of HCV/HBV among all registered deaths) were computed by gender and age class. The geographical variability in HCV-related mortality rates was investigated by directly age-standardized rates (European standard population). Proportional mortality for HCV and HBV among subjects aged 20-59 years was assessed in the native population and in different immigrant groups. RESULTS HCV infection was mentioned in 1.6% (n = 27730) and HBV infection in 0.2% (n = 3838) of all deaths among subjects aged ≥ 20 years. Mortality rates associated with HCV infection increased exponentially with age in both genders, with a male to female ratio close to unity among the elderly; a further peak was observed in the 50-54 year age group especially among male subjects. HCV-related mortality rates were higher in Southern Italy among elderly people (45/100000 in subjects aged 60-79 and 125/100000 in subjects aged ≥ 80 years), and in North-Western Italy among middle-aged subjects (9/100000 in the 40-59 year age group). Proportional mortality was higher among Italian citizens and North African immigrants for HCV, and among Sub-Saharan African and Asian immigrants for HBV. CONCLUSION Population ageing, immigration, and new therapeutic approaches are shaping the epidemiology of virus-related chronic liver disease. In spite of limits due to the incomplete reporting and misclassification of the etiology of liver disease, mortality data represent an additional source of information for surveillance. PMID:28348493

  6. Child Mortality: A Preventable Tragedy.

    ERIC Educational Resources Information Center

    Seipel, Michael M. O.

    1996-01-01

    Worldwide data reveal that child mortality (ages 1-5) accounts for about 10-15% of all deaths in developing countries, and less than 1% of all deaths in developed countries. Strategies for reducing child mortality include improving health services, improving environmental conditions, enhancing the social conditions of children, and protecting and…

  7. A new approach to the study of Romanization in Britain: a regional perspective of cultural change in late Iron Age and Roman Dorset using the Siler and Gompertz-Makeham models of mortality

    PubMed Central

    Redfern, Rebecca C.; DeWitte, Sharon N.

    2011-01-01

    This is the first study of Romanization to use the Siler and Gompertz-Makeham models of mortality in order to investigate the health consequences of the 43 AD conquest of Britain. The study examined late Iron Age and Romano-British populations (N=518) from Dorset, England, which is the only region of Britain to display continuity in inhumation burial practice and cemetery use throughout the two periods. Skeletal evidence for frailty was assessed using cribra orbitalia, porotic hyperostosis, periosteal lesions, enamel hypoplasia, dental caries, tuberculosis, and rickets. These health variables were chosen for analysis because they are reliable indicators of general health for diachronic comparison (Steckel and Rose 2002) and are associated with the introduction of urbanism in Britain during the Roman period (Redfern 2007; Redfern 2008b; Roberts and Cox 2003). The results show that levels of frailty and mortality were lower in the late Iron Age period, and no sex differences in mortality were present. However, post-conquest, mortality risk increased for children and the elderly, and particularly for males. The latter finding challenges received wisdom concerning the benefits of Romanization and the higher status of the male body in the Roman world. Therefore, we conclude that the consequences of urbanism, changes in diet and increased population heterogeneity negatively impacted health, to the extent that the enhanced cultural buffering of males did not out-weigh underlying sex differences in biology that advantage females. PMID:20925081

  8. Possible secondary apatite fission track age standard from altered volcanic ash beds in the middle Jurassic Carmel Formation, Southwestern Utah

    USGS Publications Warehouse

    Kowallis, B.J.; Christiansen, E.H.; Everett, B.H.; Crowley, K.D.; Naeser, C.W.; Miller, D.S.; Deino, A.L.

    1993-01-01

    Secondary age standards are valuable in intra- and interlaboratory calibration. At present very few such standards are available for fission track dating that is older than Tertiary. Several altered volcanic ash beds occur in the Middle Jurassic Carmel Formation in southwestern Utah. The formation was deposited in a shallow marine/sabhka environment. Near Gunlock, Utah, eight ash beds have been identified. Sanidines from one of the ash beds (GUN-F) give a single-crystal laser-probe 40Ar/39Ar age of 166.3??0.8 Ma (2??). Apatite and zircon fission track ages range from 152-185 Ma with typically 15-20 Ma errors (2??). Track densities in zircons are high and most grains are not countable. Apatites are fairly common in most of the ash beds and have reasonable track densities ranging between 1.2-1.5 ?? 106 tracks/cm2. Track length distributions in apatites are unimodal, have standard deviations <1??m, and mean track lengths of about 14-14.5 ??m. High Cl apatites (F:Cl:OH ratio of 39:33:28) are particularly abundant and large in ash GUN-F, and are fairly easy to concentrate, but the concentrates contain some siderite, most of which can be removed by sieving. GUN-F shows evidence of some reworking and detriaal contamination based on older single grain 40Ar/39Ar analyses and some rounding of grains, but the apatite population appears to be largely uncontaminated. At present BJK has approximately 12 of apatite separate from GUN-F. ?? 1993.

  9. The BALB/c mouse: Effect of standard vivarium lighting on retinal pathology during aging

    PubMed Central

    Bell, Brent A.; Kaul, Charles; Bonilha, Vera L.; Rayborn, Mary E.; Shadrach, Karen; Hollyfield, Joe G.

    2015-01-01

    BALB/cJ mice housed under normal vivarium lighting conditions can exhibit profound retinal abnormalities, including retinal infoldings, autofluorescent inflammatory cells, and photoreceptor degeneration. To explore the sensitivity of the outer retina to cyclic lighting during aging, a cohort of BALB/cJ mice was evaluated with Scanning Laser Ophthalmoscopy (SLO), Spectral-Domain Optical Coherence Tomography (OCT) and conventional histopathology. Mice were bred and reared in a low-illuminance (extracage/intracage: 13 lx/1 lx) vivarium under cyclic light (14 h light: 10 h dark). Retinal imaging (around postnatal day 70) was performed to screen for any pre-existing abnormalities and to establish a baseline. Mice with normal retinas were separated into groups (A, B, C) and placed on bottom (Groups A & B) or top (Group C) of the cage racks where cage illumination was <10 & 150 lx respectively. Experimental groups B & C were imaged multiple times over a 17 month period. Mice from group A (controls) were imaged only once post-baseline at various times for comparison to groups B & C. Mice were assessed by histology at 8, 15, 20, 36, and 56 weeks and immunohistochemistry at 15 weeks post-baseline. SLO and OCT retinal images were measured and the resulting trends displayed as a function of age and light exposure. Retinal lesions (RL) and autofluorescent foci (AFF) were identified with histology as photoreceptor layer infoldings (IF) and localized microglia/macrophages (MM), respectively. Few RL and AFF were evident at baseline. Retinal infoldings were the earliest changes followed by subjacent punctate autofluorescent MM. The colocalization of IF and MM suggests a causal relationship. The incidence of these pathological features increased in all groups relative to baseline. OCT imaging revealed thinning of the outer nuclear layer (ONL) in all groups at 1 year relative to baseline. ONL thinning followed an exponential rate of change but the decay constant varied depending on

  10. Mortality due to lung cancer in Mexico.

    PubMed

    Ruíz-Godoy, L; Rizo Rios, P; Sánchez Cervantes, F; Osornio-Vargas, A; García-Cuellar, C; Meneses García, A

    2007-11-01

    The highest mortality due to cancer worldwide for both genders corresponds to lung cancer (1,179,000 deaths). In Mexico, the crude mortality rate due to lung cancer was of 5.01 per 10(5) inhabitants in 1979. The most important risk factor is smoking. The present study was aimed at analyzing the mortality due to lung cancer in Mexico, assessing data from each of the states constituting the Mexican Republic during the 1998-2004 period. Data were obtained from the National Institute of Statistics, Geography and Informatics (INEGI, for its initials in Spanish) corresponding to deaths due to lung cancer (1998-2004). We estimated the mean annual mortality rate (MAMR) for each of the 32 states of Mexico. We used the "World Population Standard". The MAMR was standardized according to age (ARS) direct method, and the standard error was determined by Poisson's approximation at a 95% confidence interval. To know the excess risk due to mortality, we calculated the standardized mortality ratios (SMRs) of ARS for each federal state, using the national rate as reference. In this period, 397,400 deaths due to malignant neoplasms were recorded, corresponding 45,578 (11.5%) to lung cancer; for men, 31,025 (68.1%) with MAMR of 8.9 and the respective ARS of 13.2 both x10(5) inhabitants. For women, results were 4553 (31.9%) deaths with MAMR of 4.1 and ARS of 5.4 both x10(5) inhabitants. The highest mortality rates due to lung cancer in both genders were observed in the north of Mexico, whereas for women this was observed in the central states. Although smoking is the main risk for lung cancer, there are other factors such as environmental pollution or exposure to toxicants that could be associated to this cancer. The years potentially lost due to lung cancer were 258,550 for men and 133,315 for women, with a total of 391,865 according to histopathology registry neoplasm malignant RHNM (1985-1995). Studies focused on the characterization and measurement of polluting agents would be a

  11. The Gifted Rating Scales-Preschool/Kindergarten Form: An Analysis of the Standardization Sample Based on Age, Gender, and Race

    PubMed Central

    Pfeiffer, Steven L; Petscher, Yaacov; Jarosewich, Tania

    2015-01-01

    This study reports on an analysis of the standardization sample of a rating scale designed to assist in identification of gifted students. The Gifted Rating Scales-Preschool/Kindergarten Form (GRS-P) is based on a multidimensional model of giftedness designed for preschool and kindergarten students. Results provide support for: the internal structure of the scale; no age differences across the 3-year age span 4:0–6:11; gender differences on only one of the five scales; artistic talent; and small but statistically significant race/ethnicity differences with Asian Americans rated, on average, 1.5 scale-score points higher than whites and Native Americans and 7 points higher than African American and Hispanic students. The present findings provide support for the GRS-P as a valid screening test for giftedness. PMID:26346963

  12. The ageing and myasthenic thymus: a morphometric study validating a standard procedure in the histological workup of thymic specimens.

    PubMed

    Ströbel, Philipp; Moritz, Regina; Leite, Maria Isabel; Willcox, Nick; Chuang, Wen-Yu; Gold, Ralf; Nix, Wilfred; Schalke, Berthold; Kiefer, Reinhard; Müller-Hermelink, Hans-Konrad; Jaretzki Iii, Alfred; Newsom-Davis, John; Marx, Alexander

    2008-09-15

    The thymus is believed to play an important role in the pathogenesis of myasthenia gravis (MG). The 80% of MG patients with anti-acetylcholine receptor autoantibodies fall into three clinical subgroups: 1) thymoma; 2) early-onset MG (<age of 40; EOMG) and 3) late-onset (LOMG; onset after 40). Thymectomy is widely used in EOMG, but its benefits have not been established in randomized controlled trials. A multicenter international trial (MGTX) currently seeks to determine whether thymectomy reduces corticosteroid requirements, and to look for correlations with thymic histology. We here describe the validated, standardized histological workup and reporting system used in this trial.

  13. Reliability and factorial validity of the standard progressive matrices among Kuwaiti children ages 8 to 15 years.

    PubMed

    Abdel-Khalek, Ahmed M

    2005-10-01

    The Raven Standard Progressive Matrices was administered to a sample of 6,529 children in Kuwait ranging in age from 8 to 15 years. Test-retest reliability (N = 968) ranged between .69 and .85, while Cronbach coefficients alpha ranged from .88 to .93, showing from acceptable to good temporal stability and from good to high internal consistency. The loadings of the five sets of matrices on the only salient factor ranged from .73 to .89 indicating the good factorial validity of the scale. The rtest seems useful in the Kuwaiti context.

  14. Prevalence of overweight and obesity among children aged 2-5 years in Bahrain: a comparison between two reference standards.

    PubMed

    Al-Raees, Ghada Y; Al-Amer, Maryam A; Musaiger, Abdulrahman O; D'Souza, Reshma

    2009-01-01

    A cross-sectional study was carried out on Bahraini preschoolers aged 2-5 years (354 males and 344 females) to determine the prevalence of overweight and obesity using the World Health Organization and the International Obesity Task Force cut-off values. Weight and height were recorded and body mass index (BMI) was calculated to determine the proportion of overweight and obesity. Using the World Health Organization percentile cut-off values, overweight (12.3%) and obesity (8.4%) was higher in females between 2 and <4 years of age whereas, the proportion of both overweight (8.4%) and obesity (7.2%) were higher in males between 4 and <6 years of age. Relative to the International Obesity Task Force indicators, the World Health Organization cut-off values produced nearly a 2-fold increase in both overweight and obesity at most ages. It is therefore important to ensure that the same cut-off reference values are used to define overweight and obesity particularly in preschoolers. Shifting to the new World Health Organization child growth standards may have important implications for child health programmes.

  15. Apophyseal Ossification of the Iliac Crest in Forensic Age Estimation: Computed Tomography Standards for Modern Australian Subadults.

    PubMed

    Lottering, Nicolene; Alston-Knox, Clair L; MacGregor, Donna M; Izatt, Maree T; Grant, Caroline A; Adam, Clayton J; Gregory, Laura S

    2017-03-01

    This study contrasts the ontogeny of the iliac crest apophysis using conventional radiography and multislice computed tomography (MSCT), providing probabilistic information for age estimation of modern Australian subadults. Retrospective abdominopelvic MSCT data acquired from 524 Australian individuals aged 7-25 and surveillance radiographs of adolescent idiopathic scoliosis patients included in the Paediatric Spine Research Group Progression Study (n = 531) were assessed. Ossification scoring of pseudo-radiographs and three-dimensional (3D) volume-rendered reconstructions using Risser (1958) quantitative descriptors indicate discrepancies in age estimates, stage allocation, and conflicting morphological progression. To mitigate visualization limitations associated with two-dimensional radiographs, we provide and validate a modified 3D-MSCT scoring tier of ossification, demonstrating complete fusion between 17.3-19.2 and 17.1-20.1 years in males and females. Legal demarcation for doli incapax presumption and age of majority (18 years) can be achieved using probability estimates from a fitted cumulative probit model for apophyseal fusion using the recalibrated standards.

  16. Correcting bias from the standard linear adjustment of weaning weight to an age-constant basis for beef calves.

    PubMed

    Rossi, D J; Kress, D D; Tess, M W; Burfening, P J

    1992-05-01

    Standard linear adjustment of weaning weight to a constant age has been shown to introduce bias in the adjusted weight due to nonlinear growth from birth to weaning of beef calves. Ten years of field records from the five strains of Beefbooster Cattle Alberta Ltd. seed stock herds were used to investigate the use of correction factors to adjust standard 180-d weight (WT180) for this bias. Statistical analyses were performed within strain and followed three steps: 1) the full data set was split into an estimation set (ES) and a validation set (VS), 2) WT180 from the ES was used to develop estimates of correction factors using a model including herd (H), year (YR), age of dam (DA), sex of calf (S), all two and three-way interactions, and any significant linear and quadratic covariates of calf age at weaning deviated from 180 d (DEVCA) and interactions between DEVCA and DA, S or DA x S, and 3) significant DEVCA coefficients were used to correct WT180 from the VS, then WT180 and the corrected weight (WTCOR) from the VS were analyzed with the same model as in Step 2 and significance of DEVCA terms were compared. Two types of data splitting were used. Adjusted R2 was calculated to describe the proportion of total variation of DEVCA terms explained for WT180 from the ES. The DEVCA terms explained .08 to 1.54% of the total variation for the five strains. Linear and quadratic correction factors were both positive and negative. Bias in WT180 from the ES within 180 +/- 35 d of age ranged from 2.8 to 21.7 kg.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. A survey of the physical health status of pupils aged 10-14 years in Standards 3-5 at three schools in New Crossroads, near Cape Town in the Western Cape.

    PubMed

    Ramphele, M A; Heap, M; Trollip, D K

    1995-10-01

    Although adolescence is most commonly associated with risk-taking behaviour, mortality due to poverty-related conditions is high among black African children aged 10-14 years. This paper describes a study carried out in October 1991 to assess the physical health status of 860 underprivileged pupils aged 10-14 years in Standards 3-5 at three schools in New Crossroads, near Cape Town. Data on nutritional status, age at menarche, blood pressure, eyesight, physical abnormalities, injuries and use of hospitals were obtained. The response rate was 90%. Of all the children, 7.2% were below the 5th percentile weight-for-age. The proportion of boys (13.1%) below the 5th percentile weight-for-age was significantly higher than that of girls (3.7%). Of all the children, 19.5% were below the 5th percentile height-for-age. The proportion of boys (24.4%) below the 5th percentile height-for-age was also significantly higher than that of girls (16.7%). The average age at menarche was 13 years, similar to that (12.8 years) reported for the UK. In 5% of the children, the diastolic blood pressure was > 90 mmHg and the findings show some increase with age. Red Cross War Memorial Children's Hospital accounted for 30.9% of hospital attendances. 'Chest' complaints (19.5%) were frequent reasons for consultations, while 15.2% of the children reported being injured, with car accidents (16.0%), fractures (27.5%) and burns (20.6%) being the most common injuries. It is suggested that the provision of a 24-hour day hospital will ease the load on the referral hospital, i.e. Red Cross War Memorial Children's Hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Aging

    PubMed Central

    Park, Dong Choon

    2013-01-01

    Aging is initiated based on genetic and environmental factors that operate from the time of birth of organisms. Aging induces physiological phenomena such as reduction of cell counts, deterioration of tissue proteins, tissue atrophy, a decrease of the metabolic rate, reduction of body fluids, and calcium metabolism abnormalities, with final progression onto pathological aging. Despite the efforts from many researchers, the progression and the mechanisms of aging are not clearly understood yet. Therefore, the authors would like to introduce several theories which have gained attentions among the published theories up to date; genetic program theory, wear-and-tear theory, telomere theory, endocrine theory, DNA damage hypothesis, error catastrophe theory, the rate of living theory, mitochondrial theory, and free radical theory. Although there have been many studies that have tried to prevent aging and prolong life, here we introduce a couple of theories which have been proven more or less; food, exercise, and diet restriction. PMID:24653904

  19. [Analysis on mortality of cervical cancer and its temporal trend in women in China, 2006-2012].

    PubMed

    Bao, H L; Liu, Y N; Wang, L J; Fang, L W; Cong, S; Zhou, M G; Wang, L H

    2017-01-10

    Objective: To analyze the mortality of cervical cancer and its temporal trend in women in China between 2006 and 2012. Methods: The cause-of-death data about cervical cancer, which was abstracted from National Disease Surveillance Points and adjusted by special survey for underreporting, was used to analyze the age and area specific crude mortality rates of cervical cancer in China during 2006-2012. The age-standardized mortality rate was calculated by using world standardized population (Segi's). The Joinpoint regression model was used to obtain annual percentage change and 95%CI for assessing the time trend of mortality rate of cervical cancer from 2006 to 2012. Results: In 2012, the crude mortality rate of cervical cancer was 3.15 per 100 000 in women in China. The mortality rate in rural area (3.45/100 000) was higher than that in urban area (2.76/100 000), while the central area had the highest mortality rate of cervical cancer (3.77/100 000) compared with western area (3.23/100 000) and eastern area (2.54/100 000). The Segi's age-standardized mortality rate in eastern area increased by 2.9% (95%CI: 0.8%-5.0%) annually, an increase of 6.0% was observed in age group 30-59 years (95%CI: 1.6%-10.5%). However, the Segi's age-standardized mortality rate in central area declined by 4.6% (95%CI: -5.9% - -3.3%), where the declines of 3.2% and 5.7% were observed in age groups 30-59 years and ≥60 years (95%CI: - 5.0%-- 1.4% and 95% CI: - 9.3% --2.0%) and respectively. There was no significant change in cervical cancer mortality in western area. The similar trends were observed in the age-standardized mortality rate calculated according to the population of China. Conclusions: The decline of overall mortality rate of cervical cancer tended to stop in China and significant differences still exist among different areas. Our results suggest that the central/western areas and rural areas are still key areas for cervical cancer prevention and control and close attention

  20. Socioeconomic inequalities in child mortality: comparisons across nine developing countries.

    PubMed Central

    Wagstaff, A.

    2000-01-01

    This paper generates and analyses survey data on inequalities in mortality among infants and children aged under five years by consumption in Brazil, Côte d'Ivoire, Ghana, Nepal, Nicaragua, Pakistan, the Philippines, South Africa, and Viet Nam. The data were obtained from the Living Standards Measurement Study and the Cebu Longitudinal Health and Nutrition Survey. Mortality rates were estimated directly where complete fertility histories were available and indirectly otherwise. Mortality distributions were compared between countries by means of concentration curves and concentration indices: dominance checks were carried out for all pairwise intercountry comparisons; standard errors were calculated for the concentration indices; and tests of intercountry differences in inequality were performed. PMID:10686730

  1. Mortality of lead smelter workers

    SciTech Connect

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

    1985-10-01

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

  2. The mortality of companies

    PubMed Central

    Daepp, Madeleine I. G.; Hamilton, Marcus J.; West, Geoffrey B.; Bettencourt, Luís M. A.

    2015-01-01

    The firm is a fundamental economic unit of contemporary human societies. Studies on the general quantitative and statistical character of firms have produced mixed results regarding their lifespans and mortality. We examine a comprehensive database of more than 25 000 publicly traded North American companies, from 1950 to 2009, to derive the statistics of firm lifespans. Based on detailed survival analysis, we show that the mortality of publicly traded companies manifests an approximately constant hazard rate over long periods of observation. This regularity indicates that mortality rates are independent of a company's age. We show that the typical half-life of a publicly traded company is about a decade, regardless of business sector. Our results shed new light on the dynamics of births and deaths of publicly traded companies and identify some of the necessary ingredients of a general theory of firms. PMID:25833247

  3. Modelling small-area inequality in premature mortality using years of life lost rates

    NASA Astrophysics Data System (ADS)

    Congdon, Peter

    2013-04-01

    Analysis of premature mortality variations via standardized expected years of life lost (SEYLL) measures raises questions about suitable modelling for mortality data, especially when developing SEYLL profiles for areas with small populations. Existing fixed effects estimation methods take no account of correlations in mortality levels over ages, causes, socio-ethnic groups or areas. They also do not specify an underlying data generating process, or a likelihood model that can include trends or correlations, and are likely to produce unstable estimates for small-areas. An alternative strategy involves a fully specified data generation process, and a random effects model which "borrows strength" to produce stable SEYLL estimates, allowing for correlations between ages, areas and socio-ethnic groups. The resulting modelling strategy is applied to gender-specific differences in SEYLL rates in small-areas in NE London, and to cause-specific mortality for leading causes of premature mortality in these areas.

  4. Discontinuation of anti-hypertensive drugs increases 11-year cardiovascular mortality risk in community-dwelling elderly (the Bambuí Cohort Study of Ageing)

    PubMed Central

    2014-01-01

    Background Hypertension remains a major public health problem whose management is hampered by poor persistence with pharmacological therapy. The aim of this study was to evaluate the association between discontinuing antihypertensive drugs (AHDs) and the risk of cardiovascular mortality in the elderly. Methods A population-based prospective cohort study of all of the ≥60-year-old residents in Bambuí city (Brazil) enrolled 1606 subjects (92.2%), of whom 1494 (93.0%) were included in this study. The use of AHDs was ascertained annually in a real-clinical context, and time-varying AHD exposure was categorised as non-use, current use or stopped. The predicted cardiovascular mortality rates were estimated using interval Poisson models for ungrouped person-time data, taking into account current levels of systolic blood pressure (BP). Results The overall adjusted cardiovascular mortality risk ratio of AHD stoppers vs current users was 3.12 (95% CI: 2.35-4.15). There was a significant interaction with BP levels: the association between discontinuing AHDs and the risk of cardiovascular mortality was stronger at higher systolic BP levels. The estimates of the risk of cardiovascular mortality over the follow-up period were similar in AHD users and non-users, for whom AHDs were never prescribed. Conclusion Discontinuing AHDs increases the risk of cardiovascular mortality in the elderly. Misconceptions about symptoms or drug-related adverse effects could underlie a subject’s decision to discontinue AHDs. Greater attention should be paid to the choice of AHDs and informative action. PMID:25030357

  5. A Difference-in-Differences Approach to Assess the Effect of a Heat Action Plan on Heat-Related Mortality, and Differences in Effectiveness According to Sex, Age, and Socioeconomic Status (Montreal, Quebec)

    PubMed Central

    Benmarhnia, Tarik; Bailey, Zinzi; Kaiser, David; Auger, Nathalie; King, Nicholas; Kaufman, Jay S.

    2016-01-01

    Background: The impact of heat waves on mortality and health inequalities is well documented. Very few studies have assessed the effectiveness of heat action plans (HAPs) on health, and none has used quasi-experimental methods to estimate causal effects of such programs. Objectives: We developed a quasi-experimental method to estimate the causal effects associated with HAPs that allows the identification of heterogeneity across subpopulations, and to apply this method specifically to the case of the Montreal (Quebec, Canada) HAP. Methods: A difference-in-differences approach was undertaken using Montreal death registry data for the summers of 2000–2007 to assess the effectiveness of the Montreal HAP, implemented in 2004, on mortality. To study equity in the effect of HAP implementation, we assessed whether the program effects were heterogeneous across sex (male vs. female), age (≥ 65 years vs. < 65 years), and neighborhood education levels (first vs. third tertile). We conducted sensitivity analyses to assess the validity of the estimated causal effect of the HAP program. Results: We found evidence that the HAP contributed to reducing mortality on hot days, and that the mortality reduction attributable to the program was greater for elderly people and people living in low-education neighborhoods. Conclusion: These findings show promise for programs aimed at reducing the impact of extreme temperatures and health inequities. We propose a new quasi-experimental approach that can be easily applied to evaluate the impact of any program or intervention triggered when daily thresholds are reached. Citation: Benmarhnia T, Bailey Z, Kaiser D, Auger N, King N, Kaufman J. 2016. A difference-in-differences approach to assess the effect of a heat action plan on heat-related mortality, and differences in effectiveness according to sex, age, and socioeconomic status (Montreal, Quebec). Environ Health Perspect 124:1694–1699; http://dx.doi.org/10.1289/EHP203 PMID:27203433

  6. Relation of digoxin use in atrial fibrillation and the risk of all-cause mortality in patients ≥65 years of age with versus without heart failure.

    PubMed

    Shah, Mitesh; Avgil Tsadok, Meytal; Jackevicius, Cynthia A; Essebag, Vidal; Behlouli, Hassan; Pilote, Louise

    2014-08-01

    Previous studies on digoxin use in patients with atrial fibrillation (AF) and the risk of all-cause mortality found conflicting results. We conducted a population-based, retrospective, cohort study of patients aged ≥65 years admitted to a hospital with a primary or secondary diagnosis of AF, in Quebec province, Canada, from 1998 to 2012. The AF cohort was grouped into patients with and without heart failure (HF) and into digoxin and no-digoxin users according to the first prescription filled for digoxin within 30 days after AF hospital discharge. We derived propensity score-matched digoxin and no-digoxin treatment groups for the groups of patients with and without HF, respectively, and conducted multivariable Cox proportional hazards regression analyses to determine association between digoxin use and all-cause mortality. The AF propensity score-matched cohorts of patients with and without HF were well balanced on baseline characteristics. In the propensity score-matched HF group, digoxin use was associated with a 14% greater risk of all-cause mortality (adjusted hazard ratio 1.14, 95% confidence interval 1.10 to 1.17). In the propensity score-matched no-HF group, digoxin use was associated with a 17% greater risk of all-cause mortality (adjusted hazard ratio 1.17, 95% confidence interval 1.14 to 1.19). In conclusion, our retrospective analyses found that digoxin use was associated with a greater risk for all-cause mortality in patients aged ≥65 years with AF regardless of concomitant HF. Large, multicenter, randomized controlled trials or prospective cohort studies are required to clarify this issue.

  7. Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men.

    PubMed

    Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

    2016-12-05

    Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984-2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): -3.1 (95% CI, -4.6 to -1.6)) and lung cancers decreased from 2002 to 2013 (APC -2.4 (95% CI -2.7 to -2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC -2.5 (95% CI -4.1 to -0.8)) and from 2002 to 2013 (APC -5.2 (95% CI -5.7 to -4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): -3.3 (95% CI -4.7 to -1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.

  8. Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men

    PubMed Central

    Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

    2016-01-01

    Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates. PMID:27929405

  9. Fraction of stroke mortality attributable to alcohol consumption in Russia.

    PubMed

    Y E, Razvodovsky

    2014-01-01

    Stroke is an international health problem with high associated human and economic costs. The mortality rate from stroke in Russia is one of the highest in the world. Risk factors identification is therefore a high priority from the public health perspective. Epidemiological evidence suggests that binge drinking is an important determinant of high stroke mortality rate in Russia. The aim of the present study was to estimate the premature stroke mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of stroke mortality and alcohol consumption. Age-standardized sex-specific male and female stroke mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. The results of the analysis suggest that 26.8% of all male stroke deaths and 18.4% female stroke deaths in Russia could be attributed to alcohol. The estimated alcohol-attributable fraction for men ranged from 16.2% (75+ age group) to 57,5% (30-44 age group) and for women from 21.7% (60-74 age group) and 43.5% (30- 44 age group). The outcomes of this study provide support for the hypothesis that alcohol is an important contributor to the high stroke mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia. Given the distribution of alcohol-related stroke deaths, interventions should be focused on the young and middle-aged men and women.

  10. Oral cancer incidence and mortality in China, 2011

    PubMed Central

    Zhang, Shao-Kai; Zheng, Rongshou; Chen, Qiong; Zhang, Siwei

    2015-01-01

    Objective To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods Data from 177 population-based cancer registries distributed in 28 provinces were accepted for this study after evaluation based on quality control criteria, covering a total of 175,310,169 populations and accounting for 13.01% of the overall national population in 2011. Incidence and mortality rates were calculated by area, gender and age groups. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. The Chinese population in 2000 and World Segi’s population were used for age-standardized rates. Results The estimate of new cases diagnosed with oral cancer was 39,450 including 26,160 males and 13,290 females. The overall crude incidence rate for oral cancer was 2.93/100,000. The age-standardized rates by China (ASRCN) population and by World population (ASRwld) were 2.22/100,000 and 2.17/100,000, respectively. Among subjects aged 0-74 years, the cumulative incidence rate was 0.25%. The estimated number of oral cancer deaths of China in 2011 was 16,933, including 11,794 males and 5,139 females. The overall crude mortality rate was 1.26/100,000, accounting for 0.80% of all cancer deaths. The ASRCN and ASRwld for mortality were 0.90/100,000 and 0.89/100,000, respectively. Among subjects aged 0-74 years, the cumulative mortality rate was 0.10%. The incidence and mortality rates of oral cancer were much higher in males and urban areas than in females and rural areas. In addition, the incidence and mortality rates were increased by the raising of ages. Conclusions Results in the study may have important roles for oral cancer prevention and research. Although oral cancer burden of China is not high, we must pay attention to this malignancy as well. In addition, further researches need to be done for

  11. [Asthma mortality trends in Mexico].

    PubMed

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

    1994-04-01

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

  12. LEPTOSPIROSIS INCIDENCE AND MORTALITY IN MALAYSIA.

    PubMed

    Tan, Wei Leong; Soelar, Shahrul Aiman; Mohd Suan, Mohd Azri; Hussin, Narwani; Cheah, Wee Kooi; Verasahib, Khebir; Goh, Pik Pin

    2016-05-01

    Leptospirosis is endemic in Southeast Asia, Central and South America, the Caribbean, and Oceania. Malaysia was categorized as a probable endemic country without any available data. Thus, this study was conducted to determine incidence, case fatality rate and mortality rate of leptospirosis. Leptospirosis is a notifiable disease in Malaysia since 2010 whereby probable or confirmed cases must be notified to relevant health district office. There were 3,665 and 4,457 probable and laboratory confirmed leptospirosis cases notified in 2012 and 2013, respectively. In the 2-year period, the most common age group of patients was 19 years old or less (23.3%) with male:female ratio of 2.61:1. Students consisted about 16.9% of patients, followed by agriculture-based or plantation workers (14.7%). Overall age-standardized incidence rate of leptospirosis in Malaysia for 2012 and 2013 was 29.02 per 100,000. Overall case fatality rate was 1.47% for 2-year period and overall age-standardized mortality rate was 0.45 per 100,000. Leptospirosis is an emerging public health concern in Malaysia and may pose a significant health impact and burden to the nation in the coming years if not well controlled.

  13. Metropolitan governance, residential segregation, and mortality among African Americans.

    PubMed Central

    Hart, K D; Kunitz, S J; Sell, R R; Mukamel, D B

    1998-01-01

    OBJECTIVES: This study tested the hypothesis that the degree to which local government is metropolitanized is associated with mortality rates for African Americans and with residential segregation, which has itself previously been shown to be positively associated with mortality among African Americans. METHODS: One hundred fourteen US standard metropolitan statistical areas were examined. The primary dependent variable was the age-adjusted, race- and sex-specific all-cause mortality rate, averaged for 1990 and 1991. The 2 primary independent variables were residential segregation, as measured by the index of dissimilarity, and metropolitanization of government, as measured by the central city's elasticity score. RESULTS: Mortality rates for male and female African Americans were lower in metropolitan statistical areas with more metropolitanized local governments and lower levels of residential segregation. Mortality for male and female Whites was not associated in either direction with residential segregation. White male mortality showed no association with level of metropolitanization, but lower White female mortality rates were associated with less metropolitanization. CONCLUSIONS: This study suggests the need for further research into whether policy changes in areas not traditionally thought of as "health policy" areas can improve the health of urban minorities. PMID:9518976

  14. Mortality risk factors and excess mortality in a cohort of cocaine users admitted to drug treatment in Spain.

    PubMed

    de la Fuente, Luis; Molist, Gemma; Espelt, Albert; Barrio, Gregorio; Guitart, Anna; Bravo, Maria J; Brugal, M Teresa

    2014-02-01

    We assessed mortality risk factors and excess mortality compared to the general population in two Spanish sub-cohorts of 8,825 cocaine and heroin users (CHUs) and 11,905 only cocaine users (OCUs) aged 15-49 admitted to drug treatment. Heroin use (among all cocaine users), no-regular employment and drug injection (among CHUs and OCUs), daily cocaine use and previous drug treatment (among CUs), and death before 2005 and >10 years of heroin use (among CHUs) were clearly associated with higher mortality in Cox regression. Excess mortality was assessed by the directly standardized mortality rate ratio, which was higher in CHUs (14.3; 95% CI: 12.6-16.2) than CUs (5.1; 95% CI: 4.3-6.0) and in women than men, especially among OCUs (8.6; 95% CI: 7.5-10.0 vs. 3.5; 95% CI: 3.3-3.8); it decreased with age among CHUs, but did not decrease overall during 1997-2008. OCUs excess mortality was considerable and showed no signs of decline, suggesting the need for improved treatment and prevention interventions.

  15. A cohort mortality study of petrochemical workers

    SciTech Connect

    Austin, S.G.; Schnatter, A.R.

    1983-04-01

    A historical prospective cohort mortality study was conducted for a cohort of 6,588 white male employees of a Texas petrochemical plant because of a suspected increased incidence of malignant brain tumors. Mortality experience from 1941 to 1977 was determined and compared with that of the general U.S. white male population adjusting for age and time period. Overall and cause-specific standardized mortality ratios were calculated for various subgroups of the population defined by length of employment, latency and payroll status. Significant deficits in total cohort mortality were found for all causes of death, all circulatory diseases, all respiratory diseases and all digestive diseases. Although not statistically significant, fewer deaths were observed (O) than expected (E) for all malignant neoplasms. No statistically significant excess of malignant brain tumors was found in the overall plant population (O/E = 12/7.42 = 1.62). A borderline significant excess of brain cancer deaths was found among hourly employees with more than six months' employment based on 10 observed and five expected deaths. This excess was observed to occur among elderly employees (over 55 years) and in later follow-up years (post-1970). Risk did not appear to be related to length of employment. Because of the nature of the problem that prompted this study, the small number of cases involved and the lack of a suspect agent in the plant that could have produced this excess, insufficient evidence was found to conclude that these tumors were occupationally related.

  16. Cancer Mortality Projections in Korea up to 2032.

    PubMed

    Son, Mia; Yun, Jae-Won

    2016-06-01

    Predicting cancer mortality is important to estimate the needs of cancer-related services and to prevent cancer. Despite its significance, a long-term future projection of cancer mortality has not been conducted; therefore, our objective was to estimate future cancer mortality in Korea by cancer site through 2032. The specially designed Nordpred software was used to estimate cancer mortality. The cancer death data from 1983 to 2012 and the population projection data from 1983 to 2032 were obtained from the Korean National Statistics Office. Based on our analysis, age-standardized rates with the world standard population of all cancer deaths were estimated to decline from 2008-2012 to 2028-2032 (men: -39.8%, women: -33.1%). However, the crude rates are predicted to rise (men: 29.8%, women: 24.4%), and the overall number of the cancer deaths is also estimated to increase (men: 35.5%, women: 32.3%). Several cancer deaths are projected to increase (lung, liver and gallbladder, colon and rectum, pancreas and leukemia in both sexes; prostate cancer in men; and breast and ovarian cancer in women), whereas other cancer deaths are expected to decrease (stomach, esophagus and larynx in both sexes and cervical cancer in women). The largest contribution to increasing cancer deaths is due to the aging of the Korean population. In conclusion, a strategy for primary prevention, early detection, and early treatment to cope with the rapidly increasing death of cancer due to population aging is urgently required.

  17. GULF OF MEXICO AQUATIC MORTALITY NETWORK (GMNET)

    EPA Science Inventory

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

  18. Recent changes in breast cancer incidence and mortality in Estonia: Transition to the west.

    PubMed

    Baburin, Aleksei; Aareleid, Tiiu; Rahu, Mati; Reedik, Lauri; Innos, Kaire

    2016-06-01

    Background The aim of this study was to examine breast cancer (BC) incidence and mortality trends in Estonia during recent decades and to compare the pattern of these trends with other selected European countries and regions. We attempt to explain the findings in relation to changes in Estonian society and healthcare system. Methods BC incidence (1985-2012) and mortality (1985-2013) data for Estonia were obtained from the Estonian Cancer Registry and Statistics Estonia. Data for selected European countries were obtained from the EUREG database. Joinpoint regression was used to analyze age-standardized rates in Estonia by age. For international comparison of incidence and mortality rates, we used scatterplot with 95% confidence ellipses and the mortality to incidence ratio. Results The overall BC incidence continues to increase in Estonia, while mortality has been in decline since 2000. Both incidence and mortality trends varied considerably across age groups. Among women aged 60 years and older, BC incidence increased at a rate of nearly 3% per year. Significant decrease in mortality was seen only among women aged 50-59 years. Comparison of scatterplots between countries and regions revealed two clusters in Europe separated along the incidence axis. The correlation between incidence and mortality in Estonia changed its direction in the mid-1990s. Conclusion In recent years, the dynamics of BC burden in Estonia has transitioned towards the high incidence-low mortality type model, which is characteristic to Western, Northern and Southern Europe. Although overall BC incidence is much lower in Estonia than in more affluent European countries, mortality from BC is still relatively high, particularly among elderly women.

  19. Report of cancer incidence and mortality in China, 2010

    PubMed Central

    Zheng, Rongshou; Zhang, Siwei; Zhao, Ping; Zeng, Hongmei; Zou, Xiaonong

    2014-01-01

    Purpose To estimate the cancer incidences and mortalities in China in 2010. Methods On basis of the evaluation procedures and data quality criteria described in the National Central Cancer Registry (NCCR), data from 219 cancer registries were evaluated. Data from 145 registries were identified as qualified and then accepted for the 2010 cancer registry report. The incidences and mortalities of major cancers and the overall incidence and mortality were stratified by residency (urban or rural), areas (eastern, middle, and western), gender, and age. The cancer cases and deaths were estimated based on age-specific rate and national population in 2010. The China 2010 Population Census data and Segi’s world population data were used for calculating the age-standardized cancer incidence/mortality rates. Results Data were obtained from a total of 145 cancer registries (63 in urban areas and 82 in rural areas) covering 158,403,248 people (92,433,739 in urban areas and 65,969,509 in rural areas). The percentage of morphologically verified cases (MV%) were 67.11%; 2.99% of incident cases were identified through proportion of death certification only (DCO%), with the mortality to incidence ratio of (M/I) 0.61. The estimates of new cancer cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The crude incidence was 235.23/105 (268.65/105 in males and 200.21/105 in females), the age-standardized rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 184.58/105 and 181.49/105, and the cumulative incidence rate (0-74 age years old) was 21.11%. The cancer incidence and ASR China were 256.41/105 and 187.53/105 in urban areas and 213.71/105 and 181.10/105 in rural areas. The crude cancer mortality in China was 148.81/105 (186.37/105 in males and 109.42/105 in females), the age-standardized mortalities by Chinese standard population and by world standard population were 113.92/105 and 112.86/105, and the cumulative

  20. Analysis of occupational asbestos exposure and lung cancer mortality using the g formula.

    PubMed

    Cole, Stephen R; Richardson, David B; Chu, Haitao; Naimi, Ashley I

    2013-05-01

    We employed the parametric G formula to analyze lung cancer mortality in a cohort of textile manufacturing workers who were occupationally exposed to asbestos in South Carolina. A total of 3,002 adults with a median age of 24 years at enrollment (58% male, 81% Caucasian) were followed for 117,471 person-years between 1940 and 2001, and 195 lung cancer deaths were observed. Chrysotile asbestos exposure was measured in fiber-years per milliliter of air, and annual occupational exposures were estimated on the basis of detailed work histories. Sixteen percent of person-years involved exposure to asbestos, with a median exposure of 3.30 fiber-years/mL among those exposed. Lung cancer mortality by age 90 years under the observed asbestos exposure was 9.44%. In comparison with observed asbestos exposure, if the facility had operated under the current Occupational Safety and Health Administration asbestos exposure standard of <0.1 fibers/mL, we estimate that the cohort would have experienced 24% less lung cancer mortality by age 90 years (mortality ratio = 0.76, 95% confidence interval: 0.62, 0.94). A further reduction in asbestos exposure to a standard of <0.05 fibers/mL was estimated to have resulted in a minimal additional reduction in lung cancer mortality by age 90 years (mortality ratio = 0.75, 95% confidence interval: 0.61, 0.92).

  1. Standardization and Digital Enclosure: The Privatization of Standards, Knowledge, and Policy in the Age of Global Information Technology. Part of the Advances in IT Standards and Standardization Research (AISSR) Book Series

    ERIC Educational Resources Information Center

    Schoechle, Timothy, Ed.

    2009-01-01

    Recent trends have shown increasing privatization of standardization activities under various corporations, trade associations, and consortia, raising significant public policy issues about how the public interest may be represented. This book establishes a framework of analysis for public policy discussion and debate. Discussing topics such as…

  2. Exploring Pre-K Age 4 Learning Standards and Their Role in Early Childhood Education: Research and Policy Implications. Research Report. ETS RR-16-14

    ERIC Educational Resources Information Center

    De Bruin-Parecki, Andrea; Slutzky, Carly

    2016-01-01

    Currently in the United States, 50 states, 5 territories, and the District of Columbia have established prekindergarten (pre-K) age 4 learning standards that are intended to outline skills and knowledge that set children on a path to success in kindergarten and upcoming grades. These standards are emphasized as a centralizing force in early…

  3. A new approach to the study of Romanization in Britain: a regional perspective of cultural change in late iron age and roman dorset using the siler and gompertz-makeham models of mortality.

    PubMed

    Redfern, Rebecca C; Dewitte, Sharon N

    2011-02-01

    This is the first study of health in the Roman Empire to use the Siler and Gompertz-Makeham models of mortality to investigate the health consequences of the 43 AD conquest of Britain. The study examined late Iron Age and Romano-British populations (N = 518) from Dorset, England, which is the only region of Britain to display continuity in inhumation burial practice and cemetery use throughout the two periods. Skeletal evidence for frailty was assessed using cribra orbitalia, porotic hyperostosis, periosteal lesions, enamel hypoplasia, dental caries, tuberculosis, and rickets. These health variables were chosen for analysis because they are reliable indicators of general health for diachronic comparison (Steckel and Rose: The backbone of history: health and nutrition in the western hemisphere (2002)) and are associated with the introduction of urbanism in Britain during the Roman period (Redfern: J Rom Archaeol Supp Series 64 (2007) 171-194; Redfern: Britannia 39 (2008a) 161-191; Roberts and Cox: Health and disease in Britain: from prehistory to the present day (2003)). The results show that levels of frailty and mortality were lower in the late Iron Age period, and no sex differences in mortality was present. However, post-conquest, mortality risk increased for children and the elderly, and particularly for men. The latter finding challenges received wisdom concerning the benefits of incorporation into the Empire and the higher status of the male body in the Roman world. Therefore, we conclude that the consequences of urbanism, changes in diet, and increased population heterogeneity negatively impacted health, to the extent that the enhanced cultural buffering of men did not outweigh underlying sex differences in biology that advantage women.

  4. Mortality patterns following downsizing at Pan American World Airways.

    PubMed

    Steenland, Kyle; Pinkerton, Lynne E

    2008-01-01

    There are only a small number of studies on the health effects of involuntary unemployment (e.g., downsizing), and results are contradictory. The authors studied the mortality through 2002 of 13,370 Pan American World Airways employees who were born before 1940 and whose records were available after the company's bankruptcy in 1991. The cohort was divided into those who left work voluntarily (55%), involuntarily (39%), and because of illness (6%). The mean year of first employment was 1963, the mean year of last employment was 1987, and the mean age at leaving the company was 55 years. Of those who left involuntarily, 56% left at the time of bankruptcy in December 1991 or later. Twenty-two percent of the cohort died during follow-up, which began at the time of leaving the company. Standardized mortality ratios relative to the US population for all causes for those who left voluntarily, involuntarily, and because of illness were 0.72 (95% confidence interval (CI): 0.69, 0.76), 0.69 (95% CI: 0.65, 0.74), and 2.40 (95% CI: 2.22, 2.60), respectively. Ischemic heart disease mortality showed a similar pattern. Internal analyses comparing involuntary to voluntary leavers after adjusting for age, race, sex, calendar time, and education yielded all-cause and ischemic heart disease rate ratios of 0.96 (95% CI: 0.87, 1.07) and 1.11 (95% CI: 0.93, 1.35), respectively. Subanalyses of those who left involuntarily at age >/=60 years, or those who left involuntarily at the time of bankruptcy, did not indicate any excess mortality (all-cause standardized mortality ratios = 0.69 and 0.64, respectively). These data do not indicate that mortality among those who left involuntarily was higher than for those who left voluntarily. Both groups showed a strong healthy worker effect.

  5. Antioxidant Vitamin Intake and Mortality

    PubMed Central

    Paganini-Hill, Annlia; Kawas, Claudia H.; Corrada, María M.

    2015-01-01

    To assess the relationship between antioxidant vitamin intake and all-cause mortality in older adults, we examined these associations using data from the Leisure World Cohort Study, a prospective study of residents of the Leisure World retirement community in Laguna Hills, California. In the early 1980s, participants (who were aged 44–101 years) completed a postal survey, which included details on use of vitamin supplements and dietary intake of foods containing vitamins A and C. Age-adjusted and multivariate-adjusted (for factors related to mortality in this cohort—smoking, alcohol intake, caffeine consumption, exercise, body mass index, and histories of hypertension, angina, heart attack, stroke, diabetes, rheumatoid arthritis, and cancer) hazard ratios for death were calculated using Cox regression for 8,640 women and 4,983 men (median age at entry, 74 years). During follow-up (1981–2013), 13,104 participants died (median age at death, 88 years). Neither dietary nor supplemental intake of vitamin A or vitamin C nor supplemental intake of vitamin E was significantly associated with mortality after multivariate adjustment. A compendium that summarizes previous findings of cohort studies evaluating vitamin intake and mortality is provided. Attenuation in the observed associations between mortality and antioxidant vitamin use after adjustment for confounders in our study and in previous studies suggests that such consumption identifies persons with other mortality-associated lifestyle and health risk factors. PMID:25550360

  6. [Relationship between mortality from ischaemic heart and cerebro-vascular diseases, and the main dietary constituents. Study of the 1968 mortality of active French men aged 45-64 (author's transl)].

    PubMed

    Derriennic, F; Guilloud, M; Ducimetière, P

    1980-04-30

    The relation between death rates from ischaemic heart and cerebro-vascular diseases among Frenchmen aged 45-64, and some dietary constituents was studied. Data concerned population groups defined by the geographic regions and the socioeconomic classes. A specific statistical model of variance analysis was considered. A positive association between the daily sugar intake and the death rates from ischaemic heart diseases were observed. On the other hand, several positive associations between the daily intake of protein, fat, carbohydrate and total calories (without alcohol) and death rates from cerebrovascular diseases were found. The quality of nutritional data, however, implies some prudence in interpreting these results.

  7. Mortality plateaus and directionality theory.

    PubMed

    Demetrius, L

    2001-10-07

    Recent large scale studies of senescence in animals and humans have revealed mortality rates that levelled off at advanced ages. These empirical findings are now known to be inconsistent with evolutionary theories of senescence based on the Malthusian parameter as a measure of fitness. This article analyses the incidence of mortality plateaus in terms of directionality theory, a new class of models based on evolutionary entropy as a measure of fitness. We show that the intensity of selection, in the context of directionality theory, is a convex function of age, and we invoke this property to predict that in populations evolving under bounded growth constraints, evolutionarily stable mortality patterns will be described by rates which abate with age at extreme ages. The explanatory power of directionality theory, in contrast with the limitations of the Malthusian model, accords with the claim that evolutionary entropy, rather than the Malthusian parameter, constitutes the operationally valid measure of Darwinian fitness.

  8. The law of mortality revisited: interspecies comparisons of mortality.

    PubMed

    Olshansky, S J

    2010-01-01

    In 1825 the British actuary Benjamin Gompertz believed he had discovered a consistency in the timing of death in people that was so important that he labelled his observation a 'law of mortality'. To Gompertz, this 'law' was equivalent in importance to Newton's law of gravity because he believed it would be observed in all living things. Gompertz's quest for the 'law' eventually failed, as did similar efforts by other scientists in the 19th and most of the 20th century. However, the search for the law of mortality was successfully resolved in 1996 when my colleagues and I discovered that the only way to 'see' Gompertz's law expressed as common age patterns of death across species was to partition total mortality into its intrinsic and extrinsic components, and examine mortality schedules on a uniform time scale. Scientists had been unable to reveal the law of mortality in the past not only because they could not partition total mortality, but also because of the previous anthropocentric perspective that forced some scientists to view duration of life along a single time scale - one based on human measurements of chronological time. The law of mortality is relevant today not only because it links the epidemiology of disease, ageing and death across species, but because it creates a window into the future for those who study disease epidemiology in animals that now live long enough in protected environments to experience the biological consequences of ageing. In this paper I summarize the historical search for the law of mortality, explain why the solution could only be found by linking two seemingly unconnected scientific disciplines (evolution biology and actuarial/demographics), explain why age patterns of disease and death in humans may be used to understand and predict disease epidemiology in other species, and describe how a new scientific discipline has arisen in the modern era as a result of this research.

  9. Recommended Immunization Schedules for Persons Aged 0 through 18 Years--United States, 2010. Morbidity and Mortality Weekly Report QuickGuide. Volume 58, Number 51 & 52

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2010

    2010-01-01

    The Advisory Committee on Immunization Practices (ACIP) annually publishes an immunization schedule for persons aged 0 through 18 years that summarizes recommendations for currently licensed vaccines for children aged 18 years and younger and includes recommendations in effect as of December 15, 2009. The changes to the previous schedule are…

  10. [Analysis of the impact of mortality due to suicides in Mexico, 2000-2012].

    PubMed

    Dávila Cervantes, Claudio Alberto; Ochoa Torres, María del Pilar; Casique Rodríguez, Irene

    2015-12-01

    The objective of this study was to analyze the burden of disease due to suicide in Mexico using years of life lost (YLL) between 2000 and 2012 by sex, age group (for those under 85 years of age) and jurisdiction. Vital statistics on mortality and population estimates were used to calculate standardized mortality rates and years of life lost due to suicide. Between 2000 and 2012 a sustained increase in the suicide mortality rate was observed in Mexico. The age group with the highest rate was 85 years of age or older for men, and 15-19 years of age for women. The highest impact in life expectancy due to suicide occurred at 20 to 24 years of age in men and 15 to 19 years of age in women. The states with the highest mortality due to suicide were located in the Yucatan Peninsula (Yucatan, Quintana Roo and Campeche). Mortality due to suicide in Mexico has increased continually. As suicides are preventable, the implementation of health public policies through timely identification, integral prevention strategies and the detailed study of associated risk factors is imperative.

  11. Introducing Computed Tomography Standards for Age Estimation of Modern Australian Subadults Using Postnatal Ossification Timings of Select Cranial and Cervical Sites(.).

    PubMed

    Lottering, Nicolene; MacGregor, Donna M; Alston, Clair L; Watson, Debbie; Gregory, Laura S

    2016-01-01

    Contemporary, population-specific ossification timings of the cranium are lacking in current literature due to challenges in obtaining large repositories of documented subadult material, forcing Australian practitioners to rely on North American, arguably antiquated reference standards for age estimation. This study assessed the temporal pattern of ossification of the cranium and provides recalibrated probabilistic information for age estimation of modern Australian children. Fusion status of the occipital and frontal bones, atlas, and axis was scored using a modified two- to four-tier system from cranial/cervical DICOM datasets of 585 children aged birth to 10 years. Transition analysis was applied to elucidate maximum-likelihood estimates between consecutive fusion stages, in conjunction with Bayesian statistics to calculate credible intervals for age estimation. Results demonstrate significant sex differences in skeletal maturation (p < 0.05) and earlier timings in comparison with major literary sources, underscoring the requisite of updated standards for age estimation of modern individuals.

  12. Perceived stress and mortality in a Taiwanese older adult population.

    PubMed

    Vasunilashorn, Sarinnapha; Glei, Dana A; Weinstein, Maxine; Goldman, Noreen

    2013-11-01

    Perceived stress is associated with poor health outcomes including negative affect, increased susceptibility to the common cold and cardiovascular disease; the consequences of perceived stress for mortality, however, have received less attention. This study characterizes the relationship between perceived stress and 11-year mortality in a population of Taiwanese adults aged 53+ years. Using the Survey of Health and Living Status of the Near Elderly and Elderly of Taiwan, we calculated a composite measure of perceived stress based on six items pertaining to the health, financial situation, and occupation of the respondents and their families. Proportional hazard models were used to determine whether perceived stress predicted mortality. After adjusting for sociodemographic factors only, we found that a one standard deviation increase in perceived stress was associated with a 19% increase in all-cause mortality risk during the 11-year follow-up period (hazard ratio, HR = 1.19, 95% confidence interval, CI 1.13-1.26). The relationship